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Acquired Amegakaryocytic thrombocytopenia (AAT) is a rare hematological disorder characterized by bleeding and severe thrombocytopenia with marked reduction or absence of megakaryocytes in the bone marrow. Prompt recognition of this condition is essential as the condition does not respond to steroids and immunoglobulins, instead responds better to immunosupressives like Azathioprine, Rituximab, Cyclosporine, Mycophenolate, Antithymocyte globulin alone or in combination with other drugs. We report such a rare case of AAT with rapid clinical remission by cyclosporine treatment.

Introduction: The etiologies of acute symptomatic seizures (ASS) differ across the globe. We aimed to evaluate the etiological spectrum of acute seizures and to observe the pattern of seizure types among study participants.Methodology: We conducted this prospective study from 2016 to 18. We included all patients aged 20 years or older, presenting with ASS. We excluded those with pseudoseizures. We performed appropriate descriptive analyses to describe the demographic details, etiology of ASS, and pattern of ASS.Results: One hundred and thirty-eight patients were enrolled, constituting about 0.8% of total hospital admissions. The mean age at presentation was 44.33 ± 17.73 years. The most common etiologies for ASS were cerebrovascular accidents (CVA -32.6%), neuroinfections (26.8%), metabolic derangements (13%), alcohol withdrawal (10.9%), and intracranial tumors (4.3%). 71% of the patients presented with only a single episode of ASS. The predominant type of seizure was generalized tonic-clonic seizures, seen in 70.2% of all patients, followed by focal with the bilateral tonic-clonic type (15.9%) and focal seizures (10.1%). New-onset seizures presenting as status epilepticus were observed in 3.6%.Discussion: CVA and neuroinfections were the most common causes of ASS in our study, highlighting the need for community awareness of these conditions and the need to seek rapid care. The majority of our patients had only a single episode of seizures, with generalized seizures being the most common type, followed by focal onset seizures.

To study the clinical profile of coronary artery disease in women and to identify the influence of the risk factors. METHODS We conducted a prospective observational study in Vydehi Institute of Medical Science and Research Centre (VIMS & RC), Bengaluru during the period June 2012 to Dec 2013. Patients admitted with history suggestive of coronary artery disease were evaluated clinically and investigated for risk factors. Prognosis with regards to morbidity and mortality following the standard treatment protocol was documented. RESULTS Out of 100 cases of coronary artery disease (CAD), 32 had Acute Myocardial infarction (AMI), 23 with Unstable Angina and 45 patients had Stable Angina. Nearly half of the patients had the traditional risk factors, namely hypertension (HTN), diabetes mellitus (DM), hyperlipidaemia and obesity. Chest pain was the most common symptom. Mortality was 14% which was observed predominantly in post-menopausal women who presented after 24 hours of the onset of symptoms. CONCLUSION Coronary artery disease is no longer a disease of men. Men and women share the same traditional risk factors like HTN, DM, Obesity, and Hyperlipidaemia. Increased incidence of complications and mortality occurred in those who presented after 24 hours of the symptoms. Our study highlights the importance of early recognition of CAD and initiation of thrombolytic therapy, to reduce significant morbidity and mortality.

BACKGROUND To find out the presence of prolonged P-Wave Dispersion (PWD) on surface 12-lead electrocardiography and to assess the risk of rhythm abnormalities in South Indian patients with psoriasis. MATERIALS AND METHODS It was a prospective, cross-sectional, case control study. 49 psoriasis patients and 50 controls underwent relevant investigations including 12-lead surface electrocardiography. PWD was calculated in the two groups and the degree of its prolongation was compared. Severity of psoriasis measured as PASI score was also correlated with PWD. RESULTS Mean duration of the disease was 7.88 years with a mean PASI score of 7.19. Patients with psoriasis had higher triglyceride levels as compared with controls, 7% of the patients had abnormal ECGs and none among the controls. Statistically, significant difference in PWD was observed in the two groups. No correlation between the PASI score and PWD could be established. CONCLUSION Prolongation of PWD is a reliable noninvasive and easily measurable marker of risk of development of AF in chronic inflammatory conditions like psoriasis.