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Correlation of Dyspepsia with the type of First Meal of the Day; Breakfast or Brunch: A Cross-Sectional Study from Karachi, Pakistan
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SGLT2-Inhibitors and Euglycemia Diabetic Ketoacidosis: A Missed Diagnosis
Get PDFEuglycemic diabetic ketoacidosis (EuDKA), is an uncommon but potentially fatal medical emergency characterized by metabolic acidosis, ketosis, and either normal or near normal blood glucose level. The Diagnosis is delayed due to a lack of hyperglycemia leading to adverse consequences. It’s not a routine diagnosis but patients with both types of diabetes mellitus may suffer from it. Since august 2014, after the inclusion of sodium-glucose cotransporter-2 inhibitors (SGLT2i) for the management of diabetes mellitus, the incidence of euglycemia DKA has raised. The other conditions that may contribute to this metabolic disorder include fasting, chronic liver disease, pregnancy, gastroparesis, bariatric surgery, glycogen storage disease, cocaine intoxication, and insulin pump failure. Euglycemic DKA, a diagnosis of exclusion, should be considered in any unexplained metabolic acidosis among diabetic patients, who report to the hospital with nonspecific symptoms not suggesting DKA and have been taking sodium-glucose cotransporter-2 inhibitors. Here we are describing a case of ketoacidosis with normoglycemia caused by empagliflozin in a female suffering from type 2 diabetes mellitus to raise awareness of physicians to minimize the delays in the identification of this life-threatening metabolic disorder
Subdural Tubercular Empyema in an Immunocompetent Patient: A Rare Primary Presentation of CNS Tuberculosis
Get PDFTuberculosis (TB) remains a potentially-curable serious health problem in most of the developing world including Pakistan. Subdural Tubercular Empyema is a very rare presentation of CNS tuberculosis. A 25-year-old gentleman presented with a 25-day history of low-grade intermittent fever and generalized headache. On examination, he had a temperature of 99.6oF with equally round and reactive to light pupils with normal extraocular muscle movements. However, there were signs of papilledema on fundoscopic examination. Signs' of neck rigidity (Kernig and Brudzinski) were negative. There was no focal neurological deficit. CSF analysis showed TLC 660 cells/uL with 100% lymphocytes, RBC 0 cells/uL, Protein 73 mg/dl, and Glucose 43 mg/dl with no organisms on Giemsa staining but positive AFB stain microscopy. GeneXpert-PCR for MTB was also positive on CSF with no drug resistance to rifampicin detected. His brain MRI scan showed left subdural empyema. Workup for the immunosuppressive condition was negative. He was diagnosed as having Subdural Tubercular Empyema and started on Anti-tubercular therapy. On follow-up at 4 weeks, he was asymptomatic and tolerating ATT without any adverse effects
A Narrative Review of the Oral Manifestations Encountered in COVID-19 Patients
Get PDFThis article aims to review the literature regarding oral manifestations found in patients with covid-19 to aid dental professionals in diagnosing the condition if it presents in their dental offices.
A search was made in the international literature and all the articles, found in the English language, on the stated objectives, were included. Articles published between January 2020 to December 2022 were included. A review was done of the available literature.
The review was conducted on a total of 30 articles. The oral manifestations reported were dysgeusia, anosmia, dry mouth, herpetiform-like ulcers, erythematous lesion, ulceration of the palate, and oral blisters and aphthous-like ulcers
Floccular Syndrome-An Atypical Presentation of Paraneoplastic Cerebellar Degeneration (PCD)
Get PDFThe flocculus, a small and distinct region of the cerebellum, plays a crucial role in coordinating eye movements, especially in stabilizing visual images on the retina during head movements. Damage or lesions in the flocculus can lead to a specific neurological syndrome called floccular syndrome. This syndrome is characterized by abnormalities in the vestibulo-ocular reflex (VOR), which helps coordinate eye movements with head movements to maintain clear vision. Progressive ataxia, particularly affecting the flocculus, combined with vestibulo-ocular reflex abnormalities, strongly suggests the presence of paraneoplastic cerebellar degeneration. In our case study, we described the clinical presentation of a middle-aged woman who experienced gradually worsening dizziness and ocular issues. Due to the subacute onset of cerebellar symptoms and normal neuroimaging evidence of cerebellar atrophy, we initiated a paraneoplastic workup, revealing positive anti-Yo antibodies. This prompted consideration of the diagnosis of PCD (paraneoplastic cerebellar degeneration) with floccular syndrome. The patient underwent steroid therapy, resulting in partial symptom improvement. Despite thorough investigations for hidden malignancies, no occult tumor was found. Our case report aims to underscore the rare and distinct features of PCD, as observed in this particular patient
Pott’s Puffy Tumor Elicited by Klebsiella Pneumoniae: An Uncommon Clinical Entity
Get PDFA lesser-known clinical non-neoplastic entity was first described in 1775, known as Pott’s puffy tumor (PPT). PPT is characterized by frontal bone osteomyelitis with an associated subperiosteal abscess. The diagnosis is usually confirmed with a computed tomography scan of the paranasal sinuses. Early treatment is the law as there is imminent substantial morbidity if left untreated. Herein, we presented a case of a 27-year-old male with a Pott's puffy tumor due to Klebsiella Pneumoniae that was effectively treated with surgery and antibiotics for a total of 3 weeks. Even rare it is a terrifying complication, making it fundamental importance to make an early diagnosis and a correct surgical combined with medical management
Compassion Fatigue, Compassion Satisfaction, Burnout and its Associated Factors among Nurses Working in Critical Care Area of Tertiary Care Hospital, Karachi, Pakistan
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Trending in: Digitizing Pathology with the Emerging Role of Artificial Intelligence (AI)
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A Cross-Sectional Survey on Knowledge, Attitude and Practice of Dental Ethics among Dental Graduates of Karachi, Pakistan: A Multicenter Study
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Unmasking the Hidden Battle: Mental Health Challenges Faced by Oral Cancer Patients in Pakistan
Get PDFUnmasking the Hidden Battle: Mental Health Challenges Faced by Oral Cancer Patients in Pakistan
Introduction: Oral cancer not only inflicts physical suffering but also takes a toll on the mental well-being of patients in Pakistan. However, the mental health aspect of oral cancer care often remains under-addressed, perpetuating a cycle of silent suffering. In order to provide comprehensive care, it is imperative to shatter the stigmas surrounding mental health and prioritize the holistic well-being of these patients