Browsing by Author "Kohli, S."

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    Acute respiratory distress syndrome in Plasmodium vivax malaria. A case-control study of comparison between ARDS and non-ARDS patients in P. Vivax malaria
    (Medip Academy, 2023-08) Jain, V.; Bajaj, K.; Neelamegam, S.; Singh, D.; Chandra, K.; Kashyap, V.; Khan, M. A.; Alam, S.; Kohli, S.
    Background: Plasmodium vivax was conventionally considered to be a benign parasite for centuries but in the recent years have proved to be a virulent parasite causing severe malaria. Acute respiratory distress syndrome (ARDS) is one of such severe complications with a significant morbidity and mortality. The objective of this study was to find the prevalence of ARDS and identify the associated factors that could potentially lead to ARDS in patients with vivax malaria. Methods: A retrospective case-control study was conducted at a tertiary hospital in New Delhi. 329 patients with an established diagnosis of Plasmodium vivax mono-infection were identified using hospital medical records, the associated factors were evaluated and compared to calculate the odds of developing ARDS. All patients were categorized into ARDS cases and non-ARDS controls. Results: The incidence of ARDS was 7% with a female sex predominance (60.86%). Mean urea (71.5 mg/dl), creatinine (2.7 mg/dl), and AST (97.8 units/l) elevation in addition to decreased hemoglobin (7.7 gm/dl) and platelets count (38,217 cells/µl) proved to be significantly associated with ARDS in our study. Conclusions: Plasmodium vivax is a virulent parasite and can cause severe malaria even in the setting of isolated infection. Cytokine mediated diffuse inflammatory response is a postulated pathophysiology causing ARDS.
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    Conversance and attitude of budding clinicians toward antimicrobial use – A pressing priority
    (?Eldaghayes Publisher, 2024-10) Sharma, A; Singh, MK; Mittal, G; Kohli, S.
    Background: The progress in creating novel antibiotics has been lethargic in recent decennium, in spite of the pressing demand. Those on the brink of entering the medical field – final-year undergraduates, interns, and postgraduate residents – represent the forthcoming cohort of antimicrobial prescribers. It is imperative that they possess a comprehensive understanding and a conscientious approach to antibiotic prescription. This is crucial to address antibiotic resistance sagaciously and pave the way for judicious management. Aims and Objectives: The aims and objectives of the study are to assess understanding and attitudes about antibiotics, resistance, and related factors among undergraduate, intern, and postgraduate medical students. Materials and Methods: A group of 144 individuals (35 final-year medical students, 72 interns, and 37 resident doctors) completed a pre-validated questionnaire. Data collected included basic antimicrobial information, treatment protocol comprehension, and attitudes toward antimicrobials. Percentages were calculated for categorical data, and Chi-square tests were used for statistical analysis (significance level P < 0.05). Results: 86.8% correctly identified infections requiring antibiotics; 12.5% mistakenly thought that both viral and bacterial infections needed antibiotics. 93.8% said that antibiotics could be used for treatment and prophylaxis. 94.4% agreed that overuse and misuse cause antibiotic resistance. 31.3% and 62.5% identified macrolides and fluoroquinolones as common for upper respiratory infections and urinary tract infections, respectively, with a P < 0.05. 71.52% knew about infection control programs, and 48.6% were aware of their institute’s antibiotic policy. Conclusion: Despite strong foundational knowledge about antibiotics, gaps remain. The study’s findings could help set new goals for teaching medical students proper antibiotic knowledge and attitudes toward antibiotic recommendation.
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    Partial empty Sella syndrome in women-the significance of obstetric and lactational history
    (Medip Academy, 2023-06) Agrohi, J.; Kohli, S.; G. K., A.; Sehdev, R.; Agrohi, D.
    Empty Sella syndrome is an uncommon condition characterized by the shrinking or flattening of the pituitary gland, resulting in the filling of the Sella turcica with cerebrospinal fluid rather than the normal pituitary gland. In this report, we present a case of undiagnosed partial empty Sella syndrome, which was found to be caused by pituitary hypophysitis with an idiopathic etiology. The patient, a middle-aged individual, presented atypically with acute adrenal insufficiency induced by a lower respiratory tract infection. The diagnosis was made following an investigative work-up that took into consideration the presence of hypotension, electrolyte imbalances, and a history of two post-partum lactational failures. Hormonal supplements were used to manage the patient conservatively, and no significant complications were observed.
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    Partial empty Sella syndrome in women-the significance of obstetric and lactational history
    (Medip Academy, 2023-06) Agrohi, J.; Kohli, S.; G. K., A.; Sehdev, R.; Agrohi, D.
    Empty Sella syndrome is an uncommon condition characterized by the shrinking or flattening of the pituitary gland, resulting in the filling of the Sella turcica with cerebrospinal fluid rather than the normal pituitary gland. In this report, we present a case of undiagnosed partial empty Sella syndrome, which was found to be caused by pituitary hypophysitis with an idiopathic etiology. The patient, a middle-aged individual, presented atypically with acute adrenal insufficiency induced by a lower respiratory tract infection. The diagnosis was made following an investigative work-up that took into consideration the presence of hypotension, electrolyte imbalances, and a history of two post-partum lactational failures. Hormonal supplements were used to manage the patient conservatively, and no significant complications were observed.
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    Protracted tuberculous empyema necessitans following intercostal drainage tube insertion
    (Medip Academy, 2023-07) Kohli, S.; Agrohi, J.; G. K., A.; Agrohi, D.
    Empyema necessitans (EN) is a rare long-term sequela of poorly or untreated empyema thoracis, characterized by the dissection of pus through the soft tissues and skin of the chest wall, ultimately forming a fistula between skin and pleural cavity. We herein present a male patient in his late 30s, a known case of tuberculosis (TB) on anti-tubercular therapy (ATT) under directly observed treatment short-course (DOTS), who recently came with complaints of backache for 3 days. Chest X-ray showed a massive pleural effusion, in view of which an intercostal drainage tube (ICD) was inserted and 1.5 L of pleural fluid was drained. An ultrasound (USG) back done revealed subcutaneous collection with communication to pleural space, which resolved after pleural fluid drainage. As there was a persistent communication between pleural space and right-sided subcutaneous plane with a massive effusion i.e., EN, he was advised to undergo thoracotomy with decortication and resection of communication which he underwent successfully. This case is presented for its rarity with atypical presentation.