Journal of postgraduate medicine最新文献

{"title":"Primary antiphospholipid syndrome as the initial manifestation of systemic lupus erythematosus in a male: A case report.","authors":"H S Irugu, K Dhananjayan, S Kalaichelvi, C Selvaraj","doi":"10.4103/jpgm.jpgm_552_25","DOIUrl":"10.4103/jpgm.jpgm_552_25","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"151-152"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric sternal tubercular osteomyelitis presenting as a subcutaneous abscess: A rare entity.","authors":"A R Mehta, P Kothari, B A Sheth, U D Sheth","doi":"10.4103/jpgm.jpgm_222_25","DOIUrl":"10.4103/jpgm.jpgm_222_25","url":null,"abstract":"<p><strong>Abstract: </strong>Pediatric sternal abscess with associated osteomyelitis is an infrequent but challenging clinical entity. Atypical presentations and negative bacterial cultures compound its diagnosis. This report details a case of a 5-year-old boy who presented with a progressively increasing lower sternal swelling for 1 month. Upon examination, the lesion was suggestive of a sternal abscess. Work-up revealed leukocytosis and a raised erythrocyte sedimentation rate. Magnetic resonance imaging depicted a hyperintense collection in the subcutaneous tissue, extending into the retrosternal space, accompanied by osteomyelitic changes in the manubrium. Surgical drainage of the superficial abscess and curetting of the bony edges of the manubrium, including excision of the sinus tract, were performed. The patient was initiated on anti-tubercular therapy, to which he exhibited a favorable response. The follow-up visits showed adequate healing and new bone formation. Anti-tubercular therapy is a cornerstone for a successful treatment modality for pediatric sternal abscess with tubercular osteomyelitis. Timely intervention and interdisciplinary collaboration are essential for achieving optimal outcomes.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"146-148"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric angioedema without urticaria: A rare presentation of autoimmune thyroid disease with complete remission on levothyroxine therapy.","authors":"M H Archana, V Shivane, C Yamichannaiah, S S Memon","doi":"10.4103/jpgm.jpgm_211_25","DOIUrl":"10.4103/jpgm.jpgm_211_25","url":null,"abstract":"<p><strong>Abstract: </strong>Angioedema without urticaria (AEwU) is an uncommon manifestation of autoimmune thyroid disease (AITD), rarely reported in the pediatric population. A 12-year-old boy presented with recurrent episodes of angioedema affecting the lips and eyelids for 6 months, unresponsive to antihistamines. There were no systemic symptoms, wheals, or identifiable allergic triggers. Laboratory evaluation revealed normal C1-inhibitor levels and function, ruling out hereditary angioedema. Notable findings included eosinophilia (14.4%) and elevated serum Immunoglobulin E levels (1617 IU/mL), while bone marrow flow cytometry and serum tryptase levels were normal. Autoimmune screening identified AITD with overt hypothyroidism (thyroid-stimulating hormone: 34 μIU/mL). A diagnosis of AEwU secondary to AITD was considered. Initiation of levothyroxine (62.5 μg/day) led to symptom resolution within 3-4 days, with no recurrence in eight months. AEwU secondary to AITD is a diagnosis of exclusion and should be considered in patients with unexplained angioedema after ruling out hereditary and allergic causes.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"139-142"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glandular cardiac myxomas: Pathological features and histogenesis.","authors":"P Vaideeswar, P Bhatia, A Suryawanshi","doi":"10.4103/jpgm.jpgm_529_25","DOIUrl":"10.4103/jpgm.jpgm_529_25","url":null,"abstract":"<p><strong>Abstract: </strong>Cardiac myxomas (CMs) constitute one of the most common benign tumors of the heart, with a characteristic histomorphology of \"lepidic cells\" in an eosinophilic myxoid material, warranting immediate recognition. However, several, though uncommon, alterations in the classic pathological features hinder straightforward diagnosis. This is a report of one such intriguing entity, in which the myxoma shows the presence of glandular components, with a brief overview of the histogenesis, immunohistochemical characteristics, and differential diagnosis of glandular CMs.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"136-138"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent crisis in the intensive care unit: Current antimicrobial resistance landscape in an Indian hospital.","authors":"A Jorwal, S Sharma, K Bairwa, R Sharma, E Rajni","doi":"10.4103/jpgm.jpgm_396_25","DOIUrl":"10.4103/jpgm.jpgm_396_25","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) is a growing concern, particularly in critical care, where patients are more susceptible to infections by multidrug-resistant organisms. Understanding local resistance trends is essential for guiding effective empirical therapy. This study aimed to assess the prevalence and resistance profile of bacterial pathogens isolated from patients admitted in intensive care units (ICUs) in a tertiary care hospital located in northwestern India.</p><p><strong>Materials and methods: </strong>This was a retrospective observational study conducted for 1 year from January 2024 to December 2024 in the Department of Microbiology at a tertiary care teaching hospital in northwestern India. All clinical specimens (blood, urine, pus, respiratory secretions, etc.) from patients admitted in ICU were processed using standard microbiological protocols. Organism identification and antimicrobial susceptibility testing were performed using a VITEK-2 Compact system and interpreted using Clinical Laboratory Standard Institute guidelines.</p><p><strong>Results: </strong>Out of 8858 samples received, 2507 (28.3%) were culture-positive. Gram-negative bacteria constituted 60.4% of isolates, predominated by Klebsiella pneumoniae (34.4%), 88.4% being carbapenem resistant. Among nonfermenters, Acinetobacter baumannii (23.6%) was most common with carbapenem resistance around 98.4%. For Gram-positive, Enterococcus spp 245 (44.6%) predominated, followed by Coagulase-negative Staphylococcus (39.9%). The prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) was 58% and 39.7%, respectively.</p><p><strong>Conclusions: </strong>Our ICU ecosystem harbors a substantial burden of multidrug-resistant organisms, including alarming levels of carbapenem-resistance, MRSA, and VRE. These data underscore the urgent need for robust antimicrobial stewardship and stringent infection control practices. Continuous surveillance is vital to optimize empirical treatment strategies in critical care settings.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"122-127"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic cholecystectomy without biliary stenting post-ERCP clearance: Prospective outcomes from a tertiary care center.","authors":"R Prajapati, S Shetty, A Chaudhary, M Khajanchi, R Bhoir","doi":"10.4103/jpgm.jpgm_341_25","DOIUrl":"10.4103/jpgm.jpgm_341_25","url":null,"abstract":"<p><strong>Introduction: </strong>Common bile duct (CBD) stones are present in approximately 5-18% of patients undergoing cholecystectomy for gallstones. Nearly half of them suffer from complications of choledocholithiasis. Such cases are managed by endoscopic retrograde cholangio-pancreatography (ERCP) with stone clearance followed by laparoscopic cholecystectomy (LC). Prophylactic CBD stenting post-ERCP stone clearance is practiced in some centers to prevent stone reimpaction, though its necessity remains debated due to potential complications such as adhesions and technical difficulty during subsequent surgery.</p><p><strong>Materials and methods: </strong>This prospective observational study included 84 patients aged ≥18 years who underwent LC within seven days of successful ERCP with complete CBD clearance, without stenting. Intraoperative parameters and difficulties, postoperative complications, and hospital stay were recorded. Patients were followed up to 14 days postprocedure.</p><p><strong>Results: </strong>Among 84 patients (61.9% female; mean age 39.8 ± 4.5 years), 79.8% achieved single-session CBD clearance. Intraoperative adhesions were seen in 40.5% of cases. Bile spillage occurred in 17.9%; 15.5% experienced blood loss >100 ml. Conversion to open cholecystectomy was required in 11.9% of patients. The average hospital stay was 3.48 ± 1.65 days. No readmissions or recurrent CBD stones were noted at follow-up.</p><p><strong>Conclusions: </strong>Omitting prophylactic CBD stenting after ERCP does not increase intraoperative or postoperative complications. Early LC without stenting is a safe, effective, and resource-optimized strategy, suggesting ease of surgery without any stent-in-situ and early discharge as well as the added benefit of no need of stent removal later.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"128-131"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal perforation: Biliary self-expandable metal stent to the rescue!","authors":"S Patil, V Rawat, S Lad, M Ingle","doi":"10.4103/jpgm.jpgm_369_25","DOIUrl":"10.4103/jpgm.jpgm_369_25","url":null,"abstract":"<p><strong>Abstract: </strong>Esophageal perforation is a rare but critical emergency that requires early detection and prompt management. Iatrogenic esophageal injury is the most common cause of esophageal perforation in children, and most cases occur during endoscopic dilatation of strictures. There are various options available for the management of iatrogenic esophageal perforation, such as conservative management, endoscopic interventions, or surgical interventions. Surgical interventions for esophageal perforation have a high risk of perioperative morbidity and mortality. Endoscopic metal stenting is one of the minimally invasive treatment options for the management of esophageal perforation. However, this procedure is rarely implemented in the pediatric population due to the unavailability of appropriately size-matched endoscopic accessories. Here, we report a case of a 22-month-old male child born with a tracheoesophageal fistula, who underwent corrective surgery twice and developed anastomotic site esophageal stricture. The patient developed esophageal perforation during endoscopic dilatation of the stricture and was managed successfully with a biliary fully covered self-expandable metal stent.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"143-145"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory perspective of tuberculosis diagnosis -Test principles and report interpretation.","authors":"S R Kanade, N Gita, C A Kumar","doi":"10.4103/jpgm.jpgm_126_25","DOIUrl":"10.4103/jpgm.jpgm_126_25","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"105-109"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral metastatic deposits of malignant melanoma masquerading as intracerebral haemorrhage: A case report.","authors":"A Hatgaonkar, S Deotale, K Hatgaonkar, P Korde","doi":"10.4103/jpgm.jpgm_576_25","DOIUrl":"10.4103/jpgm.jpgm_576_25","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"149-150"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical coherence tomography defined morphological features of the culprit vessel in young Indian patients presenting with acute ST-elevation myocardial infarction.","authors":"C P Lanjewar, B S Shah, P P Kujur, D Kumar, G R Sabnis","doi":"10.4103/jpgm.jpgm_87_25","DOIUrl":"10.4103/jpgm.jpgm_87_25","url":null,"abstract":"<p><strong>Introduction: </strong>The alarming increase in the incidence of myocardial infarction in young population has warranted a different approach to its management. Imaging-based study of the culprit lesion has provided a new dimension in understanding this condition. The authors aimed to study the morphological characteristics in young patients (<40 years) as defined by optical coherence tomography (OCT).</p><p><strong>Materials and methods: </strong>This prospective, single-centre, open-label, observational study was conducted at a tertiary care centre and enrolled all young patients presenting with ST-elevation myocardial infarction (STEMI) who fulfilled the inclusion criteria, between January 2020 and June 2022.</p><p><strong>Results: </strong>Out of 36 patients who underwent OCT, plaque rupture was observed in 63.89%, followed by plaque erosion in 36.11%. White thrombus was evident in the majority of patients (55.56%). As most of our patients were fibrinolized and the procedure was not a primary PCI but performed within 48 hours as a pharmacoinvasive approach, the native characteristics of the lesion and thrombus might have changed. A total of five patients underwent balloon predilatation due to a critically stenotic lesion that prevented the OCT catheter from passing distally.</p><p><strong>Conclusion: </strong>Plaque rupture was the most common pathology for STEMI among young patients, with plaque erosion being another important contributor. The study also highlighted an early predilection for atherosclerotic changes in the Indian population.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":" ","pages":"117-121"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}