Three cases of acute intermittent porphyria are reported. While in first case severe pain in abdomen with intermittent exacerbation was the only presentation, the second patient presented as accelerated hypertension and acute abdominal crises in whom the clinical course was characterized by development of deep coma due to inappropriate secretion of antidiuretic hormone before she made complete recovery. The third patient, initially manifested as acute encephalitic syndrome. After initial improvement, she developed features of acute intermittent porphyria i.e. acute abdomen, neuropsychiatric symptoms, and rapidly progressing acute motor neuropathy leading to respiratory and bulbar paralysis. In addition, she developed severe and fluctuating dysautonomia leading to cardiac arrest and fatal termination. The importance of early diagnosis, recognition of autonomic disturbances, prompt treatment and counseling for avoidance of precipitating factors is stressed. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 96-99 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7354
Peritonitis in a continuous ambulatory peritoneal dialysis patient by two different species of enterococci is a rare condition. We report a case of peritonitis from which vancomycin sensitive Enterococcus faecalis and vancomycin resistant Enterococcusc faecium were isolated. It also emphasizes the effectiveness of linezolid for the treatment of vancomycin resistant enterococcal infection.
We have heard of rolling black outs as a staple of daily life in many Asian countries. We from Nepal, a country suffering rolling blackout, present a case that we refer as "Rolling blackout oral cavity". Aspiration of gastric and oral content into airway is a well known complication during endotracheal intubation but aspiration of a part of equipment during the procedure is rare. We report a case of lost bulb of laryngoscope during endotracheal intubation. Keywords: Endotracheal intubation; foreign body; laryngoscope bulb DOI: 10.3126/jcmsn.v6i3.4075Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.44-45
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