Indian Journal Of Clinical Practice
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Navigating the Monkeypox Outbreak: A Call for Vigilance and Preparedness
Get PDFMpox (earlier known as monkeypox) is a zoonotic viral illness caused by the monkeypox virus, affecting both humans andvarious animal species. Initially endemic to Central and West Africa, the virus spread to non-endemic regions such as theUnited States, Brazil, Spain, France, Colombia, Mexico, and Peru. This global spread prompted the World Health Organization(WHO) to declare it a Public Health Emergency of International Concern (PHEIC) in 2022. On August 14, 2024, a surge ofMpox cases in the Democratic Republic of the Congo, along with its spread to neighboring countries, was declared a PHEIC.Transmission occurs through direct contact with infected individuals, animals, or contaminated materials. Symptoms typicallyinclude fever, rash, and swollen lymph nodes. Differentiating Mpox from other pox-like illnesses is crucial, with diagnosisconfirmed through polymerase chain reaction (PCR) testing. Effective preventive strategies, such as vaccination, enhancedsurveillance, and strict isolation protocols, are essential for controlling the spread. Although the risk of a widespread outbreakin countries like India remains low, continued vigilance, global coordination, and robust public health preparedness are vitalto mitigating future outbreaks
DRS-WCPD: 11th World Congress on Prevention of Diabetes and Its Complications
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Prevalence and Metabolic Predictors of Metabolic Dysfunction-Associated Steatotic Liver Disease in Lean Indian Women with Polycystic Ovary Syndrome versus Those with Obesity
Get PDFMetabolic dysfunction-associated steatotic liver disease (MASLD), linked to obesity and insulin resistance (IR),is common in polycystic ovary syndrome (PCOS), but its prevalence in lean individuals with PCOS is not well-established.Hence, the aim of the present study is to investigate the prevalence and predictors of MASLD in lean PCOS patients versusthose with obesity. Materials and methods: Fifty premenopausal participants diagnosed with PCOS were divided into twogroups based on their body mass index (BMI): Group A (lean + normal weight, n = 21) and Group B (overweight + obesity,n = 29). Clinical, anthropometric, and biochemical variables were assessed, including IR, lipid profiles, and hormonallevels. The prevalence of MASLD was determined using ultrasonography (USG). Statistical analysis: Mean ± SD (standarddeviation) was used for time-varying variables, and percentages for categorical variables. Univariate analysis includedChi-square and independent t-tests (p < 0.05). Multivariate logistic regression assessed MASLD occurrence in PCOS subjects.Analysis was conducted using Stata software version 14 IC. Results: The overall prevalence of MASLD was 40%, with asignificantly higher proportion in Group B compared to Group A (62.06% vs. 9.50%; p < 0.001). IR was also more commonin Group B (79.30% vs. 23.80%; p < 0.001). In spite of lower IR, Group A participants also had elevated mean fasting insulinlevels (10.32 ± 7.01 mIU/mL), suggesting early metabolic disturbances. Also, Group B participants had significantly highertriglycerides (141.24 ± 42.75 vs. 114.10 ± 31.62 mg/dL; p = 0.018), lower high-density lipoprotein cholesterol (43.41 ± 7.57 vs.51.41 ± 7.12 mg/dL; p < 0.001) and higher prevalence of metabolic syndrome (58.62% vs. 4.70%; p < 0.001) as compared toGroup A participants. Conclusion: Our study shows a high prevalence of MASLD in obese women with PCOS, likely dueto IR. Lean women with PCOS also exhibited metabolic issues, suggesting they may be at risk. These findings highlight theimportance of early metabolic screening and interventions in PCOS women
Papilledema: A Rare Presentation of Scrub Typhus
Get PDFScrub typhus caused by Orientia tsutsugamushi, typically presents with nonspecific febrile illness but can lead to severesystemic complications. Ocular manifestations are uncommon, and papilledema is a particularly rare finding. We report thecase of a 29-year-old female who presented with fever, headache, and altered sensorium, later diagnosed as scrub typhusbased on positive serology. During treatment with intravenous doxycycline, she developed horizontal diplopia, and fundusexamination revealed grade 4 papilledema, despite a normal neuroimaging study. Cranial nerve examination was nonfocal.Other causes of raised intracranial pressure were excluded, implicating scrub typhus as the likely etiology. The patientshowed clinical and ophthalmologic improvement with continued doxycycline therapy. This case highlights the importanceof considering scrub typhus in the differential diagnosis of papilledema in endemic areas and underscores the need for earlyfundoscopic evaluation in patients with neurological symptoms
An Unusual Presentation of Splenic Rupture in a Hemodialysis Patient
Get PDFSplenic rupture, although rare in dialysis patients, can be life-threatening. In this case, a 45-year-old man with kidney failureon hemodialysis experienced sudden and severe abdominal pain in the left flank, without any history of trauma. He displayedsymptoms of hypovolemic shock, characterized by pallor, hypotension, and tachycardia. Additionally, he had abdominaldistension and tenderness. An abdominal CT scan revealed a splenic hematoma and intra-abdominal hemorrhage. Thepatient required a splenectomy to address the ongoing bleeding, but unfortunately, he succumbed to post-splenectomy sepsis2 weeks later
Lateral Cervical Cyst: A Case Report
Get PDFCystic degeneration of cervical lymph nodes is the most accepted theory for occurrence of lateral cervical cyst. It is commonlyfound in the anterior triangle of the neck, anterior to the upper third of the sternocleidomastoid. Clinical examination, imagingmodalities, such as ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI), and fine needleaspiration cytology (FNAC), are useful investigations to establish the diagnosis. Surgical excision of these lesions is reasonedcurative in most of the cases. Authors report a case of lateral cervical cyst which was successfully operated
Congenital Toxoplasmosis with Aplastic Anemia: A Rare Association
Get PDFCongenital toxoplasmosis is caused by transmission of an intracellular obligate coccidian protozoan (Toxoplasma gondii) viavertical transmission during pregnancy. The clinical manifestations are wide ranging from asymptomatic to intracranialcalcifications, seizures, developmental delay, chorioretinal lesions and even fetal death. Aplastic anemia is one of the rarepresentations of congenital toxoplasmosis. Hence, we are reporting a case of a 23-year-old male who presented to us withaplastic anemia due to congenital toxoplasmosis. Thus, congenital toxoplasmosis should always be considered as a causewhen evaluating a case of aplastic anemia