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AIM: The aim of this study is to assess the efficacy of the serum lactate/albumin (L/A) ratio as a prognostic marker of sepsis syndrome. MATERIALS AND METHODS: This study was conducted in the Internal Medicine Department at Acharya Vinoba Bhave Rural Hospital with a sample size of 160 cases of sepsis. The serum L/A ratio was calculated on admission and correlated with deaths and morbidity. Statistical analysis was significant if the P-value was less than 0.05. RESULTS: The mean age of patients was 52.83 ± 16.80 years with a male predominance (64.4% vs. 35.6%). The mean L/A ratio was 0.95 ± 0.46. The proportion of discharged subjects and mortality were 58.8% and 41.2%, respectively. The study found that a higher mean L/A ratio (1.1-1.44) was significantly linked to the various variables in the study. Furthermore, a significantly higher median L/A ratio of 1.23 was found in subjects with vasopressor use. The median L/A ratio in the Discharge group and Death group was 0.64 and 1.27, respectively. The area under the receiver operating characteristic (AUROC) curve indicated that accurate diagnostic performance was 0.976 in predicting Death versus Discharge for the L/A ratio. CONCLUSION: This study found that, compared to lactate and albumin alone, the predictor value of the L/A ratio was outstanding in predicting death and hospital stay (discharge) among sepsis participants, with a sensitivity of 100% and a specificity of 88%.
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Acute respiratory distress syndrome (ARDS)-like symptoms and rapid progression characterize the interstitial lung disease known as acute interstitial pneumonitis, also known as Hamman-Rich syndrome. It has a bad prognosis and a high incidence of mortality. We describe the case of a 25-year-old male patient with acute-onset type I respiratory failure with detrimental X-ray abnormalities who presented to the emergency room without any history of pulmonary disease or smoking. The provisional diagnosis of Hamman-Rich syndrome was reached after other clinical entities were ruled out based on CT findings. Myocardial hypokinesis of the apex and septum, as well as a modest systolic dysfunction (ejection fraction: 50%) similar to acute myocarditis, were detected by echocardiogram. Acute myocarditis in the setting of Hamman-Rich syndrome has been anecdotally reported and its mechanism remains to be elucidated.
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One of the most popular ways to commit suicide is by hanging. Injury after hanging typically results from pressure on the veins and arteries of the neck; airway compression is less likely, and cervical spine injuries are quite uncommon. Due to the severity of the hypoxic and ischemic brain injury, the external compression results in venous congestion of the brain, hypoxic circulation, diminished arterial supply to the brain, and possible death. Following a near-hanging, cerebral infarction or hypoxic encephalopathy without ischemia may be the mechanism causing brain damage.
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Dyke-Davidoff-Masson syndrome (DDMS) is a rare condition that usually presents in early life with recurrent seizures. It can be congenital or can be acquired by perinatal hypoxia, infections, and intracranial hemorrhage. Its frequency remains unknown. It is usually diagnosed by neuroimaging. The classical neuroimaging features are unilateral cerebral hemiatrophy, volume loss, and hyperpneumatization of the sinus. We present the case of a 22-year-old male who presented with complex partial status epilepticus and had a history of recurrent seizures since he was six years old. The diagnosis of DDMS was made on neuroimaging.
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Alobar holoprosencephaly is a congenital malformation that results from failure of the forebrain/prosencephalon to divide into right and left halves. Despite the literature on the genetic and chromosomal abnormalities associated with this condition, information on additional causes and explanations for variability in phenotypic expressivity are lacking. We report a case of early-onset intrauterine growth retardation with alobar holoprosencephaly, ethmocephaly, and hydronephrosis diagnosed on antenatal ultrasonography in a 27-year-old primigravida with no known risk factors or family history. The combination of holoprosencephaly with associated midline facial anomalies and the genitourinary abnormality, in this case, constitutes a rare phenotypic presentation. This case emphasizes the importance of antenatal ultrasonography in the early detection of lethal anomalies like alobar holoprosencephaly. The pregnancy was safely terminated in accordance with the mother's decision.
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Intermediate syndrome affects 10-40% of those with severe organophosphorus poisoning, causing delayed weakness in the proximal parts of the body, neck flexors, and breathing muscles. We present the case of organophosphorus poisoning that advanced to intermediate syndrome and subsequently worsened, with imaging later revealing the Marchiafava-Bignami condition, which aggravated the intermediate syndrome.
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Intussusception in adults is an unusual finding and is commonly associated with benign or malignant mass as the leading point. A preoperative diagnosis on imaging is helpful in diagnosing intussusception along with pathology causing it and aids in further management. We present a case of ileocolic intussusception with lipoma as the lead point: classic ultrasonography and CT imaging findings are described with its postoperative confirmation.
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Pituitary adenomas are benign, single, monoclonal slow-growing neoplasms usually related to chemical overproduction. A pituitary adenoma is the third most common intracranial tumor, with the first two being glioma and meningioma. Double pituitary adenoma is an infrequently occurring case and is characterized as occurrence of two adenomas in the single pituitary gland, both having typical immunohistochemical and histopathological highlights. In most of the cases, pituitary adenomas occurring as double adenomas are associated with Cushing's disease. It is further categorized into contiguous and clearly distinct types. Clearly distinct tumors are recognized on neuroradiological imaging. We present imaging findings of a rare case of a double pituitary microadenoma. Early diagnosis of such a rare condition is important and prevents further consequences.
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The commonest solid tumour in men between the ages of 15 and 44 is testicular cancer. Germ cell tumours, which are then subdivided into seminomatous and non-seminomatous tumours, are its primary histological kind. In the fourth decade of a man's life, seminoma accounts for 55% of testicular cancer. Anaplastic seminoma, which accounts for 5% to 15% of testicular seminoma, is an uncommon kind of seminoma. The anaplastic variant of classical seminoma is an uncommon type of seminoma. In order to increase confidence in diagnosing and differentiating benign from malignant lesions and localising lesions in the testis, tissue elastography has arisen as a definite, important supplementary method. We present a case report of anaplastic seminoma with its classical imaging findings on strain elastography and its correlation with ultrasound and doppler.
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Sinus histiocytosis with massive lymphadenopathy (SHML), an alternative term for Rosai-Dorfman disease (RDD), is a rare benign idiopathic immune-related lymphoproliferative condition. The central nervous system (CNS) has been documented to be involved in RDD, although lymph nodes are the organs that are most frequently and primarily associated with the disease manifestation. Nonetheless, CNS involvement in RDD is rare and poorly understood. As a result, there is a lack of a solid basis for therapeutic approaches for CNS involvement in RDD. Here, we present a case of RDD with cerebral involvement, a rare presentation of RDD with atypical symptoms. A brief assessment of the radiographic appearance, histological findings, and the peculiar manifestations of the disease is provided.
