Background. Gouty arthritis is an inflammatory arthropathy caused by monosodium urate (MSU) crystal deposition and may be associated with renal calculi and metabolic comorbidities. Conventional diagnostic approaches, including synovial fluid aspiration and standard imaging, may be limited by invasiveness, accessibility, or reduced ability to detect urate deposits. Dual-energy computed tomography (DECT) is a non-invasive imaging technique that can identify MSU deposits and differentiate urate from calcium-containing structures. This study aimed to evaluate DECT findings in patients with clinically suspected gout and assess its role in characterizing renal calculi. Methodology. This hospital-based, cross-sectional observational study was conducted in the Department of Radiology, SDMCMSH, Dharwad, from August 2019 to January 2022. Forty male patients with clinical suspicion of gout were enrolled after institutional ethics committee approval and informed consent. DECT scans of the foot and abdomen were performed using a 128-slice Siemens Somatom Definition AS scanner. Patients were classified according to the presence of MSU crystal deposition and renal calculi. Data were analysed using descriptive statistics with SPSS version 20.0. Results. The mean age of the cohort was 47.5 years, and 75% of patients lived in urban areas. Sedentary occupation (82.5%) and mixed dietary habits (87.5%) predominated. First metatarsophalangeal joint involvement was the most common clinical finding (87.5%), followed by foot joints (62.5%) and ankle joints (47.5%). Comorbidities were identified in 32.5% of patients. DECT demonstrated MSU deposition in the first metatarsophalangeal joint (80%), other foot joints (70%), tendons (57.5%), and ankle region (30%). DECT also enabled characterization of renal calculi composition. Conclusion. DECT may provide a useful non-invasive method for detecting MSU crystal deposition and characterizing renal calculi in patients with clinically suspected gout. Larger studies using comparative reference standards are required to validate its routine clinical role.
Pituitary apoplexy (PA) is a neurosurgical emergency resulting from an acute haemorrhage or infarction within the pituitary adenoma. The classic clinical presentations of PA include acute headaches and visual disturbances. However, isolated oculomotor nerve palsy as the first sign of pituitary apoplexy is highly uncommon. We present three cases of acute-onset isolated oculomotor nerve palsy, which were later diagnosed as pituitary apoplexy. One patient presented with bilateral isolated oculomotor nerve palsy, while another had pupil-sparing oculomotor nerve palsy, which is more commonly associated with ischemia than compressive disorders. Our patients recovered completely following an early neurosurgical intervention. Two patients underwent transnasal-transsphenoidal surgery, and one had a transcranial procedure. After surgery, all patients recovered well. Therefore, PA should be included in the differential diagnosis of patients with isolated oculomotor nerve palsy.
Background: Reaction time (RT) is a simple yet sensitive measure of sensorimotor and cognitive processing. As life expectancy increases, understanding age-related changes in RT is essential to assess the functional implications of aging on everyday tasks requiring attention and prompt responses. Objective: The objective of this study was to evaluate and compare simple and choice auditory and visual RTs across different age groups and genders in healthy individuals aged 21–60 years. Materials and Methods: This cross-sectional study included 120 healthy volunteers (60 males, 60 females), divided equally into four decadal age groups. RTs were measured using a digital RT apparatus (RTM-608) for simple and choice tasks using visual (red, green, yellow lights) and auditory (high, medium, low frequencies) stimuli. Statistical analysis was done using ANOVA, post hoc Tukey’s test, correlation, and regression analyses. Results: All RT measures significantly increased with age (P < 0.0001). Choice RTs began to decline earlier (from 31 to 40 years), whereas simple RTs declined more markedly after 40 years. Strong correlations with age were observed (r = 0.991 for simple RT, r = 0.965 for choice RT). Conclusion: RT slows progressively with age, with cognitive components showing earlier decline. These findings highlight the importance of early cognitive monitoring in aging populations.
Background: As a chronic illness, type 2 diabetes necessitates regular self-care. In this context, the social assistance provided is crucial. Aim and Objective: To evaluate the levels of social support in type 2 Diabetes Mellitus (T2DM) patients and to identify the influence of social support on treatment adherence and self-care activities. Methodology: A cross-sectional study was conducted among 400 T2DM patients in the medical college's field practice areas. Data regarding the sociodemographic details, clinical and treatment history, social support level (Social Support Rating Scale), and management of self-care activities (Summary of Diabetes Self-care activities) were collected. Compiled data was analyzed using IBM SPSS software. Data was interpreted as frequencies, percentages, and means. Association was tested using the Chi-square test and Spearman’s correlation. A p-value less than 0.05 was deemed significant. Results: There were 53% females and 47% males. Most participants (83.25%) had a moderate level of social support. Medication adherence and blood glucose monitoring were the most practiced self-care practices. Support level was significantly associated with activities of self-care (proper dietary practice, regular physical activity, and foot hygiene). Conclusion: More than two-thirds of the patients had a moderate to high social support level, which significantly correlated with self-care activities.
Introduction: Emphysematous Pyelonephritis (EPN) is a rare, life-threatening infection of the renal parenchyma characterised by gas formation within the kidney and surrounding tissues. When not promptly diagnosed and treated, this condition presents with a mortality rate ranging from 20% to 80%. Aim: This study aimed to evaluate the outcomes of different surgical interventions in managing EPN, focusing on minimally invasive interventions {Double J Stent (DJS), Percutaneous Nephrostomy (PCN), Percutaneous Drainage (PCD)} and nephrectomy. Materials and Methods: A retrospective cohort study was conducted at SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India, examining 80 cases of EPN over a 54-month period from January 2017 to June 2023. Data were collected from hospital records, including clinical notes, laboratory results, imaging studies, and surgical reports. The study assessed demographics, clinical presentation, laboratory investigations, imaging studies, treatment details, and patient outcomes. Descriptive statistics were used for demographic and clinical characteristics and Chi-square test was applied for categorical variables. A p-value of <0.05 was considered statistically significant. Results: The study included 80 patients with a gender distribution of 48.8% female and 51.2% male, with a mean age of 57.9±12.2 years. Flank pain (91.3%), fever (86.3%), and dysuria (36.3%) were the predominant clinical manifestations. Laboratory evaluation revealed significant findings, including anaemia (52.5%), renal dysfunction (56.3%), and sepsis (61.3%). Escherichia coli were the primary causative organism, identified in 34 patients (42.5%). Class 2 EPN was the most prevalent classification, occurring in 25 patients (31.3%). Hypotension (p-value=0.015), elevated Glycated haemoglobi (HbA1c) levels (p-value=0.018), and the need for dialysis (p-value=0.008) were significantly associated with mortality. Minimally invasive interventions were predominantly successful, with various drainage procedures employed: unilateral DJS (48.8%), bilateral DJS (27.5%), PCN (3.8%), and PCD (18.8%). Nephrectomy was required in only 5% of cases. Conclusion: This study supports the efficacy of minimally invasive intervention approaches for EPN, thereby reducing the necessity for nephrectomy. Prognostic indicators, including hypotension, elevated HbA1c, and the requirement for dialysis, warrant careful monitoring. Minimally invasive interventions, coupled with targeted antibiotic therapy, are validated as a preferred treatment for EPN.
