Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_158_23
Vinayak Parashuram Hakkaraki
{"title":"One Hundred Most-cited Papers on Bacterial Meningitis: A Bibliometric Study","authors":"Vinayak Parashuram Hakkaraki","doi":"10.4103/am.am_158_23","DOIUrl":"https://doi.org/10.4103/am.am_158_23","url":null,"abstract":"Abstract Background: In previous decades, large-scale research has been carried out on bacterial meningitis. In every field, citation analysis is the most significant contribution. The study’s objective was to identify and analyze the 100 articles on bacterial meningitis that received the most citations between 2000 and 2023, highlighting the most significant developments in the field. Objective: The objective of this study was to find out what makes a highly influential article by identifying and analyzing the characteristics of the 100 articles in the field of bacterial meningitis that receive the most citations. The goal of this study was to find and examine the 100 articles on bacterial meningitis that received the most citations. Methodology: We identified the top 100 most-cited papers in the field of bacterial meningitis from 55 journals using the Dimensions AI database. The results of each author’s analysis of 100 articles were then compared. We gathered fundamental data such as the journal’s title, country of publication, and study type. Descriptive counts or percentages were used to compare the various categories. Results: Between the year 2000 and the year 2023, articles were published. The total number of citations ranged from 115 to 1176, with 42 papers receiving more than 200 citations. In 2008, 14 articles were published, followed by 10 in 2000 and 2007. One thousand one hundred and seventy-six times were given to the most-cited paper, whereas 115 times were given to the least-cited article. “Clinical Features and Prognostic Factors in Adults with Bacterial Meningitis,” by Diederik van de Beek, et al . (2004) was the article that received the most citations. 1176 people have cited this article. van de Beek Diederik of the Academic Medical Center in The Netherlands is the author who has written the most articles, was mentioned in 14 of the top 100 articles. Papers were primarily published in Pediatrics ( n = 9) publication with 1861 citations. The Netherlands came in second with 18 publications, followed by the United States ( n = 46). Conclusion: Our study uses bibliometrics and visualization analysis of the most important articles in this field to show the current state of research in the area of bacterial meningitis, provide a history of research trends, and offer a perspective for future bacterial predicts the growth of meningitis.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_97_23
Minal Hemant Shastri, Heti P. Mistry, Vishakha Vinod, Vaishnavi Mahendrasinh Rathod, Abulkalam A. Sirajwala, Nilay Shetal Patel, Riya Kantibhai Dobariya
{"title":"Clinical Evaluation and Investigations of Atrial Fibrillation in Rheumatic Mitral Valve Disease: An Observational Study in a Tertiary Care Hospital in Western India","authors":"Minal Hemant Shastri, Heti P. Mistry, Vishakha Vinod, Vaishnavi Mahendrasinh Rathod, Abulkalam A. Sirajwala, Nilay Shetal Patel, Riya Kantibhai Dobariya","doi":"10.4103/am.am_97_23","DOIUrl":"https://doi.org/10.4103/am.am_97_23","url":null,"abstract":"Abstract Background: Atrial fibrillation (AF) is the most common sustained supraventricular arrhythmia encountered in clinical practice. Due to the higher prevalence of rheumatic fever in several regions of India, rheumatic heart disease (RHD) is the most common etiological factor of AF. Aims and Objectives: The objective of the study was to study clinical features, electrocardiographic (ECG) and echocardiographic (ECHO) findings, complications, and incidence of AF in rheumatic mitral valve disease (R-MVD). Methods: It is an observational cross-sectional study of 40 indoor patients in a Tertiary Care Hospital in Vadodara, Gujarat, carried over a period of a year. Clinical data including symptoms, signs, systemic examination, and relevant investigations were studied. Results: 67.5% ( n = 27) of patients having AF were below the age of 50 years with higher incidence among females (72.50%) as compared to males (27.5%). Fifteen (37.5%) had mitral stenosis (MS) and 13 (32.5%) had MS with regurgitation. Most of the patients 35 (87.5%) presented with breathlessness, followed by palpitation 28 (70%). The most commonly heard murmur was mid-diastolic (65%, n = 26), followed by pansystolic murmur (40%, n = 16) at the apex. Out of 40 patients, 15 (37.5%) had evidence of left ventricular hypertrophy on ECG, whereas only 5 (12.5%) had right ventricular hypertrophy. Four out of five patients with the evidence of cardioembolic stroke had left atrium (LA) size >45 mm which suggests an increased risk of embolic stroke with increased LA size. Only 3 (7.5%) patients had a visible LA clot in LA on two-dimensional ECHO, whereas only one patient had vegetation on valves. Twenty-seven out of 30 patients treated with diltiazem show good response. Heart failure was the most common complication affecting 85% ( n = 34) of the patients with AF with R-MVD. Four (10%) patients out of 40 expired including 1 (25%) of the four pregnant patients, suggesting higher mortality among pregnant females due to superimposed physiological changes occurring during pregnancy. Conclusion: In developing countries like India, RHD is a major cause of AF affecting the younger population and more commonly females. Most of the patients in our study presented with breathlessness and palpitation. LA size was directly proportional to the risk of cardioembolic stroke and most of the patients developed heart failure as a complication.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_86_23
Gurinder Mohan, Pardeep Kumar, Parminder Singh
{"title":"A Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver with Ascites at a Tertiary Care Hospital in North India: Prevalence, Clinical, and Microbiological Profile","authors":"Gurinder Mohan, Pardeep Kumar, Parminder Singh","doi":"10.4103/am.am_86_23","DOIUrl":"https://doi.org/10.4103/am.am_86_23","url":null,"abstract":"Abstract Background and Objectives: In patients with chronic liver disease and ascites, spontaneous bacterial peritonitis (SBP) is a common complication. This can progress gradually and subtly or go undiagnosed until signs start to show. Early diagnosis is essential for effective treatment and the prevention of subsequent episodes because the mortality rate following a single episode varies from 20% to 40%. The goal was to study the incidence, clinical profile, and microbiological characteristics of SBP and its variants in people with liver cirrhosis and ascites. Materials and Methods: This observational study was done on 104 cirrhotic patients with ascites admitted at a tertiary care hospital. Basic demographics, symptoms, and clinical signs of patients were recorded. Diagnostic paracentesis was done aseptically and immediately sent for ascitic fluid cytology, biochemistry, and culture. Bacterial examination and antibiotic sensitivity tests were carried out by standard microbiological techniques. Results: Out of a total of 104 cirrhotic patients, 28 (26.9%) were diagnosed with SBP. Alcohol was the most common etiological factor, followed by hepatitis C infection. Among the SBP patients, the most common presentation was culture-negative neutrocytic ascites (71.4%), followed by classical SBP (17.8%), then mono bacterial non neutrocytic bacterascites MNB (10.7%). Among the symptoms, the most common was abdominal distension, followed by icterus, pedal edema, and abdominal pain. Majority of the patients belonged to Child–Pugh’s Grade C. Of 28 cases of SBP, 8 were culture positive. Gram-negative isolates were predominant (75%) and Escherichia coli were the most common isolate. Interpretation and Conclusion: The prevalence of SBP in cirrhotic patients was 26.9%, and Gram-negative isolates were predominant. Ascitic fluid culture and susceptibility testing can lead to accurate diagnosis of SBP and can guide for treatment as resistance to antibiotics is common.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_162_23
T. Kiren, T. Arun, Anu Jacob
{"title":"Validity of Reflux Symptom Index in the Diagnosis of Laryngopharyngeal Reflux Disease","authors":"T. Kiren, T. Arun, Anu Jacob","doi":"10.4103/am.am_162_23","DOIUrl":"https://doi.org/10.4103/am.am_162_23","url":null,"abstract":"Abstract Introduction: Laryngopharyngeal reflux (LPR) is a disease, in which the diagnosis and treatment are controversial. The main objectives of this study were to assess the validity of the reflux symptom index (RSI) in patients exhibiting symptoms of LPR disease (LPRD) or gastroesophageal reflux disease (GERD). Materials and Methods: This study was a hospital-based, cross-sectional study. The study included all patients above the age of 12 years who presented to the ENT outpatient department with symptoms of LPRD or GERD. Patients who refused to give consent for the study, those who had undergone medical treatment past 6 weeks or surgical treatment for similar complaints, patients with malignancy of the hypopharynx and esophagus, patients with neurological causes of dysphonia and dysphagia, patients with a history of throat trauma or prior intubation, patients with allergies or chronic upper respiratory tract infections, and pregnant patients were excluded from the study. The variables examined in this study included age, sex, RSI, and reflux finding score. Results: The majority of patients (49.3%) with LPRD were in the age group of 31–50 years. Among the patients diagnosed with LPRD were females, only 15 patients (21.7%) diagnosed with LPRD had diabetes mellitus, only 7 patients (10.1%) had bronchial asthma, 4 patients (5.8%) diagnosed with LPRD had a history of thyroid disease, 8.7% had a history of smoking/tobacco usage addiction, and 18.8% of the patients experienced recurrent throat infection. The sensitivity was found to be 97.1%, specificity 66.7%, positive predictive value 84.8%, and negative predictive value 92.3%. The diagnostic accuracy of RSI was calculated to be 86.7%. It was found that only 46 of the 69 LPRD-positive patients (66.7%) showed symptoms suggestive of GERD. Conclusion: LPRD is predominantly a lifestyle-related disease. The fast-food lifestyle and the irregular and unhealthy spicy high acid dietary habits have led to a rapid increase in the prevalence of gastroesophageal reflux, and hence, the LPR in the general population, especially India.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_104_23
Surajit Gorai, Kinnor Das
{"title":"Concomitant Hidradenitis Suppurativa and Pyoderma Gangrenosum – Adalimumab Biosimilar can Help: A Case Report","authors":"Surajit Gorai, Kinnor Das","doi":"10.4103/am.am_104_23","DOIUrl":"https://doi.org/10.4103/am.am_104_23","url":null,"abstract":"Abstract Introduction: Systemic inflammation leading to various types of disorders with mainly cutaneous manifestations is not uncommon. Hidradenitis suppurativa (HS) and pyoderma gangrenosum (PG) may be the consequences of such situation and develop concomitantly in a single patient. Case Presentation: We present herewith a case of HS along with PG which was managed with Adalimumab biosimilar. Discussion: HS and PG are both uncommon inflammatory skin conditions linked to systemic inflammatory disorders. Adalimumab, a tumor necrosis factor-alpha antagonist, is used to treat a variety of inflammatory disorders. Biosimilars are biologics that are extremely similar to an already-approved reference biological product but are produced by a distinct company. Several biosimilar variants of adalimumab have been developed and approved by regulatory authorities in various countries. They can be used as alternatives to the reference product, resulting in potential cost-savings and increased treatment accessibility. Conclusions: Biosimilars of adalimumab have an important role in the management of HS and PS considering their favorable outcome.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_134_23
M. Mohan Ram Kumar, Deborah Rinita, P. S. Arthi, Priya Roopa
{"title":"Comparative Study of Postoperative Macular Thickness Following Uncomplicated Cataract Surgery – Diabetic versus Nondiabetic Patients in a Tertiary Care Center at Chengalpattu District","authors":"M. Mohan Ram Kumar, Deborah Rinita, P. S. Arthi, Priya Roopa","doi":"10.4103/am.am_134_23","DOIUrl":"https://doi.org/10.4103/am.am_134_23","url":null,"abstract":"Abstract Background: Cataracts are the most common cause of blindness in the world. This study aims to determine whether cataract surgery has an effect on the progression of macular thickness in nondiabetic and diabetic patients, specifically in the absence of pre-existing diabetic retinopathy (DR) changes. Methods: It is a prospective cohort study carried out between January 2022 and September 2022 at Shri Sathya Sai Medical College, which is a Tertiary Health-care Center situated at Chengalpattu district in Tamil Nadu, after obtaining ethical clearance from the Institutional Review Board. A total of 72 patients posted for cataract surgery were divided into two groups each group of 36 patients, Group 1 well-controlled diabetics without DR planned for cataract surgery and Group 2 nondiabetics. The patients underwent cataract surgery by small incision cataract surgery/phacoemulsification method based on the staging of cataract and also the surgeon’s choice and cataract surgery was done by the same surgeon and the patients were implanted with rigid/foldable intraocular lens. Results: Out of 72 patients analyzed in both the groups, 37 were male patients and 35 were female patients in the age group commonly 50–65 years. The mean age group in the diabetes group was 57.19 ± 9.18 and the normal group was 61.67 ± 7.73. The mean foveal thickness of the DR group was higher than that of the control group, but the difference was not statistically significant. At the end of the 3 rd month, the mean foveal thickness returned to near-normal range. Conclusion: The thickness of the fovea is increased after cataract surgery in the 1 st week postoperatively in both diabetic and nondiabetic groups and returns to near-normal preoperative value in both the groups at the end of 3 months postoperative period.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-09DOI: 10.4103/am.am_101_23
Amrutha Reshi, Y. V. Abhijith, N. Sharath Chandra, A. C. Ramesh, D. M. Narayanaswamy
{"title":"To Study the Prevalence and Risk Factors for Prehypertension and Hypertension among Adolescents (18–19 years) at Entry Level of Professional Course","authors":"Amrutha Reshi, Y. V. Abhijith, N. Sharath Chandra, A. C. Ramesh, D. M. Narayanaswamy","doi":"10.4103/am.am_101_23","DOIUrl":"https://doi.org/10.4103/am.am_101_23","url":null,"abstract":"Abstract Aim and Objective: To study the prevalence and risk factors of prehypertension and hypertension among adolescents (18–19 years) at the entry level of professional course. Materials and Methods: After institutional ethics committee approval and informed consent from participants, the data were collected and entered into the Excel sheet. Appropriate statistical analysis was applied. The final result was statistically interpreted. Results: A total of 273 student participants were included in the study. There were 104 males and 169 females. One hundred and seven participants were 18 years old and 168 were 19 years old. Male: female ratio is 1:1.6. Prehypertension was seen in 91 (33.3%) and hypertension was observed in 34 (12.57%). Seven (20.6%) cases had a family history of hypertension. Twenty-two (8.1%) had addictive habits. Inadequate physical activity was seen in 32 (94.1%) of cases who had hypertension. Poor sleep quality was seen in hypertensives (17; 50%). In our study also, there was no statistically significant association between gender and systolic blood pressure and diastolic blood pressure ( P > 0.05). There is a statistical significance association between the gender and body mass index (BMI) but not between BMI and hypertension status. There was statistically significant association was there between prehypertension and hypertension with habits. Conclusion: Change in habits and dietary modification will have impact on the development of prehypertension and or hypertension among adolescents. More emphasis must be given to screen adolescents at college entry. Adolescents are best target age group for primordial prevention.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-01DOI: 10.4103/am.am_138_22
BSuba Rajinikanth, RGokul Krishnan, P. Gayatri
{"title":"Implementation of thermoregulation bundle to improve admission temperature in preterm infants and their outcomes","authors":"BSuba Rajinikanth, RGokul Krishnan, P. Gayatri","doi":"10.4103/am.am_138_22","DOIUrl":"https://doi.org/10.4103/am.am_138_22","url":null,"abstract":"Introduction: Preterm infants' thermoregulation in the first few minutes after birth remains a contentious issue, but studies show that focusing on the issue and developing a guideline can reduce hypothermia in these patients. By implementing the thermoregulation bundle, this study aims to reduce the incidence of hypothermia on admission to the neonatal intensive care unit (NICU) by 50% in infants born at 32 weeks' gestation or less. Materials and Methods: Neonatology unit at a private medical college in the Chennai district was studied for 6 months from July 2021 to December 2021. The Plan-Do-Study-Act cycle from the “WHO Point-of-Care Quality Improvement Model” was used. Thermoregulation bundle was used to standardize thermoregulation management from predelivery through admission to the NICU. Results: The NICU temperature had spiked significantly to 36.38°C ± 0.67°C (P < 0.001) from the previous two readings, which was statistically significant (P = 0.001). Results from Bonferroni corrections show that the temperature induced during implementation had a statistically significant increase in temperature (23°C vs. 34°C, respectively) from the delivery point to the point of baby shifting (P = 0.001) which accounted for a 67% reduction of hypothermia. Conclusion: The present study successfully achieved its objective of reducing hypothermia by more than 50%, with a rate of 67%. Premature infants can be saved from hypothermia by implementing a standard protocol in the delivery room at the time of baby transfer and admission to the NICU.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"1 1","pages":"294 - 297"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70664210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-01DOI: 10.4103/am.am_16_23
Arpit Malani, V. Muralidhar, Atish Pal
{"title":"Patient selection criteria for improving quality and safety in patients undergoing ambulatory and day-care surgery","authors":"Arpit Malani, V. Muralidhar, Atish Pal","doi":"10.4103/am.am_16_23","DOIUrl":"https://doi.org/10.4103/am.am_16_23","url":null,"abstract":"Introduction: With advances in monitoring, anesthesia, and minimally invasive techniques, same-day surgeries are expected to rise significantly in the coming years. In this group, patients undergo diagnostic and therapeutic procedures and are sent home on the same day. This poses a great responsibility on the doctors involved and the hospital services, in ensuring the absence of delays, unanticipated admissions, and unexpected adverse events. Patient selection criteria are being used effectively by various centers across the world to prevent elective case cancellation and unplanned hospital admission and identify high-risk cases for major complications including morbidity and mortality. In recent year patient selection criteria, based on the latest guidelines, are being used to identify the risk factors and channel patients for ambulatory, day-care, and inpatient categories. Aims and Objectives: This article purposes a proper patient selection process for the improvement of quality and safety in patients undergoing day-care and office-based procedures. The patient selection criteria, if understood by all the team players, is instrumental in providing clinical guidance and appropriate patient triaging for caring for an ever-increasing, large volume of same-day surgical population. As the volume and complexity of the patient population grow, it is important to revise the patient selection criteria from time to time. Conclusion: Patient selection criteria have to be developed and modified by bodies and institutions to suit local circumstances to channel patients for ambulatory, day-care, and inpatient categories. Processes, administrative, clinical, and technical standards must be in-built into place and the pathway need to be well understood by all the team players in an institution.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"1 1","pages":"375 - 380"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70664671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apollo MedicinePub Date : 2023-10-01DOI: 10.4103/am.am_110_22
Vinit Suri, MohitKalangi Venkata Naga, Dipanjan Panda, K. Suri
{"title":"Nonconvulsive status epilepticus and encephalopathy related to ifosfamide – A case report","authors":"Vinit Suri, MohitKalangi Venkata Naga, Dipanjan Panda, K. Suri","doi":"10.4103/am.am_110_22","DOIUrl":"https://doi.org/10.4103/am.am_110_22","url":null,"abstract":"Introduction: Ifosfamide (IFX) is an alkylating drug used for chemotherapy to manage a wide range of malignancies including testicular, ovarian, head-and-neck cancers, lymphomas, and sarcomas. Central nervous system (CNS) toxicity is known to occur in 10%–40% of patients who are administered high doses of IFX. CNS toxicity includes an encephalopathy with underlying nonconvulsive status epilepticus manifesting with altered sensorium, mental confusion, seizures, ataxia, visual hallucinations, akinetic mute state extrapyramidal features, or coma. Case Report: We describe the case of a 65-year-old woman with a rapidly evolving confusional state and progressive decline in the fluency of speech progressing to mutism immediately after IFX chemotherapy. Results: Electroencephalogram (EEG) revealed evidence of nonconvulsive status epilepticus. The patient was managed with anticonvulsants, discontinuing IFX, and intravenous methylene blue infusion. Subsequently, the patient had significant improvement to an alert state with normalization of EEG abnormality. Conclusion: CNS toxicity following IFX usually manifests within 24 h of the drug administration, although clinical manifestations of toxicity may occur up to 4–6 days and a significant number of these patients may have a nonconvulsive status as the cause of the encephalopathy. Patients with encephalopathy following IFX should be evaluated with early EEG to assess for the presence or absence of a nonconvulsive status. Patients with a positive EEG would benefit from prompt and aggressive anticonvulsant therapy along with cessation of IFX therapy with or without intravenous methylene blue administration.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"15 1","pages":"58 - 61"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70663417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}