Recurrent Diabetic Ketoacidosis and Extreme Insulin Resistance Due to Anti-Insulin Antibodies: Response to Immunosuppression and Plasma Exchange.

Anti-insulin antibodies (IAs) in patients with insulin-treated diabetes, though common, correlate poorly with glycemic control, insulin requirement, and insulin resistance. We are hereby reporting the clinical course and challenges in the management of a 70-year-old man who had severe insulin resistance as evidenced by recurrent diabetic ketoacidosis and poor glycemic control despite treatment with >9 U of insulin/kg body weight per day. He was found to have anti-IAs and responded clinically to plasmapheresis and immunosuppression with mycophenolate mofetil and prednisolone.

Experience with Splenic Abscess from Southern India.

Introduction: Splenic abscess is a rare entity with potentially life threatening complications. Sparse recent published data are available documenting the aetiological profile and management of patients with splenic abscess from India.

Aim: To study the clinical profile of splenic abscess.

Association of serum interleukin-6, interleukin-8, and Acute Physiology and Chronic Health Evaluation II score with clinical outcome in patients with acute respiratory distress syndrome.

Background And Aim: Studies on potential biomarkers in experimental models of acute lung injury (ALI) and clinical samples from patients with ALI have provided evidence to the pathophysiology of the mechanisms of lung injury and predictor of clinical outcome. Because of the high mortality and substantial variability in outcomes in patients with acute respiratory distress syndrome (ARDS), identification of biomarkers such as cytokines is important to determine prognosis and guide clinical decision-making.

Materials And Methods: In this study, we have included thirty patients admitted to Intensive Care Unit diagnosed with ARDS, and serum samples were collected on day 1 and 7 and were analyzed for serum interleukin-6 (IL-6) and IL-8 by ELISA method, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring was done on day 1.

Ghosal hematodiaphyseal dysplasia-a concise review including an illustrative patient.

Ghosal hematodiaphyseal dysplasia is a rare autosomal recessive disorder characterized by metadiaphyseal dysplasia of long bones and defective hematopoiesis due to fibrosis or sclerosis of bone marrow. Approximately 15 cases of this entity have been reported in the literature so far. The diagnosis of this rare syndrome and its differentiation from other sclerosing bone disorders is important as correct diagnosis helps in treatment with corticosteroids, leading to considerable improvement in anemia and bony changes, negating the need for blood transfusions.