Pleural effusion is a common problem dealt by most of the practicing clinicians. Some causes for pleural effusion are less often considered as a differential diagnosis owing to its rarity. Here we report a case of renal amyloidosis on alternate day haemodialysis for about two months time presenting with left sided pleural effusion. On evaluation this turned out to be a case of amyloidosis on thoracoscopic pleural biopsy suggesting the possibility of Primary systemic amyloidosis.

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Study DesignCross-sectional study by non-probability consecutive sampling.PurposeThe objective of this study was to assess body mass index (BMI) and investigate vitamin D levels in patients with low back pain (LBP) and study a possible relationship with myopathy-related symptoms and Modic changes.Overview of LiteratureLBP is a multifactorial problem and the search for its patho-anatomical causes is ongoing. Modic changes seem to be a cause of back pain but the pathological mechanisms underlying this are not completely defined. Hypovitaminosis D and obesity have also been shown to cause chronic musculoskeletal pain. The relationship between vitamin D deficiency and BMI with Modic changes has not been studied in detail.MethodsThree hundred and sixteen patients with chronic LBP was selected for the study by non-probability consecutive sampling. The study was conducted over a period of 12 months from January 2014 to December 2014 at St. John's Medical College, Banglore. Questionnaires were provided to the participants and demographic information, symptoms, weight and height were recorded from the study subjects. BMI was calculated. Serum vitamin D level was assessed and Modic changes studied on magnetic resonance imaging. Correlations between vitamin D, BMI and Modic changes were studied using correlation coefficients and odds ratios obtained from logistic regression.ResultsTwo hundred and fifty-six out of 316 patients (80%) had low vitamin D. 83% of patients with BMI>25 kg/m2 had low vitamin D levels as compared to 69% with BMI<25 kg/m2. Statistically significant correlation coefficients were found between vitamin D levels, BMI and Modic changes. Significant association was found between low vitamin D levels and Modic changes (odds ratio 1.75).ConclusionsVitamin D deficiency and obesity have significant relations with LBP. Low vitamin D levels is associated with Modic changes but whether they represent a subgroup of patients whose low backpain is associated with low vitamin D needs to be further evaluated.

Background: Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) related cardiovascular and metabolic risk factors such as hypertension, diabetes mellitus and dyslipidaemia which together are commonly known as metabolic syndrome (MS) is often overlooked in pregnancy. OSAHS is known to cause higher maternal morbidity and bad foetal outcome. Aim was to study the prevalence of components of MS among third trimester pregnant women with OSAHS.Methods: A total of 100 cases and 100 controls each amongst third trimester pregnant females admitted in the Department of Obstetrics and Gynecology at the Government Medical College, Kozhikode, Kerala, India were enrolled in the study. All subjects underwent a thorough clinical, anthropometric, obstetrical examination and biochemical tests such as complete blood count, blood sugar and lipid profile. The parameters were compared between cases and controls.Results: OSAHS positive pregnant women had a higher prevalence of elevated systolic (P=0.01) and diastolic (P=0.002) blood pressure, abnormal fasting (P<0.0001) and post prandial (P=0.02) blood sugar, abnormal cholesterol (P=0.006) and triglyceride levels (P<0.001), and abnormally low HDL levels (P<0.001).Conclusions: This study showed that metabolic syndrome was highly prevalent among OSAHS positive third trimester pregnancy (52%) versus OSAHS negative (8%) pregnant women.