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2.
J Infect Public Health ; 14(2): 260-262, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33493923

RESUMO

This is a case study of a positive COVID-19 case who was diagnosed and isolated early on in the infection. However, her seventeen close contacts who were quarantined and under observation remained negative indicating no viable chain of transmission despite high-risk contact. We further discuss the importance of effective contact tracing coupled with strict isolation or quarantine in breaking the chain of transmission.


Assuntos
/diagnóstico , Busca de Comunicante , Adulto , Feminino , Humanos , Índia , RNA Viral/isolamento & purificação
3.
Asia Pac J Public Health ; : 1010539520975288, 2020 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-33289399

RESUMO

The pandemic of coronavirus disease has created a global emergency after its origin in China, in December 2019. We investigated SARS-CoV-2 infection in the local population of a prime city of Western Rajasthan in India and found that the co-morbidities like diabetes (54.3%), cardiovascular diseases (28.8%), chronic respiratory conditions (18.4%) are the predominant risk factors for acquiring the infection. The young adult male population from urban area were maximum affected by the disease. Most common presenting complains were dry cough (65.7%), fever (62.3%) followed by sore throat (24.1%). A declining positive case percentage was found over the study period, though the number of samples received for SARS-CoV-2 testing increased with time, implying the effectiveness of government policies at community level to spread the outbreak.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33155919

RESUMO

Early recognition of iliopsoas abscess is important for limiting morbidity and mortality. Mycobacterium tubercu-losis remains an important cause of iliopsoas abscess in developing countries and most patients are initiated on empirical an-ti-tubercular therapy. In this context, methicillin-sensitive Staphylococcus aureus (MSSA) as a cause of iliopsoas abscess is rare in India. Four cases were diagnosed with pyogenic iliopsoas abscesses caused by MSSA. Half of the patients had typi-cal clinical triad of fever, difficulty in walking and backache. Primary iliopsoas abscesses was present in three patients. All patients were managed with percutaneous drainage and antibiotics with favourable outcome. MSSA as a cause of primary iliopsoas abscesses is rare in India. Early diagnosis of microbial aetiology also minimizes undesirable use of antibiotics and anti-tubercular therapy.

5.
J Family Med Prim Care ; 9(6): 3154-3156, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32984190

RESUMO

We report a case of a 34-year-old male with a history of pulmonary tuberculosis and pathological fracture of shaft of long bone presented with symptoms of lower respiratory tract infection. The patient did not have any typical symptoms of multiple myeloma or hypercalcemia on presentation. Throughout his hospitalization, his serum globulin level was very high along with mild normocytic normochromic anemia and mild renal function derangement without apparent cause. Acute phase markers of inflammation, for example, erythrocyte sedimentation rate (ESR) were not elevated in this patient and there was no lytic lesion in bone radiographs. He was eventually diagnosed as a case of stage 3 multiple myeloma by immuno-fixation electrophoresis and bone marrow study. Multiple myeloma represents a pathology of diverse distribution and has varied unusual presenting symptoms. We consider it an underdiagnosed disease often missed especially in young because it is not considered by clinicians.

6.
J Family Med Prim Care ; 9(5): 2531-2534, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32754538

RESUMO

Triple A syndrome (Allgrove syndrome) is characterized by a triad of specific features, namely, alacrimia, adrenal insufficiency, and achalasia cardia. It is a rare autosomal recessive disorder. In the present study, an 18-year-old boy was presented with complaints of decreased tears, darkening of the skin, difficulty in walking and standing up from sitting position, and difficulty in swallowing liquids. Adrenal insufficiency, alacrimia, achalasia, and neurological manifestations were confirmed with relevant laboratory investigations. His condition improved with steroids and artificial teardrops. However, a vigilant eye of the clinician for clinical clues of syndromic manifestation will help in early diagnosis and proper management.

7.
Saudi J Gastroenterol ; 26(1): 20-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31997778

RESUMO

Background/Aims: The development of infection in pancreatitis increases the mortality rate up to 32%. Therefore, it is important to identify patients who are at high risk of developing infection, at an early stage. The objectives of the study were (a) to analyze the quantitative parameters of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) in infected as well as sterile pancreatic collections (b) to establish "cut-off" values for ADC that can identify infected pancreatic collections. Materials and Methods: Prospective observational study of pancreatitis cases who underwent DW-MRI from August 2018 to July 2019 were enrolled in the study. The collections were analyzed for diffusion restriction. The average of the three ADC values from the wall and center of collection was noted. Results: Infected collections were seen in 7 and sterile collections observed in 11 cases. The optimal cut-off ADC value to differentiate sterile and infected collection in our study was 1.651 × 10-3 mm2/s (sensitivity of 81.8%; specificity of 100.0%). ROC curve for mean ADC from the wall showed a significant diagnostic accuracy with AUC: 0.91; 95% CI: 0.77-1.0 (P = 0.004). Conclusion: DW-MRI is a reliable noninvasive technique to differentiate sterile and infected pancreatic collections. ADC values from the periphery of the collection can predict infected pancreatic collections at an early stage. DW-MRI should not be considered as a substitute for aspiration cytology in patients with septic symptoms and absent diffusion restriction on MRI.

8.
Br J Nutr ; 121(5): 538-548, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30843501

RESUMO

In India, there is a lack of information about the adequate daily dose of vitamin D3 supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D3 in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6-16 years with serum 25-hydroxyvitamin D (25(OH)D) levels <50nmol/l, were cluster randomised into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D3 under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11·7 (sd 2·4) years, and the overall mean baseline serum 25(OH)D level was 24·3 (SD 9·5)nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 (SD 30·0)nmol/l), followed by 1000 IU (46·8 (SD 22·5)nmol/l) and 600 IU (36·5 (SD 18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D3. Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.


Assuntos
Colecalciferol/administração & dosagem , Suplementos Nutricionais , Deficiência de Vitamina D/terapia , Vitaminas/administração & dosagem , Adolescente , Fosfatase Alcalina/sangue , Cálcio/sangue , Cálcio/urina , Criança , Creatinina/urina , Feminino , Humanos , Hiperparatireoidismo Secundário/sangue , Hiperparatireoidismo Secundário/etiologia , Hiperparatireoidismo Secundário/urina , Índia , Masculino , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Estudos Prospectivos , Método Simples-Cego , Estudantes , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/urina
9.
Int J Rheum Dis ; 16(5): 590-4, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24164848

RESUMO

BACKGROUND AND AIMS: Joint hypermobility when associated with symptoms in the absence of systemic rheumatologic disease is termed as benign joint hypermobility syndrome (BJHS). BJHS is often an under-recognised and a poorly managed entity. Indian studies on BJHS are very few and none have been carried out in any of the service rheumatology centres. Hence this retrospective study was carried out at a tertiary medical institute of the Indian Army to assess the varied clinical profile of BJHS. METHODS: All patients consecutively diagnosed as BJHS at the rheumatology clinic of the Army Hospital (Research and Referral) Delhi from May 2010 to May 2011 were included in the study. Their age, sex, presenting features, clinical profile, laboratory and radiological parameters were studied. RESULTS: The mean age of these patients was 30 ± 5.71 years with a median duration of symptoms of 42 (06-120) months. There were 45 males and 39 females (male : female = 1.15 : 1.00). The median Beighton's score in these patients was 6/9 (range 4-9). Most of our patients were military personnel (43/84), and all had knee joint pain with evidence of degenerative changes in 19 and synovitis in two patients. Eleven patients including nine military personnel had evidence of soft tissue rheumatism with associated fibromyalgia in four and anxiety disorder in one. Out of 18 patients with a Beighton's score of ≥ 7, nine had incidental findings of lateral head tilt on frontal observation. There was evidence of carpal tunnel syndrome in a patient with wrist synovitis and one patient had associated skin laxity without features of Ehlers-Danlos syndrome. CONCLUSION: BJHS is often under-recognized in clinical practice and is usually missed because of a lack of awareness. A high index of clinical suspicion to diagnose this entity is essential due to its associated morbidities, especially among those exposed to strenuous physical activities.


Assuntos
Hospitais Militares , Instabilidade Articular/diagnóstico , Articulações/fisiopatologia , Centros de Atenção Terciária , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Artralgia/diagnóstico , Artralgia/fisiopatologia , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/fisiopatologia , Feminino , Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Humanos , Índia , Instabilidade Articular/fisiopatologia , Instabilidade Articular/psicologia , Articulação do Joelho/fisiopatologia , Masculino , Militares , Valor Preditivo dos Testes , Amplitude de Movimento Articular , Estudos Retrospectivos , Doenças Reumáticas/diagnóstico , Doenças Reumáticas/fisiopatologia , Síndrome , Sinovite/diagnóstico , Sinovite/fisiopatologia
10.
J Clin Densitom ; 16(3): 353-359, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23910719

RESUMO

Obesity has been associated with increased bone mineral density (BMD). There is evidence of differential effect of regional fat on BMD. Hence, we undertook this study to evaluate the correlation between total body fat and its distribution with BMD in nonobese (mean body mass index: 25.0 ± 4.7 kg/m²) Indian adult volunteers. A total of 2347 participants (men: 39.4% and women: 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. Percent total body, truncal, and leg fat and BMD at lumbar spine, femur, and forearm were measured by dual-energy X-ray absorptiometry. The BMD at all sites (radius, femur, and spine) increased from lowest to highest quartiles of percent body fat. Percent truncal fat was positively correlated with BMD at all sites in both sexes, except for femoral neck in men, where it had negative correlation. Percent leg fat was positively related with BMD at all sites in premenopausal women, and spine and radius BMD in postmenopausal women. However, in men, it had negative correlation with femoral neck BMD. On multiple regression analysis, regional fat had positive association with BMD at all sites after adjusting for age, sex, lean mass index, 25-hydroxyvitamin D, and intact parathyroid hormone levels. Leg-to-total body fat ratio was negatively associated with BMD at all sites in men and pre- and postmenopausal women. Percent total body and regional fat have positive association with BMD at all sites in men and women.


Assuntos
Absorciometria de Fóton/métodos , Tecido Adiposo/diagnóstico por imagem , Composição Corporal , Densidade Óssea , Colo do Fêmur/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Rádio (Anatomia)/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Prevalência , Estudos Retrospectivos , Adulto Jovem
11.
J Cardiol ; 61(4): 289-94, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23473764

RESUMO

BACKGROUND AND PURPOSE: Folate and vitamin B12 are essential components in the metabolism of homocysteine (Hcy). Hyperhomocysteinemia has been implicated in endothelial dysfunction and cardiovascular disease. However, the association of Hcy, vitamin B12, and folic acid with cardiovascular risk factors in patients with coronary artery disease (CAD) has not been studied in Indian patients. This study was conducted with the aim to evaluate the relationship of vitamin B12, folic acid, and Hcy levels with cardiovascular risk factors in subjects with known CAD. METHODS AND SUBJECTS: Three hundred patients (216 men; 84 women; aged 25-92 years) who had CAD on angiography were included in this study consecutively. All patients were evaluated for anthropometry and cardiovascular risk factors, and blood samples were collected for biochemical, nutritional, and inflammatory markers. RESULTS: Percentage of vitamin B12 and folate deficiency was 86.7% and 2.7%, respectively. Hyperhomocysteinemia was present in 95.3% patients. Vitamin B12 levels were significantly lower and Hcy levels were significantly higher in subjects with dyslipidemia, DM, and/or hypertension. Serum vitamin B12 was inversely associated with triglyceride and very low-density lipoprotein (VLDL) and positively with high-density lipoprotein (HDL). Hcy was positively associated with triglyceride and VLDL and negatively with HDL. Vitamin B12 was inversely correlated with inflammatory markers (high-sensitivity C-reactive protein and interleukin-6) directly related to insulin resistance whereas Hcy showed the opposite pattern. CONCLUSIONS: Serum vitamin B12 deficiency and hyperhomocysteinemia are related with cardiovascular risk factors in Indian patients with CAD.


Assuntos
Doenças Cardiovasculares/etiologia , Doença da Artéria Coronariana/complicações , Hiper-Homocisteinemia/etiologia , Deficiência de Vitamina B 12/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Dislipidemias , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/epidemiologia , Homocisteína/sangue , Humanos , Hiper-Homocisteinemia/epidemiologia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Vitamina B 12/sangue , Deficiência de Vitamina B 12/epidemiologia
12.
J Pediatr Endocrinol Metab ; 24(3-4): 241-2, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21648303

RESUMO

We report an association of sacral agenesis and hypopituitarism in a child born of a diabetic mother. The child presented with short stature and evaluation revealed sacral agenesis, growth hormone deficiency (GHD) and adrenal insufficiency. This association might be important as short stature in children with sacral agenesis is usually attributed to mechanical factors. Early detection of GHD and treatment might help the child in gaining height.


Assuntos
Nanismo Hipofisário/diagnóstico , Gravidez em Diabéticas , Sacro/anormalidades , Insuficiência Adrenal/sangue , Insuficiência Adrenal/tratamento farmacológico , Adulto , Criança , Nanismo Hipofisário/sangue , Nanismo Hipofisário/tratamento farmacológico , Feminino , Hormônio do Crescimento Humano/deficiência , Hormônio do Crescimento Humano/uso terapêutico , Humanos , Hidrocortisona/uso terapêutico , Masculino , Gravidez , Resultado do Tratamento
13.
Int J Rheum Dis ; 14(1): 68-73, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21303484

RESUMO

OBJECTIVE: To assess bone mineral density (BMD) abnormalities in young Indian males with ankylosing spondylitis (AS) and factors influencing this. METHODS: Eighty AS male subjects were compared with 160 age/sex matched controls for BMD of lumbar spine and proximal femur. AS subjects were evaluated and followed up every 3 months for disease activity. BMD was estimated at spine and proximal femur using the dual-energy X-ray absorptiometry (DXA) technique. RESULTS: All subjects were males with mean age of 32.9 ± 8.3 years and mean duration of disease was 8.1 ± 5.8 years. AS subjects had significantly lower BMD at the spine and femur as compared with controls (both P < 0.001). Using WHO standards, osteoporosis (OP) in spine and femur neck was seen in 28.75% (controls: 1.84%, P < 0.001) and 11.54% (controls: 1.23%, P < 0.001), respectively. No statistically significant difference in prevalence of OP was seen with disease duration, C-reactive protein levels and disease activity indices (all P > 0.05). Syndesmophytes were seen in 22.5% (n = 18) of AS subjects. There was no significant difference between BMD values at spine in AS subjects with or without syndesmophytes (0.91 + 0.16 g/cm(2) vs. 0.90 + 0.14 g/cm(2), P = 0.79). CONCLUSION: OP is a significant complication in AS even in young males with early disease, and more prevalent in the spine compared to femur. In our study, BMD was not influenced by disease activity indices, inflammatory markers or total disease duration. Spinal BMD is the most sensitive site for defining OP in AS.


Assuntos
Densidade Óssea , Osteoporose/diagnóstico , Espondilite Anquilosante/metabolismo , Adulto , Comorbidade , Fêmur/diagnóstico por imagem , Fêmur/metabolismo , Humanos , Índia/epidemiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/metabolismo , Masculino , Osteoporose/epidemiologia , Osteoporose/metabolismo , Radiografia , Espondilite Anquilosante/epidemiologia , Espondilite Anquilosante/fisiopatologia
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