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Gupta, S.
- Traumatic Bilateral Lumbar Hernia: Delayed Presentation with Incarceration
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Authors
Affiliations
1 S. M. S. Medical College, Jaipur, Rajasthan, IN
1 S. M. S. Medical College, Jaipur, Rajasthan, IN
Source
The Indian Practitioner, Vol 67, No 12 (2014), Pagination: 784-786Abstract
Although blunt abdominal trauma is common, traumatic lumbar hernia is a rare entity. Acute traumatic lumbar hernia can be easily overlooked initially as it is associated with other serious injuries that demands urgent attention. Delay in diagnosis and treatment of these hernias may result in increased morbidity and complications. We describe a case of motor vehicle collision; the initial evaluation of abdomen of the victim suggested no injury. Later she developed bilateral lumbar hernia and presented to us with incarceration of one hernial sac. Patient got relieved from obstruction during initial conservative treatment. Elective repair of both lumbar hernias was done by open extraperitoneal retromuscular sublay approach using a polypropylene mesh.Keywords
Traumatic Lumbar Hernia; Bilateral Lumbar Hernia, Incarcerated Hernia.
- Clinical Profile and Prevalence of Complications in Newly Detected Type 2 Diabetics
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Authors
Affiliations
1 Department of Medicine, SSMC & SGMH Rewa (MP), IN
1 Department of Medicine, SSMC & SGMH Rewa (MP), IN
Source
The Indian Practitioner, Vol 66, No 10 (2013), Pagination: 617-623Abstract
Background: Prevalence of diabetes is rapidly rising all over globe at an alarming rate. It proceeds un-noticed silently ravaging the body. Although complications of diabetes do not occur at the onset of disease but due to delay in diagnosis, they are commonly present at the time of diagnosis.Objective: We sought to determine the clinical profile and prevalence of complications in newly detected type 2 diabetics.
Methods: The study was conducted in the wards and patients admitted from medicine OPD at SGM hospital Rewa between January 2010 and September 2011. Patients were diagnosed as type 2 diabetic if they fulfilled ADA 2010 Criteria and were thoroughly evaluated for detection of various complications.
Results: We diagnosed 150 patients as type 2 diabetic, 60% were male, 40% were females, 56.67% were in the age group 31 - 50 years with mean age of 48.25 ± 13.08 years. 58.66% had normal BMI, 43.33% had family history, classical symptoms of diabetes were present in 42% of cases. Mean HbA1C was 9.9 ± 2.7%. Complications were neuropathy (25.33%), nephropathy (17.34%), coronary artery disease (13.33%), retinopathy (12.67%), peripheral arterial disease (10%), cataract (7.33%), diabetic ketoacidosis (7.33%), diabetic foot (6%), stroke (3.33%). The prevalence of other conditions, e.g. infections (50.67%), hypercholesterolaemia (18.67%), low serum HDL (41.11% males&60% females), hypertension (40.67%), hypertriglyceridaemia (36.67%), diastolic dysfunction (28.67%), high serum LDL (27.33%) was also high.
Conclusion: A large number of patients with newly detected diabetes had already had serious complications like nephropathy, coronary artery disease, diabetic ketoacidosis, diabetic foot and stroke. Asymptomatic diabetes mellitus constituted very small percentage i.e. 4.67%. Thus efforts should be made to increase awareness about symptoms and likelihood of diabetes in high risk groups. A thorough screening programme at National level for early detection of diabetes is needed so that complications can be avoided or postponed.
- Electrolyte Profile of Dengue Infected Patients:An Observational Study from a Tertiary Care Centre in Rajasthan
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Authors
Affiliations
1 J.L.N. Medical College, Ajmer (Rajasthan), IN
1 J.L.N. Medical College, Ajmer (Rajasthan), IN
Source
The Indian Practitioner, Vol 70, No 1 (2017), Pagination: 16-18Abstract
Dengue infection is one of the most common and potentially fatal mosquito-borne infections in tropical and subtropical countries. No specific treatment is available and the mainstay of treatment is careful fluid management, specific organ support and correction of metabolic and electrolyte derangement. The aim of our study was to evaluate electrolyte disturbances in patients with dengue infection in our hospital. In this study we included total 60 clinically diagnosed and serologically confirmed age and sex matched dengue infected cases. Serum electrolytes [sodium, potassium&calcium] were measured using semi- auto analyser. The mean age of the study group was 32 years. 65% of the patients were males and 35% were females. On analysis it was found that the amount of calcium decreased significantly (p < 0.03) in the study group as compared to control group while value of sodium (p < 0.6) and potassium (p < 0.5) reduced non-significantly. Hence timely diagnosis and supportive therapy of these electrolyte disturbances can reduce associated morbidity and mortality in dengue patients.Keywords
Dengue, Electrolyte Disturbance, Hypocalcaemia.References
- L. Castilla-Guerra, M. C. Fernandez-Moreno, J. M. Lopez-Chozas and R. Fernandez-Bolanos. Electrolytes Disturbances and Seizures. Epilepsia, 2006; 47:1990–1998.
- Wichmann D, Kularatne S, Ehrhardt S, Wijesinghe S, Brattig NW, Abel W, et al. Cardiac involvement in dengue virus infections during the 2004/2005 dengue fever season in Sri Lanka. Southeast Asian J Trop Med Public Health. 2009;40:727–30.
- Bunnag T, Kalayanarooj S. J Med Assoc Thai. Vol. 94. Bangkok, Thailand: 2011. Dengue shock syndrome at the emergency room of Queen Sirikit National Institute of Child Health; pp. S57–63.
- Uddin KN, Musa AKM, Haque WMM, Sarker RSC, Ahmed AKMS. A follow up on biochemical parameters in dengue patients attending BIRDEM hospital. Ibrahim Med Coll J. 2008;2:25–7.
- Kapoor S, Singh A. Hypocalcemic tetany: An infrequently recognized association with acute dengue infection. Indian J Pediatr. 2012;79:1673.
- Constantine GR, Rajapakse S, Ranasinghe P, Parththipan B, Wijewickrama A, Jayawardana P Hypocalcemia is associated with disease severity in patients with dengue J Infect Dev Ctries. 2014 ;12:1205-9
- Bielefeldt-Ohmann H, Meyer M, Fitzpatrick DR, Mackenzie JS. Dengue virus binding to human leukocyte cell lines: Receptor usage differs between cell types and virus strains. Virus Res. 2001;73:81–9.
- Dhawan R, Chaturvedi UC, Khanna M, Mathur A,Tekwani BL, Pandey VC. Obligatory role of Ca2+in the cytotoxic activity of dengue virus-induced cytotoxin. Int J Exp Pathol. 1991;72:31–9
- Khanna M, Chaturvedi UC, Dhawan R, Tekwani BL, Pandey VC. Presence of Ca 2+ is obligatory for the cytotoxic activity of dengue virus-induced cytotoxic factor. Immunology. 1991;72:73–8
- Chaturvedi P, Saxena V, Dhawan R, Chaturvedi UC. Role of calcium in induction of dengue virus-specific helper T cells. Indian J Exp Biol. 1995;33:809–15
- Baton, S.M , Oncog A . A pilot study on the level of serum calcium in pediatric patients with dengue fever and dengue shock syndrome. Pediatric critical care medicine: 2014 ;15: suppl - p 153
- Cabrera-Cortina JI, Sanchez-Valdez E, Cedas-DeLezama D, Ramírez-González MD. Oral calcium administration attenuates thrombocytopenia in patients with dengue fever. Report of a pilot study. Proc West Pharmacol Soc. 2008;51:38–41.
- Calf Hypertrophy as Initial Presentation of Hypothyroidism:A Rare Presentation
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Authors
Affiliations
1 Department of Neurology, PGIMER and Dr. RML Hospital, New Delhi, IN
1 Department of Neurology, PGIMER and Dr. RML Hospital, New Delhi, IN
Source
The Indian Practitioner, Vol 71, No 9 (2018), Pagination: 50-51Abstract
Neurological manifestations of hypothyroidism are rare and usually seen in late stages of illness. Myopathy as initial manifestation of hypothyroidism is even rarer. Muscle hypertrophy, muscle stiffness and cramps in hypothyroid patient is known as Hoffmann’s syndrome. We report a case of a fourty year old male who presented with calf hypertrophy and very high levels of creatine phosphokinase which normalised after eight weeks of treatment with levothyroxine.Keywords
Hypothyroidism, Myopathy.References
- Wortmann RL, Vladutiu GD. The clinical laboratory evaluation of the patient with noninflammatory myopathy. Curr Rheumatol Rep 2001;3:310-316.
- Khaleeli AA, Griffith DG, Edwards RH. The clinical presentation of hypothyroid myopathy and its relationship to abnormalities in structure and function of skeletal muscle. Clin Endocrinol (Oxf) 1983;19:365-76.
- Scott KR, Simmons Z, Boyer PJ. Hypothyroid myopathy with a strikingly elevated serum creatine kinase levels. Muscle Nerve 2002;26:141-4.
- Sidibe EH, Diop AN, Thiam A, Diagne PM, Sarr A, Toure M, et al. Hoffmann’s syndrome in hypothyroid myopathy. Report of a case in an African. Joint Bone Spine 2001;68:84‑5
- Deepak S, Harikrishnan, Jayakumar B. Hypothyroidism presenting as Hoffman’s syndrome. J Indian Med Assoc 2004;102:41-2.
- Melmed S, Polonsky KS, Reed Larsen P, Kronenberg HM. The thyroid gland. In: Williams Textbook of Endocrinology. 12th ed. Philadelphia: W.B. Saunders Company; 2011. p. 410.
- Udayakumar N, Rameshkumar AC, Srinivasan AV. Hoffmann syndrome: Presentation in hypothyroidism. J Postgrad Med 2005;51:332‑3.