Scholars journal of applied medical sciences最新文献

{"title":"Abdominal Wall Abscess: An Infrequent Presentation of Colon Adenocarcinoma","authors":"Marlon San Martín-Riera, Jennifer Vega-Carrión, Francisco Paredes-Játiva, Grace Tapia-Navas, Andrés Escobar-Cortez, Genesis Carreño-Oliveros, Gabriela Castillo-Andrade, Andrea Villarreal-Juris","doi":"10.36347/sjams.2023.v11i09.008","DOIUrl":"https://doi.org/10.36347/sjams.2023.v11i09.008","url":null,"abstract":"Introduction: Colonic carcinoma has a variety of clinical presentations, however, invasion of the abdominal wall arising from the transverse colon is a rare one, as seen in this case report. Case report: 62-year-old patient with diffuse high intensity abdominal pain, fever, nausea, vomiting and an epigastric abscessed heterogeneous mass (8 x 7 x 7cm). A water-soluble contrast enema was performed, showing diverticula, absence of distal colon contrast transition and the apple core sign, compatible with transverse colon obstruction. A transverse colectomy was performed, with primary colo-colonic end-to-end anastomosis, including omentectomy and complete en-bloc resection of the affected abdominal wall area. The histopathological findings showed a transverse colon adenocarcinoma with abdominal wall invasion; all surgical margins were free of disease (R0), and 24 lymph nodes were retrieved. Patients’ recovery was successful. Discussion: Locally advanced colorectal cancers invade adjacent organs without distant metastases. They may result in abscess formation even in unusual locations like the abdominal wall, which is a rare complication (0.3 to 4%). Colon cancer diagnosis before surgery may not always be possible; and a flawed diagnosis can determine an incomplete treatment because the intraoperative macroscopic malignancy recognition is not always achievable. En-bloc resection is the gold standard treatment to accomplish a complete resection, with histologically negative margins and no residual tumor (R0). Conclusion: Colon adenocarcinoma may rarely present as an abdominal wall abscess. Image studies may include CT, radiography, etc. but the patient’s clinical status should always be prioritized; those who present abdominal obstruction with a high risk of sepsis and mortality should be offered immediate surgical treatment. En-bloc resection is the gold standard to accomplish histologically negative margins and no residual tumor.","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136193905","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":"Evaluation the Modalities of Rheumatoid Arthritis Management by General Practitioners in Bangladesh","authors":"Shafiquzzaman Siddiqui, Sadia Siddiqui, Fatema Haque Antora, Paritosh Kumar Chowdhury","doi":"10.36347/sjams.2023.v11i09.007","DOIUrl":"https://doi.org/10.36347/sjams.2023.v11i09.007","url":null,"abstract":"Introduction: Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease. It is, therefore, a major concern in public health, requiring an early customized and multidisciplinary therapeutic management. Early diagnosis and treatment are key elements in the management of patients’ conditions. Objective: To assess the Evaluation the modalities of Rheumatoid Arthritis Management by General Practitioners in Bangladesh. Methods: We conducted a questionnaire survey targeting the community of GPs, operating both in the public and in the private sectors in all regions of the Bangladesh Population. The questionnaire was sent between February and June 2022. Confidentiality of participants was strictly maintained. The questionnaire included multiple choices questions and one clinical case closely related to good practice guidelines. With this goal in mind, a survey was conducted among GPs operating both in the public and in the private sectors in Bangladesh. Results: Out of 890 GPs patients selected, 110 GPs responded, representing a participation rate of 24.71%. Returned questions were analyzed, results were expressed as a percentage. Incomplete responses were excluded from the study. 54.1% of GPs worked in the public sector and 45.9% in the private. Mean number of RA patients seen monthly by GPs was 5.75 patients per month. Of all the surveyed GPs, 66.4% had a rheumatologist as a point of contact. With regard to diagnosing RA, half of the GPs were not familiar with the deadline for early diagnosis. One usually initiated corticosteroids at a dose of 15-20 mg / day. For ongoing monitoring f RA activity, 60% of GPs were unaware of DAS28, and 59% did not know the new 2010 diagnostic criteria. For first-line therapy, 42% did not consider Methotrexate as the standard first-line treatment for patients with RA. For 83% of GPs, treatment could be initiated beyond 3 months of the window of opportunity. A substantial majority of them expressed their wish to receive ....","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363679","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":"Sociodemographic and Clinical Profile of Tubercular Meningitis Patients without Pulmonary Signs and Symptoms","authors":"Sayat Quayum, Md. Titu Miah, Tanzila Ferdous, Suriya Shahaly, Sayeda Moni Chowdhury, Faisal Bin Yousuf, Shamah Marzuqah","doi":"10.36347/sjams.2023.v11i08.030","DOIUrl":"https://doi.org/10.36347/sjams.2023.v11i08.030","url":null,"abstract":"Background: Among the different forms of CNS tuberculosis, tubercular meningitis (TBM) is the most frequent one. Early diagnosis and treatment of tubercular meningitis (TBM) can give an excellent outcome with minimal residual morbidity. Sociodemographic and clinical findings of patients with or without pulmonary signs and symptoms may be useful for the early diagnosis and treatment of suspected TBM patients. Aim of the study: This study aimed to make a sociodemographic and clinical profile of tubercular meningitis patients without pulmonary signs and symptoms. Methods: This was a cross-sectional study that was conducted in the Department of Medicine, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from September 2020 to August 2021. A total of 77 diagnosed cases of tubercular meningitis without pulmonary signs and symptoms admitted to the mentioned hospital were included in this study as the study population. In sample selection, a purposive sampling technic was used. Along with the sociodemographic as well as clinical findings, all relevant information was recorded in a data collection sheet. After completion, data analysis was done by SPSS 23.0. Results: The mean age of our respondents was 37.93±11.8 years; 53.2% of them were male and 46.8% were female. The majority of the respondents were service holders (32.5%) and the majority (57.1%) of the patients had middle-family income. In this study, 61% of the study population had a family history of TB. As for the clinical features of TBM, we observed that all of the study subjects had a fever, 80.5% had a headache, 68.8% had altered sensation, 62.3% had anorexia and nausea, 55.8% had vomiting, 19.5% had convulsions and 15.6% had neck stiffness. The majority (46.8%) of the respondents had TBM Grade II. In total, 58.4% of the respondents had Mantoux test positive and 41.6%, whereas 36.4% showed chest X-ray positive for TB. Conclusion: The prevalence of tubercular meningitis without pulmonary signs and ........","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136284021","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":"Detection of Extended Spectrum Beta Lactamase Producing Escherichia Coli and Klebsiella Species Isolated from Urine Samples of UTI Patients by Phenotypic and Genotypic Methods","authors":"Shrabanti Barua, Saikat Barua, Parash Ullah, Shamim Ara Keya, Chusung Ching Marma, Dipa Basak","doi":"10.36347/sjams.2023.v11i08.001","DOIUrl":"https://doi.org/10.36347/sjams.2023.v11i08.001","url":null,"abstract":"Background: Escherichia coli and Klebsiella spp. are the most common organisms causing urinary tract infection (UTI) and commonly responsible for extended spectrum beta lactamase (ESBL) production. This study was carried out to detect ESBL producing uropathogenic Escherichia coli and Klebsiella spp. by phenotypic and genotypic method. Rapid and accurate detection of ESBL producing E. coli and Klebsiella spp. has an important role to avoid treatment failure. Materials and Methods: This was a cross sectional observational study and carried out in department of microbiology in Chittagong Medical College, Bangladesh from January to December 2017. Urine was collected from suspected UTI patients and standard microbiological and biochemical tests were carried out. ESBL producing E. coli and Klebsiella spp. were identified by phenotypic confirmatory disc diffusion test (PCDDT). Polymerase chain reaction (PCR) was performed by using standard protocol with specific primers. Results: 448 urine samples were collected. Among them, 140 showed bacterial growth; 72 were E. coli and 35 were Klebsiella spp. Among E. coli 38(52.8%) and in Klebsiella spp. 15(42.9%) were detected as ESBL producers by PCDDT respectively. Among E. coli, 41(56.9%) and in Klebsiella spp. 21(60%) strains produced ESBL genes by PCR. Out of 38 phenotypically positive E. coli, 7 strains do not carry any detectable genes. Similarly, out of 15 phenotypically positive Klebliella spp. 3 isolates did not produce any detectable gene. On the other hand, 10 E. coli isolates and 9 Klebsiella spp. carry detectable genes although these were not phenotypically ESBL producers. Moreover, ESBL producing E. coli and Klebsiella spp. showed more multidrug resistant than Non-ESBL producing E. coli and Klebsiella spp. Conclusion: This study revealed that large portion of E. coli and Klebsiella spp. was ESBL producers. PCR can detect some additional cases of ESBL producing isolates. So, PCR can be used along with phenotypic ......","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135064463","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 of Total Serum Immunoglobulin Level, Sputum and Peripheral Eosinophil Count in Assessing the Clinical Severity in Bronchial Asthma","authors":"Dr. Stephen Anand, Dr. K. Ramesh Kumar, Dr. Siva Prasad, Dr. T. Prashanth, Dr. Ramshankar Dr. Ramshankar","doi":"10.36347/sjams.2023.v11i02.018","DOIUrl":"https://doi.org/10.36347/sjams.2023.v11i02.018","url":null,"abstract":"Correlation of total serum immunoglobulin E level, sputum and peripheral eosinophil count in assessing the clinical severity in bronchial asthma. Higher percentage of sputum Eosinophil count is present in moderate and severe persistent asthma. Higher percentage of absolute eosinophil count is present in moderate and severe persistent asthma.","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135385036","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 Impact of Functional Insulin Therapy on the Psychological Aspect of Type Diabetics","authors":"S. Bammou, A. Ait Yahya, G. El Mghari, N. El Ansari","doi":"10.36347/sjams.2023.v11i01.030","DOIUrl":"https://doi.org/10.36347/sjams.2023.v11i01.030","url":null,"abstract":"Functional insulin therapy is an educational method that is part of a strategy to intensify type 1 diabetes in order to optimize the balance of diabetes while improving the psychological aspect of the patient. The Aim: of this study is to assess the impact of functional insulin therapy on the psychological aspect of type 1 diabetics. Patients and Methods: This is a retrospective and analytical descriptive study, conducted from March 2019 to August 2019, we included 20 type 1 diabetic patients who benefited from a functional insulin therapy education program and an evaluation of the psychological impact made by a questionnaire and a psychological interview. Results: Out of a total number of 20 patients benefited from education between March 2019 to August 2019: 6 men, 14 women, average age of 20 years, average duration of diabetes of 8 years, 80% are students. Functional insulin therapy is used exclusively in all patients. The questionnaire shows an improvement in the perception of the impact of diabetes in (66%), there is a decrease in anxiety in (75%), With 16 patients or (80%) declaring satisfaction with the method, 12 patients either (60%) declared an acceptance of the treatment, 14 patients or (70%) reported more autonomy and self-management, 8 patients or (40%) reported an improvement in their socio-professional relations, The doctor-patient relationship is improved in (90%) of patients. According to the open questions, functional insulin therapy brings better control of diabetes and food freedom. The difficulties mainly felt are the calculation of the quantities of carbohydrates, the economic constraint: the cost of the insulin pens and capillary blood glucose strips and the multiple injections: more than four times a day and self- monitoring six times a day. Conclusion: The results suggest that learning functional insulin therapy improves the psychological aspect of type 1 diabetics through better control of the disease.","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135694992","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":"Assessment of Severity of Peritonitis Using Mannheim Peritonitis Index","authors":"Abhishek Kumar, Ashok Kumar Gupta","doi":"10.36347/sjams.2020.v08i03.042","DOIUrl":"https://doi.org/10.36347/sjams.2020.v08i03.042","url":null,"abstract":"Original Research Article Background: Despite advancement in diagnosis, management and critical care of patients with peritonitis due to various etiology, prognosis remain poor. Early assessment by scoring system will influence the management and prognosis. Aim: Evaluation of Mannheim Peritonitis Index Score for predicting the outcome in patients with peritonitis. Material and Method: Prospective study of 100 patient admitted and operated in National Institute of Medical Sciences & Hospital. The structured scoring system i.e. Mannheim Peritonitis index was applied along with other clinical and biochemical parameter recorded in pre-structured Performa. Data was analyzed for predicting mortality and morbidity. Results: In present study the mortality was found to be 17% with mean MPI score 31.35 with a standard deviation of 5.2 while in cured group the mean MPI score was 17.78 with a standard deviation of 6.3. The p value is highly significant as it was < .0001. Conclusion: MPI is disease specific, easy scoring system for predicting the mortality in patient with peritonitis. Increasing score are associated with poorer prognosis, needs intensive management and hence it should be routinely in clinical practice.","PeriodicalId":471520,"journal":{"name":"Scholars journal of applied medical sciences","volume":" 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141220935","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}