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Megaloblastic anemia, stemming from vitamin B12 or folate deficiencies, poses diagnostic challenges due to its diverse clinical presentation. We report a case of a 25-year-old female college student presenting with symptoms indicative of megaloblastic anemia, attributed to her recent adoption of a strict vegetarian and vegan diet. Clinical manifestations included dizziness, palpitations, blurred vision, vertigo, headaches, burning sensations, excessive sweating, mouth ulcers, and unintentional weight loss. Physical examination revealed pale palpebral conjunctiva and sweating on the palms and soles. Laboratory findings confirmed megaloblastic anemia secondary to vitamin B12 deficiency, with elevated mean corpuscular volume (MCV), reticulocyte count, serum methylmalonic acid (MMA), and homocysteine levels. Treatment with intramuscular cyanocobalamin injections and oral vitamin B12 supplementation led to symptomatic improvement and normalization of hematological parameters. This case underscores the crucial role of dietary habits in hematological health. Vegetarian and vegan diets, devoid of animal products rich in vitamin B12, increase the risk of deficiency. Early recognition and management of such deficiencies are imperative to prevent long-term complications. A literature review corroborates the association between vegetarianism/veganism and megaloblastic anemia risk. Healthcare providers should vigilantly assess dietary histories, particularly in patients with hematological abnormalities. Further research is warranted to explore strategies for optimizing nutrient intake in individuals adhering to vegetarian or vegan diets, aiming to mitigate the risk of nutritional deficiencies and associated complications.
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A 56-year-old female patient with a body weight of 60 kg was brought to the hospital with hematemesis and received one unit of packed red cells (PRCs) for this condition. After 30 min, the patient experienced tachycardia of 120 beats/min and an increased body temperature of 102°F. The patient had no relevant medical history of allergy or similar episodes in the past. The patient was not suffering from any coagulopathies or sickle cell anaemia, which is a prevalent condition in the region. The patient was receiving the PRC for the first time. After this event, the infusion was stopped and immediately injection meropenem, pantoprazole and ondansetron IV were administered. The patient's condition normalised after 6 h. No re-challenge was given after the recovery of the patient. Suspected ADR was analysed according to the World Health organization (WHO) causality assessment scale and the causality was "Possible". Meticulous monitoring and prompt therapy were provided. The patient was discharged after observing for 24 h. The adverse drug reaction was possibly caused due to the PRCs.
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Polycystic ovarian syndrome (PCOS) is one of the readily recognised endocrine gland illnesses in women, with an incidence range from 2.2% to 26% in India. Patients experiencing PCOS experience issues involving irregular menstrual periods, hirsutism, acne, being overweight, and impotence. Long-term, low-grade inflammation has emerged as a crucial factor leading to PCOS. A rise in glucose levels may stimulate oxidative stress and a troubling reaction from mononuclear cells (MNC) of females with PCOS, which normally do not rely on fat. This is required because MNC-derived macrophages are the major source of cytokine synthesis in big adipose tissue and similarly encourage adipocyte cytokine production. In summary, data reveal the substantial risks of insulin resistance in obese people who are suffering from PCOS. The findings of this specific lesson indicated that individuals with the conventional PCOS phenotype had obesity and higher insulin levels and insulin resistance, neglecting the absence of BMI differences from other phenotypes. These data show that insulin resistance is the most significant pathophysiological trait in people with PCOS.
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Psoriasis is a chronic inflammatory skin disease which is identified by the appearance of erythematous that is clearly demarcated, scaly plaques. It is a skin disease seen regularly around the elbow, scalp, trunk, and also on the knees. Psoriasis is a commonly occurring chronic disease with no cure. In psoriasis, which is thought to be an immune system-related problem, the cells of the skin grow quicker than normal cells. The rapid turnover of cells is responsible for the dry scaly patches seen clinically, also called plaque type of psoriasis. The etiopathogenesis of psoriasis is not yet fully understood. It is considered an outcome of some alteration of the cells in the immune system, which fights infections, but here, it attacks healthy cells, which is the problem. Researchers believe both environmental and genetic factors play a role. It is commonly known that psoriasis is not contagious as it does not spread by air or water. There is a chance of increasing the risk of acquiring psoriasis, also worsening the disease severity by smoking and tobacco consumption. Anyone irrespective of age or gender can develop psoriasis. Psoriasis is divided into various kinds: plaque, nail type, guttate, or inverse, also pustular. The most commonly occurring type of psoriasis is plaque psoriasis, seen with itchy, dry, scales covering patches of skin that are raised.
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INTRODUCTION: Incidence of diabetes mellitus has increased over the past few years, mainly due to our eating habits and physical inactivity. This also includes the use of artificial sweetening agents which have broadly replaced other forms of sugars and have shown a paradoxical, negative effect on blood glucose. Ingestion of these artificial sweeteners (AS) results in the release of insulin from pancreas which is mistaken for glucose (due to their sweet taste). This increases the levels of insulin in blood eventually leading to decreased receptor activity due to insulin resistance. METHODOLOGY: It is a crosssectional study that was conducted on patients diagnosed with type-2 diabetes mellitus of a tertiary care hospital in Central India. All the diabetics that presented in the OPD were divided into 2 groups based on whether they use AS (group A) or not (group B). Insulin resistance was calculated for each group using HOMA-IR and graphs were plotted. RESULTS: The HOMAIR values for Group A and B ranged from 0.9-24.33 and 0.12-10.83 with mean values 7.39 and 2.6, respectively, showing that the ones who used AS had a higher insulin resistance. The study also showed that the duration of use of artificial sweeteners had a direct impact on insulin resistance.
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OBJECTIVES: The objective of this study is to evaluate the anti-scorpion venom (ASV) property of Andrographis paniculata in comparison with anti-redscorpion venom serum and this study aimed to determine its combined effect with anti-redscorpion venom serum. MATERIALS AND METHODS: Ethanolic extract of the plant AP was obtained using soxhlet apparatus. Swiss albino mice weighing 20-30g were used. Lyophilized venom sample of Mesobuthus tamulus and Lyophilized monovalent enzyme refined immunoglobulin anti-scorpion venom serum (ASV) was used. Using lethal dose of scorpion venom (25.12µg/g), the venom neutralizing ability of plant extract (1 g/kg) and ASV individually as well as in combination was studied using in vivo and in vitro methods. Mean survival time, protection fold and percentage survival of animals over the period of 24 h were the parameters used. STATISTICAL ANALYSIS: Results were analyzed using Student's t-test. RESULTS: Ethanolic extract of AP (1 g/kg) showed some protective effect against scorpion venom. ASV was found more effective than plant extract. But, when plant extract and ASV were used in combination, potency of ASV was found to be increased both in vivo and in vitro. CONCLUSIONS: Present study demonstrates that, both plant extract and ASV have their own scorpion venom neutralising ability in vivo and in vitro, but their combination is most effective in venom neutralizing ability.