ATRA-induced bradycardia in a case of acute promyelocytic leukemia: A case report.

A 45-year-old female, a new case of acute promyelocytic leukemia (APL), received induction chemotherapy containing all-trans retinoic acid (ATRA) and idarubicin. On the sixth day of therapy, she developed sinus bradycardia and differentiation syndrome (DS). Electrolytes and cardiac imaging were normal. The patient achieved normal sinus rhythm after ATRA was withheld, and DS was treated.

Visceral leishmaniasis: A leucaemia mimicker: A case report.

Visceral Leishmaniasis (VL) is endemic in the northeast part of India, principally Bihar, Jharkhand, Uttar Pradesh, and West Bengal. We report a case of VL from the non-endemic Himalayan region of Kashmir. A 25-year-old female presented with a history of fever, generalized weakness, loss of appetite for one month. On clinical examination, there was hepatosplenomegaly and pancytopenia. There was no travel history to any VL endemic areas. Bone marrow examination revealed an amastigote form of Leishmania Donovan. Nested polymerase chain reaction (PCR) confirmed diagnosis. The patient was treated with 6 mg/kg liposomal amphotericin B, for ten days and improved clinically. Our case reveals that VL is expanding towards non-endemic regions of India, and physicians should remember the differential diagnosis of VL in a patient presenting with fever, pancytopenia, and hepatosplenomegaly.

Vitamin D toxicity due to self-prescription: A case report.

Apart from maintaining healthy bones, vitamin D is also required for cell differentiation, cell growth inhibition, and immune modulation. Vitamin D deficiency is common in the Indian subcontinent. Vitamin D presenting toxicity, leading to hypercalcemia, acute kidney injury, and altered sensorium is very rare. Here we present a case of a 65-year-old man who presented to emergency with persistent vomiting, altered sensorium, and acute kidney injury. The cause of which was an unchecked intake of vitamin D for non-specific musculoskeletal pain. When treated with intravenous fluid, diuretics, calcitonin, and steroids, the patient improved clinically. Therefore, for any patient presenting with persistent vomiting, altered sensorium, and hypercalcemia, with normal to low parathyroid hormone levels, a diagnosis of an overdose of vitamin D should be considered. Early treatment of this condition not only improves the symptoms but also prevents further kidney damage.

Rare snake bite- A case report.

Snake bite is an acute life threating medical emergency and is included amonst neglected tropical diseases.1 Every year in India 200,000 people bitten by snakes and >25% are fatal.2In Maharashtra, Konkan area, the green pit viper (Trimeresurus gramineus) is uncommon, though this snake has become more common. [ Figure 1].

Sinonasal Schwannoma - A Case Report.

Schwannomas are benign peripheral nerve sheath tumours that may occur throughout the body. They rarely occur in the nasal cavity. Paranasal schawannomas are uncommon lesions, representing less than 4% of all head and neck schawannomas. Here we report a case of sinonasal schwannoma in a 35-year-old man who presented with a history of nasal blockage since two years. The mass was removed successfully without any postoperative complication and there was no recurrence within a year of follow up.