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Diwan, A. G.
- Medi Quiz
Authors
1 Department of Medicine, Bharati Vidyapeeth University Medical College and Bharati Hospital, Dhankawadi, Pune 411043, Maharashtra, IN
Source
The Indian Practitioner, Vol 68, No 4 (2015), Pagination: 35-37Abstract
No Abstract.
- Dapsone Hypersensitivity Syndrome a Case Report
Authors
1 Department of Medicine, Bharati Vidyapeeth University Medical college and Bharati Hospital, Dhankawadi, Pune 411043, Maharashtra, IN
Source
The Indian Practitioner, Vol 68, No 5 (2015), Pagination: 40-42Abstract
Dapsone is a potent antiparasitic and anti-inflammatory drug used mainly in the treatment of leprosy and a variety of dermatological conditions. Idiosyncratic reaction to dapsone causes a generalised hypersensitivity syndrome called as dapsone syndrome or dapsone hypersensitivity syndrome (DHS). We report a patient who presented with fever, skin eruptions, cervical lymphadenopathy and jaundice. Laboratory investigations revealed anaemia, leucocytosis with eosinophilia and deranged liver enzymes. Withdrawal of dapsone and administration of steroids proved successful. A high suspicion is essential for early diagnosis of dapsone hypersensitivity syndrome and avoiding severe morbidity or even death.- Clinical Profile of Seronegative Spondyloarthropathies with Special Reference to Cardiac Involvement
Authors
1 Department of Medicine, Bharati Vidyapeeth University Medical College & Hospital, Pune - 411043, Maharashtra, IN
Source
The Indian Practitioner, Vol 68, No 10 (2015), Pagination: 25-32Abstract
Objectives: To study and to classify spondyloarthropathies and to determine the cardiac involvement in patients with spondyloarthropathy (SpA) by ECG and echocardiography.
Material and Methods: A cross-sectional observational study was conducted on 38 patients diagnosed as having seronegative SpA over 12 months. Patients were selected using screening score for diagnosis, detailed history and examination (to exclude arthropathies secondary to trauma, congenital heart defects, cardiac surgeries, other connective tissue diseases), and serological tests to exclude rheumatoid arthritis. Patients who were included, were then subjected to historical and clinical evaluation (including joint examination, dermatological and ocular examination), laboratory and radiological investigations alongwith ECG and echocardiography. The data was compiled and analysed using statistical package for social sciences (SPSS v/s 18).
Results: Out of 38 patients, male to female ratio was 2.45:1; 31.6% belonged to 21-30 years age group. 68.4% had symptoms of spondyloarthropathy since 1-10 years. Ankylosing spondylitis was the commonest SpA ocurring in 73.7%. Occurrence of articular manifestations was 100%; main joint affected was sacro-iliac joint alongwith spine in 92.1% followed by knee joint (87%), then ankle, shoulder, wrist and elbow joint in decreasing order of frequency. As opposed to this, extra articular manifestations were seen in 39.0%. ECG abnormalities such as ST segment changes and rhythm disturbances were noted in 6 patients with aortic regurgitation. ESR and CRP were raised in 90%. Echocardiography was normal in 21%. Among the rest, mitral valve involvement (prolapse, myxomatous valve, regurgitation) was highest (47.3%) followed by aortic valve (regurgitation, thickening, bicuspid aortic valve).
- Fibrinolysis in STEMI-A Second Thought
Authors
1 Bharati Hospital And Research Center, Katraj, Dhankawadi, Pune-Satara Road, Pune-411043, IN
Source
The Indian Practitioner, Vol 69, No 8 (2016), Pagination: 37-39Abstract
Cardiac sarcoidosis (CS) is an infrequent element of systemic sarcoidosis, manifesting in upto 2% cases of sarcoidosis, but found in upto 25% of these on autopsy. Despite a plethora of tools such as ECG, echocardiography, cardiac MRI, PET scan, endomyocardial biopsy (EMB), accurate antemortem diagnosis of CS remains a challenge. Pathological hallmark of CS is a noncaseating epitheloid granuloma, either microscopic or macroscopic. It causes conduction defects manifesting on ECG as a variety of arrhythmias or non-specific ST-T segment changes. Uncommon amongst these is an ST segment elevation mimicking myocardial infarction (MI). This triggers an urge for fibrinolysis if a proper history and other confirmatory biochemical markers are not sought. We report a previously healthy male presenting with chest discomfort and progressive breathlessness, and with ECG suggestive of ST segment elevation myocardial infarction (STEMI). Fibrinolytic therapy was spared owing to a high index of suspicion for CS against a background of detailed history and incoherent biochemistry. CS was confirmed by cardiac MRI and endomyocardial biopsy. Partial remission of symptoms was observed after steroid therapy alongwith anti-arrhythmics.References
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