Spontaneous pneumothorax in pregnancy is a rare and life-threatening condition. In this report, a case of spontaneous pneumothorax occurring at 34 weeks’ gestation in a healthy 34-year-old primigravida is described. She had typical complaints of chest pain and dyspnoea and diagnosis was made by chest X-ray which showed an extensive pneumothorax in the right side. Pneumothorax recurred twice over approximately three weeks. A caesarean section secondary to small pelvic parameters was scheduled with the chest tube in situ and a healthy 2.5 kg female infant was delivered. We discuss spontaneous pneumothorax during pregnancy and review the literature.
Introduction: Chronic liver disease (CLD) is a term used to describe a wide spectrum of disorders, including idiopathic, infectious, genetic, drug-induced, toxin-induced, and autoimmune disorders. The common consequence of chronic damage to the liver is cirrhosis. Cirrhotic patients are further classified by their severity based on the Child-Pugh scoring system. Currently, Child-Pugh scoring consists of ascites, hepatic encephalopathy (HE), prothrombin time, serum albumin level, and total bilirubin level. Lipid panel in CLD is a great marker in determining the severity of CLD. Method and methodology: It was a descriptive cross-sectional study conducted at a tertiary care hospital. A sample size of 122 was calculated by using a RaoSoft Digital Sample Size Calculator (RaoSoft, Inc., Seattle, WA) in which we used 5% as a margin of error, 95% as confidence interval (CI), 178 as population size, and response distribution as 50%. Non-complicated CLD patients having age in between 15 and 80 years with no cirrhotic complications including HE, spontaneous bacterial peritonitis, hepato-pumonary, or hepato-renal syndrome were included in our study; the rest of the CLD patients were excluded from our study. Results: The mean age of the study population was 47.09 ± 12.30 years with more than half of the patients lying among the age group 25-50 years. The study population included 76% of males (n=93) and 24% of females (n=29), with a mean age of females higher than the males. Diabetes mellitus (58.19%) was the most frequent comorbidity associated with CLD in subjects included in our study. Parameters of lipid panel were decreased exponentially as the severity of CLD increases from Child score A to C. Total cholesterol, lowdensity lipoprotein (LDL), very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL), and triglyceride (TG) level decreased as the severity increases in our study. The mean model for end-stage liver disease (MELD) score increased as per hypothesized as the severity increases from Child score A to Child score C, respectively. Conclusion: Our study concluded that as the severity of CLD increases from Child class A to Child class C, the lipid panel profile decreases exponentially which proved the idea that had been hypothesized at the beginning of our study.
Sepsis is extremely common amongst critically ill patients and requires early diagnosis. Hence, identifying a biomarker that could acknowledge sepsis at its prior stage is of vital significance. Immature platelets are a percentage of circulating platelets that contain RNA and is a newer parameter that is measured using automated hematology analyzers in diagnosing sepsis. This review article discusses 10 articles that reveal the role of immature platelet fraction in predicting the onset of sepsis and its relationship with mortality in sepsis. Literature search was done using PubMed, Scopus and Google Scholar and words like platelet indices and immature platelet fraction were typed in the search bar. The aim of this review article is to present a precise form of data that talk about immature platelet fraction (IPF) and its association with the severity and mortality of sepsis. Five out of 10 articles suggest that immature platelet fraction can predict the onset of sepsis and eight out of 10 articles suggest that increased IPF values are associated with high mortality.
Chronic lymphocytic leukemia (CLL) is characterized by excessive production of abnormal lymphocytes in the bone marrow. It usually presents as hepatosplenomegaly and lymphadenopathy along with constitutional symptoms of fever, tiredness, and weight loss. Pseudohyperkalemia may occur in patients with extreme leukocytosis. High serum and plasma potassium levels have been seen in pseudohyperkalemia. Whole blood potassium determination will usually help lead to a correct diagnosis. It is important to diagnose this condition early so that the patients are not inappropriately treated. We aim to highlight that hyperkalemia in CLL patients should only be treated if the patient is symptomatic or if the patient shows cardiac effects of hyperkalemia on electrocardiogram.
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