We report a case of Kimura’s disease in a 65-year-old woman who presented with generalised itching, abdominal pain, facial puffiness, difficulty in swallowing and loss of appetite. She was found to have generalised lymphadenopathy and a fine-needle aspiration cytology initially done revealed ‘reactive lymphadenitis’ which was inconclusive. PET-CT done showed features suggestive of lymphoma. Hence, lymph node biopsy was done for confirmation and incidentally after immunohistochemistry staining it turned out to be Kimura’s disease. High-dose steroid therapy was started and patient showed dramatic clinical and symptomatic improvement. Kimura’s disease almost always presents as cervical lymphadenopathy and usually never causes compressive symptoms. Our patient presented with compressive symptoms and generalised lymphadenopathy which is a rarity.
Background: The profile of acute poisoning cases is fast changing in last few years, due to advancements in agriculture, construction, sanitation, cosmetic industry and not the least in pharmacology. The advancements and invention of new chemical agents in these industries have increased the access to wide range of materials with quite varied chemical nature, which is reflected in the profile of acute poisonings.Methods: The study is a prospective observational study for a period of 18 months .The study population included all the patients presenting to the emergency department with history of acute poisoning excluding accidental non-self- poisoning.Conclusion: In the current study, highest proportion of subjects in the overall study group was between 26 to 40 years. The proportion of males and females were almost equal whereas in OPC poisoning group the proportion of males was much higher than females. Majority of the affected population were married, living in urban areas, educated ,belonged to lower class. Highest proportion was constituted by housewives and students .Organophosphorous poisoning was the most common poisoning reported followed by benzodiazepines and rat killer in thestudy.The overall mortality rate in the study was 10.53%.Mortality was highest when the subjects were presented beyond 6 hours. Among the type of poisons OPC poisoning had highest mortality.
Protein-C and protein-S deficiency is associated with a hypercoagulable state which usually presents with recurrent venous thrombosis as a common complication. But extensive thrombosis involving all the major abdominal and lower limb veins is quite rare. Here, we report a case of a 27-year-old woman presented with engorged veins all over abdomen and chest since 20 days. Clinical examination revealed signs suggestive of portal venous hypertension with moderate splenomegaly. Protein-C and protein-S levels were found to be low. Portal venous doppler ultrasound and CT-venogram revealed chronic thrombosis of portal vein, inferior vena cava, bilateral iliac and femoral veins with extensive collaterals formation and partial thrombosis in collaterals as well. The patient was successfully managed with anti-coagulating agent (acenocoumarol) and has been maintained on regular follow-up to avoid reoccurrence of thrombosis.
Introduction: Diabetic nephropathy (DN) is a multifactorial disease, one of the most common complications of diabetes and a major cause of chronic kidney disease. Kidney injury molecule-1 (KIM-1) is a sensitive and specific marker of kidney injury as well as a predictor of prognosis. Objective: The present study aimed to investigate the usefulness of serum KIM-1 as an early marker of DN. Patients and Methods: The present study included total 75 participants, among whom 25 nondiabetic participants were chosen as controls. The 50 diabetic participants were divided into two groups according to urine protein/creatinine ratio (UPCR) as participants with normoalbuminuria (T2DM patients without nephropathy) and microalbuminuria (T2DM patients with nephropathy). The complete blood count, blood glucose, HbA1c, serum electrolytes, and creatinine levels were measured using standard laboratory techniques, and serum KIM-1 levels were measured by sandwich enzyme-linked immunosorbent assay. Results: There was a significant difference in the mean serum KIM-1 between the control and diabetics without microalbuminuria ( P = 0.0001). Patients with longer duration of diabetes had a higher serum KIM-1 values ( P = 0.05 in DM without microalbuminuria; P = 0.007 for DM with microalbuminuria). Serum KIM-1 did not correlate with UPCR in controls ( P = ‒0.167), in diabetics with microalbuminuria ( P = 0.487). However, there was a significant correlation observed between UPCR and serum KIM-1 in diabetics without microalbuminuria ( P = 0.04). Conclusion: The present study observed significantly increased levels of serum KIM-1 in both the diabetic groups compared to controls. Moreover, serum KIM-1 positively correlated with the duration of diabetes. Therefore, serum KIM-1 may be used as an early diagnostic marker to predict nephropathy among diabetes in our population.
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