Medical Journal Armed Forces India最新文献

{"title":"Pre- and post-intervention oesophageal pressure topography metrics in the three subtypes of achalasia: A pilot study on Indian adults","authors":"Binit Kumar ,&nbsp;Deepanjan Dey ,&nbsp;Dharmendra Kumar ,&nbsp;P.K. Sharma","doi":"10.1016/j.mjafi.2023.07.006","DOIUrl":"10.1016/j.mjafi.2023.07.006","url":null,"abstract":"<div><h3>Background</h3><div><span>Achalasia is characterized by failure of relaxation of the lower oesophageal sphincter (LOS) and abnormal </span>peristalsis during swallowing. The study aimed to observe the effects of intervention in three sub-types of achalasia and compare the intervention outcomes among the three sub-types.</div></div><div><h3>Methods</h3><div>Forty-one patients underwent Eckardt scoring for severity of achalasia, followed by high-resolution manometry (HRM). After three and six months of intervention (pneumatic dilatation or 'Heller's Cardiomyotomy), Eckardt scoring and HRM were repeated and compared with the initial results.</div></div><div><h3>Results</h3><div>Out of the 41 patients, 13 were diagnosed with type I achalasia (31.71%), 18 with type II (43.90%), and 10 with type III (24.39%). Significant differences between the pre- and post-intervention values of median integrated relaxation pressure (IRP) and Eckardt score were found in all three sub-types. Although the beneficial effect of intervention lasted up to six months postintervention, it was less than three months postintervention values. The intervention success rates were highest for both laparoscopic Heller's myotomy (LHM) and pneumatic dilatation (PD) in Type II Achalasia at three and six months postintervention, respectively.</div></div><div><h3>Conclusion</h3><div>One-time intervention is effective in all three sub-types. This benefit tends to taper over time but remains significant after six months of intervention. Type II Achalasia shows the best intervention outcomes compared to the other two sub-types at three months and six months post-intervention. Type III Achalasia shows the least response compared to other sub-types and is the poorest responder to intervention. The benefit of one-time intervention also deteriorates most in type III achalasia at the end of six months.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S210-S216"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606907","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":"Case of COVID-19 infection-induced complement-mediated thrombotic microangiopathy","authors":"Atul Kumar Srivastava ,&nbsp;Sanjay Panda","doi":"10.1016/j.mjafi.2023.09.008","DOIUrl":"10.1016/j.mjafi.2023.09.008","url":null,"abstract":"<div><div>The SARS-CoV-2 virus can cause thrombotic microangiopathy<span> (TMA) by alternate pathway activation. We present a case of a young female patient who presented with fever and dialysis-dependent acute kidney injury<span><span>. On evaluation, she was diagnosed with COVID-19-induced complement-mediated thrombotic microangiopathy<span> (CM-TMA). She was initially managed with plasma exchange (PLEX). However, because of poor response to PLEX, she was administered Inj </span></span>Eculizumab. She became dialysis independent and had normal renal function on follow-up visits.</span></span></div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S297-S300"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811071","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":"Dermoscopic findings in chronic venous insufficiency","authors":"Rajeshwari Dabas ,&nbsp;Ajay Kumar Dabas ,&nbsp;Sandeep Arora ,&nbsp;Devinder Kumar Suhag","doi":"10.1016/j.mjafi.2023.04.003","DOIUrl":"10.1016/j.mjafi.2023.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Chronic venous insufficiency (CVI) causes cutaneous changes. This prospective observational study reveals dermoscopic findings in CVI.</div></div><div><h3>Methods</h3><div><span>Successive CVI patients of ≥18 years were included in the study. American Venous Forum classification for CVI was utilized. All underwent clinical examination, duplex ultrasound, and dermoscopy<span>. Pregnancy, pedal edema, or </span></span>pigmentation<span><span><span> from causes other than CVI, active/healed venous ulcers, prior venous interventions, </span>arterial insufficiency, and </span>deep vein thrombosis were excluded.</span></div></div><div><h3>Results</h3><div>Eighty patients were studied. Fifty-six were males [mean age of 58.9 years (SD-12.09)], and twenty-four were females [mean age of 53.9 years (SD-12.8)]. Sixty-two had bilateral, and eighteen had one limb involvement (total 142 limbs). Pigmentation was observed in 120 limbs, varicose veins in 138 limbs, eczema in 45, and edema in 33 limbs. On dermoscopy, the pigment network was accentuated and diffuse in 105 limbs and accentuated but patchy in 16 limbs. Vessel morphology noted were dotted vessels in 67 limbs, linear curved vessels in 45 limbs, linear curved vessels with branches in 11 limbs, and linear vessels in 7 limbs. Scales were white and diffuse in 56 limbs and white but patchy in 8 limbs. White and brown focal structureless areas were seen in 20 and 18 limbs, respectively. Blue-grey linear cords were seen in 34 and blue-grey clods in 6 limbs.</div></div><div><h3>Conclusion</h3><div>CVI causes changes in vessel morphology, pigmentary, and scaling patterns in the skin which are picked up by dermoscopy. Further longitudinal studies could provide insight into the temporal progression of CVI.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S185-S191"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42412092","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":"Correlation between conventional karyotype, interphase FISH and immunophenotype in risk stratification of newly diagnosed plasma cell myeloma: An observational study","authors":"Paresh Singhal ,&nbsp;Gurpreet Kaur ,&nbsp;Deepti Mutreja ,&nbsp;Arijit Sen ,&nbsp;J.K. Bhatia","doi":"10.1016/j.mjafi.2023.05.001","DOIUrl":"10.1016/j.mjafi.2023.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Plasma cell myeloma<span> (PCM) is a common adult hematological neoplasm of terminally differentiated B-cells resulting in accumulation of monoclonal plasma cells. PCM is heterogeneous disease with survival time<span> varies from months to years, determined by age, stage, cytogenetics abnormalities, and treatment response. There is conflicting evidence in role of immunophenotype<span> as a prognostic indicator. This study identified frequency of cytogenetics abnormalities and established correlation between cytogenetics and immunophenotyping in risk stratification in newly diagnosed PCM.</span></span></span></div></div><div><h3>Methods</h3><div><span><span><span>Pilot study was undertaken on 30 newly diagnosed PCM over 4 years. Apart from extensive myeloma laboratory and imaging profile, multicolor flow cytometry using panel of CD138, </span>CD38<span>, CD45, CD56, CD19, </span></span>CD20<span><span>, CD28, </span>CD200<span>, CD117, κ, and λ light-chains. </span></span></span>Karyotyping<span><span> was done using GTG banding and interphase </span>fluorescence in situ hybridization analysis on magnetically sorted plasma cells for t(4;14), t(11;14), del(13)q, and del(17)p probes.</span></div></div><div><h3>Results</h3><div><span><span>Of 30 myeloma patients, 16(53.3%) were men with mean age 57.23 ± 11.90 years. The del(13)q was commonest cytogenetics abnormality. CD56-positive cases were strongly associated with presence of del(17)p and stage III of disease (p &lt; 0.05). Negative expression of </span>CD117 was seen in advanced stage of disease and high-risk </span>genetic factor<span><span>, t(4;14) (p = 0.049). Absent CD28<span> expression was associated with higher albumin levels, lower levels of </span></span>β2MG, and lack of high-risk genetic abnormalities. Advanced clinical stages were associated with expression of CD56, CD28, and absent expression of CD45 and CD117.</span></div></div><div><h3>Conclusion</h3><div>Immunophenotypic antigens positive and negative expressions are associated with high-risk genetic abnormalities and advanced clinical stages of PCM.</div></div><div><h3>Institution ethic committee reference number</h3><div>IEC/2017/230, AFMC, Pune.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S192-S203"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43486866","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":"Isolated brachioradialis symptomatic cysticercosis in a young female: A rare entity surgically managed","authors":"Shavinder Dogra ,&nbsp;Pratibha Misra ,&nbsp;Tejpal Singh Bedi ,&nbsp;Mathews Jacob","doi":"10.1016/j.mjafi.2023.04.005","DOIUrl":"10.1016/j.mjafi.2023.04.005","url":null,"abstract":"<div><div><span><span>Taenia solium is a </span>parasite and is endemic in the developing countries due to various unhygienic faecal practices. The disseminated form is commoner with the brain being the most common site of affliction. This report is of a young female patient with complaints of an insidious and progressive swelling of the right forearm. Clinicoradiological features were suggestive of an isolated myocysticercosis which was symptomatic with restricted </span>pronation<span> and supination<span><span><span>. The symptoms persisted post a course of Albendazole, and the cyst had to be excised as it was impinging on the median and </span>radial nerves. The patient has been asymptomatic after a 3-month post-operative period with no signs or imaging evidence of residual disease. The presence of isolated intramuscular </span>cysticercosis is an extremely rare and a high index of suspicion is needed for early diagnosis. Although medical management is extremely effective, surgical excision may be required in certain cases.</span></span></div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S288-S291"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47076102","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":"Sleep duration at night affects daytime wake EEG spectra","authors":"Ankit Anurag ,&nbsp;Karuna Datta ,&nbsp;Anna Bhutambare ,&nbsp;Mamatha VL ,&nbsp;Yogita Narawade ,&nbsp;Siddharth Kumar","doi":"10.1016/j.mjafi.2023.01.007","DOIUrl":"10.1016/j.mjafi.2023.01.007","url":null,"abstract":"<div><h3>Background</h3><div><span>Sleep deprivation leads to decreased performance, alertness and degradation in the </span>health status<span> of a person. Often the person remains unaware of the reduced alertness and may end up taking inaccurate decisions. There was a need to study the sleep duration<span> of college goers and to study the effect of total night-time sleep duration on daytime Electroencephalogram (EEG) characteristics.</span></span></div></div><div><h3>Methods</h3><div>A total of 30 asymptomatic volunteers were enrolled in a cross-sectional study. A baseline sleep diary for fourteen days was taken and one daytime recording was done while carrying out their normal daytime activity. EEG, electrooculography<span> (EOG) and electromyography<span><span> (EMG) were recorded, which were used for the scoring of their sleep-wake using the American Academy of Sleep Medicine criteria. EEG data were analysed using </span>fast Fourier transform<span><span>. Fast Fourier transform was done for sleep and wake durations using DOMINO software (©SOMNOMEDICS, Germany). A Python library was used to calculate </span>power spectral density (PSD) in EEG frequency bands.</span></span></span></div></div><div><h3>Results</h3><div>A beta band was significantly reduced in the first 45 min of the recording as compared to the baseline. K means cluster showed clustering of two groups with a significant reduction of daytime sleep delta PSD values with reduced total sleep time and time in bed the previous night. The study concluded that subjects with reduced night-time sleep duration generated significantly lesser sleep delta PSD values.</div></div><div><h3>Conclusion</h3><div>Reduced duration of night-time sleep was associated with worse nap time sleep delta PSD values and vice versa. Interestingly, good quality sleep at night correlated better with delta PSD values of daytime recording.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S144-S152"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48902722","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":"Weakness of left hand in a diagnosed case of pulmonary tuberculosis: A rare case of disseminated tuberculosis with wrist tenosynovitis","authors":"Kunal Kumar,&nbsp;R.N. Verma,&nbsp;Neeraj Sharma,&nbsp;D.S. Grewal,&nbsp;Saurov Ghose,&nbsp;Deepu K. Peter","doi":"10.1016/j.mjafi.2023.08.002","DOIUrl":"10.1016/j.mjafi.2023.08.002","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S409-S411"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934581","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":"Acute generalised exanthematous pustulosis and drug reaction with eosinophilia and systemic symptoms overlap","authors":"Deepak Vashisht,&nbsp;Preema Sinha,&nbsp;Manoj Gopal Madakshira,&nbsp;Juhi Sharma,&nbsp;Akansha Tripathi,&nbsp;Parul Kamboj","doi":"10.1016/j.mjafi.2023.07.002","DOIUrl":"10.1016/j.mjafi.2023.07.002","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S386-S388"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136299426","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":"Nutcracker syndrome: A case of exertional hematuria","authors":"Sukhwinder Singh Sangha,&nbsp;Bhupesh Saini,&nbsp;Aditya Jha,&nbsp;Amit Kishore,&nbsp;Saket Bhatacharjee","doi":"10.1016/j.mjafi.2022.12.007","DOIUrl":"10.1016/j.mjafi.2022.12.007","url":null,"abstract":"","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S363-S365"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46509986","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":"Pulmonary cavitation in follow-up COVID 2019 cases: An etiological perspective","authors":"Priyanka Singh ,&nbsp;Saurabh Tiwari ,&nbsp;Aseem Yadav ,&nbsp;Shailendra Singh ,&nbsp;Sandeep Thareja ,&nbsp;Aneesh Mohimen ,&nbsp;Pawan Dhull ,&nbsp;Nitin B. Ahuja ,&nbsp;Debdeep Mitra","doi":"10.1016/j.mjafi.2022.06.015","DOIUrl":"10.1016/j.mjafi.2022.06.015","url":null,"abstract":"<div><h3>Background</h3><div>The current COVID-19 pandemic is an ongoing global healthcare challenge that has caused morbidity and mortality at unprecedented levels. Since the post-COVID pulmonary complications are evolving and challenging, a study was carried out to assess pulmonary cavitation in follow-up COVID cases from an etiological perspective. The aim of this study was to assess the incidence of pulmonary cavitation and describe its etiology and evolution in moderate and severe post-COVID pneumonia patients.</div></div><div><h3>Methods</h3><div>A prospective observational study of all patients admitted to our institution with moderate or severe COVID pneumonia was carried out. Some of these patients again became symptomatic after discharge and developed pulmonary cavitation on imaging.</div></div><div><h3>Results</h3><div>6.2% (n = 37) out of 589 patients admitted to our institution with moderate or severe COVID pneumonia developed pulmonary cavitation on follow-up. We describe the imaging characteristics of post-COVID cavitation and present these patients' clinical, laboratory, and microbiological parameters.</div></div><div><h3>Conclusion</h3><div>Cavitary lung disease in patients with moderate to severe COVID-19 disease is not uncommon, and an etiological workup is necessary to institute timely and correct therapy.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S29-S37"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9532505","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}