J Postgrad Med
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A 76-year-old male patient, who underwent a post-aortic valve replacement with a mechanical valve in 2006, was on oral anticoagulant therapy with warfarin, maintaining a stable therapeutic level of anticoagulation until 2022. He had a new diagnosis of ulcerative colitis in 2022, following which he was started on mesalamine. ⋯ The evaluation revealed severe depletion of vitamin K-dependent coagulation factors. In this report, we discuss the possible drug-drug interactions between mesalamine and vitamin K antagonists, which went unrecognized leading to life-threatening gastrointestinal bleeding.
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Balantidium coli is the largest, uncommon, and only ciliate parasite that infects humans and is more common in tropics and subtropical regions. It is mostly asymptomatic, but can cause diarrhea and abdominal pain and sometimes leads to perforation of the colon. It is harbored in animals, particularly among pigs in hotter environments and monkeys in the jungles. ⋯ Retrieval of rare parasites was possible only because of prompt stool transport and its early processing. There are only few previous reports regarding the pediatric cases of balantidiasis, and there is a little information about its clinical signs and treatment. Here, we report a case series of B. coli infection presenting as an acute diarrheal disease from Rajasthan.
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Diabetic peripheral neuropathy (DPN) is a chronic microvascular complication in diabetic mellitus patients due to chronic hyperglycemia, resulting in platelet hyperactivity and dyslipidemia. Alpha-lipoic acid (ALA) is a potent antioxidant which has antiplatelet activity and lipid-modulating characteristics and plays a major role in the prevention of disease progression. ⋯ ALA, an antioxidant, demonstrated a protective effect against DPN by the virtue of its inhibitory effect on platelet aggregation and lipid-modulating effects and was found to have good safety.
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Machine learning (ML) has been tried in predicting outcomes following sepsis. This study aims to identify the utility of stacked ensemble algorithm in predicting mortality. ⋯ The random forest showed high accuracy in train and moderate accuracy in the test data. We suggest more regional open-access intensive care databases that can aid making machine learning a bigger support for healthcare personnel.