Atharva Scientific Publications (E-Jounals)
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Primary plasma cell leukemia: A rare case report
Get PDFPlasma cell leukemia (PCL) is a rare form of plasma cell dyscrasia. Between 2% and 4% of malignant PCD cases are PCL. The presentation may be primary, de novo, or secondary, evolving from an existing case of myeloma as part of the terminal phase of the disease. The median age of patients is 50-60 years with an equal incidence in males and females. Here, we report a case of primary PCL, presenting at the age of 62 years
Kala-azar without splenomegaly: A rare presentation
Get PDFVisceral leishmaniasis is a major public health problem in Bangladesh, North East India, Nepal, Sudan and North East Brazil. In India, leishmaniasis is more prevalent in Bihar, Jharkhand, West Bengal and Uttar Pradesh. We present the case of a 55-year-old male farmer from Himachal Pradesh with complaints of fever for 2.5 months, appetite loss and weight loss for 1 month. On evaluation, he was found to have pancytopenia, transaminitis, and hyperbilirubinemia. Tropical fever serology and viral markers were negative. Blood and urine cultures were sterile, and ascitic fluid was acellular and high SAAG with normal ADA. Bone marrow was done due to non-responding pancytopenia which reveals intracellular amastigote form of Leishmania Donovani. A final diagnosis of Kala-azar without splenomegaly with moderate ascites was made as an absence of splenomegaly was the most striking aspect in our patient
Community acquired recurrent urinary tract infection caused by Pseudomonas aeruginosa in a public health institute in eastern india: A case report
Get PDFUrinary tract infection (UTI) is common in childhood with no gender preponderance. Often the diagnosis is missed or cases are neglected, and improperly treated. Common pathogens in community-acquired UTI are Escherichia coli, K. pneumoniae and Proteus spp.P. aeruginosa is quite rare as auropathogen in the community. A case of recurrent UTI was encountered in our Urban Health Centre where an eight-year-old male child had presented with urgency and frequency of urination without fever for the last one year. His urine culture revealed infection with highly drug-resistant P. aeruginosa. A history of contact with a relative who died of urosepsis at home several months back was traced. This is a serious instance of the spread of deadly strains of the bacteria into the society posing a great threat to the community particularly the vulnerable group like children
Clinical profile of late-preterm infants admitted to a tertiary care hospital
Get PDFBackground: Late-preterm babies account for nearly 10% of the total births. Understanding clinical profile of late-preterm infants is important for helping newborn care providers to anticipate and manage potential morbidity during the birth hospitalization and early follow-up. Objective: The objective of this study is to study the clinical profile of late-preterm newborns (340/7 to 366/7 weeks of gestation). Methods: This was a prospective observational study conducted in the neonatal unit of a tertiary care public hospital. All late-preterm babies delivered in the hospital from July 2016 to December 2016, who met the inclusion criteria, were enrolled after taking consent from parents. Detailed antenatal and natal history were noted along with neonatal morbidities and mortality, and the interventions and treatment required by the infants were noted in a structured pro forma. These late-preterm infants were followed up till death/discharge and readmission to hospital and reasons for readmission were evaluated. Results: We enrolled 110 late-preterm babies delivered in our center. The most common morbidity was jaundice requiring phototherapy (63.63%) followed by respiratory distress (24.54%). 25.45% of infants required respiratory support in the form of continuous positive airway pressure or mechanical ventilation. Hypocalcemia and sepsis were observed in 10% of the babies. Feed intolerance was also observed in 16.36% of the babies. The mortality in this group of late preterms was 4.54%. Conclusions: Late-preterm infants show a considerably high rate of medical complications, including need for respiratory support and prolonged hospital stay. Awareness about the neonatal morbidities in late-preterm newborns will facilitate better management of these neonates
Primary intramuscular hydatid cyst over the back: A rare presentation of echinococcosis
Get PDFHydatid disease is often manifested as a slowly growing cystic mass, with hepatic and pulmonary involvement being most common. Unusual sites of involvement frequently cause diagnostic problems, and hence, delay in diagnosis and many serious complications. In endemic areas, cystic lesions anywhere in the body, in appropriate patient group, should be evaluated for hydatid disease. We report an unusual case of primary hydatidosis of the back muscle, in which a wide excision was performed without causing any damage to the cyst wall. Injudicious approach in the management of these rare presentations may be the root cause of severe anaphylactic shock and systemic dissemination. Intramuscular hydatid cysts grow gradually and may mimic a soft tissue tumor; thus, the diagnosis of soft-tissue hydatid cysts needs a high index of suspicion
Case report: Sleep deprivation presenting as acute psychosis
Get PDFSleeping is a basic human need and plays a key role in good health and well-being. Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death. Sleep deprivation is seen in several psychiatric disorders, and there may be a cause or effect relationship. Sleep-deprived individuals may have trouble making decisions, solving problems, controlling their emotions and behavior, and coping with stress or change. We report a case who started having sleep deprivation over 15 days following a stressor, which resulted in an acute psychosis-like condition with associated disorientation and perplexity. However, the patient responded to benzodiazepine medication given for the restoration of her sleep cycle and did not require any antipsychotics. There was also complete amelioration of her behavioral and thought disturbances
A rare case of mucinous tubular and spindle cell renal cell carcinoma with sarcomatoid change
Get PDFMucinous tubular and spindle cell renal cell carcinoma is a rare and recently described subtype of RCC. We present the case ofa 45-year-old woman with incidentally detected left renal mass. Imaging revealed a large mass and left radical nephrectomy wasperformed, histopathology revealed it to be a mucinous tubular and spindle cell carcinoma with sarcomatoid change. She is underclose follow-up for the last 6 months
Multidetector computed tomography findings in a case of top of basilar syndrome
Get PDFStroke is a condition in which poor blood flow to the brain results in cell death. In India, almost 2,00,000 strokes are reported a year. Basilar artery occlusion syndrome accounts for 1–4% of all strokes. Top of the basilar syndrome is a type of basilar artery occlusion syndrome where the distal end of the basilar artery is occluded. Imaging findings include ischemic changes in the areas supplied by the distal branches of the basilar artery. A posterior circulation - acute stroke prognosis early computed tomography score system can be used to evaluate the prognosis of the patient. We are reporting a case of top of the basilar syndrome in an 85-years-old female patient who presented to us with complaints of one episode of seizure
Predictive value of cord blood bilirubin in development of neonatal hyperbilirubinemia
Get PDFIntroduction: The early detection of neonatal hyperbilirubinemia (NNH) can be done by various methods; however, the most reliable is cord blood bilirubin (CBB). Objective: The objective of this study is to evaluate the predictive value of the CBB levels for the subsequent hyperbilirubinemia in healthy term newborns and its association with various maternal and neonatal factors. Materials and Methods: Two hundred healthy term-neonates between 37 and 42 weeks of gestation were included in the study. A thorough antenatal, perinatal, and natal history was obtained. Cord blood was collected from all newborns, and the samples were sent for the estimation of serum bilirubin, blood grouping, and Rh typing. Results: Various risk factors such as gender difference (p<0.05), development of jaundice (p=0.00), extent of jaundice (p=0.00), number of cases requiring referral (p<0.05), and jaundice in siblings (p=0.01) were found statistically significant. Several maternal and neonatal factors such as maternal history of jaundice (p=0.009), gestational hypertension (p=0.01), antepartum hemorrhage (p<0.05), obstructed labor (p=0.009), use of oxytocin (p=0.008), ABO, and Rh incompatibility (p<0.001) were also found statistically significant in relation to CBB >2.5 mg/dl. At a cutoff of 2.5 mg/dl, sensitivity and specificity came out to be 33.33% and 96.25%, respectively. Conclusion: NNH and CBB level were found to be associated with several maternal and neonatal risk factors. Hence, total serum bilirubin in cord blood was indicative of the jaundice severity among neonates
Correlation of acute physiological parameters with immediate outcome among neonates transported to special care newborn unit: A prospective study
Get PDFBackground: Several sick neonates require transfer to tertiary level care neonatal unit for treatment. The facilities of neonatal transport in India are not optimal and the newborn thus transported can become hypothermic, hypoxic, and/or hypoglycemic which can affect the neonatal outcome. These parameters can be maintained during transport by adopting simple measures. Aim: Study impact of acute physiological parameters during transfer of neonates on their immediate outcome by using TOPS score. TOPS Score -temperature, oxygensaturation, perfusion (assessed by capillary refill time), blood Sugar. Materials and Methods: This prospective observational study was conducted at the special care newborn unit, Indore enrolling 513 transported neonates. TOPS scoring for each neonate was done at admission, and then the parameters of the TOPS score were correlated with the outcome at 48 h of admission. Results: A total of 513 transported newborns were assessed, 48.73% newborns were hypothermic, 33.91% had poor perfusion, 28.46% were hypoxemic, and 22.22% were hypoglycemic. Hypoxemia and hypoglycemia had the highest sensitivity (93.39% and 80.18%, respectively) while hypoglycemia had the highest specificity (92.87%). Conclusion: TOPS score is a useful and easy to use the method to assess the physiological status and predict early mortality in transported neonates