Current medical issues最新文献

{"title":"Dyke–Davidoff–Masson Syndrome – A Case Series","authors":"S. Sheetal, Joel Varghese Sujan, Athira Das, Vivek Mathai","doi":"10.4103/cmi.cmi_160_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_160_23","url":null,"abstract":"\u0000 Dyke–Davidoff–Masson syndrome (DDMS) refers to variable degrees of atrophy of one cerebral hemisphere, resulting from brain injury in intrauterine or early years of life. Clinical features of this rare syndrome include varying degrees of contralateral hemiplegia, facial asymmetry, seizures, and mental retardation. Specific neuroimaging findings include unilateral brain volume loss, ventriculomegaly, and compensatory bone hypertrophy. In addition to this, calvarial thickening and hyperpneumatization of frontal sinuses may occur. We hereby report three cases of this syndrome, with varied clinical and radiographic features, to highlight the wide spectrum of this syndrome.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785880","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":"Utility of Sensate Pedicled Medial Thigh Perforator Flaps in Treating Recurrent Ischial Ulcers in Individuals with Cauda Equina Lesions and Spinal Dysraphism – A Retrospective Analysis","authors":"Prashanth H. Chalageri, Thomas Anand Augustine, H. Magimairaj, B. Yadav","doi":"10.4103/cmi.cmi_166_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_166_23","url":null,"abstract":"\u0000 \u0000 \u0000 Ischial pressure ulcers pose a significant challenge due to their high recurrence rates. It is imperative to provide or establish a reliable, well-vascularized soft-tissue cover over the ischial area to prevent recurrences. The objective of the study was to study the utility and complication rates associated with pedicled medial thigh perforator (P-MTP) sensate flap procedures in managing recurrent ischial ulcers and perineal lesions.\u0000 \u0000 \u0000 \u0000 A retrospective cohort study was conducted at Christian Medical College, Vellore, a tertiary care center in South India. This study involved 30 patients with ischial pressure sores. Of these, 13 patients underwent P-MTP flaps, while 17 underwent alternative surgeries for ulcer closure (January 2014–June 2020).\u0000 \u0000 \u0000 \u0000 Among 13 patients who underwent P-MTP sensate flaps, 1 major complication (full-thickness flap necrosis) necessitated flap revision, while 6 minor complications occurred in the postoperative period. Three patients (23.08%) reported late recurrence of ulcers at the same postoperative site. In contrast, among the 17 patients who underwent the other (alternative) methods of surgical closure, 3 patients had wound dehiscence in the postoperative period. Four patients reported recurrence of ulcer at the postoperative site within 6 months and another four after 6 months of surgical closure. The surgical outcomes in sensate flap surgeries (P-MTP flaps) were comparable to other approaches for surgical closure. Sensation in the P-MTP flap transposed over the ischial region remained intact in all 13 patients at 6-month follow-up.\u0000 \u0000 \u0000 \u0000 The P-MTP sensate flap is a feasible and reliable treatment strategy for regional soft-tissue reconstruction in ischial and perineal lesions with postoperative complications comparable to other surgical methods for ischial ulcer closure. The sensate flap surgeries offer the additional benefit of maintaining intact sensation over the pressure injury vulnerable ischial region.\u0000","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"136 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762170","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":"Diagnosis of Cystic Fibrosis Beyond Childhood in India","authors":"Priyanka Medhi, Barney Thomas Isaac, Richa Gupta, B. Thangakunam, S. Chandy, SnehaDeena Varkki","doi":"10.4103/cmi.cmi_150_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_150_23","url":null,"abstract":"\u0000 Cystic fibrosis (CF) is a life-limiting genetic condition with multisystemic manifestations. However, there are vast phenotypic as well as genotypic variations. This contributes to delay in diagnosis, especially in pancreatic-sufficient patients who may not manifest typical symptomatology. The last decade has witnessed significant breakthroughs in CF therapeutics. This in combination with early diagnosis through newborn screening, and aggressive supportive care can offer near-normal life expectancy for a majority of patients with CF (pwCF) worldwide. Even while addressing disparities in CF care around the world, it is crucial to train medical professionals to suspect and diagnose CF in children as well as in adults. Here, we share our experience of pwCF diagnosed beyond 16 years of age with an aim to highlight the clinical presentations in young adults, the need for screening family members of a newly diagnosed pwCF, and the negative effects of late diagnosis of CF.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"49 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768457","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":"Rhythm Generating Mechanisms in Rat Sinoatrial Node","authors":"Jesi Charles, Latha Nedumaran, Swetha Raman, Elizabeth Vinod, Rajalakshmi Rajasegaran, Kamalakannan Vadivel, A. Bhaskar, Sathya Subramani","doi":"10.4103/cmi.cmi_124_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_124_23","url":null,"abstract":"\u0000 \u0000 \u0000 The major membrane currents responsible for sinoatrial (SA) rhythm generation are generally studied in isolated cardiac cells using electrophysiological tools. Such studies are resource and labor-intensive.\u0000 \u0000 \u0000 \u0000 Here, we have studied four major currents in isolated rat heart preparations, perfused in Langendorff mode, and demonstrate that this is a good preparation for such studies. Heart rates of isolated perfused rat hearts were recorded using surface electrocardiogram before and after perfusion with drugs and solutions that affect the four major currents responsible for SA rhythm generation.\u0000 \u0000 \u0000 \u0000 The rates of whole isolated hearts beating with SA rhythm decreased with cesium and decreased by about half with ivabradine, both blockers of the funny current (If). Importantly, the rhythm was not abolished even with a high dose of ivabradine at which total blockade of If is expected. The rate was not affected by nickel, a blocker of T-type calcium current. The SA rhythm was abolished by the reduction or removal of sodium from the perfusate (interventions that inhibit the calcium-extrusive mode of the sodium-calcium exchanger) or by nifedipine, the L-type calcium channel blocker.\u0000 \u0000 \u0000 \u0000 The inferences made based on these observations are (a) If contributes significantly to pacemaking, (b) ICaT does not play a role and (c) INCX and ICaL are obligatory rhythm-generating currents in the SA node. Cyclical calcium release from SR during diastole (the calcium clock), responsible for driving INCX in its forward mode is probably a phenomenon independent of membrane events, as total If blockade did not abolish rhythm generation. These results corroborate with published literature where most studies were done on single cells.\u0000","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"32 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771567","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 6-year Retrospective Study on the Clinical Profile and Outcomes of Postrenal Transplant Patients in the Emergency Department","authors":"Rashid Tariq Rashid Alshamsi, D. Hazra, A. Al-Alawi","doi":"10.4103/cmi.cmi_167_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_167_23","url":null,"abstract":"\u0000 \u0000 \u0000 Kidney transplantation is widely recognized as the primary treatment for those with end-stage renal disease. Our goal was to provide an overview of the clinical characteristics of postrenal transplant patients (commercial vs. noncommercial) seeking care in the emergency department (ED).\u0000 \u0000 \u0000 \u0000 The study was conducted at a leading Omani ED from 2015 to 2021; this study included all postrenal transplant patients. Various variables were categorized, coded, and analyzed.\u0000 \u0000 \u0000 \u0000 A total of 55 postrenal transplant patients were included in our study. Of these, 60.0% were male (n = 33). Among the participants, 14.5% (n = 8) had undergone noncommercial renal transplants, whereas the remaining 85.5% (n = 47) had undergone commercial renal transplants. Among noncommercial postrenal transplant patients, the most common reasons for ED visits were fever (5), gastrointestinal symptoms (4), and cardiac symptoms (3). They also presented with pain at the surgical site (2) and urological symptoms such as dysuria and hematuria (2). In contrast, the most frequent clinical presentations among commercial postrenal transplant patients were cardiac symptoms (13) and pain at the surgical site (13), followed by fever (12). Noncommercial renal transplant patients had a high discharge rate of 62.5% (5) and a low admission rate of 37.5% (3). On the other hand, commercial renal transplant patients necessitated a high admission rate of 59.6% (28) and a low discharge rate of 40.4% (19).\u0000 \u0000 \u0000 \u0000 The majority of patients had received commercial kidney transplants, and the most common complaints upon their presentation to the ED were cardiac symptoms and pain at the surgical site. Patients undergoing commercial transplants had higher rates of admission.\u0000","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"214 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779615","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":"Compound Odontome Causing Agenesis of Mandibular Canine","authors":"Ashwin K Harekal, S. Buch","doi":"10.4103/cmi.cmi_5_24","DOIUrl":"https://doi.org/10.4103/cmi.cmi_5_24","url":null,"abstract":"","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764808","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":"Prevalence of Depression, Anxiety, and Stress along with Coping Strategy and Work-related Sense of Coherence in Anesthesia Care Providers during the COVID-19 Pandemic in a Tertiary Care Hospital: A Cross-sectional Study","authors":"Meghna Jiwanmall, Jerry Joseph Joel, Aparna Williams, S. Jiwanmall, Bharath Kumar, Ekta Rai","doi":"10.4103/cmi.cmi_4_24","DOIUrl":"https://doi.org/10.4103/cmi.cmi_4_24","url":null,"abstract":"\u0000 \u0000 \u0000 Numerous studies have reported the prevalence of psychological issues in anesthesia professionals during stressful situations like the COVID-19 pandemic; however, there are limited data exploring the coping strategies and work satisfaction in this workforce during the pandemic.\u0000 \u0000 \u0000 \u0000 In this observational cross-sectional study, three validated questionnaires, namely, the Depression, Anxiety and Stress Scale 21, the Brief-Coping Orientation to Problems Experienced inventory, and the Work-related Sense of Coherence (Work-SoC) scale, were handed out to 150 anesthesia health-care providers (doctors and allied health staff [AHS]). The prevalence of depression, anxiety, and stress; Work-SoC conditions; and coping strategies were compared between groups of participants based on age (<30 years vs. ≥30 years), gender (males vs. females), and occupation (doctors vs. AHS).\u0000 \u0000 \u0000 \u0000 Participants aged <30 years reported more depression (P = 0.0134) and stress (P = 0.0453) compared to participants aged ≥30 years. Younger participants used emotion-focused and avoidant coping styles, whereas older participants used coping styles that were emotion focused and problem focused. Similarly, a problem-focused coping style was observed frequently among both doctors and AHS. Work-SoC assessment showed that younger participants (P = 0.0088) and more AHS respondents (P = 0.000) attributed poor meaningfulness, but doctors reported poor comprehensibility (P = 0.058) to their working conditions.\u0000 \u0000 \u0000 \u0000 Younger professionals were more susceptible to stress and depression during the pandemic. Similar to AHS, they perceived work conditions as unrewarding and less meaningful. Doctors perceived working conditions as unmanageable, unpredictable, and unstructured. There were age-related differences in coping strategies where older adults engaged in more proactive coping.\u0000","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"40 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784928","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":"Health of Tribal Population in India: A Glimpse of the Current Scenario","authors":"Angel Ivy Linda, Debkumar Pal, N. Murmu, Manish Taywade","doi":"10.4103/cmi.cmi_153_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_153_23","url":null,"abstract":"\u0000 Article 366(25) of the Indian constitution refers to indigenous people as “scheduled tribes,” which constitute 8.6% of the country’s population. For decades, the health of the tribal people had remained neglected and incorporated in rural health care because of incorrect assumptions of their similar health needs to that of the rural population. An expert committee coordinating with the Ministry of Health and Family Welfare and the Ministry of Tribal Affairs provided a detailed report on the current scenario and recommendations related to tribal health in India. They considered the health-care needs of the tribal population, highlighted their specific health problems, and gave a roadmap of best approaches. The tribal population has a unique and higher burden of health problems than the mainstream population, influenced by their health-seeking behavior, lack of awareness and education, sociocultural and magico-religious beliefs, customs, and practices. The current health-care system incorporates their health needs with approaches such as differing population norms in tribal areas, nonmonetary incentives to staff, mobile medical units, identification of high-priority districts, and the emergence of the “Swasthya” portal. However, tribal health is transitioning as with the rest of the population. Moreover, the present health-care services are unable to address this. Legal recognition of indigenous peoples’ rights to self-determination, their land, natural resources, and their knowledge is a need of the hour.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"67 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795165","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":"Transitioning from Contrast-induced Nephropathy and Contrast-associated Nephropathy to Contrast-associated Acute Kidney Injury","authors":"D. Hazra, Edwin Stephen","doi":"10.4103/cmi.cmi_7_24","DOIUrl":"https://doi.org/10.4103/cmi.cmi_7_24","url":null,"abstract":"","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"181 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793837","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":"Should Medicine be Taught in Leading Medical Languages or the Mother Tongue?","authors":"Abdullah Ashraf Hamad, B. Amer","doi":"10.4103/cmi.cmi_123_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_123_23","url":null,"abstract":"\u0000 In non-English speaking developing countries, several debates have arisen over choosing the language of instruction in medical education, whether it should be one of the leading medical languages, such as English, or the mother tongue. In this article, we discuss this debate and provide a brief review of the pedagogical evidence supporting the superiority of the mother tongue as a language of instruction. We also highlight the academic challenges associated with second-language-based medical education and emphasize the impact of language of instruction on the doctor–patient relationship and health care. Finally, we examine the reasons or arguments for not including the mother tongue in medical education. In conclusion, the importance of English as a leading scientific and medical language should not overshadow the crucial role of the native language as the language of instruction in non-English speaking countries. Each country should develop strategies to include the mother tongue in medical education, following the example of developed countries.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"66 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760971","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}