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Background Hyponatremia, often encountered in hospitalized patients, is associated with adverse outcomes in ischemic stroke patients. In this study, we investigated the frequency of hyponatremia and its impact on prognosis and clinical outcomes in ischemic stroke patients from a tertiary care hospital. Methodology A total of 289 patients admitted to the hospital with ischemic stroke from September 2022 to February 2023 were considered in this cross-sectional study. Serum sodium level was measured on admission, and hyponatremia was defined as sodium less than 135 mmol/L. The primary outcome of the study was assessed by the National Institutes of Health Stroke Scale (NIHSS) score on admission and discharge and inpatient mortality. Data were analyzed using SPSS version 20 (IBM Corp., Armonk, NY, USA), and multivariate logistic regressions were conducted using variables identified as having a relationship with hyponatremia. Results Our study shows that among 289 patients with ischemic stroke, the mean age was 61 ± 8.53 years. Hyponatremia was observed in 101 (35%) patients, and all baseline characteristics and risk factors for stroke were similar between patients with and without hyponatremia. The patients with hyponatremia had higher NIHSS scores on admission (p = 0.041) and at discharge (p = 0.039). In the resultant multivariate analysis, hyponatremia was an independent predictor of mortality rates during the hospital stay. The cumulative incidence rates of in-hospital mortality for hyponatremia and normal sodium level were 16.8% and 10.1%, respectively. Conclusions Hyponatremia is prevalent in ischemic stroke and is independently associated with in-hospital mortality and worse NIHSS scores at admission and discharge.
RESUMEN
Neurofibromatosis type 1 (NF1) or von Recklinghausen syndrome is an autosomal dominant disorder that affects the multisystem in the body with complex presentation caused by the neurofibromin gene mutation on chromosome 17. These patients tend to develop soft tissue sarcomas more than the general population. Leiomyosarcoma is a malignant soft tissue tumor that may occur in patients with NF1 in rare cases. We present a case of a rare development of leiomyosarcoma in a 45-year-old female patient with a history of NF1. She developed a progressively growing mass in the left axilla associated with numerous neurofibromas and axillary freckling. MRI revealed a heterogeneous large mixed signal intensity mass in the left axilla, and the diagnosis was confirmed through biopsy.
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Dengue is a febrile viral illness transmitted by Aedes Aegypti mosquito, presenting with a range of clinical features including a mild febrile illness to a life-threatening hemorrhagic fever or shock syndrome. Additionally, dengue fever can present with atypical features with the involvement of multiple organ systems including the heart. Here, we report a case of a 35-year-old female with dengue fever who presented with chest pain and dyspnea and was diagnosed with perimyocarditis.
RESUMEN
Guillain-Barré syndrome (GBS) is an autoimmune demyelinating disease that is usually triggered by an antecedent infection and is characterized by flaccid paralysis and hyporeflexia. Although a sporadic disease, a few cases of GBS have been reported in families, suggesting a genetic predisposition. Here, we present a case of simultaneous occurrence of GBS in three members of the same family, with two members having a preceding history of diarrhea. They were diagnosed via cerebrospinal fluid routine examination and nerve conduction study and responded to plasmapheresis. This suggests possible genetic susceptibility along with environmental triggers in the pathogenesis of GBS.
