Atul Gogia

Is benign tertian malaria actually benign

This retrospective study was conducted in order to determine the incidence of various complications of Plasmodium vivax malaria based on a review of case records in a tertiary care hospital in New Delhi, India. The case records of all confirmed cases of malaria over the period of one year were studied. Complete blood count, peripheral blood findings, liver and kidney functions were reviewed. There were 165 confirmed cases. Of these, 121 were due to P. vivax and 42 to P. falciparum. Two cases had mixed infection. The complications seen in the P. vivax cases were: thrombocytopenia; hepatic dysfunction; renal damage; and acute respiratory distress syndrome (ARDS). There were three deaths as a result of ARDS. This paper highlights the fact that P. vivax malaria, although considered to be a benign entity, can have a severe and complicated course, which is usually associated with P. falciparum malaria.

Unusual complication of prolonged indwelling urinary catheter - iatrogenic hypospadias

Long-time urethral catheterization may be responsible for various complications such as urethral stricture, urethral fracture, urinary tract infections, and hypospadias. Hypospadias is the most common congenital anomaly of male external genitalia. However, urethral catheter-induced iatrogenic hypospadias is a rare entity. In this article, we describe a case of an elderly male who was found to have iatrogenic hypospadias 2 months after urinary catheterization.

Skeletal fluorosis mimicking seronegative spondyloarthropathy: a deceptive presentation.

Skeletal fluorosis is rarely recognized early and is a major cause of morbidity. We report on a 40-year-old man with skeletal fluorosis mimicking seronegative spondyloarthropathy.

Waist–thigh Ratio: A Surrogate marker for Type 2 diabetes mellitus in Asian North Indian patients

Introduction: Diabetes is a major world-wide healthcare problem. Cost effective markers for screening and diagnosis of T2DM are the need of the day especially in developing and under-developed countries. Simple anthropometric measurements may help us in identifying individuals likely to have diabetes. Material and Methods: Data from 1055 North-Indian subjects was analysed. Results: Out of several anthropometric measurements studied, Waist-Thigh ratio (WTR) correlated significantly and positively with all three measures of diabetes i.e. FPG, RPG and PPG. (P < .0001) suggesting that it is the best predictor of diabetes. Subjects with diabetes had greater WTR (mean 2.088) than those without (mean1.842). (P < .0001). A thresh-hold effect was evident at a cut-off WTR of 2.3. Out of those subjects who were diagnosed to have diabetes by AACE/AHA guidelines, 82% had WTR greater than this value (P < 0.001). Conclusion: WTR may prove to be a simple and inexpensive marker for detecting Type 2 diabetes. Larger studies are required to develop population norms.

Low backache in adults as an initial presentation of acute lymphoblastic leukemia

Low backache as an initial manifestation of acute lymphoblastic leukemia (ALL) in adults has been rarely reported. In this hematological disorder, although bone marrow is replaced by malignant cells, not many cases of low backache as an initial presentation of ALL are reported. We present a series of clinical cases with low backache, which on evaluation found to have ALL.

Pyrexia in lupus: cryptococcal fungaemia - an unusual aetiology.

Cerebral malaria (CM) is a diffuse encephalopathy associated with coma and seizures commonly caused by Plasmodium falciparum (P. falciparum) in children with severe malaria. We present a case of a 19-year-old man with CM due to Plasmodium vivax (P. vivax) infection. Cerebrospinal fluid (CSF) was negative for Japanese B encephalitis, enterovirus, herpes simplex 1 and 2, varicella and mumps viruses as determined by real-time polymerase chain reaction (PCR). P. falciparum and P. vivax species were analysed by microscopy, immunochromatography and PCR assays and confirmed mono-infection of P. vivax in the patient’s blood, and P. falciparum infection was established to be negative. The patient was discharged after intensive supportive care and antimalarial treatment (intravenous artesunate and oral doxycycline). We conclude that P. vivax infection is associated with CM, a life-threatening complication rarely seen in coastal districts of Karnataka. In endemic areas, the possibility of CM should be considered even with P. vivax infection.

Urinary catheterization from benefits to hapless situations and a call for preventive measures

Catheter-associated complications are common, expensive, and often preventable by reducing unnecessary catheter usage. These complications range from most common nosocomial infection to uncommon conditions such as urethral diverticula and ischemic necrosis of the penis. Often, removal of a single known essential cause may be sufficient to prevent a disease. This review raises issues associated with urinary catheterization and emphasizes on the need of preventive measures a physician should take to reduce disappointing situations. The main objective of this literature review is to intercept or oppose unwanted catheter use and thereby, the disease processes associated with urinary catheterization. There is well-described literature available on catheter-associated urinary tract infection, but little is known about noninfectious complications resulting from catheter use; therefore, we also tried to draw attention on these unusual complications.

An interesting case of characteristic methanol toxicity through inhalational exposure

Methanol poisoning is rare but carries high risk of morbidity and mortality. Most of the cases witnessed in emergency are due to consumption of adulterated alcohol. Here we are reporting a very rare case of methanol poisoning through inhalational exposure leading to putamen necrosis and decreased visual acuity. He had dyselectrolytemia and metabolic acidosis which was successfully managed with early intervention. Its importance lies in the fact that inhalational methanol poisoning is an entity which if picked up early can prevent long-term neurological sequelae.

A rare combination: chylous polyserositis and autoimmune myelofibrosis as a presentation of systemic lupus erythematosus.

Chylous polyserositis and autoimmune myelofibrosis occurring concomitantly inn a case of SLE are a rare phenomenon. We here report a case of a 38‐year‐old woman who was admitted with a history of cough and shortness of breath for 1½ months along with fever and abdominal distension for 1 month. She also had arthralgias, weight loss and pancytopenia. She was diagnosed as a case of SLE with Chylous polyserositis and autoimmune myelofibrosis. She was started on steroids and immunosuppressive therapy, to which she responded.