International Journal of Medical Science And Diagnosis Research

SARS-CoV-2 Induced Multisystem Inflammatory Syndrome in Children (MIS-C) with Seropositive Scrub Typhus: A Case Series.

2023-03-05T05:04:45+00:00

Statement of the problem: Pediatric patient with history of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was diagnosed with a serious condition called Multisystem Inflammatory Syndrome in Children (MIS-C). It is a post infectious excessive immune response differing from cytokine storm of SARS-CoV-2. MIS-C ranges from mild tosevere form, with multiorgan involvement viz, cardiac, gastrointestinal, renal, neurological, hematological etc.; and laboratory evidence of hyperinflammation. Scrub Typhus (ST), a mite borne rickettsial febrile zoonosis; has been reported in India and worldwide^. It is caused by a gram-negative coccobacillus called Orientia tsutsugamushi and transmitted by the bite of chiggers, the infected larva of trombiculid mites (genus Leptotrombidium). ST present as a febrile illness with eschar and rash, but can manifest with a myriad of unusual presentations involving different organ system. Incidence of different organ involvement with rarity of association between these two conditions grew our interest on this case series.

Methodology and Theoretical orientation: The study was conducted in the Pediatrics department of Malda Medical College and Hospital for a period of 6 months. All the subjects (age < 12 years) with complain of fever was evaluated for all tropical causes and among them the 3 child with

a) Scrub Typhus IgM Ab Positive
b) SARS-CoV-2 RTPCR Negative
c) SARS-CoV-2 IgG antibody Positive
d) MIS-C Positive (as per WHO’s definition) was included in the study. The 3 cases was clinically evaluated in details with signs, symptoms , laboratory parameters and treatment given.

Findings: The CASE 1 and CASE 2 came with a neurological presentation on admission where as the CASE 3 presented with gastrointestinal one, fever being common in both. IV steroids, IVIg, Enoxaparin s/c were given to the patients but fever subsided with introduction of doxycycline after they became seropositive for scrub typhus. After thorough investigation it was found that both of them were positive for SARS-CoV-2 IgG antibody and Scrub Typhus IgM antibodywith features of MIS-C.

Conclusion and Significance: Recently a seroprevalence study also reported a 5% co-infection of Scrub Typhus with seropositive MIS-C. The attribution of the co- infection in the Tsutsugamuschi Triangle with this clinical scenario and febrile presentation mimicking tropical diseases make this condition a circumstantial challenge. Pediatrician should be more vigilant while dealing with the febrile illness for early diagnosis and proper treatment of this condition.

To Compare the Attention Span of Down Syndrome Children with Healthy Children of Same Age Group

2023-03-15T06:14:47+00:00

Introduction: Down syndrome is the most common congenital chromosomal disorder. In terms of genetic causes of mental impairment, this condition is the most prevalent. The typical characteristics of students with intellectual disability, such as down syndrome are limited attention span and motor skills. Attention is the first stage in information processing. It collects parts of the environmental information for later processing. However, there are dearth of studies which compares attention span of down syndrome children with healthy children of same age group.

Aim: The aim of the study is to examine the attention span of down syndrome children and comparing their attention span with healthy children of same age group.

Materials and methods: The present study had a cross-sectional comparative research design. 20 subjects were taken conveniently which included 10 down syndrome and 10 healthy children (8-14 years old). The attention span was measured by using Stroop color and word test and analyzed with independent t-test.

Results: Independent t-test indicated a significant difference between the attention span of down syndrome and healthy children.

Conclusion: This research evaluated that down syndrome children have less attention span than healthy children of same age group. Therefore, down syndrome children need more attention training.

Keywords: Attention span, Down syndrome, healthy children, Comparison.

Need to Establish Telerehabilitation Guidelines in India

2023-03-15T06:14:44+00:00

Abstract: Telerehabilitation is a viable option to provide continuum of rehabilitation intervention in situations like the ongoing pandemic. Presently, there was no legislation or guidelines to maintain minimum standards of telerehabilitation through video, phone, internet based platforms (web/chat/apps etc.) in India. In the phase of COVID pandemic, this paper looks on overview of guidelines given by various countries and to evaluate effectiveness of treatment delivered via telerehabilitation and assists in formulating appropriate guideline for telerehabilitation in India. The suggested guidelines can help develop and replicate similar models of telerehabilitation to reach people in need or in difficult situations like COVID 19 pandemic.

Keywords: Guidelines, Remote, Telerehabilitation, Telehealth, Tele practice

A Study on Ureteric Abnormalities in Single Contrast Bolus CT Urography at A Tertiary Care Centre

2023-03-15T06:14:41+00:00

Introduction: CT urography is an imaging technique in which the i.v contrast is injected and phases of CT scan are taken to study the entire urinary system. It has essentially replaced intravenous urography (IVU) in most imaging practices. CT Urography has evolved as an ideal imaging tool for comprehensive imaging assessment of patients with flank pain, malignancies, hematuria, trauma, renal calculi, suspected congenital malformations and in various clinical settings^. Other CT advantages include the use of multiplanar reconstruction (MPR), curved planar reformatted images, maximum intensity projection (MIP) and three-dimensional (3D) reconstruction which gives valuable information to the clinician about the extent of the lesions and helps in management.

Aim: To study various types of ureteric abnormalities in CT Urography in various clinical presentation.

Materials and methods: This is a tertiary hospital based observational Descriptive Cross sectional study conducted on 360 patients referred for CT Urography with Clinical Signs & Symptoms of urinary tract abnormalities, having ureteric imaging abnormalities. Siemens somatum High Definition 128 slice CT scanner was used for single bolus CT urography.

Results: Males were more as compared to females with age group 31 to 50 years (44.4%). Abdominal pain with urinary complaints was seen in maximum number of patients (203 cases- 56.4%). Urinary complaints in known abdomino-pelvic malignancies was seen in 18% cases. 285 patients had obstructive urography findings like hydronephrosis or hydroureter, and 75 cases had non obstructive findings like ureteral filling defects due to calculi, clots, etc or abnormal ureteric course or only congenital abnormality. Most hydroureter cases were secondary to obstructive calculus followed by obstruction by external malignant mass.

Conclusion: This study outlines the most common ureteric abnormalities in patients referred for CT urography which were mostly obstructive findings most cases were secondary to obstructive calculus followed by obstruction by external malignant mass. The non obstructive findings like ureteral filling defects were due to calculi, clots, etc or abnormal ureteric course or only congenital abnormalities. Delayed phase of CT urography can also be applied in Contrast CT study of abdomen & Pelvic scans on case to case basis to study ureteric involvements & pathologies.

WPW Syndrome type a in an Adult Male- A Unique Case Report: Fascinating three Decades Roller-Coaster Journey of WPW Syndrome type a and its Subsequent Resolution.

2023-03-18T04:11:11+00:00

Wolff-Parkinson-White syndrome is the most common form of ventricular preexcitation and affects 1-3 per 1,000 persons worldwide. Many patients remain asymptomatic throughout their lives: however, approximately half of the patients with Wolff-Parkinson-White syndrome experience symptoms secondary to tachyarrhythmias, such as paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, and rarely, ventricular fibrillation and sudden death. Patients with Wolff-Parkinson-White syndrome may present with a multitude of symptoms such as unexplained anxiety, palpitations, fatigue, light-headedness or dizziness, loss of consciousness, and shortness of breath. We report a peculiar case of three decades of fascinating journey of an adult male suffering from WPW syndrome Type A and its spontaneous resolution eventually.

Keywords: WPW Syndrome, spontaneous resolution of delta wave, three decades natural

history of WPW.

Flipped Classroom Learning Approach in Physiotherapy Education - A Journey Towards Digital Era.

2023-03-15T06:14:17+00:00

The objective of this study was to assess the effectiveness of the Flipped Classroom Approach which is a blended learning approach in which students receive digital lectures as homework, while active learning activities are used in the classroom. To start with students are provided information about this model and its implications on learning. Classroom learning resources consists of about 12 hours pre-recorded video lectures, YouTube videos, e-learning course video lectures, watching of pre-recorded lectures video prepared by experts and experienced teachers, seven full day seminars for 8 weeks period, assignments (ranging in difficulties from lower order thinking skills to higher order) and films. The role of the educator is to council the group and is to organize the seminars. The course examination took place about 8 weeks after the last seminar. The students’ performance was assessed with grades.

Meta-analysis yielded statistically improvement in learner’s performance in higher order thinking skills, self-regulatory learning and clinical competences as compared to conventional teaching. It also encourages collaborative work environment.