role of virtual autopsy in uncertain clinical scenarios

We present a case of a patient who was transferred from the general ward to the ICU in an unstable condition and passed away within approximately twenty-four hours without having had full investigations due to her unstable clinical condition. In the absence of necessary investigations, a virtual autopsy to search for a medical cause of her rapid deterioration was performed. The virtual autopsy revealed cardio-respiratory failure. Post-mortem computed tomography [PMCT] scans were performed, which revealed that the immediate cause of her deterioration was most likely to have been a myocardial infarction associated with pneumonia

Effectiveness of intensive insulin therapy in the management of acute necrotizing pancreatitis induced by very severe hypertriglyceridemia

Hypertriglyceridemia may be responsible for up to 4% of acute pancreatitis. Complicated pancreatitis is a serious medical condition and might be fatal. Therefore, treating the underlying cause along with supportive measures is crucial to prevent further deterioration and possible death. There have been reports where Insulin has been the mainstay of treatment for reducing triglyceride levels in patients with pancreatitis, however, there are no well-established guidelines. We present a forty-year-old female patient diagnosed with acute necrotizing pancreatitis. CT abdomen revealed acute necrotic pancreatitis [Balthazar E] with extensive peri-pancreatic and peritoneal fluid collections. The patient was managed in the ICU for 28 days. She continued to receive gemfibrozil and insulin infusion, initiated according to the ICU's Protocol - Algorithm 1 targeting glucose values of 4.4 mmol/L to 10 mmol/L along with heparin infusion. She was successfully treated and recovered. She was discharged on antidiabetic and lipid lowering medications