Electrifying Consequences: Posterior Reversible Encephalopathy Syndrome After an Electric Shock Injury.

Reversible posterior leukoencephalopathy syndrome, often referred to as posterior reversible encephalopathy syndrome (PRES), is a disorder characterized by acute cerebral dysfunction and is seen in conjunction with vasogenic edema on brain imaging. Headaches, visual issues, seizures, abnormal mentation, disturbances in awareness, and focal neurological symptoms are its defining features. In this case report, we present a 40-year-old male patient who developed PRES after experiencing a high-voltage electric shock.

Advancements in Wearable Digital Health Technology: A Review of Epilepsy Management.

This review explores recent advancements in wearable digital health technology specifically designed to manage epilepsy. Epilepsy presents unique challenges in monitoring and management due to the unpredictable nature of seizures. Wearable devices offer continuous monitoring and real-time data collection, providing insights into seizure patterns and trends. Wearable technology is important in epilepsy management because it enables early detection, prediction, and personalized intervention, empowering patients and healthcare providers. Key findings highlight the potential of wearable devices to improve seizure detection accuracy, enhance patient empowerment through real-time monitoring, and facilitate data-driven decision-making in clinical practice. However, further research is needed to validate the accuracy and reliability of these devices across diverse patient populations and clinical settings. Collaborative efforts between researchers, clinicians, technology developers, and patients are essential to drive innovation and advancements in wearable digital health technology for epilepsy management, ultimately improving outcomes and quality of life for individuals with this neurological condition.

Guarding Health: A Comprehensive Review of Nosocomial Infections in Sickle Cell Anemia, a Multifaceted Approach to Prevention.

This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life.

A Comprehensive Review of the Immunomodulatory Effects of Vitamin D in Sepsis.

Sepsis remains a critical global health challenge characterised by a dysregulated immune response to infection, leading to systemic inflammation and organ dysfunction. This review examines the immunomodulatory effects of Vitamin D in sepsis, focusing on its regulation of immune cell function, modulation of cytokine production, and enhancement of antimicrobial responses. While the potential of Vitamin D as an adjunctive therapy in sepsis management is evident, challenges such as variability in Vitamin D status, uncertainties regarding optimal dosages and patient heterogeneity, and potential adverse effects require careful consideration. The review highlights the implications for future research and clinical practice, emphasising the need for standardised measurement protocols, elucidation of optimal supplementation strategies, and integration of Vitamin D assessments into routine care. Despite the complexities, Vitamin D emerges as a promising avenue for personalised interventions in sepsis, necessitating ongoing research collaboration and evidence-based guidelines to harness its full therapeutic potential and improve clinical outcomes.

Unraveling Neurological Shades: Vitamin D Toxication and Central Pontine Myelinolysis Exposed.

This case report is about a middle-aged female who presented with complaints of pain in the abdomen with intractable vomiting for three months, pain and weakness in bilateral lower limbs for two months, and irritability for three days. She was previously treated for lumbar disc bulge and severe narrowing of the spinal cord whose treatment also included vitamin D supplements. After taking high doses of a vitamin D supplement daily for approximately four months, it resulted in vitamin D toxicity. The sodium level of the patient was in the normal range throughout the treatment. Her magnetic resonance imaging brain revealed features of central pontine myelinolysis. The development of central pontine myelinolysis due to vitamin D toxicity, with normal sodium levels, makes this a rare case for discussion.

Methylcobalamin Deficiency Presenting as Thalamic Syndrome in the Elderly: Association or Chance?

Vitamin deficiency is common in the geriatric population and is responsible for majorly imbalanced hematological, neurological, and neuropsychiatric functioning. Methylcobalamin deficiency or vitamin B12 deficiency can be underestimated in some cases and be misdiagnosed as other illnesses, such as thalamic syndrome. Timely diagnosis of this deficiency is essential, especially in the geriatric population, as it might cause irreversible structural brain damage. This is also presented as elevated levels of homocysteine and methylmalonic acid. Clinically, it presents with the following symptoms: lower sensitivity levels to touch and light, psychosis, paresthesia, anemia, imbalance, fatigue, cognitive disturbances, difficulty remembering, and confusion. Symptoms are usually progressive and worsen over a period of time. In this case report, we present the case of a 62-year-old male with clinical symptoms of numbness and tingling in the right side of the body. The neurological presentations resembled left thalamic infarct, but the underlying reason was methylcobalamin deficiency.

The Spectrum of Shoulder Pathologies on Magnetic Resonance Imaging: A Pictorial Review.

Patients present to the orthopedic outpatient department with complaints of shoulder pain on movement or restriction of movement in the shoulder joint and are referred for magnetic resonance imaging (MRI) of the shoulder joint. Almost all the patients have similar complaints but may have a wide range of pathology affecting the joint and causing pain. Rotator cuff tears or tendinopathy are the most common causes of shoulder pain. Ultrasound (USG) and MRI are the most commonly used imaging modalities for assessing rotator cuff pathologies. There is a wide range of pathologies affecting the shoulder joint, other than rotator cuff tendinopathies or tears, for which USG is less sensitive and specific in detecting accurate pathology. MRI is the choice of imaging for shoulder joint pathologies. We present a pictorial review discussing and depicting MRI features of a wide list of pathologies of the shoulder joint complex that should be kept in mind when the patient presents with shoulder pain.

Role of Apparent Diffusion Coefficient in Evaluating Degeneration of the Intervertebral Disc: A Narrative Review.

Degeneration of the lumbar intervertebral disc is the most common cause of lower back pain. It is directly related to daily activities, mechanical stress, and other biological factors. We use imaging modalities to assess the degree of disc degeneration, out of which magnetic resonance imaging (MRI) is the most popular non-invasive modality. It is believed that early changes in disc degeneration are due to the biochemical events in the disc and can be evaluated by sequences in MRI involving the diffusion of water molecules. The apparent diffusion coefficient (ADC) is one such sequence that captures the signals based on the diffusion of water molecules. Ten articles were chosen from PubMed and Google Scholar using the MeSH terms 'lumbar spine degeneration' and 'apparent diffusion coefficient'. This review article has summarized various studies intending to gain a better understanding of the biochemical events leading to the development of disc degeneration. This study has also gathered the role of various sequences in MRI that can quantitatively assess disc degeneration.

Amaurosis Fugax in Posterior Reversible Encephalopathy Syndrome: A Vexed Hurdle in a Postpartum Primigravida Patient.

In this case report, we highlight a case of a 24-year-old primigravida who suffered a sudden and painless loss of vision and headache in the immediate postpartum period. Vision loss was transient and remarkable. Her brain magnetic resonance imaging revealed vasogenic edema in parieto-occipital white matter, suggestive of posterior reversible encephalopathy syndrome. Posterior reversible encephalopathy syndrome is a clinical-radiological entity, having hemodynamic catastrophe also known as reversible posterior cerebral edema syndrome. It tends to occur during pregnancy complicated by eclampsia. Hypertension and a hypercoagulable tendency tend to engulf the entire homeostasis into its deadly clutches sending the autoregulation into a frizzy. It presents with a gamut of red flags like headache, seizures, encephalopathy, amaurosis fugax, cortical visual disturbances, and even blindness. Clinical improvement was seen with supportive treatment in this patient. Thus, timely diagnosis and intervention help reverse the dire consequences.

Acenocoumarol-Induced Diffuse Alveolar Hemorrhage: A Case Report.

Diffuse alveolar hemorrhage (DAH) is bleeding into the alveolar spaces of the lung. DAH is often associated with systemic autoimmune diseases, coagulation disorders, drugs, inhaled toxins, or transplantation. This study describes a rare case of acenocoumarol-induced DAH, a pulmonary disorder, which has not been reported before. A 48-year-old male presented with a history of rheumatic heart disease with mitral stenosis with moderate mitral regurgitation status post mitral valve replacement. He was taking acenocoumarol but did not keep his prothrombin time-international normalized ratio (PT-INR) monitoring and came to the hospital with complaints of cough, hemoptysis, and breathlessness. Chest x-ray and high-resolution computed tomography (HRCT) thorax were done which revealed diffuse patchy opacities and pulmonary hemorrhage, respectively. After nine days of hospital stay with appropriate management with corticosteroids, antibiotics, and intravenous fluids, the patient was doing well.

Efficacy of Oral Versus Injectable Iron in Patients With Chronic Kidney Disease: A Two-Year Cross-Sectional Study Conducted at a Rural Teaching Hospital.

Aim Anaemia (particularly iron deficiency) is of important concern in patients with chronic kidney disease (CKD) as it reflects the outcome of the disease. Current recommendations for the use of intravenous iron (IV) therapy in the management of anaemia in such patients are limited. This study highlights the comparison of oral to intravenous iron in patients with chronic kidney disease. Materials and methods This is a prospective case-control study comparing intravenous iron to oral iron in chronic kidney disease patients admitted to the Medicine Department of Acharya Vinoba Bhave Rural Hospital, in central India from October 2018 to October 2020. A total of 150 patients were divided into two groups of 75 each, one receiving oral iron (ferrous sulfate 325 mg tablets) and the other intravenous iron (IV iron sucrose). Results Serum iron, serum ferritin, and transferrin saturation (TS) showed increased levels in the IV iron group than in the oral iron group. In the IV group, a statistically significant increase was found in haemoglobin levels after therapy among all stages of kidney disease (p<0.05) while the same was not reported in the oral iron group. Conclusion IV iron sucrose therapy had been found to be effective, well-tolerated, and more successful than oral iron treatment in chronic kidney disease patients as far as the parameter of iron deficiency anaemia is concerned.