Acute parkinsonism in a patient with myxedema crisis: A case report.

Both myxedema crisis and Sheehan's syndrome are uncommon conditions. The first-time presentation as myxedema crisis is rare in Sheehan's syndrome. The present study describes the case of a 31-year-old female patient who presented with altered sensorium in the emergency room.

Clinical Spectrum of Patients Admitted with Hymenoptera (Bees and Wasps) Stings in a Medical College Hospital of Himachal Pradesh, India.

: Hymenoptera (bees and wasps) stings are a common health hazard in the tropics, particularly in rural areas. The study was planned to describe the clinical spectrum of patients with Hymenoptera (bees and wasps) stings admitted to a medical college hospital in Himachal Pradesh, India. : This was a hospital-based open cohort prospective study conducted on patients admitted with a history of Hymenoptera (bees and wasps) stings.

Spectrum, Outcomes, and Mortality Predictors of Acute Kidney Injury among Non-COVID-19 Patients during COVID-19 Pandemic: Data from Four Intensive Care Units.

Introduction: The data of acute kidney injury (AKI), that is, community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI) among non-COVID patients from intensive care units (ICU) during the coronavirus disease-2019 (COVID-19) pandemic are scarce. We planned to study the change in the profile of such patients compared to the pre-pandemic era.

Materials And Methods: This prospective observational study was conducted at four ICUs dealing with non-COVID patients at a government hospital in North India, and was aimed at assessing outcomes, and mortality predictors of AKI among non-COVID patients during the COVID-19 pandemic.

A randomized trial of once daily versus twice daily dosing of oral iron in CKD.

We investigated the effect of two dosing regimens of oral iron on iron status and hematological parameters in patients with CKD. In this single center, open label, randomized, active controlled clinical trial, stable adult patients with CKD stage G3-4 with percentage transferrin saturation (%TSAT) ≤ 30% and serum ferritin ≤ 500 ng/ml were eligible. Participants were randomized to receive either 100 mg of ferrous ascorbate once daily (OD group) or 100 mg of ferrous ascorbate twice daily (BD group, total daily dose 200 mg).

Hyperviscosity syndrome complicating immunoglobulin G myeloma-Cognisance of early plasmapheresis is crucial.

Hyperviscosity syndrome (HVS) is an infrequent but life-threatening complication of multiple myeloma (MM) and classically presents with the triad of mucosal bleed, neurological, and visual disturbances. HVS is typically associated with immunoglobulin M (IgM) MM and very rarely may complicate immunoglobulin G (IgG) MM. Even suspicion of HVS necessitates therapy based on clinical severity rather than the calculated degree of viscosity.

Recurrent haematospermia: an unusual presentation of autosomal dominant polycystic kidney disease.

Haematospermia, even though alarming, is usually benign and self-limiting, especially in a sexually active male. Nevertheless recurrent, refractory or painful haematospermia is troublesome and warrants thorough evaluation. In this context, we describe a rare case of recurrent haematospermia whereby evaluation revealed haemorrhage in seminal vesicle cysts and consequently established the aetiology of autosomal dominant polycystic kidney disease.

The application of six-minute walk test to identify 'pre-hypoxemia' phase in asymptomatic/mild disease COVID-19 patients managed in home isolation or primary health care setting.

The clinical spectrum of COVID-19 infection patients extends from being asymptomatic to mild, moderate and severe disease. This classification is largely based on oxygen saturation and respiratory rate. Asymptomatic/mild disease patients are managed in home isolation or COVID care centers.

The Indian Chronic Kidney Disease (ICKD) study: baseline characteristics.

Background: Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. There is a lack of information on epidemiology and progression of CKD in low-middle income countries. The Indian Chronic Kidney Disease (ICKD) study aims to identify factors that associate with CKD progression, and development of kidney failure and cardiovascular disease (CVD) in Indian patients with CKD.

Plasma cell rich acute rejection: Risk factors, treatment and outcomes.

Plasma cell-rich rejection is a rare and poorly defined entity. Its treatment is not clearly defined and has universally poor prognosis. More data should be published from various transplant centers around the world to identify the treatment that has the best outcomes and to formulate treatment guidelines for these cases.

Quality of Life and its Determinants in Patients with Diabetes Mellitus from Two Health Institutions of Sub-himalayan Region of India.

Background: Diabetes mellitus (DM) causes serious deterioration in general quality of life (QoL) mainly affecting the health-related quality of life (HRQOL). Routine assessment of QoL improves communication with the patient, helps to predict treatment response, and supports clinical decision-making. QoL can predict an individual's capacity to manage the disease and maintain long-term health and wellbeing.

A randomized open-label trial to evaluate the efficacy and safety of triple therapy with aspirin, atorvastatin, and nicorandil in hospitalised patients with SARS Cov-2 infection: A structured summary of a study protocol for a randomized controlled trial.

Objectives: The pathophysiology of SARS-Cov-2 is characterized by inflammation, immune dysregulation, coagulopathy, and endothelial dysfunction. No single therapeutic agent can target all these pathophysiologic substrates. Moreover, the current therapies are not fully effective in reducing mortality in moderate and severe disease.

Pneumoperitoneum needle vs. introducer needle: Comparison of complications and short-term outcomes in percutaneously inserted peritoneal dialysis catheters in naïve abdomens.

Percutaneous peritoneal dialysis catheter (PDC) insertion for continuous ambulatory peritoneal dialysis (CAPD) entails a higher risk of complications such as bowel injury, vascular injury, and catheter migration compared to the surgical insertions. We conducted a comparative analysis of two techniques of peritoneal entry for PDC insertion by Seldinger technique. We performed a retrospective review of 426 percutaneously inserted PDCs in nonobese naïve abdomens for CAPD at two tertiary care teaching hospitals in India over 6 years.

Fracture Embolism of Guidewire-Bewildering Aetiology of Protracted Pyrexia in a Patient with End Stage Renal Disease!

Guidewire embolism during venous access for haemodialysis is not uncommon yet potentially avoidable iatrogenic complication. Unrecognised, long-standing guidewire may predispose to thrombosis and become a nidus for infection. This entity should always be borne in mind and considered as one of the differentials of unexplained pyrexia in patient on maintenance haemodialysis.

Catastrophic Antiphospholipid Syndrome in Immune Thrombocytopenic Purpura - Beyond Tenuous Concomitance!

Significance of antiphospholipid antibodies in immune thrombocytopenic purpura is debatable and pose a diagnostic and therapeutic dilemma. Catastrophic antiphospholipid syndrome is a rare life-threatening entity, occurring in patients with antiphospholipid syndrome, usually after a triggering event. We describe an adult lady of chronic immune thrombocytopenic purpura (in remission) with antiphospholipid antibodies, who presented with rapidly progressive renal failure and had primary antiphospholipid syndrome nephropathy.

Depression prevalence, its psychosocial and clinical predictors, in diabetes mellitus patients attending two health institutions of north India catering rural population.

Background: Diabetes mellitus (DM) poses a greater risk of depression and a poor quality of life (QoL). There is a limited data regarding relationship of depression to QoL in patients from rural health care settings of North India.

Aim: To know the prevalence and predictors of depression in patients of DM among various sociodemographic, clinical and QoL variables.

Splenic artery aneurysm in a patient of autosomal dominant polycystic kidney disease: beyond tenuous concomitance!

Splenic artery aneurysm (SAA) is rare, with risk of rupture especially if diameter is >2 cm. It is usually asymptomatic and detected incidentally on imaging either in young pregnant women or elderly cirrhotic patients. Extracranial vascular abnormalities known to be associated with autosomal dominant polycystic kidney disease (ADPKD) include ascending aortic aneurysms, dissections of coronary and vertebral arteries and rarely SAA.

Deceptively asymptomatic cryptococcaemia in a renal transplant recipient: the lull before a storm.

Cryptococcal infection constitutes around 3% of opportunistic infections in solid organ transplant recipients. Most common organ affected in renal transplant recipients (RTRs) is central nervous system and usually presents with chronic meningoencephalitis (CME). Ischaemic stroke as a consequence of cryptococcal meningoencephalitisis rare and possibly due to the involvement of intracranial vessel by exudates causing vasculitis-related thrombosis.

Prostatic cyst in autosomal dominant polycystic kidney disease: unusual association.

Prostate cyst, as an extrarenal manifestation in patients with autosomal dominant polycystic kidney disease, although infrequent, nevertheless goes beyond tenuous concomitance and may rarely contribute to recurrent urinary tract infection or outflow obstruction and mostly remains asymptomatic. In this context, we report a case of incidentally detected, an asymptomatic prostatic cyst in a patient of autosomal dominant polycystic kidney disease.

Multiple cerebral abscesses in a renal transplant recipient: Two swords in one scabbard!

Although rare, both () and have been known to be associated with brain abscess in renal transplant recipients (RTRs), however co-infection has never been reported till date. In the present case, 40 years old renal transplant recipient on curtailed immunosuppressive therapy presented with progressive headache and altered sensorium. The computed tomography of head showed multiple ring-enhancing discrete lesions in the left frontal lobe, with moderate perilesional oedema.

Plasma levels of Rifampicin and Pyrazinamide with pre and post meal administration in tuberculosis patients.

Context: Various factors affect plasma concentrations of antitubercular drugs in different populations so dosing schedule should be adjusted after therapeutic drug monitoring.

Aims: To study variability in plasma concentrations of Rifampicin and Pyrazinamide with pre and post-meal administration of drugs in tuberculosis patients.

Methods And Material: 52 patients of pulmonary tuberculosis, divided in to two groups, pre and post-meal through systemic randomization.

Acute febrile hepato-renal dysfunction in the tropics: co-infection of malaria and leptospirosis.

Malaria and leptospirosis are both common in the tropics. Simultaneous infections are possible, although not frequently reported. We report two cases of malaria from India with compelling serologic evidence of coexistent acute leptospirosis.

Surfing for scoliosis: the quality of information available on the Internet.

Study Design: A cross section of Web sites accessible to the general public was surveyed.

Objective: To evaluate the quality and accuracy of information on scoliosis that a patient might access on the Internet.

Summary Of Background Data: The Internet is a rapidly expanding communications network with an estimated 765 million users worldwide by the year 2005.