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Establishment of peripherally inserted central catheter line clinic at a tertiary care hospital: Review of first 100 cases 三级医院外周置管中心线门诊的建立:前100例的回顾
Apollo Medicine Pub Date : 2023-10-01 DOI: 10.4103/am.am_73_23
SarojKumar Pattnaik, Satyanarayan Sahoo, Binati Hota
{"title":"Establishment of peripherally inserted central catheter line clinic at a tertiary care hospital: Review of first 100 cases","authors":"SarojKumar Pattnaik, Satyanarayan Sahoo, Binati Hota","doi":"10.4103/am.am_73_23","DOIUrl":"https://doi.org/10.4103/am.am_73_23","url":null,"abstract":"Objectives: Peripherally inserted central catheter (PICC) lines are increasingly being used as a reliable central venous access in the management of patients on long-term intravenous medications. These are usually placed by different specialists; however, an intensivist-driven PICC line program with a dedicated clinic covering outpatient chemotherapy patients is an added avenue to our subspecialty. We share our experience of starting a PICC line clinic in our hospital and developing the team for insertion, maintenance, and troubleshooting of PICC lines, so to make this procedure smooth and complication free. Materials and Methods: We conducted a retrospective cross-sectional study of the first 100 consecutively placed PICC lines by intensivists at our hospital with our experience of starting a PICC line clinic. We analyze the success rates of PICC line placement under ultrasound guidance, also reporting complications encountered. Results: The initial 100 PICC lines placed in 92 patients during the 2-year study period having catheter days of 8674 days were analyzed. All the PICC lines were successfully placed (100%), the majority on chemotherapy patients (84%). A total of 39 complications were found in 16 patients, at a rate of 4.49/1000 catheter days; out of which only 2 (2%) cases had infection with septicemia. None of the 12 patients in the intensive care unit with catheter days of 164 days had any catheter-induced infection. Conclusions: Ultrasound-guided PICC line placement by an intensivist is a safe method in patients requiring prolonged intravenous medication. PICC line clinic increases awareness among such patients and makes the procedure with afterward care more standardized.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"1 1","pages":"341 - 345"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70669003","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}
引用次数: 0
Tramadol – A better alternative to clonidine as an additive agent to ropivacaine for postoperative analgesia in below umbilical surgeries 曲马多-作为罗哌卡因的添加剂用于脐下手术术后镇痛的较好选择
Apollo Medicine Pub Date : 2023-10-01 DOI: 10.4103/am.am_78_23
Arvinpreet Kour, J. Gadhavi, R. Midha, Ajaydeep Singh, Ramnandan Prasad, Harnoor Singh
{"title":"Tramadol – A better alternative to clonidine as an additive agent to ropivacaine for postoperative analgesia in below umbilical surgeries","authors":"Arvinpreet Kour, J. Gadhavi, R. Midha, Ajaydeep Singh, Ramnandan Prasad, Harnoor Singh","doi":"10.4103/am.am_78_23","DOIUrl":"https://doi.org/10.4103/am.am_78_23","url":null,"abstract":"Background: Epidural anesthesia is commonly used for providing both postoperative analgesia in infra umbilical surgeries. An adjuvant increases the effectiveness of the local anesthetic drug by prolonging its action and also causes decreased doses of the local anesthetic agent. Aims: The sight and focus of our study are to juxtapose the effect of clonidine and tramadol as an additive to epidural ropivacaine for postoperative analgesia. Materials and Methods: A randomized, concurrent cohort, prospective study was performed on 60 patients (American Society of Anesthesiologists [ASA] Grade I and ASA Grade II) of either gender, those who were planned for chosen elective infraumbilical surgery under combined spinal epidural anesthesia, and divided into two groups. The patients in Group I were administered 15 mL 0.5% ropivacaine + clonidine (2 μg/kg), whereas Group II patients received 15 mL 0.5% ropivacaine + tramadol (2 mg/kg). Postanesthesia vitals, the duration for motor and sensory effects, i.e., block, adverse effects, and time to rescue analgesia, was recorded. Results: A significant decrease in the heart rate was observed in clonidine group patients compared with tramadol group patients after spinal anesthesia. The duration of motor and sensory block in the tramadol group was significantly longer. Time to rescue analgesia was also prolonged significantly in the tramadol group. The incidence of adverse effects was comparable in the two groups. Conclusion: Tramadol, as an additive to epidural ropivacaine, was found to have a better motor and sensory block, prolonged postoperative analgesia, and minimal adverse side effects. A significantly decreased demand for rescue analgesics was seen compared to clonidine.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"1 1","pages":"336 - 340"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70668923","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}
引用次数: 0
Thinking beyond tremors – A prospective observational study to evaluate depression and sleep pattern disturbances in patients of idiopathic parkinson's disease 震颤之外的思考——一项评估特发性帕金森病患者抑郁和睡眠模式障碍的前瞻性观察研究
Apollo Medicine Pub Date : 2023-10-01 DOI: 10.4103/am.am_7_23
ShalinD Shah, AadityaR Kolte, Sagar R. Bhimani, S. Malhotra
{"title":"Thinking beyond tremors – A prospective observational study to evaluate depression and sleep pattern disturbances in patients of idiopathic parkinson's disease","authors":"ShalinD Shah, AadityaR Kolte, Sagar R. Bhimani, S. Malhotra","doi":"10.4103/am.am_7_23","DOIUrl":"https://doi.org/10.4103/am.am_7_23","url":null,"abstract":"Background: Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder characterized by motor and nonmotor symptoms. Neuropsychiatric symptoms include sleep disorders, psychosis, cognitive impairment, depression, and anxiety. Because this neuropsychiatric aspect remains unexplored in such patients, we examined depression and sleep pattern disturbances in such patients. Methodology: All patients with a confirmed PD diagnosis attending an outpatient clinic and a PD support group will participate in this study. After recording the drug name, mechanism of action, frequency and duration of treatment, and examining drug use patterns, patients were assessed on the Hamilton Depression Scale (HAM-D) and the Parkinson's Disease Sleep Scale (PDSS-D). (2) Assess for depression and disturbed sleep patterns. Pearson's correlation test was used for correlations between various variables. Results: Thirty-five patients fulfilling the inclusion criteria and exclusion criteria were enrolled in the study. The mean ± standard deviation age of the patients was 66.46 ± 9.21 years. A total of 6 single drugs and 4 fixed-dose combinations were prescribed in a span of a mean of 6.53 years. Levodopa + carbidopa (125 mg), followed by pramipexole, is the most prescribed drug among the study population. The mean score of the HAM-D Scale of 35 patients was 23.02. The maximum score was 52. The mean score of the PDSS-2 of 35 patients was 22.8 (out of 60) and there was a weak or moderate correlation between the different variables. Conclusion: Major part of the treatment plan in PD patients was levodopa + carbidopa (125 mg). Out of 35 patients, the majority of them were depressed and it could be one of the reasons for nocturnal disturbances based on PDSS-2 scoring. Furthermore, there was a weak correlation between different variables but it was not statistically significant.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"1 1","pages":"358 - 364"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70668245","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}
引用次数: 0
When We Fight a Winnable Battle in an Unwinnable War? The Story of a Cancer – A Case Report 当我们在一场不可能赢的战争中打一场可能赢的战斗时?癌症的故事-一个病例报告
Apollo Medicine Pub Date : 2023-10-01 DOI: 10.4103/am.am_81_23
Debabrata Chakraborty, Nirmalya Ray, Sanjay Bhaumik, Sadanand Dey
{"title":"When We Fight a Winnable Battle in an Unwinnable War? The Story of a Cancer – A Case Report","authors":"Debabrata Chakraborty, Nirmalya Ray, Sanjay Bhaumik, Sadanand Dey","doi":"10.4103/am.am_81_23","DOIUrl":"https://doi.org/10.4103/am.am_81_23","url":null,"abstract":"Introduction: Breast cancer is the most frequent malignancy in women and is curable in ~70-80% of patients with early-stage detection and without complication. Paraneoplastic neurologic syndrome of breast cancer is one such complication which is often hard to diagnose, severely debilitating, and also challenging to treat. Materials and Methods: A 57-year- old woman with no known co-morbidity presented with sudden onset altered sensorium. She was in status epilepticus when brought to emergency and progressed to super refractory status epilepticus in-spite of our efforts. MRI of the brain with contrast done revealed hyper intense signal in bilateral frontal, parietal, occipital, bilateral thalami, periaqueductal region and dorsal midbrain. Cerebrospinal fluid (CSF) study revealed only increased protein. The comprehensive infective panel of CSF was negative. The vasculitis marker, anti NMO and anti MOG antibody were absent. So, we suspected a possibility of autoimmune aetiology and started methylprednisolone along with intravenous immunoglobulin. Results: Her epileptic discharges settled in an electroencephalogram, and we weaned her off ventilation. We detected a right breast mass on clinical examination. The PET CT scan revealed metastasis in the liver, bones, right axillary lymph nodes, and bone marrow. Conclusion: Our patient, who had the first-time presentation, was diagnosed to have paraneoplastic encephalopathy in the background of breast cancer. The importance of proper clinical examination and whole-body PET CT scan, followed by a trial of immunomodulator therapy, is necessary in all patients with non-infective encephalitis.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135706124","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}
引用次数: 0
Case Report and a Brief Review on Fragile X Associated Premature Ovarian Insufficiency (FXPOI) 脆性X染色体相关性卵巢早衰(FXPOI)病例报告及综述
Apollo Medicine Pub Date : 2023-08-07 DOI: 10.4103/am.am_67_23
Anitha Saminathan, K. Gowrishankar, I. Nagarathinam
{"title":"Case Report and a Brief Review on Fragile X Associated Premature Ovarian Insufficiency (FXPOI)","authors":"Anitha Saminathan, K. Gowrishankar, I. Nagarathinam","doi":"10.4103/am.am_67_23","DOIUrl":"https://doi.org/10.4103/am.am_67_23","url":null,"abstract":"\u0000 \u0000 \u0000 Primary ovarian insufficiency (POI) is a major cause of female infertility due to early loss of ovarian function and menopause before the age of 40 years. POI is highly heterogeneous with both genetic and nongenetic etiologies. Approximately 20% of POI women are carriers for FMR1 premutation CGG repeats\u0000 \u0000 \u0000 \u0000 \u0000 FMR1 CGG repeat sizing is done by triplet primed repeat polymerase chain reaction. We report the case of a 25-year-old woman presenting with primary infertility carrying fragile X premutation.\u0000 \u0000 \u0000 \u0000 Genetic evaluation and counseling for fragile X syndrome in POI is very important for effective reproductive options.\u0000","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43229714","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}
引用次数: 0
Respiratory Paralysis in Sjogren’s Syndrome 干燥综合征的呼吸麻痹
Apollo Medicine Pub Date : 2023-08-07 DOI: 10.4103/am.am_108_23
Rachit Jain, K. Nath, Z. Siddiqui
{"title":"Respiratory Paralysis in Sjogren’s Syndrome","authors":"Rachit Jain, K. Nath, Z. Siddiqui","doi":"10.4103/am.am_108_23","DOIUrl":"https://doi.org/10.4103/am.am_108_23","url":null,"abstract":"\u0000 \u0000 \u0000 Primary Sjogren’s syndrome (pSS) a systemic autoimmune disease also known as sicca syndrome, primarily affects exocrine glands, particularly the salivary and lacrimal glands, and causes xerostomia and xerophthalmia. Renal involvement in cases of pSS is a rare occurrence. Patients with Sjogren’s syndrome presenting with severe hypokalemia or paralysis are uncommon.\u0000 \u0000 \u0000 \u0000 We present a case of a 45-year-old female presenting in our emergency department with hypokalemia-induced quadriparesis resulting from distal renal tubular acidosis due to Sjogren’s syndrome. It was revealed that symptoms of arthralgia and dry mouth had frequently been present for the past few years, with a persistent need for water intake.\u0000 \u0000 \u0000 \u0000 The patient was given symptomatic treatment during hospitalization and recovered successfully. The report emphasizes that although Sjogren’s syndrome is most often associated with chronic sicca symptoms, it may present for the first time with extraglandular manifestations, which may be life-threatening.\u0000 \u0000 \u0000 \u0000 Extraglandular forms of Sjogren’s disease can result in severe hypokalemia and paralysis of the limbs and respiratory muscles, which, if ignored, can be deadly for the patient. The course of action for such situations should be early identification and timely treatment because they are treatable and can give patients an asymptomatic and decent quality of life.\u0000","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46155159","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}
引用次数: 0
Prevalence of Mental Health Problems among School-going Adolescents in Melmaruvathur 梅尔马鲁瓦图尔学龄青少年心理健康问题的流行情况
Apollo Medicine Pub Date : 2023-08-07 DOI: 10.4103/am.am_43_23
Sashidharan Chandrasekar
{"title":"Prevalence of Mental Health Problems among School-going Adolescents in Melmaruvathur","authors":"Sashidharan Chandrasekar","doi":"10.4103/am.am_43_23","DOIUrl":"https://doi.org/10.4103/am.am_43_23","url":null,"abstract":"\u0000 \u0000 \u0000 Around 2.2 billion of the world’s population are children and adolescents. Ninety percentage live in low-and middle-income countries, where they make up 30%–50% of the population. This study examines mental health issues and their association with gender in Melmaruvathur, teenage school children.\u0000 \u0000 \u0000 \u0000 After receiving approval from the Ethics Committee, a descriptive cross-sectional questionnaire-based study was carried out on adolescents who were attending school in Melmaruvathur. The participants in the study filled out the questionnaires. The power of the study was set at 80%, and the significance level was set at 0.05. The estimated size of the sample was 500. The duration of the study was approximately 1 ½ years, beginning on June 1, 2021, and ending on December 30, 2022. The age range was anywhere between 11 and 17 years, participants had to be adolescents who attended school. Those who had participated in mental health training programs in the past were not allowed to participate.\u0000 \u0000 \u0000 \u0000 There were about 43.4% of females and 56.6% of males among the study participants. About 3.0% had very high conduct problems, 5.80% had high conduct problems, 1.4% had very high hyperactivity, around 1.80% had very high emotional problems, around 7.40% had very high peer problems, and 6.80% had very low prosocial. There was no statistically significant difference between the genders regarding conduct problems, hyperactivity problems, emotional problems, peer problems, and prosocial. In the case of females, 77.52% had a total difficulty score that was quite close to the average and in males, 81.53% received a total difficulty score that was quite close to the average.\u0000 \u0000 \u0000 \u0000 The findings are significant for several reasons, including the understanding of gender-specific vulnerabilities, the creation of youth mental health interventions that are more specifically focused on youth, and the peculiarities of the home setting.\u0000","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45596301","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}
引用次数: 0
Role of Pulse Oximetry as a Screening Tool for the Detection of Congenital Heart Disease in Newborn Babies 脉搏血氧仪在新生儿先天性心脏病筛查中的作用
Apollo Medicine Pub Date : 2023-08-07 DOI: 10.4103/am.am_55_23
Ritu R. Nathawani, N. Chandra, Y. V. Abhijith, A. Ramesh, M. Ramesh
{"title":"Role of Pulse Oximetry as a Screening Tool for the Detection of Congenital Heart Disease in Newborn Babies","authors":"Ritu R. Nathawani, N. Chandra, Y. V. Abhijith, A. Ramesh, M. Ramesh","doi":"10.4103/am.am_55_23","DOIUrl":"https://doi.org/10.4103/am.am_55_23","url":null,"abstract":"\u0000 \u0000 \u0000 Congenital heart disease (CHD) is one of the commonly seen malformations, with incidence varying from 7 to 8/1000 live birth. Causes are multifactorial. Routine examination of neonates may miss more than 50% of cases. Pulse oximetry is a simple, noninvasive, bedside test which estimates the percentage of oxygen bound to hemoglobin (oxygen saturation [SpO2]). Detection of critical CHD (CCHD) has been possible with SpO2 screening. Many countries included SpO2 as part of newborn screening due to this. As a primary approach, both pre- and post-ductal extremity SpO2 is measured after 24 h of life. Echocardiography (ECHO) will be done on neonates with SpO2 readings <95%. Neonates born in high-altitude regions, studies have suggest to use adjusted threshold values. In India, there are limited studies.\u0000 \u0000 \u0000 \u0000 The aim of this study was to determine the usefulness of pulse oximetry as a screening tool for early detection of CHD in otherwise asymptomatic newborns. To determine, the accuracy of SpO2 for detecting clinically unrecognized CCHD in newborns.\u0000 \u0000 \u0000 \u0000 This is a prospective observational study done in the department of pediatrics in a tertiary hospital. The study was conducted over 12 months. During the study period, all neonates born who fulfilled the inclusion criteria were included in the study. After 24 h of life, neonates were examined clinically and the pre- and post-ductal SpO2 was measured. Neonates with SpO2 <90% in room air were excluded from the study. If the SpO2 was between 90% and 94%, clinical examination was repeated, if suspicious of CHD, they were referred for ECHO. If there was no suspicion of CHD, SpO2 was repeated after 6 h and ECHO was done if SpO2 ≤95. The difference of SpO2 >3% between the right upper limb and right lower limb was considered positive. Positive neonates were evaluated with two-dimensional echocardiograph. Inclusion criteria - All hemodynamically stable neonates were born during the study period. Exclusion criteria (1) Antenatally diagnosed cardiac anomalies, (2) Outborn neonates, (3) Parents/guardians are not willing to participate in the study and/or further investigation, (4) Sick neonates and those with SpO2 <90% at birth.\u0000 \u0000 \u0000 \u0000 1117 (83.7%) were eligible for the study out of 1333 neonates born. 669 (59.9%) were born by cesarean section and 448 (40.1%) by vaginal delivery. 996 (89.2%) were born at term (≥37 weeks of gestation) and 121 (10.8%) were preterm (<37 weeks of gestation). The male-to-female ratio was 1.03:1. The mean birth weight of the neonates was 2.91 ± 0.46 kg (mean ± standard deviation). The mean SPO2 in the right upper limb was 96.62 ± 1.73, in the right lower limb was 96.87 ± 1.76, in the left upper limb was 96.59 ± 1.90, and in the left lower limb was 97.06 ± 1.74. The average SPO2 difference between the right upper limb and right lower limb was 1.04 ± 1.07. Based on SpO2, 858 (76.8%) cases were not suspected of having CHD and 259 (23.3%) were suspected of having CHD and were evaluat","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42070941","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}
引用次数: 0
Impact of Pulmonary Rehabilitation on Recuperation of Moderate-to-Severe Coronavirus Disease 2019 Patients in Western India 肺部康复对印度西部2019中至重度冠状病毒病患者康复的影响
Apollo Medicine Pub Date : 2023-08-07 DOI: 10.4103/am.am_99_23
Manoj K. Singh, K. Annamalai
{"title":"Impact of Pulmonary Rehabilitation on Recuperation of Moderate-to-Severe Coronavirus Disease 2019 Patients in Western India","authors":"Manoj K. Singh, K. Annamalai","doi":"10.4103/am.am_99_23","DOIUrl":"https://doi.org/10.4103/am.am_99_23","url":null,"abstract":"\u0000 \u0000 \u0000 Coronavirus disease 2019 (COVID-19) virus has caused widespread Acute Respiratory Disease globally since 2020. Patients with evidence of lower respiratory illness either clinically or radiologically had moderate-to-severe illness. COVID respiratory and nonrespiratory symptoms (psychological and cognitive) noticed after 4–8 weeks of primary disease were called long COVID syndrome. Survivors of moderate-to-severe disease had a poor quality of life. The main objective of this retrospective study was to assess the role of outpatient pulmonary rehabilitation (PR) done in moderate-severe COVID-19 survivors who had symptoms after 4–8 weeks at Shaivam Lung Rehabilitation Centre, Ahmedabad.\u0000 \u0000 \u0000 \u0000 We analyzed the impact of PR on 30 patients’ post-COVID-19 who were willing to participate during the ongoing pandemic. It was an outpatient 6–8 weeks of program designed to target respiratory and general muscle training, relaxation technique, nutritional counseling, occupational and psychological support. Patients were tested with of combination of self-assessment quality of life scale (adapted from short form 36 questionnaire), muscle training, dyspnea scale, and physical assessment. The standard objective assessment included oxygenation index (SpO2/FiO2 ratio), 6 min walk distance (6 MWD), Modified Medical Research Council (MMRC) score, manual muscle testing (MMT) along with pulmonary function testing. All these subjective and objective variables were tested pre- and post-PR program to assess the impact on defined parameters.\u0000 \u0000 \u0000 \u0000 From December 2020 to March 2022, we studied the impact of PR on 30 out of 55 patients fitting into the inclusion criteria. Significant benefit was noted in subjective Short Form 36 (SF 36) score and objective (6 MWD, MMRC, oxygenation, MMT) quality of life post-PR program (P < 0.001). Improvement in spirometry was not statistically significant, indicating structural chronicity of COVID pulmonary fibrosis.\u0000 \u0000 \u0000 \u0000 PR is safe, effective, and feasible on an outpatient basis in COVID-19 survivors of illness with poor quality of life. Further research is required to prove its widespread benefit in such patients.\u0000","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43498878","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}
引用次数: 0
Novel Hybrid Treatment Approach for Dural Arteriovenous Fistula with Isolated Sinus and Absent Direct Dural Feeders 硬脑膜动静脉瘘的新型混合治疗方法——孤立窦加硬膜外直接喂食器
Apollo Medicine Pub Date : 2023-08-07 DOI: 10.4103/am.am_4_23
S. Govindappa, B. Rao, Y. R. Karthikeyan, Sujit Kumar, C. Adiga
{"title":"Novel Hybrid Treatment Approach for Dural Arteriovenous Fistula with Isolated Sinus and Absent Direct Dural Feeders","authors":"S. Govindappa, B. Rao, Y. R. Karthikeyan, Sujit Kumar, C. Adiga","doi":"10.4103/am.am_4_23","DOIUrl":"https://doi.org/10.4103/am.am_4_23","url":null,"abstract":"\u0000 \u0000 \u0000 Dural arteriovenous fistula (AVF) may present with varied imaging presentation. Hybrid treatment approches which include surery and endovascular techniques are beneficial for isoloated sinus in dural AVF.\u0000 \u0000 \u0000 \u0000 We present two case scenarios of complex cerebral dural AVFs. Both the patients had similar appearances on imaging which mimicked hemorrhage and tumor. With likely suspicion of fistula, digital subtraction angiography was initially performed, which confirmed the diagnosis. We chose to adopt a hybrid technique to treat them using the neurosurgical suite. Burr-hole craniotomy procedure followed by the direct embolization of the fistula was offered to both patients.\u0000 \u0000 \u0000 \u0000 Fistulae were completely cured with the minimal duration of hospital stay. Follow-up showed the complete resolution of their symptoms.\u0000 \u0000 \u0000 \u0000 Treating complex cerebral dural AVFs is as challenging as diagnosing them on cross-sectional imaging and may require a combined approach.\u0000","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44000350","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}
引用次数: 0
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