The Journal of the Association of Physicians of India
-
Coccidioidomycosis is a deep mycosis caused by the fungus Coccidioides immitis. Disseminated disease can affect any part of the body. Coccidioidal synovitis is a rare manifestation of musculoskeletal coccidioidomycosis requiring aggressive treatment. ⋯ He was treated with itraconazole. He was doing well on the most recent follow up. The case is presented for its rarity in India.
-
A 40 year old male victim of a road traffic accident presented to our emergency trauma services with multiple limb injuries and a Glasgow Coma Score (GCS) of 15/15. Soon after admission, he became confused, stuporous, febrile and tachycardic. A clinical diagnosis of thyrotoxic crisis precipitated by trauma was confirmed by relevant investigations, with appropriate therapeutic response. A review of the clinical features and management of this rare medical emergency, with only few cases reported worldwide, is presented.
-
J Assoc Physicians India · Feb 2011
Acute inflammatory ankle arthritis in northern India--Löfgren's syndrome or Poncet's disease?
To analyse patients presenting with acute inflammatory ankle arthritis from an aetiological standpoint; whether they had Löfgren's syndrome (acute presentation of sarcoidosis), or Poncet's disease (reactive arthritis due to tuberculosis infection). An additional objective was to establish a simple, practical yet optimal algorithm for diagnostic approach and management of such patients. ⋯ Investigated on standard lines without any invasive procedure, patients with isolated inflammatory ankle arthritis could be classified in 2 distinct categories namely: (1) Löfgren's syndrome in its complete (with EN) or incomplete (without EN) form; (2) Poncet's disease. Appropriate treatment gave satisfactory response and patients remained well over a period of 1 year of follow-up.
-
Hypomagnesemia is an important but underdiagnosed electrolyte abnormality in critically ill patients. There are many studies to find the prevalence of hypomagnesemia and its effects on mortality and morbidity in these patients. Most of these studies have been carried out in intensive care units caring for patients with medical and surgical conditions and postoperative patients or those in respiratory intensive care unit, or critically ill cancer patients. This study was carried out on patients admitted to the medical acute care unit in a major tertiary care hospital. ⋯ There was a high prevalence of hypomagnesemia in the critically ill patients. Hypomagnesemia was associated with a higher mortality rate in critically ill patients. The need for ventilatory support was significantly higher in hypomagnesemic patients. Hypomagnesemic patients required ventilator support for longer duration. Hypomagnesemia was commonly associated with sepsis and diabetes mellitus. The duration of MICU stay and APACHE score on admission did not vary in patients with low magnesium and normal magnesium. Hypomagnesemia is more commonly seen in patients with hypocalcemia and hypoalbuminemia.