Introduction: Nephrotic Syndrome (NS) is characterised by proteinuria, oedema, hypoalbuminaemia, and hypercholesterolemia. The latter is a risk factor for atherosclerosis, suggesting a higher risk of ...cardiovascular disease in children with NS. Atherosclerosis is proposed to be caused by vascular endothelial dysfunction, reflecting the inflammatory response to tissue damage. Aim: To investigate indices of early vascular involvement in children with Idiopathic Nephrotic Syndrome (INS). Materials and Methods: This case-control study was conducted at a tertiary-care hospital, Pt. BD Sharma PGIMS Rohtak, Haryana, India, over a period of two years and two months. The study included 50 children aged <14 years with NS. Vascular indices, including Carotid Intima Media Thickness (CIMT), highsensitive C Reactive Protein (hs-CRP), and Atherogenic Index of Plasma (AIP), were evaluated. Analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The correlation of cardiovascular risk in children with NS was calculated by measuring CIMT, AIP, and CRP levels, and the relationship was analysed using the Chisquare test. A p-value of <0.05 was considered statistically significant. Results: The study found that the thickness of CIMT in group 1 was 0.67±1.39 mm, while in group 2, it was 0.31±0.04 mm. The calculated p-value was <0.001, which was statistically significant. The hs-CRP level in group 1 was 4.64±5.87 mg/L, higher than the control group (0.85±0.10 mg/L), with p-value of <0.001. Furthermore, AIP was higher in children with NS (0.80±0.19) compared to the control group (0.02±0.16). There was a statistically significant difference between both groups (p<0.001). Conclusion: Early assessment of indices of vascular involvement, such as CIMT, hs-CRP, and AIP, in children with INS can aid in the early identification and prevention of cardiovascular complications.
Introduction: Deep-vein thrombosis (DVT) is one of the precarious complications of spinal cord injury (SCI). The present study was aimed to determine the incidence of DVT in acute traumatic SCI in ...the Indian population, factors associated with DVT, and to evaluate the role of D-dimer and color Doppler in establishing the diagnosis. Patients and Methods: Fifty patients with acute SCI presenting to a tertiary care center within 48 h of injury were clinically evaluated for the level, extent, and severity of SCI according to the ASIA standards. The local examination for the assessment of DVT was conducted. D-dimer test and color Doppler for DVT were performed at initial presentation, on day 7 and 14, 1 month, 3 months, and 6 months. Results: Three patients developed DVT between 14 days to 1 month. Overall DVT incidence was found to be 6%. Neurological level (P < 0.05) and the severity of the deficit (P < 0.001) were found to be associated with DVT. Patients with DVT had significantly more thigh and calf circumference at 1 month. Significantly higher levels of D-dimer were observed right from initial presentations to 6 months. Color Doppler was positive in all the three cases of DVT. Conclusions: The incidence of DVT is low in SCI patients in India, but it is not a rare complication. The occurrence of DVT has a significant correlation with factors such as the level and severity of injury. Frequent clinical examinations including the thigh and calf circumference along with D-dimer level estimation are good screening indicators, and color Doppler is an effective tool for establishing a definitive diagnosis of DVT in SCI patients.
Objective
The objective of this study is to investigate the effect of endodontic treatment on flow-mediated dilatation (FMD) and carotid intima-media thickness (c-IMT) in patients with apical ...periodontitis (AP).
Material and method
The study includes 32 young men having AP with a mean age of 25.78 years free from cardiovascular disease (CVD) and its risk factors, including periodontitis. All subjects underwent complete physical and dental examination, echocardiography, and ultrasound assessment of FMD on the brachial artery and c-IMT on the carotid artery at baseline and 12 months after the endodontic treatment. Data were analyzed using paired Student’s
t
-test and Pearson’s correlation coefficient (
r
) test using SPSS 26 version.
Results
Endodontic treatment leads to the improvement of FMD significantly from a pooled baseline value of 4.84 ± 1.55% to 7.68 ± 2.08% (
p
< 0.05). The study also depicts a statistically significant difference between c-IMT (mean = 0.62 ± 0.11 mm) before treatment as compared to 12 months after treatment (mean = 0.59 ± 0.11 mm) (
p
< 0.05).
Conclusion
Endodontic treatment leads to improved FMD and decreased c-IMT suggesting that treating AP can be help revert the early stages of CVD.
Clinical relevance
AP could be a potential etiological factor of future CVD and should be treated as soon as diagnosed.
Summary
Ultrasonography is an easily available and portable tool to assess the dynamic changes in the upper airway and surrounding soft tissue. This study aimed to evaluate the utility of oropharynx ...ultrasonography as a screening tool for obstructive sleep apnea (OSA). The study sequentially enrolled overweight individuals (body mass index >25 kg/m2) and subjected them to OSA screening tools (Berlin questionnaire, Epworth Sleepiness Scale and STOP‐Bang scores), ultrasonography of the oropharynx followed by overnight polysomnography. A total of 30 healthy individuals were also recruited as controls. Detailed dynamic and static ultrasonography measurements of the oropharynx and surrounding tissue were done. The diagnostic ability of various ultrasonography parameters to detect OSA was determined using receiver operating characteristic curve analysis. A total of 63 subjects were enrolled, with 33 in the OSA group and 30 in non‐OSA overweight group. All baseline characteristics were similar in the two groups. Except for the dynamic measurements of oropharynx (Retropalatal% change‐inspiration, retropalatal% change‐Muller manoeuvre, retroglossal% change‐inspiration, and retroglossal% change‐Muller manoeuvre) all other parameters were similar in the OSA and non‐OSA overweight subjects. The area under the receiver operating characteristic curve was highest for retropalatal% change‐inspiration: 0.989, followed by retropalatal% change‐Muller manoeuvre: 0.988. Both were also significant predictors of OSA with odds ratios of 0.338 (p = 0.003; 95% confidence interval CI 0.164–0.696) and 0.346 (p = 0.018; 95% CI 0.143–0.837), respectively. Ultrasonography provides a near complete picture of the dynamic changes and collapsibility of the oropharynx and can be an effective tool in screening for OSA.
Abstract Background Uterine myomas are benign tumours affecting 20–40% women. Various medical and surgical therapeutic options are available but the search for an ideal medical option continues. ...Aromatase inhibitors have recently been reported to have a potential role in the management of oestrogen-dependent conditions like endometriosis and leiomyoma. Objective To evaluate the effect of letrozole on uterine myoma size and symptomatology in perimenopausal women. Study design Prospective interventional study conducted on 30 premenopausal women aged between 30 and 55 years with menstrual or pressure symptoms and having a single intrauterine myoma of size 4 cm or more with or without one or more additional myomata each of size 2 cm or less. They received tablet letrozole 2.5 mg a day for 12 weeks, and the effect of the drug on myoma size and volume and symptomatology was studied along with the adverse effect profile and patient satisfaction. Results The mean myoma size reduced from 5.4 ± 1.3 cm to 4.3 ± 0.9 cm ( p < 0.05) and the myoma volume exhibited a reduction of 52.45% ( p = 0.00) at the end of 3 months. The symptomatology score showed a significant improvement that persisted up to 3 months after cessation of therapy. No significant effect was observed on lipid profile, serum estradiol, progesterone, testosterone and FSH and LH levels during the therapy. Nausea and hot flushes were the main adverse effects observed and were self-limiting. Conclusion Letrozole significantly reduces myoma size and volume and also improves the associated symptoms. It has a good adverse effect profile and appears to be a promising medical option for management of uterine myomas.
Purpose
To evaluate the relationship between sonographic measurements of umbilical cord coiling index during late second trimester of pregnancy and perinatal outcome.
Methods
This prospective study ...was conducted on two hundred pregnant women with uncomplicated, singleton pregnancy between 20 to 24 weeks of gestation. The antenatal umbilical coiling index (UCI) was calculated by doing a transabdominal ultrasound at the time of induction into the study as the reciprocal of the pitch of one complete vascular coil. The patients were followed up till delivery and any adverse antenatal and/or perinatal event was noted.
Results
The mean value for the UCI was noted to be 0.36 + 0.07 coils/cm with a 95 % CI of 0.35–0.37. The values for the 10th and the 90th percentile were 0.26 and 0.46 coils/cm respectively. Accordingly the cases were divided into three groups- hypocoiled (UCI <10th percentile)-18, normocoiled (UCI between 10th–90th percentile)-162 and hypercoiled (UCI >90th percentile)-20. Hypocoiling was observed to be significantly associated with preterm labour pains (
P
value 0.0344), oligohydramnios (
P
value 0.0021), intrapartum foetal heart rate abnormalities (
P
value 0.0012), instrumental vaginal delivery (
P
value 0.0275) and low birth weight (
P
value 0.0344). Hypercoiling was found to be significantly associated with intrauterine growth restriction (
P
value 0.0323), foetal heart rate abnormalities during labour (0.0399) and low birth weight (
P
value 0.0095).
Conclusion
Abnormal umbilical coiling index in the form of either hypo- or hypercoiling is associated with several adverse antenatal and neonatal outcomes.
Introduction: Controversy exists over the pain during prostate biopsy. Periprostatic nerve block (PNB) is a gold standard anesthetic technique during transrectal ultrasound (TRUS)-guided prostate ...biopsy. Recent studies showed that PNB alone is insufficient as analgesic. We compared the efficacy of tramadol and intraprostatic nerve block (INB) in addition to PNB.
Materials and Methods: We conducted a prospective double blinded placebo controlled study at our institute in 150 consecutive patients. Patients were randomized into three groups. Group A received PNB with INB with 1% lignocaine. Group B received oral tramadol with PNB. Group C patients were administered PNB only with 1% lignocaine. Patients were asked to grade the pain level using 11 point linear visual analog scale (VAS) at the time of ultrasound probe insertion, at time of anesthesia, during biopsy, and 30 min after biopsy.
Results: The study groups were comparable in demographic profile, prostate-specific antigen (PSA) levels, and prostate size. Group A recorded the minimum mean pain score of 2.66 during prostate biopsy which was significantly lower than group 3 ( P < 0.001). Group B recorded significantly lower pain score at time of probe insertion and at anesthetic needle insertion than other two groups.
Conclusions: PNB provides better pain control in TRUS-guided prostate biopsy but still there is need of additional analgesic in the form of tramadol or INB. Tramadol has advantage of oral intake and analgesic effect at time of probe insertion and at nerve block. Both tramadol and INB may be used in combination along with PNB.
In the present study, the salbutamol sulfate-loaded sodium alginate-pectin (SS-loaded SA-PEC) bubble beads have been optimized and evaluated for drug loading, in vitro drug release, in vivo floating ...behavior in the stomach, etc. Nine batches (F1–F9) of bubble beads with different SA and PEC contents were prepared by novel co-axial needle air-injection method and related to their percent drug loading efficiency (%DLE) and percent drug release at 4 h (%R4h) as response factors. The multivariate analysis has shown the effect of SA/PEC ratio, total polymer content, as well as their interaction on %DLE and %R4h. In the quantitative modeling, the satisfactory adjustment of the linear models (along with interaction terms) with the experimental data for both %DLE and %R4h has confirmed the findings of the multivariate analysis. The optimized SS-loaded SA-PEC bubble beads based on 2D (contours), 3D, desirability, and overlay plots has exhibited %DLE of 87.35 ± 2.48% (n = 3 and error = 2.94%) and %R4h of 85.79 ± 2.98% (n = 3 and error = 0.25%). The in vitro drug release studies have shown almost complete (≥85%) SS release from all the batches within 4–6 h in simulated gastric fluid (SGF) pH 1.2. The in vivo clinical findings by ultrasound studies have shown excellent floatation (>6 h) behavior of bubble beads in the upper gastrointestinal tract (GIT) and efficient stomach-specific gastroretention.
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Type B congenital pyloric atresia: a case report Singh, Dikshant; Kumar, T. Seetam; Sen, Jyotsna
International journal of research in medical sciences,
06/2020, Letnik:
8, Številka:
7
Journal Article
This is a case of congenital pyloric atresia type B not associated with any other anomaly rare condition, seen as an isolated anomaly with excellent prognosis) of two days female child presenting ...with vomiting since birth. X-ray abdomen showed only stomach air bubble, sonography showed distended stomach with echoes and on barium meal no passage of contrast was seen beyond pyloric antrum even after 24 hours. Patient underwent Heineke-Mikulicz pyloroplasty and postoperative recovery was uneventful.
Summary Objective Krukenberg tumors in pregnancy are extremely rare. Only three cases have been reported, two of which were diagnosed postpartum. Case Report A 20-year-old, primigravida with ...bilateral malignant ovarian tumors, who received no prior antenatal care, was presented with intestinal obstruction at 5 months' gestation. Pregnancy was preserved, and bilateral oophorectomy, omentectomy with resection of sigmoid colon growth, and colostomy were performed. The patient aborted spontaneously and postoperatively, and was treated with adjuvant chemotherapy. Conclusion Because platinum-based chemotherapy can be safely given during pregnancy, hysterectomy can be avoided in cases of bilateral malignant ovarian tumors if the uterus is not grossly involved, so allowing preservation of an existing pregnancy.
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