Background: Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages. The prevalence of end-stage renal disease (ESRD) in India is increasing with an estimated annual incidence of about 100 per million populations. About 50-100% of patients with ESRD have at least one associated cutaneous change. These cutaneous disorders can precede or follow the initiation of hemodialysis treatment, and there are more chances to develop newer skin changes during the course of hemodialysis therapy, which may affect the quality of life. Objectives of the study was to find out the prevalence of various dermatological manifestations in patients undergoing hemodialysis in a tertiary care centre. Methods: A cross sectional study was carried out in the general medicine department of a tertiary care Centre. All cases of chronic kidney disease were diagnosed according to the criteria of KDQQI CKD guidelines, age group between 30-60 years are included. Pediatric patients with chronic kidney disease, patients who had renal transplantations, patients on peritoneal dialysis and renal injury patients are excluded. Results: Out of the 100 study participants majority are males (60%). Majority of the patients belongs to lower socioeconomic status family (59%). Atleast one dermatological manifestation was present in all patients. 23% of the patients presented with two dermatological manifestations and 22% of the participants had three or more dermatological manifestations. Xerosis was the most common dermatological manifestation present among the patients. Conclusions: This study reflects that quality of life in dialysis patients is mainly depend on timely recognition and prompt management of these dermatological conditions.
We report a case of multiple congenital anomalies in a female newborn infant, born to the mother from a hill tribe. The Doppler echocardiography of the baby showed large atrial septal defect amounting to single atrium, atretic left atrioventricular valve, large single right sided ventricle, aorta shifted to the left arising from single ventricle and diminutive hypoplastic left ventricle. Right atrioventricular valve was normal forming single inlet into the ventricle. Pulmonary artery was small and hypoplastic and no antegrade flow was observed in it. The patient was diagnosed as having single ventricle, pulmonary atresia, patent ductus arteriosus (PDA) and major aortopulmonary collateral artery (MAPCA). compared to an earlier report from South India (25.6 per 1000 live births). 1,5 Ventricular septal defects are found to be the most prevalent type of defects in most of the studies on Indian population. 1 The frequency of other rare types of CHDs namely atrioventricular septal defects, pulmonary stenosis, single ventricle, hypoplastc left heart syndrome has been reported to be less in India when compared to the data from western population.1 It can be noted here that most of the congenital heart defects which are considered to be less frequent among Indian population, like single ventricle, pulmonary atresia, atrial septal defect, hypoplastic left ventricle have been observed in the present case along with exomphalos.It has been reported that the most commonly observed CHDs are ventricular septal defects with pulmonary atresia.6 Ugurlucan et al. have reported a case of ventricular septal defect, pulmonary atresia, non-confluent cardiac anomalies, pulmonary arteries and bilateral patent ductus arteriosi.7 Similar case of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries has been reported in a 10 month old Thai baby. 8 In the present case, though the patient showed other associated cardiac anomalies, pulmonary atresia, patent ductus arteriosus and major aortopulmonary collateral arteries are considered as functionally significant. When there is such multiple congenital cardiac anomalies, aortic arch anomalies like patency of ductus arteriosus and major aortopulmonary collateral arteries are common and vital, otherwise death is inevitable.7 Pulmonary atresia with intact ventricular septum causing sudden death due to myocardial ischaemia is well-established. 9 However, in the present case, though there was no ventricular septal defect, the patient survived, may be due the origin of aorta from the single right ventricle and major aortopulmonary collateral arteries.Though the formation of major aortopulmonary collateral vessels is essential for the survival of patients with pulmonary atresia and ventricular septal defects, they pose a unique and challenging problem at the time of surgical repair. Such repairs involve the closure of ventricular septal defect, relief of right ventricular outflow tract obstruction, maintenance of pulmonary valve competency when possible, and establ...
Occurrence of abnormal muscles in the pelvic wall is very rare. During a routine dissection of the pelvic wall, an abnormal muscle referred to as sacrococcygeus ventralis was noted in a 65-year-old South Indian cadaver. The fleshy fibers of the muscle were arising from the lateral part of the ventral surface of the sacrum at the level of S3 segment. The muscle passed downwards in front of the S4 and S5 sacral segments, halfway through its course it became tendinous and finally became inserted in the ventral surface of the coccyx. Sacrococcygeus ventralis is a muscle which is well developed in animals where it acts on their tail. In human beings, sacrococcygeus ventralis is seen only during fetal life. A rare case of its persistence in an adult pelvic wall is reported and discussed here.
Introduction: The novel Coronavirus disease 19 (COVID-19) affected India, predominantly in two time periods – the first wave from March to December 2020, and the second wave began from April 2021 to July 2021. Although the time duration of second wave was shorter than the first, the onslaught of the disease was much more severe during the second wave. Methodology: Demographic, duration of hospitalization, ICU admission, and mortality data of 482 RT-PCR positive COVID-19 individuals were retrospectively analyzed in a teaching hospital in South India. The case file data were compared between the first and second wave. Results: The median age of hospitalisation was 46.2 years and 48.39 years during first and second wave respectively, with male preponderance in second wave. During the second wave, statistically significant difference was found in mean duration of stay (9.04 vs 7.53), mean Spo2 at admission (98.4 vs 96.65), NIV requirement (1.5% vs 8.7%), oxygen requirement(7.4 % vs 13.9%), ICU care, Remedesevir, steroids and enoxaparin. Conclusion: During the second covid wave, significantly higher hospitalisation, intensive care requirements and inpatient mortality was observed. Diabetes and other comorbid conditions had elevated CRP, lymphocytopenia were associated with higher severity and poor outcomes in both waves.
Background: Coronary artery disease is a continuum of a pathological process, in which the coronary arteries gradually thicken, harden and atherosclerotic plaques develop which further occludes the blood flow. The prevalence of coronary artery disease is rapidly rising in India. There are various risk factors of CAD which have been extensively studied, out of which Type-2 diabetes is an important etiopathogenic factor of accelerated CAD. Insulin resistance plays an important role in the pathogenesis of the development of type-2 diabetes. Despite the clear relationship between type-2 diabetes and CAD, the association of insulin resistance and CAD is more obscure in people without diabetes: Aims & Objectives: To find the association between insulin resistance and Coronary artery disease, to evaluate the role of postprandial lipid profile and its relationship with development of CHD and the evaluation of apolipoproteins (a and b) on the same group. Subjects and Methods: Fifty patients of coronary artery disease admitted to ICCU/CCU of psg institute of medical sciences and research were studied. The cases of this present study were 50 non diabetic CAD patients and controls were selected based on age and sex matched non diabetic 'and non CAD patients who has to undergo similar set of investigations as cases to find out association of insulin resistance by using HOMA score and to find out the significance in abnormalities of postprandial lipid profile in these patients. Results: 92% of the cases had insulin resistance, 52% of the controls had normal HOMA score when compared to cases. Apolipoprotein b was significantly elevated in cases (84%) than controls. All patients were normoglycemic. Serum triglycerides were significantly high in cases than controls in both fasting and postprandial states. Conclusion: Improving insulin sensitivity would offer substantial benefits by decreasing the morbidity, mortality, and economic burden associated with CAD especially in the country like India
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