Online ISSN: 2515-8260

Keywords : Clinical


DIAGNOSTIC UTILITY OF MRI FINDINGS COMPARED TO PER-OPERATIVE FINDINGS IN LUMBAR INTERVERTEBRAL DISC PROLAPSE PATIENTS

Dr. Venkata Sivaram G V, Dr. S.V.L.Narasimha Reddy,Dr Kolla Srinivas Yadav, Dr. Sridhar Jakkepally, Dr Roish Uddin

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1006-1013

Background: Diagnosis of syndromes related to lumbar spine has improved with use of magnetic resonance imaging (MRI). Neurological signs of herniated lumbar disc are important to make a decision whether to operate the patient or not. Hence, clinical examination is also important in patients with herniated lumbar disc.
Objective: To study diagnostic utility of MRI findings compared to per-operative findings in Lumbar intervertebral disc prolapse patients
Methods: Hospital based diagnostic evaluation study was carried out among 30 patients having signs and symptoms of herniated lumbar disc. All the consecutive patients presenting with low back ache (LBA) and sciatica admitted were thoroughly examined. Neurological examination, X-ray Lumbar Spine AP and lateral, MRI were done. MRI lumbar spine was graded as per Michigan scale. Surgery was done electively under general anesthesia in prone position. Patients were followed to assess the pain.
Results: Both MRI and per-operative findings agreed on the actual finding of zone of disc prolapse in 24 (80%) of the cases and differed in remaining six (20%) of the cases. The sensitivity of MRI compared to per-operative finding in diagnosing central zone of disc prolapse was 84.6% of cases and 76.5% in diagnosing lateral zone of disc prolapse. The outcome of surgery was excellent in 43.3% of cases followed by fair in 50% of the cases. It was poor in only two cases.
Conclusion: Subjects in the age groups 40-59 years were commonly affected MRI is a very sensitive in detecting symptomatic lumbar disc prolapse

A study on clinical presentation of rhino orbital cerebral mucormycosis associated with COVID-19 infection

Dr. Bomma Vijay Kumar, Dr Naresh Mogilicharla, Dr. Potlacheruvu Nagaraju, Dr. Moota Madhuri, Dr. A Shobhan Babu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1988-1997

Background and aims: During the second wave of coronavirus disease 2019 [covid-19] in India, there is a rapid surge of opportunistic fungal infections among covid-19 patients. Rhino-Orbito-Cerebral mucormycosis is the most common disease among these patients apart from pulmonary aspergillosis. The study aims to determine the clinical presentation, signs, and symptoms in patients with rhino-orbito-cerebral mucormycosis associated with coronavirus disease in the present scenario.
Methods: It is a retrospective observational study. The Clinical history of 100 patients from medical records with Rhino-Orbito-Cerebral mucormycosis associated with covid-19 during the months of May and June 2021 is collected and analyzed.
Results: In our study on 100 patients with mucormycosis infection 95 patients were diagnosed with covid-19 infection and 82 patients were diabetic. Among the diabetic group, 53 were chronic diabetic and 29 were detected denovo. The disease is seen most prominently in the people of the age group between 30-60yrs. Males are more affected. The urban population represented 67 percent. The chief complaints of the patients with mucormycosis related covid-19 are pain (88%), swelling/edema (79%), visual disturbance (51%), numbness over the face (47%), nasal discharge (45%). Clinical findings of the disease are, ptosis (52%), blurring/absent vision (51%), proptosis (41%), ophthalmoplegia (33%), discoloration over the face (26%) and necrosis of the soft tissues (8%).The percentage of people presented with mucormycosis between diagnosis of covid-19 infection and onset of symptoms of mucormycosis is observed to be 72% within two weeks and 89% within three weeks. Regarding the covid-19 symptoms, mild symptoms were seen in 59.9%, moderate symptoms in 29.4% and severe symptoms in 10.5% of patients. 76 patients were on corticosteroid therapy and 35 patients were oxygen-dependent.

Clinical, etiological profile and outcomes of patients with acute pancreatitis in a tertiary care hospital, South India: A cross-sectional study

Dr. Anjaney Yadur, Dr. Dhanalaxmi Neginhal, Dr. Sagar Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 12003-12009

Background: Acute pancreatitis, characterised by inflammation, auto-destruction and activation of pancreatic enzyme is a common gastro-intestinal cause of hospital admission. Understanding the etiology, clinical profile and clinical outcomes of these patients in regional setting is key for appropriate management.
Methods: A hospital based observational study was carried out between August 2011 and July 2013 among patients above 18 years of age who presented to the outpatient department with acute pancreatitis. Patients demographic, clinical information, and laboratory findings was obtained at admission. All patients were subjected to ultrasonography and patients with severe disease were subjected to Computed Tomography. The clinical severity and outcomes were recorded. Data was summarised as mean (SD) for continuous variables and proportions for categorical variables.
Results: Among 94 subjects included in the study, about 85% were males and 69% were aged less than 45 years. Abdominal pain (88%) was the most common clinical presentation, followed by vomiting (49%). Alcohol was the most common etiological factor seen in about 60% of the subjects. Ultrasonography revealed bulky pancreas in 38% and gallbladder calculi in 33% of the subjects. Acute kidney Injury was present among 3% of the patients. About 9% had severe disease and mortality was 2.1%. There was marked increase in the levels of pancreatic enzymes, BUN and serum creatinine among patients with severe disease when compared to patients with mild/moderate disease.
Conclusions: Acute pancreatitis is a leading causes of hospitalization due to gastro-intestinal cause. Clinical assessment along with radiological findings correlates well with the disease severity and mortality. Understanding the clinical and etiological profile of patients with acute pancreatitis would be helpful to plan the management strategies for the local setting.

Clinical and Ultrasonography Evaluation of Pregnancy of Unknown Location in First Trimester of Pregnancy

Dr. Ditya Kumari, Dr.Hansa thagele, Dr. Deepti Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2975-2979

Background &Method: Present study was conducted with an aim tostudy clinical and
ultrasonography evaluation of pregnancy of unknown location in first trimester of pregnancy.
500 Pregnant patients in the first trimester of pregnancy were included in the study. Complete
clinical evaluation and general physical examination were performed and patients were then
subjected to ultrasound examination.
Result:Among 500 pregnant females almost 5% were pregnancy of unknown location. 4% of
all the pregnancy of unknown location was diagnosed to be ectopic pregnancy. 0.6% of
pregnancy of unknown location was failed PUL. 0.4% of pregnancy of unknown location was
persistent PUL. β-hCG level is best indicator for predicting ectopic pregnancy while
progesterone is best indicator for viability. Serum progesterone levels can be helpful at
determining the viability of pregnancies; however, they are not specific to pregnancy
location.
Conclusion:Ultrasonography is paramount in utility as a diagnostic tool for ANC patients.
When used in combination with clinical information and serum β-hCG levels, it can provide
diagnostic and prognostic information regarding pregnancy confirmation, viability and rapid
information regarding life-threatening conditions. One great concern of PULs is that they are
cases of ectopic pregnancy whose diagnosis might be postponed.

Three Case Reports of Ameloblastoma with relevant clinico-radiographic and histopathologic correlations

Dr. Mohamed Abdulcader Riyaz SS

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1269-1281

Ameloblastoma is one of the most common clinically significant tumor. It belongs to 1% of all oral tumors. Compared to maxilla, the mandible is qyite commonly affected (4:1). It affects both male and female population equally. The age at presentation is usually between 3rd and 7th decade of life. The usual clinical presentation is that of a slow growing asymptomatic intraoral swelling. There are four clinico-radiographic types of Ameloblastoma namely Unicystic, Multicystic, Peripheral (extra-osseous) and Desmoplastic. The Histologic types include Follicular, Plexiform, Acanthomatous, Granular, Basal cell & Desmoplastic. The unicystic type has three histologic variants namely luminal, intra-luminal and mural. This article is aimed at documenting three case reports of Ameloblastoma with histopathologic variations and correlating them with clinico-radiographic findings

Meteopathogenic Mechanisms Of Development And Aspects Of Prevention Of Glaucoma Under The Conditions Of A Risk Continental Climate Of Uzbekistan

Ne’matjon S. Mamasoliev; B. M. Nazarov; Ziyadullo N. Mamasoliev

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4209-4220

In recent years, there have been significant changes in the field of screening
diagnostics and glaucoma prevention. At the same time, the specificity of glaucoma
control, due to a number of regional reasons, needs corrections. In a prospective clinical
and meteorological study, 1112 cases of glaucoma were analyzed. A direct dependence of
the development of glaucoma on the level of fluctuations of the main meteorological
elements – atmospheric pressure, relative humidity of air, solar fusion and thermal regime
was noted. The scientific foundations have been created for the implementation of effective
methods of meteorological prevention off glaucoma in the sharply continental climate of
Uzbekistan.

Understanding Clinical Waste Management and the Risk of Cross-Contamination Diseases in Malaysian Public Healthcare Facilities

Marziah Zahar; Fauzuradhi Fazir

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 3926-3937

Clinical waste management in the hospital plays a considerable role in healthcare facilities, as it serves as the frontline that deals with clinical disposal, where zero cross-contamination exposure to the public must be ensured. In this paper, a preliminary study was conducted to investigate the biohazard container etiquette in a selected Malaysian healthcare facility. The yellow bin is a designated container used to dispose of contaminated clinical waste that could spread pathogenic microorganisms to humans. The findings show that several biohazard bins were positioned in non-restricted pathways containing general plastic, papers, and rejected medical parts. It is assumed that a lot of effort is required to educate both the public and the staff regarding biohazard bin etiquette. To date, more inspections are still being conducted to determine the impact of misusing the biohazard bin. Nevertheless, the authors are currently developing descriptive statistics to investigate the public awareness of biohazard bin etiquette in hospitals. A new strategy to improve clinical waste management sustainability in a healthcare facility is also being proposed