Study of haematological, biochemical profile and clinical presentation in dengue positive patients: 82 cases

Background: Dengue Fever (DF) is a self-limiting disease caused by arbovirus and transmitted by Aedes mosquitoes (Aedes aegypti and Aedes albopictus). It is one of the 17 neglected tropical diseases by WHO. Diagnosis of dengue depends mainly on the detection of IgM and IgG antibody, and NS1 antigen.Methods: The study was carried out in Department of Pathology, affiliated with a government hospital. It includes 82 dengue patients, admitted from August 2015 to August 2016. Haematological, biochemical profile, clinical signs and symptoms were recorded. The Tourniquet test was performed in all the patients on admission. Grading of dengue: DF/DHFI/DHFII/DHFIII/DHFIV. Grade III and IV were collectively called as Dengue Shock Syndrome.Results: Total 82 Dengue positive cases were studied, 52 (63%) were males and 30 (37%) were females. 24 (29%) patients were recorded in September 22 (27%) in October 19 (23%) in August. 12 (14.60%) had positive tourniquet test. Thrombocytopenia was present in 86.5 % patients. Majority cases were of classical dengue fever 51 (62.20%), 14 (17.07%) were of DHF I, 12 (14.63%) were of DHF II, 3 (3.66%) were of DHF III and 2 (2.44%) were of DHF IV.Conclusions: It is very important to correlate clinical examination with haematological and biochemical profile in dengue patients. Hematocrit value, leucopenia, thrombocytopenia, raised liver enzymes is very important to monitor dengue cases in their initial stages and thus facilitate early treatment. This would minimize morbidity and mortality arising out of serious complications of dengue fever

A Hospital-based Observational Study of Type 2 Diabetic Subjects from India

Aim: The aim of this study was to describe the profile of the subjects with type 2 diabetes mellitus (T2DM) to obtain aclear picture from Western India, that would help in management of diabetes. Methods: An observational study wasconducted with newly diagnosed 622 type 2 diabetic subjects attending Dept. of Diabetology, All India Institute ofDiabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad during the period from August 2006 to January 31, 2009. Subjects completed an interviewer-administered comprehensive questionnaire, which included variables such as sociodemographic presenting symptoms, risk profile (hypertension, obesity, dyslipidemia and glycemic status), family history of diabetes, physical activity and behavioral profile. Blood pressure, body mass index (BMI), glycosylated hemoglobin (HbA1c) and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using SPSS version 11.5. Results: A total of 622 T2DM cases with mean age (years) 47.7 ± 10.9 were studied. Of these, 384 (62%) were male. The majority of T2DM subjects were obese (68%) and 67% had positive family history of diabetes. Renal dysfunctions and vision impairment were found in 10% (62/622) and 9% (57/622), respectively in T2DM subjects. The mean HbA1c level was 9.02% ± 1.67 and good glycemic control (HbA1c level <7%) was achieved only in 7.4% T2DM subjects. The Chi-square (χ2) analysis showed that higher BMI (≥25 kg/m2) is significantly associated with hypertension among T2DM subjects (p < 0.01). There were statistically significant differences between male and female study subjects with respect to mean age, BMI, waist and hip circumference and mean low-density lipoprotein (LDL) level (p < 0.05). Conclusions: The present study revealed that obesity, family history of diabetes, dyslipidemia, uncontrolled glycemic status, sedentary lifestyles and hypertension were more prevalent in T2DM subjects. Hence, the overall risk profile was very poor and needs improvement. The characterization of this risk profile will contribute in defining more effective and specific strategies for screening and controlling T2DM in Western India

A Hospital-based Observational Study of Type 2 Diabetic Subjects from Gujarat, India

The aim of this observational study was to describe the profile of subjects with type 2 diabetes mellitus from Gujarat, India. The study was performed with newly-diagnosed 622 type 2 diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad, during August 2006–January 2009. The subjects completed an interviewer-administered questionnaire. The questionnaire included variables, such as sociodemographic factors, presenting symptoms, risk profile (hypertension, obesity, dyslipidaemia, and glycaemic status), family history of diabetes, physical activity, and behavioural profile. Blood pressure, body mass index (BMI), glycosylated haemoglobin levels, and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using the SPSS software (version 11.5). In total, 622 type 2 diabetes mellitus (T2DM) cases with mean age of 47.7±10.9 years were studied. Of the 622 subjects, 384 (62%) were male. The majority (68%) of the T2DM subjects were obese, and 67% had a positive family history of diabetes. Renal dysfunctions and vision impairment were, respectively, found in 10% (n=62) and 9% (n=57) of the 622 T2DM subjects. The mean HbA1c level was 9.02±1.67%, and good glycaemic control (HbA1c level <7%) was achieved only in 7.4% of the T2DM subjects. Results of chi-square analysis showed that higher BMI (≥25 kg/m2) was significantly associated with hypertension among the T2DM subjects (p<0.01). There were significant differences (p<0.05) between male and female subjects with respect to mean age, BMI, waist and hip-circumference, and mean low-density lipoprotein (LDL) level. The results revealed that many factors, such as obesity, fami-ly history of diabetes, dyslipidaemia, uncontrolled glycaemic status, sedentary lifestyles, and hypertension were prevalent among the T2DM subjects. The characterization of this risk profile will contribute to designing more effective and specific strategies for screening and controlling T2DM in Gujarat, India

Distributed Design of Controllable and Robust Networks using Zero Forcing and Graph Grammars

This paper studies the problem of designing networks that are strong structurally controllable, and robust simultaneously. For given network specifications, including the number of nodes $N$, the number of leaders $N_L$, and diameter $D$, where $2 \le D \le N/N_L$, we propose graph constructions generating strong structurally controllable networks. We also compute the number of edges in graphs, which are maximal for improved robustness measured by the algebraic connectivity and Kirchhoff index. For the controllability analysis, we utilize the notion of zero forcing sets in graphs. Additionally, we present graph grammars, which are sets of rules that agents apply in a distributed manner to construct the graphs mentioned above. We also numerically evaluate our methods. This work exploits the trade-off between network controllability and robustness and generates networks satisfying multiple design criteria.Comment: American Control Conference (ACC 2023

Clinical, biochemical and haematological changes in leptospirosis

Background: Leptospirosis is a globally important zoonotic disease caused by pathogenic leptospira. Leptospira species are spirochetes belonging to the order spirochetes and the family leptospiraceae. Present study is done to find out the incidence of thrombocytopenia in leptospirosis and to correlate it with other parameters like renal dysfunction, hepatic dysfunction and bleeding manifestation.Methods: Study includes 51 clinically suspected and diagnosed cases of leptospirosis, in Government hospital, South Gujarat, during a period from January 2017 to December 2017. Clinical signs and symptoms and complications, biochemical profile like bilirubin and creatinine, haematological profile like Hb, WBC count and platelet count were recorded. Thrombocytopenia was defined as a platelet count below 1,50,000/cmm.Results: The present study includes 51 cases of Leptospirosis. Age ranged from 16 years to 61 years (male-39 and Females-12) There were 38 (74.5%) cases with thrombocytopenia and 13 (25.4%) cases with normal platelet count. Out of 38 thrombocytopenic cases, 32 (84.2%) cases had renal dysfunction, 26 (68.4%) cases had hepatic dysfunction and 16 (42.1%) cases had pulmonary haemorrhage. Among 13 cases with normal platelet count, 8 (61.5%) cases had hepatic dysfunction and 7 (53.8%) cases had renal dysfunction and 3 (23%) cases had pulmonary haemorrhage.Conclusions: Thrombocytopenia is a frequent complication (present in more than half of the patient) in leptospirosis and associated with more frequent and more severe complications. Therefore, early recognition of thrombocytopenia is recommended to prevent complications and mortality in leptospirosis

Ventricular Entrapment Due To Isolated Intraventricular Aspergillus Infection

Introduction: Intraventricular aspergillus infections are a rare manifestation of fungal infections of the central nervous system (CNS). Intraventricular aspergillus infections have most commonly been identified in immunocompromised patients. Spread to the central nervous system is thought to occur hematogenously (usually from pulmonary infection) or directly from the paranasal sinuses. Clinical diagnosis is difficult, as symptoms are nonspecific, but imaging can be used to create a more accurate differential. This case report describes the rare diagnosis of an intraventricular aspergillus infection in an immunocompromised patient presenting with ventricular entrapment and demonstrates the role of imaging in making the diagnosis. Case Report: We present the case of a 59-year-old male with a history of renal transplant on immunosuppressive therapy, presenting with a two-week history of right-sided weakness and speech difficulty. Of note, patient was diagnosed with acute invasive pulmonary aspergillosis during a prior admission this year and had just completed a 12-week course of antifungal therapy. CT of the head at that time demonstrated only slight asymmetry of the ventricles without definite intracranial lesion. Initial non-contrast CT of the head demonstrated a complex cystic mass within the left lateral ventricle with asymmetric ventricular enlargement. CT of the head with contrast demonstrated a complex lesion within the left ventricle with peripheral enhancement and enlargement of the ventricle. MRI demonstrated a cystic lesion within the left lateral ventricle with a hyperintense FLAIR component anteriorly with restricted diffusion. Post-contrast MRI showed enhancement at the periphery of the complex lesion. There was also entrapment of the left lateral ventricle. After placement of an external ventricular drain for hydrocephalus, surgical biopsy of the lesion demonstrated numerous uniform, septate, fungal hyphae with rare acute angle branching consistent with aspergillus. Throughout the admission, there had been slow, but progressive, decline in neurological function. The patient has been continued on antifungal therapy pending improvement in neurological function. Conclusion: Isolated intraventricular aspergillus infection is a rare manifestation of CNS fungal infection, most commonly seen in immunocompromised patients. Given the nonspecific clinical symptoms of this diagnosis, imaging can localize and narrow the vast differential for these CNS lesions. Patients that have been diagnosed as such require immediate, long-term, and systemic antifungal therapy. With the mortality rate of patients with intraventricular aspergillus infections being highly dependent on accurate and immediate diagnosis, recognizing key imaging features can aid in improving current poor outcomes.https://scholarlycommons.henryford.com/merf2020caserpt/1097/thumbnail.jp

Preoperative Localization of Parathyroid Adenomas Using 4-Dimensional Computed Tomography: A Pictorial Essay

AbstractAccurate preoperative localization is the key to successful parathyroid surgery in the era of minimally invasive parathyroid surgery. This article presents and discusses the embryologic basis of parathyroid gland and ectopic location and different imaging modalities helpful in diagnosing and localizing parathyroid adenomas and/or hyperplasia. We also aim to review the current surgical concepts in treatment of parathyroid adenomas and/or hyperplasia, the utility of 4-dimensional computed tomography for accurate preoperative localization of hyperfunctioning parathyroid glands, imaging classification of adenomas and/or hyperplasia, and, finally, present some of the limitations of 4-dimensional computed tomography

Rediscovery, resurrection and lectotypification of endemic Isoetes sampathkumarnii L. N. Rao from India

An interesting species of Isoetes was collected from Jambughoda, Wildlife Sanctuary, Gujarat. After a review of literature and comparison of the morphological characters with type specimens, it was identified as I. sampathkumarnii L. N. Rao. It is endemic species of south India and rediscovered after a lapse of 63 years. The species shows several features that make it unique in the genus. Earlier, I. sampathkumarnii was also treated as synonym of I. coromandelina L.f. and I. sahyadrii Mahabala. However, it has an idiosyncratic velum character and spore ornamentation that makes it different from other species. Hence, the authors resurrected it as a distinct species. The original material is ambiguous hence, a lectotype of I. sampathkumarnii has been designated here

Autopsy findings in sudden death in adults: a study of 150 cases

Background: World Health Organization (WHO) defines sudden death as “deaths within 24 hours from the onset of the symptoms”. It is also defined as death, which is sudden, unexpected, clinically unexplained. Aims of the study was to classify underlying causes of sudden death, to find out risk factors, associated diseases and triggers of sudden deaths in the autopsy specimens received in the Department of Pathology, Government Medical College, South Gujarat.Methods: A review of autopsies of sudden deaths performed between January 2018 to August 2018 in age group 15-45 years at Department of Pathology, Government Medical College, South Gujarat were done.Results: A total of 150 cases were studied for sudden deaths during the study. The age ranged from 15 to 45 years. Maximum deaths occurred in the age group between 35-45 years. Males (n=120) were affected more than females (n=30). The cause of deaths in 84 cases (56%) were attributed to cardiac causes and the remaining cases (44%) were due to noncardiac causes like pulmonary diseases (17.3%) followed by hepatobiliary diseases (5.4%), cerebrovascular (2%) and others like suicide by ingestion of poisoning, hanging and asphyxia (9.3%). Major cardiac cause for sudden deaths was Coronary Artery Disease (CAD) (95.2%).Conclusions: Sudden deaths were common in young adults and most are attributed to a cardiac cause. This study highlights the serious health concern in our society and a necessity to create awareness among the population at risk so that sudden deaths can be averted and life expectancy can be improved

Cerebral Angiography in Posterior Fossa Revascularization

With advances in microsurgical techniques and refinement of cerebral angiography, many new surgical approaches for the treatment of vertebrobasilar insufficiency (VBI) have been developed. Detailed selective cerebral angiography is essential for confirming the clinical diagnosis, for demonstrating the exact anatomical and topographical vascular pathology, and for deciding on the best surgical procedure. Angiography is recommended to evaluate treated patients both in the early and late postoperative periods. It is an essential element of any future randomized study to assess the value of surgical vs medical treatment of patients with VBI. The benefits of cerebral angiography far outweigh the small risk associated with the procedure