Prabhat Agrawal

Fulminant leukemoid reaction due to postpartum Clostridium sordellii infection.

Clostridium sordellii is gram positive anaerobic spore forming rod and it has been demonstrated to cause gas gangrene, refractory shock, leukemoid reaction, and pleuroperitoneal effusion due to capillary leak. We report here a case of postpartum female who presented with leukemoid reaction, ascites, pleural effusion, and shock without fever 7 days after normal vaginal home delivery.

Imatinib-induced dental hyperpigmentation in chronic myeloid leukemia in an adult female

The course of chronic myeloid leukemia (CML) has changed since the introduction of imatinb, and its side-effects are still being reported. We are reporting a case of a CML patient who presented to us with discoloration of the upper front teeth following 6 months of therapy with imatinib. On detailed evaluation, the patient was found to have imatinib-induced dental hyperpigmentation.

A comparative analysis of formulae used for the estimation of glomerular filtration rate to determine the kidney function test in patients with chronic kidney disease

There are many equations available for estimation of creatinine clearance, but regrettably, most of the formulae have many limitations. Prabhats formula is a novel equation which provides appropriate values of creatinine clearance with the lesser or no limitations. The calculation can be done using the formula as follows: (i) CrCl = 100/(1.3 × S. Creatinine) × (0.8 if female) when age is between 30 and 40 years; (ii) CrCl = 100/(1.5 × S. Creatinine) × (0.8 if female) when age is between 41 and 50 years; and (iii) CrCl = 100/(1.8 × S. Creatinine) × (0.8 if female) if age >51 years. On the other hand, it is evident that using Prabhats formula the calculated creatinine clearance is quite similar to the one that we get using other formulae for the same. Unlike other methods, this equation has no such limitations. The formula is quite reliable for calculating the creatinine clearance and estimating the kidney function test. However still, future studies with this formula in this field are very important and should focus on issues such as the elderly patients with decreased GFR and modification of this formula to get more accurate results.

Levels of Thyroid Hormones and Human Chorionic Gonadotropin in Normotensive Pregnant Women

During pregnancy the hormonal changes take place, resulting in changes in thyroid functions. The present study was conducted to determine thyroid hormones and human chorionic gonadotropin (hCG) in normotensive pregnancy. Fifty normotensive pregnant subjects were included in the study. Age-matched 50 nonpregnant subjects, not having any disease were taken as control. Total triiodothyronine (total T3), total thyroxine (total T4), thyroid stimulating hormone (TSH), and hCG were estimated by using enzyme amplified chemiluminescent immunoassay. The level of thyroid hormones was found significantly increased in normotensive pregnant subjects as compared to that of control group. We therefore conclude that investigations should be done routinely in pregnancy.

RIFAXIMIN INDUCED HYPONATREMIA: A CASE REPORT

ABSTRACT Rifaximin is one of the common drugs used in clinical practice in the management of traveler’s diarrhea, irritable bowel syndrome (IBS), and hepatic encephalopathy. Hyponatremia is one of the rare side effects of this drug. We hereby present the case of a middle-aged woman who was a known case of IBS: Diarrhea predominant who developed symptoms of hyponatremia after a short duration of rifaximin treatment, no other cause of hyponatremia was found on evaluation, so we suspect this as a rare side effect of rifaximin therapy. Keywords: Rifaximin, Hyponatremia, Irritable bowel syndrome.

Neuropsychiatric Symptoms at Menopause

Neuropsychiatric symptoms, such as depression and anxiety are more frequent in women than men. Various factors, such as genetic predisposition, psychosocial vulnerability, excessive stress and somatic diseases may explain gender differences. Moreover a strong association in the precipitation of symptoms seem to be related to the female reproductive cycle: premenstrual tension syndrome, postpartum depression or climacteric depression. These indicated the influence of hormonal fluctuations on the brain. Estrogen modulates several neurotransmitters, has direct effect on neurons by stimulating axonal sprouting, including vasodilatation. These findings lead to the theory that neuropsychiatric symptoms at menopause may be associated with declining estrogen levels and hormone therapy may help in appropriate cases.