Indian Journal of Clinical Medicine最新文献

{"title":"Outbreak Investigation of a “Mystery Illness” Among Students in a Coastal School in North Kerala, India","authors":"R. Vaman, Anu Elizabeth Augustine, M. Kalyanasundaram, Manoj Murhekar","doi":"10.1177/26339447241261116","DOIUrl":"https://doi.org/10.1177/26339447241261116","url":null,"abstract":"An outbreak of acute headache, weakness, breathing difficulty and gastrointestinal symptoms occurred among schoolchildren who went near the seashore of a coastal school in North Kerala, India. This article describes a field investigation conducted in response to this outbreak. The overall attack rate was 47% among schoolchildren on the seashore, with a higher rate of 76% among girls. The symptoms subsided uneventfully within 1 day. The investigation team suspected heat stress, mass hysteria or harmful algal blooms. Our team could not identify the cause of the outbreak even after extensive environmental investigations. We recommend training and capacity building for public health specialists in the district’s rapid response team on environmental epidemiological methods to promptly respond to future events.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"2 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141919875","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 Course of Recovery From Moderate and Severe COVID-19 and its Sequelae: A Three-month Observational Follow-up Study in Indian Population","authors":"Deepika Gupta, Jony Garg, S. Palta, Kshitiz Vashista, Deepanshu Dhiman","doi":"10.1177/26339447241235456","DOIUrl":"https://doi.org/10.1177/26339447241235456","url":null,"abstract":"Introduction: Challenges associated with COVID-19 are not only associated with its acute phase but also with its sequelae. Multiple studies have been conducted on long-term follow ups of patients suffering from COVID-19. In a detailed search of the literature, we did not find any long-term follow up study in the Indian population. Methodology: The present study is an ambi-directional observational follow up study. A total of 83 patients were included in the study and a follow up was conducted at 2, 6 and 12 weeks after recovery from acute phase of moderate to severe COVID-19. The primary objective was to identify symptoms pertaining to respiratory, cardiac, neurological and mental health in post-COVID period. Secondary objectives were to identify patients consistent with a diagnosis of post-COVID syndrome and to assess the difference in the recovery profile between moderate and severe cases. Results: Significant improvement was observed in fatigue, cough, SpO2, breath-holding time and EuroQL-5D with maximum improvement by 12 weeks of recovery. Patients having longer ICU stays and requiring non-invasive ventilation had a longer persistence of symptoms. Forty-five patients had symptoms persistent even after 12 weeks consistent with a diagnosis of post-COVID syndrome. Conclusion: We observed 50% of the patients in the cohort had complete resolution of symptoms by six weeks follow up. Therefore, a follow up period of at least six weeks is warranted for all patients suffering from moderate to severe COVID-19, along with continuous screening of patients who tend to develop post-COVID-19 syndrome.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"203 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140750400","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":"Nephrotic Syndrome with Eosinophillic Ascites: A Case Report","authors":"R. Ravi, Jinsi N., Sreeja S. Nair, Vimala A.","doi":"10.1177/26339447241234148","DOIUrl":"https://doi.org/10.1177/26339447241234148","url":null,"abstract":"Minimal change disease (MCD) as a cause of nephrotic syndrome in the elderly is seen in around 15%–20% of patients. Also eosinophillic gastroenteritis (EGE) is a very rare disease. The association with minimal change nephropathy and EGE is even rarer and to the best of our knowledge there is only a single case report of the same. Theoretically atopy is a common factor in the pathogenesis of both diseases and both may be IgE mediated. Here we present the case of a gentleman with nephrotic syndrome who underwent abdominal paracentesis and was found to have eosinophillic ascitis. Renal biopsy including electron microscopy was suggestive of minimal change disease. He responded completely on starting steroids with resolution of ascitis, proteinuria and decrease in IgE levels.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"9 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140254151","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":"Seizures as the Cardinal Manifestation of \u2028Idiopathic Intracranial Hypertension: A Case Report","authors":"Camelia Porey, B. Jaiswal","doi":"10.1177/26339447241234166","DOIUrl":"https://doi.org/10.1177/26339447241234166","url":null,"abstract":"Idiopathic intracranial hypertension (IIH) conventionally presents with features like headache, visual obscuration, diplopia and tinnitus. We present a case of a middle-aged male patient with headache and visual complaints and concurrent drug-resistant right focal seizures. Imaging revealed the presence of a left petrous bone defect with temporal lobe encephalocele with other features suggestive of IIH. Resolution of the symptoms was obtained after placement of theco-peritoneal shunt. Focal seizures in IIH are a rare phenomenon, precipitated by parenchymal herniation through eroded bony defects producing encephaloceles leading to tissue traction and ictal focus formation. In evaluation for drug-resistant temporal lobe epilepsy, IIH-induced encephalocele formation should be carefully considered.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"223 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140265304","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":"An Unusual Case of Isolated Right Ventricular Thrombus and Bilateral Extensive Pulmonary Thromboembolism in an Adult with Nephrotic Syndrome Occurring Five Years after the Diagnosis: A Case Report","authors":"Balijepalli Gopala K. Sudhakar","doi":"10.1177/26339447231214871","DOIUrl":"https://doi.org/10.1177/26339447231214871","url":null,"abstract":"It is an established fact that nephrotic syndrome is associated with a heightened risk of thromboembolic complications including deep vein thrombosis (DVT), renal vein thrombosis (RVT) and pulmonary thromboembolism (PTE). Intra-cardiac thrombi are not uncommon but predominantly involve left atrium (LA), right atrium (RA) and left ventricle (LV). However, Isolated right ventricular (RV) thrombus in an adult with nephrotic syndrome was very rarely reported. Common causes of intra-cardiac thrombi include LV dysfunction, atrial fibrillation (AF), mitral stenosis (MS), nephrotic syndrome, cardiac prosthetic valves, indwelling central venous catheters, pacing leads, anti-phospholipid antibody syndrome, hyperhomocysteinemia, infection with COVID-19 virus, Behcet’s disease and congenital thrombophilia. Above conditions can cause intra-arterial, intravenous, as well as, intra-cardiac thrombi. Patients with nephrotic syndrome especially due to membranous glomerulonephritis can develop a hypercoagulable state in greater than 25% of adult patients. The risk of thrombosis was noted to be highest in the first three to six months after diagnosis. The exact incidence and prevalence of venous thromboembolism (VTE) are unknown in nephrotic syndrome. We are reporting a rare case of isolated RV thrombus presenting as acute PTE five years after initial diagnosis of nephrotic syndrome due to membranous glomerulonephritis which responded to thrombolytic therapy. There were only three case reports of isolated RV thrombus in an adult with nephrotic syndrome published so far.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139624439","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":"Cardioprotective Effect of Nano Gold Kalimag Injection via Inhibiting Oxidative Stress and Improving Myocardial Energy Metabolism in Ischemic Heart Injury Model","authors":"Jin-A Cha, Un-Rim Sim, Song-Chol Mun, Ji-Myong Kim, Kwon-Gi Kang, Sol-Hyang Choe","doi":"10.1177/26339447231214858","DOIUrl":"https://doi.org/10.1177/26339447231214858","url":null,"abstract":"Many people worldwide die from cardiovascular diseases. Myocardial ischemia can be induced by atherosclerosis, and the main factor responsible for atherosclerosis is the deposition of lipid peroxide in vessels. Therefore, atherogenesis may be prevented and treated at the cellular level by preventing oxidative stress using the properties of nanogold, magnesium and potassium. In this study, we have elucidated the cardioprotective effect of Nano Gold Kalimag injection (NGKM) in the ischemic heart injury model in rats. The ischemic heart injury models were made with adrenaline and pituitrin, and a few myocardial damage-related parameters of the models were observed after NGKM injection. After NGKM injection, the levels of lactate dehydrogenase (LDH), aspartate transamiase (AST), and creatine kinase (CK) in an ischemic heart injury model in rats were detected, and TTC staining and H&E staining were performed. In addition, in the myocardial tissues of rats, superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), catalase, and Na+-K+-ATPase activity were measured, and lactate content and ATP content were measured. NGKM can reduce the infarct area in the ischemic heart injury model and significantly lower LDH, AST, and CK levels. SOD, GSH-Px, and arterial tissue CAT levels significantly increased compared to the model, and MDA contents significantly decreased in myocardial tissue compared to the model group. In addition, myocardial tissue ATP content and Na+-K+-ATPase level in myocardial tissues significantly increased compared to the model group, and lactate content in myocardial tissue significantly decreased compared to the model group. Our findings suggest that NGKM injection has cardioprotective effects by inhibiting oxidative stress in an ischemic heart injury model in rats.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"12 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139439744","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":"Advancement of HIV and Co-infections: A Prospective Observational Study","authors":"J. Ahuja, M. Soneja, N. Wig, Ashutosh Biswas, I. Xess, Gagandeep Singh, Deepti Vibha, N. Nischal","doi":"10.1177/26339447231179577","DOIUrl":"https://doi.org/10.1177/26339447231179577","url":null,"abstract":"To assess the incidence of comorbidities and opportunistic infections (OIs) in advanced HIV. This is a prospective observational study conducted on people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) with a laboratory-confirmed cluster of differentiation-4 (CD4) counts <100/mm 3 . Recruitment of 102 PLHA patients was performed with no filtering criteria based on the duration of diagnosis, antiretroviral therapy (ART) naive, or ART failure. Data collection was initiated post-clearance by the Institutional Ethics Committee. The study was conducted at the tertiary care center. The prevalence of underlying comorbidities and the incidence of multiple OIs were assessed in 102 HIV patients with CD4 <100/mm 3 . A detailed clinical examination was carried out, and all relevant investigations were digitally recorded. The mean age of the participants among the 102 PLHA with a CD4 count of 100/mm 3 was 41.4 + 11.2 years, and their mean CD4 count was 62.3 + 20.5/mm 3 at the time of recruitment. A total of 62 (60.8%) patients were ART-naive. The two most prevalent comorbidities in the research population were anemia and renal failure. Fungal infections (66.6%) in the study cohort varied from the most frequent oral thrush (42.1%) to disseminated histoplasmosis (7.8%). Tuberculosis was the second most prevalent opportunistic illness (36.2%). Syphilis cases were prevalent (8.8%) among sexually transmitted illnesses linked to HIV, with most of the cases being latent syphilis; 3.9% of the patients were coinfected with chronic hepatitis B and HIV, and only one possessed chronic hepatitis C. Comorbidities and OIs are major public health concerns in Indian healthcare settings. Our findings show that the prevalence of comorbidities and OIs is high. Furthermore, late diagnosis with HIV, a CD4 count <100/mm 3 , and poor adherence indicate an increased incidence and decreased survival time among PLHA with underlying comorbidities and OIs . Early care-seeking and the beginning of ART, as well as ongoing monitoring of patients to ensure they take their medication on schedule, are critical to reducing OIs and improving general health. Further research is highly recommended to gain deeper insights.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"19 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139389580","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":"A Case Report of Potassium Permanganate Poisoning: How to Manage Successfully","authors":"Shaveta Dahiya, Rohit Sharma, Raj Kumar, H. K. Aggarwal, Manish Kumar, Gaurav Rathee","doi":"10.1177/26339447231214411","DOIUrl":"https://doi.org/10.1177/26339447231214411","url":null,"abstract":"KMnO4 is a highly corrosive and powerful oxidizing agent with reported lethal dose of 10 g in adults. Poisoning by ingestion is associated with a wide range of local and systemic complications including ARDS and multi-organ failure. Very few cases of KMnO4 poisoning have been reported until now. As no antidote is available for KMnO4 poisoning, only supportive management is given, which includes airway securing on a priority basis. N-acetyl cysteine is given as an empiric treatment to prevent hepatic injury, and endoscopy is very useful in locating and seeing the severity of injury in the esophagus and stomach and is also helpful in guiding the treatment of such patients. This case report highlights the successful management of a patient with KMnO4 poisoning (by ingestion) with rapid interventions in preventing further damage and hastening the recovery.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138521","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":"Histoplasmosis: A Mimicker of Granulomatosis with Polyangitis","authors":"Sreedevi Suresh, Soumya Shylaja, A. Reghukumar, VS Kiran Kumar, Athul Gurudas, Betty Abraham","doi":"10.1177/26339447231214857","DOIUrl":"https://doi.org/10.1177/26339447231214857","url":null,"abstract":"A 31-year-old male from the southern part of India with no known comorbidities presented with painful oral erosions over his palate following a dental procedure. Over 2 months, it progressed to the desquamation of blackish necrotic skin, gingival hypertrophy associated with intermittent fever and odynophagia. He had elevated acute-phase reactants. Biopsy of the gingiva showed necrotising vasculitis. ANCA was weakly positive for the cytoplasmic pattern by immunofluorescence. The HRCT chest showed a single cavitating nodule in the right upper lobe and a non-cavitary nodule in the left upper lobe with right maxillary sinus thickening. With the above clinical and biopsy findings, granulomatosis with polyangiitis was the first consideration. He was referred to our centre since the oral lesions did not improve and nodular swellings developed on the palate. The examination showed cervical lymphadenopathy, which was subjected to an excision biopsy. It showed extensive areas of necrosis with karyorrhectic debris and numerous intracellular and extracellular round-to-ovoid spore-like structures. Special stains were positive for histoplasmosis. Abdomen imaging showed adrenal enlargement. Cultures were negative, which could be due to the fact that he was on multiple medications. He was treated with amphotericin and itraconazole. His symptoms improved. But later, he had worsening clinical parameters suggestive of a progressive disseminated form of histoplasmosis. In spite of aggressive efforts, he couldn’t be resuscitated owing to the dissemination of the organism. Even though considered to be more common in immunosuppressed individuals in nonendemic areas, it is reported in immunocompetent individuals as well and should be strongly suspected if the clinical picture fits so for early diagnosis and aggressive management to prevent fatal complications. There have been only fewer case reports of histoplasmosis from the southern part of India. ANCA is only rarely reported false positively in histoplasmosis.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139170517","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":"Successful Dilation and Stenting of Severe Tracheal Stenosis Following Brief Intubation","authors":"Riya Kataria, J. V. Balasubramaniyan, J. S. S. Murthy","doi":"10.1177/26339447231214401","DOIUrl":"https://doi.org/10.1177/26339447231214401","url":null,"abstract":"Tracheal stenosis following brief intubation is a relatively rare but serious problem. However, some degree of airway injury is common following intubation, regardless of the duration. We herein report a rare case of a female patient in her late sixties, who developed severe tracheal stenosis following just a weeklong intubation. The tracheal stenosis was successfully treated via dilation and stenting using a self-expanding metal stent.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"140 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139171656","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}