Prompt Diagnosis Research Articles

New insights about prognosis of Spermatic Cord Torsion.

Spermatic Cord Torsion (SCT) is a serious surgical emergency. Prospective studies regarding the prognosis of the torsed testis lack in the global literature. Prompt diagnosis and treatment are crucial to increase the risk of saving the torsed testis. Testicular salvage can be predicted by the duration of symptoms, along with the degree of twisting and the ultrasound findings, regarding the homogeneity of the testicular parenchyma. The "golden window" to salvage the testicular function is suggested to be at 4-8 h, after the symptoms' onset. As the time passes, the ischemia is settled and the risk of necrosis is increased. It is generally accepted, that the possibilities of conducting orchiectomy are increased when not promptly intervening after the symptoms' onset. A few studies, tried to describe the impact of SCT on long- term fertility. The aim of this study is to collect them and elucidate with some general perceptions on this topic.

Diagnosis of cerebral malaria: Tools to reduce Plasmodium falciparum associated mortality.

Cerebral malaria (CM) is a major cause of mortality in Plasmodium falciparum (Pf) infection and is associated with the sequestration of parasitised erythrocytes in the microvasculature of the host's vital organs. Prompt diagnosis and treatment are key to a positive outcome in CM. However, current diagnostic tools remain inadequate to assess the degree of brain dysfunction associated with CM before the window for effective treatment closes. Several host and parasite factor-based biomarkers have been suggested as rapid diagnostic tools with potential for early CM diagnosis, however, no specific biomarker signature has been validated. Here, we provide an updated review on promising CM biomarker candidates and evaluate their applicability as point-of-care tools in malaria-endemic areas.

Detection and Grade Classification of Diabetic Retinopathy and Adult Vitelliform Macular Dystrophy Based on Ophthalmoscopy Images

Diabetic retinopathy (DR) and adult vitelliform macular dystrophy (AVMD) may cause significant vision impairment or blindness. Prompt diagnosis is essential for patient health. Photographic ophthalmoscopy checks retinal health quickly, painlessly, and easily. It is a frequent eye test. Ophthalmoscopy images of these two illnesses are challenging to analyse since early indications are typically absent. We propose a deep learning strategy called ActiveLearn to address these concerns. This approach relies heavily on the ActiveLearn Transformer as its central structure. Furthermore, transfer learning strategies that are able to strengthen the low-level features of the model and data augmentation strategies to balance the data are incorporated owing to the peculiarities of medical pictures, such as their limited quantity and generally rigid structure. On the benchmark dataset, the suggested technique is shown to perform better than state-of-the-art methods in both binary and multiclass accuracy classification tasks with scores of 97.9% and 97.1%, respectively.

Acute liver failure in a young patient with dengue shock syndrome: a case report.

Dengue fever is caused by dengue virus, which has four different serotypes and is transmitted by the Aedes mosquitos. This disease is endemic to Southeast Asian countries, including Nepal. Liver involvement in dengue is a crucial feature, and the effect ranges from an asymptomatic rise in liver enzymes to the development of acute liver failure. Acute liver failure often results in multiorgan dysfunction including hemodynamic instability, renal failure, cerebral edema, and even death because of shock. Prompt diagnosis and management are necessary to prevent complications. However, there is no proven proper treatment for this condition, and the only treatment modality is to prevent the symptoms. We presented the case of a young female with dengue fever who developed a life-threatening acute liver failure because of dengue shock syndrome.

Mimicry of Two Disease Guillain-Barre Syndrome and Japanese encephalitis: A Case Report

Guillian-Barre syndrome (GBS) is an acute immune-mediated inflammatory demyelinating polyneuropathy characterized by symmetrical limb weakness and areflexia preceded by an infection while Japanese encephalitis (JE) virus is a neurotropic RNA virus belonging to Flaviviridae family. GBS can have different clinical manifestations which overlaps JE. GBS secondary to JE has been reported earlier though in the incidence is low.Involvement of the peripheral nerve, areflexic paralysis, electrophysiological nerve examination and JE IgM in CSF were consistent with a diagnosis of GBS with JE. Prompt detection and diagnosis can reduce morbidity and mortality.

Techniques for Diagnosing Anastomotic Leaks Intraoperatively in Colorectal Surgeries: A Review.

Colorectal cancer is one of the most common surgically curable malignancies worldwide, having a good prognosis even with liver metastasis. This improved patient outcome is marred by anastomotic leaks (AL) in operated patients of colorectal cancer despite a microscopically margin-negative resection (R0). Various risk factors have been attributed to causing this. Preoperative non-modifiable factors are age, male sex, cancer cachexia, and neoadjuvant chemo-radiotherapy, and modifiable factors are comorbidities, peripheral vascular disease, anemia, and malnutrition. Intraoperative risk factors include intraoperative surgical duration, blood loss and transfusions, fluid management, oxygen saturation, surgical technique (stapled, handsewn, or compression devices), and approach (open, laparoscopic, or robotic). Postoperative factors like anemia, infection, fluid management, and blood transfusions also have an effect. With the advent of enhanced recovery after surgery (ERAS) protocols, many modifiable factors can be optimized to reduce the risk. Prevention is better than cure as the morbidity and mortality of AL are very high. There is still a need for an intraoperative technique to detect the viability of anastomotic ends to predict and prevent AL. Prompt diagnosis of an AL is the key. Many surgeons have proposed using methods like air leak tests, intraoperative endoscopy, Doppler ultrasound, and near-infrared fluorescence imagingto decrease the incidence of AL. All these methods can minimize AL, resulting in significant intraoperative alterations to surgical tactics. This narrative review covers the methods of assessing of integrity of anastomosis during the surgery, which can help prevent anastomotic leakage.

Epstein-Barr virus-associated primary intracranial leiomyosarcoma in an immunocompetent patient: illustrative case.

Primary intracranial leiomyosarcomas (PILMSs) are extremely rare tumors arising from smooth muscle connective tissue. PILMSs have been shown to be associated with Epstein-Barr virus (EBV). Thus far, EBV-associated PILMS has been exclusively described in immunocompromised patients. A 40-year-old male presented with a 2-year history of left-sided headaches, nausea, and vomiting. Magnetic resonance imaging demonstrated a large, heterogeneously enhancing, lobulated, dura-based mass arising from the left middle cranial fossa with associated edema and mass effect. The patient underwent an uncomplicated resection of suspected meningioma; neuropathology revealed the exceedingly rare diagnosis of EBV-associated PILMS. Follow-up testing for human immunodeficiency virus (HIV) and other immunodeficiencies confirmed the patient's immunocompetent status. Primary intracranial smooth muscle tumors are often misdiagnosed as meningiomas due to their similar appearance on imaging. PILMSs have a poor prognosis and gross total resection is the mainstay of treatment in the absence of clear recommendations for management. Prompt diagnosis and resection are important; therefore, these tumors should be included in the differential of dura-based tumors, especially among immunocompromised patients. Although EBV-associated PILMSs usually occur in immunocompromised individuals, their presence cannot be ruled out in immunocompetent patients.

Automatic detection of pulmonary embolism in computed tomography pulmonary angiography using Scaled-YOLOv4.

Pulmonary embolism (PE) is a common but fatal clinical condition and the gold standard of diagnosis is computed tomography pulmonary angiography (CTPA). Prompt diagnosis and rapid treatment can dramatically reduce mortality in patients. However, the diagnosis of PE is often delayed and missed. In this study, we identified a deep learning model Scaled-YOLOv4 that enables end-to-end automated detection of PE to help solve these problems. A total of 307 CTPA data (Tianjin 142 cases, Linyi 133 cases, and FUMPE 32 cases) were included in this study. The Tianjin dataset was divided 10 times in the ratio of training set: validation set: test set=7:2:1 for model tuning, and both the Linyi and FUMPE datasets were used as independent external test sets to evaluate the generalization of the model. Scaled-YOLOv4 was able to process one patient in average 3.55 s [95% CI: 3.51-3.59 s]. It also achieved an average precision (AP) of 83.04 [95% CI: 79.36-86.72] for PE detection on the Tianjin test set, and 75.86 [95% CI: 75.48-76.24] and 72.74 [95% CI: 72.10-73.38] on Linyi and FUMPE, respectively. This deep learning algorithm helps detect PE in real time, providing radiologists with aided diagnostic evidence without increasing their workload, and can effectively reduce the probability of delayed patient diagnosis.

Prevalence, Clinic-Etiological Spectrum and Outcome of Pediatric Metabolic Epilepsy - A Single Centre Experience.

Inborn errors of metabolism (IEM) are a rare cause of epilepsy in pediatric age group. Prompt diagnosis is essential, as some of these disorders are treatable. To determine the prevalence, clinical, and etiological profile of metabolic epilepsy in children. A prospective observational study of children with new onset seizures diagnosed as inherited metabolic disorder in a tertiary care hospital, South India. Among 10,778 children with new onset seizures, 63 (0.58%) had metabolic epilepsy. The male female ratio was 1.3:1. Onset of the seizures were in neonatal period in 12 (19%), infancy in 35 (55.6%), and between one and 5 years of age in 16 (25.4%) children. Generalised seizures were seen in 46 (73%), followed by multiple seizure types (31.7%). The associated clinical features included developmental delay in 37 (58.7%), hyperactivity in 7 (11%), microcephaly in 13 (20.6%), optic atrophy in 12 (19%), sparse hair and/or seborrheic dermatitis in 10 (15.9%), movement disorder in 7 (11%), and focal deficit in 27 (42.9%) patients. Magnetic resonance imaging brain was abnormal in 44 (69.8%) and diagnostic in 28 (44.4%) patients. Causative metabolic errors included vitamin responsive errors in 20 (31.7%), disorders of complex molecules in 13 (20.6%), amino acidopathies in 12 (19%), organic acidemias in 10 (16%), disorders of energy metabolism in 6 (9.5%), and peroxisomal disorders in 2 (3.2%) patients. With specific treatment, seizure freedom could be achieved in 45 (71%) children. Five children lost to follow-up and two died. Among the remaining 56 patients, 11 (19.6%) had a good neurological outcome. Vitamin responsive epilepsies were the most frequent cause of metabolic epilepsy. Early diagnosis and prompt treatment is necessary as only one-fifth had a good neurological outcome.

An Observational Study to Validate the Relationship Between Hypertensive Retinopathy and Dehaprakruti

What is good for health and what is to be avoided is very important to stay healthy and this acceptance and rejection is depends on our own constitution i.e., Dehaprakruti as the Prakruti of the individual is unique. Netra is supreme Dhyanendriya among all the five and it is very important as we acquired all the knowledge primarily through Netra. Hypertensive retinopathy is the retinal vascular damage caused by hypertension. Prompt and accurate diagnosis of hypertensive retinopathy, especially when associated with malignant hypertension is necessary to avoid visual loss and systemic morbidity. Knowing owns constitution enables us to understand the function of one’s entire life and dictates the form of the body and also it contains one’s balance point as well as one’s tendencies towards disease. This study will be helpful to deal with patients of hypertensive retinopathy and also to overcome its complications by giving appropriate patients education regarding proper Ahar, Vihar, Dinacharya and Ritucharya according to Dehaprakruti. So we undertaken the study entitled as “An observational study to validate the relationship between hypertensive retinopathy and Dehaprakruti.” In the study already diagnosed 90 patients of Hypertensive retinopathy as per inclusion and exclusion criteria of age group 40-70 yrs were taken. Prakruti Parikshan of the patients done with the help of questioner’s. In the study maximum 95.55% patients had essential hypertension. It was observed that maximum 64.44% patients were of Vatapitta Dehaprakruti followed by 22.22% that of Vatakapha Dehaprakruti but no any significant association was found in between grades of hypertensive retinopathy and Dehaprakruti. It was also found that visual impairment occurred in maximum 68.89% patients out of which maximum 45 patients were of Vatapitta Dehaprakruti and significant association was found between hypertensive retinopathy and Dehaprakruti.

Role and added value of contrast enhanced ultrasound of the painful scrotum in the emergency setting.

Emergency imaging of the scrotum is part of routine medical practice. Indications include epididymitis/epididymo-orchitis, testicular torsion, trauma, tumors and infarction. Prompt diagnosis and management are needed to ensure optimal patient outcome. Ultrasound (US) is the initial, and often the only, imaging modality for testicular pathologies. Usually, B-mode and color Doppler US are adequate. In challenging cases, contrast-enhanced US (CEUS) facilitates final diagnosis or increases the examiner's confidence by confirming findings on non-enhanced US. This paper elaborates on the examination technique of CEUS for testicular pathologies, thereby showing its added value over baseline US techniques in the emergency setting.

Clinical Profile of Children with Pyelonephritis and Cystitis in Dr. Soetomo General Academic Hospital, Surabaya

Highlights:1. In patients younger than one year old, cystitis was more frequent in boys. Meanwhile, in patients aged 1-5, girls were more frequent in pyelonephritis and cystitis.2. In pyelonephritis, all patients had fever, followed by diarrhea and lethargy.3. Urinary symptoms, such as dysuria and hematuria, were more frequent in cystitis than in pyelonephritis. AbstractIntroduction: Urinary tract infection (UTI) is a common infection in children. Prompt diagnosis and treatment of this infection are important to prevent further damage to the kidney. This study aimed to examine the clinical profile of children with pyelonephritis and cystitis in Dr. Soetomo General Academic Hospital, Surabaya.Methods: This was a descriptive study conducted in Dr. Soetomo General Academic Hospital, Surabaya, from June 2013 until December 2015, using secondary data and presented by percentage. Samples included in this study were children aged two months to five years old with UTI as a primary or secondary diagnosis of diarrhea and had urine culture results ≥ 105 CFU/ml.Results: There were 30 patients with pyelonephritis and 27 patients with cystitis. The prevalence of pyelonephritis was 0.285% and of cystitis was 0.247%. In pyelonephritis patients younger than one-year-old, boys and girls were equal. However, boys (60%) were more frequent in cystitis patients. In both pyelonephritis and cystitis patients aged 1-5, girls were more frequent (56.3%; 64.7%). In pyelonephritis patients, all patients were found with fever, followed by diarrhea (60%) and lethargy (56.7%) as the two most common symptoms. The two most common symptoms in cystitis patients were lethargy (44.4%) and irritability (33.3%). Urinary symptoms, such as dysuria and hematuria, were more frequent in cystitis (11.1%; 7.4%) patients than in pyelonephritis patients.Conclusion: Boys were more frequent to suffer urinary tract infections. Systemic symptoms were frequently found in pyelonephritis patients, while urinary symptoms were more frequent in cystitis patients.

Clinical characteristics and identification of risk factors of testicular torsion in children: Aretrospective study in a singleinstitution.

Testicular torsion (TT) is a common urological emergency posing serious health problem in children. Prompt diagnosis and treatment of TT are very important for children to protect the affected testis. The aim of this study was to evaluate the historical features, physical examination findings, laboratory tests, and ultrasound examinations in children with TT, as well as to identify the predictors of testicular salvage in children. We conducted a retrospective record of clinical findings, laboratory data, ultrasound findings, operating results, and the results of follow-up in hospitalized children with TT from November 2004 to December 2021. A multivariable logistic regression model was used to identify predictors of testicular salvage. A total 102 hospitalized children who presented with TT were included. Patients were aged from 1 month to 16 years, with a median age of 7.71 years. TT is significantly more common in the winter. Of these patients, 77 torsions were left-sided, 24 were on the right side, and only 1 was on bilateral sides. Meanwhile, we detected that 88 children suffering from TT had intravaginal torsion of the spermatic cord, and the rest were outside. Anticlockwise torsion was found in 65 cases (63.73%) and clockwise torsion in 37 (36.27%). As a result, 60 underwent orchidectomy, while 42 had a scrotal exploration with fixation of the testis. Multivariate analysis showed that cause of TT, time to intervention, white blood cell (WBC), and mean platelet volume (MPV) were correlated with the risk of a surgical outcome. Only a small proportion of TT children received timely surgical management. Testicular salvage can be predicted by cause of TT, time to intervention, WBC, and MPV. Early scrotal exploration based on careful physical examination decreases the risk of misdiagnosis of spermatic cord torsion. A certain percentage of children with TT presenting with scrotal trauma or epididymo-orchitis should have their testicles checked to make sure that they do not have torsion, especially those who visit in the cold season.

Prevalence of Cardio-Embolic Brain Complications in Permanent and Paroxysmal Atrial Fibrillation Patients.

Background: Atrial fibrillation (AF) is the most frequent of all cardiac arrhythmias, with an increasing prevalence in the last 20 years. Cardio-embolic brain complications (CEBC) related to AF often occur or recur, even following appropriate treatment. Method: We conducted a retrospective study and analyzed the presence of stroke, dementia, and Parkinson’s disease (PD) in both paroxysmal and permanent AF patients. The records of 1111 consecutive admitted patients with primary diagnosis of AF at the Municipal Emergency University Hospital, Timisoara, between 2015 and 2016 were examined. Statistical analysis was performed on the patients included in the study based on the inclusion and exclusion criteria. Results: A significant statistical difference was noted among the permanent AF group for stroke (48.75% vs. 26.74%, p < 0.001) and dementia (10.25% vs. 3.86%, p < 0.001) compared to paroxysmal AF patients. Permanent AF patients presented a higher risk of developing stroke, dementia, and PD compared to patients with paroxysmal AF. Meanwhile, male gender and an increase in age showed an increase in the odds of having cardio-embolic brain complications in patients with paroxysmal AF. Conclusion: Based on the results obtained, it can be concluded that the risk of cardio-cerebral embolic complications is greater in permanent AF patients compared to paroxysmal AF cases. Ischemic stroke and dementia are more frequent in the permanent AF group, but analyzing the data regarding the age of onset paroxysmal AF is critical due to the fact that it involves a younger population. Prompt diagnosis and treatment can help significantly in saving stroke patients.

Epidemiological Study of Hepatopancreatobiliary Sarcoma in Iran, 2010 - 2014

Background: Hepatopancreatobiliary (HPB) malignancies are a relatively rare but important type of cancer with usually poor prognosis. Prompt diagnosis and treatment are crucial to improving the patient’s outcome. For this issue, acknowledgment of epidemiological characteristics is helpful. Objectives: In this study, the epidemiological characteristics of cases with HPB sarcoma among Iranian patients were assessed. Methods: In this epidemiological study, 133 consecutive cases with HPB sarcoma in Iran from 2010 to 2014 were evaluated, including gallbladder, pancreas, hepatic, pancreatic body and head, and other biliary tumors. Results: Nine gallbladder sarcoma cases were reported between 2010 and 2014, accounting for 6.7% of all HPB sarcoma cases, and leiomyosarcoma was the most common. A total of 16 patients of pancreatic origin were reported during this period, with the highest rate of 6 cases in 2011; in this sarcoma category, malignant type spindle cell tumor was the most common type accounting for 12.5% of all cases. Ninety-five cases of liver sarcomas were reported generally. Non-specified and desmoplastic small round cell tumors were the most common types. Five cases of pancreatic head sarcomas were reported during 2010 - 2013. There was no predominant tumor type. Five cases of pancreatic head sarcoma were reported during 2010 - 2013. There was no dominant tumor type. About the other biliary tract sites, six patients were reported. Gastrointestinal stromal sarcoma was the most common type. Conclusions: Hepatopancreatobiliary sarcoma in the Iranian population generally has diverse types, and there are different patterns according to the age and sex distribution in patients according to the initial location of the tumor and also their pathological subtypes.

Retrospective multifactorial analysis of ocular firecracker injuries and review of literature

Purpose To analyse demographics, risk factors, clinical features, functional, anatomical outcomes, and prevalence of blindness in firecracker injury patients presenting to a tertiary eye care centre. Methodology A retrospective analysis of ocular firecracker injuries patients who presented to our hospital from April 2018 to March 2019 was performed. A total of 114 patients with a minimum follow-up of 3 months were included. The parameters recorded were demographics, mode of injury, type of cracker, baseline and last follow up best-corrected visual acuity (BCVA), anterior and posterior segment findings, seidel's test, intraocular pressure, gonioscopy, treatment, functional and anatomical outcomes. Investigations in form of B Scan, X-ray, or CT scan were undertaken whenever indicated. Results A total of 132 eyes of 114 patients were analysed. The mean (SD) age was 18.96 +/−15.4 years (range 3–71 years). Seventy-four (64.91%) patients were ≤ 18 years of age. The male-to-female ratio was 4:1. The ratio of right: left eye involvement was 1:1. Eighteen patients (15.79%) had bilateral involvement. A total of 125 eyes had closed globe injury, 7 eyes had open globe injury and 17 patients needed hospital admission for management. The mean (SD) baseline BCVA was 0.54(+/−0.75). The mean (SD) final BCVA improved to 0.23(+/−0.62) till the last follow-up. The final outcome was good in most patients, except 5 eyes (3.78%) which resulted in near/total blindness. Conclusion Firecracker injuries are a major cause of irreversible blindness, especially among the younger age group. Prompt diagnosis with meticulous management can prevent devastating sequelae.

Immunobullous Disorder: A Diagnostic Dilemma Faced at a Tertiary Care Centre in Kanyakumari, Tamil Nadu, India

Introduction: Immunobullous disorders are morphologically heterogenous and hence the differentiation between various subtypes is essential for proper treatment and prognosis. Prompt diagnosis needs clinicopathological concordance added with Immunofluorescence (IF) in particular Direct Immunofluorescence (DIF) study to avoid discrepancies. Aim: To study the clinicopathological profile along with immunological features and to analyse the utility of IF in particular DIF of immunobullous disorders. Materials and Methods: The present study was a single institution based cross-sectional observational hospital study done in the department of pathology in SreeMookambika Institute of Medical Sciences, Tamil Nadu over a period of one year (July 2019-August 2020) involving 70 outpatients in the department of dermatology with clinical evidence of bullous disorders. Two biopsies were taken from the patient, one from a newly formed bulla or vesicle for Haematoxylin and Eosin (H&amp;E) stain and the other from a perilesional normal looking skin for DIF study. Statistical analysis was done by using SPSS software. Chi-square test was used for statistical analysis. A p-value of less than 0.05 was considered as statistically significant. However, the final diagnosis was arrived after considering clinical, bedside investigations, histopathology and DIF study. Results: Out of seventy (70) patients included in this study, the most common age group of distribution was between 51-60 years in a frequency of 22 (31.4%). Out of 70 patients, 39 patients were diagnosed with intraepidermal bullous disorders and 31 patients were diagnosed with subepidermal bullous disorders. The most common disorder diagnosed was based on clinical findings was Pemphigus Vulgaris (PV) 31 (44.3%) followed by Bullous Pemphigoid (BP) 23 (32.9%). The common disorder diagnosed based on histopathology was PV 33 (47.1%). Clinical and histopathological concordance was conclusive in 31 cases of PV. The percentage of diagnosis of DIF was positive in 67 (95.71%). Patients which reached to inconclusive (DIF was not definite) diagnosis was in only three patients. Conclusion: Since, in most of the cases there occurs an overlap in clinical and histopathological features, IF in particular, DIF plays a sensitive tool in confirming diagnosis as well as distinguishing immunobullous disorders from other disorders.

Diagnosing Descemet Membrane Detachment in Patients Undergoing Cataract Surgery using an AS-OCT-based HELP Algorithm: A Prospective Cross-sectional Study

Introduction: Descemet Membrane Detachment (DMD) is a rare complication of cataract surgery which is more likely to occur during the learning curve especially during surgical training in residency. There are various methods of diagnosing DMD using slit lamp biomicroscopy, Ultrabiomicroscopy (UBM) and Anterior Segment Optical Coherence Tomography (AS-OCT). AS-OCT can be utilised to confirm, classify DMD and decide the plan of management by using Height, Length, Extent and Pupil (HELP) algorithm. Descemetopexy is the gold standard treatment in the management of DMD. The management of DMDs usually depends upon the site and extent of the detachment. Prompt diagnosis and timely management, leads to a good functional and anatomical outcome. Aim: To study the occurrence and management of DMDs during cataract surgeries using an AS-OCT-based HELP algorithm in a training hospital. Materials and Methods: This prospective cross-sectional study, included 25 eyes of 25 patients, who underwent cataract surgery which resulted in DMD in Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India, from June 2021 to December 2021. AS-OCT-based HELP algorithm was used for diagnosis and determining, whether medical management needs to be done or surgical management. Either medical or surgical management (Descemetopexy) was done in all the 25 eyes. All the study subjects were followed on Postoperative Day (POD)- 1,7,30 for Descemet’s Membrane (DM) reattachment. The outcome measures were successful DM reattachment and/or improvement in visual acuity by atleast two Snellen lines. Paired t-test was used to test the mean difference between LogMAR visual acuity values pre and postoperatively. The p-value &lt;0.05 was considered as statistically significant. Results: Out of 1008 cataract surgeries, 25 patients had DMD intraoperatively. The mean age of the patients was 61.12±7.29 years with a male:female ratio of 10:15. The most common surgery preceding DMD was Manual Small Incision Cataract Surgery (MSICS) (84%; n=21). The mean pre- and postmanagement visual acuities were 0.96±0.445 and 0.215±0.196, respectively (p&lt;0.0001). A successful DM reattachment was seen in 92% (n=23) with the first attempt. There was a statistically significant improvement in visual acuity after management (p&lt;0.0001). Conclusion: Management of DMD is crucial, as early diagnosis and treatment of patients with DMD leads to good visual outcome. AS-OCT-based HELP algorithm is very beneficial in the diagnosis of DMD. Descemetopexy is the gold standard in the management of DMD.

Diagnostic Value of Routine Biomarkers in Predicting Septicaemia in Hospitalised Patients: A Cross-sectional Study

Introduction: Sepsis is a potentially fatal condition that leads to alterations in coagulation, immunosuppression, and multiorgan failure. Predicting the risk of septicaemia before the onset of organ dysfunction poses a challenge. Prompt diagnosis, coupled with triaged management, is crucial in determining disease outcomes. Aim: To assess the role of routinely employed biomarkers in the early identification of septicaemia in patients. Materials and Methods: A cross-sectional study was conducted on 564 blood samples from Jaipur National University Institute of Medical Sciences and Research Centre (JNUIMSRC) in Jaipur, Rajasthan, India, over a period of six months (July 2019-December 2019). Blood culture, identification, and antimicrobial sensitivity testing were performed for all the samples following the Clinical and Laboratory Standards Institute (CLSI- M100) guidelines. Standard septic markers, such as Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Serum Glutamic Pyruvic Transaminase (SGPT), Serum Glutamic Oxaloacetic Transaminase (SGOT), serum urea, serum creatinine, Haemoglobin (Hb), and Total Lymphocyte Count (TLC), were studied. The culture-positive patients were compared with a negative control group. The t-test and logistic regression were used for analysis. Results: Out of 564 patients suspected of sepsis, 135 (23.94%) were culture positive, with a male-to-female ratio of 1.41. No significant differences were found in septic markers {TLC (p-value=0.261), ESR (p-value=0.186), SGPT (p-value=0.336), SGOT (p-value=0.264), Hb (p-value=0.179), serum urea (p-value=0.350), and serum creatinine (p-value=0.155)} between the culture-positive group (135/564, 23.93%) and the culture-negative group (429/564, 76.06%), except for CRP (p-value=0.006). The results of logistic regression also showed that CRP was a significant predictor of septicaemia (p-value=0.009). Amikacin, doxycycline, and piperacillintazobactam were found to be sensitive. Conclusion: Currently used blood markers do not provide sufficient evidence for the prediction of septicaemia, although CRP may be preliminarily useful. There is an urgent need to combine them with novel markers for the early detection of septicaemia.

Is there a correlation between the diagnostic test results and the histopathological diagnoses of acute appendicitis in a Turkish hospital in Somalia?

Appendicitis is the most common cause of acute abdomen. This study aimed to investigate the demographic and clinical data of the patients diagnosed with acute appendicitis in the emergency department of a Turkish tertiary care center in Somalia. The association between the diagnostic test results and the histopathological diagnoses was also analyzed. Data of the patients diagnosed with acute appendicitis at the emergency department between the 1st of January 2021 and the 31st of December 2021 period were retrospectively reviewed. The demographic data, clinical features, laboratory test results and radiological and histopathological findings of the participants were retrieved from the hospital’s electronic medical records for patients in the database. Overall, 83 patients were included. Among those, 59 (71.1%) were male, and the mean patient age was 22±8.2. The mean values of the leukocyte and neutrophil counts and the C-reactive protein levels were higher than the normal range. The laboratory test, abdominal ultrasonography, and enhanced computerized tomography results were compared with the histopathological findings. Only the neutrophil-lymphocyte ratio was found (to be) significant in the diagnosis of complicated appendicitis. The clinical data, laboratory tests, and radiological imaging findings should be evaluated together to diagnose acute appendicitis. Prompt diagnosis is essential for the prevention of postoperative complications and mortality. A statistically significant difference was found in the comparison of the lymphocyte counts, NLR values, and histopathological findings (p=0.01 and p=0.008).