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Burkitt's lymphoma (BL) is a highly aggressive type of B-cell non-Hodgkin lymphoma. BL commonly occurs in children of age 4-7 years and is uncommon in adults, with a worse prognosis. Patients often present with a rapidly growing mass typically involving the abdomen (liver and spleen) and head and neck (nodes, jaw, and facial bones). Pancreas involvement is very rare and very few case reports have been documented so far. Fluorine-18 positron emission tomography/ computed tomography (F-18 PET/CT) is a whole-body survey commonly used for initial staging evaluation. Here, we present an interesting case of BL in an adult female of 43 years, who presented with swelling in the left submandibular region after tooth extraction with multiorgan involvement found on F-18 fluorodeoxyglucose PET/CT. [ABSTRACT FROM AUTHOR]

The multiorgan deleterious effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) are now well known. Although COVID-19 disease is a hypercoagulable state and thrombotic complications occur in about one-third of critically ill patients with COVID-19, thrombosis is not typically a presenting symptom. We report the case of a patient presented with the complaints of abdominal pain due to renal vein thrombosis as the first feature of the COVID-19. [ABSTRACT FROM AUTHOR]

A 54-year-old man with hypertension, end-stage renal disease (ESRD) who was receiving thrice-weekly haemodialysis for the past 3 years, developed breathlessness after a session of haemodialysis. Oxygen saturation by pulse oximetry (SpO2) was 88% and he was admitted for evaluation. Nasopharyngeal swab real time-polymerase chain reaction (RT-PCR) had tested positive for SARS-CoV-2. He was started on intravenous azithromycin, dexamethasone 8 mg, and subcutaneous heparin. On the 8th day after admission, he had painful swelling, redness and watering of the left eye. Within hours, he also complained swelling of the left half of the face, diminished vision and reduced eye movements of the left eye. Magnetic resonance imaging (MRI) and magnetic resonance angiography of the brain revealed left orbital cellulitis. angioinvasive fungal sinusitis. Laboratory testing confirmed the diagnosis. The patient was treated with intravenous ammphotericin B and surgery. [ABSTRACT FROM AUTHOR]

Drugs associated with gingival overgrowth fall into three broad categories - anticonvulsants, immune suppressants and calcium channel blockers. Amlodipine is a third-generation dihydropyridine. The prevalence of amlodipine-induced gingival hyperplasia is 4.2%. We report two patients with the amlodipine-induced gingival hyperplasia. [ABSTRACT FROM AUTHOR]

Even though a small number of published single patient reports have more recently reported pulmonary cavitation in COVID-19 disease, it is still considered a rare radiology feature. We report a 45-year-old man with COVID 19 disease and a pulmonary cavity. [ABSTRACT FROM AUTHOR]

Background: The Incidence of Poisoning Is Constantly On The Rise In The Modern World With A Gradual Shift Towards The Use of Agricultural Poisons In Suicides With Majority of Cases Using Organophosphate Compounds And In India The Incidence of Ingested Suicidal Poisoning Is High Especially In The Southern States. This Study Is Undertaken With A View To Asses If There Is Any Correlation Between Plasma Levels of Pseudocholinesterase and mortality in cases of acute organophosphate poisoning. Method: The study was conducted on patients of organophosphate poisoning admitted to Bapuji Hospital (J.J.M. Medical College), Davangere during a period of October 2011 to March 2013. Total number of cases studied were 150. Detailed history was obtained regarding the amount of poison, type of poison, quantity of poison, etc from the patient and his/her relatives as well from the police. Clinical examination of each patient was carried out and according to signs and symptoms, the patients were grouped into 3 grades, mild, moderate and severe according to Dreisbach's criteria. At the time of admission pseudocholinesterase was measured. All patients were followed-up for 3 days to know the outcome and results were compared and analysed. Conclusion: Our study concludes that there is a very good correlation between the levels of plasma pseudocholinesterase and mortality as well as morbidity [ABSTRACT FROM AUTHOR]

Background: Compared to the developed world, the pattern of acute kidney injury (AKI) is different in tropics. The present study was undertaken to study the epidemiological profile and outcomes in AKI. Methods: This prospective observational study was conducted in a tertiary care teaching hospital in South India. Demographic details, detailed medical history, aetiological factors, comorbid conditions, prognostic factors and outcomes were studied. Acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were calculated at admission for every patient to know the prognosis. Results: A total of 193 patients who fulfilled the inclusion criteria were enrolled in the study. Majority of the patients were in their sixth decade of life. The mean age was 52.1 ± 14.8 years (male:female = 1.7:1). Hypertension (41.5%; n = 80) and diabetes mellitus (33.7%; n = 65) were the most common comorbid illnesses in our patients. The average duration of hospital stay was 8 days. AKI was secondary to medical causes in 69.4% (134/193), surgical causes in 25.4% (49/193) and obstetric is 5.18% (10/193). Renal replacement therapy was required in 56.4% (n = 109) of the study population. The mortality rate observed in our study was 21.8% (n = 42). The mean APACHE II score and mean SOFA score were found to be significantly higher in the non survivors compared to the survivors. Conclusions: Patients with AKI who have higher APACHE II or SOFA score should be carefully monitored and aggressively treated to reduce mortality. [ABSTRACT FROM AUTHOR]

Fungal infections account for 5% of all infections in renal transplant recipients. Mucormycosis has emerged as an important invasive fungal infection in transplant recipients associated with aggressive clinical course and substantial rates of death. A 28-year-old male with chronic kidney disease underwent renal transplantation from a deceased brain-dead donor. Implantation kidney biopsy showed features of acute tubular necrosis. On follow-up, the patient had progressive renal failure. The patient expired 3 months after transplantation due to sepsis with refractory shock. Postmortem needle biopsy done on the liver showed areas of necrosis with broad, aseptate filamentous fungal hyphae stained positive with Gomori methenamine silver stain favoring mucormycosis. Mucormycosis is a fatal mycosis in transplant recipient due to its angiophilic and thrombosis/hemorrhage-oriented characteristics. The overall mortality rate among solid-organ transplant recipients with mucormycosis is 38%-48%. Early detection and appropriate timely management of fungal infections play a decisive role in improving the survival and reducing the mortality. [ABSTRACT FROM AUTHOR]

The pleiotropic cytokine osteopontin (OPN) is found to be involved in the pathogenesis of both kidney and cardiovascular disease (CVD). We evaluated the relationship between OPN, other cardiovascular risk factors and carotid intima-media thickness (CIMT) in chronic kidney disease (CKD) (predialysis) patients. This is a 2-year cross-sectional prospective study involving 75 patients with CKD from stage 1 to stage 5 attending the nephrology outpatient department and 25 healthy controls. Routine biochemical parameters were analyzed on clinical chemistry Autoanalyzer Beckman Coulter DXC 600 Synchron, USA. OPN was estimated by ELISA method. Carotid intima-media wall thickness was estimated by Doppler of carotid vessels. Serum OPN and other nontraditional cardiovascular risk factors such as CIMT, lipoprotein (a) Lp(a), fibrinogen, and homocysteine were significantly increased in patients of CKD compared to controls. OPN, Lp(a), fibrinogen, CIMT, parathyroid hormone, and homocysteine progressively increased from early stages of CKD and increased further with progression of the disease, but nitric oxide (NO) level progressively decreased with progression of CKD. OPN showed a positive correlation with CIMT, Lp(a), fibrinogen, and homocysteine and negative correlation with estimated glomerular filtration rate and NO. There was a close direct association between circulating levels of OPN and the presence of atherosclerotic plaques in carotid arteries of patients with CKD. Osteopontin and nontraditional CVD risk factors are altered in early stages of CKD and might predict adverse outcomes in these patients. [ABSTRACT FROM AUTHOR]

Scrub typhus caused by organism Orientia tsutsugamushi and transmitted to humans by the bite of a leptotrombidium mite (chigger). Although eschar formation is one of the important signs that aid in diagnosis, multiple eschar formation is a rare presentation. Although scrub typhus causes multiple organ dysfunction, the pancreas involvement is rare. Here, we describe a patient with scrub typhus with multiple eschars complicated with acute pancreatitis and acute kidney injury. [ABSTRACT FROM AUTHOR]

Fungal infections are a common cause of morbidity and mortality among patients on continuous ambulatory peritoneal dialysis (CAPD). We present the clinical manifestations, and management of five CAPD patients with fungal peritonitis seen during the last seven years. Microscopy and culture of the peritoneal fluid tested positive for fungus in all patients. Filamentous fungi were identified as the causative fungi among four patients and Candida nonalbicans was the cause in one patient. Catheter was removed and appropriate antifungal therapy was given to all the patients. Four patients recovered and one died due to ventilator associated infection. Previously treated bacterial infections, old age more than 50 years, diabetes and hypertension were recognised as the risk factors leading to fungal infection among CAPD patients. [ABSTRACT FROM AUTHOR]

Strongyloides stercoralis, an intestinal parasitic nematode, infects more than 100 million people worldwide. Strongyloides are unique in their ability to exist as a free-living and autoinfective cycle. Strongyloidiasis infection usually remains asymptomatic, but in immunocompromised hosts hyperinfection and dissemination can occur, which has a high mortality. We report a 30-year-old male patient with membranous nephropathy who was receiving oral corticosteroids and cyclophosphamide who presented with disseminated strongyloidiasis. Larvae of S. stercoralis were isolated from the stool and the sputum specimens. Seven days later despite anti-helminthic therapy and intensive care support the patient died. Early detection and diagnosis of this condition is based on a high index of clinical suspicion, especially in immunocompromised hosts. Screening for Strongyloidiasis infection before the initiation of immunosuppressive therapy can be considered. [ABSTRACT FROM AUTHOR]

Nephropathy is an important and a frequent complication of long-term type II diabetic nephropathy. Strong evidence exists that genetic predisposition plays a major role in the development of diabetic nephropathy. Recent studies have implicated association between angiotensin converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and nephropathy. The deletion gene polymorphism of ACE gene has been shown to be associated with increased activity of this enzyme. This study examines the association of ACE I/D polymorphism with type II diabetes without nephropathy in 30 patients and type II diabetes with nephropathy in 30 patients. The results of the study suggest the association between the DD polymorphism and type II diabetes with nephropathy. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is associated with a higher risk for stroke in studies from developed countries. This prospective study was conducted to study the clinical profile, management, and outcome of stroke in patients of chronic kidney disease who had been admitted in our institute during the period from December 2004 to December 2006. A higher incidence of stroke was found in men and in the fifth decade of life. Hypertension and diabetes were found in 88.8 and 48.1% of the patients respectively. CKD was detected for the first time during stroke evaluation in 55.5% of the patients. Stroke was due to cerebral infarction in 48.14% and due to cerebral hemorrhage in 40.7% of the patients. Surgical intervention was needed in 14.8% of all patients while stroke was managed medically in the rest. Over 70% of the patients were discharged after they showed improvement in the symptoms. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented describing the case of a 62-year-old lady with type 2 diabetes and hypertension diagnosed with gangrene and bacteremia due to Corynebacterium jeikeium obtained from her maintenance hemodialysis.

The author discuss a case of a 15-year-old girl who presented with weakness of both lower limbs, sensory loss below costal margin, and bladder disturbances, and loss of vision in the left eye for 3 months with past history of similar illness. On examination she was diagnosed with Devic's neuromyelitis optica (NMO), an inflammatory disease characterized by severe attacks of optic neuritis and myelitis. She was given five sessions of plasma exchange on alternate days after which she recovered.

Accelerated atherosclerosis and cardiovascular disease are major causes of morbidity and mortality in patients of end-stage renal disease. Carotid intima media thickness is taken as a useful surrogate marker of atherosclerosis. Thirty end-stage renal disease (ESRD) patients were subjected to ultrasonography to study CIMT before the initiation of dialysis. CIMT was found to be higher in ESRD patients than in controls. Levels of a serum marker of oxidative stress were also found to be higher in patients than in the controls. CIMT is an easy, noninvasive, reproducible, and cost-effective investigation in patients with chronic renal failure. [ABSTRACT FROM AUTHOR]

Leptospirosis is an important zoonosis with a worldwide distribution that is characterized by a broad spectrum of clinical manifestations ranging from inapparent infection to fulminant disease. The presentation of paraparesis in combination with acute renal failure is rare. [ABSTRACT FROM AUTHOR]

The article focuses on a case of bilateral necrosis of the kidney cortex in a patient with acute pancreatitis. Bilateral cortical hypodense areas in both kidneys were revealed through contrast enhanced computed tomography (CT) of the patient's abdomen. General supportive management was given to the patient, and he also received dialysis and antibiotics. The incidence of bilateral cortical necrosis was 3.8% in north India based on a study.

Background: A child is a nation's supreme asset and future. India homes 444 million children, aged between 0 and 18 years, contributing to 19% of the world's children. Crime against children is detrimental to their mental and physical health and affects their growth and development. The National Crime Record Bureau recently reported that a crime targeting children happens every 4 minutes. There is a paucity of literature regarding the burden of crime against children. To understand the magnitude and spatial distribution of crime against children, a retrospective surveillance study was conducted in the state of Tamil Nadu, India, from 2017 to 2021., Materials and Methods: This is a cross-sectional analytical type of study conducted in KIMSRC, Chengalpattu, Tamil Nadu. The data from the yearly crime review bulletin of Tamil Nadu from 2017 to 2021 were cleaned, transformed, and analyzed using Python v3.8 and subjected to geospatial auto-correlation and hotspot analysis using the Getis-Ord Gi* in ArcGIS Pro v3.1. The endemicity pattern was studied through cluster analysis with Hierarchical Density Based Scanning in Python and visualization in ArcGIS pro v3.1 in the study area., Results: In Tamil Nadu, only one hotspot district in 2017 [Tiruppattur (95% confidence, P < 0.05)] and one hotspot in 2020 [Villupuram (90% confidence, P < 0.1)] were identified, with others being insignificant. The districts which show very high prevalence of crimes against children are Chennai, Ranipet, Chengalpattu, Viluppuram, Tiruvannamalai, Vellore, Tiruppattur, Krishnagiri, Dharmapuri, Salem, Cuddalore, Thanjavur, Tiruchirappalli, Karur, Tiruppur, Coimbatore, Dindigul, Pudukkottai, Sivaganga, Tenkasi, Thoothukkudi, Tirunelveli, and Kanniyakumari., Conclusion: This study identifies key areas within the state of Tamil Nadu which have a high prevalence of crimes against children and also areas that are hotspots for such crimes. Greater resources and measures can now be targeted toward these areas by stakeholders, which can help in the reduction of crimes against children., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Introduction: Patients with autosomal dominant polycystic kidney disease (ADPKD) who have normal renal function (creatinine clearance, >90 ml per minute per 1.73 m 2 of body-surface area) might potentially benefit from frequent water intake that would be sufficient to reduce plasma AVP levels and decrease the average urine osmolality, bringing it closer to that of plasma., Materials and Methods: In this cross-sectional study, the patients of ADPKD, chronic kidney disease stages 1-5 were included. We formed a questionnaire on the dietary recommendation to the patients. The questions enquired whether the patients received the recommendation from the faculty and the postgraduates of the nephrology department that (a) they should consume at least 3000 mL of water per day, (b) that they should not consume coffee and tea,(c) adherence of patients to the advice of the nephrologists., Results: Of 294 patients, 142 (48.2%) did not receive any dietary recommendation. The rest 152 (51.7%) were given the appropriate dietary recommendation. Majority of the patients mentioned that they lacked the access to the water when they intend to consume. Despite the advice from the nephrologists, 95 (32.3%) failed to observe the abstinence from coffee and tea. The reason expressed for not quitting coffee and tea was the force of the habit., Conclusion: Treating doctorsfailed to inform 48% of patients the proper diet. Only 20.3% of patients consumed >3.0 litre of water per day. The demand of the agricultural work at a place away from home deprived majority of the participants of the study from the potable water., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)

Introduction: One of the reasons for the peritoneal dialysis (PD) underutilization is related to the training of nephrology postgraduates in PD. This notion is not yet investigated in our country., Methods: We gathered the emails of the heads of the departments of nephrology of all medical colleges and the institutes, which impart DM nephrology post-graduation. We sent the questionnaire framed on the postgraduate training of PD. We received the questionnaire responses anonymously. The broad headings in the questionnaire are information on training resources, training activities, perceived adequacy of the training, and the factors, which limit the utilization of PD., Results: There are 42 medical colleges and institutes (excluding Sri Venkateswara Institute of Medical Sciences) that impart DM nephrology post-graduation in our country. Of these, 30 heads of the departments had responded. More than half of the heads of the department felt that the PD training postgraduates were inadequate. When asked to describe the reason for the perceived inadequacy of PD training, the primary reason noted included was insufficient numbers of PD patients (66.67%)., Discussion: The conclusion may be drawn from our study that the postgraduate training in PD in our country is gratifying. Our hypothesis that a lacuna in postgraduate training in PD may be one of the reasons for the underutilization of PD seems ungrounded., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Nephrology.)

In the last decade, pockets of endemic nephropathy have been recognized worldwide, in regions of Central America, Sri Lanka, and India. In India, the nephropathy has been recognized in the Uddanam area of north Andhra Pradesh and has been termed the Uddanam endemic nephropathy (UEN). The disease is distinctive in that besides the geographic distribution, it affects rural populations engaged in farm labor and agriculture, often silent in the initial phase with most patients presenting with advanced renal failure. The renal biopsy findings in all geographic areas including UEN have been one of a chronic tubulointerstitial nephritis with varying degrees of tubular injury, interstitial inflammation, tubular atrophy, and interstitial fibrosis with nonspecific glomerular obsolescence and lack of immune deposits. More recently, the demonstration of dysmorphic lysosomes in renal biopsies has favored a toxic etiology. There are thus many gaps in the understanding of this serious disease prevalent among poorer populations., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Indian Journal of Nephrology.)