A 35-year-old male presented with left loin pain. On evaluation, he was diagnosed to have a left renal lower polar mass. He underwent partial nephrectomy. The histopathological examination was suggestive of teratoma of the kidney. We present this case, as intrarenal teratomas in adults are extremely rare and only a very few cases are reported in literature.
Preterm neonates and specifically low birth weight neonates tolerate gentamicin poorly. Dosage and/or interval of administration of the medication may need modification in this group to minimise toxicity.
BACKGROUND: Diabetes mellitus is a metabolic disorder showing an alarming increase in developing countries, particularly in India. In contrast to developed countries, we find that the clinical profile of diabetes mellitus is different in India. Most of the patients are not obese. Hence it is worth comparing the clinical profile of lean diabetics with normal and obese type 2 diabetic patients. OBJECTIVE: To screen the occurrence and pattern of micro vascular complications in lean type 2 diabetic patients compared to normal weight and obese diabetics. MATERIALS AND METHODS: An observational study of 1070 patients was conducted in our hospital between June 2011 to July 2013. We have selected patient's aged 30 years and older diabetics from outpatient and inpatient medicine department of our hospital and compared the urine protein creatinine ratio (PCR), monofilament testing and ophthalmoscopy findings in three groups (Lean, Normal weight and obese diabetics). RESULTS: Among the micro vascular complications, nephropathy was observed in 52.2% of lean diabetics compared to 44.5% and 39.2% of normal weight and obese diabetics respectively (p value-0.035). Neuropathy was observed in 46% of lean diabetics compared to 29.8% and 34.1% in normal weight and obese diabetics respectively (p value-0.003). Retinopathy was observed in 45.1% of lean diabetics compared to 32.3% and 30.8% of normal weight and obese diabetics respectively. (p value-0.014). CONCLUSION: Among diabetic patients who were screened for micro vascular complications in outpatient and inpatient medicine departments, lean diabetics were more prone for micro vascular complications when compared with normal weight and obese diabetics.
Background The burden to healthcare systems following alcohol abuse across various ages has become a very huge cause of concern in recent times. At a time when NHS finances are being increasingly scrutinised to identify areas where cuts can be made, it is increasingly debated whether illnesses caused due to personal overindulgence need to be covered under the NHS umbrella. The actual impact of the problem can be assessed only if we have some demographics of drunken children This study looks at this aspect of children under the age of 18 years presenting to the A&E department in a North East District General Hospital over a year. It also assesses the use of referral pathways in place for these children by the A&E staff. Design of study Retrospective review of all paediatric case notes in A&E over a one year period from 1st January 2010 to 31st December 2010, numbering approximately 12000 was undertaken. Children with history of or symptoms attributable wholly or partially to alcohol ingestion were identified for inclusion. Data was manually collected using a custom made proforma to identify the demographic characteristics, details of presentation and co morbidities. Data was entered onto an Access database and results analysed. Results See table 1. Abstract G139(P) Table 1 Characteristic M F Data NA Total cases reported during study period 32 43 – Age distribution: 16-18 yrs 02 09 14-16 yrs 23 27 <14 yrs 07 07 Time of presentation: Before 2000 hrs 05 06 2000-2400 hrs 21 21 0001-0200 hrs 04 07 Beyond 0200 hrs 03 08 Reduction in GCS on presentation 06 14 06 Choice of drink- Vodka 10 10 17 Mode of arrival: By ambulance 18 38 Outcome of presentation: Admitted to ward 04 11 Discharged home 23 26 Co-morbidities (Drug/Assault/Head injury etc) 04 10 No Blood sugar data availability 17 18 Support services referral 04 05 Conclusion Underage drinking and associated co morbidities are significant social issues that need to be addressed urgently in the community. The risky behaviour seems more common in 15-16 year age group and is commoner females. This group needs targeted intervention. As low blood sugar is a common occurrence in drunken states and contributes to increased morbidity, this needs to be regularly monitored in pre hospital setting. Less than 10% of children have been referred to available supportive services and this needs a serious review.
Hyperparathyroidism and hypercalcaemia are considered to be a rare cause of acute pancreatitis. The relationship between hyperparathyroidism and pancreatic inflammatory disease remains controversial. (1) But it has been shown that surgical correction of parathyroid disease and normalization of serum calcium levels may ameliorate the acute pancreatitis. (2) A case of acute pancreatitis and hyperparathyroidism due to parathyroid gland hyperplasia occurred in a 51years-old woman is reported. After the excision of parathyroid gland the serum calcium levels and the function of the pancreas returned to normal. This suggests a cause and effect relationship between hyperparathyroidism and acute pancreatitis. (3)
BACKGROUND:The nephrotic syndrome is recognized as an independent entity of renal disease for over half a century. 1 Causes of nephrotic syndrome varies with age, time period, geographical location and race. In children, minimal change nephrotic syndrome is the commonest 2 ; however, membranous nephropathy is most frequent in adults. 3 As it commonly affects the younger age group and is associated with high morbidity and mortality, there is a need to understand and diagnose the disease at an early stage. Hence, this study has been done to identify the clinical presentation, biochemical parameters and histopathology associated with nephrotic syndrome in adults and its subtypes. OBJECTIVE: To study the clinical, biochemical and histopathological profile of patients with Adult Nephrotic Syndrome admitted in our tertiary care hospital. METHODS: Prospective study of 100 patients with Adult Nephrotic Syndrome admitted in our tertiary care hospital were screened with facial puffiness and pedal edema. They were tested for urine proteinuria, urine protein creatinine ratio or 24 hour urine protein estimation. Later renal biopsy was done for all patients to stratify the subtypes. RESULTS: In this study, males were predominantly affected. Most common presenting complaints were facial puffiness and pedal edema. Systolic BP was increased in 96% of patients and diastolic BP was elevated in 50% of patients. Serum LDL and TGL were elevated in nephrotic syndrome. In young patients less than 40 years Focal Segmental Glomerulosclerosis (FSGS) is the commonest type, then Membrano Proliferative Glomerulo Nephritis (MPGN) and Minimal Change Disease (MCD). In individuals more than 40 years, membranous nephropathy was predominantly seen followed by FSGS. CONCLUSION: There is a changing trend in primary nephrotic syndrome and FSGS was found to be the commonest subtype. Male preponderance was noticed and also FSGS was found to be more common in younger adults. Most patients in this study were found to have high BP at presentation. Serum creatinine was markedly elevated in patients with IgA Nephropathy and FSGS subtype. Most patients with FSGS who had elevated creatinine were found to have significant protein loss in urine. Lipids were observed to be elevated in all the subtypes, most significantly in the IGA nephropathy type.
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