High Male Preponderance Research Articles

Angular Trajectory of the Vestibular Aqueduct in a Cohort of Chinese Patients with Unilateral Ménière's Disease: Association with Other Imaging Indices and Clinical Profiles.

We aimed to investigate the association between the angular trajectory of the vestibular aqueduct (ATVA) with other radiological parameters of temporal bone and clinical characteristics in patients with Ménière's disease (MD). A total of 125 unilateral MD patients and 118 controls were enrolled. Computer tomography (CT)-based radiological parameters included ATVA, vestibular aqueduct (VA) visibility, VA morphology, the vertical part of the posterior semicircular canal-the posterior fossa distance (PPD), and peri-VA pneumatization. The clinical characteristics of MD patients included gender, age of diagnosis/onset, disease duration, migraine history, clinical staging, and the results of audio-vestibular tests. The radiological parameters and clinical characteristics in MD patients were compared. Compared with control ears, ATVA ≥ 140° was more prevalent and ATVA ≤ 120° was less frequent in the MD-affected side. For the MD-affected side, MD patients with ATVA ≥ 140° exhibited more severe VA invisibility and obliteration and higher male preponderance than those with ATVA ≤ 120°. Other radio-clinical features did not differ between these two subgroups. In the current study, ATVA ≥ 140°, an indicator of a hypoplastic endolymphatic sac, was found in approximately one-third of the affected and unaffected ears of patients with MD, as well as in a minority of controls. This suggests that the indices may be a predisposing factor rather than a specific marker for the MD ear. The male preponderance in MD patients with hypoplastic ES suggests a gender difference in the anatomical factors for MD pathogenesis.

Does Vocal Fold Pathology Play a Role in Determining the Timeline of Presentation to an Ear, Nose, and Throat Surgeon?

Abstract Background: The primary objective is to study the average time duration between the onset of vocal symptoms and presentation to an ear, nose, and throat (ENT) surgeon, in different vocal pathologies. Our second objective is to study gender distribution among various pathologies. Methods: Our voice clinic records were retrospectively reviewed for 1 year, from August 2022, for details regarding gender, and the average time taken for presentation (ATTFP) in months, to an ENT surgeon. Disorders were grouped into vocal fold nodules, polyps, cysts, paralysis/paresis, sulcus, spasmodic dysphonia (SD), and premalignant and malignant conditions. Results: A total of 17 patients of vocal fold nodules (15 females), 47 vocal fold polyp patients (45 males), 40 vocal fold cyst patients (24 females), 64 paralysis/paresis patients (44 males), 41 sulcus patients (31 males), 35 SD patients (22 females), and 65 premalignant and malignant condition patients (51 males) presented to us. The ATTFP for nodules was 8.1 months, 6.8 months for polyps, 10.2 months for cysts, 22.8 months for idiopathic and 6 months for other causes of paralysis/paresis, 32.4 months for sulcus, 26.1 months for SD, and 10.2 months for premalignant and malignant conditions. Conclusion: Sulcus patients took the longest time to present to an ENT surgeon, followed by SD patients, both groups averaging over 2 years. Vocal fold paralysis/paresis patients with a nonidiopathic diagnosis were the earliest to present. A high male preponderance in vocal fold polyps (96%) as opposed to a high female preponderance in vocal fold nodules (88%), both considered phonotraumatic lesions, warrants further research into possible varying etiopathogenesis.

Genotyping of cryptosporidium species in cases of irritable bowel syndrome: A case control study from a tertiary care center

Irritable bowel syndrome (IBS) is functional bowel disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of detectable structural abnormalities. Protozoan cysts are commonly found in the stool samples of patients with IBS and a rising body of evidence suggests a direct causal relationship. Cryptosporidium infection can be a potential candidate for IBS. We studied prevalence, association, and genotype of cryptosporidium at a tertiary care centre. Using a case-control design, a total of 100 cases and 100 controls were selected between 2016 and 2017. Fresh stool samples were collected and processed for microscopic examination. Positive samples were subjected to PCR RFLP for speciation and results analysed for Odd’s ratio, relative risk and relationship between variables. There was a high male preponderance (m: f=9:1). Most patients belonged to the middle age group (34.8-42.4 years). Amongst the clinical subtype IBS with diarrhoea (IBS-D) was the most common subtype (63%). Odd’s ratio for having IBS was 57.5 with cryptosporidium with a relative risk of 2.09. Adjusted Odd’s ratio for age was 1.014 suggesting a linear correlation (r value=0.07) with age. Our study shows a significant risk of developing IBS with cryptosporidium infection. The authors recommend studies with larger population samples both within the northern regions of India and across the country to determine prevalence, speciation of cryptosporidium and its relationship to IBS.

Barrett’s Esophagus in Eosinophilic Esophagitis in Swiss Eosinophilic Esophagitis Cohort Study (SEECS)

Introduction: There is a complex interrelationship between gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) potentially promoting the occurrence and modulating severity of each other reciprocally. Presence of Barrett’s esophagus (BE) is a defining factor for the diagnosis of GERD. While several studies investigated the potential impact of concomitant GERD on the presentation and course of EoE, little was known with regards to BE in EoE patients. Methods: We analyzed prospectively collected clinical, endoscopic, and histological data from patients enrolled in the Swiss Eosinophilic Esophagitis Cohort Study (SEECS) regarding differences between EoE patients with (EoE/BE+) versus without BE (EoE/BE−) and determined the prevalence of BE in EoE patients. Results: Among a total of 509 EoE patients included in our analysis, 24 (4.7%) had concomitant BE with a high male preponderance (EoE/BE+ 83.3% vs. EoE/BE− 74.4%). While there were no differences in dysphagia, odynophagia was significantly (12.5 vs. 3.1%, p = 0.047) more common in EoE/BE+ versus EoE/BE−. General well-being at last follow-up was significantly lower in EoE/BE+. Endoscopically, we observed an increased incidence of fixed rings in the proximal esophagus in EoE/BE+ (70.8 vs. 46.3% in EoE/BE−, p = 0.019) and a higher fraction of patients with a severe fibrosis in the proximal histological specimen (8.7 vs. 1.6% in EoE/BE, p = 0.017). Conclusion: Our study reveals that BE is twice as frequent in EoE patients compared to general population. Despite many similarities between EoE patients with and without BE, the finding of a more pronounced remodeling in EoE patients with Barrett is noteworthy.

Chip-Derived Vs De Novo Treatment-Related Myeloid Neoplasms after Autologous Stem Cell Transplant for Lymphoid Disorders

Autologous stem cell transplant (ASCT) involves high intensity conditioning regimens with significant cytotoxicity. Therapy-related myeloid neoplasms (tMN) represent a serious complication characterized by high-risk features and poor treatment outcomes in patients potentially cured from their primary neoplastic disorders. While the 2016 WHO classification broadly divides tMN into MDS or AML, yet their heterogeneity warrants a more distinctive characterization based on specific prior exposures and subsequently-developed unique features, as emphasized by the updated 2022 WHO revision. We previously analyzed the genomics of tMN including features suggestive of their derivation from either CHIP or de novo driver mutations1. Specifically for tMN pathobiology, ASCT may be very instructive due to the high dose therapy and repopulation of the hematopoiesis out of a limited number of transplanted hematopoietic stem cells. Post-ASCT tMN may be unique and possibly related to antecedent CHIP, CHIP induced by the procedure, or driver lesions. We took advantage of a large volume of ASCT performed at our institution along with excellent clinical annotations and long follow up to study the dynamics of tMN in this setting. We accrued a total of 1507 patients undergone ASCT, of whom 35 (2.3%) developed tMN at a median follow up time of 5.4 years following the procedure. The clinical and molecular phenotype of these index cases were then compared to a cohort of tMN patients (n=263) without prior history of ASCT. Of note, both groups had similar MDS/AML proportions. Compared to the rest of the ASCT cohort, patients developing tMN were older at the time of the transplant procedure (66 vs 46% ≥60 years, P=.02) and had a higher male preponderance (91 vs 59%, P<.0001). Post-ASCT tMN was more common following non-Hodgkin's lymphoma (NHL) than multiple myeloma (MM) (2.5 vs 1.1%, P=.0002) but similar between NHL and Hodgkin's disease (2.5 vs 1.5%, P=0.13). We then studied whether graft size and mobilization regimens could increase the risk of tMN. The incidence of this complications was higher with a mobilization involving GCSF (G), Etoposide (E) and Plerixafor (P) (GEP) rather than G, G+E or G+P (P=.0001), as well as when a CD34+ dose ≤3.5 x106 (4.1 vs 1.9%, P=.03) was infused. No difference was noted with respect to time to engraftment following ASCT. Multivariate analysis confirmed the independent influence of age ≥60 (HR 2.4, 95% CI 1.1-5.6), male sex (HR 7.1, 2.5-29.9), diagnosis (prior NHL vs MM; HR 3.3, 1.5-8.2) and mobilization scheme (GEP vs G+P; HR 4.7, 1.3-13.7). The caveat was the lack of significant effect of the graft size on tMN risk. When compared to non-transplanted cases, tMN following ASCT still showed a male preponderance (91 vs 51%, P<.0001) and exhibited a higher prevalence of high-risk (IPSS-R>3.5) MDS (79 vs 57%, P=.05). Furthermore, tMN arising post-ASCT appeared to follow a more aggressive course with a significantly shorter latency duration following the procedure (median 2.6 vs 6.5 years, P<.0001) and shorter overall survival (median 16 vs 58 months, P<.0001; Fig1). Cytogenetic profiling revealed higher frequencies of complex karyotype (49 vs 31%, P=.05), del(5q)/5- (26 vs 20%, P=.5), del(7q)/7- (46 vs 27.5%, P=.03), and del(17p)/17- (27 vs 6%, P=.0025) in the ASCT-exposed as opposed to non-transplanted cases. Subsequent analysis of isolated cytogenetic aberrations showed that isolated del(7q)/7- was significantly enriched in post-ASCT tMN (20 vs 6%, P=.0129). Mutational analysis revealed similar patterns with the exception of TP53, which was significantly more frequent in the ASCT-exposed group (41 vs 13%, P=.0028), mostly displaying a multi-hit configuration (32 vs 11%, P=.0178). We have previously shown that ancestral hits in DNMT3A, TET2, ASXL1 and JAK2 (CHIP-mutations) indicate derivation of disease from CHIP vsU2AF1, RUNX1 and STAG2 highlighted de novo cases, thereby prompting us to investigate whether CHIP may have been the originator of tMN post ASCT2. However, the frequencies of CHIP- and de novo -mutations were similar across the post-ASCT tMN and the non-ASCT tMN groups. Interestingly, within the post-ASCT tMN, patients who had CHIP-derived tMN had lower survival compared to the rest of the group (median 9 vs 25 months, P=.0079). Sequencing experiments on serial specimens are ongoing to determine whether CHIP- derived mutations were present prior to ASCT constituting a risk for tMN. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

A study of chronic superficial venous insufficiency in patients with competent saphenofemoral junction

Background: Chronic venous insufficiency (CVI) is a condition that affects the venous system of the lower extremities rendering the superficial, perforating, and deep veins incompetent. This results in venous hypertension causing various pathologies including pain, swelling, edema, skin changes and ulcerations. Traditionally SFJ incompetence was viewed as the primary pathology for varicose veins and Trendelenburg’s surgery is considered as a standard surgical procedure for the treatment of varicose veins. Later studies have shown incidence of chronic superficial venous insufficiency (CSVI) with competent SFJ was seen in as many as about 40% cases. Therefore, present study aims to identify the incidence of CSVI with competent SFJ, severity of disease in these individuals and patient outcome and response to Trendelenburg’s surgery.Methods: Prospective observational study with non-randomised purposive sampling.Results: Prevalence of competent SFJ was about 40.54% in patient with CSVI. 56.7% patients had C4 disease, 26.7% had C6 disease, 13.3% had C5 disease and 3.3% had C2 disease. In all the patients, progression of the disease was arrested after surgical intervention and no recurrence or ulceration was seen by the end of the 3 months.Conclusions: In comparison to patients with CVI with incompetent SFJ, patient with CSVI. Competent SFJ vary in that there is high male preponderance compared to females, disease progression and severity is independent of age and gender. Surgical outcomes were comparable to the patients with CSVI and incompetent SFJ Trendelenburg surgery can be used as the choice of surgical treatment in patients with competent SFJ and CSVI.

Frequency of Sickle Cell Hemoglobin in High-Performance Liquid Chromatography Received in a Centralized Laboratory

BACKGROUND: Sickle cell disease and its variants result from an abnormal hemoglobin, hemoglobin S (HbS), caused by a single point mutation in the Beta-Globin gene. Hypoxia causes polymerization and distortion of Hb S containing red blood cells resulting in sickle crisis and hemolytic anemia. Common diagnostic methods include high-performance liquid chromatography (HPLC) and hemoglobin electrophoresis. The purpose of this research is to determine the frequency of sickle cell hemoglobin in HPLC samples and its geographical distribution in Pakistan. MATERIALS AND METHODS: Data was collected from the samples received from 1st February 2020 to 31st January 2021. Proforma included demography, complete blood count parameters, and variants of sickle cell disease which were extracted from hospital records. Analysis was done using the SPSS (version 26). RESULTS: Out of 14,740 samples, 295 (2%) revealed HbS. These patients had a mean age of 14.2 years. The male-to-female ratio was 1.5:1. The samples were received from Baluchistan (43%), followed by Sindh (32.1%), Khyber Pakhtunkhwa (16%), and Punjab (8.9%). Mean hemoglobin was 8.6 ± 2.6 g/dl, lowest and highest were 2.4 g/dl and 16.9 g/dl, respectively. Sickle cell trait was found in 21.3% of the patients, homozygous HbSS in 27.7%, sickle beta thalassemia in 30.8%, 4.4% were compound heterozygotes for Hb S and Hb D, whereas 15.5% were posttransfusion samples. CONCLUSION: Our analysis showed that the highest frequency was of sickle beta thalassemia and other variants being low. This study also proved it to be more prevalent in Baluchistan with relatively high male preponderance.

Sporadic dyskeratosis congenita in a male – A case report

Dyskeratosis congenita was first described in 1960 as Zinsser-Engman-Cole syndrome. It is a rare inherited condition with a progressive nature and a tendency to involve multiple systems like pulmonary, gastrointestinal, genitourinary, cerebral, and dental. It has an X-linked recessive (most common) or Autosomal dominant or recessive inheritance with a high male preponderance. The genetic defect lies in the DKC1 gene which encodes for Dyskerin protein. Dyskeratosis congenita patients are at a higher risk of development of malignancies, pulmonary fibrosis and eventually aplastic anemia and bone marrow failure which may be the cause of death. This report details a case of Dyskeratosis congenita affecting a 21 year old male patient with the most benign presentation.

Heterogeneity of Type 1 Diabetes at Diagnosis Supports Existence of Age-Related Endotypes.

Previous findings suggest that there are age-related endotypes of type 1 diabetes with different underlying etiopathological mechanisms in those diagnosed at age <7 years compared with those diagnosed at age ≥13 years. We set out to explore whether variation in demographic, clinical, autoimmune, and genetic characteristics of children and adolescents with newly diagnosed type 1 diabetes support the existence of these proposed endotypes. We used data from the Finnish Pediatric Diabetes Register to analyze characteristics of 6,015 children and adolescents diagnosed with type 1 diabetes between 2003 and 2019. We described and compared demographic data, clinical characteristics at diagnosis, autoantibody profiles, and HLA class II-associated disease risk between three groups formed based on age at diagnosis: <7, 7-12, and ≥13 years. We found significant age-related differences in most of the characteristics analyzed. Children diagnosed at age <7 years were characterized by a higher prevalence of affected first-degree relatives, stronger HLA-conferred disease susceptibility, and higher number of autoantibodies at diagnosis, in particular a higher frequency of insulin autoantibodies, when compared with older children. Those diagnosed at age ≥13 years had a considerably higher male preponderance, higher frequency of glutamic acid decarboxylase autoantibodies, longer duration of symptoms before diagnosis, and more severe metabolic decompensation, reflected, for example, by a higher frequency of diabetic ketoacidosis. Our findings suggest that the heterogeneity of type 1 diabetes is associated with the underlying disease process and support the existence of distinct endotypes of type 1 diabetes related to age at diagnosis.

Fistulectomy and incontinence: do we really need to worry?

Anal fistula is often considered to be a dilemma because of the need to maintain a fine balance between postoperative incontinence and recurrence. We tried to find whether apprehension of causing incontinence should stop us from performing fistulectomy. The aim of this study was to determine whether fistulectomy was associated with increased rate of fecal incontinence and recurrence, compared to other procedures used for the treatment of anal fistula. It was a prospective, single center, observational study. All patients with anal fistula operated at a tertiary care teaching institute over a period of two years were included in the study. Recurrence rates and fecal incontinence were compared between patients subjected to fistulectomy and other procedures for treatment of fistula in ano. A total of 124 patients with anal fistula were included. 92.8% patients were ≤ 60 years of age with high male preponderance (89.5%). Perineal discharge was the commonest complaint (95.96%). Intersphincteric (47.58%) followed by transphincteric fistulas (45.16%) accounted for the majority of fistulas. Fistulectomy was the most common procedure, performed in 90 (72.58%) patients. Incontinence occurred in 8/90 (8.88%) from the fistulectomy group and 2/34 (5.9%) patients in other surgery group, p=0.726. Recurrence occurred in 8/90 (8.88%) from the fistulectomy group and 8/34 (23.5%) patients from other surgery group, p=0.038. Overall rates of incontinence and recurrence were 8.1% and 12.9% respectively. Fistulectomy, as compared to other procedures, results in less chances of recurrence without compromising continence.

Clinicopathological Difference Between Gingivobuccal and Oral Tongue Cancers: A Cross-Sectional Observational Study from a Tertiary Healthcare Centre in Northern India.

Gingivobuccal and oral tongue squamous cell carcinomas are commonly considered together as a single clinical entity for staging and treatment purposes. Though there is data suggesting a significant difference between SCC of various oral cavity subsites, very few studies have compared clinicopathological characteristics between the tongue and gingivobuccal primaries. We retrospectively analysed 225 patients with biopsy-proven gingivobuccal (GB) and oral tongue (OT) SCC operated between April 1, 2018 and April 30, 2021 in All India Institute of Medical Sciences, Rishikesh, India to compare their clinicopathological characteristics. Demographic, clinical and histopathological data were collected from electronic medical records. An independent sample t-test was used to compare means and Pearson chi-square test or Fisher exact test was applied to compare the distribution of categorical variables. A relative male preponderance (12:1 vs. 5:1, p = 0.036) and increased smokeless tobacco consumption (82% Vs. 69%, p = 0.003) was seen in GB-SCC. Significantly higher proportion of patients with OT-SCC presented with early primaries (T1/T2) (54.1% vs. 24.8%, p < 0.001). Similarly, a higher proportion of GB-SCC patients presented with palpable neck nodes (cN +) (81% Vs. 67%, p = 0.02). Due to early primary tumours at presentation, stage I/II disease was also significantly higher in cases of OT-SCC (36.5% Vs.13.7%, p < 0.001). No difference was noticed in age at presentation, neck node status, and other clinicopathological parameters. GB-SCC has a higher male preponderance than OT-SCC due to relatively higher consumption of smokeless tobacco in males. Oral tongue cancers presented at an earlier stage than gingivobuccal malignancies. No difference in neck node status, however, suggests a relatively aggressive disease behaviour and early regional metastasis in tongue cancers. Follow up data regarding recurrence and survival is required to further characterise the differences between these two common OSCC subsites.

Clinical Characteristics and Early Interventional Responses in Patients with Severe COVID-19 Pneumonia.

Progressive acute respiratory distress syndrome (ARDS) is the most lethal cause in patients with severe COVID-19 pneumonia due to uncontrolled inflammatory reaction, for which we found that early intervention of combined treatment with methylprednisolone and human immunoglobulin is a highly effective therapy to improve the prognosis of COVID-19-induced pneumonia patients. Objective. Herein, we have demonstrated the clinical manifestations, laboratory, and radiological characteristics of patients with severe Coronavirus Disease-2019 (COVID-19) pneumonia, as well as measures to ensure early diagnosis and intervention for improving clinical outcomes of COVID-19 patients. Summary Background Data. The COVID-19 is a new infection caused by a severe acute respiratory syndrome- (SARS-) like coronavirus that emerged in China in December 2019 and has claimed millions of lives. Methods. We included 37 severe COVID-19 pneumonia patients who were hospitalized at Taizhou Public Health Medical Center in Zhejiang province from January 17, 2020, to February 18, 2020. Demographic, clinical, and laboratory features; imaging characteristics; treatment history; and clinical outcomes of all patients were collected from electronic medical records. Results. The patients' mean age was 54 years (interquartile range, 43−64), with a slightly higher male preponderance (57%). The most common clinical features of COVID-19 pneumonia were fever (29 (78%)), dry cough (28 (76%)), dyspnea (9 (24%)), and fatigue (9 (24%)). Serum interleukin (IL)-6 and IL-10 were elevated in 35 (95%) and 19 (51%) patients, respectively. Chest computerized tomography scan revealed bilateral pneumonia in 35 (95%) patients. Early intervention with a combination of methylprednisolone and human immunoglobulin was highly effective in improving the prognosis of these patients. Conclusions. Progressive acute respiratory distress syndrome is the most common cause of death in patients with severe COVID-19 pneumonia owing to an uncontrolled inflammatory response. Early intervention with methylprednisolone and human immunoglobulin was highly effective in improving their prognosis.

Impact of diabetes mellitus on short-term prognosis, length of stay, and costs in patients with acute kidney injury: A nationwide survey in China.

BackgroundInternational data suggest that people with diabetes mellitus (DM) are at increased risk for worse acute kidney injury (AKI) outcomes; however, the data in China are limited. Therefore, this study aimed to describe the association of DM with short-term prognosis, length of stay, and expenditure in patients with AKI.MethodsThis study was based on the 2013 nationwide survey in China. According to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) and expanded criteria of AKI, 7604 patients with AKI were identified, and 1404 and 6200 patients were with and without DM, respectively. Clinical characteristics, outcomes, length of stay, and costs of these patients were compared. Multivariate regression analyses were conducted to evaluate the association of DM with mortality, failed renal recovery, length of stay, and costs.ResultsPatients with AKI and DM were older, had higher male preponderance (61.9%), presented with more comorbidities, and had higher serum creatinine levels compared with those without DM. An apparent increase in all-cause in-hospital mortality, length of stay, and costs was found in patients with DM. DM was not independently associated with failed renal recovery (adjusted OR (95%CI): 1.08 (0.94–1.25)) and in-hospital mortality (adjusted OR (95%): 1.16 (0.95–1.41)) in multivariate models. However, the diabetic status was positively associated with the length of stay (β = 0.06, p<0.05) and hospital expenditure (β = 0.10, p<0.01) in hospital after adjusting for possible confounders.ConclusionIn hospitalized AKI patients, DM (vs. no DM) is independently associated with longer length of stay and greater costs, but is not associated with an increased risk for failed renal recovery and in-hospital mortality.

Demographic, diagnostic and therapeutic characteristics of autosomal dominant polycystic kidney disease in Ghana

BackgroundAutosomal Dominant Polycystic Kidney Disease (ADPKD) is the commonest of the hereditary kidney diseases and mostly ensues in utero with signs delayed until after several decades. This study assessed the demographic, diagnostic (clinical and biochemical features) and therapeutic patterns among ADPKD patients who attended the nephrology unit of Komfo Anokye Teaching Hospital (KATH) from 2007 to 2018.MethodsThis cross-sectional retrospective analysis of ADPKD patient records was conducted at the nephrology unit of KATH in October 2020. The records of 82 ADPKD was used for this study. Demographic, clinical, biochemical, ultrasonographic and therapeutic data was obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS).ResultsADPKD was most prevalent in people within the ages of 31–40 years (25.6 %), with a male (52.4 %) preponderance. The most common clinical features presented were flank pain (30.5 %) and bipedal swelling (18.3 %). Hypertension (42.7 %), urinary tract infections (UTIs) (19.5 %), and anemia (13.4 %) were the most common complications reported. Average level of HDL-c was higher in females (1.7) than in males (1.2) (p = 0.001). Hematuria (34 %) and proteinuria (66 %) were among the biochemical derangements presented. About 81.7 % had CKD at diagnosis with the majority in stages 1 (27.0 %), 3(23.2 %) and 5 (20.3 %). Poor corticomedullary differentiation was observed in 90.2 % of participants and increased echogenicity was observed in 89.0 % of the participants. Estimated GFR (eGFR) correlated positively with echotexture (r = 0.320, p = 0.005) and negatively with CMD (r= -0.303, p = 0.008). About 95.1 % of patients were on conservative therapy including: 73.2 %, 52.4 %, 22.0 %, 13.4 %, 8.5 % on Irebesartan/Lisinopril, Nifecard XL, Hydralazine, Methyldopa and Bisoprolol respectively for hypertension; 26.8 and 3.7 % on Gliclazide and Metformin respectively for Type 2 diabetes mellitus; 25.6 %, 24.4 and 18.3 % on CaCO3, fersolate and folic acid respectively as nutrient supplements with 4.9 % of participants on renal replacement therapy (RRT).ConclusionsADPKD occurs in people aged ≥ 31 years with a higher male preponderance. Clinical features include flank and abdominal pain, bipedal swelling, headache, amongst others. Uremia, hematuria, proteinuria, decreased eGFR, were the common biochemical derangements reported with higher severity detected in men. The therapeutic interventions mostly involved conservative therapy to manage symptoms and other comorbid conditions and rarely renal replacement therapy (RRT).

A clinical and mycological study of dermatophytosis in a tertiary care hospital

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; With changing climatic conditions, socio-demographic profile, economic conditions and occupational profile of the population, the profile of the dermatophyte infections is also changing. Hence, the study was done to find out the prevalence of various clinical pattern of dermatophytosis and correlate the clinical diagnosis with KOH positivity and fungal culture positivity.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This prospective observational study was conducted in a tertiary care hospital, Puducherry. The study included patients presenting to the dermatology outpatient department with skin lesions suggestive of dermatophyte infections between January 2016 to July 2017. The KOH test and fungal culture were done.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean age of the patients was 33.65±11.61 years, with the majority belonging to 16 to 30 years of age group. There was a high male preponderance 72% with male:female ratio of 2.57:1. The most common clinical diagnosis was &lt;em&gt;Tinea corporis&lt;/em&gt; in 47.50% of the population., followed by &lt;em&gt;Tinea Unguium&lt;/em&gt; in 28% and &lt;em&gt;Tinea cruris&lt;/em&gt; in 19.50%. KOH positivity was seen in 86 (43%) out of 200 cases in the study population. The culture was positive in 55 (27.50%) of the study population. The most common organism isolated in culture was &lt;em&gt;Trichophyton mentagrophyte&lt;/em&gt; (10%), followed by &lt;em&gt;Trichophyton rubrum&lt;/em&gt; (9.5%) and &lt;em&gt;Trichophyton tonsurans&lt;/em&gt; (5.5%). 55 (27.5%) of the people had both culture and KOH positive.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Dermatophyte infections commonly affect the young and economically productive age group of 16 to 30-year, with high male preponderance. KOH tends to show a higher proportion of positivity as compared to culture.&lt;/p&gt;

English

BACKGROUND Workers in a construction site may be exposed to various hazardous substances, physical agents, poor hygienic living conditions and harsh environmental factors. It is associated with plethora of health risks and increased risk of various dermatological conditions is one such phenomenon which needs evaluation. We did this study to assess the prevalence and pattern of skin diseases among migrant construction workers. METHODS The current study was a community based cross-sectional study. Group of construction workers working in a single cluster were selected by convenient sampling. Data collection was done from March to September 2019. All the migrant construction workers, who were available onsite were screened by a team of qualified dermatologists and diagnosis of skin diseases was made using clinical skills and lab facilities. Descriptive analysis was carried out by mean and standard deviation (SD) for quantitative variables, and frequency and proportion for categorical variables. Data was analysed using IBM SPSS statistical software version 21. RESULTS A total of 833 construction workers were screened. There was a high male preponderance, with male to female ratio of 7.42:1. The overall prevalence of any dermatological morbidity was 36.2 %. Infective skin diseases contributed to 61.56 % of the dermatological morbidity. Among infective conditions, fungal infections (65.5 %) were the most common infective dermatoses. Mite infestation (scabies) was found in 46 (23.35 %) workers. The common bacterial infections observed were furuncle and folliculitis in 7 (3.55 %) subjects each. Sycosis barbae was seen in 2 (1.02 %) subjects. Viral infections like herpes and molluscum contagiosum have contributed to the minor portion of the dermatological morbidity. One subject was found to have Hansen’s disease. Allergic contact dermatitis (29.27 %), photodermatitis (14.63 %), miliaria (12.20 %), hand eczema (9.76 %) and irritant contact dermatitis (7.32 %) were the common non-infective skin conditions affecting the study population. CONCLUSIONS There is high burden of dermatological morbidity among construction workers. Majority of the skin conditions were infective in nature. Poor literacy levels, overcrowded living conditions and poor personal hygienic practices were the possible risk factors. KEYWORDS Dermatological Morbidities, Construction Workers, Prevalence

Seasonal Variation in Epistaxis in Upper Assam Region: A Cross-sectional Study

Introduction: Epistaxis whether spontaneous or acquired is one of the most common ENT emergencies. Its management can be challenging depending on the origin of bleeding and presence of precipitating factors. Aim: To find out the seasonal variation in epistaxis according to age, gender, region and aetiological factor. Materials and Methods: This cross-sectional study was conducted from June 2019 to June 2020 in a tertiary care centre in Upper Assam. In this study, the seasons were divided according to weather atlas as follows: Winter- December, January, and February; Spring- March and April; Summer- May and June; Rainy season- July, August and September; and Autumn- October and November. Outcome was to find the seasonal variation in epistaxis according to age, gender, region and aetiological factor. The data collected was tabulated in Microsoft Excel Worksheet and the categorical variables were summarised as proportions and percentages. Results: Out of 313 patients, 221 (70.6%) were males and 92 (29.4%) were females. High male preponderance with male to female ratio of 2.4:1 was noticed. Maximum number of patients were seen in month of October 66 cases (21%). Minimum male patients were seen in month of June 2020 (0.6%) 2 cases and minimum number of female patients were seen in the month of February and April (0.3%). Conclusion: The major cause of epistaxis in this region is hypertension, therefore peripheral health facility should be ready for giving treatment.

A two-year retrospective survey of drowning deaths in the state of Goa

A two year retrospective survey was conducted spanning from 2017–2018 in the Department of Forensic Medicine and Toxicology on cases brought for postmortem as deaths due to drowning. A total of 220 cases of drowning in the state of Goa have been categorically analyzed and presented based on age, sex, fresh water or salt water drowning and the manner of death.The most common source of fresh water drowning was found to be rivers (40%). The study showed that accidental drowning (73.08%) was more common than suicidal (26.37%) and homicidal (1%) drowning. Highest number of deaths was recorded in the age group of 31–45 years, with higher male preponderance.

Seroepidemiology of dengue viral infection at a tertiary care hospital, Bommakal, Karimnagar, India

Introduction: Dengue viral fever has become a disease of major concern. India in last decade has faced many outbreaks and now declared as an endemic zone. Therefore, the present study was designed: Aim: To know the prevalence of dengue viral infection in the north east region of Telangana state Bommakal, Karimnagar, the prevalence of acute primary and recent secondary dengue viral infection and the influence of various demographic factors. Materials and Methods: A retrospective observational study was designed during the period Jan.2015 –Dec. 2016 from 6706 suspects of dengue fever. Dengue NS1 antigen, IgM and IgG antibodies were detected using rapid immunochromatographic test from J. Mitra Co. Results: About 2686 (40.05%) gave a positive serological test for dengue viral infection. Acute primary dengue infection was diagnosed in 2375 (88.42%) of the suspects and recent secondary in 37 (1.37%) presumptively. Male predominance of 68.92% was noticed in suspects and as well seropositives as 64.18%. The most affected age group was 16-30 years followed by 31-45years as 58.32% and 25.39%. Further it is noticed that infection was prevalent throughout the year with seasonal spurts in monsoon and post monsoon. Highest percentage of suspects and cases were observed during the months Sep – Nov 72.93%% and 81.57%. Conclusion: Dengue primary infection is very high in this particular region of Telangana state and seasonal upsurge is seen during monsoon and post period of the year. High male preponderance is seen with maximum affected in the productive age group. Dengue ICT test are most suitable for point of care testing for early case detection and management but couldn’t provide specific clue on disease epidemiology; which is essential for monitoring, surveillance and implementing effective vector control measures. Keywords: Dengue, NS1 antigen, IgM and IgG antibodies, Acute primary and recent secondary infection.

Central aortic pressure and long-term outcome in hypertensive patients undergoing percutaneous coronary intervention

Elevated central pulse pressure (CPP) had a negative influence on long-term outcome in patients with hypertension (HT). However, little is known about the impact of central pulse pressure on long-term outcomes in hypertensive patients undergoing PCI. A total number of 1184 hypertensive patients who received PCI procedure were prospectively collected. They were divided into two groups according to the median of central pulse pressure. Baseline characteristics, risk factors, hemodynamic data including central systolic pressure (CSP), central diastolic pressure (CDP) and CPP were measured. Invasive strategies were also analyzed to compare the long term outcome between patients with reference CPP and patients with high CPP. We further analyzed the predictors for myocardial infarction (MI), mortality, repeated PCI procedure in hypertensive patients undergoing PCI. We found patients in the reference CPP group had a lower CSP and higher CDP compared with high CPP group (Both P < 0.001) and male preponderance (P < 0.001). Patients with diabetes and chronic kidney disease (CKD) tend to have a high CPP (both P < 0.001). Drugs including Angiotensin Converting Enzyme inhibitors (ACEI) and statin were used more frequently in patients with reference CPP group (P = 0.035 and P = 0.001, respectively). Freedom from all-cause mortality and cardiovascular(CV) mortality was lower in the patients with high CPP group (P = 0.001, P = 0.01, respectively).Logistic regression revealed that CPP is a major predictor for all-cause mortality and repeated PCI procedure [hazard ratio (HR): 2.46 and 1.41, respectively]. In hypertensive patients receiving PCI, elevated CPP had a negative impact on long-term mortality; CPP also strongly predicts all-cause mortality and repeated PCI procedures in hypertensive patients undergoing PCI.