International Journal of Research in Medical Sciences
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Beaver tail liver: an anatomical variant
Get PDFBeaver tail liver, is a rare anatomical variation in which the left hepatic lobe extends laterally to encircle the spleen. This variant is typically asymptomatic and is often discovered incidentally during abdominal imaging. While it does not impair liver function, it presents diagnostic challenges and potential clinical implications, including misinterpretation as a splenic mass or hematoma. We report the case of a 20-year-old female who presented to the emergency department with a high-grade fever, headache, right-sided limb weakness, and aphasia. Imaging studies revealed subdural empyema with pachymeningitis. A contrast-enhanced CT of the abdomen was performed to investigate potential extrapulmonary tuberculosis and incidentally identified an elongated left hepatic lobe encircling the anterior border of the spleen, confirming a diagnosis of beaver tail liver. This case highlights the importance of recognizing beaver tail liver as a benign anatomical variant to avoid unnecessary interventions. Awareness of its implications in trauma assessment, surgery, and transplantation is essential for optimal patient management
Detection of pyrazinamide resistance among multidrug resistant tuberculosis in North Karnataka
Get PDFBackground: Pyrazinamide was identified as a result of a structural activity connection with nicotinamide, which exhibits antitubercular properties (PZA). PZA possesses the exceptional capacity to be directly identified in vivo, first in Mycobacterium TB-infected mice and guinea pigs and subsequently in clinical settings. Pyrazinamide (PZA) is a newly developed antituberculosis (anti-TB) medication that is necessary to shorten the duration of TB treatment. Drug-resistant and drug-susceptible TB, including multidrug-resistant TB, require PZA as part of any therapy regimen because it eliminates nonreplicating persisters that other TB treatments are unable to.
Methods: All clinical specimens presented to the centre for follow-up or for newly diagnosed cases requiring programmatic treatment of DRTB were included in the research. Salivary or insufficient samples, as well as samples that satisfied the centre’s SOP rejection criteria, were excluded from the research. MGIT-based susceptibility testing was used to evaluate the PZA susceptibility for 609 isolates.
Results: Of the 11104 samples, 207 (1.8%) were identified as MDR, 101 (0.9%) as mono-rifampicin resistant, and 619 (5.5%) as mono-isoniazid resistant. The BACTECTM MGITTM 960 technique was then used to cultivate 609 samples. The Bioline TB Ag MPT64 test is a quick way to find the M. tuberculosis complex. PZA susceptibility for 609 isolates was assessed using MGIT-based susceptibility testing. PZA resistance was detected in 194 (31.8%) of the 609 isolates.
Conclusions: The results may emphasise the necessity of regular DST for PZA in Indian public health labs and more study to better identify the variables linked to PZA resistance. In order to inform evidence-based approaches for tuberculosis control and care, this study also highlights the significance of ongoing surveillance of medication resistance patterns
Case report of a 19-year-old patient with β-thalassemia major, type 1 diabetes mellitus, osteoporosis and other major complications
Get PDFThis case report presents a detailed clinical profile of a 19-year-old male with β-thalassemia major, highlighting the multi-system complications associated with long-term disease management and chronic transfusion therapy. Diagnosed at one year of age due to symptoms including poor feeding, irritability, developmental delays, and failure to thrive, the patient’s haemoglobin electrophoresis showed markedly elevated HbF levels, confirming β-thalassemia major. Over the years, the patient has undergone regular transfusions and a splenectomy at age seven to address hypersplenism. Family screening in 2014 identified β-thalassemia trait in both parents and three siblings, prompting genetic counselling. In 2020, the patient developed diabetic ketoacidosis, presenting with hyperglycaemia and ketonuria, and was subsequently diagnosed with type 1 diabetes mellitus, managed with insulin therapy. By 2023, he exhibited signs of iron overload, with MRI showing iron deposition across multiple organs and serum ferritin levels exceeding 2000 ng/mL. Additional findings included hepatomegaly, mild pleural effusion, thyroid dysfunction, and osteoporosis confirmed by bone mineral density testing. Current management includes oral deferasirox for iron chelation, calcium and vitamin D supplementation, folic acid, and insulin therapy tailored to his glucose needs
Primary omental torsion: a rare case report and an emergency diagnostic dilemma
Get PDFPrimary omental torsion is an uncommon surgical condition resulting from the rotation of the greater omentum on its long axis, leading to vascular compromise and infarction. Clinically, it presents with nonspecific abdominal pain that mimics more prevalent acute abdominal conditions such as appendicitis, cholecystitis, or diverticulitis, often leading to diagnostic delays. We present a case of a 50-year-old male who experienced persistent, dull, left-sided abdominal pain for two weeks. Imaging with contrast-enhanced computed tomography (CECT) suggested omental torsion, which was confirmed on diagnostic laparoscopy. The affected, necrotic segment of the omentum was resected laparoscopically, and the patient had an uneventful postoperative recovery. Histopathology confirmed haemorrhagic infarction. This case underlines the importance of considering omental torsion in patients with unexplained abdominal pain and highlights the diagnostic value of cross-sectional imaging. Timely surgical intervention prevents complications such as abscess formation or peritonitis and can be effectively managed with laparoscopic techniques.
Extranodal NK/T-cell lymphoma, nasal type: a case report
Get PDFExtranodal NK/T-cell lymphoma, nasal type (ENKTL-NT), is a rare and aggressive malignancy associated with Epstein-Barr virus (EBV). Its clinical presentation includes midfacial destruction, ulceration, and nasal obstruction, often leading to misdiagnosis. A 43-year-old male presented with a rapidly progressive nasal lesion. Clinical evaluation, imaging, and histopathological analysis with immunohistochemistry confirmed ENKTL-NT. Treatment includes radiotherapy and chemotherapy, improving survival rates, though prognosis remains poor in advanced cases. Early diagnosis is crucial for better outcomes
Development and validation of questionnaire to assess knowledge, attitude and awareness about stroke among young population
Get PDFBackground: Stroke is a neurological condition which is caused by disturbed blood supply to the brain, causing mental, physical and social impairment. Stroke prevalence in young individuals is rising globally, as well as in India. The young population is still ignorant about stroke and thinks of it as an illness of the elderly. Due to lack of understanding and education about ailment, one contributing aspect maybe one's attitude towards the condition. Considering these factors this questionnaire was developed.
Method: The knowledge, attitude and awareness–questionnaire was developed and validated in 2 phases. In phase I, development and content validation of the questionnaire were done, and in phase II, a pilot study was done on the population for validation, and participants were interviewed using a self-developed questionnaire.
Results: The computed content validity index (CVI) for the questionnaire was found to be 0.92. The Cronbach’s Alpha values were determined to be 0.947, 0.909, 0.887, respectively, reflecting strong internal consistency. The overall benchmark is 0.95 which is statistically excellent for validity of outcome
Conclusion: The KAAS-SYP, designed to evaluate knowledge, attitude, and awareness about stroke among young populations, demonstrated statistically robust content validity and excellent reliability. While the young population shows an understanding of the term "stroke," there is limited awareness of its risk factors and warning signs. Furthermore, their attitude towards stroke tends to be less positive, highlighting the need for targeted educational and awareness initiatives
Profiling of kidney disease patients undergoing hemodialysis
Get PDFBackground: Kidney failure represents a substantial global health challenge; however, hemodialysis functions as a vital treatment for end-stage renal disease (ESRD). This study offers insights into the causes (and) demographic distribution of kidney failure among patients undergoing hemodialysis in Haryana and Uttar Pradesh, India. Although there are various factors contributing to this condition, understanding the nuances is essential because it can help to formulate better healthcare strategies.
Methods: A cross-sectional study (conducted by DCDC kidney care) involved 3,254 patients undergoing hemodialysis across Haryana and Uttar Pradesh. Data collected on demographic parameters, clinical characteristics and as per the clinical history of kidney failure were analyzed. Descriptive statistics helped to analyse age, gender and perceived causes of kidney failure; however, regional variations were highlighted. This study is significant, because it provides insights into the complexities of kidney failure, although it does have its limitations.
Results: The majority of patients undergoing hemodialysis were middle-aged, with the highest representation in the 41-50 years (25.1%) and 31-40 years (22.1%) age groups. Male patients constituted 70.9% of the population. Hypertension was identified as the most prevalent cause of kidney failure (60.35%), followed by diabetes (17.02%) and painkiller misuse (21.30%). Self-reported causes varied regionally; blood pressure was the leading cause in both Haryana (68.3%) and Uttar Pradesh (45.6%). However, excessive drug use (13.7%) and other unspecified causes (15.6%) were more prominent in Uttar Pradesh. These findings underscore regional disparities in awareness, risk factors and healthcare practices.
Conclusions: The study highlights the multifactorial nature of kidney failure, with hypertension, diabetes, and medication misuse being the primary contributors. Regional variations in the perceived causes of kidney failure reflect differences in risk factor awareness and healthcare practices between Haryana and Uttar Pradesh. Tailored interventions addressing modifiable risk factors and regional disparities are crucial for effective prevention and management of kidney failure
Reviving liver health with ayurveda: a systematic review of non-alcoholic fatty liver disease management
Get PDFLiver diseases (Yakrit Roga) constitute a global health concern. Non-alcoholic fatty liver disease (NAFLD), which exhibits a global prevalence of 25%, is on the rise, raising significant concerns regarding its impact on global health. NAFLD results in the accumulation of triglycerides and unbound fatty acids within the hepatic tissue. This systematic literature review presents a comprehensive examination of the restoration of liver health in individuals with NAFLD through the principles of Ayurveda. It analysed the results in this discipline from its inception in 2016 to the latest research published in recent years. utilizing PubMed and Scopus, employing specific inclusion and exclusion criteria. Based on the research results, it can be concluded that there is existing evidence regarding both the safety and effectiveness of Ayurvedic interventions along in the treatment of NAFLD. The combined effects of Triphala Guggulu and Arogyavardhini Vaṭi in combination with Pathya (Ayurvedic diet and exercise) showed promising combination. Physical exercise and dietary management are the principal methods for regulating the progression of NAFLD and significantly elevates the probability of non-alcoholic steatohepatitis, (NASH) cirrhosis, and hepatocellular carcinoma
Study on utilization of blood and blood components in surgical patients in a tertiary care hospital in Himachal Pradesh, India
Get PDFBackground: This study aims to assess the utilization patterns and appropriateness of blood and blood components and evaluate transfusion practices across various surgical procedures.
Methods: A one-month record based cross sectional retrospective study involving 1392 patients fulfilling the inclusion criteria for surgical procedures has been conducted at the department of immunohematology and blood transfusion, Indira Gandhi Medical College and Hospital, Shimla, India.
Results: Out of 1392 patients enrolled, females accounted for 746 (53.6%) and males for 646 (46.4%). Surgical procedures have been broadly classified as elective and emergency. Among elective procedures most commonly performed was cholecystectomy 394 (28.3%), least common was involving surgery for Ca breast 7 (0.5%) and Ca prostate 7 (0.5%). Among emergency procedures the highest proportion was orthopaedic surgeries 143 (10.2%), lowest proportion was herniorrhaphy 12 (0.8%) and extradural haemorrhage 12 (0.8%). After further scrutinizing the data, it was found that among elective procedures, cholecystectomy, appendectomy, H. cyst, Ca Breast, Ca Prostate, Ca Colon, orthopaedics, transurethral resection of prostate (TURP), cardio-thoracic and vascular surgeries (CTVS) demonstrated a crossmatch to transfusion (C/T) ratio below 2.5, transfusion probability (TP) below 30% and transfusion index (TI) >0.5%. However, herniorrhaphy and burns demonstrated a C/T ratio>2.5, TP > 30% and TI >0.5%. Among emergency procedures, cholecystectomy, appendectomy, peritonitis, intestinal obstruction, intussusception, RSA, fracture, EDH, SDH, SAH demonstrated a C/T ratio below 2.5, TP below 30% and TI >0.5%.
Conclusions: Blood utilization practice for both emergency and elective surgical procedures appear effective with CT ratio of 1.2, TP 80.6 and TI 0.8
Toxicological and demographic patterns in poisoning fatalities: a retrospective study at AIMS, B. G. Nagara
Get PDFBackground: Poisoning related fatalities represent a major global health concern, contributing to a substantial number deaths each year. Identifying mortality trends from such poisoning is fundamental to designing effective preventive and remedial strategies. The objective of study aims to examine the autopsy profile of poison related fatalities at AIMS, BG Nagara, India.
Methods: This study is 4 years retrospective case record analysis of a population comprising suspected poison cases brought for autopsy. The cases with suspected poisoning, confirmed through clinical evaluation or chemical analysis, were included in the study.
Results: During the study period, a total of 395 cases were examined, of which 113 (28.6%) were confirmed cases of poisoning. Among these, 90 cases (79.60%) involved males, while 23 cases (20.40%) involved females. The most affected age group was 31-50 years, accounting for 41 cases (36.30%). Regarding the manner of death suicidal poisoning was predominant, with 101 cases (89.40%), whereas accidental poisoning accounted for 12 cases (10.60%). Forensic chemical analysis (FSL) yielded positive identification of poisons in 84 cases (74.30%). Among the identified poisons, organophosphates poisoning was the most prevalent, observed in 57 cases (50.40%). The predominant survival duration prior to death was between one day and one week, observed in 55 cases (48.07%). Seasonal variation analysis showed minimal differences, with peak 29 cases (25.60%) recorded between September and November.
Conclusions: Poisoning is a major health issue, especially among middle-aged men, often linked to suicide. Better safety, mental health care and testing can help reduce deaths and improve public health