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2019 | July-September | Volume 5 | Issue 3

EDITORIAL

Dr S Sangeetha, Dr K Archana Rao

Editorial

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jmeds-5-3-iv  |  Open Access |  How to cite  | 

Original Article

Kammili Jyothirmayi

Analysis of Distribution of Allergens and its Seasonal Variation in Allergic Rhinitis

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:4] [Pages No:59 - 62]

Keywords: Allergens, Allergic rhinitis, Dust mite, Seasonal

PDF  |  DOI: 10.5005/jp-journals-10045-00129  |  Open Access |  How to cite  | 

Abstract

Introduction: Allergic diseases are common and they have increased in frequency over the last few decades. More than 30% of the population suffers from allergic rhinitis (AR). It is defined as a combination of two or more symptoms, namely, watery rhinorrhea, nasal obstruction, itching, and sneezing. Allergic rhinitis occurs when these symptoms are the result of immunoglobulin E (IgE)-mediated inflammation following exposure to allergens. The common inhalant allergens causing AR are house dust mites, pollens, fungi, and insects. Skin prick test (SPT) is the gold standard test in the diagnosis of AR. Aim: To study the distribution of inhalant allergens in AR and to find out seasonal variations in allergens by SPT. Materials and methods: A descriptive study was done in 120 patients who came with symptoms of AR to ear, nose, and throat (ENT) outpatient department (OPD) of tertiary care hospital. The study was done from November 2017 to October 2018. The patient was clinically evaluated and the SPT was performed to analyze the distribution of inhalant allergens and its seasonal variations. Results: The majority of the patients are males between 21 and 30 years of age. Majority of the people are urban residents. Dust mites followed by pollens yielded the highest number of positive responses among inhalant allergens. Dust mites and dusts are more common during winter season, pollens are more common during summer season, and fungi and insects (5.83%) during rainy season. Conclusion: Analyzing the distribution of specific allergens for a particular geographical area and its seasonal variation helps in appropriate diagnostic evaluation of allergens, educating the patient on what allergen to avoid and also to find the best formulation of allergen immunotherapy for effective AR treatment.

Original Article

Shushan S Jayker, Sahithi Tadi, Jyothi R Kaluva, Sharmila P Surhonne

Spectrum of Lesions in Peritumoral Area in Association with Carcinoma of Breast

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:4] [Pages No:63 - 66]

Keywords: Breast cancer, Peritumoral area, Proliferative breast disease

PDF  |  DOI: 10.5005/jp-journals-10045-00130  |  Open Access |  How to cite  | 

Abstract

Introduction: Breast cancer remains a global health problem with an increasing incidence. Breast carcinogenesis emerges by a multistep process via steps of hyperplasia, premalignant change, and in situ carcinoma. Women with proliferative breast disease have been observed to have an increased risk of breast cancer. Improved knowledge of breast carcinogenesis will provide insight for defining the high-risk groups, thus resulting in improved screening and management regimens. Materials and methods: The present study included 60 radical mastectomies for carcinoma of breast at RajaRajeswari Medical College and Hospital, Bengaluru, from August 2015 to July 2018. The primary tumor and peritumoral area were studied both grossly and microscopically for the different lesions and the results were analyzed. Observation and results: Of the 60 cases of breast carcinomas, the predominant type of carcinoma was infiltrating ductal carcinoma, no specific type (88%) (IDC, NOS). The lesions in peritumoral area were fibrocystic changes (62%), proliferative breast lesions (13%), and ductal carcinoma in situ (DCIS) (25%). Conclusion: Most of the peritumoral area showed fibrocystic changes which have a less absolute risk of 3%, whereas DCIS has an absolute lifetime risk of 25–30% transforming into carcinoma of breast, making those patients mandatory for follow-up and management.

REVIEW ARTICLE

Fahim LH Rajiwate, Deepak Bolbandi

Primary Seminal Vesicle Abscess: A Diagnostic Dilemma— A Review of Current Literature

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:3] [Pages No:67 - 69]

Keywords: Abscess drainage, Magnetic resonance imaging, Seminal vesicle, Transrectal ultrasonography

PDF  |  DOI: 10.5005/jp-journals-10045-00126  |  Open Access |  How to cite  | 

Abstract

Seminal vesicles (SV) are accessory sex organs of male genitourinary (GU) tract, which play a crucial role in male fertility. Primary seminal vesicle abscess (SVA) is a rare pathologic entity with no specific symptoms with very few reported cases in literature, posing a great diagnostic difficulty to the clinicians. Common pathologies of seminal vesicle include cyst, congenital abnormalities and seminal vesicle infection, and abscess, secondary to obstruction and infection of the neighboring organs have been frequently addressed. Cross-sectional imaging advancement has expanded not only our knowledge of GU tract abnormalities but also our treatment approaches. Seminal vesicle abscess is a rare pathological condition and diagnosis is based on clinical and radiological findings. Conservative treatment could be effective in selected cases. In cases refractory to conservative management, surgical decompression can be an option. Transrectal ultrasonography-guided mini-invasive drainage modalities can be proposed successfully.

BRIEF COMMUNICATION

RV Anuradha, H Sahajananda

A Study on Menstrual Problems among High School Girls Studying in Rural Field Practice Area of a Tertiary Care Hospital

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:3] [Pages No:70 - 72]

Keywords: Dysmenorrhea, High school girls, Menstrual hygiene, Menstrual problems

PDF  |  DOI: 10.5005/jp-journals-10045-00127  |  Open Access |  How to cite  | 

Abstract

Menstruation is an important event in life of adolescent girls and is often associated with menstrual problems such as irregular menstruation, excessive bleeding, dysmenorrhea, and many more. Present study was conducted to find menstrual problems among high school girls. The objectives were to enumerate menstrual problems among high school girls and to assess the awareness and practices on menstruation hygiene in them. Materials and methods: The study was conducted in the rural field practice area of RajaRajeswari Medical College and Hospital, Bengaluru, after taking institutional ethical clearance. That area has two high schools which had 120 girls in total. Permission was taken from the school authority to conduct the study and the complete enumeration of the schools was done. Menstrual problems, awareness, and practices on menstrual hygiene were assessed by semistructured questionnaire. Health education regarding menstrual health was given to them after data collection. The data collected were compiled and entered into a Microsoft Excel worksheet. Descriptive statistics and suitable tests of significance were used as required. The data were then analyzed using Statistical Package for Social Sciences (SPSS) software v.21.0. Results: Nearly 112 high school girls participated in the study. Most of them mentioned that dysmenorrhea was the major menstrual problem (48%). The practices of menstrual hygiene among high school girls were found to be satisfactory (99%). Conclusion: In conclusion, dysmenorrhea was the most common menstrual problem among high school girls. Majority of them lack awareness that sanitary pads are to be disposed in dustbins.

CASE REPORT

Manaswini Mullapudi, R Madan, Vishnu Vardhan, M Vidhyavathi

Aripiprazole-induced Diplopia: A Rare Case Report

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:2] [Pages No:73 - 74]

Keywords: Adverse effects, Aripiprazole, Diplopia

PDF  |  DOI: 10.5005/jp-journals-10045-00122  |  Open Access |  How to cite  | 

Abstract

Background: Aripiprazole is a second-generation antipsychotic (SGA) drug. The commonly reported side effects of aripiprazole are headache, nausea, constipation, somnolence, or insomnia. However, ocular side effects are rarely reported with aripiprazole, with myopia being the most commonly reported. Eight cases of aripiprazole-induced myopia were reported and only two cases of diplopia secondary to aripiprazole use were reported in literature. Aim: We aim to report a case of aripiprazole-induced diplopia in a 28-year-old woman who was treated for depression with psychotic symptoms. Case description: A 28-year-old woman who was a known case of depression with psychotic symptoms was treated with 3 mg oral risperidone but had to be switched to aripiprazole due to hyperprolactinemia. Within 10 days of starting oral aripiprazole at a dose of 10 mg, the patient reported symptoms of double vision and blurring of vision in both eyes. On ophthalmologic evaluation, the patient did not have any refractory error. She did not have signs of any extrapyramidal symptoms, and preliminary neurological examination did not reveal any other abnormalities. Keeping in mind the possibility of the rare side effect of diplopia, she was advised to discontinue aripiprazole. On stopping the drug, the patient reported reduction in symptoms within 5 days with complete resolution in 10 days of stopping aripiprazole. The acute onset of diplopia and resolution of symptoms after stopping the drug correlates strongly with aripiprazole-induced diplopia. Till date, only two such cases were reported. Conclusion: Both the treating psychiatrists and ophthalmologists should be well aware that though rare, diplopia is a possible adverse effect of aripiprazole. Prompt discontinuation can reverse the condition.

CASE REPORT

Madan Rajashekar, Manaswini Mullapudi, Vishnu Vardhan, Vidhya Malyam

Polyembolokoilamania: A Rare Case Report

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:2] [Pages No:75 - 76]

Keywords: Hallucinations, Polyembolokoilamania, Schizophrenia

PDF  |  DOI: 10.5005/jp-journals-10045-00125  |  Open Access |  How to cite  | 

Abstract

The introduction of foreign bodies into the rectum dates back to 16th century. When featured in literature, it has been typically discussed in medical subdisciplines, such as surgery, gastroenterology, emergency medicine and urology. However, in-depth exploration of this multidimensional phenomenon in the field of psychiatry has thus far been limited. Polyembolokoilamania inserting foreign bodies into orifices is a rare disorder and rectal insertions happen mostly due to erotic activity. Insertion of foreign bodies in psychiatric patients is associated with psychiatric disorders like schizophrenia, either due to delusional beliefs or in response to command hallucinations. In this case report, we are reporting a 35-year-old male patient who had inserted a metal tumbler into anal orifice and claimed that spirits had inserted the object into anal orifice against his will, later the patient was diagnosed as having paranoid schizophrenia and was treated. It is likely that any radiologist and surgeons will encounter this type of case, and thus should be familiar with both diagnostic and management options and refer for psychiatric help to avoid recurrences.

CASE REPORT

P Balaji, Abhinav Balaji, RV Ramanakumar, Midhun M John

Laparoscopic Cholecystostomy in Gangrenous Cholecystitis with Localized Peritonitis

[Year:2019] [Month:July-September] [Volume:5] [Number:3] [Pages:3] [Pages No:77 - 79]

Keywords: Gangrenous cholecystitis, Interval cholecystectomy, Laparoscopic cholecystostomy

PDF  |  DOI: 10.5005/jp-journals-10045-00128  |  Open Access |  How to cite  | 

Abstract

Introduction: Gallstone is a very common disease condition and affects 10–20% of the adults in the developed countries and 20% of the patients present with acute calculous cholecystitis.1 One of the severe complications is gangrenous cholecystitis, which can occur in as high as 40%2,3 of patients with acute cholecystitis, and perforation of gallbladder (GB) in 2–18%.4 Gangrenous cholecystitis is defined as necrosis and perforation of the GB wall as a result of ischemia following progressive vascular insufficiency and is a severe complication of cholelithiasis. Factors such as male sex, advanced age, delay in seeking treatment, leukocytosis, cardiovascular diseases, and diabetes mellitus increase the likelihood of developing gangrenous cholecystitis and carry a significantly higher mortality rate between 15% and 50%.5 Hence, early diagnosis and immediate intervention are required in these cases. Laparoscopic cholecystectomy for gangrenous cholecystitis carries a high risk of morbidity and mortality. Hence, safer treatment modalities such as laparoscopic cholecystostomy help the patient to recover from the critical illness and the definitive procedure can be performed at a later, safer period. Case description: Six patients with gangrenous cholecystitis, i.e., five females and one male, underwent laparoscopic cholecystostomy. All the patients recovered from sepsis, and no complication was reported during or after the procedure and were discharged after a stay of 5–7 days. All the patients underwent elective laparoscopic cholecystectomy after 10–12 weeks and are doing well at 1-year follow-up. Conclusion: Cholecystectomy in gangrenous cholecystitis carries high risk of morbidity and mortality. In this setting, laparoscopic cholecystostomy is a safe and reliable procedure to recover the patient from the acute sepsis and proceed with elective laparoscopic cholecystectomy at a later date.

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