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Syed Ifthekar Kaustubh Ahuja Samarth Mittal Bhaskar Sarkar Gagan Deep Watson Thomas Pankaj Kandwal 《Indian Journal of Orthopaedics》2021,55(3):673
BackgroundInjuries involving upper cervical spine are serious and fatal injuries which are associated with alteration of normal occipital–cervical anatomy. These injuries may result in permanent neurologic deficits or neck deformity if not treated in a timely and appropriate manner.ObjectiveTo evaluate the outcomes of neglected upper cervical spine injuries treated by various methods.Study designRetrospective study.Materials and methodsTwelve patients attending ER or OPD with a history of neck trauma and who were diagnosed with fractures and fracture dislocations C1 and C2 were included in the study. Fresh injuries sustained within a week were excluded from study. The outcomes were measured in terms of improvement in VAS, ODI Scores and correction of the neck deformity. Surgical parameters like duration of surgery and blood loss were also observed.ResultsEleven males and one female. The mean age was 40.9 ± 16.9 (07–67 years). Eleven patients underwent posterior instrumentation, while one patient was treated anteriorly. The mean delay in presentation was 28 ± 8.67 days (15–42 days). The mean duration of surgery was 188.3 ± 34.35 min (120–240 min), average blood loss was 350 ± 111.8 ml (150–600 ml). The mean VAS improved from 8.45 ± 0.89 to 3.9 ± 0.51 (p < 0.05). The mean ODI Pre-operatively was 88.45 ± 5.89 which improved to 31.9 ± 4.01 (p < 0.05). The neck deformity/torticollis was corrected in all the patients.ConclusionsNeglected upper cervical spine injuries are difficult to treat and a posterior approach is helpful in reducing the subluxations indirectly and to obtain a posterior fusion. 相似文献
33.
Akash Pramod Sali Priyal Motghare Munita Bal Neha Mittal Swapnil Rane Shubhada Kane Asawari Patil 《Head and neck pathology》2021,15(2):544
Parathyroid carcinoma (PC) is a rare malignancy that poses a diagnostic challenge on histologic examination. We analyzed various clinicopathologic features of PC. Pathology reports and slides were reviewed to evaluate the diagnostic histopathologic features of archived cases of PC from the years of 2004–2018. The study cohort comprised twenty cases of PC. The median age was 49 years (range 21–73 years) with equal gender distribution (M:F = 1:1). Most patients presented with symptoms of hypercalcemia (n = 7, 54%). Serum calcium and serum parathyroid hormone were elevated in all but one patient. The right inferior parathyroid was commonly involved (n = 8/14, 57%). The mean tumor size was 2.4 cm (range 0.8–3.5 cm). On frozen section examination, PC was diagnosed in 8 out of 9 cases. Vascular (n = 19/20, 95%) and soft tissue invasion (n = 10/20, 50%) were the most common characteristic histologic findings. Capsular invasion was identified in all cases. Perineural invasion or metastasis at presentation was absent in all cases. Other histological features noted were intratumoral fibrous bands (70%), nodular growth pattern (70%), moderate nuclear atypia (30%), prominent nucleoli (20%), and necrosis (20%). Regional lymph nodes were negative for metastatic disease in all cases (n = 10). Eight out of 16 patients received adjuvant radiotherapy. Follow-up was available in 16 cases (median 21.5 months). Two patients died of disease. Vascular and soft tissue invasion are the most common diagnostic histologic features of PC. Capsular invasion is important to distinguish PC from its benign counterparts. Intraoperative frozen section examination can be used for accurate diagnosis and surgical management. 相似文献
34.
Rashi Jain Rinkee Kumari Sushmita Chakraborty Dipendra K. Mitra Anant Mohan Vijay Hadda Karan Madan Randeep Guleria 《European journal of immunology》2023,53(10):2250255
Sarcoidosis is a systemic inflammatory disorder characterized by tissue infiltration due to mononuclear phagocytes and lymphocytes and associated noncaseating granuloma formation. Pulmonary sarcoidosis (PS) shares a number of clinical, radiological, and histopathological characteristics with that of pulmonary tuberculosis (PTB). Due to this, clinicians face issues in differentiating between PS and PTB in a substantial number of cases. There is a lack of any specific biomarker that can diagnose PS distinctively from PTB. We compared T-cell-based signature cytokines in patients with PS and PTB. In this study, we proposed a serum biomarker panel consisting of cytokines from cells: T helper (Th) 1 [interferon-gamma (IFN-γ); tumor necrosis factor-alpha (TNF-α)], Th9 [interleukin (IL)-9], Th17 [IL-17], and T regulatory (Treg) [IL-10; transforming growth factor-beta (TGF-β)]. We performed the principal component analysis that demonstrated that our serum cytokine panel has a significant predictive ability to differentiate PS from PTB. Our results could aid clinicians to improve the diagnostic workflow for patients with PS in TB endemic settings where the diagnosis between PS and PTB is often ambiguous. 相似文献
35.
Raminderpal Singh Sibia Ankita Sood Arshula Subedi Anushya Sharma Anirudh Mittal Gaaminepreet Singh Thakur Gurjeet Singh Ravinder Singh Jaura Sanjay Goyal 《Journal of medical virology》2023,95(1):e28152
The present study was designed to check the serum levels of protease-activated receptor (PAR-1) in patients during different phases of dengue severity. Moreover, a correlation between serum PAR-1 levels and hematological parameters, inflammatory cytokine levels, and liver functional changes was also determined. Based on the World Health Organization criteria, the study population was divided into: nonsevere dengue fever (DF; n = 30), severe dengue hemorrhagic fever (DHF; n = 19), and severe dengue shock syndrome (DSS; n = 11). The platelet count (PLT) and hematocrit (HCT) were analyzed using an automated hematology analyzer and liver function enzymes aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphate (ALP), bilirubin were checked by auto-analyzer using diagnostic kits. Moreover, the levels of inflammatory mediators C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-17 (IL-17), and PAR-1 were determined using respective ELISA kits. The HCT levels were elevated and platelet count decreased significantly during dengue complications (DHF and DSS) compared to the DF patients, while the levels of liver functional biomarkers AST, ALT, ALP, and bilirubin remained elevated in DHF and DSS groups than in the corresponding DF group. Similarly, the inflammatory cytokine levels of CRP, TNF-α, IL-6, and IL-17 in DHF and DSS subjects were markedly increased when observed against DF subjects. Notably, the PAR-1 levels were significantly elevated in DHF and DSS groups than in the DF group and positively correlated with changes in HCT levels, inflammatory biomarkers, and liver enzymes. Our findings conclude that PAR-1 levels persistently increased with the severity of the dengue infection and are strongly associated with various clinical manifestations. Thus, PAR-1 levels can be used as a diagnostic marker for assessing dengue severity. 相似文献
36.
Verma AK Vohra A Maitra A Banerjee M Singh R Mittal SK Bharadwaj V Batra V Bhatia A Aggarwal P 《Indian journal of pediatrics》1995,62(6):725-729
Of 613 children evaluated in a village in Haryana 94 (15.3%) were observed to have chronic suppurative otitis media (CSOM).
Fifty eight (61.7%) children had hearing impairment. CSOM contributed to 71.6% of the hearing impaired (58/81). On analysis
of association of CSOM with literacy and socio-economic status of mothers, and age, sex, and upper respiratory tract infections
(URI) in children positive correlation was observed only with URIs (P<0.001).
Literacy and socio-economic status of the mothers did not correlate significantly with knowledge about treatment seeking,
and ear cleaning practices, probably due to the narrow range of incomes and literacy levels. An intervention program consisting
of play, demonstrations, health charts and slogans, and aural cleaning and antibiotic drops was introduced. 相似文献
37.
38.
Acute and subacute toxicity of the herbicide trifluralin on fish was investigated in laboratory toxicity tests with carp. Median lethal concentrations were determined in acute tests. The 96-h LC50 value was 0.045 (0.036-0.051)mg/L. Fish were exposed to subacute concentrations of the herbicide (0.005, 0.01, and 0.02 mg/L trifluralin) in the 14-day toxicity tests and the effects on the relative growth rate, some biochemical parameters [alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanin aminotransferase (ALT) activities in serum, gills, liver, and kidney], gills, liver, and kidney structure were studied. A decrease in relative growth rate was found. An increase of functional enzyme activities in blood serum and the organs examined, particularly in the highest concentration of trifluralin indicated changes in the vital organs, was confirmed by histological analysis. The most severe changes (although mostly reversible) were found in the gills and kidney of the fish examined. 相似文献
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40.
Performance on a particular attribute has an asymmetric impact on patient satisfaction. Gaining insight into this asymmetric effect can help refine management tools such as impact analysis. For overall satisfaction, negative performance on an attribute will have a much larger impact than positive performance. Therefore, managers should optimize, rather than maximize attribute-level performance to maximize patient satisfaction. Because of this asymmetry, the benefit from eliminating negative performance may be larger than the benefit gained from increasing positive performance on an attribute. So you can increase overall satisfaction faster by eliminating the negatives. 相似文献