Liver Cirrhosis First Time Presented With Delirium Unveiled As Accidental Secondary Hypothermia

Liver cirrhosis is a condition which is defined histopathologically but cannot be diagnosed clinically without any non-invasive tests. There are various etiologies of cirrhosis such as alcoholic liver disease, chronic viral hepatitis B, C, and non-alcoholic fatty liver diseases. Liver, not only function as an organ for detoxification, conjugation, and synthesis but also it regulates body heat. Cirrhosis patients thus are prone to body heat loss and hyperthermia. We present a case with undiagnosed liver cirrhosis patient, 1st time presenting with altered sensorium, revealed as accidental secondary hypothermia with ECG changes of hypothermia. The patient treated for hypothermia only after which she recovered.

Door-to-Needle Time in Myocardial Infarction: Small Steps, Huge Dividends

The Himachal Pradesh acute coronary syndrome registry highlighted a prehospital delay of 780 min. Additional door-to-needle time delay by 1 h increases the hazard ratio of death by 20%. We conducted a retrospective (group 1) and a prospective (group 2) analysis of 63 patients each to measure the impact of a fast-track protocol in the emergency department (ED) on the door-to-needle time in ST-elevation myocardial infarction (STEMI). The fast-track protocol involved zero cost to the hospital and saved 63 precious door-to-needle minutes for patients with STEMI. Thrombolysis in ED can save 33 precious minutes wasted in shifting patients to the coronary care unit.

Lymphocytic Hypophysitis Masquerading As Transient Secondary Hyperadrenalism Followed By Panhypopituitarism

Lymphocytic hypophysitis (LH) is a rare inflammatory disease of the pituitary gland. This condition strikingly shows female preponderance and commonly affects women during pregnancy or in the post-partum period. It’s a clinical presentation and radiological features may mimic pituitary adenoma. Though its treatment modality is uncertain steroid remains the 1st option for treatment. Here, we report an unusual case of LHin a 21-year-old female patient where initially, the patient presented with hyperadrenalism and secondary hyperthyroidism followed by pan-hypopituitarism (Addisonian crisis) which is attributed to initial autoimmune destruction of the gland followed by subsequent fibrosis. Thus, it is a rare case report which exquisitely explains this rare presentation and such cases should be investigated thoroughly since there are many differential and response to steroids is remarkable