Severe Thrombocytosis in Chronic Liver Disease Secondary to Iron Deficiency Anemia: A Case Report

Thrombocytopenia is the commonest haematological abnormality seen in chronic liver disease. Thrombocytosis is of two types: Primary and secondary. In secondary form of thrombocytosis usually there is mild to moderate elevation of platelet count. Here, we present a case of 60 year old patient, a known case of chronic liver disease who presented with severe thrombocytosis secondary to iron deficiencyanaemia. Thrombocytosis normalized with treatment of iron deficiency anaemia with parenteral iron

Thyrotoxic Periodic Paralysis as a Presentation of Thyrotoxicosis: A Case Report

Thyrotoxic periodic paralysis (TPP) is a rare but potentially serious complication of hyperthyroidism characterized by muscular weakness and hypokalemia in a patient with thyrotoxicosis. It is predominantly seen in Asian males.The etiology of thyrotoxicosis in most of the cases of TPP is Graves’ disease. We present a case of a 19-year-old male who presented in emergency with paraparesis. Investigations revealed hypokalemia and thyrotoxicosis related to toxic nodular goitre. Diagnosis of thyrotoxic periodic paralysis was made and patient was treated with potassium replacement, propranolol and antithyroid treatment

Hypokalemic Quadriparesis Associated with Dengue: A Case Series

Dengue is an important viral cause of febrile illness in tropical and subtropical regions. Manifestations may range from an asymptomatic infection to life threatening hemorrhagic fever and shock syndrome. Neurological presentations of this disease are rare. Here, we are presenting a case series of three confirmedcases of dengue fever with hypokalemic paralysis presenting as acute pure motor reversible quadriparesis. A clinician should keep dengue virus associated hypokalemic paralysis in mind while dealing with a case of fever with quadriparesis

A review of Mukta : An Ancient drug in Rasa Shastra

Rasa Shastra or preferably called as the ancient Indian Alchemy, deals with the preparation of medicines that has helped mankind since thousands of years. Rasa which means Mercury has been the chief area of interest for the Ancient Alchemists of Rasa Shastra. Along with safe use of Mercurial preparations as medicines since many years, Rasa Shastra also deals with preparation of other herbomineral compounds using varied drugs of plant as well as animal origin. One of the drug, that has been used widely in Rasa Shastra is Mukta or Pearl. There are several categories or groups of drugs (Varga) used in Rasa Shastra viz. Maharasas, Uparasas etc. whereas Mukta is classified under Ratna (precious gems) Varga. Mukta is a shining off white coloured hard spherical object found in sea shells. Due to its lucrative appearance it is widely used in jewelry, cosmetics, as well as in clothing. It is formed by deposition of several concentric layers of calcium carbonate and conchiolin around central nucleus. According to Rasa Shastra classics, Mukta has Madhura, Sheeta and Laghu properties. And so is widely used as a potent Pitta Shamaka. Its purification and Pishti processes are also mentioned in Rasa Shastra classics which makes pearl more potent to cure diseases. Mukta is also widely used in conditions like Amlapitta, Jwara, Daha etc

A Review on Pishti Kalpana

Rasa Shastra deals with the preparation of variety of medicaments and formulations that include Bhasmas, Kharaliya Rasayanas, Kupipakwa Rasayanas, etc. These sections of formulations also depend upon the different types of raw materials that are to be used in it as chief ingredients. Rasa Shastra has a vast and varied history of preparing these medicines and its safer use since thousands of years. Pishti is one such section of formulations that is chiefly used when the raw materials cannot tolerate heat but at the same time are very effective without heat treatment. In Rasa Shastra, mainly the drugs of animal origin or precious gems are subjected to levigation or trituration in a particular media to form a particular Pishti. The word Pishti literally means that which is finely triturated and made into a very fine powder similar to flour. Mukta Pishti, Prawal Pishti being some of the important examples

Disseminated Histoplasmosis in an Immunocompetent Host presenting as Pyrexia of unknown origin (PUO)

Histoplasmosis is a progressive granulomatous disease caused by intracellular dimorphic  fungus Histoplasma capsulatum. The fungus present in the soil infects through inhalational route and can manifest as any of the three main types – Acute primary pulmonary type, chronic cavitatory or progressive  disseminated. In Disseminated histopasmosis (DH) the fungus is detected from more than one location in the body. This is the rarest form of all three types and is usually present in immunocompromised individuals. We report the case of a 27-year-old immunocompetent patient who presented with prolonged fever, weight loss, pain abdomen and skin lesions. She was found to have hepatosplenomegaly and pancytopenia. Biopsy from skin lesions and bone marrow stained positive for Histoplasma capsulatum sp. She was treated with amphotericin B for 28 days, followed by oral itraconazole for 6 months, leading to complete resolution of the disease. This case is interesting due to the presence of disseminated histoplasmosis in an immunocompetent host with prominent skin lesions

Bulk Utilization of Red Mud in Geopolymer Based Products

Red Mud is the solid residue generated from Alumina refinery during the process of bauxite ore processing through Bayer’s process. Typical generation of red mud is 1.5 tons of red mud per ton of alumina produced. The disposal and storage of red mud has been a concern for the alumina industry since its inception, more than a hundred years ago. With the increase in alumina production, the magnitude of the problem is getting multiplied. Its alkaline nature (Na2O ~ 3-7%) and fine size make red mud unsuitable for many applications; a limited utilization is reported in cement industries as one of the raw mix components for cement. The present work deals with the utilization of red mud in geopolymer based paving blocks. Alumina, silica and alkali are the essential items required for geopolymer preparation. Having all these in red mud, the current study attempted to use the same in geopolymer based products. The focus has been on bulk utilization of red mud; target strength of 20 MPa after 28 days of curing (M20 grade) has been the goal as this strength is sufficient for many applications. The study focused on optimizing the red mud content, alkali concentration, fly ash content, etc. The samples are tested for its compressive strength and leachability. The study reveals that significant amount of red mud incorporation is possible with products conforming to USEPA 1311 norms

Balanced double aortic arch with tetralogy of Fallot

AbstractWe present a rare case of balanced double aortic arch in a 19year old cyanotic boy, a known case of tetralogy of Fallot. This was suspected on chest X-ray and confirmed on further imaging by cardiac catheterization and computed tomography. We discuss the clinical and surgical implications of this condition

Antimicrobial prescribing pattern in a tertiary care teaching hospital: a pilot study

Background: The emergence of antimicrobial resistance is a worldwide challenge threatening to negate the gains made by discovery of antimicrobial agents (AMAs).  Antimicrobial Stewardship Program (ASP) is an important strategy for ensuring appropriate use of AMAs and controlling emergence of antibiotic resistance. Implementation of ASP must start with assessment of the current state of antimicrobial use. This study was therefore conducted to assess the prevalent prescribing patterns in a tertiary care hospital and identify gaps which warrant corrective intervention.Methods: This prospective pilot study presents analysis of the first 30 Patients from the medicine ward prescribed at least one antimicrobial agent during the two months of study period. Relevant data was collected in AMA record form. Appropriateness of AMAs was analyzed regarding selection as well as administration protocol as per the hospital antibiotic policy.Results: Out of the 60 AMAs prescribed to these patients, most commonly prescribed were cephalosporins (63.3%), anti-amoebics (26.6%) and macrolides (23.3%). Common diseases involved were urinary tract infection, acute gastroenteritis, sepsis and lower respiratory tract infections.  Use of AMAs was found to be appropriate for the indication in 42 %, dose in 97%, duration 60 %, route 93% and frequency 90 %.Conclusions: This gap between the appropriate and the actual practice use of AMAs indicates an urgent need of rigorous implementation of ASP in order to avoid emergence of resistance and to conserve the sensitivity to the available AMAs