Search

Type 1 diabetes mellitus (T1DM) is an autoimmune illness that targets specific organs and associated with other autoimmune conditions. Dermatomyositis is an idiopathic systemic autoimmune condition involving skeletal muscles and skin. Co-occurrence of both disorders is quite rare. We diagnosed dermatomyositis in a young male with T1DM who presented with muscle weakness and cutaneous manifestations. There is an additional metabolic hurdle in T1DM, as high doses of glucocorticoids used in dermatomyositis management are related to glycemic instability which requires regular blood sugar monitoring and insulin dose titration accordingly. Considering the prognostic consequences, early diagnosis and management of dermatomyositis is essential. [ABSTRACT FROM AUTHOR]

In preventive orthodontics, after an early primary tooth loss, a space maintainer (SM) is designed. The fabrication of a conventional fixed SM necessitates numerous visits and the cooperation of the patient. The present case presents a unique instance where the arch space for the unerupted lower premolars was preserved by designing a "mesial shoe" appliance. A prefabricated SM was employed on the 8-year-old child in this case report. At the 10th-month appointment, the crown tip of the succedaneous tooth was seen clinically mesial to the intra-alveolar extension of the appliance. The present case report demonstrates that prefabricated SMs could be a useful and novel alternative to traditional fixed SMs. [ABSTRACT FROM AUTHOR]

Introduction: Multiple mechanisms were proposed for the etiopathogenesis of type 1 diabetes mellitus (T1DM). An interplay between genetic, environmental, and immunological factors leads to generate autoantibodies against glutamic acid decarboxylase 65, intracellular adhesion (ICA)-512, and insulin autoantibodies (IAA) proteins of beta cells. Molecular mimicry is the best proposed mechanism of the above, but yet needs much solid evidence. Zinc transporter 8 (ZnT8) and proinsulin (PI) proteins of beta cells act as epitopes for some partially recognized proteins (MAP3865c, MAP1, 4agbp, and MAP2404c) of mycobacterium paratuberculosis (MAP) generating autoantibodies against them. Similarly, other protein molecular mimickers were also reported. This review collects the latest evidence for the environmental etiopathogenesis of T1DM pertaining to MAP at the background of the phenomenon of molecular mimicry, and it proposes more directions for research in the field. Materials and Methods: Using the keywords "MAP and T1DM," "MAP and zoonotic diseases," T1DM and Molecular mimicry" and "T1DM and epitopes" searches were conducted in PubMed, Science Direct, and Google Scholar following PRISMA guidelines. This review related original articles and case reports were collected for the compilation of all proposed proteins having a tendency of molecular mimicry. This review includes 12 original articles and 17 case reports published till date. Results: A strong association was found in peptide pairs MAP3865c/ZnT8, 4agbp/PI, and MAP2404c/PI between MAP and human beings. Discussion: Multiple MAP proteins show strong homology to human proteins generating antibodies against pancreatic beta cells. MAP exists in dairy products, posing a high risk of transmission to human beings. An uninterrupted but silent exposure of human beings to MAP could be an environmental trigger for T1DM. [ABSTRACT FROM AUTHOR]

Objective: To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography (CT) severity score. Methods: A prospective, non-randomized, observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021. Fifty-nine were male [mean age (54.1±12.2) years] and 41 were female [mean age (46.9±15.1) years]. Patients with previous cardiovascular disease, previous chronic lung disease, and pre-existing primary or secondary pulmonary hypertension were excluded. Patients were examined, and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality. Results: Post-COVID-19 patients had persistent symptoms, the most common being fatigue (59%). Most of these symptoms were relieved on follow-up. A rise in systolic, diastolic blood pressure, and pulse rate was observed. The electrocardiographic evaluation revealed ST-T segment changes, sinus tachycardia, ventricular hypertrophy, and arrhythmias among a considerable number of patients. On echocardiography, left ventricular diastolic dysfunction was most common (43%). Pulmonary hypertension, as evidenced by elevated pulmonary artery systolic pressure, was seen in 15% of patients. Conclusions: The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease. [ABSTRACT FROM AUTHOR]

Maternally inherited diabetes and deafness (MIDD) is a rare subtype of diabetes with a prevalence of up to 1% globally but often missed if not suspected. We present a case of MIDD and a thorough review of the literature related to it. The phenotypic presentation of diabetes depends on heteroplasmy levels of m.3243A>G mutation of the individual patient. Patients with MIDD may have involvement of other organs such as eye, muscles, kidney, and heart. In our patient, along with diabetes and deafness, there was also an associated vision loss with a strong maternal inheritance of diabetes. A young male who presented with diabetic ketoacidosis (DKA) and hearing and vision impairment and on further diagnostic work up turned out to be a case of genetically confirmed (m.3243A>G mutation) MIDD. To the best of our knowledge, this should be the first case of MIDD presenting as DKA being reported from India. [ABSTRACT FROM AUTHOR]

Background: Despite of several guidelines metformin and glimepiride remains the first prescribed drug in most people with diabetes. Very often canagliflozin and teneligliptin remain the third prescribed OHA. Efficacy of teneligliptin and canagliflozin as solo drug or in combination with other single OHA’s on glycaemic parameters, lipid profiles & blood pressure is already established. But their efficacy on above parameters when used as third drug next to metformin and sulfonylurea is still not investigated. Aims and objectives: Aim of this study is to compare glycaemic and non-glycemic effects of canagliflozin and teneligliptin as third line drug. Objective is to establish their multiple pleotropic effects at this position. Methods: Subjects with uncontrolled glycaemic parameters with hypertension and diabetic dyslipidaemia already on half maximal doses of metformin and glimepiride were enrolled in the study. Out of 87 selections, 45 were prescribed canagliflozin 100 mg/d and to 42 subjects, teneligliptin 20mg/d, each for 24 weeks. Effects over HbA1c, fasting and post prandial plasma glucose, systolic and diastolic blood pressures, HDL’c and triglycerides were observed pre and post intervention. Results: As a third drug both canagliflozin and teneligliptin show significant reduction in HbA1c (1.5 versus 1.6%), fasting (-20.2 versus -28.8 mg %), and post prandial (-39.9 versus – 58.5mg %). Effects over systolic (4 mmHg versus 1.1 mmHg) and diastolic BP (3.1 mmHg versus 0.2 mmHg) was clinically and statistically significant (p = 0.3 and 0.1) respectively in both groups. A statistically insignificant (9.6 versus 4.1 mg%; p =) reduction in Triglycerides but significant (7.6 versus 1.2; p <0.0001) increase in HDL’c was observed. Conclusion: Canagliflozin and teneligliptin, both retains their glycaemic and non-glycaemic benefits even when used as third OHA for diabetes management. Canagliflozin scores better for comorbid hypertension and diabetic dyslipidaemia. [ABSTRACT FROM AUTHOR]

Background: The burden of diabetes is increasing day by day, and diabetic individuals are predisposed to develop micro- and macrovascular complications leading to increased mortality and morbidity. Platelet indexes can alert us regarding endothelial dysfunction in diabetes and in turn regarding microvascular complications. Materials and Methods: A case-control study was conducted on 100 diabetic patients with age and sex matched and 100 nondiabetic controls. All diabetic patients were evaluated for microvascular complications such as diabetic neuropathy, retinopathy, and nephropathy. Clinical history of all patients was taken regarding associated comorbidities and association. Fasting and postprandial blood sugar, HbA1c, platelet count, and platelet indices were measured. Statistical analysis was performed by using student unpaired t test and X2 test. Results: Platelet indices mean platelet volume, plateletcrit, platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly higher in diabetic patients compared with controls. It was also observed that changes in mean platelet volume, PDW, and P-LCR were more significant in diabetic patients with microvascular complications than diabetic patients without microvascular complications. Conclusion: Values of platelet indices were statistically associated with diabetes and its microvascular complications. [ABSTRACT FROM AUTHOR]

Introduction: Multiple factors including infections affect graft and patient outcomes in Renal Allograft Recipients. Survival data from tropical countries is scarce, especially during the COVID 19 pandemic. Subjects and Methods: In this ambispective study, records of KTRs between 2011 to 2019 and prospective follow up of subsequent transplants up till 2021 was done. Infection rate, etiology, and patient and graft outcomes were studied with appropriate investigations. Univariate and multivariate analysis was done to assess the predictors of patient and graft outcomes. Results: A total of 249 patients were studied, of which 218 episodes of infection occurred in 129 patients (49.79%). Bacterial infections were the most common (40.50%), followed by viral (35.20%), mycobacterial (11%), and fungal (8.10%). Of all infections, 52.3% of cases occurred within the 1st 6 months. Infections led to patient mortality in 14.7% of cases. Infections were significantly associated with graft rejection and chronic graft dysfunction. Donor age, cytomegalovirus (CMV) infection, and graft rejection were independent predictors of chronic graft dysfunction. Recipient age and graft rejection were independent predictors of graft loss. Graft survival was 88.53%, 73.75%, and 44.90% at the end of 1, 3, and 5 years, respectively, with average 18% of total graft losses occurring during the pre-COVID era as compared to 39% in COVID period. Conclusion: Invasive fungal infections and tuberculosis are more common in late transplant period. Recipient and donor age, graft rejection, CMV infection, and COVID pandemic period affected graft and patient outcomes. COVID pandemic period led to a disproportionately higher occurrence of graft loss. [ABSTRACT FROM AUTHOR]

Diabetic patients are at an increased risk of multiple complications, among which one of the most dreaded complications is diabetic nephropathy. Early diagnosis and appropriate management will at least prolong the life of the kidney and prevent the development of end-stage renal failure. Materials and Methods: Simple urinalysis is a useful tool for early diagnosis of diabetic kidney disease and helps differentiate between diabetic and nondiabetic kidney diseases. In this review, we have discussed the usefulness of urinalysis for a diabetic patient. Results: Early detection of an abnormality can be an alarming sign, and we can diagnose treatable causes of renal failure in diabetic patients. Conclusions: History, examination, and urinalysis are sufficient in most of the cases for diagnosing diabetic kidney disease. Renal biopsy is indicated in special situations where diagnosis cannot be made even after appropriate non-invasive investigations. Few limitations of the study are resource settings and knowledge of this simple test to predict an alarming sign of the kidney disease. [ABSTRACT FROM AUTHOR]

Context: Pulse oximetry is one of the most revolutionary methods used to monitor the patients in the clinical setting, particularly intensive care and anesthesia. We usually use the index or middle finger to measure SpO2 values, but little is known about the inter-digital differences that exist between the fingers. Aim: We aim to compare the peripheral capillary oxygen saturation among fingers of both hands. A total of 93 healthy volunteers aged between 18 and 50 years participated in the study. Materials and Methods: Their SpO2 values were recorded from each finger with at least 1 minute of resting interval. Their blood pressure, heart rate, and body temperature were recorded as well. Result: A total of 930 measurements were obtained from 93 volunteers. The highest average SpO2 value of right-handed volunteers was measured from the left little finger (98.48 ± 0.62) of right-handed volunteers, and it was statistically significant when compared with the right ring finger, right little finger, left thumb, left index, left middle finger, and left ring finger. The highest average SpO2 from left-handed volunteers was obtained from the right index finger, but it was statistically insignificant. Conclusion: We assume ethnic and climatic differences to play a role in contradictory results noted from previous studies conducted, and this needs to be investigated further. It is recommended that multiple readings may be obtained from other fingers as well before coming to any conclusion as inter-finger variability cannot be ignored. [ABSTRACT FROM AUTHOR]

Diabetic striatopathy is a rare clinico-radiological phenomenon characterized by hemichorea/hemiballismus, hyperglycemia, hyperosmolarity in the absence of ketoacidosis. It is due to lesion in contralateral basal ganglia which is evident as T1 hyperintensity in MRI brain study. Here we are reporting a case of hemichorea/hemiballismus which was associated with hyperglycemia. Our patient improved significantly once blood glucose was controlled adequately. As it carries good prognosis, we are reporting this rare case to illustrate the importance of recognition of this rare syndrome. [ABSTRACT FROM AUTHOR]

Chronic myeloid leukemia (CML), BCR-ABL1-positive, is classified as a myeloproliferative neoplasm predominantly composed of proliferating granulocytes and determined to have the Philadelphia chromosome/translocation t (9;22)(q34;q11.2). Skin is said to be the mirror to systemic diseases, with skin manifestations ranging from nonspecific cutaneous lesions to specific lesions. The cutaneous manifestations of CML are generally reddish-brown to violaceous papules and nodules, indurated or hemorrhagic plaques, perifollicular acneiform papules, bullae, and palpable purpura. Other unusual manifestations could be erythema nodosum, pyoderma gangrenosum, erythema annulare centrifugum, and so on. Here we present a case of a 50-year-old woman with a history of recurrent pruritic skin lesions and erythema annulare centrifugum as the presenting complaint of CML. [ABSTRACT FROM AUTHOR]

Rationale: COVID-19 usually presents with flu-like symptoms and signs, but some rare presentations like leukemoid symptoms cannot be ignored. Patient's concerns: A 37-year-old female presented to the outpatient department with flu-like symptoms. Diagnosis: The RT-PCR test for SARS-CoV-2 infection was positive, while complete blood cell and peripheral blood smear showed leukemoid reaction. Intervention: Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation. Outcomes: On the 10th day, the patient was asymptomatic and RTPCR was negative. So the patient was discharged and leukemoid presentation subsided after clearance of viral disease. Lessons: COVID-19 has a myriad of presentations, and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection. [ABSTRACT FROM AUTHOR]

Introduction: Pioglitazone has been a cornerstone of oral hypoglycemic therapy. Concerns have been raised about its association with urinary bladder cancer. Considering the wide usage of this drug, concrete and multiple population-based studies are needed to establish the safety of this drug. The present retrospective study is aimed to assess the association of pioglitazone with urinary bladder cancer. Materials and Methods: Clinical records of 4170 patients (2085 pioglitazone users and similar number of nonpioglitazone users) attending the diabetes clinic at a tertiary level teaching hospital were accessed, and the patients were subjected to symptom-directed questionnaire, urine examination, and cystoscopy and bladder biopsy (whenever clinically indicated). The risk of bladder cancer was also assessed with respect to cumulative dose and duration of pioglitazone. Results: We did not observe any increased risk of bladder malignancy with pioglitazone exposure; furthermore, there was no association with cumulative dose and duration of pioglitazone therapy. Pioglitazone was found to be effective and safe in managing glycemic control in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Globally, case fatality rate is more in males compared to females. Some studies have suggested. It is hypothesized that estrogen hormone may decrease susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS CoV-2.) Objective: The objective of the study was to evaluate the gender differences in SARS CoV-2 outcomes and to analyze if there are any differences in outcomes in premenopausal females compared to postmenopausal females. Materials and Methods: Patients tested positive for SARS CoV-2 through real-time reverse transcription-polymerase chain reaction by Thermo Fischer Taqpath assay approved by the Indian Council of Medical Research were included in the study. The data obtained was analyzed for the epidemiological, clinical, and laboratory characteristics from their medical records. Results: The mortality rate in females was 12.6%, whereas mortality in males was 19.4%. In between-group analysis, 8.6% (16/185) of females died in premenopausal age group versus 12.8% (27/211) in postmenopausal group. The proportion of females who expired due to COVID significantly differ by age and postmenopausal status X2 (1, n = 293) = 7.2, the P value is 0.007. The difference is statistically significant at P < 0.05. Postmenopausal women were more likely to expire due to COVID-19 infection compared to premenopausal women. Conclusion: The mortality rate in postmenopausal age group was greater than mortality in premenopausal females emphasizing the protection provided by estrogens hormone in them. Postmenopausal women are also at higher risk of severe COVID-19 infection than premenopausal women. Mortality is greater in males compared to females, further strengthening the role of estrogens. [ABSTRACT FROM AUTHOR]

Introduction and Aim: The present study aims to assess the glycemic status during voluntary blood donation as a strategy to detect undiagnosed diabetes mellitus and diabetic nephropathy. Material and Method: Study was conducted at a tertiary care hospital and medical college. All voluntary blood donors underwent random capillary blood glucose screening and patients who had random blood sugar exceeding 200 mg/dl were subjected to undergo oral glucose tolerance test (OGTT). The subjects thus detected diabetic by capillary blood sugar and OGTT underwent screening diabetic kidney disease with urine albumin to creatnine ratio (UACR). Data collected was statistically analyzed using SPSS 16 using Student's t test. Results: Seven hundred and sixty five males and 443 females were enrolled for the study. Capillary blood sugar of 54 subjects was ≥200 mg/dl. 48 subjects gave consent for OGTT, stratified data showed 22 subjects (12 males and 10 females) were in range of 200–300 mg/dl. 20 subjects (12 males and 8 females) were in range of 300–400 mg/dl, whereas 6 subjects (5 males and 1 female) had blood sugar more than 400 mg/dl. The HbA1C ranges in respective glycemic groups were 200–300 mg/dl – 7.4% to 8.6% (mean – 8.05%), 300–400 mg/dl – 8.7% to 11.8% (mean 9.63%), more than 400 mg/dl – 11.8% to 14.2% (mean – 13%). Male preponderance was observed in all glycemic groups, though the difference was statistically insignificant. Of the 48 diabetic subjects, 13 (27.08%) were detected to have albuminuria, of these 11 (22.91%) had microalbuminuria (UACR 30 – 300 mg/gm), whereas 2 (4.16%) had overt proteinuria (UACR exceeding 300 mg/gm). Conclusion: Glycemic screening with random capillary blood glucose screening, 75 gm 2 hour OGTT and HbA1C amongst voluntary blood donors can be used to detect pre diabetes and undiagnosed diabetes mellitus and diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Drug-induced generalized skin eruption in a diabetes mellitus patient receiving a dipeptidyl peptidase-4 inhibitor plus metformin. On consultation with our dermatology department, we made the diagnosis of drug-induced Papulonodular lesions in a patient of Diabetes Mellitus receiving Sitagliptin and Metformin. Sir, In animal models, incretin-based therapy has been shown to be effective in protecting and preserving -cell functions.[[1]] Farilla I et al i . 2002 and Li I et al i . 2003 have corroborated that DPP-4 inhibitors increase islet cell proliferation, and decrease cell apoptosis I in vitro i .[[2]] However, as with any other drugs we need to be aware of the adverse effects of Sitagliptin so that it may be withdrawn at the very advent of any adverse reaction. [Extracted from the article]

Introduction: The golden proportion is based on the premise that there is a link between natural beauty and mathematics. The maxillary anterior teeth size, shape, and arrangement are the most influential factors for harmonious appearance. One of the most important tasks in esthetic dentistry is creating a balanced proportion when restoring or replacing these teeth. Aim: To analyze the mesiodistal width of maxillary anterior teeth in primary and permanent dentition to determine whether golden proportion existed among them. Methodology: Sixty subjects were randomly selected in accordance with inclusion and exclusion criteria. Participants were divided into two groups, each comprising 30 children of primary dentition between 3 and 6 years and 30 children of permanent dentition 12-13 years. Intraoral photographs using a smartphone were taken using the cheek retractor with the head upright and occlusal plane parallel to the floor. The distance between the participant and the camera was fixed at 4 cm. The digital photographic images were transferred to the computer and the perceived mesiodistal width was measured for anterior teeth using Adobe Photoshop CS (version 8) software. Results: The ratio of lateral incisor to central incisor was not found to differ significantly between permanent and primary dentition (P > 0.05). However, the ratio of canine to lateral incisor was significantly greater in primary dentition compared to permanent dentition (P < 0.05). Conclusion: The study revealed that, golden proportion was inconsistent in terms of relative tooth width in primary dentition. [ABSTRACT FROM AUTHOR]

Vitamin B12 deficiency is rare and presents with combinations of hematological changes, discoloration of skin, hair and nails, weakness, syncope, and diarrhea. Causes of vitamin B12 deficiencies are malabsorption, pernicious anemia, gastric resection, and rarely inadequate intake. Inadequate intake occurs commonly in people having a strict vegetarian diet. Megaloblastic anemia has a slow onset when compared to that of other anemias. It results in defect in the red cell DNA synthesis and is mostly due to hypovitaminosis, specifically vitamin B12 deficiency. Hyperpigmentation of skin has been reported in medical literature as the presenting manifestation of vitamin B12 deficiency. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the common phenotype of hyperglycemia secondary to various pathophysiologic mechanisms that include reduced insulin secretion, decreased glucose utilization, and increased glucose production. Individuals suffering from Type 2 DM (T2DM) tend to be at a higher risk for the development of both micro as well as macrovascular complications. Management strategy includes an armamentarium of drugs and lifestyle modifications. 35 years old male diagnosed with T2DM was started on a fixed-dose combination of 20 mg Teneligliptin and 1 g metformin once daily. After consuming this dose for a month, he observed no reduction in his blood sugar levels and consequently escalated the dose to twice daily without any consultation or supervision. Subsequently, on next visit OPD his blood sugar was controlled, however, he complained of hair loss from the scalp. This complaint was resolved with the discontinuation of Teneligliptin. [ABSTRACT FROM AUTHOR]

A 49-year-old woman with type 2 diabetes and hypertension presented to our outpatient department with complaint of wasting of facial muscles on both sides of face for the last 8-10 months. On further workup, she also had other signs and symptoms of metabolic syndrome. We ruled out other causes of lipodystrophy. Therefore, probably, this is the first case of acquired partial lipodystrophy of face associated with resistant diabetes. [ABSTRACT FROM AUTHOR]

Granuloma annulare (GA) is usually a self-limited, benign granulomatous disease of the dermis and subcutaneous tissue. It's generalized or disseminated form is associated with underlying diabetes mellitus and at times it precedes the sign and symptoms of diabetes mellitus. We are reporting a case of a 56-year-old female, who is a known case of type 2 diabetes mellitus she presented to us with symmetric lesions on her trunk, arms, and legs. On further evaluation by the dermatologists, it was established to be lesions of GA. This case has been reported to highlight the incidence and the importance of recognition of this common but rarely diagnosed condition. [ABSTRACT FROM AUTHOR]

We report a case of a middle-aged male patient presenting with complaints of infertility. On examination and history-taking, familial koilonychia was reported without any association with ectodermal, systemic, or orthopedic defects. His iron profile was within normal limits. Hemoglobin was in normal limit. KOH smear taken from the nail showed no fungal growth. Family history of three generations revealed males suffering with familial koilonychias with infertility. Patients admitted with azoospermia should be asked about family history of koilonychia and pedigree analysis should be done. [ABSTRACT FROM AUTHOR]

Background: Hiccups are a normal physiological response, but sometimes they become a cause of social embarrassment. Materials and Methods: A 72-year-old male who is a known case of type II diabetes mellitus for the last 6 years came to our outdoor department with complaints of hiccups. Currently, he was on Glimipride 2 mg daily for the last 6 years and on Sitagliptin 100 mg daily for the last 6 months. Results: On stopping Sitagliptin himself, his hiccups stopped. Conclusion: Hiccups are regarded as a normal behavior and time-limited symptom but if prolonged or intractable, a thorough history and investigation must be done to find out the cause which might lead to serious consequences. Most probably, this is the first case report showing that Sitagliptin is the cause of hiccups. [ABSTRACT FROM AUTHOR]

Portomesenteric venous thrombosis (PMVT) is a rare but well-reported complication following laparoscopic surgery. We present three cases of PMVT following laparoscopic surgery. Our first case is a 71-year-old morbidly obese woman admitted for elective laparoscopic giant hiatus hernia (LGHH) repair. Post-operatively, she developed multi-organ dysfunction and computed tomography scan revealed portal venous gas and extensive small bowel infarct. The second patient is a 51-year-old man with known previous deep venous thrombosis who also had elective LGHH repair. He presented 8 weeks post-operatively with severe abdominal pain and required major bowel resection. Our third case is an 86-year-old woman who developed worsening abdominal tenderness 3 days after laparoscopic right hemicolectomy for adenocarcinoma and was diagnosed with an incidental finding of thrombus in the portal vein. She did not require further surgical intervention. The current guidelines for thromboprophylaxis follow-up in this patient group may not be adequate for the patients at risk. Hence, we propose prolonged period of thromboprophylaxis in the patients undergoing major laparoscopic surgery. [ABSTRACT FROM AUTHOR]

We report a case of drug-induced hyperprolactinemia in a 46 year postmenopausal female presenting as galactorrhea and painful breast engorgement as result of ranitidine exposure. The occurrence of galactorrhea as an adverse effect of ranitidine therapy is scarcely reported in literature and to the best of our knowledge this is first such reported case. [ABSTRACT FROM AUTHOR]

Mycobacteria are intrinsically resistant to most antibiotics as a result of multiple mechanisms. Linezolid, a member of the oxazolidinones, is a newer class of synthetic antimicrobials which is frequently used to treat mycobacteria. Here, we report a case of a patient with an ulcer on the right arm, caused by atypical mycobacteria, who presented with discoloration of both the upper and lower teeth after being treated with linezolid for a period of 2 months. On detailed evaluation, the patient was found to have linezolid‑induced dental hyperpigmentation. This is the first case reported ever in an adult having linezolid‑induced dental hyperpigmentation. [ABSTRACT FROM AUTHOR]