The Journal of the Association of Physicians of India
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J Assoc Physicians India · Sep 2004
Case ReportsAcute renal failure following consumption of raw fish gall-bladder from Manipur.
Three cases of acute renal failure following consumption of raw grass gall bladder are reported here from NE State, Manipur.
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Hyperkalemia is a commonly encountered electrolyte disturbance in patients with renal insufficiency. It develops very rapidly when potassium is supplemented while a patient is on a potassium-sparing diuretic. ⋯ Muscle weakness and paralysis although described is seldom observed in clinical practice. We report one such case.
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To study the relevance of the ECG changes in the reciprocal leads in patients with acute anterior and inferior wall myocardial infarction, with regard to culprit artery localization and left ventricular (LV) function. ⋯ Patients of acute AWMI with Q waves in inferior leads indicate a smaller infarct with higher incidence of mid/distal LAD occlusion and a relatively preserved LV function. AWMI patients without reciprocal changes in inferior leads have a better LVEF. Patients of acute IWMI with ST depression in apicolateral leads have more occurrence of multivessel disease with significant LV dysfunction. Reciprocal ST depression in I, aVL suggests a possibility of RCA lesion.
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Rheumatoid arthritis (RA) is a chronic progressive disease of the joints associated with significant morbidity, deformity, and impaired quality of life. A satisfactory remission of disease is seldom achieved, so therapy is aimed at controlling joint damage and pain with preservation of joint mobility. Until recently, NSAIDs, followed by DMARDs, was considered the treatment of choice. ⋯ In light of limitations of cost and lack of long-term safety and efficacy data, newer agents for the time being are used as second- or third-line agents in patients with active RA. The dilemma is that which patients with RA are most suitable for such therapy, since it is still not possible to accurately predict which patient with RA will develop severe disease. One alternative approach may be to limit the use in patients who can afford it, and who are at high risk of radiographic progression and disability.