10.18639/RABM.2022.9800018
Tuberculosis
Jan 31, 2022
Pulmonary Tuberculosis.
Tuberculosis is one of the first most common causes of death in the world alongside HIV/AIDS, causing considerable mortality globally. Tuberculosis is also accompanied by hematological alterations although the alteration related to the disease is not well determined yet and showed variation in different studies. This study aimed at evaluating hematological profiles in pulmonary tuberculosis patients in Metema hospital and Gondar referral Hospital, North West Ethiopia. A case-control study design was conducted from January to July 2018. A total of 88 blood samples (44 from cases and 44 from control groups) were collected. The collected blood samples were tested using a Hematology analyzer (Sysmex) for hematological profiles. The mean+standard deviation of hemoglobin, hematocrit, and red blood cell count of the cases were significantly lower than the control groups (P< 0.05). However, platelet and total white blood cell counts; and erythrocyte sedimentation rate were significantly increased as compared with control groups (p<0.05). Body mass index had significant positive associations with red blood cell count, hemoglobin, and hematocrit (P < 0.05). Pulmonary Tuberculosis patients in this study showed hematological profile abnormalities; where the red blood cell count, hematocrit and hemoglobin were significantly reduced. However, the total white blood cell count, thrombocyte, and erythrocyte sedimentation rate of tuberculosis patients were significantly elevated than control groups. The factors associated with hematological profile alterations require a due attention to prevent further complications and further studies should be conducted.
COVID
Nov 25, 2021
COVID-19
The unremitting COVID-19 pandemic is evoking anxiety, fear, panic, and socio-occupational stress among human population all around the globe. This cross-sectional study was planned to assess the fear and anxiety because of COVID-19 pandemic among health care professionals, patients, and general public in IGMC, Shimla. A cross-sectional, web-based survey was conducted in month of December 2020. COVID-19 fear questionnaire was used to assess fear among participants. A total of 162 responses were received. Ninety-five (41.35%) respondents were males and 67(58.64%) were females. Average total score of COVID-19 fear based on questionnaire was 17.71 among the participants. The majority of respondents 67(41.4%) were afraid of COVID-19, 53(32.7%) were neutral, whereas 42 (25.9%) were not afraid of COVID-19. Sixty-two (38.3%) responders were uncomfortable thinking about COVID-19, whereas, 67(41.4%) were not uncomfortable. Only 22 (13.6%) participants felt their hands clammy when they thought of COVID-19, 78 (48.15%) respondents were afraid of losing their life, 78 (48.15%) respondents disagreed with the question of being nervous or anxious to hear news and stories of COVID-19. Thirteen (8%) participants were informed of sleeplessness, and 22 (13.5%) reported palpitations due to COVID-19 fear. COVID-19 fear was evident in 65.15% of all males and 55.8% of all females’ respondents, respectively. Seventy percent of participants of age more than 40 years were afraid of COVID-19, whereas only 54.83% participants of less than 40 years had COVID-19 fear. COVID-19 fear was more evident among non-HCW (74.42%) as compared to HCW in whom it was seen in 53.03% participants. Rampaging Pandemic has ingrained fear and anxiety among non-HCW as well as health care workers. But undeterred by COVID-19 fear, majority of participants didn’t fear death and didn’t have other effects of fear. Despite (can be used) surging pandemic when fear of COVID-19 is soaring, HCW and non-HCW could work, think, and live.
Cancer and Oncology
Nov 01, 2021
Plastic surgery and cancer.
The purpose of the study was to analyze the various causes of nasal defects seen in practice by plastic surgeons in the Department of Plastic Surgery, in a tertiary care North Indian Hospital. The study included all patients of any age and sex presenting to the outpatient department or emergency department with nose defects. The patients were enquired about the cause and history of their nasal defects. The most common etiologies of nasal defects seen were skin tumors of the nose, the most common one being the basal cell carcinoma (BCC) followed by squamous cell carcinoma (SCC), and congenital naevus. Both the malignancies BCC and SCC were seen in older age. While BCC was significantly more common in males, a specific gender preference could not be concluded in SCC. Trauma was the next most common cause and included road traffic accidents, assaults, and animal bites. These were more commonly seen in the youth and less commonly in geriatric or pediatric populations. Other less common causes of nasal defects included postburn lesions.
Original Research Article
Oct 04, 2021
Plastic surgery.
Deformities in the craniofacial region are of great social and functional importance. Several surgical techniques have been used to treat such pathologies often with high morbidity and lacking the ability to address smaller contour defects. The minimally invasive technique of fat transplantation has evolved rapidly within the last few decades. The objective of this paper is to present the versatility and applicability of fat transplantation in a wide range of contour deformities in the craniofacial region. We share our experiences in treating 24 patients with autoimmune disorders, congenital malformations, and acquired defects.
Case Report
Sep 30, 2021
Priapism.
Priapism is an uncommon urological emergency. Drugs are known causes of priapism. Self-medication and use of over-the-counter drugs are very common in India. Withania somnifera is common over the counter herb used in India for anxiety, depression, boosting immunity, infertility, etc. Despite the unprohibited and over-the-counter use of drug, the efficacy and adverse events data are not available. We report a patient of anxiety and depression self-medicating with W. somnifera and multivitamins presenting with ischemic priapism.
Agriculture and Allied Sciences
Sep 30, 2021
Pest management using insecticides.
Chlorophorus annularis Fab. (Coleoptera: Cerambycidae) damages cut and dry bamboo. Chlorpyriphos 0.04% yielded 39.13 per cent for the control of bamboo borer followed by chlorpyriphos 0.02%, which controlled 34.78% of borer attacks while cypermethrin and deltamethrin were found least effective. Among the systemic insecticides, imidacloprid 0.04% gave 26.32 per cent control of borer attack.
Cancer and Oncology
Sep 29, 2021
Cancer.
Acute megakaryoblastic leukemia (AMKL) is a subtype of acute myeloid leukemia (AML) accounting for 3%–10% of primary AML in childhood. Clinical manifestations of AML patients can include low grade of fever, diarrhea, easy bruising, failure to growth, and life-threatening clinical manifestations. Laboratory tests are very crucial to make a definitive diagnosis and treatment. We report here an uncommon case of AMKL in a 12-month-old boy who presented with general paleness and fatigue. Based on blood film investigation, bone marrow examination report, and immunophenotyping, he was diagnosed as a case of AMKL without Down syndrome.
Original Research Article
Sep 29, 2021
Epidemiology and Electrical Burn Injury.
Electrical burns account for a small percentage of all burn injuries. However, in burn patients, they are a major source of disability. They put socioeconomic burden on the society. This is a retrospective epidemiological study of 282 electrical burn patients admitted in burn unit of a tertiary care hospital of North India. Majority of the electrical burn was due to accidental touching of uncovered wires and occupation-related burns in laborers and industrial workers who were mainly young males in the age group 20 to 40 years. Most of the cases were of high-voltage (≥1000 V) electrical burns. More severe burns, longer hospital stays, and more problems and operations were all linked to high-voltage burns. Amputation rates for high-voltage burns were significantly higher (37.3%) as compared to low-voltage burns (13.6%). Electrical burn injuries can be prevented by awareness programs, proper training, and safety measures both by public and government.
Original Research Article
Sep 29, 2021
Postburn Hand Deformities.
The hand is one of the top 3 locations for burn scar contracture deformity. The functionality of the hands is one of the primary determinants of burns survivors’ quality of life. Although most burn abnormalities are preventable, they do arise when adequate treatment is not delivered in an emergency or when they are part of a major burn. Reconstructive surgeries can significantly improve hand function. For a burn’s survivor, the right methods and timing of surgery, followed by supervised physiotherapy, can be a game changer.
Cardiovascular Disease
Aug 09, 2021
Hypertension.
The morphological changes in myocardial tissue in spontaneously hypertensive rat (SHR) occurring after administration of propylthiouracil (PTU) were assessed in the project. PTU at a concentration of 0.1% was given to the animals with drinking water for 47 days. After the end of the experiment, the morphological parameters of cardiomyocytes, the density of cardiomyocytes and fibroblasts in the myocardium, and the average area of the lumen of veins were examined. The progressive development of dystrophic processes in the myocardium was established against the background of PTU intake, which was characterized by a decrease in the cardiomyocyte density and an increase in the volume of connective tissue, venous congestion, and expansion of the lumen of veins.
COVID
Jun 30, 2021
COVID-19.
Coronavirus disease-2019 (COVID-19) is an infectious disease that has spread worldwide and led to ongoing global concern. The pandemic prompted researchers to examine the impact of COVID-19 on human organs. The heart is one such organ. This study investigates the possible prediction of heart condition using some biochemical markers of particularly critically ill patients referred to an intensive care unit (ICU). Results of various serum biomarkers of patients infected with COVID-19 receiving treatment in the ICU, Asir Central Hospital, Asir Region, Saudi Arabia, were extracted and compared with healthy individuals using the Mann–Whitney U test. The study showed a distinguished increase in total Serum creatine phosphokinase-Total (CPK-Total), Serum creatine phosphokinase-MP (CPK-MP) levels among COVID-19/ICU patients. But, this increase was not statistically significant. Besides, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase levels revealed a statistically significant increase in the infected group compared with controls. Examination of electrolytes showed a reduction in calcium median value in COVID-19/ICU patients. Data revealed a possible influence of COVID-19 on the heart. Herein, we observe significant parameters that may reflect cardiovascular injury elicited by the virus. These biomarkers possibly used to monitor the severity of disease on the cardiovascular system.
COVID
Jun 30, 2021
COVID-19.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic infection that emerged in December 2019 leading to an outbreak worldwide. We aimed to investigate the hematological parameters and coagulation profiles specifically for the referral of coronavirus disease 2019 (COVID-19) patients to intensive care unit (ICU) due to the severity of illness to determine a pathognomonic association of infection severity and the hematological markers. The pathognomonic markers could assist physicians in better management of the infection to reduce mortality and morbidity. Thirty patients infected with COVID-19 who were receiving treatment during November and October 2020, in the ICU at Asir Central Hospital, Asir Region, Saudi Arabia, were recruited. The age of patients ranged between 30 and 90 years old. COVID-19 patients in the ICU displayed a statistical reduction in red blood cells (RBCs), hemoglobin (HBG), and hematocrit (HCT). Leukocytosis, neutrophilia, thrombocytopenia, and lymphocytopenia were significant in ICU COVID-19 patients. Hematological parameters and coagulation profiles may be used as signs to predict the severity of the coronavirus infection. COVID-19 cases in the ICU showed a dramatic change in hematological parameters and coagulation profiles, indicating that the virus may interfere with hemoglobin, platelet, and immune cell functions through either inhibition or stimulation, leading to severe complications.
Original Research Article
Apr 30, 2021
Orthopaedics.
Management of infected gap non-unions of long bones has always been a challenging undertaking. Issues like compromised vascularity of bone, poor soft tissue envelop, persistent infection along with bone gap makes treatment complex. Staged treatment with fibular graft is a promising method for bridging the gap in bone defects created by debridement and sequestrectomy. Therefore, the objective of our study was to evaluate the outcome of non-vascularized fibular strut grafting in the management of infected gap non-union of long bones in paediatric patients. The prospective study included patients ≤ 14 years, with an infected gap non-union of long bones due to haematogenous osteomyelitis. Non-unions due to trauma, tumour, or other causes were excluded. Pre-operative evaluation of the patient included age, sex, anatomic site, and size of the bone gap. Staged treatment protocol for adequate healing of the infection as well as non-union was undertaken. The primary outcome measure was bone healing which was defined as complete fracture union with fibular graft incorporation and hypertrophy. Secondary outcome measures were mal-union, delayed union, peri-implant fracture, and re-activation of infection. Nine patients underwent staged treatment for infected gap non-unions with a mean age of 5.78 years. The average size of the bone gap was 5.83 cm. The average time between stage I and II surgeries was 3.56 months. The mean follow-up was 32 months. The most common bone involved was the femur (n = 6). Successful eradication of infection and consequent healing of non-union occurred in 7 (77.8%) patients. Non-union was seen in two (22.2%) patients. Stable fixation of graft with plate resulted in better outcome. Average time of radiological union was 6.5 months (range 5 - 9 months). Hypertrophy of fibula was evident radiologically at one-year follow-up in all of the patients, except two with graft failure. Delayed union and reactivation of infection were seen in one patient each. Limb-length discrepancy (mean = 5.5 cm) was seen in all patients with lower-limb involvement. Regrowth of the fibula was seen in all patients, and no patient developed common peroneal palsy. The use of non-vascularized fibular graft as a staged procedure for the treatment of infected gap non-union in children is a promising technique, which brings forth predictable and reproducible outcomes in all hands without the need for any microsurgical expertise. In addition, it has a minimal complication rate. Finally, the role of stable fixation in graft incorporation warrants further study.
Case Report
Mar 31, 2021
Urethral Stricture.
Urethral calculi are uncommon diagnoses. Large urethral stones with peculiar shapes have been reported. Management of such large stones depends upon size, shape, position, and associated abnormality of the urethra. We present a case of dumbbell-shaped large calculus secondary to bulbar urethral stricture. The patient was managed with Suprapubic cystotomy, antibiotics. Retrograde-urethrogram and micturating cystourethrogram showed bulbar urethral stricture. Trans vesical removal of stone was attempted; however lower part of the calculus was impacted. Perineal retrieval of the calculus was done, followed by stage 1 urethroplasty with perineal urethrostomy. After three months, stage 2 urethroplasty was done.
Original Research Article
Feb 26, 2021
Overseas Medical Treatment.
More and more Sri Lankans reach for overseas medical treatment with the raising standards of living in the country. However, it is largely an unexplored area. Economic burden of overseas medical treatment is largely an out-of-the-pocket expenditure. Considering the economic burden and low health insurance penetration among Sri Lankans, healthcare decision-makers should explore the clinical dynamics of this subset of patients to improve the services within the country. The study aimed to describe the clinical characteristics and cost of medical treatment by medical travellers for treatment overseas. A descriptive study was carried out by a team of experts analyzing the data of estimated overseas medical expenditure recorded at the President Fund, a body established to assist Sri Lankans who need financial assistance for the said purpose. The team studied the deidentified databases for 2018 and 2019. Of the 60 patients studied, liver transplant, treatment for scoliosis, and bone marrow transplant topped the list by the number of cases and the estimated cost for the procedure overseas. Advance cancer treatment, cardiac surgery, and brain and spinal cord surgery also contributed significantly to the burden. Highest estimated unit cost per procedure has been recorded by the liver and bone marrow transplant surgeries. In conclusion, the healthcare decision-makers should liaise with relevant professional bodies to establish liver and bone marrow transplant services, advance brain and spinal cord surgery including treatment of scoliosis, and advance cancer treatment and cardiac surgeries. Considering the lack of data sources on the economic burden of overseas medical treatment, authorities should act promptly to capture nationwide details of this important group of patients.
