Post-partum recurrent hypoglycemia

Hypoglycemia can be effortless to treat. Its evaluation on the other hand, needs a thorough appraisal. The studied patient had recurrent episodes of hypoglycemia post-delivery which were unprovoked. These conspicuous episodes of hypoglycemia prompted an evaluation and a swift arrival at the diagnosis. In hindsight, she had multiple, typical risk factors predisposing her to develop a Sheehan’s syndrome. This was an acute presentation of a familiar disease

A myriad of fat

Hypertriglyceridemia is a familiar issue a physician and his patients face. Writing a prescription for the same may be effortless, but without a thorough evaluation, we may miss out on a number of concealed diseases. Treating the underling secondary disease, avoids an unnecessary pill burden, eventually decreasing healthcare costs also. Unearthing prevalent diseases like diabetes mellitus (DM) is rewarding in its own way and pays dividends multifold. The physician must be aware that secondary causes of hypertriglyceridemia manifesting as lipemia can commonly be seen in disorders like obesity, primary hypothyroidism and DM. The studied patient presented to us obviously shaken with a long history of weight gain and lipemia during a blood draw. She turned out to have the commonest risk factors for hypertriglyceridemia - Obesity, hypothyroidism and DM causing the alarming lipemia. It was an oddly interesting presenting symptom of hypertriglyceridemia, obesity, hypothyroidism and DM which resulted in an appropriate and prompt management of her underlying diseases.

Scrub typhus presenting without fever

Scrub typhus may be a very a familiar reason for an acute undifferentiated fever. Although there has been an improvement in the diagnostics as well as an increased awareness regarding this disease, it still remains belatedly diagnosed and eventually turns fatal. We present a male patient who was brought to us with jaundice, tender hepatomegaly and distinctly no history fever who turned out to have a Scrub typhus infection and was salvaged owing to a diverse empirical antibiotic coverage. This represents an atypical clinical presentation of a very familiar infection: Tropical rickettsioses infection presenting with afebrile jaundice in an immunocompetent patient. It also brings into perspective the wavered nature of its disease presentation, the significant merit of procuring a good patient history and a change in empirical antibiotic policies especially in areas endemic for scrub typhus