A case of neurofibromatosis type 1 with clival chordoma

Neurofibromatosis type-1 is an autosomal dominant tumour syndrome with a high clinical susceptibility to malignancies, especially nervous system malignancies. Here, we reported a case of neurofibromatosis type-1 in a male in his 50s, who presented with generalised weakness, headache associated with ear pain, a feeling of heaviness of the head, and giddiness for a duration of 1 week. On examination, he had axillary freckling and multiple neurofibromas over his body. Nystagmus and dysdiadokokinesia were present. MRI brain revealed an enhancing lesion in the sphenoid and clivus, extending into the sellar and supra-sellar region. The possibility of pituitary adenoma and clival chordoma were considered. He was referred to Neurosurgery and underwent Trans-nasal Trans-sphenoidal near-total resection of the tumour. Biopsy of the lesion was indicative of conventional clival chordoma, which is rarely reported with NF-1. The post-operative period was uneventful and the patient is planned for regular follow-up to detect recurrence

Covid study dataset

Study aimed at finding the association between haematological parameters and severity of Covid-19 infection to help in further triaging and care.</p

Predictors and patterns of empirical antibiotic therapy and associated outcomes in COVID-19 patients: a retrospective study in a tertiary care facility in South India

The coronavirus disease (COVID-19) led to a global health crisis. Inappropriate use of antibiotics in COVID-19 patients has been a concern, leading to antimicrobial resistance. This study evaluated the patterns and predictors of empirical antibiotic therapy in COVID-19 patients and associated outcomes. A hospital-based retrospective study was conducted with 525 patients admitted to Kasturba Hospital, Manipal, India, with moderate and severe COVID-19 from 1 March to 1 August 2021. They were divided based on empirical therapy, and predictors of antibiotic usage were assessed by logistic regression. Four hundred and eighty (91.4%) COVID-19 patients received at least one course of antibiotics, with 440 (83.8%) initiating empirical therapy. Patients with severe COVID-19 manifestations were more likely to be prescribed empirical antibiotics. Multivariable analysis showed that patients initiated on empirical antibiotics had significantly elevated levels of procalcitonin [OR: 3.91 (95% CI: 1.66–9.16) (p = 0.001)], invasive ventilation [OR: 3.93 (95% CI: 1.70–9.09) (p = 0.001)], shortness of breath [OR: 2.25 (95% CI: 1.30–3.89) (p = 0.003)] and higher CRP levels [OR: 1.01 (95% CI: 1.00–1.01) (p = 0.005)]. Most antibiotics (65.9%) were prescribed from the ‘Watch’ group, the highest being ceftriaxone. Only 23.8% of the patients had microbiologically confirmed infections. The study identified predictors for initiating empirical antibacterial therapy in our setting.</p