John S.,Amala Institute of Medical science
Indian Journal of Psychiatry | Year: 2013
Background: Psychiatric morbidity and Health Related Quality of Life (Hr-QoL) in Ischemic Heart Disease (IHD) are relatively less studied in our country. Aims: This cross-sectional observational study was undertaken to assess the common psychiatric disorders and Hr-QoL in IHD. Materials and Methods: One-hundred and thirty patients with IHD were evaluated for psychiatric morbidity and Hr-QoL. Tools used were SCID-1, Euro QoL-5D, and Socio-demographic data sheet. The data were analyzed using SPSS v 10.0 software, Chi-square test, T-test, ANOVA were used as needed. Results: Psychiatric morbidity was assessed using psychiatric assessment schedule SCID-I for generating diagnosis as per DSM-IV criteria. Major depressive disorder was found in 34.6% (n=45) patients. 23.8% (n=31) patients had a diagnosis of depression due to general medical condition. Anxiety disorder due to general medical condition was present in 36.9% (n=48) patients. Around 95.4% of patients reported psychiatric symptoms, either depression or anxiety. Though widely disputed, low educational status was reported as significantly associated with psychiatric morbidity in IHD. Female sex of the patient and the presence of diabetes mellitus were associated with psychiatric morbidity in a significant manner. Majority of patients with poor quality of life were in the domain of anxiety/depression. Conclusion: The findings of our study reveal a high rate of psychiatric morbidity and impaired quality of life in IHD Patients.
Harisankar C.N.,Amala Institute of Medical science
Clinical nuclear medicine | Year: 2014
Fat spared area of liver can appear as focal areas of elevated FDG uptake on a PET scan. This may mimic metastases. PET scan performed for metastatic workup in a 35-year-old female patient, a case of exocrine tumor of the pancreas, showed focal areas of increased FDG uptake. Contrast-enhanced CT performed as a part of the PET/CT study showed enlarged fatty liver with focal hyperdense areas suggesting fat sparing. Sulfur colloid scan showed physiological colloid uptake in the suspicious areas indicating preserved Kupffer cell function. The patient is on close follow-up without any evidence of metastatic disease.
Harisankar C.N.B.,Amala Institute of Medical science
Indian Journal of Nuclear Medicine | Year: 2015
Natural killer/T-cell (NK/T-cell) lymphoma is a rare condition, which presents as necrotic, granulomatous lesions involving the nose and the upper respiratory tract. The condition usually has an aggressive clinical course. The predominant subtype of NK/T-cell lymphoma noted in Asian population is the nasal type. We describe a case of biopsy-proven NK/T-cell lymphoma with bilateral adrenal involvement. Adrenal involvement by lymphoma is usually of B-cell type and occurs in disseminated disease and often unilateral. Bilateral adrenal involvement by T-cell lymphoma is extremely rare. © 2015, MEDKNOW. All rights reserved.
Iqbal S.,Amala Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2013
Background: Cerebrovascular diseases such as stroke, aneurysms and arterio-venous malformations are very much prevalent in our country. Circle of Willis, as an anastomotic polygon at the base of the brain forms an important collateral network to maintain adequate cerebral perfusion. Changes in the normal morphology of the circle may condition the appearance and severity of symptoms of cerebrovascular disorders, such as aneurysms, infarctions and other vascular anomalies. A possible link between abnormalities of the circle of Willis and the mentally ill patients has been observed. Aim and Objectives: The aim of the present study is to have an intimate knowledge of the variations in the cerebral arterial circle and to clarify the clinical importance of these variations in certain forms of cerebrovascular diseases. So an attempt was made to analyse the anatomical variations of the circle in a random population. Material and Methods: The work was based on fifty adult brains from persons died of diverse causes. The materials were obtained during routine autopsy studies. The base of the brain including the brain stem with intact arterial circle was preserved in 10% formalin for 10 days. The circle of Willis and its major branches were carefully dissected under water using a magnifying lens. The variations were recorded and photographed. Results: Majority of the circles (52%) showed anomalies. Hypoplasia was the most frequent anomaly and was found in 24% of the brains. Accessory vessels in the form of duplications/ triplications of anterior communicating artery were seen in 12% of the circles. The embryonic origin of the posterior cerebral artery from the internal carotid persisted in 10% of the circles. An incomplete circle due to the absence of one or other posterior communicating artery was found in 6% of the specimens. Variations are more frequent in posterior half of the circle. Conclusion: The anatomical variations of the circle of Willis were probably genetically determined, develop in early embryonic stage and persist in post natal life. The amplitude of neck movements, racial, environmental and hemodynamic factors may also modify these variations. These anomalies may alter the occurrence, severity of symptoms, treatment options and recovery from certain cerebrovascular disorders viz., stroke and aneurysms. A detailed knowledge of the vascular variants is useful to surgeons in planning their shunt operations, choice of the patients and also keeps away inadvertent vascular traumas during surgeries.
Puthoor D.K.,Amala Institute of Medical science
Orthopaedic surgery | Year: 2012
A retrospective study was carried out in patients with giant cell tumor of bone to compare the functional and radiographic outcome of curettage and bone grafting using a novel CT based selection strategy to that of patients of a similar age treated with anatomic/standard curettage and bone grafting. Curettage and bone grafting after CT classification was performed in 31 patients and curettage and bone grafting without CT classification in 20. The surgical approach for curettage in the CT classified group of patients was through the site of the cortical break, irrespective of the standard approach to the particular region of bone involved. The aim of this approach was to achieve wide excision of the possibly involved soft tissue. At similar duration of follow up (72 months) in patients with a similar mean age (33 years), Musculoskeletal Tumor Society (MSTS) scores for CT classified patients were similar to those of patients who had undergone standard curettage. However, the postoperative recurrence rate in the CT classified group was significantly less (12.9%) than in the non-CT classified group. A CT based selection strategy is a valid preoperative tool for evaluation of giant cell tumor. Further, for curettage these lesions are better approached through the site of cortical break, irrespective of standard approaches, so that adequate soft tissue clearance can be achieved. © 2012 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.