Two Cases of Vasculitis with Renal Vein Thrombosis.

We present a series of two cases of ANCA associated Vasculitis (AAV) presenting as Pulmonary Renal syndrome with associated renal vein thrombosis. Although there are enough evidences suggesting association of venous thrombosis with AAVs, the incidence of renal vein thrombosis is rare. Renal vein thrombosis should be ruled out in cases where there is delay in recovery of renal function in patients with AAV. Positive laboratory values for anti-Proteinase-3 (PR3) and anti-Myeloperoxidase (MPO) ANCA in the cases that presented as Rapidly Progressive Glomerulonephritis, helped in early initiation of treatment with complete recovery of Renal function.

Passenger Lymphocyte Syndrome after Renal Transplant: Case Report.

Passenger lymphocyte syndrome (PLS) is a rare cause of anemia resulting from immune-mediated hemolysis in the post-transplant recipient. We report a case of 26-year-old male who underwent renal transplant. His mother as donor was O positive while he was A positive. He developed anemia at 1-week post-transplant, which later turned out to be PLS. Laboratory findings included rapidly decreasing Hb level and intravascular hemolysis. Hemolysis was brief, because the lymphocytes passed on with the donor organ were able to proliferate only for a while. The case signifies the importance of PLS as a cause for anemia, specifically in the early period after solid organ transplant. It is usually self-limiting, and the treatment requires blood transfusion of donor's blood group.

Burden Faced by Caregivers of Stroke Patients Who Attend Rural-based Medical Teaching Hospital in Western India.

BACKGROUND: Stroke results in significant caregiver burden and strain. OBJECTIVE: The main objectives of this study is to assess the burden and its consequences in caregivers of stroke patients and to determine the associated factors to caregivers' burden. METHODS: A cross-sectional study was conducted over 1 year on 70 consecutive patients who attended the Shree Krishna Hospital, Karamsad stroke clinic. Demographic and clinical characteristics of all patients were recorded after obtaining the consent. The modified rankin scale and Barthel index were administered to the patient, whereas Caregiver strain index, Caregiver burden scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Kuppuswami scale were administered to the patient's caregiver. Descriptive statistics were used to portray demographic and clinical profiles. Correlation coefficients were used to assess the association between different scales, and t-test was applied to assess association of caregivers' burden with different categorical variables. RESULTS: The mean age was 60 years for patients and 47 years for caregivers. Nearly 72.8% of patients were male, whereas 57% of caregivers were female. The mean caregiver burden scale score was 28.26. Caregivers' burden decreased with increase in stroke duration (P = 0.01), increase in education level (P = 0.054), and upper socioeconomic status (P = 0.02). Caregivers' burden increased with caring for male gender (P = 0.18), being a female caregiver (P = 0.31), longer caregiver hours (r = 0.51), and increased patient disability (P < 0.01). A strong correlation existed between caregivers' burden and depression (0.72); anxiety and depression (0.84); caregivers' burden and caregiver strain index (0.72). CONCLUSIONS: A structured and targeted caregiver intervention is urgently needed to relieve caregivers' burden and related psychological comorbidities in an Indian setup.