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Introduction: Cardiovascular diseases are a major cause of death among patients with Diabetic Kidney Disease (DKD). Left Ventricular Hypertrophy (LVH) is a threatening prognostic sign and an independent risk factor for cardiovascular mortality and morbidity. A number of epidemiological studies have proven that LVH is common in patients with DKD. Aim: To estimate the Serum Uric Acid (SUA) levels in DKD patients and its association with LVH and estimated Glomerular Filtration Rate (eGFR). Materials and Methods: The current study was a cross-sectional study conducted at KR Hospital, Mysuru, a teritary care hospital, in Mysuru, Karnataka, India, during the period from 1st January 2020 to 31st December 2020. which included 53 patients with DKD. The demographic data, relevant investigations like Renal Function Test (RFT), SUA levels, complete haemogram, Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PPBS), glycosylated haemoglobin, Liver Function Tests (LFT), urine routine, Urine Albumin Creatinine Ratio (UACR), electrocardiogram, 2D echo were done. The results were tabulated, and the patients were classified into those with high and low SUA levels. They were also evaluated for the presence of additional risk factors like hypertension and Ischaemic Heart Disease (IHD). Data obtained was analysed statistically using Statistical Packages of Social Sciences (SPSS) version 21.0 software. Mean, Standard Deviation (SD), Chi-square test, and Fischer's-exact tests were used where appropriate, with a p-value <0.05 considered statistically significant. Patients were classified into two groups, one with SUA more than 6.5 and the other with less than 6.5, as normouricaemia and hyperuricaemia, respectively. Results: The majority of the cases were in the age group of 51-60 years, accounting for 43.4%. Out of 53 patients, males constituted 60.4% and females 30.6%, with a male-to-female ratio of 1.52:1. Total 33 patients (62.3%) were hypertensive, 32 patients (60.4%) had LVH, and 15 patients (28.3%) had IHD. Among 38 patients with SUA levels >6.5 mg/dL, the mean UACR value was higher (1807.9 mg/gm), the mean eGFR value was 32.4 mL/min/1.73 m2, and the mean Left Ventricular Mass index (LVMI) was 117.1 g/m2, which was statistically significant. Conclusion: In patients with DKD, higher SUA levels were associated with significantly higher values of UACR, lower eGFR values, higher LVMI values, and an increased risk for LVH, hypertension, and IHD. However, there was no significant association between higher uric acid levels and HbA1c. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular involvement, which is among the leading causes of morbidity and mortality worldwide. Echocardiography (ECHO) could be a reliable, non-invasive tool for predicting the risk of cardiovascular modalities in patients with COPD. Combining the ECHO parameters with highly selective cardiac troponin could predict the severity and outcome of patients with COPD. Methods: This prospective observational study was conducted at a tertiary care hospital in South India. All patients who met the criteria were included. Patients with other concomitant chronic lung diseases were excluded. An echocardiographic examination was performed, and blood samples for hs-Tnt were taken on admission for patients admitted with COPD. Categorical variables were analyzed using Pearson's Chi-square test, and the T-test was used to compare the means. One-way analysis of variance (ANOVA) followed by the Bonferroni multiple comparison tests was done to compare different echo parameters concerning COPD severity. Results: The mean tricuspid annulus plane systolic excursion (TAPSE) and right ventricle (RV) fraction area change (FAC) values were lower with the increase in the disease severity (P < 0.001). There was a significant increase in the mean systolic pressures in the right atrium and ventricle in patients with severe COPD (P < 0.001). The mean hs-TnT values were significantly higher in patients with severe COPD (18.86 ± 18.12) and correlated well with the increase in the severity of the disease (P < 0.001). Changes in the echo parameters, such as mean TAPSE and RV FAC values, negatively correlated with COPD severity. There was an increase in systolic pressure in both atria and ventricles with the progression of COPD. Troponin helped predict mortality during hospitalization. Conclusion: Comprehensive echocardiographic parameters, such as TAPSE and RV FAC, help assess the disease's severity, predict mortality, and evaluate whether the proper ventricular function is reliable. Troponin is a valuable adjunct that is an independent and strong predictor of overall mortality in patients with COPD. [ABSTRACT FROM AUTHOR]

Introduction: One of the most challenging aspects of systemic sclerosis is the potential involvement of the cardiopulmonary system, which can lead to significant morbidity and mortality if not detected and managed promptly. Aim: To assess the clinical characteristics and prevalence of specific cardiopulmonary involvement and to investigate its association with disease duration in patients with systemic sclerosis from South India. Materials and Methods: This cross-sectional, observational study was conducted at the Department of General Medicine, Government Medical College, Thrissur, India, between January 1, 2020, and December 31, 2020. Forty patients with systemic sclerosis were included according to the European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology classification criteria. Skin thickening was evaluated using the modified Rodnan Skin Score (mRSS). Investigations such as chest X-ray, echocardiogram, and antibody profiling were conducted to evaluate cardiopulmonary involvement. The data were analysed using Statistical Package for Social Sciences (SPSS) version 23.0, and the Chi-square test was used to compare qualitative variables between groups. Results: Sixteen patients (40%) had an mRSS score between 11 and 20, followed by 14 patients (35%) with mRSS scores between 21 and 30. The prevalence of Interstitial Lung Disease (ILD) was 50%. The echocardiogram findings showed mitral regurgitation and moderate Pulmonary Arterial Hypertension (PAH) in 30% (n=12) and 25% (n=10) of patients, respectively. High-Resolution Computed Tomography (HRCT) and pulmonary function tests were normal in 10 patients (25%). The duration of the disease was three to eight years in 14 patients and eight to 12 years in 12 patients. Both ILD and PAH were significantly associated with the duration of the disease (p<0.05). Anti-scleroderma-70 and anti-centromere were the most common antibodies present in patients with ILD and PAH, respectively. Conclusion: The study indicated a high prevalence of PAH and ILD in patients with systemic sclerosis. Moreover, both ILD and PAH were significantly associated with the duration of the underlying disease, with longer disease duration being associated with a higher likelihood of these conditions. [ABSTRACT FROM AUTHOR]

Noonan syndrome (NS) is a pleomorphic genetic disorder. Up to 50-80% of individuals have associated congenital heart disease. The scope of cardiac disease in NS is quite variable depending on the gene mutation. The most common forms of cardiac defects include pulmonary stenosis, hypertrophic cardiomyopathy (HCM), atrial septal defect and left-sided lesions. Amongst the rare vascular abnormalities few case reports have been mentioned about coronary artery lesions apart from sinus of Valsalva aneurysm, aortic dissection, intracranial aneurysm. This is a case report a rare case of asymptomatic coronary artery aneurysm in a young male with NS. There is lack of unified protocol for the screening, diagnosis, treatment, and follow-up of coronary artery disease in patients with NS. We conclude, echocardiography is sufficient in most cases in children. But a CT scan is appropriate in adults or when other lesions are suspected. [ABSTRACT FROM AUTHOR]

Introduction: Coronary heart disease (CAD) is the leading cause of morbidity and mortality worldwide, with India being the top cause. The Asian subcontinent accounts for 20% of the world's population, but 60% of the cardiovascular disease burden is due to genetic predisposition and environmental factors. Arterial stiffness increases with aging, accelerated by cardiovascular risk factors like hypertension and diabetes. Endothelial dysfunction in coronary arteries affects arterial stiffness and potentially reversible in atherogenesis. Pressure wave velocity (PWV) is a useful index for assessing endothelial status and large artery stiffness. Large artery stiffening can increase systolic blood pressure, left ventricular afterload, and left ventricular hypertrophy, potentially limiting coronary perfusion. Material and Methods: A prospective cross-sectional study was conducted at Sri Jayadeva Institute of Cardiovascular Sciences and Research Centre in Bangalore, India, from 1/6/2018 to 31/01/2019. Thirty patients with triple vessel disease and 30 age-matched controls underwent angiography at the institute. Echocardiography and Doppler evaluation assessed heart carotid pulse wave velocity and transit time. The study included patients with triple vessel disease and normal epicardial coronary arteries. The study excluded patients over 70 years old, having a heart rate above 100, having severe LV dysfunction below 30%, having chronic kidney disease, or having coronary artery stenosis. Demographic details, family history, medical history, clinical presentation, diagnostic tests, and blood tests were collected from patients. The study used descriptive and inferential statistical analysis, with continuous measurements presented as Mean ± SD and categorical measurements as Number (%). Results: The study involved 30 cases and 30 controls, with the majority of patients aged 50-70 years and controls aged 40-60 years. The gender distribution was predominantly males. Diagnosis distribution was similar between the two groups, with patients with EA, UA, or TMT positive being more likely to undergo angiography. BMI (kg/m2) distribution was similar between the two groups, with the majority of patients still overweight or obese but having normal BMIs. Pulse transit time (PTT) was significantly lower in the triple vessel disease case group compared to the control group with normal coronary angiography. Pulse wave velocity (PWV) increased in the case group compared to the control group. In contrast to the control group, 66% of the patients in the case group showed some kind of LV dysfunction due to more patients with myocardial infarction. Pulse wave velocity was significantly lower in the case group, with 20% and 63% shorter. LMCA distribution was also similar between the two groups, with patients with LMCA having lower pulse transit time (20%) and (63% shorter) compared to the control group. The study highlights the importance of assessing patients' angiography and LMCA distribution in determining the appropriate treatment for patients with LV dysfunction. Conclusion: Aortic PWV predicts future cardiovascular risk by accounting for known risk variables. It could be a valuable biomarker for intermediate risk, but randomized controlled studies are needed to prove its therapeutic utility before implementation. [ABSTRACT FROM AUTHOR]

Benign prostate hypertrophy (BPH) is one of the most common causes of lower urinary tract symptoms (LUTS) in elderly men. BPH is caused by a combination of the proliferation of the prostate and obstruction of the lower urinary tract. Patients benefitted from both standard treatment and nurse-directed education programs; however, the improvement in symptom severity and physical component of quality of life were greater in patients who received the nursedirected education program. [ABSTRACT FROM AUTHOR]

Background: Transurethral resection of the prostate (TURP) is one of the best available treatments for benign hypertrophy of the prostate. Many of the complications in TURP are associated with the absorption of irrigation fluid. In BIPOLAR TURP, normal saline is used as an irrigant which is more physiological. Aims and Objectives: Our aim of the study is to evaluate the correlation between post-operative electrolyte changes to perioperative factors in bipolar TURP. Materials and Methods: One hundred and ten patients enrolled in this study who were admitted to Meenakshi Mission Hospital, Madurai, Tamil Nadu, India. Results: Mean age of the participants was 65.68 (±8.50) years with a median of 66 years. mean hemoglobin drop was 1.21 (±1.36) g/dl. The mean serum sodium drop was 1.55 (±3.01) mEq/L. The mean serum potassium change was 0.06 (±0.74) mEq/L. There was a significant positive association between operative time and serum sodium drop (P<0.001). There was no significant correlation between any of the other parameters prostate size, resection time, resected volume were noted, and post-operative electrolyte April 2019-March 2021. Patient pre-operative changes and hemoglobin drop is observed. Correlation is assessed with Spearman Rho. Conclusion: Our study concluded that as operative time increases sodium drop and hemoglobin drop significantly increases. Resected and preoperative prostatic volumes do not affect electrolyte and hemoglobin levels. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) are the most prevalent cause of death and disability worldwide; more people die annually from CVDs than from any other cause. An estimated 17.7 million people died from CVDs in 2015, representing 31% of all global deaths. This transition is characterized by rapid urbanization and its accompanying adverse lifestyle changes (e.g., drug and alcohol addictions, unhealthy diet, physical inactivity and increasing psychosocial ailments) and by increasing longevity. India is experiencing an alarming increase in heart disease, which seems to be linked to changes in lifestyle and diet, rapid urbanization, and possibly an underlying genetic component. Objectives and Aims: To evaluate application of Doppler echocardiography in determining left ventricular diastolic dysfunction in primary hypertension. Proportions of hypertensive patients having left ventricular diastolic dysfunction. Materials and Methods: This study was carried out in the Department of General Medicine at Swami Dayan and Hospital, Delhi. This is the Cross sectional Observational Study. Study of diastolic function in hypertensives in tertiary care centre was observed. The study observed that 44% had abnormal diastolic function in hypertensive patients. Taking this value as reference, the minimum required sample size with 10% margin of error and 5% level of significance is 95 patients. So total sample size taken was 100. Observations and Results: Sample size was of 100 cases, the variable Age (Years) was not normally distributed (p = <0.001). The Age ranged from 26-67 years. The mean Age was 49.64 years (11.45). The median Age was 50 years (15.50). Maximum patients were between age of 50-59 years (comprises 30%) followed by age group 40-49 year (comprises 26%).Only 10.0% of the patients had age less than 30 Years. Diastolic Dysfunction was present in 56 patients out of 100 (56%). Majority of patients (42%) had mild diastolic dysfunction and only 4% had severe diastolic dysfunction. Conclusion: The prevalence of diastolic dysfunction is high among the population of patients with hypertension as reported in this study. There is a linear increase in the prevalence of DD with the increase in age. There is no difference in the prevalence of DD among males and females. LV diastolic dysfunction is significantly correlated with presence of high blood pressure, LVH and high BMI. The higher prevalence of left ventricular diastolic dysfunction and left ventricular hypertrophy among hypertensives in our study support the need for improved attainment of blood pressure goals in these patients. Every effort needs to be put in for early detection of LVDD as it has important diagnostic, prognostic and therapeutic implications. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a very common disease worldwide with even more prevalence in developing countries like India. Prevalence of anemia among women of reproductive age (% of women ages 15-49) in India was 51.40% as of 2016, compared to 9% prevalence in developed countries. It is also the second most common cause of maternal mortality in India. Anemia leads to hyperdynamic state of heart at rest leading to impaired oxygen supply to myocardium. This ultimately leads to supply-demand myocardial mismatch causing myocardial ischemia or infarction. Long standing hyperdynamic state due to anemia may lead to cardiac dilatation and hypertrophy as well. These changes in heart cause cardiac disturbances. Electrocardiography is used to detect ischemic heart diseases, hypertensive heart diseases and asymptomatic arrhythmias. The abnormalities may be proportional to the severity of anemia or show no correlation to hemoglobin levels. The studies which show the effect of iron deficiency anaemia on ECG changes in females are few in India. Hence in the present study we decided to study the electrocardiographic changes in female anemic population. Materials and methods: It is the cross section observation study of 100 female patients of age group between 19-49 years those who were admitted with Hb less than 12 gm/dl. We excluded the patients with pregnancy, diabetes, hypertension, fever, renal disease, liver disease, COPD, cardiac disease and who not giving consent. Results: In the present Cross sectional observational study ECG changes in female anemic patents was studied. In the present study, anemia prevalence was higher in age group 20-40. Studies have shown reduced triglyceride levels in patients with anaemia. In the present study, 31 patients out of the 100 had shown cardiomegaly in chest X-ray. In the present study 45% of the patients presented with sinus tachycardia in ECG. Left axis deviation and left ventricular hypertrophy are seen 30% of the patients in the present study. Lower the hemoglobin values higher is the frequency of left axis deviation In the present study there were no changes in the P wave and QRS complexes. In the present study, 26% of the patients had ST segment depression and 18% of the patients had inverted T wave in the ECG. Conclusion: Anemia is more prevalent in India. Anemia has major effect on heart due to hyperdynamic state. ECG is the basic tool to identify various cardiac diseases. The studies which show the effect of iron deficiency anaemia on ECG changes in females are few in India. Hence in the present study we decided to study the ECG changes in female anemic population. [ABSTRACT FROM AUTHOR]

Background: The benign enlargement of the prostate gland is known as benign prostatic hyperplasia (BPH). It refers to stromal and glandular epithelial hyperplasia that develops in the region of the prostate that surrounds the urethra known as the periurethral transition zone. Aims and Objectives: The aim of the study was to perform a survey of urologists over the management of BPH in India. Materials and Methods: A survey questionnaire was e-mailed to a random sample of 57 urologists of India through surveymonkey.com. The enrolled questionnaires were statistically analyzed. Of the 57 questionnaires sent, nine were returned, and 48 of those were included in the final analysis (response rate of 84.21%). Results: Majority of urologists' opinion is that USG-KUB with uroflowmetry is the most reliable investigation for diagnosis of BPH. Tamsulosin (tamsulosin 0.4 mg) was the most preferred α-1 selective blocker drug in BPH patients across all the age groups, whereas silodosin was the most preferred α-1 selective blocker drug in cardiac patients having BPH. The preferred 5-alpha reductase inhibiting drug and dose was recorded as dutasteride 0.5 mg/day. Solifenacin is the preferred anti-cholinergic drug for urinary urgency and incontinence. The IPSS score of the patient improved usually within 1-6 weeks of treatment with alpha blockers/5-alpha reductase inhibitor. As per Indian urologists, the drug therapy with alpha blockers gave the fastest symptomatic improvement in BPH patients. Conclusion: In our conclusion, there is no uniformity in the treatment of acute urinary retention; however, the overall care must be individualized for the patient. Lack of understanding of the population's history of BPH hinders advancement in appropriate care. [ABSTRACT FROM AUTHOR]

Introduction: Otitis Media with Effusion (OME) occurs as a sequela of adenoid hypertrophy. But most often hearing loss due to OME goes unnoticed in children. This causes poor cognitive development, inattention and thus poor scholastic performance. Aim: To estimate the frequency of asymptomatic OME in children with adenoid hypertrophy and to find the association between adenoid size and occurrence of OME and hearing loss. Materials and Methods: The present study was a prospective cross-sectional study conducted in a tertiary care centre in South India from November 2019 to November 2021. Children of 5-12 years of age, with symptoms suggestive of adenoid hypertrophy and with no complaints of hearing loss, were selected. A detailed ear, nose, throat examination, Pure Tone Audiometry (PTA) and tympanometry were done in all patients. Adenoid size was graded by nasal endoscopy using Mc Murray and Clements scale and also based on radiographs (comparing the distance between maximum convexity of adenoid and line drawn along basiocciput (A) and posterior part of hard palate and sphenobasioccipital synchondrosis (N)) using A/N ratio. All patients subsequently underwent adenoidectomy. Myringotomy was done along with adenoidectomy in cases with bilateral OME. All OME patients were followed-up with tympanometry, one month and three months postoperatively. The frequency of OME was presented as percentage. The association between adenoid size and asymptomatic OME as well as hearing loss was done using Fisher's exact test. Results: A total of 150 children between 5-12 years with adenoid hypertrophy were analysed. The mean age was 9 years. On analysing the association between adenoid size (both radiographically and endoscopically) and OME, 30 (20%) had bilateral effusion and 18 (12%) had unilateral effusion and prevalence of asymptomatic OME was calculated as 32%. Most of the patients had Grade 2 adenoids radiographically, and Grade 3 adenoids as per nasal endoscopy. Majority of patients had Type B Tympanogram. There was significant association between OME and adenoid size. Association between adenoid size with hearing loss showed significant association between the two with p=0.001 on right ear and p<0.001 on left ear (radiographically), and p=0.0027 on right ear and p=0.043 on left ear (as per nasal endoscopy). About 93% of children with bilateral Type B tympanogram and all children with unilateral Type B and bilateral Type C returned to normal on three months follow-up. Conclusion: There was association between adenoid size, and occurrence of OME and hearing loss. About 32% of the study population were detected to have asymptomatic OME. [ABSTRACT FROM AUTHOR]

Introduction: Adverse local tissue reactions after Total Hip Replacement (THR) have been widely described in literature recently as a course of aseptic loosening. Evaluation for any adverse soft tissue reactions is challenging with traditional imaging techniques like Magnetic Resonance Imaging (MRI), and are limited, due to production of metallic artifact. Ultrasound, specifically its refined form elastography, has emerged recently as a useful tool for assessing the soft tissues. Aim: To determine the incidence of soft tissue reactions in cases of THR and to evaluate role of elastography in assessment of periprosthetic soft tissue. Materials and Methods: This prospective observational study was conducted in the Department of Orthopaedics, Dr. Hardas Singh Orthopaedic Hospital, Amritsar, Punjab, India, from May 2013 to April 2014. Study comprises of consecutively followedup 66 hips which were evaluated and assessed clinically and radiologically using ultrasound elastography for periprosthetic soft tissue and degree of fibrosis. The MRI was done in patients with positive findings only. Diagnosis was then confirmed with biopsy in patients who underwent revision surgery. Incidence of clinical symptoms, implant loosening, stability of implant, various types of soft tissue reactions, pseudotumour formation and synovial hypertrophy were determined and association between clinical and radiological findings was done. Chi-square test was determined to see the statistical significance. Results: Total of 66 hips were studied in 60 patients with mean age of 56.08±16.55 years (26-95 years). The incidence of soft tissue reactions observed in the study was 83.3% (n=55), of all 66 hips 36 were symptomatic, Implant loosening was seen in 29 hips, pseudotumours were detected in 3 (4.5%) hips, cystic nodules in 2 (3.0%) hips, enlarged lymph nodes in one (1.5%) hip, fibrogranuloma in 2 (3%) hips and synovial thickening was seen in 12 hips. Association of Harris Hip Score with capsular thickness, implant stability and acetabular loosening was found to be statistically significant. Conclusion: The study shows a substantially higher incidence of soft tissue reaction and capsular hypertrophy following THR. Ultrasound elastography is a good screening tool to detect early soft tissue changes in periprosthetic tissue. [ABSTRACT FROM AUTHOR]

Introduction: The etiopathogenesis of pelviureteric junction obstruction (PUJO) has been debated. Recently, the role of interstitial cells of Cajal-like cells (ICC-LC) has been studied and reported to be the cause of this functional obstruction. We studied the histopathology and ICC-LC density at PUJ and compared it with that of PUJ of the control group and distal ureteric margin of the study group. Methods: A prospective study was conducted which included PUJO patients in the study group and the renal tumor patients in the control group. Histopathological examination (muscle hypertrophy and fibrosis) and immunohistochemistry (ICC-LC density) were done. The muscle hypertrophy, fibrosis, and ICC-LC density at the PUJ in both the groups were compared. A similar comparison was performed between the findings at the PUJ and the distal margin in the study group. Results: The study and control groups included 37 PUJO patients and 13 Wilms tumor patients. The ICC-LC density at PUJ in the study group was significantly lower than that in the control group (P < 0.001) and that at the distal resected margin of the study group (P < 0.001). Significantly increased muscle hypertrophy (P < 0.001) and fibrosis (P = 0.002) were seen at PUJ in the study group compared to the control group. No significant association was noted between the ICC-LC density and muscle hypertrophy at PUJ and the distal resected margin in the study group. Conclusion: A significant decrease in the density of ICC-LC and increased fibrosis and muscle hypertrophy at PUJ in children with PUJO play a role in the etiopathogenesis of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Ischaemic Heart Disease (IHD) is one of the most common co-morbidity among Indian population, so is Diabetes Mellitus (DM). IHD is associated not only with systolic, but also with Diastolic Dysfunction (DDFx) of Left Ventricle (LV). However, there is scarcity of data correlating the severity of Coronary Artery Disease (CAD) with LV DDFx. Aim: To assess the severity of CAD in diabetic stable IHD patients with normal LV systolic function (LV Ejection fraction ≥50%) and it's association with degree of DDFx. Materials and Methods: A prospective cross-sectional study was conducted over a period of one year, in a tertiary care hospital of Odisha, India among diabetic stable IHD patients. Grades of DDFx were assessed among the study population, using Transthoracic Echocardiography (TTE). Subsequently, severity of CAD was assessed, using invasive Coronary Angiography (CAG) using The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score. Next, grades of DDFx were correlated with severity of IHD. Results: Among a total of 93 diabetic stable IHD patients with normal LV ejection fraction, 76.3% were males and the mean age was 60.7±8.9 years. Majority presented with chronic stable angina (59, 63.4%). Hypertension (50, 53.7%), followed by dyslipidaemia (36, 38.7%) and renal dysfunction (19, 20.4%) were the most common co-morbidities. Majority of patients had grade I (39.8%), followed by grade II (17.2%), and grade III (9.7%) DDFx. On invasive CAG, 39.8% had a SYNTAX score of ≤ 22, 36.6% had a score of 23-32, and 23.6% had a score of ≥33. Grades of DDFx were found to be significantly higher among the patients with greater SYNTAX score. Conclusion: Among diabetic stable IHD patients, greater the severity of CAD on CAG, higher were the grades of DDFx. [ABSTRACT FROM AUTHOR]

Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms-monopolar transurethral resection and bipolar transurethral resection. Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate. Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source. Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group. Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation. [ABSTRACT FROM AUTHOR]

• We report 20 LOPD patients from India. • The common c.−32–13T>G (IVS1) Caucasian mutation is absent. • Increased severity of disease phenotype with earlier age at disease onset. • Significant cardiac involvement than previously reported in Caucasian population. • GAA variant spectrum and novel variants. We evaluated the clinical histories, motor and pulmonary functions, cardiac phenotypes and GAA genotypes of an Indian cohort of twenty patients with late onset Pompe disease (LOPD) in this multi-centre study. A mean age at onset of symptoms and diagnosis of 9.9 ± 9.7 years and 15.8 ± 12.1 years respectively was identified. All patients had lower extremity limb-girdle muscle weakness. Seven required ventilatory support and seven used mobility assists. Of the four who used both assists, two received ventilatory support prior to wheelchair use. Cardiac involvement was seen in eight patients with various combinations of left ventricular hypertrophy, tricuspid regurgitation, cardiomyopathy, dilated ventricles with biventricular dysfunction and aortic regurgitation. Amongst 20 biochemically diagnosed patients (low residual GAA enzyme activity) GAA genotypes of 19 patients identified homozygous variants in eight and compound heterozygous in 11: 27 missense, 3 nonsense, 2 initiator codon, 3 splice site and one deletion. Nine variants in 7 patients were novel. The leaky Caucasian, splice site LOPD variant, c.−32−13T>G mutation was absent. This first study from India provides an insight into a more severe LOPD phenotype with earlier disease onset at 9.9 years compared to 33.3 years in Caucasian patients, and cardiac involvement more than previously reported. The need for improvement in awareness and diagnosis of LOPD in India is highlighted. [ABSTRACT FROM AUTHOR]

Background: In a developing country like India where mobile phone usage is increasing at an exponential rate, tele monitoring techniques could be used to reduce cardiac related morbidity and mortality. The current study was undertaken to evaluate the acceptance and feasibility of handheld tele-ECG for screening general population for cardiac related abnormalities. Methods: The study was conducted among walk-in patients and their attenders of an urban health training centre attached a tertiary care teaching hospital for a period of 6 months in 2019. Results: Among the 410 respondents, majority were of age group 30-39yrs (54%) and females (62%). Left ventricular hypertrophy (15.4%) was the commonest abnormality. Majority (97.5%) were very satisfied with the hand held Tele-ECG instrument. Conclusion: Telecardiology has a potential to revolutionize the healthcare system particularly in resource poor rural and urban slum settings in bridging the gap between primary and secondary care. [ABSTRACT FROM AUTHOR]

HTN after renal transplantation is associated with cardiovascular morbidity. ABPM allows diagnosis of masked HTN and isolated nocturnal HTN. Longitudinal ABPM data in children post‐transplant are limited. ABPM was performed in children post‐transplant and repeated in 6‐12 months. BP indices were used to determine the prevalence of masked HTN, masked uncontrolled HTN (masked HTN in patients on antihypertensive medications), and isolated nocturnal HTN. Linear regression determined the association between LVMI and ABPM indices. Thirty children underwent a baseline ABPM. Ambulatory HTN was present in 25 (83%). Masked HTN was present in 18 (60%) and isolated nocturnal HTN in 13 (43%). Nocturnal ambulatory BP was higher than corresponding daytime BPs (P <.001 for systolic and diastolic) and 25 (83%) had a blunted nocturnal dip. Prednisone dose predicted nocturnal DBP index and DBP load (r2 =.40, P =.024 and r2 =.178, P =.02). ABPM was repeated in 18 patients within 11 (±3) months. BP indices decreased with time, but nocturnal BPs remained higher than daytime (P <.001 for SBP and DBP). Blunted nocturnal dip did not improve. LVH was present in 12 (57%). LVMI was directly related to the nocturnal SBP index (r2 =.377, P =.003) and nocturnal DBP index (r2 =.493, P <.001). We found no association between LVMI and daytime BP indices. The prevalence of masked HTN, isolated nocturnal HTN, and blunted nocturnal dip was high in children with kidney transplants. Nocturnal BP predicted LVMI. Ambulatory BP improved on longitudinal follow‐up, but the pattern of isolated nocturnal HTN persisted. [ABSTRACT FROM AUTHOR]

Most of the time, pediatrician is the first to see children with adenotonsillar hypertrophy (AH) and they mostly rely on clinical assessment with or without some investigation to refer these children to otorhinolaryngologist. Numerous methods have been described for evaluation of AH, but many of these methods are not possible to follow in busy pediatric outpatient unit either because of lack of cooperation from child or due to limited availability of test or due to cost constraints. This study has been conducted to determine the diagnostic accuracy of lateral neck X-ray (LNX) for assessing AH and to assess the correlation between adenoid size in LNX and clinical symptoms in a pediatric unit. Prospective study conducted in Department of ENT, Pathmavathy Medical Foundation, Kollam, Kerala, India from January 2015 to March 2016. 60 consecutive children of both genders, between the age group of 5 to 14 years, attending Department of Pediatrics with a provisional diagnosis of AH were included in the study. The symptom scores, radiographic ratio of adenoid to nasopharynx and endoscopic scorings were calculated. Lateral neck X-ray with calculation of adenoid-to-nasopharynx ratio is found to have significant correlation with patient reported symptoms and findings in nasal endoscopic examination (NE). LNX can be considered as a useful objective tool in evaluation of children with adenoid hypertrophy. Primary care physicians or pediatricians can confidently use lateral neck X-ray for making clinical decisions and can consider nasopharyngoscopy when clinical picture remains unclear or more evaluation is needed. [ABSTRACT FROM AUTHOR]

Background: This exploratory study reports the prevalence of lipohypertrophy (LH) in insulin-treated type 2 diabetes patients attending a private tertiary hospital in Mumbai, India, and explores the factors associated with this condition. Methods: A total of 96 patients attending the outpatient department, completed an interviewer-administered questionnaire followed by an examination of insulin injection sites for the presence of LH by a trained diabetes nurse educator. Results: Nearly 68% of the respondents had LH. Most patients (82%) had LH on at least two injection sites, with the frontal areas of the right and left side of the abdomen being the most common sites. Despite a high prevalence of LH, the majority of patients were unaware that they had the condition (77%) and could not identify the causes (74%). Half of the patients reported awareness about the different sites for injecting insulin, injection techniques, and the need for rotating injection sites. Only 26% always rotated injection sites, while 16% changed needles more than half of the time in the week prior to the interview. Bivariate analysis found higher number of years with diabetes and on insulin and a higher insulin dose per day as significant factors (p value < 0.05). Logistic regression showed a strong relationship between the presence of LH and the number of years on insulin (p value < 0.05). The number of years on insulin for patients with and without LH averaged 8.2 and 3.7, respectively. Conclusion: Findings highlight a gap in patients' knowledge and management of LH, and call for a hospital-wide intervention encompassing patient education and provider sensitization. [ABSTRACT FROM AUTHOR]

To establish an association between adenoid hypertrophy and hearing loss and its impact on speech and language in pediatric age group. A prospective case control study done in a tertiary hospital in South India. Twenty children with hearing loss were recruited in the study group and twenty-four children as controls. These groups underwent at detailed otorhinolaryngologic examination, hearing and speech evaluation. The size of the adenoids was graded endoscopically. Findings between the two groups were compared and analysed. Our study found statistically significant association between adenoid hypertrophy with choanal obstruction and abutment of eustachian tube opening seen on endoscopy with hearing loss (p = 0.025). The children with hearing loss also had speech and language delay (p = 0.004). Children with enlarged adenoids obstructing the > 50% of the choanae or abutting the eustachian tube opening are more likely to have hearing loss and may develop speech and language delay. The ACE endoscopic adenoid grading system is consistent and reliable in evaluation of adenoids. [ABSTRACT FROM AUTHOR]

A 23 year female presented with bilateral recurrent swelling of eyelids along with ptosis and proptosis for last 3 years. She also had swellings over the right cheek, parotid gland, and retro auricular area along with regional lymphadenopathy. Systemic laboratory workup revealed raised serum IgE and a high peripheral eosinophil count. Computed tomography and magnetic resonance imaging showed bilateral enlargement of extraocular muscles, lacrimal glands, and ipsilateral parotid gland. Excision biopsy of the retro-auricular lymph node was suggestive of Kimura's disease (KD). The patient responded well to systemic corticosteroid. KD rarely affects orbit, but it should be included in the differential diagnosis of inflammatory diseases of the orbit. To our knowledge, this is the first reported case of KD from India involving the orbit, lacrimal gland, extraocular muscles, parotid gland and buccal area. [ABSTRACT FROM AUTHOR]

Background: There are only few studies available on the prevalence of lower urinary tract symptoms (LUTS) evaluated by the international prostate symptom score tool (IPSS), and it has not been validated in the Indian population. Aim: The purpose of the present study was to determine the prevalence of lower urinary tract symptoms in patients of benign prostatic hyperplasia (BPH) and to validate the IPSS tool in our studied population. Materials and Methods: One hundred BPH aged >51 years attending the outpatient department of Urology were recruited for the study. LUTS were evaluated using the international IPSS. The IPSS was validated for reliability and reproducibility by Cronbach's alpha and intraclass correlation coefficient (ICC). Results: The coefficients of Cronbach's alpha and ICC were 0.80 and 0.86, respectively. The majority of patients had moderate symptoms (72%) followed by severe symptoms (17%). Severity of symptoms increased with age (P < 0.01). The total score was associated with age (P < 0.01). The majority of patients (12%) with the severity of symptoms had reported that symptoms bother them to some extent. Conclusion: The results of the study showed that IPSS could serve as a good instrument to assess LUTS in this population. [ABSTRACT FROM AUTHOR]

Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD. [ABSTRACT FROM AUTHOR]

Bilateral hydroureteronephrosis involves the dilatation of the renal pelvis, calyces and ureter; it develops secondary to urinary tract obstruction and leads to a build-up of back pressure in the urinary tract, and it may lead to impairment of renal function and ultimately culminate in renal failure. Although clinically silent in most cases, it can be diagnosed as an incidental finding during evaluation of an unrelated cause. In a minority of patients, it presents with signs and symptoms. Renal calculus is the most common cause, but there are multiple non-calculus aetiologies, and they depend on age and sex. Pelviureteric junction obstruction, benign prostatic hypertrophy, urethral stricture, neurogenic bladder, retroperitoneal mass and bladder outlet obstruction are some of the frequent causes of hydroureteronephrosis in adults. The incidence of non-calculus hydronephrosis is more common in males than in females. Ultrasonography is the most important baseline investigation in the evaluation of patients with hydronephrosis. Here, we report a rarely seen case of bilateral hydroureteronephrosis associated with a hypertrophied, trabeculated bladder in an adult male cadaver, suspected to be due to a primary bladder neck obstruction, and analyse its various other causes, clinical presentations and outcomes. [ABSTRACT FROM AUTHOR]

Background: Cardiorenal complications (CRCs) associated with T2D are a major cause of morbidity and mortality. There is a paucity of data regarding the burden of undiagnosed silent CRCs among individuals with T2D in India. Aim: To present country-specific analyses from the 'Take CaRe of Me' program, a subset of the iCaReMe global, cloud-based registry (NCT03549754), evaluating the prevalence and clinical manifestations of CRCs among individuals with T2D from the primary care setting in India. Methods: Cross-sectional data of adults with T2D and no history of CRCs at index visits were collected from December 2020 through December 2021. Here we present descriptive analyses of baseline cardiorenal characteristics. Presence of cardiovascular (CV) risk was analyzed as per ESC 2019 guidelines and renal risk as per KDIGO guidelines. Continuous variables were summarized as mean ± SD and categorical variables as frequency (%). Results: A total of 3284 individuals (mean ± SD age: 54.8 ± 11.92 years, BMI: 26.7 ± 4.7 kg/m2; 46.6% females) were enrolled. Mean HbA1c was 8.1 ± 1.97% (62.7% with HbA1c ≥7%) with a mean T2D duration of 9.1 ± 7.21 years; 61.5% of individuals had a T2D duration ≥5 years. Hypertension was reported in one-third (34.3%). Overall, 1091 (33.2%) individuals had moderate-to-severe renal risk (per urine albumin creatinine ratio). Of the 1280 (39.0%) individuals with high and very high CV risk, 251 (19.6%) had echocardiographic data, of whom, 70 (27.9%) had abnormal echocardiogram (12.0% left ventricular hypertrophy, 8.4% left atrial enlargement, 4.4% valvular disease, 2.4% diastolic dysfunction, and 0.8% pulmonary hypertension). Clinical heart failure was detected in 18 (0.5%) individuals overall [Table]. Conclusion: The results show silent CRCs to be prevalent in more than one-third of individuals with T2D. Such a high burden of unrecognized CRCs highlights the unmet need for early diagnosis, risk factor management, and the use of cardioreno protective anti-hyperglycemic drugs for individuals with long-standing T2D in India. [ABSTRACT FROM AUTHOR]

Hypertension is common in children with chronic kidney disease (CKD) and is a major determinant of CKD progression. Ambulatory blood pressure monitoring (ABPM) has been proposed to be better in detecting hypertension as compared to casual blood pressure (CBP). This study aims to study the usefulness of ABPM in detecting masked hypertension, evaluating the adequacy of blood pressure (BP) control and predicting left ventricular hypertrophy (LVH) amongst children with CKD. A prospective cross-sectional study of 46 children with stage 3-5 CKD was conducted at the Pediatric Nephrology department of a tertiary hospital in South India. All children underwent CBP, ABPM and an echocardiography. Results were categorized as normal BP; confirmed hypertension; masked hypertension and white coat hypertension. Out of 46 children studied, 11 were undergoing dialysis. While 39.1 % children had stage 3 and 4 CKD each, 21.7% had stage 5 CKD. Masked hypertension was detected in 19.6% and 21.7% had confirmed hypertension. Thirty-four (73.9%) children were already receiving antihypertensive medication. In these, CBP was elevated in 23.5% and ABP in 47%. Among children with hypertension as defined by ABPM, LVH was detected in 32.2%. We found that higher the number of abnormal ABPM indices (assessed by BP Index, nocturnal dipping and BP Load) higher the likelihood of LVH (P = 0.046). ABPM is better in detecting hypertension and monitoring adequacy of treatment in children with CKD. The high prevalence of masked hypertension and its association with LVH supports early echocardiography and ambulatory BP monitoring to evaluate cardiovascular risks in this population. [ABSTRACT FROM AUTHOR]

Twenty five percent of total liver volume (TLV) is considered as the ideal functional liver remnant (FLR) in major liver resections. In patients with macro-vesicular steatosis, early cirrhosis, and post-neoadjuvant chemotherapy (NACT), hepatocellular injury is common. In such instances, up to 40% of FLR may be required. So in cases of marginal FLR, pre-operative portal vein (PV) embolization or two-stage hepatectomy with PV occlusion is used. Both of which take up to 14 weeks between stages and 30% of patients fail to reach the second resection either due to inadequate FLR growth or disease progression. Associated liver partition and portal vein ligation (ALPPS) procedure has become the gold standard for those cases. A 57-year-old male presented with rectosigmoid growth + multiple right liver and segment 4B metastases. Post-NACT MRI showed interval progression of lesions. Preoperative CT (computed tomography) volumetric scan showed a FLR/TLV (future liver remnant/total liver volume) of 22%. Since patient received 10 cycles of NACT, ALPPS procedure was planned ahead of direct liver resection. Robotic ALPPS stage 1 sparing left lateral segment and 4A + anterior resection was done. We transected the parenchyma between the FLR and the diseased part of the liver with concomitant right portal vein ligation done robotically. CT abdomen done on POD7 showed hypertrophied left lateral segment. Second stage was performed on the eighth post-operative day with FLR/TLV increasing to 37%. Robotic ALPPS procedure for stage one is a safe and feasible technique in experienced centers with advanced robotic skills. [ABSTRACT FROM AUTHOR]

As injectable therapies such as human insulin, insulin analogs, and glucagon-like peptide-1 receptor agonists are used to manage diabetes, correct injection technique is vital for the achievement of glycemic control. The forum for injection technique India acknowledged this need for the first time in India and worked to develop evidence-based recommendations on insulin injection technique, to assist healthcare practitioners in their clinical practice. [ABSTRACT FROM AUTHOR]

Objectives:To study the role of mometasone furoate aqueous nasal spray for the management of adenoidal hypertrophy in children with more than 50 per cent obstruction, and to assess its impact on change in quality of life.Methods:A prospective, randomised, double-blind, interventional placebo-controlled study was conducted. A total of 100 children aged 2–12 years completed treatment and follow up. The symptoms and degree of obstruction were evaluated by nasopharyngoscopy conducted pre-treatment and 24 weeks post-treatment. Subjects received mometasone furoate nasal spray at a daily dose of 200 µg for 8 weeks, followed by a dose of 200 µg on alternate days for 16 weeks. Results were compared with those of a matched control group who were given saline nasal spray.Results:With mometasone treatment, there was an 89.8 per cent reduction in clinical symptom score, and the degree of obstruction dropped from 87 to 72 per cent (p < 0.0001). A statistically significant change in quality of life scores was seen in patients treated with the mometasone nasal spray (score change of 37.47) as compared with those given saline nasal spray (score change of 11.25) (p = 0.0001).Conclusion:Mometasone nasal spray appears to be effective in treating children with obstructive adenoids. [ABSTRACT FROM PUBLISHER]

Background: Electrocardiogram (ECG) is a cost effective tool to evaluate left ventricular hypertrophy (LVH). However, its reliability is often questionable when compared to the gold standard - echocardiography.The validation of ECG as a tool to diagnose LVH would benefit centres that lack access to echocardiography. Aim: (1) To assess the efficacy of ECG criteria to screen for left ventricular hypertrophy in comparison to echocardiography. (2) To determine whether ECG can be used as a screening tool for LVH in rural primary health centres Materials and Methods: Fifty hypertensive patients admitted to a tertiary level hospital fulfilling the inclusion and the exclusion criteria, were evaluated for LVH using ECG and echocardiography. Romhilt-Estes and Sokolow-Lyon criteria were applied to all subjects and their efficiency in detecting LVH was measured using Kappa statistics in comparison to echocardiography. Results: Among the 50 patients, 23 had LVH by echocardiography. In comparison to echocardiography, Romhilt-Estes and Sokolow- Lyon criteria were specific for LVH (96.3%, 88.9% respectively), but were poorly sensitive (43.5%, 43.5%). Combining both the criteria, raised the sensitivity to 60.9% and specificity to 85.2%. Kappa statistical analysis showed moderate to fair agreement of the Romhilt-Estes criteria with echocardiography. Both criteria had high positive predictive values (90.9%, 76.9%). Conclusion: Both Romhilt-Estes and Sokolow-Lyon ECG criteria are poor screening tools due to low sensitivity. But during routine screening of hypertensive patients with ECG alone, if any patient is positive by Romhilt-Estes criteria or both criteria, it would certainly warrant echocardiographic evaluation. As echocardiography cannot be recommended to screen every patient with hypertension in developing countries, initial evaluation using ECG can certainly help in selecting those who require echocardiography. [ABSTRACT FROM AUTHOR]

The morbidity and mortality associated with otitis media is really a challenge for the health care systems. This study is a small attempt to look into the magnitude of this problem in the society, where in school going children in Yavatmal city were studied. A total of 4104 students were studied. It was found that the overall prevalence of chronic suppurative otitis media in Yavatmal city is 3%. The incidence of acute otitis media was found to be 1.3% Chronic suppurative otitis media was commoner in students belonging to low socioeconomic strata and its association with adenoid hypertrophy was statistically significant. The authors recommend that a few more such studies should be carried out in different parts of the country to collect vital data for the health care system managers. Suppurative otitis media, school children, Yavatmal city. [ABSTRACT FROM AUTHOR]

From 2017‐2019, during the winter months (November–January), epidermal papilloma like benign tumor was observed in farm-reared adult grass carp, Ctenopharyngodon idella at the northern part of India. An investigation was undertaken to establish the causative agent of this epizootiology. Based on the clinical signs and ineffectiveness of antibiotics to control this disease, viral infection was suspected. A primer was designed to PCR amplify the partial DNA polymerase gene of lymphocystis disease virus (LCDV) from the tumor of moribund grass carp, which yielded 460 bp amplicon. After sequencing this 460 bp amplicon, the viral agent from the tumor of grass carp was identified as lymphocystis disease virus and given strain designation LRI-18 (Genbank accession number-MK347473). Phylogenetic analysis based on the nucleotide sequence of DNA polymerase gene of LCDV revealed the close association of LCDV LRI-18 to LCDV strain from Israel with 99.0% and 96.5% nucleotide and amino acid sequence identity, respectively. LCDV LRI-18 form single (type A; 0.5–2.0 μm) or multiple (type B; 0.5–2.0 μm) intracytoplasmic inclusion bodies on lymphocystis and erythrocyte cells of infected grass carp. Transmission Electron Microscopy (TEM) of blood revealed the presence of enveloped icosahedral virions of approximately 280 nm in diameter with electron dense core and an outer capsid. Histopathological study of various organs of LCDV infected grass carp revealed extensive hypertrophy and fusion of secondary gill lamellae, focal hemorrhage in the eye, pyknotic nuclei in the liver, inflammation in the myocardium, fused villi of intestine and degeneration of the glomeruli in the kidney. Experimental infection by a dip to grass carp fingerlings (average body weight 4.4 ± 0.9 g) using 0.45 μm filtered LCDV crude suspension did not reproduce the disease, and also no mortality were observed. This is the first report of the occurrence of lymphocystis disease in grass carp in India. • LCDV infection was reported for the first time in India in farm reared grass carp during winter. • Intra-cytoplasmic inclusion body was present in RBC and nodule of grass carp. • Diagnosis of LCDV was carried out by molecular, histopathological and electron microscopy. • LCDV 1 LRI-18 of current study shows maximum similarity with LCDV from Israel. • Extensive histopathological changes was observed in gill and heart. [ABSTRACT FROM AUTHOR]

Purpose: To report the spectrum of chest computed tomographic (CT) imaging findings in coronavirus disease-19 (COVID-19) infected Indian patients.Methods: This was a prospective descriptive study comprising 147 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. Prevalence, distribution, extent and type of abnormal lung findings were recorded.Results: Among the total study cohort of 147 patients, 104 (70.7 %) were males and 43 (29.3 %) were females with mean age of 40.9 ± 17.2 years (range 24-71 years). We observed lung parenchymal abnormalities in 51 (34.7 %) cases whereas 96 (65.3 %) RT-PCR positive cases had a normal chest CT. Only 12.2 % of the patients were dyspneic, 6.1 % had desaturation, 7.4 % had increased respiratory rate and 10.9 % had comorbidities. Among the patients with abnormal CT findings bilateral 39/51 (76.5 %), multilobar (88.2 %) lung involvement with a predominant peripheral and posterior distribution was commonly observed. With regards to the type of opacity, ground glass opacity (GGO) was the dominant abnormality found in all 51 (100 %) cases. Pure GGO was observed in 15 (29.4 %), GGO with crazy paving pattern was seen in 15 (29.4 %) and GGO mixed with consolidation was noted in 21(41.2 %). Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was observed in 36 (70.6 %) cases.Conclusion: In this study population predominantly with mild symptoms and few comorbidities, two-thirds of RT-PCR positive patients had a normal chest CT; whereas the remaining patients showed typical findings of predominant GGOs with a bilateral distribution and peripheral predominance. [ABSTRACT FROM AUTHOR]

Long-term observations over a period of 22 years in an Indian family with primary dysferlinopathy are recorded, defining phenotypic variability. In the propositus, the dystrophy began distally in the tibialis anterior muscles, before involving the gastrocnemius. Transient painful calf hypertrophy, followed by calf wasting was observed. The proximal lower and upper limbs weakened after three to four years. The younger sibling presented with the proximo-distal phenotype. Both patients showed very high creatine kinase values early into the illness. Disease progression was slow. The younger sibling lost ambulation 14 years after onset, while the elder one remains ambulatory 22 years into the illness. Muscle biopsy showed dystrophic features and absence of dysferlin. Monocyte western blotting confirmed absence of dysferlin. Genetic analysis detected a heterozygous mutation in Exon 54 [c.6124C>T] in the DYSF gene. This is the first family with a diagnosis of dysferlinopathy supported by genetic data, reported from India. [ABSTRACT FROM AUTHOR]

The article presents a case study on the removal of the cherry eye, a protrusion of the hypertrophied glands of the nictitating membrane, of the dog in India. The Diazepam-Ketamine, and normal saline were used in the surgery of the cherry eye. The hemmorrhage after excision, cauterization, the post operative bleeding were some of the techniques used in the operation.