Clinical profiles of patients with optic neuritis and papillitis: A prospective study

To analyse the demographics and presenting features of patients presenting with optic neuritis and papillitis. Clinical profiles of 40 patients presenting with optic neuritis and papillitis at a tertiary care center were collected retrospectively and prospectively. Detailed medical and ophthalmic history was taken especially about mode, duration and course of the disease, drug intake, alcoholism, smoking, pregnancy, lactation, convulsions, pyrexia, history suggestive of TB, syphilis, neurological deficit. A comprehensive ophthalmological and neurological evaluation was done for each patient along with radiological work up. Patients were prospectively followed up for an average of three months. Females in the reproductive age group constituted largest number of the patients (61.8%) in the present series. Maximum patients (70%) were between 20-50 years of age. Vision was found to be affected in all the patients at presentation and most of them presented with vision CF or HM (35.4% and 29.25% respectively) while 4 patients had complete loss of vision. Two third (66.7%) of patients reported eye pain at presentation. Abnormal pupillary reaction was found in most patients with the most common being RAPD on swinging flash light which was seen in 85.4%. Equal percentage (39.5%) of patients presented with Blurred Hyperemic (BH) disc and ophthalmoscopically normal appearing disc. Onset and progression of disease was found to be rapid in most cases ranging from few hours to days. Visual recovery post treatment was found to be good with most eyes achieving vision 6/24 or better. Optic neuritis has varied clinical presentations. Most of our patients were young to middle aged females. The most common presenting features were decrease in vision ranging from slight to profound, eye pain and abnormal pupillary reaction. Morphological abnormalities in appearance of optic disc were also found in two third of cases.Rapid progression was noted in almost all cases. Most of the cases achieved a good outcome at the end of follow up period.

CLINICAL PROFILES OF PATIENTS UNDERGOING PACEMAKER IMPLANTATION

Background and Objective: The implantation of a permanent cardiac pacemaker for the treatment of bradyarrhythmia is one of the most popular cardiac interventions. The goal of this study is to look at the clinical profiles of individuals who have permanent pacemakers implanted Material and Methods: The study was conducted using observational methods. The study included patients who received a permanent pacemaker for bradyarrhythmias between November 2019 and November 2021. A thorough review of the demographic profile and indications was performed. Results: The vast majority of the 312 patients were older, with the majority being between the ages of 56 and 88 years old (75 % ). Pacemakers were implanted in more men than in women. Complete heart block was the most common ECG finding and the most common presenting symptom was syncope. The most prevalent sign of pacing was acquired A-V block, and the most common pacemaker mode was single chamber (VVI/VVIR). Conclusion: Acquired A-V block and SSS were found to be the most common reasons for pacemaker implantation in our study. Higher implantation rates were linked to advanced age and male gender.

A study on socio-clinical profile and associated risk factors of stroke patients admitted to neurology department of SCB medical college, Cuttack, Odisha

Background: Non-communicable diseases (NCDs) are ragging reality of today’s world and have moved up the priority list of most countries worldwide including India. Objectives were to find out prevalence of different types of strokes among the patients admitted in neurology department of SCB medical college, to study socio-clinical profiles of admitted stroke patients and to find out associated risk factors with different types of strokes.Methods: Cross-sectional hospital-based study in neurology ward of SCB MCH, Cuttack, Odisha in 2019-20.Results: The mean age 60.93±12.8, males are more affected, 60-69 years were more affected, 76% were ischemic strokes, 85% cases weakness of limbs reported, hypertension, diabetes, alcoholism, smoking, dyslipidemia were major risk factors. Hypertension and smoking found to be highly significant in case of young stroke patients.Conclusions: Major modifiable risk factors were hypertension (63.3%) followed by alcohol intake 53.9%.

Speech characteristics of parkinson disease

Objective: Parkinson Disease (PD) is known the second most frequent neurodegenerative age-related disorder after Alzheimer’s disease. Although over the six million people worldwide suffer from PD, the main cause of the disease remains are unknown. Speech and language impairments have emerged in most patients with PD during the course of the disease. However, clinical profiles or characteristics that might differentiate individuals with PD who are predisposed to speech and language deficits are generally overlooked. Moreover, factors that expedite language disability have still been remained elusive. It is thought that the awareness of speech and language impairments in PD can significantly help to maintain language abilities as the disease progresses and also may contribute to improving communication skills with patients. For this reason, the present study aims to constitute a comprehensive frame for the speech and language characteristics of individuals with PD

Concussion Subtyping in Patients With Persistent Post-Concussive Symptoms Using a New Concussion Clinical Profile Screen Tool (CP Screen)

ObjectiveTo identify the prevalence of subtypes in Persistent Post Concussion Symptoms (PPCS) and investigate their potential relationships.BackgroundThe CP-Screen is designed to evaluate 5 clinical profiles and 2 modifiers that are predominant within concussion patients. The CP screen includes 29 items that are expressed as weighted outcome scores for each of the 7 concussion subtypes.Design/MethodsThis was a retrospective-chart review of 1,136 visits for 362 patients with PPCS at a concussion center. Age range was 12–81 and average age was 32, 65.7% were female and 34.3% male. 360 visits were in the 12–21 pediatric age range. Each patient completed an electronic CP-Screen prior to each visit, which was uploaded to the EHR. All patients were seen between October 2020 and April 2021.ResultsOverall, the most common subtypes were cognitive (34.0%), neck (17.8%), and mood (16.8%). The highest overall observed subtype average CP symptom score was mood (32.8/89) and the lowest was visual (23.6/89). For pediatric the most common phenotypes were cognitive (36.7%), mood (17.9%), and visual (15.4%). The highest observed pediatric average CP symptom score was mood (30.8/89) and the lowest was sleep (20.1/89). For those with cognitive primary profile, neck and ocular were the most common secondary and tertiary profiles in both groups. Females presented with cognitive, mood, neck as their most common profiles compared to cognitive, neck, ocular in males in both groups. Neck, mood, and visual primary profiles all presented with cognitive fatigue as their secondary profile.ConclusionsCP screen was overall a useful tool in helping identify clinical profiles in PPCS. Cognitive fatigue was a predominant profile in PPCS across all ages and sexes. Those with predominant mood profiles presented with the highest symptom scores. Mood profile was more predominant in females. Cognitive primary profile was found to be most linked to cervical, mood, and visual profiles.

Clinical profiles of Asians with NAFLD: A systematic review and meta-analysis

Introduction: NAFLD is increasingly prevalent in Asia, where people suffer more metabolic comorbidities at a lower body mass index (BMI), suggesting potential differences in their clinical profile. Therefore, we attempted to characterize the clinical profile of Asians with NAFLD via a meta-analytic approach. Methods: We searched Pubmed, EMBASE, and Cochrane databases from January 1, 2000 to January 17, 2019. Two authors independently reviewed and selected 104 articles (2,247,754 persons) that identified NAFLD in Asians and reported relevant data, especially BMI and ALT, and excluded individuals with other liver disease and excessive alcohol consumption. Individual patient-level data were obtained from seven cohorts in Asia to complement meta-analyzed data. Results: Overall, the mean age was 52.07 (95%CI:51.28-52.85) years with those from Southeast Asia (42.66, 95%CI: 32.23-53.11) being significantly younger. The mean BMI was 26.2 kg/m2, higher in moderate-severe vs. mild hepatic steatosis (28.3 vs. 25.7) patients and NFS ≥-1.455 vs. <-1.455 (27.09 vs. 26.02), with 34% having non-obese NAFLD. The mean ALT was 31.74 U/L, higher in NFS <-1.455 vs. ≥-1.455 (33.74 vs. 27.83), though no differences were found by obesity or steatosis severity. The majority of males (85.7%) and females (60.7%) had normal to minimally elevated ALT (1-1.5x 95% ULN). Individual patient-level data analysis (N=7,668) demonstrated similar results. Conclusion: About one-third of Asians with NAFLD were non-obese and the majority did not have markedly elevated ALT. Therefore, abnormal ALT or BMI are not recommended as a criterion for NAFLD screening in this population. Additionally, there were significant differences in the clinical profiles of NAFLD among the different regions of Asia.

Quality of Life and Clinical Correlates in Adults with Social Phobia: A Scoping Review

Objective: In light of the substantial clinical and societal burden of social phobia (SP) and impact on the sense of well-being of affected individuals, we sought to summarise extant data related to quality of life and relevant correlates in adults with SP to distill clinical profiles for earlier identification and appropriate management. Methods: A scoping review was carried out on studies examining quality of life in adults with SP and clinical correlates within different settings. PubMed/Medline and Web of Science databases were searched for relevant articles beginning from database inception until May 2021. Results: A total of 25 papers were included. Most of the studies (92%) were cross sectional in nature (80%), conducted in the West (92%), and within clinic or community settings (88%). Patients with comorbid psychiatric conditions, and undergraduate students reported higher rates of SP compared with community population. Significant correlates of SP included demographic (such as females, younger age, living alone, fewer years of education, unemployment) and clinical factors (such as family history of anxiety disorders, suicidal ideas, avoidant personality features). SP was widely associated with decreased QoL involving several domains and especially related to complexity, greater number of feared or trigger situations, and comorbid medical and psychiatric conditions. Conclusion: SP is not uncommon within clinical, and undergraduate populations, and has a significantly negative impact on quality of life. Awareness of its associated clinical profiles allows better identification and overall management of this condition including improvement in QoL.

Clinical Profiles in Acute Heart Failure

Background:Phenotypes could be more frequently related to outcomes than classical classifications of AHF. Our goal was to identify clinical profiles for acute heart failure (AHF) based on clinical variables at the time of the patient arrival to the Emergency Department (ED).Methods:Design: Prospective cohort study. Participants: Patients with symptoms of AHF were recruited at the EDs of seven Spanish National Health Service hospitals between April 2013 and December 2014. Main measures: Information on sociodemographic, baseline functional status, medical history, and time since diagnosis was collected when the patient arrived at the ED. In addition, the MLWHF questionnaire was administered at arrival and at 1 year after discharge from the ED. Change in MLWHF score and mortality, revisits and readmissions during this first year were considered as outcomes. We combined multiple correspondence analysis (MCA) and cluster analysis (CA) to create clinical profiles.Results:A total of 1599 subjects were included in the study. Patients were located on two axes: one was defined as duration of HF and the other as cardiovascular comorbidity. Cluster analysis identified three subtypes of patient (A, B, and C), group B being most frequently corresponding to a “de novo” case. Differences in outcome, including mortality, readmissions and changes in MLWHF score, were encountered between group B and the rest of the groups, results being similar in groups A and C.Conclusions:The clinical phenotypes found were associated with clinical and patient-reported outcomes. Such clinical phenotypes could be useful in decision making processes in ED settings.Clinical registration:ClinicalTrials.gov ID: NCT03512704