Comparing diabetic and nondiabetic emphysematous pyelonephritis and evaluating predictors of mortality.

Mortality among patients with emphysematous pyelonephritis (EPN) has reduced from 78% to 21%, yet it is one of the most serious urologic emergencies. This prospective observational study aims to study and compare clinical profile, management, and outcomes in diabetic and nondiabetic patients with EPN. All patients of EPN admitted to emergency medical services were included in the study.

Single-dose and Steady-state Pharmacokinetics of Vancomycin in Critically Ill Patients Admitted to Medical Intensive Care Unit of India.

Rationale: Vancomycin remains the standard of care for gram-positive bacterial infections, though there are significant developments in newer antibacterial agents. Efficacy can be improved by linking pharmacokinetic with pharmacodynamic principles, thus leading to optimum antibiotic exposure. There is scarcity of pharmacokinetic data in Indian intensive care unit (ICU) population.

Budd-Chiari Syndrome With Spontaneous Intrahepatic Portosystemic Shunts: A Case Series.

Intra-hepatic portal-venous collaterals are characteristic of Budd-Chiari syndrome (BCS) and are usually of small caliber and seen on Doppler. Creation of large portal-systemic shunt, either radiologically (Transjugular intrahepatic porto-systemic shunt) or surgically results in excellent long term outcomes in BCS. Here, we report a series of three rare cases of asymptomatic BCS, who had spontaneous large intra-hepatic portal-systemic shunts.

Comparison of Pediatric Risk of Mortality III, Pediatric Index of Mortality 2, and Pediatric Index of Mortality 3 in Predicting Mortality in a Pediatric Intensive Care Unit.

 To compare and validate the Pediatric Risk of Mortality (PRISM) III, Pediatric Index of Mortality (PIM) 2, and PIM 3 scores in a tertiary care pediatric intensive care unit (PICU) (Indian setting).  All consecutively admitted patients in the PICU of a public hospital (excluding those with unstable vital signs or cardiopulmonary resuscitation within 2 hours of admission, cardiopulmonary resuscitation before admission, and discharge or death in less than 24 hours after admission) were included. PRISM III, PIM 2, and PIM 3 scores were calculated.

SubcapitalNeck of Femur Fracture in a Case of Osteonecrosis of Femoral Head - Rare Presentation.

Introduction: Osteonecrosis of femoral head is a common debilitating condition affecting young males most commonly. It is endpoint of a series of events leading to disturbance in the blood supply of femoral head. Rarely, these cases present with acute pain following trivial trauma due to pathological fracture in the neck of femur.

Treatment of Chronic Simple Elbow Dislocation by Two Separate Incisions - A Case Report.

Introduction: Chronic elbow dislocation is a highly disabling condition to be treated and to provide a successful functional outcome. Surgical treatment of such conditions might result in persisting instability or stiffness of the elbow joint due to associated shortening and contracture of the soft tissues and articular incongruity. Most of the described open reduction techniques are through an extensile posterior approach which might result in increased post-operative stiffness.

Secretory Paravertebral Paraganglioma of the Lumbar Spine: A Case Report and Review of Literature.

Introduction: Paragangliomas are relatively rare group of well-vascularized tumor having an origin from the embryonic neural crest cells. They arise from extra-adrenal autonomic paraganglia and have neuroendocrine cells that can secrete catecholamines. Most head and neck paragangliomas are parasympathetic type and are non-functional.

Bimalleolar Fracture: A Unique Case of Complication of Complex Regional Pain Syndrome of Lower Extremity After Prolonged Undue Immobilisation.

Introduction: The complex regional pain syndrome (CRPS) is an agonizing and disabling condition that can affect one or more extremities. Contrary to expectation, sporadic case reports about lower limb CRPS are present in literature. The usual sequence of events with respect to CRPS has always been prior trauma or inciting event, leading to manifestations.

A Case Report of Aneurysmal Bone Cyst with Pathologic Fracture of Proximal Femur Managed with EnblocExcision and Autologous Non-vascularized Fibular Graft.

Introduction: Aneurysmal bone cyst (ABC) is typically a benign, expansile, and cystic lesion of the bone that can be locally aggressive characterized by vascular gaps separated by fibrous septae. Treatment modalities available are sclerosing agents, arterial embolization, surgical excision, curettage with or without bone grafting, and adjuvant radiotherapy.

Case Report: We report a rare case of ABC with pathologic fracture in the proximal femur in a 15-year-old female patient, treated with en blocexcision, bone grafting with non-vascularized fibular strut graft and stabilized with a 95°dynamiccondylar screw plate system.

Unusual Presentation of Koch's Spine Involving Posterior Elements of Vertebra- A Case Report.

Introduction: Spinal Koch involving posterior elements of the neural arch is one of the atypical presentations which are often missed.

Case Presentation: A 40-year-old female presented with radiculopathy and bilateral lower limb claudication for 5 months. Radiological investigations showed compressive lesion resembling flavum hypertrophy and a degenerative etiology was thus suspected.

A multicenter observational cohort study of 24 h and 30 day in-hospital mortality of pediatric and adult trauma patients - An Indian urban tertiary care perspective.

Background/purpose: India with its evolving trauma system needs multicenter studies on trauma outcomes to help determine the need for planning and structuring care better and to bridge the gap between the burden of disease and research. Therefore here we studied 24 h and 30 day mortality in adult and pediatric trauma population presenting to urban tertiary care hospitals.

Methodology: Data from multicenter observational cohort study conducted from July 2013 to December 2015, Towards improved trauma care outcomes in India (TITCO) were used.

Pharmacokinetics of isoniazid in Indian children with tuberculosis on daily treatment.

Objective: To assess the pharmacokinetics of isoniazid (INH) at 10 mg/kg/day among Indian children.

Methods: INH levels were estimated using liquid chromatography-tandem mass spectroscopy in 35 children aged 1-15 years on daily anti-tuberculosis treatment. Blood samples were collected 0, 1, 2, 3, 6 and 24 h after INH administration.

Ruptured Posterior Circulation Aneurysms with Bilateral Internal Carotid Artery Occlusion: Surgical Nuance.

Background: Craniotomy and surgical clipping is the standard modality of treatment in patients of cerebral aneurysms. However, the surgical clipping of aneurysm may pose serious difficulties in the case of a bilateral carotid artery occlusion. The endovascular treatment has shown promising results in this disease.

[Comparison of endotracheal tube cuff pressure changes using air versus nitrous oxide in anesthetic gases during laparoscopic abdominal surgeries].

Background And Objectives: The purpose of this study was to compare the endotracheal tube cuff pressure changes during laparoscopic surgeries using air versus nitrous-oxide in anesthetic gas mixture; and to observe the incidences of postoperative sore throat, hoarseness and dysphagia.

Methods: Total 100 patients scheduled for elective laparoscopic abdominal surgery were allocated into two groups. Group A ( = 50) received air while Group N ( = 50) received nitrous-oxide in anesthetic gas mixture.

Randomized, Controlled, Phase 2 Trial of Povidone-Iodine/Dexamethasone Ophthalmic Suspension for Treatment of Adenoviral Conjunctivitis.

Purpose: To evaluate the efficacy/safety of an ophthalmic suspension of povidone-iodine (PVP-I) 0.6% and dexamethasone 0.1% in patients with acute adenoviral conjunctivitis.

Discontinuity of the arch beyond the origin of the left subclavian artery in an adult: Interruption or coarctation?

Congenital aortic anomalies are uncommon causes of secondary hypertension and are seldom suspected in the adult age group. We present a case of aortic interruption unexpectedly diagnosed on autopsy in a 38-year-old male who presented with cardiovascular collapse. Apart from interruption, a finding unique to our case was aneurysmal dilation of the proximal descending aorta just before the obstruction with thrombosis.

Disseminated histoplasmosis in an immunocompetent patient - utility of skin scrape cytology in diagnosis: a case report.

Background: Histoplasma capsulatum is a dimorphic fungus predominately found in soils enriched with bird and bat excreta. Although several cases of histoplasmosis have been reported in India, diagnosis using cytology has been done in very few cases.

Case Presentation: We report here a case of disseminated histoplasmosis in a 46-year-old Indian man.

When potion becomes poison! A case report of flecainide toxicity.

We report a 48-day-old female infant, who developed cardiac conduction abnormalities and seizures secondary to supratherapeutic doses of oral flecainide. Flecainide was started in this infant for treatment of supraventricular tachycardia. The drug was withdrawn with successful normalization of the QRS complex and no further recurrence of seizures.