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Cervical pregnancy, being the second rarest form of ectopic pregnancy after abdominal pregnancy, is a difficult clinical entity to diagnose and manage in a young primigravida with no identifiable risk factors or associated symptoms. Further, early intervention is of utmost importance owing to the deleterious complications and high mortality associated with it if not addressed to. It is also difficult to choose a particular management approach for this out of the available options. We report a case of 23-year-old primigravida with 8 weeks of gestation, asymptomatic and with no underlying risk factors, diagnosed with cervical pregnancy during a routine antenatal scan. She was successfully managed with bilateral uterine artery embolization in conjunction with systemic methotrexate followed by suction and evacuation. [ABSTRACT FROM AUTHOR]

Objectives: Cardiovascular risk factors (e.g., diabetes and hypertension) are comorbidities associated with cognitive impairment. The present study was planned to study the relationship between cardiovascular risk factors and cognitive impairment using General Practitioner assessment of Cognition (GPCOG) scale, which is easy to use scale in the primary care. Materials and Methods: A total of 350 older adults (mean age=66.71 ± 6.53 years; M:F = 220:130) among 3000 who reported to the primary care center in West India were screened. Cardiovascular risk factors were assessed based on written medical records. GPCOG was used for cognitive screening of those over the age of 60 with subjective memory complaints. Results: Frequency of cardiovascular (CV) risk factors in those with cognitive impairment was 46.2% (n = 162/350) and 29% (101/350) in those without cognitive impairment. A Chi-square test of proportion showed values to be statistically significantly different (Chi-square value = 22.04; P =< 0.001; 95% confidence interval [CI] = 10.0463-24.1076%). Odds ratio was found to be 1.6 (95% CI =2-2.1; P =< 0.05). Conclusion: A higher CV risk factors were observed among those with cognitive impairment compared to those cognitively normal older adults in the primary care. [ABSTRACT FROM AUTHOR]

Introduction  Timely detecting dementia is an important goal of clinicians and public health professionals alike for better management and prevention of complications. Community screening of dementia could be a powerful strategy. Facilities for dementia screening at primary care level are virtually nonexistent and are a prominent implementation gap. Hence, a study was done to assess the feasibility of dementia screening at primary care using General Practitioner Assessment of Cognition (GPCoG) scale among older adults with subjective memory complaints. It was further aimed to assess the frequency of cardiovascular risk factors in those who met screening criteria for cognitive impairment. Materials and Methods  Older adults coming to three urban primary care centers in western India for screening of noncommunicable diseases such as diabetes and hypertension (opportunistic screening) with subjective memory complaints were enrolled and screened for dementia using GPCoG. A Mini-Mental State Examination (MMSE) was done in patients who came alone for referral purpose in case the score levels in GPCoG examination met cutoff limits for informant interview. Written medical records were examined to assess status of comorbid vascular risk factors such as diabetes, hypertension, coronary artery disease, and cerebrovascular accidents. Results  A total of 350 older adults (M:F = 276: 74; mean age ± 68 ± 6.7 years) were screened out of 3,000 older adults who reported during the study period. There were 161 older adults with GPCoG score less than or equal to 5 (56.14%) and 149 subjects with MMSE less than or equal to 24 indicating significant cognitive impairment (42.5%). There were very few (n  = 11, 3.14%) out of 350 people who came with caregivers; hence, MMSE was done along with for referral to healthcare providers. A total of 142 had comorbid diabetes/and or hypertension (40.5%). A total of 86 had diabetes alone (24.5%) and a total of 128 had hypertension (36.5%). Conclusion  Current study results indicate that using a simple screening tool such as GPCoG, community screening of probable dementia, is feasible in primary care settings, as is indicated by significant yield of probable dementia cases (42.5%). These cases can be referred to appropriate centers for further workup, confirmation of diagnosis, and treatment. Also, detection of comorbid cardiovascular conditions, for example, diabetes and hypertension, that can be managed along with cognitive impairment/dementia for potential prevention/further deterioration, which can strengthen noncommunicable disease screening. [ABSTRACT FROM AUTHOR]

Longitudinally extensive transverse myelitis (LETM) is an unusual manifestation of systemic malignancy. It has been mainly reported with lung cancers and lymphoproliferative malignancy. LETM in systemic malignancy can be caused by either intramedullary metastases or paraneoplastic syndrome. Occurrence of LETM as the first manifestation of malignancy has been rarely reported. We present clinical, laboratory, and imaging findings of a 66-year-old man with nonsmall-cell lung (adeno) carcinoma, who presented with LETM without having any cardinal manifestations of lung malignancy. The rarity of the disease and especially such a presentation can cause considerable delay in the diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Meningitis caused by varicella zoster virus (VZV) is quite rare among young immunocompetent adults though immunocompromised patients are often seen to be affected by reactivation of VZV presenting with primary clinical features of dermatomal rashes and neurological sequelae. Here, we report the clinical scenario of a young, healthy male who had presented with fever, headache, and onset of dermatomal rashes later than the fever and was eventually diagnosed to be a case of VZV meningitis. We would like to highlight the fact that even young immunocompetent patients though rarely, might contract VZV meningitis and clinicians should have a high index of suspicion and keen eyes to catch the more obvious features of VZV infection on complete physical examination and must not harbor any reservations in ordering polymerase chain reaction for VZV DNA or initiating aggressive antiviral therapy. [ABSTRACT FROM AUTHOR]