Splenic lesions due to tuberculosis are extremely rare in immunocompetent indi-viduals and delays in diagnosis are frequent. Here, we describe a 49-year-woman presenting with pyrexia-of-unknown origin with no evidence of any immunodefi-ciency. Computed tomography of the abdomen showed an enlarged spleen having multiple small focal hypodense lesions; the later were confirmed to be of tubercu-lous etiology on histopathological examination. She had favorable response with anti-tubercular chemotherapy. We report this case of tuberculosis spleen in an im-munocompetent individual for its rarity and to highlight the fact that these patients can be managed by medical treatment effectively.
Pneumothorax due to mycetoma is extremely rare and has been described only in patients undergoing intensive cytotoxic therapy for hematologic malignancies. A non-immunocompromised subject presenting with pneumothorax due to rupture of the mycetoma into the pleural cavity is being described here.
Background: Acute coronary syndrome (ACS) refers to a group of clinical symptoms compatible with acute myocardial ischemia and includes unstable angina, non-ST segment elevation myocardial infarction and ST-segment elevation myocardial infarction. Aims and Objectives: To study the incidence of lipid profile abnormalities in young patients (age 40 years or below) with ACS with clinical and cardiovascular risk profile. Material and Methods: The study was conducted on 223 young patients of acute coronary syndrome with age 40 years or below. 89 young patients with acute coronary syndrome having lipid abnormalities were further followed up after 1 month. Results: Majority of patients (55.15%) in the study population belonged to 35–40 years age group. Mean age of study population was 35.65 + 4.62 years with 90.13% males and 9.86% females. Main presenting symptom was precordial chest pain in 93.72% patients. Smoking was the commonest risk factor in young adults (81.7%). Other risk factors like diabetes, hypertension, family history were less common in young adults. Drug addiction was also higher in younger population (16%). Majority of young adults with acute coronary syndrome had more than 1 (47.53%) risk factor. Majority of patients were in Killip class I (86.9%) and only few patients (13.1%) had Killip class II or above. ST elevation myocardial infarction was far more common than NTEMI/USA and was found in 164 (73.5%) patients. Most common type of infarction was anterior wall myocardial infarction (62.80%). Majority of young patients had negative TMT, so it suggests that ACS in younger population has lesser complications during presentation, hospital stay and on follow-up. Conclusion: ACS in young continues to increase in Indian subcontinent. Younger patient with an ACS have different clinical characteristics and a different prognosis than older patients. The extent of CAD and degree of myocardial necrosis has influence on presentation and subsequent MACE in ACS and in this study, it appears dyslipidemia do not play any significant role in influencing extent of CAD and has little effect on outcome whether during acute stage or on immediate follow-up after ACS.
Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.
INTRODUCTIONIn patients with epilepsy, chronic therapy with conventional enzyme inducing antiepileptic drugs (EIAED's) causes abnormalities in calcium metabolism. These including hypocalcaemia, hypophosphatemia, elevated levels of serum alkaline phosphatase, serum parathyroid hormone and reduced serum levels of biologically active vitamin D metabolites. These changes cause radiologic evidence of rickets, and histological evidence of osteomalacia. [1][2][3][4] These patients are also at high risk for pathological fractures due to reduction in the bone mineral density. These EIAED's which include phenytoin, carbamazepine, primidone, phenobarbitone and benzodiazepines cause decrease in bone mineral density by hepatic induction of cytochrome P450 enzymes ABSTRACT Background: Objective of the study was to determine the Levetiracetam monotherapy effect on serum calcium and serum vitamin D levels in tertiary care hospital in Haryana, India. Methods: A total of 110 patients with epilepsy, were enrolled to the study for one year between April 2013 to August 2014. All male patients aged 15-60 years and premenopausal females with epilepsy were included in the study. The study was a interventional prospective study design. The antiepileptic drug levetiracetam was administered starting from a dose of 20 mg/kg and dose was titrated according to the clinical response. During the follow up period, the subjects were asked about the seizure frequency and other side effects. The patients were be subjected to questionnaires based proforma. Baseline investigations, Hemogram, renal and liver function tests, calcium, phosphate, vitamin D and bone mineral density and T scores were noted. All investigations were repeated after one year of levetiracetam monotherapy. Results: The mean age of onset of seizures in the study group was 23.22±6.62 years. 58% (n=29) were seizure free after 1 year of levetiracetam monotherapy, 28% patients had adequate control and 14% patients had poor control of their seizure episodes. There was an insignificant change in Hemoglobin, total leukocyte count, platelet count, renal parameters and Liver enzymes from baseline over a year of levetiracetam therapy. Serum calcium levels increased insignificantly from baseline levels of 9.68±0.59 mg/dl to 9.72±0.56mg/dl. Vitamin D levels increased from baseline of 39.35±14.91ng/ml to 39.84±14.07 ng/ml. Bone mineral density increased insignificantly from baseline of 0.92±0.13 g/cm 2 to 0.93±0.13 g/cm 2 . Conclusions: Present study has shown an overall beneficial effect on serum calcium, Vitamin D level, bone mineral density and T scores on DEXA scan.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.