Debate 2: Is the Management of Childhood Empyema Primarily Medical, or Surgical?

The management of empyema thoracis has changed in the past 1-2 decades with the advent of video-assisted thoracoscopy (VATS), the surgeon's weapon and fibrinolytic agents, the physician's weapon. Inappropriate use of either and inability to accept their failure in some cases cause prolonged morbidity in an unsuspecting patient. VATS has been shown to be very effective in stage 2 empyema and is associated with early amelioration of symptoms and early discharge from hospital.

Etiology of new-onset seizures in adult patients of different age groups presenting to the emergency department in North India and their outcomes.

Introduction: Seizures are one of the most common neurological emergencies encountered in both urban and rural India. There is only limited research work on the etiology of new-onset seizures in adult patients of different age groups presenting to the emergency department, especially from the Indian sub-continent. A new-onset seizure can be the first presentation of stroke, or it may be a symptom of brain infections, metabolic abnormality, brain tumor, systemic disease, or an early phase of epilepsy, which needs scrutiny and appropriate management.

Comparison of diltiazem and metoprolol for atrial fibrillation with rapid ventricular rate: Systematic review and meta-analysis.

Background: Intravenous calcium channel blockers or beta-blockers are the preferred rate control medications for hemodynamically stable patients with atrial fibrillation with rapid ventricular rate (AF-RVR) in the emergency department.

Objectives: To compare the efficacy of intravenous diltiazem and metoprolol for rate control and safety with respect to development of hypotension and bradycardia in patients with AF-RVR.

Methods: For this systematic review and meta-analysis, we searched PubMed, Embase, Cochrane databases, and the clinicaltrials.

Correlation of mortality with Pro-BNP and precipitating factors of acute heart failure in patients presenting to a medical emergency of tertiary care hospital: an observational study from north India.

Objective: Acute heart failure is a syndrome defined as the new onset de novo heart failure or worsening [acutely decompensated heart failure (ADHF)] leading to symptoms and signs of HF, mostly related to systemic congestion as based on the European Society of Cardiology (ESC) definition. India has a huge burden of heart failure patients. Several factors have been identified as precipitating acute HF hospitalizations.

A rare case of primary renal hydatid cyst.

Unlabelled: Involvement of the kidney is a rare clinical scenario seen in case of Echinococcus infection, with isolated involvement of the kidney being even rarer. Patient may be asymptomatic or present with symptoms of lumbar region pain, haematuria, and hydatiduria. We present a rare case of primary right renal hydatid cyst with presenting features of right lumbar pain.

Immediate breast reconstruction for phyllodes tumors.

Phyllodes tumors are rare breast tumors. Surgery is the mainstay of treatment and mastectomy has been the traditional procedure adopted for these tumors. Although wide excision with adequate margins gives equivalent results, mastectomy may still be required if the tumors are very large.

Common queries in thalassemia care.

Beta thalassemia is a common genetic disorder in Indians. Around 10,000 thala-ssemia major cases are born every year. The treatment of thalassemia major patients imposes a financial burden on the family.

Rosai-Dorfman disease: unusual cause of diffuse and massive retroperitoneal lymphadenopathy.

Rosai-Dorfman disease (RDD), originally described as sinus histiocytosis with massive lymphadenopathy, is a rare histiocytic proliferative disorder with a distinctive microscopic appearance. Patients usually present with massive cervical lymphadenopathy. However other nodal sites (mediastinal and inguinal) are also frequently involved.