RESUMO
Autoimmune pancreatitis is a rare fibroinflamatory disorder of the pancreas with immunoglobulin G 4[IgG4] associated systemic disease which is steroid responsive.1,2 It has a variable clinical presentation ranging from obstructive jaundice, abdominal pain, steatorrhea and diabetes mellitus. In general presentation of autoimmune pancreatitis as acute pancreatitis is considered to be uncommon. The article presents a case of a 30 years old female newly diagnosed as diabetes mellitus presented with obstructive jaundice with raised lipase and amylase treated as acute pancreatitis. Due to persistent elevation of amylase and lipase and deranged liver function test she was further evaluated her CT findings were typical of autoimmune pancreatitis with raised serum IgG4 levels diagnosed as autoimmune pancreatitis. She was treated with steroids and responded well and after few months presented with relapse
RESUMO
Acute poisoning with various substances is common worldwide. Exposure to agrochemicals, medicines and environmental agents are the major causes of poisoning.1 It is one of the commonest causes of morbidity and mortality to the patients which has drawn the world attention
Objectives: to determine the socio-demographic characteristics and causes and agents of poisoning among patients visiting emergency department with acute poisoning
Methods: all the poisoning cases that fulfilled the inclusion criteria and attended the emergency department from February 2014 till March 2015 with acute poisoning were evaluated. A hospital medical record form were used for data collection in which the details of patient's demography, agents of poisoning and intension of poisoning, were entered from hospital records and analyzed
Results: a total of 364 patients attended the emergency department of Zia Uddin university hospital over period of 12 months. In this population 36% were male and 64% were females. Commonest age group for poisoning was 15-30 yrs. and commonest agent was organophosphate. Intentional poisoning comprised of 88% while accidental poisoning comprised of 12%
Conclusion: on the basis of our study we can conclude that female adolescents and adults are more prone to intentional acute poisoning and pesticides are the commonest agents involved in acute poisoning
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Complete heart block also known as third-degree atrioventricular block [AV block] is a condition in which there is no conduction of the impulse produce in the sinoatrial node [SA node] in the atrium to the ventricle.[1] Complete heart block may be congenital or acquired. There are certain conditions which can lead to third-degree heart block, commonest being the coronary ischemia. Initially there may be first degree atrioventricular block [AV block], second degree atrioven-tricular block [AV block], bundle branch block or bifasicular block ultimately leading to complete heart block. In most cases third-degree AV block presents with acute myocardial infarction.[2,3] A 45 years old male with no known comorbids and without any risk factors for coronary heart disease coming with a short duration of complaints of dizziness and vertigo was diagnosed as a case of complete heart block without any functional and anatomical impairment in conduction system
Assuntos
Masculino , Humanos , Pessoa de Meia-Idade , Bloqueio Atrioventricular , Nó Sinoatrial , Isquemia , Sistema de Condução CardíacoRESUMO
Background: Dengue fever and malaria both can present with thrombocytopenia and is regarded as a strong predictor of dengue fever. Thrombocytopenia is also considered criterion of disease severity, bad prognostic factor and its presence is associated with increase probability of malaria
Objective: To determine frequency of co-existence of dengue fever and malaria in thrombocytopenic patients presented with acute febrile illness in tertiary care hospital
Methods: Cross-sectional, observational study conducted at the department of Emergency Medicine, Ziauddin University Hospital, Karachi from April 2013 to January 2014. A total of 159 patients meeting inclusion criteria were included in this study. 5ml of blood by venupuncture in EDTA anti-coagulant for platelet count and preparing thick and thin films and 2 ml of blood in plain bottle for detection of dengue specific IgM was collected from all patients. Thick films are used to identify malarial parasites and thin films to identify specie. Dengue fever was diagnosed on positive dengue IgM. Co-existence was labeled as positive if malarial parasites and dengue IgM found to be present at the same time. This diffusion susceptibility test was use to determine susceptibility of bacterial agents to antibiotics. Data was analyzed by descriptive statistics using SPSS software version 19
Results: Overall mean [+/- SD] age was 38.3 [+/- 7.9] years, with Male to female ratio was 1.1: 1. Coinfections [Dengue and Malaria] were diagnosed in 5 [5.6%] of cases. From 5 cases, 3 [60%] were male and 2 [40%] were female. Mean [+/- SD] age of 5 positive cases of co-infection was 37.8 [+/- 8.3] years
Conclusion: Concurrent infections were found 5.6% in this study, however, this percentage is slightly low; and special consideration should be given to the likelihood of co-infection with dengue and malaria Co-existence of dengue fever and malaria in thrombocytopenic patients presented with acute febrile illness