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Clinical profile and response to tuberculosis treatment in patients with chronic kidney disease
Get PDFIntroduction: Tuberculosis (TB) is a major public health problem, especially in the developing countries Patients with CKD have a weakened immune system due to the chronic inflammatory state due to CKD per se, also due to long term renal replacement therapy. Aims of The Study
To study the clinical profile of tuberculosis in chronic kidney disease patients
To study the response to anti tubercular treatment including adverse effects.
Methodology: This study was carried out in the Department of Nephrology at Government Stanley Medical College and Hospital, Chennai during the period between October 2018-May 2019. A detailed history was taken, Age, symptomatology, non CKD risk factors like smoking, alcoholism, previous history of pulmonary TB, presence of diabetes mellitus, other infections like HCV, and in case of post-transplant patients, use of induction therapy, any graft dysfunction etc. was noted. The definitions for cure, treatment completed, and treatment failure being used in the study.
Results: There were a total of 55 patients with CKD diagnosed as tuberculosis by various means-clinical, histopathologic, biochemical, microbiologic, radiologic or a combination of factors.
Conclusion: Tuberculosis is a common infection among Chronic Kidney disease patients, due the immunosuppressed state, hence a high index of suspicion should be maintained, with ways of early screening to be followed based on clinical grounds. Risk factors, namely, smoking, alcoholism, diabetes mellitus predisposes CKD patients to Tuberculosis in addition to the immunosuppressed state of CKD
Assessment of psychiatric co-morbidities in patient of interstitial lung disease attending a tertiary medical centre: Assessment of psychiatric co-morbidities in patient of interstitial lung disease attending a tertiary medical centre
No full textAims and Objectives: Interstitial lung disease (ILD) is a diverse group of conditions that are characterized by inflammation and fibrosis of the pulmonary parenchyma. In general, ILD is chronic and progressive diseases that result in substantial morbidity and mortality. The cardinal symptom of ILD is dyspnea; however, other pulmonary and extra-pulmonary symptoms are often present [1]. ILD is a common respiratory illness, in which some of the disease-related factors may increase the vulnerability to psychiatric disorders. This study was done to determine the prevalence of psychiatric co-morbidity in patients of ILD.
Methodology: It is an observational study conducted in 110 follow-up patients of Interstitial lung disease attending respiratory medicine OPD at a tertiary care center in central India. Psychiatric comorbidities are assessed by a pre-designed short structured questionnaire using Mini international neuropsychiatric interview.
Result: Among 110 patients of ILD 28% had psychiatric co-morbidity mainly depressive episodes (59%). A significant association is found between upper socioeconomic status (P =0.01), duration of active illness (more than 1 year) (P =0.001), and age of patient between 40 to 60 years (P =0.001) with psychiatric co-morbidity of ILD patient.
Conclusion: Our study shows there is an increased prevalence of psychiatric co-morbidities in patients of ILD, higher than the national average. The predominant psychiatric disorder seen is depressive disorder, so treatment of ILD should be a multidisciplinary approach including medical treatment of ILD and psychiatric evaluation to prevent psychiatric comorbidity or its early management. This will greatly reduce the morbidity, visits to hospitals, expenditure on treatment and thereby having better outcomes in our patients of ILD
TRAUMATIC BRAIN INJURY IN ADULTS: AGE, ETIOLOGY, AND TREATMENT OUTCOME
Get PDFTraumatic brain injury had been described as silent epidemic. The etiology is said to be changing and older adults have been said to have worse outcome compared to the younger ones. We prospectively studied adults managed for traumatic brain injury in our center over a four and half year period.
Objectives: To determine the effects of age and etiological factors on the outcome of adults managed for traumatic brain injury.
Methods: It was a prospective study on adults managed for traumatic brain injury in our center from August 2010 to January 2015. Patients were resuscitated in accident and emergency using Advanced Trauma Life Support (ATLS) protocols. Biodata, history and physical examinations were done in accident and emergency. Severity of the injury was assessed using Glasgow Coma Scale. Comatose patients were admitted in intensive care unit (ICU), while orders were admitted in the wards. Data were collected using structured Performa which was component of our prospective data bank that was approved by our ethics and research committee. Data were analyzed with Environmental Performance Index (EPI) info 7 software.
Results: Two hundred and eighty seven patients were studied. There were 244 males. Their ages ranged from 20 – 76 years. The most common etiology in all age groups was road traffic accident (RTA).The outcome was worse in older patients.
Conclusion: We found that more males had traumatic brain injury. The most common etiology in all ages was RTA. The outcome was significantly affected by age. Older patients had worse outcome
TYPE 1 DIABETES DILEMMA IN SUB-SAHARAN AFRICA
Get PDFType 1 diabetes is a rigorously studied metabolic and human disease that mostly affects young people, and it is dependent upon human insulin and insulin analogs for its control. The Type 1 diabetes has low-frequency incidence in sub-Saharan Africa than I n more advanced societies, ostensibly due to delayed onset in Africa. However, it is projected that in the foreseeable future that the trend may metamorphose into an increase in the frequency rate in subSaharan Africa due to cross-cultural and other influences. Due to pecuniary difficulties, socioeconomic status and awareness, inadequate healthcare and clinical settings, the increase in morbidity and mortality associated with Type-1 diabetes may increase at a frightening rate in Sub-Saharan Africa
Main sexual problems in Parkinson disease patients
Get PDFThe incidence of impaired sexual function in adults with Parkinson’s disease (PD) is greater than in the general population. Sexual problems are commonly reported in PD .Gender differences of SD patterns have been demonstrated. In men the predominant SD were found to be erectile dysfunction (ED), difficulties in reaching orgasm, and premature ejaculation (PE), whereas the predominant symptoms for women with PD were low sexual desire and difficulties with arousal and with orgasm. Sexual disorders create problems among couple: the need to fill the role of a caregiver, the burden that becomes heavier as the disease progresses both physically and mentally, the reduced attractiveness of the PD partner due to abnormal movements, sloppy dressing, masked faces, excessive sweating, or salivation. Medications used to treat anxiety, agitation, insomnia, and psychosis are commonly associated with SD
Melioidosis: A case series from a tertiary care hospital in Assam
Get PDFMelioidosis is sporadically reported from various parts of India. We present a case series from Assam, highlighting the varied manifestations of the disease. Three cases of culture-proven melioidosis are presented in whom Burkholderia pseudomallei were isolated from aspirate or blood. Melioidosis had a varied presentation involving multiple abscesses in the soft tissues, liver, spleen, mediastinum, and the subdural space. It presented as either acute fulminant sepsis or followed a chronic indolent course, mimicking tuberculosis. Most cases had predisposing risk factors such as diabetes and chronic alcoholism.
 
RESULTS OF PENETRATING KERATOPLASTY IN TERTIARY CARE CENTRE
Get PDFBlindness due to corneal scarring is one of the leading causes of treatable blindness. Full thickness penetrating keratoplasty is still considered to be the most acceptable surgical method, keeping this in mind and with the Purpose To study visual outcome after penetrating keratoplasty and to evaluate intra and post operative complications and to study the various factors which influences the graft survival. In our study we have operated 32 eyes of 32 patients and they were studied over 24 month’s period. Patient with all types of corneal opacity, Keratoconus and Failed corneal transplant were considered for optical keratoplasty. At the end of 24 months we found that Out of 32 patient’s male to female ratio was 2.2:1.Mean age was 47 ±12 years. Most common indication was corneal scar (43.75) most common preoperative risk factor for graft failure was vascularised recipient cornea (28.12%). Good quality graft (2+) had better survival rate (83.33%) and better visual prognosis (81.8%).Small graft size had better survival rate (78.57%) Young donor below 50 years of age, graft survival rate was 87%.Most common intraoperative complication was suture related difficulties (28.12%). Postoperative corneal graft edema was commonest complication (57%) Total 34.36% of patients gained vision ≥ 6/24. 37.5% patients between 4/60-6/60. Total graft survival rate was 71.87%.Total corneal graft failure rate was 28.13%.Conclusions: Full thickness Penetrating Keratoplasty gives satisfactory visual outcome .Pre-operative evaluation of donor corneas & recipient eyes is important. Post operative follow up is recommended
Sleep disorders in people suffering from Parkinson’s disease
Get PDFParkinson’s disease (PD) is a chronic, progressive neurodegenerative disease affecting approximately 1 % of those older than 60 years. (1) In PD degeneration of dopamine neurons, most prominently in the substantial nigra (SN) of the brainstem, is recognized as a characteristic pathologic finding. Deterioration of non-dopaminergic pathways is now recognized as contributing greatly to these disorders, especially the nonmotor symptoms such as neuropsychiatric problems, dysautonomia, fatigue, and sleep disorders
Bilateral mandibular impaction: A case report and review of literature
Get PDFImpacted tooth refers to a tooth that fails to erupt in the dental arch in its normal position due to its surrounding structures. Multiple local and systemic factors influence this condition. Impaction of mandibular permanent lateral incisor and canine on either side is rare phenomenon in dental practice. As they are positioned in aesthetic and functionally important zone, treatment is quite challenging and requires multidisciplinary intervention
Psycho neurobics practices for self-healing for individual seafarer: Wellness at sea
Get PDFPsycho-neurobics is actually a set of exercises of transferring Spiritual Energy in neuro cells by connecting Psyche (Mind) to the supreme source of Spiritual Energy. It\u27s the greatest methodology in order to guide the mind to be able to make use of brain energy for creative work, to heal the body and to keep body and mind healthy. In this paper, we would understand how Psycho-neurobics support seafarers in various forms of self-healing. We will also understand how Psycho-neurobic exercises are designed with a holistic approach to removes negative energy, healing Chakras and improving mental strength. The study will also discuss the importance of Psychoneurobics Practices for sailors to overcome any illness or overcoming with day to day sea life’s stress through practicing Psycho-neurobic for keeping them mentally and physically fit at sea