ABSTRACT
Background:Early detection of electrocardiogram (ECG) abnormalities in high risk cardiovascular patients with routine ECG screening is the need of the hour. The aim of the e-survey was to understand the use of ECG in high risk cardio-metabolically deranged patients at outpatient departments (OPDs) by Indian physicians.Methods:A cross-sectional India office ECG (IOECG) e-survey was conducted using Google form questionnaire from November 2021 to December 2021 among Indian physicians. Survey results were collected and analysed using Google form survey tool.Results:We received total of 1863 responses. The results of the survey showed that while 90% of physicians agreed to the necessity of doing 12 lead ECG of cardio-metabolically deranged patients, only 61% of all physicians could perform ECG screening in less than 40% of high risk cardio-metabolic patients mainly, due to several practical challenges. Among physicians, 40.2% physicians believed that 12 lead ECG was too time consuming, 35.8% physicians believed that the unavailability of ECG device was common reason while 27.5% physicians believed that there was a lack of trained staff. Majority of physicians (69.7%) agreed to use point of care ECG device which can be a solution for more screening of such patients whether symptomatic or asymptomatic. According to the survey, 88.7% physicians would appreciate if a portable handheld ECG device was made available to facilitate screening in their practice.Conclusions:There is a need of the portable handheld ECG device which helps physicians to screen large number of cardio-metabolically deranged patients in their busy OPDs.
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Abstract Objective: To describe the spectrum of magnetic resonance imaging (MRI) findings in patients with neurological manifestations of dengue. Materials and Methods: We included nine patients with dengue fever (three females and six males; age range, 9-30 years), all of whom presented with neurological manifestations. The MRI examinations, performed in 1.5 T or 3 T scanners, included T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences. Diffusion-weighted imaging with apparent diffusion coefficient mapping was also employed. Fast low-angle shot and susceptibility-weighted gradient-recalled echo sequences, as well as contrast-enhanced T1-weighted scans, were also obtained in order to assess parenchymal enhancement. MRI scans were analyzed for lesion distribution and imaging features. Results: All patients showed areas of altered signal intensity that appeared as hyperintensity on T2-weighted and FLAIR sequences. The most commonly affected site was the basal ganglia-thalamus complex. Other affected sites were the cerebellum, cerebral cortex, white matter, and brainstem. In all cases, we observed patchy areas of restricted diffusion and focal areas of hemorrhage. Conclusion: Dengue encephalitis commonly affects the basal ganglia, thalamus, cerebellum, cerebral cortex, and white matter. Therefore, MRI should be an indispensable part of the evaluation of patients with neurological complications of dengue fever.
Resumo Objetivo: Descrever o espectro dos achados de ressonância magnética (RM) em pacientes com manifestações neurológicas de dengue. Materiais e Métodos: Foram incluídos nove pacientes com dengue (três do sexo feminino e seis do sexo masculino; faixa etária: 9-30 anos), todos com manifestações neurológicas. Os exames de RM, realizados em aparelhos de 1,5 T ou 3 T, incluíram sequências ponderadas em T1 e em T2, assim como fluid-attenuated inversion recovery (FLAIR). Também foi empregada a imagem ponderada em difusão com mapeamento de coeficientes de difusão aparente. Além disso, foram obtidas sequências gradiente-eco ponderadas por suscetibilidade e em fast low-angle shot, bem como imagens ponderadas em T1 pós-contraste, para avaliar o realce parenquimatoso. As imagens de RM foram analisadas quanto à distribuição de lesões e características de imagens. Resultados: Todos os pacientes apresentaram áreas de intensidade de sinal alteradas que apareceram como hiperintensidade em sequências ponderadas em T2 e sequências FLAIR. O local mais comumente afetado foi o complexo gânglios basais-tálamo. Outros locais afetados foram o cerebelo, o córtex cerebral, a substância branca e o tronco encefálico. Em todos os casos observamos áreas irregulares de difusão restrita e áreas focais de hemorragia. Conclusão: A encefalite por dengue geralmente afeta os gânglios basais, o tálamo, o cerebelo, o córtex cerebral e a substância branca. Portanto, a RM deve ser uma parte indispensável da avaliação de pacientes com complicações neurológicas da dengue.
ABSTRACT
Introduction: The patient’s desire for esthetics, coupled with the decreasing use of amalgam, requires that clinicians be comfortable and proficient in the use and placement of tooth-colored restoratives.Case Report: A 30 yrs old male came with chief complaint of large metallic filling on lower left back region came to the department for esthetic restoration. Patient had dental history of endodontic treatment with 36,37,46,47 and periodontal surgery with 46,47. Patient was advised by endodontic department for proper restoration of endodontically treated teeth to avoid fracture of treated tooth.Discussion: Indirect composite restorations demonstrate enhanced physical properties and predictable clinical performance having less polymerization shrinkage than direct composites. There is more strength in highly filled indirect composite. One of the most important attributes of indirect composite is the ability to create ideal contours and contacts with adjacent and opposing teeth that might be difficult to achieve clinically with large, directly placed composite restorations. [Kaushik ANJIRM 2016; 7(5):98-100]