Natl Med J India
-
Acute pancreatitis (AP) is a common emergency in gastroenterology. After gallstone disease and alcoholism, hypertriglyceridaemia (HTG) is the next common cause for AP. The role of intensive insulin therapy (IIT) and plasma exchange (PE) in hypertriglyceridaemic acute pancreatitis (HTG-AP) is still debatable. ⋯ He received early IIT initially, and PE once haemodynamic stability was achieved. This approach improved the functioning of the organs. In haemodynamically unstable patients with HTG-AP, we suggest early initiation of IIT, followed by adjuvant PE after the resolution of shock, to ameliorate organ dysfunction and improve overall outcome.
-
Chronic lymphocytic leukaemia (CLL) is a heterogeneous disease with uncertain course. Treatment should be tailored to the patient's disease as well as the prognostic subgroup. With the increased use of rituximab as well as other selective and non-selective immunomodulatory agents, the incidence of infectious complications and second malignancies has also increased. ⋯ One year after the last rituximab exposure, progressive muscle weakness developed and polyoma JC virus DNA was observed with increased titres in the cerebrospinal fluid, and the patient was diagnosed as having PML. The patient died 2 months later. Our patient had an unusual course of CLL over 8 years, with relapses, complicated with a secondary malignancy and an infectious complication.
-
The choice of a postgraduate specialization in medicine is influenced by many factors. What motivates students to take up pathology as a career option or to reject the same remains unexplored. This study aimed to understand the perceptions of medical students from a college in southern India regarding the role played by pathologists in clinical practice and how this influenced their choice of pathology as a career. ⋯ A career in pathology can be rewarding and intellectually stimulating. The fact that a pathologist plays an important role in diagnosis and also patient management must be emphasized in the undergraduate medical curriculum. The medical student will then be able to take an informed decision about his or her career.