Journal of Comprehensive Clinical Practice

Impact of the Digital World on Eye Health

2025-01-24T18:03:21+0530

We, as ophthalmologists have seen a drastic surge in patients in the last few years, especially in the post-COVID era, with complaints of Digital Eye strain and digital fatigue, also known as “Computer vision” syndrome.
It is now considered the most frequent ocular condition that affects all age groups due to the prolonged usage of digital devices. Though it is not known to cause any permanent eye damage, the symptoms impact the patient’s quality of life, including a decline in work performance, both at a personal and professional level.

Living in the Moment!

2025-01-24T12:18:33+0530

We, as medical professionals or for that matter the working class of today is so caught up in the rat race of trying to excel, to prove ourselves on the work front, to be recognized for our achievements that perhaps we don’t realize that time is ticking by!
We spend many years getting ourselves educated and trained to enter a profession and then plunge into work with excitement and the belief that we can be better than the best! Sometimes, it is the professional fulfillment that drives us and at other times, it is the financial stability that success brings. In this time, however, we ignore our health and compromise on precious family time.

A Rare Occurrence of Papillary Carcinoma in Ectopic Thyroid Tissue: A Case Report

2024-12-15T22:51:38+0530

Introduction: Ectopic thyroid tissue can be found anywhere alоng the path of the thyroglossal duct, from the foramen cecum to the mediastinum, and may present as either a lingual thyroid or a thyroglossal duct cyst. In uncommon instances, abnormal migration of the gland can lead to lateral ectopic thyroid tissue. Similar to the native thyroid gland, ectopic tissue can also undergo malignant transformation.

Case Report: A 38-year-old female presented with neck pain and swelling that had persisted for 4 to 5 months. She visited the surgical outpatient department of the hospital, where she underwent surgery for excision of a mass located in the infrathyroidal region over the trachea. The excised specimen was sent to the pathology department for histopathological examination. Routine laboratory tests showed normal levels. Thyroid function tests were normal.

Conclusion: This case illustrates a rare presentation of papillary thyroid carcinoma originating in ectopic thyroid tissue, while the primary thyroid gland remains unaffected by cancer.

Sonographic Evaluation of Tibial and Common Peroneal Nerves in Patients with Long Standing Diabetes

2024-12-04T20:20:34+0530

Introduction: Ultrasound is a helpful imaging tool to determine the location, extent, type of lesion as well as the presence of nerve swelling and inflammation in patients with diabetic peripheral neuropathy. The study highlights the significant impact of long-standing diabetes on the tibial and common peroneal nerves, underscoring the importance of sonographic evaluation in diabetic patients.
Method: This Cross-sectional observational study was carried out in the Radiodiagnosis department of Vivekanand Polyclinic & Institute of Medical Sciences, focusing on 48 patients having long standing diabetes (>10 years). Ultrasonography was performed with Siemens Acuson NX3 Elite using a linear transducer (4–12 MHz) in patients meeting inclusion criteria.
Results: The study's correlation analysis of sonographic findings and clinical parameters revealed that there is strong positive correlation between the duration of disease and CSA and MTNF of the Tibial nerve, moderate positive correlation between Blood sugar levels and all nerve parameters, strong and moderate correlations between HbA1c levels and all nerve parameters, with the highest correlation observed for the CSA of the Tibial nerve and lastly moderate correlation between clinical features and all nerve measures, most notably with MTNF of the Tibial nerve.

Conclusion: Ultrasound is a non-invasive, low cost, and real-time imaging technique to evaluate peripheral nerves in diabetic patients to identify changes in these nerves early so that healthcare providers can implement more targeted interventions to mitigate the progression of neuropathy.

HRCT Assessment of Interstitial Lung diseases and its Correlation with Spirometry Indices

2024-12-04T20:29:58+0530

Introduction: Interstitial lung diseases (ILDs) include disorders characterized by inflammation and fibrosis of the lung interstitium. These pathologies lead to restrictive lung function and impaired gas exchange. HRCT findings and spirometry indices are essential for a comprehensive evaluation of ILDs. The integration of HRCT and spirometry data empowers healthcare professionals to gain insights into the severity and progression of ILDs and have a better comprehension of the impact of interstitial changes on respiratory mechanics, prognosis, and treatment planning

Aim: To correlate radiological pattern and extent of involvement of ILD in HRCT with Spirometric indices and verify radiological functional relationship.

Materials and Methods: The study was conducted at VPIMS, Lucknow and included a total of 50 patients. HRCT chest was done on 64 slice Siemens-Somatom go. Up CT scanner and Spirometry were performed using Masters medi Spiro digital spirometry system. Lung parenchymal abnormalities were categorized and a semiquantitative Warrick score was applied for grading severity.

Results: Correlations between severity scores and spirometry indices underscore the inverse relationship between disease severity and lung function.

Conclusion: This understanding of disease severity and extent facilitates personalized treatment strategies, leading to improved patient management and tailored interventions to mitigate symptoms and slow disease progression.

Infantile Bronchogenic Cyst: A Rare Cause of Persistent Respiratory Distress and Recurrent Pneumonia

2024-11-25T19:28:19+0530

A 3-month-old male infant presented with difficulty in breathing, severe chest retractions, and grunting. He had a history of multiple episodes of hospitalization for severe pneumonia. Imaging studies (chest X-ray & MRI) revealed a mediastinal-based, well-defined, predominantly cystic lesion in the right upper and mid-zone, compressing the trachea. The infant underwent surgical excision of the cyst, and histopathological examination confirmed a bronchogenic cyst. The postoperative course was uneventful, and the infant was discharged on the 5^th postoperative day.

Unusual Imaging findings in a Child with Acute Hepatitis A Infection

2024-11-15T09:54:35+0530

Hepatitis A infection in children generally presents with mild, self-limiting symptoms. Extrahepatic manifestations, such as acute renal injury, are rarely reported in non-fulminant hepatitis A. We present a case of a 14-year-old girl with non-fulminant hepatitis A infection, who was incidentally detected with a left adnexal mass during routine ultrasound imaging. Further evaluation with MRI unexpectedly revealed findings suggestive of acute pyelonephritis, contrary to the typical presentation of hepatitis A.

Walking in Hot Summer may be Dangerous for the Elderly

2024-11-03T16:01:37+0530

This report details a case of exertional heat stroke in a 78-year-old male who collapsed after his regular evening walk in high-temperature conditions (ambient temperature 42.5°C, humidity 25%). After 30 minutes of walking, he lost consciousness and experienced a tonic-clonic seizure. Upon arrival at the emergency department, he was drowsy (Glasgow Coma Scale score of 12) and had recurrent seizures. The patient was intubated and mechanically ventilated. Treatment included cold sponging, intravenous fluids, intravenous lorazepam, and levetiracetam, leading to cessation of seizures and improved consciousness. He was extubated after 25 hours and discharged after seven days. This case underscores the heightened risk of exertional heat stroke in elderly individuals during exercise in hot weather.

Suicides in Kota: Alarm Bells!

2024-06-28T12:33:58+0530

I read, with great dismay, a recent newspaper article mentioning that a student preparing for the National Eligibility Entrance Test (NEET) had committed suicide in Kota, Rajasthan which was the eighth suicide of the year. I was horrified! I wondered what the poor fellow must have gone through before taking such a step and what must be the state of his parents now?
Although medicine is a very fulfilling and noble profession, it has its fair share of stress during training. Long working hours, scores of patients to look after, sleep deprivation, and no proper meal times –the list goes on! However, these things do not happen when a child prepares for the entrance examination. At that time, the stress is of a different type i.e., whether or not the child will clear the examination and whether all the hard work, time, and money gone into coaching for the same would be wasted! Children need to be loved and cared for in these difficult times and counseled regarding failure. Maybe not clearing that particular examination might steer them towards another better profession in life! The burden of parental expectations and the inability to tackle failure drives children far away from home, staying in coaching centres to take such drastic steps!
Let’s think about this carefully and try to make things better, starting at our own homes! Let us not burden our children with the weight of our expectations and teach them to work very hard yet be able to tackle failure!! Remember- “change begins at home!”

Blood Component Therapy in Sick Newborns

2024-04-28T20:20:00+0530

Background: Sick neonates admitted to NICU (neonatal intensive care unit) frequently need blood component transfusion including WB (whole blood), PRBC (packed red blood cells), FFP (fresh frozen plasma) and platelets.
Aim: This study was aimed to evaluate the indication and frequency of various blood components used in NICU.
Method: This was a retrospective observational study, done at tertiary level NICU in north India. All the neonates admitted in NICU from July 2023 to December 2023 were included and their records were screened for blood component transfused and their indications.
Results: During the study period, out of 141 admissions, 15.6% of newborns required blood component transfusion. PRBC (53.3%) was the most commonly transfused component followed by platelet concentrate (28.9%). 41% of newborns required more than one transfusion. 91.1% of transfusions were appropriate as per our NICU transfusion protocol.
Conclusion: A large number of sick newborns admitted to NICU required blood component transfusion during hospitalization, especially preterm. PRBC, being the most commonly used blood component, should be used appropriately and judiciously.