ABSTRACT
Background: Fever remains the most enigmatic clinicalsymptom to treat. The differential diagnosis of Fever ofunknown origin is the most wide-ranging in medicine. Hence;the present study was conducted for assessing the patientswith Undiagnosed Fever in a Known Population.Materials & Methods: A total of 85 patients with undiagnosedfever were enrolled in the present study. Thorough clinicalexamination of all the patients was carried out. Blood sampleswere obtained from all the patients and routine investigationswere carried out. Patients remaining undiagnosed after thatwere referred to higher centers. All the results were recorded inMicrosoft excel sheet and were analysed by SPSS software.Chi- square test was used to assess the level of significance.Results: In all these patients, final diagnosis was establishedbased on haematological and clinical examination. Finaldiagnosis was found to be infectious in 49.41 percent of thecases, while it was found to be inflammatory (non-infectious) in16.47 percent of the cases. Haematological pathology wasfound to be present in 12.94 percent of the cases.Undiagnosed cases were found to be 5 in number.Conclusion: Undiagnosed fever might occur in such variablepathologies as infections, malignancy and drug effect and dueto environmental toxicity. Even after intensive search, theetiology of a sizeable proportion of fevers remains unclear.
ABSTRACT
Thyrotoxic neuropathy is a rare entity in literature. The association between thyrotoxicosis and neuropathy is under-recognized. We here present a rare case report in which patient was presented with ascending sensory-motor paralysis coupled with respiratory muscle weakness which closely resembles Guillain–Barré syndrome (GBS). But relevant history suggested thyrotoxic features, thus a timely focused investigation revealed the diagnosis. It was confirmed in nerve conduction studies (NCS) and other necessary investigations ruled out other differential diagnosis. Patient was treated with anti-thyroid drugs. On follow up patient’s power improved and NCS after 6 months came out to be normal which established the diagnosis. Thyrotoxic neuropathy is a close differential diagnosis of LGBS and other commonly encountered neuroparalytic illnesses. So high degree of suspicion is needed to diagnose this potentially treatable neuropathy
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Rheumatoid arthritis is the most common chronic autoimmune disorder involving joints and extra-axial system. Varied presentations have been described in the literature. Pulmonary involvement is also common. Inflammatory pleural effusions are an uncommon complication and are rarely seen in about 2% to 5% of patients with rheumatoid arthritis. Here, we present an interesting case where the patient presented with bilateral pleural effusion early in the disease. On further evaluation of the patient and the pleural fluid, it was found to be consistent with pleural effusion secondary to rheumatoid arthritis. The patient responded to oral non-steroidal anti-inflammatory drugs along with disease-modifying agents
ABSTRACT
Liver cirrhosis is a condition which is defined histopathologically but cannot be diagnosed clinically without any non-invasive tests. There are various etiologies of cirrhosis such as alcoholic liver disease, chronic viral hepatitis B, C, and non-alcoholic fatty liver diseases. Liver, not only function as an organ for detoxification, conjugation, and synthesis but also it regulates body heat. Cirrhosis patients thus are prone to body heat loss and hyperthermia. We present a case with undiagnosed liver cirrhosis patient, 1st time presenting with altered sensorium, revealed as accidental secondary hypothermia with ECG changes of hypothermia. The patient treated for hypothermia only after which she recovered.
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Severe pulmonary embolism as first-time presentation of Nephrotic syndrome is rare but Nephrotic syndrome secondary to membranous nephropathy (MN) may impose a greater thrombotic risk for unclear reasons. Here, we report the case of a 36-year-old female patient presented with complaints of sudden onset of shortness of breath since 4-5 days and features of right-sided heart failure. There was no preceding history of any chronic disease or renal disease. She was diagnosed as having a bilateral severe pulmonary embolism. Extensive workup and renal biopsy were done which was suggestive of primary membranous nephropathy.
ABSTRACT
Lymphocytic hypophysitis (LH) is a rare inflammatory disease of the pituitary gland. This condition strikingly shows female preponderance and commonly affects women during pregnancy or in the post-partum period. It’s a clinical presentation and radiological features may mimic pituitary adenoma. Though its treatment modality is uncertain steroid remains the 1st option for treatment. Here, we report an unusual case of LHin a 21-year-old female patient where initially, the patient presented with hyperadrenalism and secondary hyperthyroidism followed by pan-hypopituitarism (Addisonian crisis) which is attributed to initial autoimmune destruction of the gland followed by subsequent fibrosis. Thus, it is a rare case report which exquisitely explains this rare presentation and such cases should be investigated thoroughly since there are many differential and response to steroids is remarkable
ABSTRACT
Ocimum sanctum (Lamiaceae) commonly known as tulsi, is well known for its excellent nutritional and medicinal values throughout the world. The present study was undertaken to test the effect of methanolic extract of Ocimum sanctum leaves (50, 100 and 200mg/kg, p.o) on psychosis employing Ketamine induced stereotypic behaviour in mice and Pole climbing avoidance in rats. Haloperidol (1mg/kg, i.p.) and Olanzapine (5mg/kg, i.p.) are established antipsychotic drugs used as standard drugs in the present study. Effect of methanolic extract of Ocimum sanctum leaves (OS), on brain dopamine levels was also estimated. Methanolic extract of Ocimum sanctum leaves (50, 100 and 200mg/kg, p.o), significantly reduced the Ketamine induced falling, weaving, head bobbing and turning behavior in mice. Furthermore, it significantly delayed the latency time taken by the rats to climb the pole. Haloperidol (1mg/kg; i.p.) and Olanzapine (5mg/kg, i.p.) significantly reduced the Ketamine induced stereotypic behavior in mice and condition avoidance behavior in rats. Interestingly, Brain dopamine level was significantly reduced by methanolic extract of Ocimum sanctum leaves. These findings, when taken together indicate that methanolic extract of Ocimum sanctum leaves possesses anti-psychotic like property.
ABSTRACT
An efficient in vitro protocol was standardized for Almond (Prunus dulcis) propagation using dormant axillary buds as explants. Explants were cultured on Murashige and Skoog (MS) and woody plant medium (WPM) supplemented with different concentration/combination(s) of phytohormones. MS basal medium showed lowest shoot induction and took longest duration for shoot initiation. Multiple shoots were induced in MS medium supplemented with the combination of BAP (0.5 mgL-1). Cultures showed poor response for rooting in all combinations of plant growth regulators (PGRs) and took 90 days for initiation. Rooting was higher in half strength of MS than in full-strength. The highest root induction (33.33%) was recorded in half MS medium supplemented with 0.1 mgL-1 IBA (indole-3-butyric acid) followed by full strength of MS medium (20%) supplemented with IBA (0.1 mgL-1). α-Naphthalene acetic acid (NAA) was less effective for rooting than IBA. The highest root induction (25%) was found in half strength of MS medium supplemented with 0.1 mgL-1 NAA followed by full strength of MS medium (20%). The protocol developed would be of use in mass propagation of almond and also support in vitro conservation.
ABSTRACT
Background: As other microvascular complications, respiratory involvement is far less studied among patients with type-2 Diabetes Mellitus (DM). Objective: to study the extent of pulmonary function limitation among patients with type-2 DM. Methods: Hospital based matched case-control study. Results: Total of 90 cases and 90 controls matched for age, sex, height and weight were recruited. Patients with DM had neuropathy [63.3% (57; male=27: Female: 30)], retinopathy [44.4% (40; male=22: Female: 18)], nephropathy [41.1% (37; male=17: Female: 20)] and microalbuminuria [14.4% (13; male=5: Female: 8)]. All cases and 88 controls observed with FEV1:FVC ratio of >70.0%, further assessment for delineation of normal and restrictive pattern patients with high level of predicted values of FEV1 as compare to FVC showed that significantly (P = 0.00) more (Cases: 76.6%; Controls: 42.2%) cases had FEV1 >FVC predicted levels as compare to controls, means among diabetics odds of restrictive pattern of lung abnormality is four times (OR: 4.4; CI: 2.3-8.5) more as compare to non-diabetics. In addition a long duration of DM was significantly (r: 0.39; P = 0.00) positively correlated with lung dysfunction. Conclusion: Patients with type 2 DM patients as compare to its controls observed with restrictive pattern of lung dysfunction.
ABSTRACT
Automobiles, construction, festivals, factories, stations, diesel shades, garages and workshops are sources of noise. Vehicles are increasing enormously beyond the carrying capacity of the road. Study was carried out at 12 locations with sound level meter to assess day time and night time noise levels of Lucknow city. In residential areas, noise ranged between 67.7 to 78.9 and 52.9 to 56.4; in commercial cum traffic areas 74.8 to 84.2 and 68.2 to 74.9 and in industrial areas 76.9-77.2 and 72.2-73.1 dB(A) during day and night time respectively. Values were higher than their prescribed standards which may pose a significant impact on quality of life.