International Journal of Advances in Medicine

Journal Information
ISSN / EISSN : 2349-3925 / 2349-3933
Published by: Medip Academy (10.18203)
Total articles ≅ 2,250
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SHERPA/ROMEO
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Raman Sharma, Kajal Khajuria
International Journal of Advances in Medicine; https://doi.org/10.18203/2349-3933.ijam20222050

Abstract:
Background: Dengue epidemics are more frequent in developing countries like India. Dengue is a self-limiting disease but its complication in children may cause high morbidity and mortality. Objective: The main objective of this study was to assess the clinical profile of dengue fever in children less than 15 years of age. Methods: This was a retrospective study done in a pediatric department of Maharishi Markandeshwar institute of medical science and research hospital, Ambala, a university level medical college of North India for a period of 17 months. Results: A total of 130 patients of dengue fever were identified in our study. Out of these 130 patients, 39 patients were included in dengue without warning signs,78 were included in dengue with warning signs and 13 in severe dengue category. The most common age group was between 5 to 10 years of age. Fever was the most common presenting symptom in all dengue patients. No mortality was observed during our study period due to dengue. Conclusions: It is one of the dreaded fevers for all the pediatric age group. So, early suspicion and effective management can reduce the severity.
Shubham Jain, Birata Debbarma, Devdas Rai
International Journal of Advances in Medicine, Volume 9; https://doi.org/10.18203/2349-3933.ijam20221809

Abstract:
Background: Microalbuminuria is multifactorial and it is an important marker for diabetic nephropathy. The aim of the study was to assess the incidence and association of serum magnesium levels, serum uric acid levels and microalbuminuria in patients with type 2 DM. Methods: This study was a cross-sectional study conducted for a period of 2 years from October 2015 to September 2017, where the patients diagnosed as type 2 DM admitted in AJIMS were taken up for the study. All the patients’ blood sample was sent for estimation of serum magnesium, serum uric acid, FBS, PPBS, HBA1C and urine spot albumin:creatinine ratio. Results:In our study, out of 100 patients with type 2 diabetes, 79 patients had microalbuminuria. Out of these, 83.3% (N=75) was having hypomagnesemia (p<0.000) associated with microalbuminuria. Hyperuricemia was seen in 63% (N=63) of the population but 79.4% (N=50) hyperuricemics were associated with microalbuminuria(p<0.000). Conclusions:There was a significant microalbuminuria in patients with type 2 DM, with reduced serum Mg levels and elevated serum uric acid levels as compared with patients who had serum Mg and uric acid levels within the normal range.
Agus Dody Pranata Suadi Putra, Ketut Suryana, Dewi Catur Wulandari, Ida Ayu Uttari Priyadarshini
International Journal of Advances in Medicine, Volume 9, pp 875-878; https://doi.org/10.18203/2349-3933.ijam20221845

Abstract:
Stevens-Johnson syndrome (SJS) is systemic immune reactions (type IV hypersensitivity) that are usually present by blistering and erosions of skin and mucous membranes with involvement of multiple organ systems. The incidence of SJS is rare, with the common comorbidities are diabetes mellitus, epilepsy, hypertension, and stroke. This condition is associated with systemic proinflammatory state. Diabetes mellitus is a metabolic disorder that is characterized by abnormally elevated levels of blood glucose due to glucose intolerance, hyperglycemia, and impaired insulin secretion. Nowadays, pathogenesis of diabetes is considered to be dysregulation of immune factors that are recognized as important etiological components in the development of insulin resistance. We report a case of a 30-years-old man with fever and sore throat, who had type 2 diabetes mellitus (T2DM) and used carbamazepine and amitriptyline for diabetic neuropathy, then followed by redness and blistering on his lips, palates, face, and trunk which subsequently diagnosed with SJS.
Kenneth Dermawan, Bernard Jonathan Christian Yong, Made Suma Wirawan
International Journal of Advances in Medicine, Volume 9, pp 883-888; https://doi.org/10.18203/2349-3933.ijam20221847

Abstract:
According to the global cancer observatory (GLOBOCAN), there were 16,485 new cases of pancreatic cancer in Southeast Asia in 2020, with men (9458 cases) having the highest incidence compare to woman (8320 cases). The death rate from 16,485 cases was 16,167 cases (98%). A person's chance of developing pancreatic cancer in addition to other cancers is between 1% to 20%. In this study, we reported a case of pancreatic tumor with lung tumor. A 68 years old woman presented with right quadrant abdominal pain since 1 month ago. The pain occurs randomly, but mostly occur during night. The pain didn’t occur after eat fatty food and during exercise. The pain didn’t relieve by rest. The patient also experienced nausea and vomit. The vomit consist of food and blood. She complains black colored stools and dark yellow urine. She also lost weight from 62 kg to 47 kg. There was history of gastric bleeding in 4 month ago. She was passive smoker. We then did several tests such as complete blood count, blood chemistry, serology, chest x-ray and abdominal CT-scan. The test showed pancreatic tumor with suggestive primary lung tumor. Patient with multiple primary tumor are an extremely rare type of cancer, which need comprehensive approach to both diagnosis and treatment of these numerous primary tumors.
Rishab Rampradeep, V. Gandadharan, Prasanth Gururaj
International Journal of Advances in Medicine, Volume 9, pp 899-902; https://doi.org/10.18203/2349-3933.ijam20221850

Abstract:
Tuberculosis, although an ancient disease, affecting humans for millennia; continues to present in atypical ways. Whilst the development of bullous lung disease in patients suffering from Pulmonary Tuberculosis, has been reported, it remains an extremely rare phenomenon. The underlying mechanisms remain unknown, and potential causes have been hypothesized, including the role of Isoniazid as part of antitubercular therapy. We reported one such case of a rapid development of bullous lung as a complication of Pulmonary Tuberculosis.
Muhammad Iqbal Nurfadhilah, Heka Priyamurti, Arsanto Tri Widodo
International Journal of Advances in Medicine, Volume 9, pp 860-863; https://doi.org/10.18203/2349-3933.ijam20221843

Abstract:
Background: Since there are too many cases of lumbar canal stenosis in Indonesia. The aim of the study was to discover all the factors that influence the incidence of lumbar canal stenosis. Methods: This study used all cases of lumbar canal stenosis in Koja District Hospital in Jakarta from 2011 to 2021. This was a medical record-based retrospective study in which files of patients with the diagnosis of lumbar canal stenosis were reviewed. A descriptive analytic test was used to analyze results was presented in the form of a table. Results: There were 48 lumbar canal stenosis cases in male patients out of 66 total patients. Incidents of lumbar canal stenosis occurred more frequently in anatomical locations L4-5 than in other locations. There were 48 lumbar canal stenosis cases with anatomical locations L4-5 in 50 patients from 66 patients. Incidents of lumbar canal stenosis occur in people with obesity more frequently than in people without obesity. There were 48 lumbar canal stenosis cases in people with obesity patients out of 66 total patients. The incidence of lumbar canal stenosis with a moderate VAS score was greater than that with a mild or severe VAS score. There were 48 lumbar canal stenosis patients with a moderate vas score out of 66 patients. There were 59 lumbar canal stenosis patients who got surgery out of 66 patients, and 7 of them had no surgery. Lumbar canal stenosis more frequently occurred in men than women, with more frequent anatomical lesions in L4-L5, and more frequently in people with obesity than in people without obesity. Most of them had a moderate VAS score and got surgery. Conclusions: According to this study, males had more lumbar canal stenosis incidents than females.
Gabrielle Alexander Kartawan, Tiffany Alexander Kartawan
International Journal of Advances in Medicine, Volume 9, pp 879-882; https://doi.org/10.18203/2349-3933.ijam20221846

Abstract:
Coronary artery spasm, marked by coronary vasoconstriction, is one of the etiologies of myocardial ischemia, often presenting as vasospastic angina. Vasospastic angina is diagnosed when angina which predominantly occurs at rest, is accompanied by ST-segment changes in ECG, or in the setting of borderline ECG changes, a positive provocation test through coronary angiography is required. Although coronary artery spasms could manifest in wide clinical settings, the occurrence of ventricular arrhythmias and acute myocardial infarction solely caused by spasms without evidence of prior coronary artery disease is rare. This case report is about a 46-year-old man who presented with ventricular tachycardia and acute myocardial infarction that later was found to be secondary to coronary vasospasm observed directly through coronary angiography. We aim to emphasize the importance of coronary artery spasms as the etiology of malignant ventricular arrhythmias and acute myocardial infarction manifestation. Optimization in treatment and prevention shall reduce future life-threatening complications of coronary artery spasms.
Priyadharshini V., Sanjay Surya G. S., Gowri A. Shankar, Sachin K. Dhande, Anbalagan Pichaimuthu
International Journal of Advances in Medicine, Volume 9, pp 894-898; https://doi.org/10.18203/2349-3933.ijam20221849

Abstract:
Pancreaticopleural fistula is a very rare complication of acute and chronic pancreatitis. High index of suspicion is needed to diagnose in patients with alcohol induced pancreatitis, presenting with recurrent or persistent pleural effusion. Patient typically presented with pulmonary symptoms, rather than abdominal complaints, leading to delay in the diagnosis. Here we present a case of a known chronic pancreatitis who presented to us with massive left sided pleural effusion. Blood coloured pleural fluid analysis showed lipase and amylase levels in hundred thousand and ten thousand ranges. Diagnosis was made by CECT abdomen and confirmed with MRCP. Patient was treated with first line medical management of thoracocentesis and ERCP with pancreatic duct stenting.
Sobhasini D. Laimujam, Joy S. Akoijam, Nandabir S. Yumnam, Ningthemba S. Yumnam, Bhupes Pheiroijam, Purnimala C. Kongkham, Margaret Chabungbam
International Journal of Advances in Medicine, Volume 9, pp 869-874; https://doi.org/10.18203/2349-3933.ijam20221844

Abstract:
Background: Anterior cruciate ligament (ACL) injuries are one of the most common ligamentous injuries of knee. Treatment options for partial ACL tear range from conservative treatment up to partial reconstruction. PRP may have enhancing effect on ACL cell viability and promotion of cell proliferation in partial tear of ACL. Thus, the purpose of this study is to determine the role of PRP on partial ACL tear. Methods: A RCT was done among athletes with partial ACL injury who visited department of Sports Medicine, RIMS, Imphal during June 2019-December 2020. Patients with MRI diagnosed grade 1 and 2 ACL injury (n=48) randomized into PRP injection plus rehabilitation, (n=24) and rehabilitation alone, (n=24) groups. The outcomes were compared using International Knee Documentation Committee (IKDC) score, Lysholm score and VAS at baseline, 1st month, 4th month, 8th month and 12th month respectively. Results: Baseline characteristics were not statistically significant.At the end of 1st month, there were statistically significant improvement in both mean difference of IKDC score (.001), Lysholm score (0.001) and VAS (0.007). At the end of 4th month, there were statistically significant improvement in both mean difference of IKDC score (0.001), Lysholm score (0.026) and VAS (0.001). At the end of 8th and 12th month, improvement in mean difference of IKDC score, Lysholm score, VAS were observed however not statistically significant. Conclusions: Ultrasound guidedPRP injection along with conservative rehabilitation program might be a treatment choice for ACL partial tear.
Agnes Theodora, Ketut Suryana
International Journal of Advances in Medicine, Volume 9, pp 889-893; https://doi.org/10.18203/2349-3933.ijam20221848

Abstract:
COVID-19 pandemic in dengue endemic countries has becoming a concern due to its similarities in early clinical symptoms and laboratory features. The cases of co-infection between the two diseases are inevitable and associated with higher morbidity and mortality. Here we presented a case of a 28 years old female diagnosed with co-infection of COVID-19 and dengue hemorrhagic fever that complicated with severe thrombocytopenia and spontaneous bleeding.She came with fever that started 3 days prior to admission. Laboratory examination showed leucopenia, thrombocytopenia, elevated liver enzymes, and D-dimer. Patient tested positive for non-structural protein 1 (NS-1) dengue antigen. She had a pre-screening rapid test for COVID-19 as part of hospital protocol, and she tested positive. Followed by positive COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) test confirming the diagnosis. During admission, patient started menstruating, resulting in active spontaneous bleeding while platelet counts dropped to below 10×109/l. Patient was given platelet transfusion, supportive therapy and put under close monitoring. The case of co-infection between COVID-19 and dengue is inevitable in tropical and sub-tropical countries. Both infections shared similar pathophysiology through different mechanism, such as plasma leakage, thrombocytopenia, and coagulopathy.Complications may arise and physician must aware of the therapeutical approach. Diagnostic testing must not be withheld when there was suspicion towards the infection. Prompt treatment and close monitoring can result in good prognosis.
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