Span Diagnostics (India)

Aneurysmal bone cyst (ABC) is rarely seen in the calcaneus of young children. To our knowledge, till date very less number of calcaneal ABC have been reported in the literature. A 5-year-old female child suffered chronic heel pain for last 2 months and was presented with x-ray showing a solitary and expansile osteolytic lesion within the calcaneus. Detailed clinico-radiological and histopathological examination suggested the lesion as ABC. The volume of the lesion was 11.9 cm3 as measured in the MRI. Curettage was not opted as wall of entire calcaneus was very thin and lesion was big compared to the age of child. Treatment was done with 4 sequential sclerosant polidocanol injection therapy over 9months, with minimum of 6 weeks interval in each injection. Dosage of the sclerosant therapy was calculated by weight of the patient (2-4 mg/kg) instead of volume of the cyst. No recurrence was observed over next 1 year by sequential X-rays. Age of the patient, anatomical location and severity in our case makes it unique. ABC can also be found in unusual locations like calcaneus even at 5 years age and can be managed by standard polidocanol protocol. In very young children with thin-walled, calcaneal ABCs, serial sclerosant injection may avoid morbid curettage/grafting.

ABSTRACT Introduction: A shift in policy has occurred with the introduction of molecular diagnostic tools for the upfront diagnosis of all cases of tuberculosis, including drug-resistant tuberculosis. The impact of this shift in policy on severity of disease was studied, and comparisons were drawn between the year 2015 and 2020. Study Type and Design: This was an observational study conducted between 2020 and 2021. Seventy patients of MDR-TB with or without additional drug resistance, hospitalized in the year 2015 and 2020, were studied. Results: The study reveals a substantial reduction in the median time from the onset of symptoms to diagnosis between 2015 and 2020. Specifically, the median duration decreased from 12 weeks in 2015 to 8 weeks in 2020. Moreover, we found that in 2015, all cases under study had a history of tuberculosis in comparison to 2020. Additionally, there was a higher incidence of anemia in 2015 compared to 2020. In the radiological examination, it was observed that in 2015, a higher frequency of cases exhibited cavitations, bronchiectasis, and fibrosis on chest X-rays compared to the findings in 2020. The mean cavity size in 2015 measured 6.73 cm, while in 2020, it averaged 4.06 cm. Additionally, we noticed a higher occurrence of significantly advanced cases in 2015 in contrast to 2020. Conclusion: The implementation of the new policy of upfront DST was noted to decrease the time required for diagnosis and bacterial load as ascertained from degree of sputum smear positivity, radiological lesions, and severity of anemia.

Background: Fungal infections are predominantly opportunistic infections in immunocompromised patients and in immunocompetent adults with a history of trauma. Recently, there is an increase in trends of fungal infections in immunocompetent individuals also without any history of trauma. Pigmented fungi are a group of fungi that have pigment in their cell wall and also known as dematiaceous fungi. These pigmented fungi include phaeohyphomycosis with a differential diagnosis of chromoblastomycosis, cryptococcosis, mycetoma, and aspergillus. Phaeohyphomycosis is a subcutaneous or systemic infection characterized histologically by dark-colored fungal hyphae and yeast forms (black yeast). Aims and Objectives: The aim of the present study is to analyze the clinicopathological features of pigmented fungal infections in biopsy specimen based on their histomorphology. Materials and Methods: This was a prospective study in which we have analyzed the dematiaceous fungal species by their histomorphological characteristics in biopsy specimens. Results: A total of 21 cases of biopsy specimens (with the clinical presentation of cutaneous/subcutaneous lesions) were studied histologically which showed 13 cases of phaeohyp homycosis, seven cases of eumycotic mycetoma, and one case of chromoblastomycosis. There was male predominance (17, 80.95%) and the majority of the patients were >60 years (16, 76.19%). Most common site of infection was foot with predominant clinical presentation as subcutaneous mass lesion. Conclusion: All the cases of dematiaceous fungal infections were diagnosed by histopathological examination. Melanin in the cell wall of dematiaceous fungi is the pathogenic factor. Phaeohyphomycosis is no longer considered as a rare infection rather there is an increasingly incidence of recognized infection. Although culture and histopathological study remain important tools for final diagnosis, various molecular studies might be helpful for accurate diagnosis.

Klippel Feil Syndrome (KFS) is a congenital anomaly having fusion of 2 or more cervical vertebral bodies characterized by the presence of classic triad of low posterior hairline, short neck, and restricted range of motion. We have reported a rare case of Type III Klippel Feil Syndrome having classical clinical triad with Sprengel deformity and atlantooccipital assimilation. The baby was born at Sanjay Gandhi Memorial Hospital, Mangolpuri, New Delhi, India. The detailed discussion is done in the case report. Prognosis is based on radiological classification by Samartzis et al which classifies KFS under 3 types with type II as the commonest variety. Associated anomalies include scoliosis or kyphosis, renal disease, Sprengel deformity, loss of hearing, synkinesis or mirror movements, congenital heart defects, craniofacial malformations, and skeletal abnormalities of ear, nose, mouth and larynx. Proper management requires multidisciplinary approach including neurologist, orthopedic surgeon, pediatrician, nurse practitioner, physical therapist, and neurosurgeon.

This research looks at how the imbalance ratio and classifier affect how well various resampling techniques work when dealing with imbalanced data sets. The research examines the effects on learning when previously imbalanced data is changed into fictitiously balanced class distributions using a variety of resampling strategies. When data sets are significantly uneven, analyses utilising attribute selection, four different classifiers, and six performance evaluation criteria demonstrate that over-sampling (95 percent accuracy) the minority class routinely outperforms under-sampling (77 percent accuracy) the majority class.

The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400-700cells/mm3 ) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4% showed reduced susceptibility to fluconazole. HIV status results in significantly elevated rates of OCC Calbicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.

In the resent past one field which has brought in many changes in the human lives is the technology. Technology is meant for bringing innovation in human lives and reduces the efforts to accomplish a task. Corporate hospitals today employ large number of doctors specialized in various fields. Out patients who wish to consult a particular doctor finds it very difficult to locate their respective doctor’s cabin. Keeping the patient’s difficulty of tracking the doctors, an embedded based device has been designed to assist patients to easily locate the doctor’s cabin. The device displays the patient’s name and token number outside of the consultant’s room

Low back pain is non-specific in 85% of population. Posterior-to-anterior (PA) mobilization and press-up exercises are common physical therapy interventions used to treat low back pain. The purpose of this study was to investigate the effect of posterior-to-anterior spinal mobilization and prone press-ups in non-specific low back pain. The study design was double blind randomized clinical trial. Forty participants reporting to Physiotherapy Out-patient department in hospital who were 18-45 years of age and had diagnosis of non-specific low back pain were included. Primary outcome measures were lumbar extension range, pain and physical function. Both interventions resulted in significant reduction in the average pain scores for both groups. Similarly, gain in total lumbar extension was significant in both the PA mobilization group and the press-up group. Functional scores significantly improved for both the groups. Both the groups significantly differed in terms of pain, lumbar extension and functional scores. PA mobilization proved to be a superior intervention. PA mobilization and press-ups can be used as an effective intervention in non-specific low back pain.