The Bombay Hospital journal最新文献

{"title":"Fluorine-18-FDG-PET/CT in Cytomegalovirus Colitis","authors":"Hemant Rathore, Nirav Thaker, Inder Talwar","doi":"10.15713/ins.bhj.47","DOIUrl":"https://doi.org/10.15713/ins.bhj.47","url":null,"abstract":"with 25 of took a which reveal no The patient is diabetic on with acute kidney injury, pre-treatment investigations reveal a HB of 7.2, TLC 11,600, S. Cr – 3.60 mg/dl, BUN – 118, and Na 124, nearly normal all other relevant investigations. Blood analysis for widal, HBsAg, HCV, blood Further and colonic Biopsy from a cecal revealed a diagnosis of cytomegalovirus (CMV) colitis with the presence of CMV DNA on IHC. IgM CMV ABSTRACT Cytomegalovirus (CMV) colitis as a cause of pyrexia of unknown origin (PUO) is rarely document on fluorodeoxyglucose-positron-emission-tomography/computed-tomography (FDG-PET/CT) scan in Indian literature. The typical pet images with intense FDG uptake in large bowel are rare to see and are exclusively ruled out the cause of pathology. Only few cases reported with FDG-PET/CT in CMV colitis in world literature. We present a case of 55-year-old female with PUO diagnosed as an acute CMV colitis. A fluorine-18-FDG-PET/CT scan (F-18-FDG-PET/CT scan) was performed to diagnose the infective focus which reveals symmetrical intense increased pathological FDG uptake in entire large bowel from cecum to sigmoid colon with corresponding CT images showed mildly edematous bowel wall. Further colonoscopy revealed edematous and ulcerated colonic mucosa. Biopsy from small cecal ulcer revealed a diagnosis of CMV colitis with the presence of CMV DNA in IHC. CMV antigenemia in blood is also confirmed on evaluation which responded to antiherpes treatment ganciclovir. From these findings, this case highlights a typical pattern of FDG uptake in F-18-FDG-PET/CT scan. Fused CT and PET CT images in axial, coronal and sagittal reconstructions revealing diffuse right colonic mural thickening with","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"221 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77575906","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":"Rare Cause of Pain in Abdomen in Second Trimester Pregnancy","authors":"F. Siddiqui, Varsha Pai Dhungat","doi":"10.15713/ins.bhj.59","DOIUrl":"https://doi.org/10.15713/ins.bhj.59","url":null,"abstract":"Uterine dehiscence in pregnancy is a rare life-threatening complication. It mainly occurs in third trimester of pregnancy or during labor, especially in previously scarred uterus. It is rarely seen during the second trimester. Uterine dehiscence is referred to the process of gradual myometrial rupture without disruption of overlying uterine serosa in a pre-existing scar. The fetus, placenta, and umbilical cord are within the uterine cavity.","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83767356","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 Prevalence of Inducible and Constitutive Macrolide-lincosamide-streptogramin B-Resistant (iMLSB and cMLSB) Phenotypes among Clinical Isolates of Staphylococcus aureus at a Tertiary Care Hospital in South Mumbai","authors":"A. Sakle, S. Swaminathan","doi":"10.15713/ins.bhj.43","DOIUrl":"https://doi.org/10.15713/ins.bhj.43","url":null,"abstract":"Staphylococcus aureus is one of the most common causative organisms of health care as well as community-acquired infections in every region of the world. Moreover, increase in the prevalence of methicillin resistance among Staphylococci is a matter of concern.[1] Due to this, there has been a renewed interest in the usage of macrolide-lincosamide-streptogramin B (MLSB) antibiotics for the treatment of S. aureus infections. Moreover, clindamycin is the preferred agent because of its exceptional pharmacokinetic properties.[2] Clindamycin can be used as an alternative antibiotic in penicillin-allergic patients for the treatment of skin and soft-tissue infections caused by S. aureus. It achieves high intracellular levels in phagocytic cells, high levels in bone, and appears to be able to reduce toxin production in toxin-producing strains of staphylococci. Except central nervous system, it has very good tissue penetration.[3] It is a good option for outpatient prescription or as a follow-up drug after intravenous therapy because of its good oral absorption.[4] However, a possibility of inducible clindamycin resistance among Staphylococcal isolates is a major concern in use of clindamycin.[5] There are three mechanisms of resistance to the MLSB class of antibiotics: Modification of target site, enzymatic inactivation, and impermeability or macrolide efflux pumps.[6] Resistance due to modification of ribosomal target is mediated by erythromycin ribosomal methylases encoded by ermA/ ermC genes and it affects the activities of macrolides as well as clindamycin. This type of resistance may be inducible or constitutive.[7,8] The constitutive resistance MLSB (cMLSB) strains can easily be detected by standard susceptibility testing methods because they are resistant to both macrolides and lincosamides alike. However, the inducible resistant MLSB (iMLSB) strains appear erythromycin resistant and clindamycin sensitive in routine laboratory tests, unless the tests include measures that result in induction of clindamycin resistance.[4] In such cases, therapy with clindamycin may ABSTRACT","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72925408","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 Rare Case of Microphthalmos with Anophthalmos","authors":"P. Asgaonkar","doi":"10.15713/ins.bhj.48","DOIUrl":"https://doi.org/10.15713/ins.bhj.48","url":null,"abstract":"Unilateral anophthalmia is an extremely rare congenital anomaly having prevalence of around 0.003%. [1] Congenital microphthalmia is again a rare anomaly having prevalence rate of around 0.014%–0.035% and affects 3%–11% of blind children. [1-3] The objective is to report a case of a 5-year-old male showing clinical right-sided microphthalmos and left-sided anophthalmos.","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75342513","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":"Surgical Neurology at the Bombay Hospital, Mumbai","authors":"C. Deopujari","doi":"10.15713/ins.bhj.41","DOIUrl":"https://doi.org/10.15713/ins.bhj.41","url":null,"abstract":"Bombay Hospital Trust started as a philanthropic organization for quality patient care for the common man in the new spirit of independent India in 1949 under the chairmanship of Mr. Rameshwardas (R.D.) Birla. The amalgamation of the Singhania trust and Marwari trust within the new entity resulted in the formation of a hospital building (presently called the Old Wing) located at the marine lines in South Bombay (now Mumbai), which was inaugurated by Sardar Vallabhbhai Patel, then home minister of the new Indian Republic in 1951. Soon thereafter, the neurosurgery service was started at the hospital by the first neurosurgeon in West India, Prof. Ram Ginde in 1953.","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80368055","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 of Sphenoid Plasmacytoma","authors":"Suneel Shah, A. Bhagwat","doi":"10.15713/ins.bhj.57","DOIUrl":"https://doi.org/10.15713/ins.bhj.57","url":null,"abstract":"from myeloma are [2] as follows: ABSTRACT Extramedullary plasmacytoma is a rare pathology of the upper aerodigestive tract, of which sphenoid plasmacytoma is a rare variant. It usually presents like a sellar mass, with headache being the most common symptom, and severity of other symptoms proportional to the extent of invasion of surrounding structures. The importance of identifying red flag symptoms associated with headache cannot be exaggerated, in this regard. Bereft of specific clinical or imaging findings, it can prove to be a diagnostic dilemma. Standard protocols of treatment of multiple myeloma are followed, due to the rarity of the condition and the lack of site specific data thereof. Subject to resectability, the outcome with multimodality therapy is generally good. We describe our own experience in dealing with this relatively scarcely described condition with respect to diagnosis, surgery, additional evaluation,","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85516199","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":"How to do Effective Nutritional Counselling for People with Diabetes?","authors":"T. Lathia, Pratiksha Patil, R. Surya","doi":"10.15713/ins.bhj.07","DOIUrl":"https://doi.org/10.15713/ins.bhj.07","url":null,"abstract":"iabetes is reaching epidemic Dproportions in India. Lifestyle changes form the cornerstone of successful diabetes management along with pharmacological treatment. In order to achieve meaningful changes in lifestyle behav iour , e f f ec t i ve nut r i t i ona l counselling is important. This can be achieved using techniques like \"person centred approach\", \"closing the loop\" and positive reinforcement. This article discusses some of these techniques along with use of appropriate language when speaking to people with diabetes to foster collaborative care. Introduction Diabetes mellitus is a global epidemic with India being one of the hardest hit countries. 1 in 6 adults with diabetes are from India. More than one million deaths are attributable to diabetes, the second highest among all IDF (International Diabetes Federation) regions in the world according to the recently released IDF","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74393951","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":"Electrodiagnosis in Diabetic Neuropathy","authors":"K. Mansukhani","doi":"10.15713/ins.bhj.10","DOIUrl":"https://doi.org/10.15713/ins.bhj.10","url":null,"abstract":"Dx a diagnostic procedure which Econsists of a series of tests employed for the diagnosis of neuromuscular diseases. These tests must be conducted by a physician trained in electrodiagnostic medicine as they are customised according to the presenting clinical problem, sequentially done, collectively interpreted and then correlated with the clinical features to arrive at a diagnosis that explains the neuromuscular disease. It is the only procedure that evaluates the function of the lower motor & sensory neuron. Multiple tests can be performed depending on the disease, but below given are a few with relation to the diagnosis of diabetic neuropathies. EDx tests lNerve conduction studies: sensory and motor lF wave studies lH reflex studies lN e e d l e e l e c t r o m y o g r a p h i c examination (NEE or EMG) lHeart rate variability test lSympathetic skin response Terminology in Electrodiagnosis lClinical neurophysiology includes EDx, EEG and Evoked potential testing lElectrodiagnosis (EDx) aka neuroelectrodiagnosis lElectroneuromyography (ENMG) is synonymous with EDx and is the preferred term (as there cardioelectrodiagnosis as well) lNCS is nerve conduction studies lEMG is electromyography also known as needle electromyography lAn Electromyographer is the physician conducting the procedure: the Electrodiagnostician lAn Electromyograph is the equipment Fig. 1","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73339947","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":"Menopausal Hormone Therapy - Pros and Cons","authors":"S. Khadilkar, Pradnya Changede","doi":"10.15713/ins.bhj.27","DOIUrl":"https://doi.org/10.15713/ins.bhj.27","url":null,"abstract":"Menopausal hormone therapy (MHT) is surrounded by controversies after the revolutionary reports from Women’s Health Initiative (WHI) trial in 2002. The universal hormone therapy (HT) policy used before WHI became obsolete after 2002. Majority of women who were already taking MHT discontinued the therapy worldwide. Even practitioners stopped prescribing MHT. Several studies have suggested a “timing hypothesis” or a “window-of-opportunity” for the initiation of MHT, which is early after menopause. This means that MHT is best given immediately postmenopause for a short duration of time. MHT started many years is best given immediately postmenopause for a short duration of time. MHT started many years after menopause and given for long duration following menopause has more side effects. The use of MHT decreased drastically after the results of these two studies were published. However, due to Danish Osteoporosis Prevention Study and the Kronos Early Estrogen Prevention Study, interest has been generated in MHT due to beneficial results of MHT. Excellent symptom relief can be provided by MHT for healthy women who experience menopausal symptoms. MHT poses a low risk in these healthy women with no comorbidities. With regard to cardiovascular diseases and osteoporosis, not giving MHT in symptomatic women may pose a risk. When MHT is initiated in elderly women and in those with comorbidities, it may be associated with increased risk. Prior discussion with patient about HT is a must before starting MHT. Personalized discussion with patient about symptoms, treatment goals, analysis of age, time since menopause, and consideration of comorbidities influences decision-making about starting MHT. We recommend further studies on MHT for better understanding of risk versus benefit of MHT.","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78694860","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":"Psychiatric Manifestations in Endocrine Disorders","authors":"Sharita Shah-Munshi","doi":"10.15713/ins.bhj.09","DOIUrl":"https://doi.org/10.15713/ins.bhj.09","url":null,"abstract":"Tfluctuations and their relationship to human behav iour i s ca l l ed as Psychoneuroendocrinology. A number of psychiatric symptoms are seen to be associated with multiple endocrine disorders. These may be a direct result of either hyperor hypo secretion of the hormones from the endocrine glands. At times, many psychiatric or neurological conditions affect the hypothalamus or the pituitary gland and interfere with the physiological endocrine functions. Often common endocrine disorders present with psychiatric symptoms and may be mistaken for primary psychiatric disorders. An interdisciplinary team comprising of a physician, an endocrinologist, a gynaecologist, a urologist, and also a psychiatrist, is required to help identify, diagnose and treat the comorbid psychiatric symptoms to help achieve the best possible outcome and an improved quality of life for the patients. Adrenal Glands H y p e r c o r t i s o l a e m i a o r Hypocortisolaemia may be a result of a centra l cause , increased ACTH production, or a local cause at the level of the adrenal glands. The relationship between the Hypothalamic Pituitary Adrenal (HPA) axis and mood disorders is complex. Glucocorticoids can be both anabolic and catabolic in nature. They are stress hormones that prepare an individual for the demands placed by a stressful environment and create a fight or flight response. Depression is related to hyperactivity of the HPA axis. However, depressive disorders are seen in both hyper and hypocortisolaemic states. 1. Cushing's Syndrome Major Depressive Disorder (MDD), Panic Disorder and Generalised Anxiety Disorder (GAD) are seen in over 50% of cases of both the pituitary dependent and the pituitary independent form of","PeriodicalId":85654,"journal":{"name":"The Bombay Hospital journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91020969","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}