APIK Journal of Internal Medicine最新文献_第4页

Aripiprazole “Induced” and Aripiprazole “Worsened” Parkinsonism 阿立哌唑“诱发”和“加重”帕金森病

APIK Journal of Internal Medicine Pub Date : 2023-09-12 DOI: 10.4103/ajim.ajim_13_23

Nagashree V Sharma, Kuldeep S Shetty

引用次数: 0

Double Trouble: A Case of Ictal Bradycardia Syndrome Complicating Temporal Lobe Epilepsy 双重困扰:发作性心动过缓综合征并发颞叶癫痫1例

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_27_23

Ganaraja Valakunja Harikrishna, Vivek Bhat, Suresha Kodapala

引用次数: 0

Association of Neutrophil-to-lymphocyte Ratio with Prognosis in Sepsis – An Observational Study from a Tertiary Care Center 中性粒细胞与淋巴细胞比值与脓毒症预后的关系——来自三级保健中心的观察性研究

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_23_23

Birjesh Kumar Thakran, Yogesh Kumar Chahar, Shikha Jain, Sundeep Jain

{"title":"Association of Neutrophil-to-lymphocyte Ratio with Prognosis in Sepsis – An Observational Study from a Tertiary Care Center","authors":"Birjesh Kumar Thakran, Yogesh Kumar Chahar, Shikha Jain, Sundeep Jain","doi":"10.4103/ajim.ajim_23_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_23_23","url":null,"abstract":"Abstract Objectives: This study aims to determine the association of neutrophil-lymphocyte ratio (NLR) with sequential organ failure assessment (SOFA) score, ventilator use, duration of intensive care unit (ICU) stay, and mortality among patients with sepsis. Methods: This prospective observational study included 220 patients with sepsis admitted to the ICU. Details such as age, gender, comorbidities, complaints, SOFA score, diagnosis, and outcomes were collected. Routine investigations included complete blood count, C-reactive protein, and procalcitonin. NLR was derived using the Beckman Coulter DXH-800 Hematology Analyser. A cutoff of 9.11 was taken as high NLR. Patients were followed up till 28 days after treatment. The outcomes studied included 28-day mortality and ICU stay. Results: The mean SOFA score were 7.07 ± 2.56. Based on NLR cutoffs, 146 (66.36%) patients had high NLR while 74 (33.64%) cases had normal or low NLR. SOFA score showed no significant association with high NLR ( P = 0.62). Ventilator was used in 118 (53.6%) cases with median of 3.5 days’ duration. The overall ICU stay was 5.6 ± 4.9 days. Mortality was seen in 46 (20.9%) cases. Compared to those with normal NLR, patients with high NLR had significantly more ventilator use (60.9% vs. 39.1%, P = 0.0027) and mortality (30.14% vs. 2.7%, P = 0.0004). The duration of ventilator use and ICU stay was statistically comparable. Conclusion: High NLR shows a significant association with adverse outcomes of sepsis patients in terms of ventilator use and mortality. Since it is cheap and easy to use, it can be applied in more basic settings while monitoring sepsis patients.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135980846","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}

引用次数: 0

Estimation of Risk and Proportion of Coronary Artery Disease in People Living with HIV/AIDS in Indian Setting: A Pilot Study 印度艾滋病毒/艾滋病感染者冠状动脉疾病风险和比例的估计:一项试点研究

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_33_23

Anmol Sharma, Amitabh Sagar, Navreet Singh

{"title":"Estimation of Risk and Proportion of Coronary Artery Disease in People Living with HIV/AIDS in Indian Setting: A Pilot Study","authors":"Anmol Sharma, Amitabh Sagar, Navreet Singh","doi":"10.4103/ajim.ajim_33_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_33_23","url":null,"abstract":"Abstract Objective: The objective of this study was to assess the Framingham Risk Score as well as the prevalence of coronary artery disease (CAD) in people living with HIV/AIDS (PLHA) male patients, in an Indian setting. Design: This descriptive pilot study was conducted in a multispecialty hospital which is a reference center for HIV/AIDS. Materials and Methods: The study included 50 HIV-positive male patients who underwent basic biochemical analysis, namely lipid profile, blood sugar (fasting), electrocardiogram, CD4 count along with basic personal history (including smoking habits and lifestyle), course of disease progression, and drug history. All were subjected to a two-dimensional echocardiogram and treadmill test (TMT). Subjects with a positive TMT underwent a confirmatory stress thallium/coronary angiography. Framingham Risk Scores were calculated, using standard scoring charts. Standard protocol forms were made for each patient. Results: The median diagnosed duration of HIV disease was 2.8 years (range: 0.5–7 years). The median 10-year risk of CAD (as calculated from the Framingham scores) was 1%. Major contributing risk factors were dyslipidemia, diabetes, and hypertension and were found to be greater as compared to published literature. Four patients had positive TMT, but all four had a negative, coronary angiogram. Conclusions: Biological plausibility suggests that CAD may be more common in PLHA due to the chronic inflammatory nature of the disease and the effects of the dyslipidemia effect of ART; however, our pilot study with the limitations could not substantiate this.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135981262","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}

引用次数: 0

Nosocomial Infection in MICU: An Observational Study icu院内感染:一项观察性研究

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_48_23

Chennakesavulu Dara, Surendra Babu Darivemula, Triven Sagar Sandepogu, M. Saranya, N. Vijayalakshmi, S. Swetha

{"title":"Nosocomial Infection in MICU: An Observational Study","authors":"Chennakesavulu Dara, Surendra Babu Darivemula, Triven Sagar Sandepogu, M. Saranya, N. Vijayalakshmi, S. Swetha","doi":"10.4103/ajim.ajim_48_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_48_23","url":null,"abstract":"Abstract Introduction: Nosocomial infections are infections; patients acquire while admitted to a health-care facility and generally develop 48 h or later after admission. These infections can lead to serious problems such as sepsis and even death. Materials and Methods: A prospective observational study was conducted for 6 months to estimate the incidence of nosocomial infections acquired in the medical intensive care unit (MICU), their risk factors, the causative pathogens, and the outcome. The patients admitted for more than 48 h to the MICU and willing to give consent were included in the study. Of 496 patients in MICU, 216 patients stayed 48 h and Acute Physiology and Chronic Health Evaluation II (APACHE II) score during the first 24 h of admission to the MICU. Results: The incidence of nosocomial infections in MICU was 14.9% (32 out of 216). Age, APACHE II score >13, MICU stay >7 days, and comorbidities such as peripheral venous line, central venous catheter, duration of urinary catheterization, duration of endotracheal intubation, nasogastric tube, and mechanical ventilator of >7 days were found to be independent risk factors of acquiring nosocomial infections ( P < 0.05). Important causative organisms for nosocomial infections were Pseudomonas aeruginosa in 18 patients (32.72%), Escherichia coli in 11 (20.0%), Acinetobacter species in 8 (14.54%), and Klebsiella pneumoniae in seven patients (12.72%). Mortality among patients with nosocomial infections was 25% (8/32) and among those without nosocomial infections was 6.5% (12/184), P = 0.002. The length of ICU stay was higher in patients with nosocomial infections (15.42 ± 6.93 days) than in those without nosocomial infections (6.7 ± 5.14 days), P < 0.001. Conclusion: Nosocomial infections are common in ICU settings and contribute to significant mortality and morbidity. Infection control strategies are necessary to reduce nosocomial infection rates as well as ICU mortality and morbidity.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135980683","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}

引用次数: 0

Chronic Vitamin D Deficiency and its Effects on Human Health: A Literature Review 慢性维生素D缺乏及其对人体健康的影响:文献综述

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_47_23

Maria Nefeli Georgaki, Charalampos Georgakis, Marianna Charalambous, Katerina Mamisi, Sofia Karachrysafi

{"title":"Chronic Vitamin D Deficiency and its Effects on Human Health: A Literature Review","authors":"Maria Nefeli Georgaki, Charalampos Georgakis, Marianna Charalambous, Katerina Mamisi, Sofia Karachrysafi","doi":"10.4103/ajim.ajim_47_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_47_23","url":null,"abstract":"Abstract Introduction: Vitamin D plays a vital role as an essential nutrient for human health, but a significant number of people worldwide have a deficiency in this vitamin. Chronic Vitamin D deficiency has been linked to several adverse health outcomes, including musculoskeletal disorders, cardiovascular disease (CVD), cancer, and autoimmune disorders. Methodology: We conducted a comprehensive literature search using academic databases, including PubMed, MEDLINE, Scopus, and Google Scholar. The search terms included “Vitamin D deficiency,” “chronic disease,” “musculoskeletal disorders,” “cardiovascular disease,” “cancer,” and “autoimmune disorders.” We focused on articles that examined the link between chronic Vitamin D deficiency and various health outcomes. Results: Studies suggest that Vitamin D deficiency may contribute to several chronic diseases, including osteoporosis, osteoarthritis, hypertension, and CVD. Evidence indicates that inadequate levels of Vitamin D can increase the risk of certain types of cancer, such as colorectal and breast cancer. Studies have also found that people with autoimmune disorders, such as type 1 diabetes, multiple sclerosis, and rheumatoid arthritis, have lower levels of Vitamin D compared to healthy individuals. Conclusions: The findings of this literature review highlight the importance of identifying and treating chronic Vitamin D deficiency to prevent or manage associated health conditions. Strategies to prevent Vitamin D deficiency include increased sun exposure, dietary changes, and Vitamin D supplementation. Regular screening for Vitamin D deficiency may also be necessary, particularly in high-risk populations. Clinicians should consider Vitamin D status when evaluating patients with chronic diseases and take appropriate steps to address any deficiencies.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135981002","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}

引用次数: 0

An Interesting Case of Sjögren’s Syndrome Presenting with Hypokalemic Quadriparesis and Distal Renal Tubular Acidosis 一例有趣的Sjögren综合征，表现为低钾性四肢瘫和远端肾小管酸中毒

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_28_23

M. Bhanukumar, Prakruthi Mohan, Nimrah Fathima, A. N. Venkatesh Darshan

引用次数: 0

Our Experience on Unusual Manifestations of Hansen’s Disease - A Case Series 我们对汉森病异常表现的经验-一个病例系列

APIK Journal of Internal Medicine Pub Date : 2023-09-11 DOI: 10.4103/ajim.ajim_9_23

Ganaraja Valakunja Harikrishna, C. A. Jayashankar, Sukriti Arora, Kavya Mala, A. S. Shalini

{"title":"Our Experience on Unusual Manifestations of Hansen’s Disease - A Case Series","authors":"Ganaraja Valakunja Harikrishna, C. A. Jayashankar, Sukriti Arora, Kavya Mala, A. S. Shalini","doi":"10.4103/ajim.ajim_9_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_9_23","url":null,"abstract":"Abstract Hansen’s disease is caused by an acid–fast bacillus – Mycobacterium leprae . Diagnosis of Hansen’s disease is mainly clinical. Hence, it is crucial to be aware of its diverse manifestations. We hereby report three such cases of Hansen’s disease with uncommon presentation. Case 1: A 26-year-old male presented with progressive numbness and multiple skin lesions over both upper and lower limbs in the past 3 years. Case 2: A 26-year-old male presented with tingling sensation of both upper limbs and lower limbs along with multiple skin lesions all over the body in the past 10 months. Case 3: A 39-year-old male presented with multiple joint pain, electric shock-like sensation of both upper limbs, and weakness of both hands along with skin rashes all over the body in the past 1 month. Skin examination of all these patients revealed multiple hypoanesthetic erythematous patches in the involved areas. Nerve conduction study was suggestive of asymmetric sensory motor axonal polyneuropathy. Skin biopsy from the lesions of the first patient revealed epithelioid granulomas suggesting borderline tuberculoid leprosy. Ziehl–Neelsen stain was positive for both fragmented and intact bacilli in the second and third cases, suggesting lepromatous leprosy. All of them were treated successfully with antileprosy drugs. It is essential to consider leprosy as a differential diagnosis in all patients presenting with symptoms of peripheral neuropathy, so that an early diagnosis and treatment is possible.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135980541","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}

引用次数: 0

Long Coronavirus Disease 2019 Sequel among Cohorts Admitted to a Tertiary Care Hospital, Hyderabad 2019年海得拉巴一家三级护理医院住院人群中的长期冠状病毒疾病后遗症

APIK Journal of Internal Medicine Pub Date : 2023-08-22 DOI: 10.4103/ajim.ajim_69_23

S. Bala, S. Darivemula, Venkatesham Animalla, R. Bandaru

{"title":"Long Coronavirus Disease 2019 Sequel among Cohorts Admitted to a Tertiary Care Hospital, Hyderabad","authors":"S. Bala, S. Darivemula, Venkatesham Animalla, R. Bandaru","doi":"10.4103/ajim.ajim_69_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_69_23","url":null,"abstract":"\u0000 \u0000 \u0000 Long COVID is commonly encountered by many individuals during the coronavirus 2019 pandemic. It is best diagnosed by a history consistent with acute coronavirus disease 2019 (COVID-19) followed by a prolonged recovery. An attempt has been made to enlist the sequel of long COVID clinically and to assess their risk factors.\u0000 \u0000 \u0000 \u0000 Confirmed COVID-19 patients admitted to our hospital were enquired about their persistent symptoms following infection after 3– 12 weeks for acute symptoms and after 12 weeks for chronic symptoms through the predesigned questionnaire schedule about their manifestations and followed up every month for 6 months.\u0000 \u0000 \u0000 \u0000 A total of 152 patients were included in our study and found acute long COVID symptoms related to neurological (72.2%), respiratory (64.7%), and musculoskeletal (61.4%) system being most commonly affected. Chronic symptoms were comprised predominantly musculoskeletal (63.1%) followed by fatigue (43.4%) and neurological (29.6) manifestations. Risk factors estimate of postacute COVID-19 symptoms showed that females had increased risk with odds ratio (OR) (and 95% confidence intervals) (OR) of 2.412 (1.239–4.692), sedentary lifestyle OR 1.775 (1.345–2.762), body mass index (BMI) >23 OR 3.877 (1.613–6.144), and presence of comorbidities OR 2.526 (1.277–4.997). Similarly, risk factor estimate of Postchronic COVID-19 symptoms showed that females had increased risk with OR 1.879 (0.952–3.709), sedentary lifestyle OR 5.091 (2.853–9.085), BMI >23 OR 2.082 (1.005–4.134), and presence of comorbidities OR 1.851 (0.925–3.705).\u0000 \u0000 \u0000 \u0000 Long COVID symptoms noted were mainly related to musculoskeletal disorders, neurological, respiratory, and fatigue. This enumeration will help us to bring the further pathway to include this long COVID entity for preventive strategies in our regular setup at the primary care level.\u0000","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44945505","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}

引用次数: 0

Unusual Cause of Recurrent Syncope in an Elderly Patient: Multiple System Atrophy 老年患者反复晕厥的不寻常原因:多系统萎缩

APIK Journal of Internal Medicine Pub Date : 2023-08-22 DOI: 10.4103/ajim.ajim_65_23

Priyal Contractor, P. Damor, Archana U. Gandhi, S. Bhowmick

引用次数: 0