Hypertriglyceridemia can cause severe diseases such as acute pancreatitis (AP) and coronary artery disease. The routine management of hypertriglyceridemia is dietary restriction of fat and lipid-lowering medications to manage the secondary or precipitating causes of hypertriglyceridemia. However, in cases of AP with severe hypertriglyceridemia (SHTG) (triglycerides [TG] >1000 mg/dl) rapid reduction of TG levels to well below 1000 mg/dl can improve outcome and prevent further episodes of pancreatitis. Plasmapheresis is a therapeutic option in such medical emergencies. We discussed 2 cases of severe AP with SHTG where we used early plsmapheresis along with other supportive management.

BACKGROUND HIV infection is a multisystem disease and haematological abnormalities are among the most common complications of HIV. HIV associated haematological abnormalities seem to be dependent on the level of virus replication, as these abnormalities are severe in late stage AIDS patients with high viremia. 1,2 These abnormalities reflect the underlying immune status and may be prevented or corrected by use of highly active antiretroviral therapy (HAART). Haematological abnormalities such as impaired haematopoiesis, immune and non-immune mediated cytopenias, and altered coagulation have been described in patients with HIV infection/AIDS. We wanted to evaluate the various haematological parameters in HIV patients and their association with CD4 counts. METHODS One hundred HIV positive patients, symptomatic as well as asymptomatic, diagnosed by enzyme-linked immunosorbent assay (ELISA) method according to the National AIDS Control Organization (NACO) guidelines were included. Complete haematological profile was recorded. Relationship between CD4 counts and various haematological parameters were analysed. Association between two attributes was calculated and p value of less than 0.05 was considered statistically significant. RESULTS The most common haematological abnormality was anaemia, seen in 93% (n=93) of patients. Normocytic normochromic anaemia was seen in 42% of patients, which was the most common type followed by normocytic hypochromic in 25 (25%) cases. A strong association between anaemia and CD4 counts was observed. Other haematological parameters also showed corresponding low values with decreasing CD4 counts. CONCLUSIONS HIV affects virtually all organ systems, with well-known abnormalities related to hematopoietic system. Anaemia being the most common abnormality has strong correlation with CD4 counts and therefore could be used to predict the development of a more advanced disease.

A bstract Cardioembolic stroke in a patient with peripartum cardiomyopathy (PPCM) patient is rare despite a higher incidence of thromboembolic events. We report a case of acute right middle cerebral artery territory cardioembolic stroke in a postpartum female as the initial presenting feature of PPCM. The patient was thrombolyzed with intravenous alteplase and had an almost complete neurological recovery. How to cite this article: Nasa P, Mortada M, Ali A, Malhotra V, Koul K, Singh A. Cardioembolic Stroke with Peripartum Cardiomyopathy: An Unusual Presentation. Indian J Crit Care Med 2021;25(1):97–99.

Retrospective case-control analysis of all COVID-19 patients between March 15,2020 to May 15, 2020 with severe to critical disease in ICU. • Patients were evaluated for CRS, and 22 patients who met the criterion were given tocilizumab. • The primary objective was to evaluate the effect of tocilizumab on escalation of respiratory support and ICU mortality. • The secondary objectives were ICU length of stay, trends of inflammatory markers, and any adverse effects.