A 38-year-old male was diagnosed with aortoiliac aneurysm while evaluating for new-onset hypertension. On further workup, the cause was identified as tubercular aortoiliac aneurysm. His aneurysm had ...stormy course and disseminated further while ongoing antitubercular therapy with multiple episodes of aneurysmal rupture and endovascular interventions. Management of this case was complicated with several other rarer entities, such as haemophagocytosis and thrombotic microangiopathy with disseminated intravascular coagulation resistant to steroids and plasmapheresis, within a span of few weeks. Moreover, first-line antitubercular therapy had to be regularly modified in view of emerging complications. While case reports for each individual entity exists in literature, this is the first case to the best of our knowledge where such varied complications were present in a patient of tubercular mycotic aneurysm.
Background: Hematological and neurological symptoms can be signs of B12 inadequacy. This work was intended to evaluate the severity of B12 deficiency and link it to peripheral neuropathy (PN) and ...anaemia in type 2 diabetes mellitus (T2DM) adults who were using metformin. Methods: To assess PN, the Michigan Neuropathy Screening Instrument (MNSI) directed a hospital-based cross-sectional investigation of 245 adults with T2DM who were taking metformin. 155 subjects who fulfilled the insertion and rejection criteria provided fasting blood samples for measurement of vitamin B12, haemoglobin, HbA1c, and cell morphology using chemiluminescent enzyme immunoassay (C.L.I.A), high performance liquid chromatography (HPLC), and C.B.C respectively. Results: Among adults with T2DM taking metformin, B12 deficiency (B12< 200pg/ml) was prevalent in 52% cases. O.R of vegetarian diet and B12 insufficiency was 2.33 (C.I. 1.22-4.47) (p < 0.05). Despite the fact that there were no cases of macrocytic anaemia, 40% of people had anaemia, which was not related to a B12 deficiency. According to ROC analysis, serum B12 has emerged as a fair test to predict PN scores of 2.25 (p < 0.001). 38% of people had PN (PN score ≥ 2.5) Conclusions: The usage of metformin was linked to biochemical B12 insufficiency. B12 deficiency was likely to result in PN scores ≥ 2.5 on the MNSI. In T2DM individuals using metformin, serum B12 screening and the use of MNSI for PN are suggested.
Background: Human immunodeficiency virus (HIV) infects cells of the immune system, leading to a compromised and depleted immune system. Progressive failure of the immune system predisposes an ...individual to many life-threatening opportunistic infections and malignancies. As compared to the general population, the incidence of anal squamous cell carcinoma (ASCC) is substantially higher in HIV-infected individuals. Majority of ASCC are related to infections caused by high-risk strains of human papillomavirus (HPV).
Aims: We conducted an observational study on HIV-positive men who had a history of homosexual contact. The aim of this study was to assess the spectrum of cytological abnormalities on anal smear cytology in individuals with HIV infection, and also estimate the prevalence of anal infection with high-risk HPV strains.
Materials and Methods: We enrolled 56 individuals for this pilot study. This study involved the collection of specimens from the anal canal of the patients by using cytobrush in liquid-based cytology (LBC) vial. The sample was simultaneously tested for cytological abnormalities by LBC (Sure Path, BD) and for 13 high-risk strains by Hybrid Capture II technique (Qiagen) based on antibody capture and chemiluminescent signal detection. Anal smear cytology was reported as per guidelines of The Bethesda System of reporting anal cytology, 2014.
Results: The prevalence of high-risk HPV infection was seen in 41.07% of individuals and low-grade squamous intraepithelial lesion and atypical squamous cells of undetermined significance were seen in 12.5% and 16.07% individuals, respectively. Cytology was useful in 7% of cases to diagnose opportunistic infections. The latter is a field yet to be tapped.
Conclusion: We would recommend LBC in HIV-positive patients, for screening of cytological abnormalities and HPV status. This would also give an opportunity to screen for opportunistic infections, which have otherwise not been diagnosed.
COVID-19 in pregnancy: A review Tripathi, Shikhar; Gogia, Atul; Kakar, Atul
Journal of family medicine and primary care,
09/2020, Letnik:
9, Številka:
9
Journal Article
Recenzirano
Odprti dostop
COVID-19 has led on to a global healthcare crisis, similar to none in the recent past. Special emphasis must be laid on the status of pregnant women amid this outbreak, considering the vulnerability ...seen in pregnant women toward previous coronavirus diseases. In this review, we will try to elicit the correlation between the complications of previous coronavirus diseases (Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome) and COVID-19, the possibility of materno-fetal vertical transmission and the obstetric management protocol.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
We report a patient with COVID-19 infection presenting with acute pancreatitis. The diagnosis of pancreatitis was based on laboratory as well as radiological evidence, and all the usual etiologies ...were ruled out. The temporal association with COVID-19 is strongly suggestive of novel coronavirus induced pancreatic injury.
Background: *Soluble urokinase-type plasminogen activator receptor (suPAR) is a new biomarker, which is increased in conditions associated with inflammatory immune cell activation. In low resource, ...densely populated countries, there is a need for a quick test for triage and prognosticating in the emergency department. Materials and Methods: *A pilot, observational study was conducted wherein all consenting adult patients (>18 years) presented to casualty with acute medical illnesses were included. Detailed clinical history, examination, and suPAR quick tests were done and patients were categorized into five groups based on the emergency severity index (ESI) triage algorithm. Patients with suPAR level more than 5.5 ng/mL were advised hospitalization and those below were advised follow-up. All patients were followed-up after 3 days. Results: Total 190 patients (20-80 years), 80 males and 110 females participated. ESI triage 1, 2, and 3 had suPAR levels > 5.5 ng/mL and ESI triage 4 and 5 had suPAR level of <5.5 ng/mL. In ESI-1, 29 patients were admitted in ICU and 16 left against medical advice (LAMA) and on follow-up mortality was 96% (P = <0.05). In ESI-2, all patients were admitted in high dependency units and on follow-up they still needed hospitalization. In ESI-3, 22 patients admitted in ward and 24 went LAMA, on follow-up all improved except LAMA patients who required hospitalization (P - <0.05). Patients in ESI-4 and 5 did not require admission (P = <0.001).Conclusion: *suPAR can reliably be used in the emergency department to prognosticate and triage.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Telemedicine: An evolving practice in India Kakar, Udit; Tripathi, Shikhar; Gogia, Atul ...
Current medicine research and practice,
01/2021, Letnik:
11, Številka:
1
Journal Article
We report a case of a 68-year-old female who was a known case of diabetes mellitus and chronic liver disease and presented with complaints of dry cough and other constitutional symptoms since one ...month. During initial investigations, the patient was found to have peripheral blood eosinophilia. Upon investigating further,the patient was found to have mediastinal lymphadenopathy and fine-needle aspiration of mediastinal lymph nodes showed features of tuberculosis. The patient was started on anti-tubercular treatment and her eosinophil counts returned to normal levels. Correlation between eosinophilia and tuberculosis has not been established in classical literature. This case highlights the same association and raises awareness on this crucial finding. Coexistence of eosinophilia and tuberculosis in our patient is suggested since peripheral blood eosinophilia improved with anti-tubercular treatment. The exact pathogenesis of coexistence of tuberculosis and peripheral blood eosinophilia yet remains to be deciphered, but tissue pathology is mainly associated with the discharge of toxic eosinophil products.
PDF
