A Case of COVID-19 Pneumonia Leading to Acute Respiratory Distress Syndrome (ARDS) and Multi-organ Failure Requiring Extracorporeal Membrane Oxygenation (ECMO) for Six Months and an Associated Critical Limb Ischemia.

This article presents the case of a 57-year-old woman with a history of rheumatoid arthritis who developed severe coronavirus disease 2019 (COVID-19) pneumonia that progressed to acute respiratory distress syndrome (ARDS) and multi-system organ failure. Despite initial slow progression and multiple hospital readmissions, her condition rapidly deteriorated, leading to full respiratory failure requiring intubation and ventilation. She was transferred to a specialized center where she underwent extracorporeal membrane oxygenation (ECMO) and hemodialysis for acute renal failure. Unfortunately, she remained dependent on ECMO for an extended period of six months. Although she made a gradual recovery, the prolonged critical care treatment resulted in critical ischemia of multiple extremities, necessitating a below-knee amputation (BKA) of her left lower extremity and transmetatarsal amputations of her right hand. This case reports one of the longest ECMO treatments for COVID-19 and associated comorbidities in the literature. Clinicians could include a longer duration of treatment and potential associated disabilities in the informed consent.

Driving Under the Influence: An Unusual Case of Basal Ganglia Stroke Misdiagnosed as Intoxication.

Traditionally, strokes are characterized by negative symptoms, including contralateral hemiparesis, facial paralysis, and sensory loss in the upper face and upper extremities. Strokes rarely cause movement disorders such as ballismus, a severe chorea characterized by brief, sudden dance-like movements. Early identification of non-traditional stroke symptoms and risk factors for cerebrovascular disease is vital in providing timely treatment and improving patient outcomes. Our case highlights an uncommon complication of stroke and the need to use advanced imaging modalities, including MRI, to identify brain lesions when other testing is negative. This report adds to the body of literature highlighting ballismus, a rare presentation of stroke, and the lessons learned from managing this case.

Assessment of abnormalities in lipid profiles of patients with chronic kidney disease from different hospitals of Lahore, Pakistan: A case control study.

The current study aimed to evaluate lipid profile parameters in patients with chronic kidney disease (CKD). This case-control study was conducted at the Zoology Department of Lahore College for Women University, Lahore, Pakistan, from September 2016 to June 2017 and analysed lipid profiles of patients with CKD attending different hospitals of Lahore. Of the randomly collected 100 blood samples, 50 were healthy, while the remaining 50 were patients with CKD. Lipid profile parameters were analysed using Hitachi 704 Analyser. For data analysis Chi-square test was used by means of SSPS 17. Results showed that all the parameters, including high density lipoprotein, triglycerides and low density lipoprotein were considerably altered in patients with CKD as compared to the control group. The values of triglycerides and LDL parameters were higher, while HDL cholesterol was lower in patients with CKD as compared to controls.

Cytogenetic bio-monitoring in fuel station attendants of Gujrat, Pakistan through buccal micronucleus cytome assay.

OBJECTIVE: To analyse buccal epithelial cells for scoring the frequency of cytogenetic toxicity in petrol pump workers. METHODS: The case-control study was conducted at the Lahore College for Women University, Lahore, Pakistan, from September 2014 to February 2015, and comprised petrol pump workers. Buccal micronucleus cytome assay was carried out by the collection of buccal cells after the written and oral consent of petrol pump workers. Frequencies of genotoxic (micronucleated and binucleated) and cytotoxic (karryorhetic and karyolitic) cells were scored and compared with the control group. The control group samples were collected randomly by keeping in view that these workers had not worked in petrol pumps ever. SPSS 16 was used for data analysis. RESULTS: Of the 200 participants, there were 100(50%) workers and 100(50%) controls. Statistically significant results were observed on the comparison of frequencies of different cell anomalies in subjects compared to controls on the basis of job duration, smoking habits and age (p< 0.05 each). CONCLUSIONS: Pump workers showed higher frequencies of cytogenetic toxicity compared to controls.