Clinical predictors of warfarin-associated bleeding: A case-control study.

Despite the advent of directly acting oral anticoagulants, warfarin is still widely used in resource-poor settings. Bleeding as a result of warfarin overdosage is common and risk factors seem to vary between patient populations. Predictors of bleeding in patients using warfarin were studied using a case-control design.

Pyuria in hospitalized general medical patients without urinary tract infection.

Urine microscopy for detecting pus cells is a common investigation ordered in hospitalized general medical patients as part of routine care. A few previous studies have shown that sterile pyuria is not uncommon in this population. We studied the prevalence of pyuria among patients hospitalized with non-urinary tract infection (UTI) diagnosis in the medical wards.

Validating a linear regression equation using mid-upper arm circumference to predict body mass index.

Background: Estimating body mass index (BMI) in hospitalised patients for nutritional assessment is challenging when measurement of weight and height is not feasible. The study aimed to validate a previously published regression equation to predict BMI using mid-upper arm circumference (MUAC). We also evaluated the proposed global MUAC cut-off of ≤24 cm to detect undernutrition.

Impact of nutrition status and body mass index on mortality in hospitalized general medical patients: A prospective observational study.

Background: Malnutrition and low body mass index (BMI) are risk factors for mortality in hospitalized patients. Data substantiating this are unavailable for hospitalized general medical patients in our setting. We studied the prevalence of malnutrition among patients admitted to general medical wards in a tertiary care hospital and its role as a risk factor for 1-month mortality.

An outbreak of Salmonella Enteritidis food poisoning following consumption of chicken shawarma: A brief epidemiological investigation.

Background: Shawarma, a popular meat-based fast food could be a source of foodborne outbreak due to non-typhoidal (NTS). A clustering of acute gastrointestinal (GI) illness following intake of chicken shawarma occurred primarily among the staff and students of a tertiary care hospital in southern India.

Methods: A case-control study was conducted among 348 undergraduate medical students (33 cases, 315 controls).

Urine microscopy and neutrophil-lymphocyte ratio are early predictors of acute kidney injury in patients with urinary tract infection.

Objective: Urinary tract infection (UTI) is a common cause of morbidity and hospitalisation in the population worldwide. Upper UTI is indolent and causes subclinical acute kidney injury (AKI) resulting in preventable cause of scarring of renal parenchyma. We explored urinary and serum levels of kidney injury molecule-1 (KIM-1), haematological parameters and quantitative urine microscopy parameters to predict kidney injury.

Asymptomatic bacteriuria among medical inpatients: Data from an Indian teaching hospital.

Studies indicate that asymptomatic bacteriuria in medical inpatients is often inappropriately treated with antibiotics. We prospectively studied the proportion of asymptomatic bacteriuria among 200 positive urine cultures which were ordered in hospitalised medical inpatients of a teaching hospital in southern India. We used pre-defined criteria to classify patients as urinary tract infection and asymptomatic bacteriuria.

Association of genetic polymorphisms in vitamin D receptor (, and ) with vitamin D and glycemic status in type 2 diabetes patients from Southern India.

Objectives: To evaluate the association of polymorphisms (, and ) with vitamin D levels and glycemic status in type 2 diabetes patients from Southern India.

Methods: In this observational study, genotype frequencies and vitamin D levels of 200 cases (type 2 diabetes patients) were compared with 300 controls (unrelated anonymised stored samples of healthy volunteers) from south India. Serum 25 (OH) D levels were measured by immunoassay technique, glycated hemoglobin (HbA) was measured using HPLC and genotyping of VDR polymorphisms were carried out using Real time Polymerase Chain Reaction (RT PCR).

Association of genetic polymorphisms in vitamin D receptor (, and ) with vitamin D and glycemic status in type 2 diabetes patients from Southern India.

Objectives: To evaluate the association of polymorphisms (, and ) with vitamin D levels and glycemic status in type 2 diabetes patients from Southern India.

Methods: In this observational study, genotype frequencies and vitamin D levels of 200 cases (type 2 diabetes patients) were compared with 300 controls (unrelated anonymised stored samples of healthy volunteers) from south India. Serum 25 (OH) D levels were measured by immunoassay technique, glycated hemoglobin (HbA) was measured using HPLC and genotyping of VDR polymorphisms were carried out using Real time Polymerase Chain Reaction (RT PCR).

Factors Associated With Normal Flow (TIMI 3) After Thrombolysis With Streptokinase in ST-Elevation Myocardial Infarction: A Prospective Observational Study.

Background Thrombolysis with streptokinase (STK) is the most widely used reperfusion strategy for ST elevation myocardial infarction (STEMI) in India. Achieving full reperfusion as evidenced by thrombolysis in myocardial infarction (TIMI) flow grade 3 in coronary angiography (CAG) is associated with better outcomes. Recent studies show that hematological indices like neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) estimated before thrombolysis could predict TIMI 3 flow.

Point-of-care infrared thermal imaging for differentiating venomous snakebites from non-venomous and dry bites.

Background: Local envenomation following snakebites is accompanied by thermal changes, which could be visualized using infrared imaging. We explored whether infrared thermal imaging could be used to differentiate venomous snakebites from non-venomous and dry bites.

Methods: We prospectively enrolled adult patients with a history of snakebite in the past 24 hours presenting to the emergency of a teaching hospital in southern India.

Reevaluating the true diagnostic accuracy of dipstick tests to diagnose urinary tract infection using Bayesian latent class analysis.

Objective: Previous studies on diagnostic accuracy of dipstick testing for leukocyte esterase (LE) and nitrite to diagnose urinary tract infection (UTI) had used urine culture, which is an imperfect gold standard. Estimates of diagnostic accuracy obtained using the classical gold standard framework might not reflect the true diagnostic accuracy of dipstick tests.

Methods: We used the dataset from a prospective, observational study conducted in the emergency department of a teaching hospital in southern India.

Acute kidney injury in patients hospitalized with febrile urinary tract infections: A prospective observational study.

Background: Febrile urinary tract infection (fUTI) can be associated with acute kidney injury (AKI). We aimed to study the risk factors for AKI, its pathophysiological categories, and the role of urinary neutrophil gelatinase-associated lipocalin (uNGAL) in differentiating these categories in patients hospitalized with fUTI.

Materials And Methods: We prospectively studied patients with fUTI admitted to the Department of Medicine of a tertiary care hospital in southern India from January 2017 to December 2018.

Frequency and clinical significance of prostatic involvement in men with febrile urinary tract infection: a prospective observational study.

: Frequent asymptomatic involvement of the prostate has been demonstrated in men with febrile urinary tract infection (fUTI). In view of this, men with fUTI are often given a longer duration of antibiotic treatment; however, evidence to support this is limited. : We prospectively studied adult men with fUTI admitted under the Department of Medicine in a tertiary care hospital in southern India.

Impact of Therapeutic Drug Monitoring on Once-Daily Regimen of Amikacin in Patients With Urinary Tract Infection: A Prospective Observational Study.

Background: Amikacin is a semisynthetic antibiotic used in the treatment of gram-negative bacterial infections and has a narrow therapeutic index. Although therapeutic drug monitoring is recommended for amikacin, it is not routinely performed because of the use of a less toxic once-daily regimen. Only few studies have evaluated the role of therapeutic drug monitoring in patients treated with amikacin.

Primary Sjogren's syndrome: a great masquerader.

A 41-year-old woman presented with paresthesia and inability to walk for 7 days. She had history of fatigue, polyarthralgia and difficulty in swallowing food for the last 1 year. She became edentulous over the last 5 years and wore dentures for the same.

In vitro effect of fosfomycin on multi-drug resistant gram-negative bacteria causing urinary tract infections.

Background: Rising rates of resistance to antimicrobial drugs among limit the choice of therapeutic agents to treat urinary tract infections. In this context we assessed the in-vitro effect of fosfomycin against extended-spectrum beta-lactamases, AmpC beta-lactamases and carbapenemase-producing strains of spp, and isolated from the patients with urinary tract infection (UTI) and also studied the effect of fosfomycin on their biofilm formation.

Materials And Methods: A total of 326 multidrug-resistant (MDR) isolates comprising of spp, and from the urine samples of the patients with a diagnosis of UTI were included in the study.

Spontaneous intracranial hypotension associated with pachymeningeal enhancement in a patient with systemic lupus erythematosus (SLE): an extremely rare presenting feature.

A 16-years-old girl presented to our institution with history of severe bilateral headache for 5 days associated with vomiting. She also had fever for 2 months without any localising symptoms and skin lesions for 1 month. Examination revealed erythematous rash over bridge of nose and ear lobes, ulcer over hard palate and tenderness of small joints of both hands.

Prevalence and risk factors of gastro-esophageal reflux disease among undergraduate medical students from a southern Indian medical school: a cross-sectional study.

Objective: Gastro-esophageal reflux disease (GERD) affects all age groups, and various lifestyle as well as psychological factors are recognized as risk factors for GERD. Undergraduate medical students are exposed to lifestyle changes and psychological stressors. We aimed to study the prevalence of GERD among undergraduate students of a medical school in southern India in a cross-sectional survey using a validated symptom score.

Stopping the effective non-fluoroquinolone antibiotics at day 7 vs continuing until day 14 in adults with acute pyelonephritis requiring hospitalization: A randomized non-inferiority trial.

Objective: To evaluate whether stopping the effective antibiotic treatment following clinical improvement at Day 7 (Truncated treatment) would be non-inferior to continued treatment until Day 14 (Continued treatment) in patients with acute pyelonephritis (APN) requiring hospitalization treated with non-fluoroquinolone (non-FQ) antibiotics.

Methods: Hospitalized adult men and non-pregnant women with culture-confirmed APN were eligible for participation after they had clinically improved following empirical or culture-guided treatment with intravenous non-FQ antibiotic(s). We excluded patients with severe sepsis, abscesses, prostatitis, recurrent or catheter-associated urinary tract infection, or urinary tract obstruction.

Angioedema as the presenting feature of systemic lupus erythematosus.

A young female in her early 20s presented with low-grade fever for 1 month, puffiness of face and abdominal distension for 15 days. Evaluation revealed pancytopenia with normocellular marrow, hypocomplementaemia and Coomb's positive haemolytic anaemia. She had angioedema with laryngospasm and worsening facial oedema which had dramatic response to steroids.

Primary Intestinal Lymphangiectasia (Waldmann's Disease) Presenting with Chylous Effusions in a 15-Year-Old.

Primary Intestinal Lymphangiectasia (PIL) is a rare disease of unknown aetiology which presents in the paediatric age group with anasarca, diarrhoea, hypoproteinaemia, lymphoedema and chylous effusions. Tuberculosis, filariasis, chest trauma, malignancies and haematological disorders usually contribute to most cases of secondary lymphangiectasia and chylous effusions. We hereby describe a case of PIL presenting with chylous effusions which remained undiagnosed for eight years.