Background: Snakebite is one of the major causes of morbidity and mortality in India, particularly in rural regions. Of the 57 known venomous species of snakes in India, the 4 most dangerous snakes are the cobra, the common krait, the Russell viper, and the sawscaled viper. Of these, the snakes commonly implicated with neurotoxicity are the cobra and the common krait-both elapidae. Acute neuromuscular weakness with respiratory system involvement is the most lethal neurotoxic effect. Case Report: A 24-year-old female was brought to the emergency department in an unresponsive state with a history of snakebite on the left foot. The patient was intubated, mechanically ventilated, and promptly started on snake antivenom and anticholinesterase agents. The patient improved significantly and was extubated. On day 6, she developed blurred vision and slurred speech. She was diagnosed with bilateral optic neuropathy and treated with repeat snake antivenom and steroids. She improved significantly and was discharged on day 14. Conclusion: When a person is bitten by a venomous snake, antivenom is the mainstay of treatment, but clinicians must also consider possible reactions and complications. Optic neuritis following a snakebite is rare but does occur. The prognosis is generally good if clinical suspicion for such a complication is strong, the snake is identified, and the patient receives timely treatment with steroids.
Takotsubo cardiomyopathy may present like acute coronary syndrome and is characterized by reversible left ventricular (LV) apical ballooning in the absence of any significant underlying coronary artery disease. A 65-year-old lady presented to the ED with history of sudden onset left-sided weakness of body. Head CT scan was suggestive of right gangliocapsular intracerebral bleed with intraventricular extension. 2D Echo showed characteristic LV apical ballooning with hypokinesia and LV ejection fraction of 25%-30%. Diagnosing Takotsubo cardiomyopathy includes resolution in electrocardiogram (ECG) changes and reversible LV dysfunction on two-dimensional echocardiogram, and a normal coronary angiography.
A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The heart rate was 114 beats/min, and blood pressure was 106/90 mmHg. Electrocardiogram showed tachycardia with S 1Q 3T 3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable. Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis.
Background: Hemoglobin A1c reflects patient's glycemic status over previous 3 months. Iron deficiency anemia elevates hbA1c concentration independent of glycemia. This study aim to analyze effect of microcytic hypochromic anemia on HB1C in non-diabetic. Inclusion Criteria Males and females,18 -60 year age group, Microcytic and hypochromic anemic patients, Non diabetics. Exclusion Criteria Below 18 years and above 60 years, Known diabetics, Anemia other than microcytic hypochromic, Patients with heamoglobinpathies and haemolytic anemia, History of acute or chronic blood loss, Acute renal failure & chronic renal failure patients, Pregnant females, History of chronic alcoholism. Aims & Objectives: The study aimed to find the co relation between microcytic hypochromic anemia and glycosylated hemoglobin and to exercise caution while using HbA1C levels to diagnose diabetes in patients who have microcytic hypochromic anemia. Material & Methods: The study was conducted at MGM Hospital Kamothe over a period of two years with 50 patients and 50 control group which include all non-anemic, non-diabetic individuals. HbA1c was compared in the anaemic group vs. non-anaemic control group Results:The study established that HbA1c was significantly raised in anemic individuals, hence it is imperative to watch for anemia or to avoid using HbA1c altogether as a diagnostic or prognostic test for diabetes in anemic patients. The study establishes HbA1c is raised in individuals with microcytic hypochromic anemia. In anemic individuals novels markers like glycated albumin and frcutosamine may be used as an alternative to HbA1c.
A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The Electrocardiogram showed tachycardia with S1Q3T3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable. Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis.
Angiosarcoma is an incredibly rare type of malignancy, accounting for only 1%–2% of all soft-tissue sarcomas globally. It is clinically, pathologically and radiologically difficult to diagnose angiosarcoma owing to its varied presentation with little or no well-defined imaging findings.Kasabach-Merritt syndrome is also a lesser-heard entity which carries extremely poor prognosis. It is primarily seen in infants with vascular malformations and in kaposiform haemangioendothelioma. It is a condition of consumptive coagulopathy and only few of the cases have been reported so far in the adults with a background of angiosarcoma.This report presents the case of a male in his 70s who was diagnosed with metastatic angiosarcoma and experienced a complicated disease course due to Kasabach-Merritt syndrome.
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