International Journal of Research in Medical Sciences
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Unilateral mandibular central giant cell granuloma in a child: a case report
Get PDFAt the Department of Pedodontics of Buddha Institute of Dental Sciences and Hospital (BIDSH), an 11-year-old girl presented with a main complaint of widespread edema measuring 2×3 cm along her left cheek. It was really hard and not at all sensitive. "The lymph nodes in the left submental region and the submandibular region were soft, sensitive, movable, and palpable. Located in the lower left vestibule, an intra-oral growth measuring approximately 4 into 4 cm was observed. A destructive lesion stretching from the lower canine region on the right side to the lower central incisor on the left was shown in the computed tomography (CT) 3D reconstruction image. The diagnosis of central giant cell granuloma was confirmed by the histopathology of the incisional biopsy, which showed mostly sheets of spindle to ovoid fibroblastic cells intermingled with gigantic cells that looked like osteoclasts. Under general anesthesia, the patient underwent marsupalization and enucleation. Histopathology was then used to confirm the diagnosis
The diagnostic challenge of type 3 Brugada pattern: clinical implications and provocative testing strategies
Get PDFThe Brugada syndrome (BrS) is a channelopathy associated with an increased risk of sudden cardiac death (SCD), characterized by distinctive electrocardiographic (ECG) patterns. While type 1 Brugada pattern is diagnostic, type 2 and 3 patterns are non-diagnostic and require further evaluation. The type 3 Brugada pattern, characterized by a <2 mm saddleback ST-segment elevation followed by a positive T-wave, poses significant diagnostic uncertainty due to its dynamic nature and overlap with benign ECG variants. Provocative testing with sodium channel blockers (e.g., ajmaline, flecainide, or procainamide) is often necessary to unmask a diagnostic type 1 pattern. However, the indications, timing, and safety of pharmacological challenge remain debated, particularly in asymptomatic individuals or those with low pretest probability. This review explores the diagnostic dilemmas of type 3 Brugada pattern, analyzes risk stratification criteria, and provides evidence-based recommendations on when to perform provocative testing. Key considerations include clinical history, family history of SCD, syncope of unknown origin, and the presence of arrhythmic symptoms. A structured diagnostic approach is essential to avoid both underdiagnosis and overmedicalization in this clinically ambiguous population.
Clinico-social profile of adult patients with uncontrolled seizures attending a neurology OPD at a tertiary care hospital in Goa
Get PDFBackground: Of the 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India. Nearly one-third of the patients with newly diagnosed epilepsy on long-term follow-up will have their seizures unsatisfactorily controlled by treatment with available anti-epileptic drugs (AEDs). Objective of this study was to study the clinico-social profile of adult patients with uncontrolled seizures.
Methods: A cross-sectional study was conducted over a period of 3 months among 106 patients with uncontrolled seizures. Universal sampling was used to select the participants, and a semi-structured questionnaire was used to collect the data.
Results: Poor compliance to medication was the most common cause for uncontrolled seizures (51.8%) and was significantly associated with those who were prescribed <3 AEDs (OR=2.532, p=0.041). Focal with impaired awareness (34.9%) and generalised tonic clonic seizures (GTCS) (34.9%) were the most commonly seen.
Conclusions: Patient compliance is of utmost importance in maintaining good seizure control
Rehabilitation of pharyngeal dysphagia and spastic dysarthria following acute ischemic stroke: a case study
Get PDFWe present the case of a 49-year-old female with a history of coronary artery disease, hypothyroidism, and prior coronary artery bypass grafting, who presented with slurred speech, left-sided mouth deviation, and difficulty swallowing. Imaging confirmed acute ischemic stroke affecting the left precentral gyrus and left corona radiata. The patient was diagnosed with spastic dysarthria and pharyngeal dysphagia, with severe swallowing difficulties and aspiration. A comprehensive swallowing therapy plan was developed, focusing on both rehabilitative and compensatory techniques. Rehabilitative therapy included exercises like the chin-down posture to improve tongue control and laryngeal closure, the tongue anchor exercise to increase pharyngeal wall pressure, and the Valsalva maneuver to promote safer swallowing. The supraglottic swallow and effortful swallow techniques were introduced to improve bolus clearance and reduce residue. Compensatory strategies such as thermal tactile stimulation, the sour bolus strategy, and the dry gargle technique were applied to improve sensory awareness and swallowing safety. The patient was gradually introduced to different food consistencies, progressing from thickened liquids to a regular diet. After two weeks of therapy, swallowing function significantly improved, with increased oral intake, improved dysphagia severity scores, and a transition to a regular diet. This case emphasizes the importance of targeted swallowing therapy in post-stroke rehabilitation
Prevalence and patterns of physical deconditioning and fatigue in post-COVID-19 patients: evidence from a case-control study
Get PDFBackground: Physical deconditioning and fatigue are increasingly recognized as a significant consequence of the COVID-19 pandemic, especially in individuals recovering from infection. The aim of the study was to determine the proportion, pattern and severity of physical deconditioning and fatigue among post-COVID-19 patients versus non-infected controls.
Methods: Physical deconditioning and fatigue are increasingly recognized as a significant consequence of the COVID-19 pandemic, especially in individuals recovering from infection. This study aimed at determining the proportion, pattern and severity of physical deconditioning and fatigue among post-COVID-19 patients versus non-infected controls.
Results: Demographically both groups were similar with male predominance in this study. Significantly higher proportions of fatigue (89.3% vs. 64.6%) and physical deconditioning (94.0% vs. 68.3%) were observed among cases compared to controls. Moderate to severe fatigue and higher grades of deconditioning were notably prevalent among cases, whereas controls reported milder symptoms. COVID-19 patients suffered more severe deconditioning across functional mobility, productivity.
Conclusions: COVID-19 survivors exhibit a higher prevalence and greater severity of physical deconditioning and fatigue across daily life domains compared to non-infected individuals. Integration of comprehensive rehabilitation and early intervention is critical for optimizing recovery and restoring quality of life in affected patients
Use of the Mustardé flap in facial reconstruction following surgery for cutaneous squamous cell carcinoma: a case report
Get PDFBasal cell carcinoma (BCC) is the most common cutaneous malignancy, comprising nearly 80% of non-melanoma skin cancers. Despite its typically slow growth and low metastatic potential, BCC demonstrates a locally aggressive behavior capable of causing substantial tissue destruction if not promptly addressed. Lower eyelid is frequent site of involvement, representing a unique therapeutic challenge due to its intricate anatomical architecture and the critical balance between its protective ocular function and aesthetic significance. Surgical management in this region demands precise oncologic excision combined with meticulous reconstructive planning to preserve eyelid function and facial harmony
Mā’ al-Laḥm (meat soup): a narrative review on Unani Pharmacopeial protein formulation dosage form
Get PDFIn the Unani system of medicine, diet is an integral part of the treatment regimen, and dietary recommendations for health promotion have been practiced for ages. Special diets such as Mā’ al-Laḥm (meat soup), Mā’ al-Jubn (whey), Mā’ al-Asal (honey water), and Mā’ al-Sha‘īr (barley water), are the essential therapeutic agents in Unani medicine that can effectively and affordably address lifestyle disorders and malnutrition-related diseases. Among these, Mā’ al-Laḥm is a unique Unani Pharmacopeial formulation made with meat and herbal ingredients in the form of soup or distillate. It is a protein-rich liquid dosage form that revitalizes the body by strengthening organs and enhancing physical strength and energy. This natural remedy is used to treat various health issues, including anemia, cardiac weakness, liver and stomach problems, weak immunity, and general debility. Mā’ al-Laḥm combines the health benefits of both meat and medicinal herbs. Meat constitutes high-quality proteins, vitamins, minerals, bioavailable iron, and an assembly of beneficial bioactive compounds such as conjugated linoleic acid, glutathione, creatine, taurine, L-carnitine, carnosine, and bioactive peptides. The medicinal herbs contribute additional bioactive components, including carotenoids, coumarins, flavonoids, lignans, phthalates, plant sterols, polyphenols, saponins, and terpenoids, which offer various positive health effects. Unani medicine may offer much-needed and affordable nutritionally and therapeutically dense choice for consumers. This review article attempts to provide a comprehensive account of Mā’ al-Laḥm, covering its preparation methods, different formulations, therapeutic uses, and the characteristics of different types of meat. Nutritional composition and bioactive constituents of meat are also described to signify the nutritional and medicinal properties of Mā’ al-Laḥm
Juvenile post dengue mucormycosis-reporting a rare entity with review of literature
Get PDFInvasive mucormycosis is a life-threatening fungal infection that most frequently occurs in patients with underlying comorbidities that impacts immune system function. It is an opportunistic and frequently fulminant fungal infection caused by a saprophytic organism belonging to class zygomycetes. These organisms are omnipresent and grow in their natural state on the variety of decaying organic materials. These organisms are present in the nasal passages and oral cavities of normal individuals. Here, we report a rare case of juvenile post dengue mucormycosis along with brief insight into the review of literature. Histopathological examination of the necrotic bone and overlying tissue was done in OPD in a juvenile patient who reported with purulent discharge and having a history of dengue. There were abundant PAS positive fungal hyphae. This case report will acquaint the oral care providers of a possible association of mucormycosis and dengue and highlight the importance of early diagnosis to optimize the treatment outcomes and prognosis in such cases. Mucormycosis is a rare opportunistic infection that spreads promptly and is life-threatening. Therefore, early diagnosis and prompt treatment is required to reduce the mortality and morbidity of this lethal infection
Role of early catheter-based interventions in acute pulmonary embolism: a case report
Get PDFAcute pulmonary embolism (PE) is a life-threatening condition requiring prompt and effective treatment. We present an interesting case of Intermediate-high-risk PE patient who underwent catheter-directed thrombolysis with thrombosuction cum thrombectomy, resulting in significant clinical improvement. The patient had evidence of deep vein thrombosis and presented with dyspnoea and hypotension. Following CT pulmonary angiography confirmation, he underwent catheter-directed interventions using a penumbra CAT 6 catheter (Continuous Aspiration Mechanical Thrombectomy Catheter) along with receiving very low-dose thrombolytic therapy (Alteplase 20 mg). Post-procedure, the patient showed marked improvement, with no major complications. He was discharged on Rivaroxaban and remained asymptomatic on follow-up. This case demonstrates the effectiveness, early recovery and safety of catheter-directed interventions in managing acute PE, highlighting their potential as valuable treatment options for selected patients
Radiological and histopathological correlation of hepatic tumors in computed tomography and magnetic resonance imaging
Get PDFBackground: Hepatic tumors present a diagnostic challenge due to overlapping radiological features with both benign and malignant lesions. Differentiating these tumors accurately is essential for appropriate management. Correlating imaging findings with histopathology can enhance diagnostic confidence and reduce unnecessary interventions.
Methods: A prospective study was conducted at SCB Medical College, Cuttack, from January 2021 to December 2022, involving 100 patients with hepatic tumors. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) followed by histopathological evaluation. Radiological findings were compared with histopathology and immunohistochemistry for diagnostic correlation.
Results: Out of 100 hepatic tumor cases, 58% showed hypervascularity and 82% had well-defined margins on imaging. T2 hyperintensity was observed in 77% and T1 hypointensity in 60% of lesions. Fat was detected radiologically and histologically in 40% of cases. Histopathology confirmed hepatocellular carcinoma in 45%, angiomyolipoma (AML) in 12%, and other benign tumors in the rest.
Conclusions: Radiological features alone may be insufficient for definitive diagnosis. Correlation with histopathology is essential, especially in fat-deficient lesions