Medicine and Health Sciences Commons^™

Primary Hypertrophic Osteoarthropathy: A Case Series, Varuni Pragya, Mahabaleshwar Mamadapur Dr, Rahul Bisaralli Dr, Deepak Benny Dr, Purna Bansal

Digital Journal of Clinical Medicine

Skeletal dysplasia encompasses a spectrum of over 400 rare inheritable skeletal abnormalities typically manifested early in childhood. Hypertrophic Osteoarthropathy is a clinical syndrome marked by abnormal skin and osseous tissue proliferation at the distal extremities. It is characterized by unique clinical features such as digital clubbing, periostosis of tubular bones, and synovial effusions.

We report three cases of HPOA for further understanding and insight into this infrequent cause of clubbing. Case 1 involved a 25-year-old male presenting with joint pain, primarily in wrists and knees, accompanied by progressive swelling in both lower limbs for the past 3 years. Case 2 …

An Internal Audit On Patient Safety And Quality Of Services In A Rural Health Training Center, Coimbatore., Josphine Priscilla Charles, Kathiravan Rajendran, Jenit Osborn

Digital Journal of Clinical Medicine

Prioritizing patient safety is imperative for enhancing quality healthcare, especially in lower- and middle-income countries. Recognizing this urgency, India's Ministry of Health and Family Welfare introduced the 'SaQushal' toolkit, empowering health facilities to self-assess and improve their safety practices. This study presents an internal audit at a Rural Health Training Centre (RHTC) in Coimbatore, India, utilizing the 'SaQushal' framework. The facility achieved an overall score of 63%, exceeding the 50% minimum threshold for each domain, indicating commendable efforts towards establishing good quality standards. Notably, all domains scored above 50%, highlighting strengths across various safety dimensions. While acknowledging this progress, the …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Importance Of Geriatrics In Psychiatric Postgraduate Education, Dr Anand R, Dr Kishor M, Dr Murali M R

Digital Journal of Clinical Medicine

Introduction

To assess the importance of Geriatrics in Psychiatric postgraduate education

Methodology

Marks allotted in question papers from Geriatrics in Psychiatry postgraduate examination from a university for a 5-year period was evaluated.

Discussion

1-6% of entire theory evaluation was related to Geriatric mental health topics predominantly on dementia and related disorders.

Knowledge, Attitude, And Perception Of The General Public Towards The Impact Of Hemoglobinopathies On Pregnancy Outcomes: A Questionnaire-Based Study, Kumud Dhankhar, Kiran Dahiya, Shobha Chikkavaddaragudi Ramachandra, Akila Prashant

International Journal of Health and Allied Sciences

Background: Knowledge about hemoglobinopathies in the general public is unsatisfactory. Many couples are unaware of their carrier status and a child can be born with unexpected, serious hemoglobinopathies. Willingness to participate in screening programs can substantially help in bringing down the birth of children affected with hemoglobinopathies. To understand the knowledge, attitude, and perception of the general public on various hemoglobinopathies and their pregnancy outcomes we performed a questionnaire-based descriptive survey. Methods: After obtaining approval from the institutional ethics committee and validation by an expert panel we circulated a Google form consisting of 21 questions via WhatsApp which was made …

Psychiatric Morbidity And Dental Problems Among Women From Institutional Care, Meghana Hanchate, Kishor M, Ashwini T S

Digital Journal of Clinical Medicine

No abstract provided.

Pelvic Fractures - An Overview, Shashank Cheemalapati

Digital Journal of Clinical Medicine

Pelvic fractures are injuries commonly caused by high-energy trauma, such as motor vehicle accidents and falls from a height. Understanding the anatomy, mechanisms of injury, classification, diagnosis and the management of these fractures is crucial to improve patient outcomes. This short article aims to provide a comprehensive overview of the current state of knowledge regarding pelvic fractures.

Neuroimaging Manifestatations In Covid-19 And Its Sequelae, Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogenic virus in late 2019, infecting millions of people with severe pulmonary infections. It spread worldwide in a short time and became a pandemic, after which the World Health Organization (WHO) declared it a public health emergency. Central nervous system involvement by COVID-19 is already an established entity in the literature. The aim of this study was to evaluate in detail the acute and delayed neurological manifestations of COVID -19.

RESULTS: COVID-19 infection can cause various neurologic manifestations and imaging findings. The most common neuroradiological abnormality is cerebrovascular …

Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis

Digital Journal of Clinical Medicine

Abstract

Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.

Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.

Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …

A Review On Anatomical And Surgical Importance Of Mammary Gland, Sneha Jm Sneha Jm Dr, Pushpa Nb Dr, Vidya Cs Dr, Manjappa M Dr

Digital Journal of Clinical Medicine

ABSTRACT

The mammary gland is an exocrine gland present in female mammals responsible for the production and secretion of milk during the process of lactation. It is mainly composed by epithelial cells and adipocytes. The features that make mammary gland unique are 1) its highly plastic properties displayed during pregnancy, lactation and involution (all steps belonging to the lactation cycle) and 2) its requirement to grow in close association with adipocytes which are absolutely necessary to ensure mammary gland development at puberty and remodelling during the lactation cycle. (Georgia colleluori, Jessica perugini, Giorgio barbatelli, and saverio cintr (2021).

Conclusion

The …

Rare Event Of Intraoral Kinking Of Endotracheal Tube Upon Prone Positioning In A Patient Undergoing Posterior Fossa Surgery, Sonali Turki, Amiya K. Barik, Amit Sharma, Abhishek Arya

International Journal of Health and Allied Sciences

Prone position is commonly employed for many surgical procedures including neurosurgeries, spine surgeries, urological procedures, and in refractory ARDS patients. An endotracheal tube is a conduit to provide a secured airway to the patient. But in case of any equipment failure, it can cause catastrophic events. Intra-oral kinking is a rarer event. It can pose a major troubleshooting standstill owing to the inaccessible view of the kinked portion and the rarity of its occurrence to cross the clinician’s mind in the emergency scenario. We thus report this as the first such case of intraoral kinking against the soft palate in …

A Rare Case Of Combined Immunodeficiency Syndrome With Otomastoiditis, Parotitis & Facial Nerve Palsy, Parth Garg, Amulya T M, Prakash B.G., Sandhya D

Digital Journal of Clinical Medicine

This article presents a case study of a 4-month-old female baby with combined immunodeficiency syndrome complicated by bilateral otomastoiditis, right-sided parotitis, and facial nerve palsy. The patient presented with symptoms of fever, cold, earache, and ear discharge. Clinical examination revealed redness and swelling in the post-auricular region, along with bloody discharge from the right ear. Further investigations, including blood tests, culture sensitivity, ultrasound scans, and imaging studies, confirmed the diagnosis. The patient was treated with appropriate antibiotics, antifungals, and supportive care. The article discusses the challenges in diagnosing and managing primary immunodeficiency diseases (PIDs), emphasising the importance of early recognition …

Eosinophilic Granulomatosis With Polyangiitis (Churg Strauss Syndrome) – A Case Report, Rudrani Mukherjee, Bhanukumar M

Digital Journal of Clinical Medicine

Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg Strauss syndrome, is a rare small vessel vasculitis characterized by asthma, eosinophilia, and systemic involvement. This case report presents a 51-year-old man with a history of asthma, who presented with neurological symptoms including blurring of vision, bilateral ptosis, and altered sensorium. The patient had a previous history of cervical and lumbar spine surgeries for symptoms attributed to spondylosis. Further examination revealed hyperpigmented lesions on the limbs, wasting of small muscles, and foot drop.

Investigations showed eosinophilia and thrombocytosis on blood analysis, with bone marrow aspiration revealing eosinophilic and megakaryocytic hyperplasia. The …

Tenofovir Induced Hypokalaemia - A Case Report, Ankisha Gupta, Kiran P. K, Rajendra Prasad S

Digital Journal of Clinical Medicine

Tenofovir, an important medication for HIV/AIDS, carries the risk of hypokalemia in patients receiving treatment. Factors such as dietary deficits, vomiting, or diarrhea further increase this risk. Tenofovir acts as a mitochondrial toxin by inhibiting the DNA polymerase gamma enzyme, crucial for mitochondrial DNA replication. Consequently, ATP generation is depleted through the aerobic pathway, leading to dysfunction in the proximal tubule. This dysfunction manifests as renal acidosis type 2, which involves reduced bicarbonate excretion by the proximal tubule, resulting in renal bicarbonate wasting and decreased serum bicarbonate levels. Consequently, the lumen of the distal nephron becomes negatively charged, leading to …

Unilateral Agenesis Of Adnexa, Srinidhi Govindarajan, Poornima M Associate Professor, Rashmi H.S., Aishwarya Bhat

Digital Journal of Clinical Medicine

No abstract provided.

A Rare Case Of Deep Vein Thrombosis Secondary To Protein S Deficiency And Antithrombin Iii Deficiency With Mthfr (C677t) Heterozygous Mutation, And Crohn’S Disease, Anusha Garg, Vanama Lakshman Sai, Ankit Singh, Aditi Rao

Digital Journal of Clinical Medicine

Deep vein thrombosis is a condition wherein a thrombus develops in the deep veins of the body, most commonly in the legs, due to increasing tendency of the blood to coagulate. One such reason is the MTHFR gene mutation, wherein an increase in homocysteine levels causes irritation of the blood vessel endothelium, causing a disturbance in Virchow’s triad, hence triggering clot formation. [1]

The MTHFR gene is responsible for instructing the body to produce an enzyme called methylene tetrahydrofolate reductase(MTHFR) [2]. MTHFR gene mutations can lead to a wide range of disorders, either as a result of the elevated levels …

Multiple System Atrophy: Case Of Atypicalparkinson With Parkinson Predominant Presentation And Progressive Cerebellar Degeneration With Extrapyramidal And Autonomic Involvement, Aayushi Sharma

Digital Journal of Clinical Medicine

ABSTRACT

BACKGROUND

Multiple System Atrophy is a rapidly progressive neurodegenerative disease. Symptoms tend to appear in 50s and advance rapidly over the course of 5-10 years with progressive loss of motor and autonomic function.

Some of the common symptoms include frequent falls with or without tremors and b/l akinetic rigidity with involvement of the axial muscles. Postural tremor, severe stridor and cranio cervical dystonia may be seen. Alpha synnuclenopathies are generally characterized by REM behavioral disorders and severe dysautonomia years before the onset of the disease.

Individuals with MSA typically do not have sustained improvement in their symptoms with levodopa. …

Association Of Physical Activity And Screen Time Usage Of Adolescents In Rural Areas Of Mysore., Aakash Pavan Kumar, Nayanabai Shabadi, Bikram Sinha Roy, Anchu R. Nath, Arun Gopi

Digital Journal of Clinical Medicine

Introduction:

In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity.

Methods & materials:

A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen …

A Case Of Galeazzi Fracture Subluxation Of Left Forearm In Paediatric Age Group, Sauparna Dey

Digital Journal of Clinical Medicine

A case report of a rare form of fracture- Galeazzi fracture subluxation in paediatric age group. Showing post operative progress of the patient, with a discussion on possible methodology of approaching such fractures. Correct management of the fracture is essential for proper healing and avoiding complications.

A Case Of Obstructed Left Diaphragmatic Hernia, Shikha Agarwal Dr.

Digital Journal of Clinical Medicine

Diaphragmatic hernia is protrusion of abdominal viscera into the chest cavity. Most commonly seen due to congenital defects in the diaphragm, hence causing herniation of abdominal contents including stomach, bowel, pancreas, omentum. Acquired diaphragmatic hernia can be secondary to injury to diaphragm. Patient presents with respiratory distress, due to reduced lung expansion. Early correlation with radiological scans is required for appropriate timely management, to prevent further deterioration of condition.

Meningitis In Hiv Positive And Negative Patients: A Comparative Demographic Profile., Sridhar Amalakanti, Jyothi Priya Jillella, Krishna Sagar Gajula

Digital Journal of Clinical Medicine

Background: Meningitis is a serious infection in HIV patients claiming millions of lives across the world. Comparative studies of meningitis in HIV positive and negative patients are scarce. Methods: We performed a comparative study of the demographic features of meningitis in HIV positive [116] and HIV negative [218] patients at a tertiary hospital over a period of four years. Results: In HIV seropositive patients the percentage of women was lesser [29.6% vs. 42.5%], the proportion of students was lesser [4.8% vs.14%], but the proportion of professionals was higher [17.5% vs. 10.8%] when compared to HIV seronegative group. Even though Tuberculosis …

Stroke: A Neurological Complication In Covid-19., Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

No abstract provided.

A Study On The Prevalence Of Vitamin B12 Deficiency In Eastern Indian Type 2 Diabetes Mellitus Patients With Peripheral Neuropathy On Metformin Presenting To A Tertiary Care Hospital, Ajay Hanumanthu, Soumik Goswami, Kavya Bhadrapura Thimmegowda, Nilanjan Sengupta, Arjun Baidya, Pranab Kumar Sahana

Digital Journal of Clinical Medicine

Introduction:

The association between long-term metformin use in type 2 diabetes mellitus (T2DM) and low vitamin B12 levels has been proven and screening for the same is recommended by American Diabetes Association (ADA) guidelines. The potential of the deficiency to cause or worsen diabetic peripheral neuropathy (DPN) in T2DM patients has been investigated in previous studies. However, the prevalence estimates of vitamin B12 deficiency in T2DM patients treated with long term metformin and having established DPN is lacking in our country. The aim of our study was to estimate the prevalence of vitamin B12 deficiency in T2DM patients with DPN …

Mgso4 For Neuroprophylaxis In Preterm Birth – Clinical Audit- Re Audit, Dr Anupama Marnal B A Sr, Poornima M Associate Professor, Suma K B Professor, Sahana K Assistant Professor

Digital Journal of Clinical Medicine

No abstract provided.

The Trichobezoar Enigma: Untangling The Intricacies Of Rapunzel Syndrome, Debabrata Sahu, Dr Rajkishor Sahu

Digital Journal of Clinical Medicine

Rapunzel Syndrome is a rare manifestation of trichobezoar, characterized by the presence of hair strands extending beyond the stomach and into the duodenum. Trichobezoars typically develop in individuals with a history of trichotillomania, a compulsive behavioral disorder involving hair-pulling, combined with trichophagia, the ingestion of hair. While trichobezoars predominantly form within the stomach, their occurrence in the jejunum is infrequent. This condition is more commonly observed in adolescent females.

The formation of bezoars within the gastrointestinal tract is typically attributed to anatomical changes. However, in cases where no such anatomical abnormalities are present, psychiatric disorders like trichotillomania can lead to …

Modified Electroconvulsive Therapy As Maintenance Treatment, Jatin Kumar, Kishor M, Murali M R

Digital Journal of Clinical Medicine

Depression is the most common psychiatric condition that significantly affects the quality of life of individual affected with it and it can present with various signs and symptoms. It usually presents with persistent and pervasive sadness of mood, anhedonia, sleep disturbance, reduced appetite, reduced concentration, multiple somatic symptoms, and suicidal thoughts. In this case report a 61-year-old gentleman presented with sadness of mood, loss of interest, sleep disturbance, multiple body aches, and abdominal pain which varied from 2 to 6 weeks. He had failed to respond to multiple classes of antidepressants, mood stabilizers, and antipsychotics. However, he would respond well …

Diagnostic Dilemma: Schwannoma Or Ganglion Cyst, Karthik Ks, Prakash M, Gurumurthy B, Sujanatheja Js, Pramod Bm, Punith N

Digital Journal of Clinical Medicine

Schwannomas are rare, slow growing benign tumors of peripheral nerve sheath originating from Schwann cells surrounding the nerve associated with delayed presentation of pain and paresthesia. Their incidence being 5% of all upper extremity tumors. They may be a part of neurofibromatosis called schwannomatosis with multiple peripheral schwannomas. We present a case of solitary schwannomas from the peripheral nerves probably superficial branch of median nerve mistaken initially for ganglion cyst.

Case Series; Imaging In Lesser-Known Ailments Of The Pituitary Gland And Sellar Region, Harisha H L, Kavya Bhadrapura Thimmegowda, Ajay Hanumanthu, Vikram Patil Dr, Gurumurthy B, Dr Abhijith Roys

Digital Journal of Clinical Medicine

No abstract provided.

Mpd, Dr.Amara Charitha Duggirala, Dr.Savitha Vijayakumar, Dr . Shashidhara K C, Dr.Jerin Joseph

Digital Journal of Clinical Medicine

No abstract provided.

A Clinical Profile Of 50 Cases Of Hypoglycemia In A Tertiary Care Hospital, Rohan Karkra, Ravikumar Y S

Digital Journal of Clinical Medicine

Hypoglycemia is defined as a blood glucose level/dl. It is usually seen in Diabetics due to an improper balance between blood glucose-lowering drugs and food. Patients can have various symptoms, ranging from headaches and palpitations to coma and death. Patients are typically treated with oral carbohydrates and IV carbohydrates/Glucagon if needed. It is essential to understand the presenting complaints of Hypoglycemia as it often complicates the management of Diabetic patients, and sometimes non-Diabetic patients. The symptoms may frequently be mild but can cause significant long-term complications. It is also essential to understand the cause of Hypoglycemia in order to prevent …