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NEUROIMAGING MANIFESTATATIONS IN COVID-19 AND ITS SEQUELAE
Get PDFBACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogenic virus in late 2019, infecting millions of people with severe pulmonary infections. It spread worldwide in a short time and became a pandemic, after which the World Health Organization (WHO) declared it a public health emergency. Central nervous system involvement by COVID-19 is already an established entity in the literature. The aim of this study was to evaluate in detail the acute and delayed neurological manifestations of COVID -19.
RESULTS: COVID-19 infection can cause various neurologic manifestations and imaging findings. The most common neuroradiological abnormality is cerebrovascular events, which can also occur as a sequela of the infection. This study found a lower mean age of presentation in patients with cerebrovascular events, but no significant association was found between acute neurologic manifestations and demographic factors (like age, sex) or concomitant diseases. The severity of COVID-19 infection, as measured by the CT severity index (1), did not significantly impact neuroimaging findings, suggesting that they can occur even in patients with milder pulmonary symptoms.
CONCLUSION: Understanding neuroimaging patterns in COVID-19 is crucial for patient care and preventive measures. This study offers a comprehensive insight into the topic
Importance of Geriatrics in Psychiatric postgraduate education
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To assess the importance of Geriatrics in Psychiatric postgraduate education
Methodology
Marks allotted in question papers from Geriatrics in Psychiatry postgraduate examination from a university for a 5-year period was evaluated.
Discussion
1-6% of entire theory evaluation was related to Geriatric mental health topics predominantly on dementia and related disorders
The Herlyn-Werner-Wunderlich (HWW) syndrome– A rare case report
Get PDFA 20-year-old unmarried female, student by occupation, well built and nourished presented with intermenstrual spotting from past 1 month. No h/o pelvic pain/ mass/ fever. No h/o of similar complaints in the past. Attained menarche at 14 years. Menstrual history otherwise normal.Known case of right renal agenesis (diagnosed incidentally at the age of 8 years).
Pelvic examination by gynecologist revealed a cystic bulge to the anterior wall of vagina. On MRI, our case is right sided renal agenesis; uterus didelphys with obstructed hemi vagina and to infected collection along the vaginal wall
Eosinophilic granulomatosis with polyangiitis (Churg Strauss Syndrome) – a case report
Get PDFEosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg Strauss syndrome, is a rare small vessel vasculitis characterized by asthma, eosinophilia, and systemic involvement. This case report presents a 51-year-old man with a history of asthma, who presented with neurological symptoms including blurring of vision, bilateral ptosis, and altered sensorium. The patient had a previous history of cervical and lumbar spine surgeries for symptoms attributed to spondylosis. Further examination revealed hyperpigmented lesions on the limbs, wasting of small muscles, and foot drop.
Investigations showed eosinophilia and thrombocytosis on blood analysis, with bone marrow aspiration revealing eosinophilic and megakaryocytic hyperplasia. The cerebrospinal fluid analysis indicated eosinophilia and lymphocytic predominance. Imaging studies revealed hypodense areas in the midbrain and pons, as well as age-related cerebral atrophy.
Based on the diagnostic criteria for EGPA, the patient fulfilled the requirements of asthma, blood eosinophilia, peripheral neuropathy, transient pulmonary infiltrates, paranasal sinus abnormalities, and the presence of extravascular eosinophils on biopsy. The diagnosis was further supported by the presence of positive antineutrophilic cytoplasmic autoantibodies (ANCA-MPO). Treatment was initiated with intravenous corticosteroids and azathioprine due to the severity of the disease.
EGPA is a heterogeneous disease with varying clinical presentations and organ involvement. Early and accurate diagnosis is crucial for appropriate management and improved outcomes. Glucocorticoids, such as prednisolone, are the mainstay of treatment. While the overall mortality rate is relatively low compared to other systemic vasculitides, cardiac involvement can contribute to significant morbidity and mortality.
In conclusion, this case report highlights the importance of considering EGPA in patients with asthma, eosinophilia, and multi-system involvement. Prompt recognition and initiation of appropriate therapy can help mitigate complications and improve patient outcomes. Further research is needed to better understand the pathogenesis and optimal management strategies for this rare vasculitic disorder
A Study On The Prevalence Of Vitamin B12 Deficiency In Eastern Indian Type 2 Diabetes Mellitus Patients With Peripheral Neuropathy On Metformin Presenting To A Tertiary Care Hospital
Get PDFIntroduction:
The association between long-term metformin use in type 2 diabetes mellitus (T2DM) and low vitamin B12 levels has been proven and screening for the same is recommended by American Diabetes Association (ADA) guidelines. The potential of the deficiency to cause or worsen diabetic peripheral neuropathy (DPN) in T2DM patients has been investigated in previous studies. However, the prevalence estimates of vitamin B12 deficiency in T2DM patients treated with long term metformin and having established DPN is lacking in our country. The aim of our study was to estimate the prevalence of vitamin B12 deficiency in T2DM patients with DPN on metformin and find out the risk factors for vitamin B12 deficiency in these patients.
Methods:
This cross-sectional study was conducted in the department of endocrinology in a tertiary care hospital on T2DM patients with DPN on long term metformin therapy. Vitamin B12 levels were estimated in all the subjects and the prevalence and risk factors for Vitamin B12 deficiency were assessed.
Results:
The prevalence of vitamin B12 deficiency in our patients was 32%. Based on the correlation estimates, none of the factors studied were significantly associated with variations in Vitamin B12 levels.
Conclusion:
Our study found that a third of metformin treated T2DM patients with peripheral neuropathy had vitamin B12 deficiency with no specific clinical predictor for the same. We thereby recommend screening for vitamin B12 deficiency in T2DM patients on long-term metformin and with established DPN
A CASE OF GALEAZZI FRACTURE SUBLUXATION OF LEFT FOREARM IN PAEDIATRIC AGE GROUP
Get PDFA case report of a rare form of fracture- Galeazzi fracture subluxation in paediatric age group. Showing post operative progress of the patient, with a discussion on possible methodology of approaching such fractures. Correct management of the fracture is essential for proper healing and avoiding complications
Association of Physical Activity and Screen Time Usage of Adolescents in Rural Areas of Mysore.
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In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity.
Methods & materials:
A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen time was evaluated using a questionnaire. School sports, Leisure Time Physical Activity (LTPA), and mode of transportation to school was evaluated for their physical activity pattern and the amount of time spent on each type of screen device – TV, Computers, video games, mobile phones, and tablets was measured in hours per day.
Results:
Prevalence of excessive screen time usage was 36%and physical activity \u3e1hr./day was found to be 57% in study subjects. However, there is no correlation between physical exercise and screen time found in rural adolescents.
Conclusion:
Prevalence of excessive screen time with 57% of adolescents having physical activity more than 1hr/day. A tighter control of screen usage was also shown by 77% of adolescents, being role models for appropriate screen time, all are factors for an improved lifestyle
The Increasing Vulnerability of African Youths to Mental Health Disorders: Risk Factors, Advocacy and Recommendations
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“Cost-effective markers to identify metabolically healthy/unhealthy individuals and their future risk for cardiovascular disorders”
Get PDFBackground: With the rising prevalence of metabolically healthy obese, it becomes essential to identify markers to differentiate them from metabolically unhealthy obese and their future risk for cardiovascular disorders (CVD). The study aims to identify suitable markers for risk stratification of metabolically healthy/unhealthy individuals and their risk for CVD. Method: Total 84 individuals aged 18-60 years of age without any comorbidities were enrolled. Their demographic details along with anthropometric measurements were noted. The biochemical parameters like fasting glucose, insulin, lipid profile, and serum adipokines were estimated. Insulin resistance (IR) markers and atherogenic indices were calculated. The data were analyzed on Microsoft Excel 2010 lnk sheet. P-value o
COVID-19 Vaccine Effectiveness in Preventing Severe Infections and Mortality among Patients in Kerala, India.
Get PDFABSTRACT
Background:
India has a top status among world countries, related to the COVID-19 mortality that had crossed the 3-lakh level. The second wave of COVID19 had ravaged the world countries, created havoc of the highest order, leaving many hapless, thanks to the low availability of oxygen, ICU facilities, vaccines and counselling prospects.
There is a lack of information about how COVID-19 vaccines have affected mortality in specific geographic areas.
Method:
A Retrospective record-based design. Patients were matched for age, sex, ethnicity, co-morbidities and grouped into fully immunized, partially immunized and non-immunized.
The primary outcome was in-hospital deaths and secondary outcome was severe covid infections. (Severe covid infections are defined as Category C in WHO and ICMR classification)
Results:
Vaccines administered in standard dosage confer considerable benefit by reducing severe illness, hospitalization and death. This is clearly visible by the lower proportions of those with hypoxia, high levels of markers, those requiring ICU support and death in vaccinated individuals. The type of vaccine administered did not have any influence on the severity and outcome of illness.
Conclusion:
The second wave that peaked in May 2021 would have been less disastrous had more people been vaccinated. Without a reimagined vaccination strategy, reaching the desired full vaccination status was a difficult endeavor.
The signs are unmistakable that a combined approach involving swift vaccination and scientific measures to curb transmission holds great promise. A zero covid world looks less imminent. But humans can make the microbe less lethal