Medical Journal Armed Forces India最新文献

{"title":"Pulmonary thromboembolism in adults: Experience from a tertiary care center","authors":"Vikas Marwah ,&nbsp;Robin Choudhary ,&nbsp;Gaurav Bhati ,&nbsp;Virender Malik ,&nbsp;V. Pravin Kumar ,&nbsp;Tentu Ajai Kumar ,&nbsp;I.M. Pandey ,&nbsp;Ashok Basnet","doi":"10.1016/j.mjafi.2022.09.011","DOIUrl":"10.1016/j.mjafi.2022.09.011","url":null,"abstract":"<div><h3>Background</h3><div><span>Venous thromboembolism (VTE) includes </span>deep vein thrombosis<span> (DVT) and pulmonary embolism (PE). We aimed to analyze the risk factors, clinical presentations, evaluation and management strategies as well as outcomes of adult pulmonary thromboembolism cases at a tertiary care center.</span></div></div><div><h3>Methods</h3><div>In a retrospective observational study, all consecutive adult pulmonary thromboembolism cases admitted from January 2019 to September 2020 at our center were enrolled in this study.</div></div><div><h3>Results</h3><div><span><span><span>Forty-eight patients were included in the present study. The commonest presenting features were dyspnea (93.8%) and cough<span> (79.2%). The risk factors included hypertension 11 (23%), diabetes 6 (12%), recent trauma<span> and recent surgery 3 (6%) each, and malignancy in 2 (4%). DVT was present in 12 (25%) cases while history of smoking was significant, 31 present in (64.6%). Tuberculosis was also found to be an important risk factor for PE in 8 (16.7%). The current COVID-19 pandemic has come up as an important risk factor for PTE which was also true in our case with 13 (27%) patients being cases of moderate to severe COVID-19 pneumonia. Electrocardiogram revealed </span></span></span>sinus tachycardia (56.25%), precordial lead T-wave changes (6.3%), and S1Q3T3 pattern (16.67%). Diagnosis was confirmed by computed tomographic </span>pulmonary angiography<span><span> (CTPA) in 81% of cases. Treatment options included low molecular weight heparin (LMWH) in 91%, newer </span>oral anticoagulants (NOACs) in 2% of the patients and </span></span>thrombolysis<span> was needed in 12.5% of patients. There was no in-hospital mortality; however one patient had major bleeding.</span></div></div><div><h3>Conclusion</h3><div><span>The clinical presentation of PE varied from dyspnea to cough, though the commonest feature of dyspnea remains unchanged compared to prior studies. CTPA has been modality of choice for diagnosis, however few patients with high probability for PTE were diagnosed clinically along with suggestive echocardiography and ECG findings. Thus, a high index of suspicion and timely therapeutic </span>anticoagulation with various agents led to effective management and better outcome in the studied patients.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S78-S83"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47588828","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}

{"title":"Neuroinflammation in COVID-19: Fibrinogen (fibrin), a potential culprit!","authors":"Rohan Magoon,&nbsp;Shalvi Mahajan","doi":"10.1016/j.mjafi.2023.07.008","DOIUrl":"10.1016/j.mjafi.2023.07.008","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S407-S408"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135762042","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}

{"title":"Extended spectrum beta-lactamase and aminoglycoside modifying enzyme genes in multi drug resistant Gram-negative bacteria: A snapshot from a tertiary care centre","authors":"Muqtadir Malik ,&nbsp;Mahadevan Kumar ,&nbsp;Gurpreet Singh Bhalla ,&nbsp;Kundan Tandel","doi":"10.1016/j.mjafi.2023.09.007","DOIUrl":"10.1016/j.mjafi.2023.09.007","url":null,"abstract":"<div><h3>Background</h3><div><span>This study aims to enhance the existing knowledge of the prevalence of genes responsible for beta-lactam resistance and aminoglycoside resistance in </span>gram negative organisms<span><span> by molecular detection of extended spectrum beta-lactamase and aminoglycoside modifying </span>enzymes in multidrug-resistant gram-negative bacteria.</span></div></div><div><h3>Methods</h3><div><span>Out of 864 gram-negative isolates, 710 were phenotypically identified as multidrug-resistant by antibiotic susceptibility testing. From the above isolates, 102 representative isolates as per </span>sample size<span> calculated were selected for further molecular studies. The presence of blaTEM, blaCTX-M blaSHV, and five AmpC genes was detected by real-time polymerase chain reaction (PCR). Conventional PCR<span> was performed to detect seven aminoglycoside modifying enzyme genes namely aac(6')-Ib, aac(6')-Ic, aac(3)-Ia, aac(3)-Ib, aac(3)-IIa, ant(2'')-Ia, and ant(4'')-IIa.</span></span></div></div><div><h3>Results</h3><div>Most common multidrug-resistant isolate was Klebsiella pneumoniae (35%) followed by Escherichia coli (30%). Among the 102 selected isolates all harboured blaTEM gene, 71 (69.6%) harboured blaCTX-M gene and 48 (47%) blaSHV gene. Among the selected isolates 60% showed the presence of AmpC genes. Most common aminoglycosie modifying enzyme gene was AAC 6' Ib (51%) followed by ANT 2\" Ia (36%).</div></div><div><h3>Conclusion</h3><div><span>This study suggests a wider use of molecular methods using specific PCR amplification of resistance genes. It would be beneficial to perform the molecular identification of </span>antimicrobial resistance<span> genes to effectively monitor and manage antibiotic resistance, administer appropriate antimicrobial medication, practice antimicrobial stewardship and improve hospital infection control procedures.</span></div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S223-S231"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135664297","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}

{"title":"Sweetness and positivity together aren't a happy ending: Case controlled study amongst severe COVID-19 for impact of diabetes mellitus on survival","authors":"Uday Yanamandra ,&nbsp;Srinath Rajagopal ,&nbsp;Bhavya Aggarwal ,&nbsp;Praneet Kaur ,&nbsp;Anurag Singh ,&nbsp;Nupur Aggarwal ,&nbsp;Pavan B. Sai Kumar ,&nbsp;Gaytri Duhan ,&nbsp;Rajesh Sahu ,&nbsp;A.S. Menon","doi":"10.1016/j.mjafi.2022.06.010","DOIUrl":"10.1016/j.mjafi.2022.06.010","url":null,"abstract":"<div><h3>Background</h3><div>India is the epicenter of diabetes mellitus (DM). The relationship between COVID and DM in age/gender-matched non-diabetics has not been studied yet. The role of DM in predicting the disease severity and outcome in COVID patients might provide new insight for effective management.</div></div><div><h3>Methods</h3><div>We conducted a prospective comparative study at a COVID care center from 25th April–31st May 2021. Among 357 severe-COVID patients screened, all consecutive diabetes (n-113) and age/gender-matched non-diabetes (n-113) patients were recruited. All diabetics and non-diabetics at admission were subjected to high resolution computed tomography (HRCT) chest and inflammatory markers (C-reactive protein (CRP), D-dimer, ferritin, interleukin-6 (IL-6), lactate dehydrogenase (LDH), Neutrophil-Lymphocyte Ratio (NLR)) before starting anti- COVID therapy. Statistical analysis was done using JMP 15·0 ver·3·0·0.</div></div><div><h3>Results</h3><div>The prevalence of DM among the screened population (n-357) was 38·37%. The mean age of the study population was 61y with male preponderance (57%). There was no statistical difference in the HRCT-score or inflammatory markers in the two groups except for higher NLR (p-0·0283) in diabetics. Diabetics had significantly inferior overall survival (OS) (p-0·0251) with a 15d-OS of diabetics vs. non-diabetics being 58·87%, 72·67%, and 30d-OS of diabetics vs. non-diabetics being 46·76%, 64·61%, respectively. The duration of the hospital stay was not statistically different in the two groups (p-0·2).</div></div><div><h3>Conclusion</h3><div>The mortality is significantly higher in severe-COVID patients with DM when compared to age/gender-matched non-diabetics. There was no significant difference in most inflammatory markers/CT at admission between the two groups.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S14-S20"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33443471","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}

{"title":"Magnetic foreign body ingestion: An avoidable attraction in children","authors":"Iti Jain,&nbsp;V. Shankar Raman,&nbsp;Gunjan Singh","doi":"10.1016/j.mjafi.2022.12.013","DOIUrl":"10.1016/j.mjafi.2022.12.013","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S366-S367"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44974023","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}

{"title":"Periumbilical contact dermatitis mimicking Cullen's Sign","authors":"Suchi Acharya,&nbsp;K.M. Adhikari","doi":"10.1016/j.mjafi.2022.09.010","DOIUrl":"10.1016/j.mjafi.2022.09.010","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S352-S353"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46286824","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}

{"title":"Lupoid leishmaniasis successfully treated with oral fluconazole in a child","authors":"Arshiya Khan,&nbsp;Bhushan Madke,&nbsp;Vikrant Saoji,&nbsp;Kaveri Rusia,&nbsp;Sharwari Jaiswal,&nbsp;Soham Meghe","doi":"10.1016/j.mjafi.2022.12.014","DOIUrl":"10.1016/j.mjafi.2022.12.014","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S368-S370"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47786764","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}

{"title":"Trench foot: A forgotten entity!","authors":"Balakrishnan Arivalagan,&nbsp;Rohit Vashisht,&nbsp;Vijoy Kumar Jha,&nbsp;Aakash K M,&nbsp;Srishti Bhardwaj","doi":"10.1016/j.mjafi.2023.11.002","DOIUrl":"10.1016/j.mjafi.2023.11.002","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S419-S421"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539119","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}

{"title":"Unmasking of asymptomatic COVID-19 cases following vaccination","authors":"Saurabh Bobdey,&nbsp;S.K. Kaushik,&nbsp;Rajesh Vaidya,&nbsp;Arun Kumar Yadav,&nbsp;Suraj Kapoor,&nbsp;Prabhakar Teli,&nbsp;Prem Vardhan,&nbsp;Kunal Koundinya,&nbsp;Gurmanbir Singh Dhillon","doi":"10.1016/j.mjafi.2022.06.001","DOIUrl":"10.1016/j.mjafi.2022.06.001","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S344-S346"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40677213","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}

{"title":"The importance of the immunohematologic evaluation for presumed autoimmune hemolytic anemia in the COVID-19 era","authors":"Jeremy W. Jacobs,&nbsp;T.D. Schlafer","doi":"10.1016/j.mjafi.2023.03.012","DOIUrl":"10.1016/j.mjafi.2023.03.012","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S389-S391"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9769928","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}