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Scrub typhus is a common zoonotic disease with high case fatality rate. The clinical presentation of this disease may vary from acute febrile illness, thrombocytopenia, gastrointestinal manifestations, coagulopathy to neurological manifestations. The common neurological manifestations are meningitis and meningoencephalitis, whereas subdural hemorrhage, cerebrovascular accident, i.e., intracerebral hemorrhage, infarct, subarachnoid hemorrhage, etc. are among rare neurological presentations. Scrub typhus-induced neurological disease should be investigated to provide a timely and appropriate diagnosis and to reduce the mortality in complicated scrub typhus infection. Here we report a case of scrub typhus complicated with subdural hemorrhage admitted in our hospital.
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Introduction: Rasmussen’s encephalitis (RE) is an inflammatory encephalopathy characterized by progressive refractory focal seizures, cognitive deterioration and focal neurological deficit that occur with gradual atrophy of one brain hemisphere. Case presentation: We report a case of an 18-year-old male with a history of abnormal body movements involving the right half of the body without loss of consciousness for the last 15 years. Noncontrast computed tomography (NCCT) head and magnetic resonance imaging (MRI) revealed hemiatrophy of the left cerebral hemisphere. Conclusion: RE is a rare disease; hence, diagnosing and managing such patients may be challenging. Our aim is to draw attention of the treating physicians towards this disease with the help of this case report.
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Introduction: Erectile dysfunction (ED) constitutes a large burden on society given its high prevalence and impact on quality of life. Diabetes is a common cause of organic ED. Prevalence of ED in diabetes ranges from 35% to 85% depending on the study, versus 26% in general population. Platelet-lymphocyte ratio (PLR) has been detected as an important marker for inflammation. Some studies have identified its role in ED but more research is needed. Material and methods: It was a hospital-based prospective observational study. According to International Index of Erectile Function (IIEF)-5 questionnaire, patients were divided into 4 categories: mild ED with score 17 to 21, mild-to-moderate ED with score 12 to 16, moderate ED with score 8 to 11 and severe ED with score 1 to 7. Presence of ED and its severity was correlated with age, residence, duration of diabetes, glycemic status, lipid profile, PLR, complications, body mass index (BMI), etc. Results: Prevalence of ED in male diabetes patients was found to be 72.4%. Among 110 cases with ED, 8 had mild ED (7.2%), 27 had mild-to-moderate (24.5%), 27 had moderate ED (24.5%) and 48 had severe ED (43.6%). Prevalence of ED was found to be proportional to age. Majority of cases in ED group were those with long-standing diabetes. Correlation of ED with complication of diabetes, like nephropathy and retinopathy, was significant, whereas it was not significant with neuropathy. Significant correlation of ED was found with BMI and PLR. Conclusion: ED prevalence was high among the diabetes patients and it increased with age and duration of the disease. Presence of diabetic complications was significantly associated with ED. BMI was significantly associated with development of ED. PLR was significantly higher in ED group and closely related to severity of ED.
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Scrub typhus, also called bush typhus, is a zoonotic disease a Gram-negative bacterium. Its presentation may range from nonspecific febrile illness to severe disease, with cardiovascular, renal, hepatic and neurological involvement. Myocarditis is one of the rare complications of scrub typhus. Hence, we are reporting a case of a 50-year-old male, farmer by occupation, presenting to us in multiorgan dysfunction syndrome who developed myocarditis during second week of his illness.
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Background: Diabetes mellitus is an endocrine disorder which involves multiple organ systems and leads to significant morbidity and mortality. Diabetes mellitus has been defined as “A metabolic syndrome characterized by chronic hyperglycemia and disturbance of carbohydrate, fat and protein metabolism associated with absolute or relative deficiency in insulin secretion and or insulin action”. Thyroid diseases are also a common endocrinopathy seen in the adult population. Thyroid hormones are intimately involved in cellular metabolism. The present work is a modest attempt to study the prevalence of thyroid disorders in patients with type 2 diabetes mellitus.Methods: The study was carried out in total 108 diabetic patients without known thyroid disorder admitted in various Medical wards of R.N.T. Medical college and attached group of hospitals, Udaipur. It was a cross Sectional study done over a period of 10 months. Results: In the present study, 13% of patients with type 2 diabetes mellitus had abnormal thyroid profile. Out of which the most common presentation was sub clinical hypothyroidism found in 9.25% followed by1.9% had overt hypothyroidism and 1.9% had sub clinical hyperthyroidism. In persons with abnormal thyroid profile 85.7% were females and 14.3% were males which was statistically significant.Conclusions: Prevalence of thyroid dysfunction is common among T2DM patients and is higher in females than in males. There is no significant correlation between thyroid dysfunction and age, diabetes control, family history, type of treatment and HbA1c level in diabetic patients.
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Introduction: Diabetes Mellitus is one of the most commonendocrinal diseases in the world. Incidences of this disease areincreasing worldwide and this disease is called disease of thismillennium. This study was undertaken to correlate fastingblood sugar level, Glycosylated haemoglobin (HbA1C) leveland serum lipid levels in patients with diabetes mellitus.Material and Methods: This study was a cross sectionalstudy conducted on 100 patients of diabetes mellitus came toM.B Govt. Hospital, Udaipur. The fasting blood sugar (FBS)levels, HbA1C levels and serum lipid levels were performedand then correlated fasting blood sugar level with HbA1Clevels and FBS and HbA1C with serum lipid levels. There wasa significant positive correlation between FBS and HbA1C,and FBS and HbA1C with serum cholesterol and serumtriglycerides level and negative correlation with serum HDLcholesterol levels.Results: This study demonstrated that HbA1C level wasincreased in diabetics and it showed correlation with the statusof control of diabetes.Conclusion: Diabetics have got increased level of serumcholesterol, triglycerides and decreased levels of serumHDL-cholesterol. HbA1C showed stronger correlation withserum cholesterol and triglycerides as compared to FBS.HDL-cholesterol showed stronger correlation with FBS thanHbA1C.
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Introduction: Poisons are the substances that can causesevere organ damage or death, if ingested, breathed, injectedinto the body or absorbed through the skin.1 The word poisonwas firstly used in 1200 A.D., which means a deadly potionor substance.2 This word was derived from Latin word‘potionem’ (a drinking of drink). Every substance may act aspoison and only the dose plays an important role. Aims andobjectives: 1) to study the demographic profile of poisoningin the patients admitted in MBGH, Udaipur. 2) To study theincidence of different types of poisoning.Material and methods: This study was hospital basedprospective study. The study was conducted from Jan, 2017to Jan, 2018; carried out in Department of Medicine RNTmedical college and MBGH hospitals Udaipur (Raj). 200patients were included who fulfilled the eligible criteria.Results: Males (54.50%) were affected more than females(45.50%).Maximum numbers of patients 34.00% were inthe age group between 21-30 years. Most of the people werefrom rural area (67.00%). Highest numbers were reportedamong agricultural worker (21.50%) followed by students(21.00%). Intentional poisoning was found among 159 cases(79.5%). Family problems (n=78, 39%) were contributingfactor for committing suicides. The leading poison wasOrganophosphorous group of compounds 33.00%. Highestmortality was seen in aluminum phosphide which constituted16 cases (51.61%).Conclusion: Acute poisoning is one of the common problemsin a clinical practice and our study suggests that Insecticidesare one of the most common agents causing this problem
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Introduction: Hypertension is one of most commoncardiovascular disorder in clinical practice. It is also calledhigh blood pressure. Hypertension is well known risk factorfor cardiovascular, renal and cerebrovascular disease. Evenslightly rise elevated blood pressure lead to increase risk incardiovascular disease and strokes (CVD). Hypertensiveemergency is define as recent increase in blood pressure toa very high level (> 180 mmHg systolic and > 110 mmHgdiastolic) with target organ damage. Study aimed to evaluatethe modes of presentations, clinical profile and spectrum oftarget organ damage in patients with hypertensive emergency.Material and methods: This study was hospital basedprospective study. The present study was carried out in 100patients admitted in various medical wards in R.N.T. MedicalCollege Udaipur, Rajasthan over a period of eight months.Patients fulfilling the eligible criteria were included.Result: Among the 100 patients studied, 70 were males andthe male female ratio was 2.33:1. In the age distribution, 72%patients were found age more than 50 years and rest 28% wasless than 50 years. The commonest clinical presentation foundwas neurological deficits in 50% followed by dyspnoea in34% and chest pain in 10% patients.Conclusion: The present study done over hypertensiveemergencies patients conclude that majority of patientsbelonged to the fifth and sixth decades of age and of malesex. It was commonly observed in the patients knownhypertensive. Diabetes and dyslipidemias was commonassociation observed. Commonest mode of presentation wasneuro deficit and higher level of mean blood pressure at thetime of presentation may associated with worst out come
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Introduction: Changes in human behavior and lifestyleover the last century have resulted in a dramatic increase inthe incidence of diabetes worldwide. Diabetes mellitus is animportant cardiovascular risk factor. The rate of death due tocardiovascular disease in diabetic patients is 2-4 times higherthan in non-diabetic population. In this study, we aimedto investigate the mortality rate among diabetic, Impairedfasting Glucose and Non-Diabetic groups who are havingacute myocardial infarction (AMI) during the first 7 days ofhospitalization.Material and methods: The study was conducted in R.N.T.Medical College and Associated Group of Hospitals inUdaipur (Rajasthan). The main catchment area was ruralwith few township and municipal area. This study involvedDepartment of General Medicine, Intensive cardiac CareUnit for patient’s selection and Departments of Biochemistry,Pathology and Radiology for the necessary laboratory testsand investigation data.Result: In our study we found that the mortality was 4% innon-diabetic group, 20% in diabetic group and 18% in patientswith impaired fasting glucose (IFG). Mortality in patientshaving IFG and DM were significantly higher compared toNON-DM patients.Conclusion: In conclusion, mortality in patients havingImpaired Fasting Glucose (IFG) and the Diabetes Mellitus(DM) during the acute phase (first 7 days) of MyocardialInfarction (AMI) were significantly higher compared to NONDM patients; and mortality in patients having IFG was likethat of patients having DM.