Pub Date : 2024-05-17DOI: 10.4103/ajim.ajim_114_23
Emad Mir Abbas, R. Harshavardhan, K. M. Faseeh, B. R. Shivakumar
Hypoparathyroidism is the most common complication following total thyroidectomy, occurring in 7.6% following anterior neck surgeries. The majority (19%–38%) of postoperative hypoparathyroidism is transient, resolving within 6 months, and permanent hypoparathyroidism is observed in 1.5% after total thyroidectomy, increasing to 6.4% in patients undergoing total thyroidectomy with prophylactic neck dissection. A 26-year-old Indian married woman, a mother of a 6-month-old baby currently lactating, presented with complaints of multiple joint pains and fever of 3-day duration with a history of thyroidectomy 8 years back and developed symptoms of hypocalcemia during the hospital stay. Evaluation revealed hypoparathyroidism. The nonspecific nature of hypocalcemic symptoms and lack of continuous follow-up for a long time after thyroidectomy could contribute to a delay in the diagnosis of hypoparathyroidism. However, it is an important diagnosis to consider in any patient with a history of neck surgery.
{"title":"Delayed Hypoparathyroidism Following Thyroidectomy","authors":"Emad Mir Abbas, R. Harshavardhan, K. M. Faseeh, B. R. Shivakumar","doi":"10.4103/ajim.ajim_114_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_114_23","url":null,"abstract":"\u0000 Hypoparathyroidism is the most common complication following total thyroidectomy, occurring in 7.6% following anterior neck surgeries. The majority (19%–38%) of postoperative hypoparathyroidism is transient, resolving within 6 months, and permanent hypoparathyroidism is observed in 1.5% after total thyroidectomy, increasing to 6.4% in patients undergoing total thyroidectomy with prophylactic neck dissection. A 26-year-old Indian married woman, a mother of a 6-month-old baby currently lactating, presented with complaints of multiple joint pains and fever of 3-day duration with a history of thyroidectomy 8 years back and developed symptoms of hypocalcemia during the hospital stay. Evaluation revealed hypoparathyroidism. The nonspecific nature of hypocalcemic symptoms and lack of continuous follow-up for a long time after thyroidectomy could contribute to a delay in the diagnosis of hypoparathyroidism. However, it is an important diagnosis to consider in any patient with a history of neck surgery.","PeriodicalId":504011,"journal":{"name":"APIK Journal of Internal Medicine","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pneumonia is a major medical problem and is foremost infectious cause of death in developed countries. A rapid and reliable predictor might aid physicians in identifying hospitalization, intensive care unit admission, and treatment changes. B-type natriuretic peptide (BNP) has consistently been observed to improve the diagnosis and management of hospitalized patients with pneumonia. This investigation aimed to study the importance of BNP in the assessment of severity of pneumonia in a tertiary care center in South India. A hospital-based observational research was carried out on patients admitted during the period of September 2016 to July 2018 with sample size of 108. All patients satisfying the inclusion criteria were enrolled. Detailed clinical history and physical examination findings were noted. Diagnostic criteria symptoms were recorded following the standard protocol. BNP was measured using the double-antibody sandwich enzyme-linked immunosorbent assay. The statistical analyses were done using the statistical software R version 3.6.3 and MS Excel. Out of 108 patients, 48 (44.44%) were female and 60 (55.56%) were male. Of these, 45 (41.67%) patients identified with community-acquired pneumonia, 27 (25%) with health-care-associated pneumonia, 26 (24.07%) with aspiration pneumonia, and 10 (9.26%) with pneumonia with comorbid conditions. BNP levels among survivors and nonsurvivors were 193.52 ± 124.93 and 413.08 ± 149.38 pg/ml, respectively. The total mortality was 13/108 (12.04%). Out of 13 patients, 12 (92.31%) nonsurvivors had BNP level ≥200 pg/ml and 1 (7.69%) had 100–200 pg/ml. BNP levels could be a useful single prognostic marker for pneumonia. BNP levels correlated with the clinical severity of pneumonia.
{"title":"Prognostic Value of B-Type Natriuretic Peptide in Hospitalized Patients with Pneumonia","authors":"Nagappa H. Handargal, Faisal Usman","doi":"10.4103/ajim.ajim_2_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_2_23","url":null,"abstract":"\u0000 \u0000 \u0000 Pneumonia is a major medical problem and is foremost infectious cause of death in developed countries. A rapid and reliable predictor might aid physicians in identifying hospitalization, intensive care unit admission, and treatment changes. B-type natriuretic peptide (BNP) has consistently been observed to improve the diagnosis and management of hospitalized patients with pneumonia. This investigation aimed to study the importance of BNP in the assessment of severity of pneumonia in a tertiary care center in South India.\u0000 \u0000 \u0000 \u0000 A hospital-based observational research was carried out on patients admitted during the period of September 2016 to July 2018 with sample size of 108. All patients satisfying the inclusion criteria were enrolled. Detailed clinical history and physical examination findings were noted. Diagnostic criteria symptoms were recorded following the standard protocol. BNP was measured using the double-antibody sandwich enzyme-linked immunosorbent assay. The statistical analyses were done using the statistical software R version 3.6.3 and MS Excel.\u0000 \u0000 \u0000 \u0000 Out of 108 patients, 48 (44.44%) were female and 60 (55.56%) were male. Of these, 45 (41.67%) patients identified with community-acquired pneumonia, 27 (25%) with health-care-associated pneumonia, 26 (24.07%) with aspiration pneumonia, and 10 (9.26%) with pneumonia with comorbid conditions. BNP levels among survivors and nonsurvivors were 193.52 ± 124.93 and 413.08 ± 149.38 pg/ml, respectively. The total mortality was 13/108 (12.04%). Out of 13 patients, 12 (92.31%) nonsurvivors had BNP level ≥200 pg/ml and 1 (7.69%) had 100–200 pg/ml.\u0000 \u0000 \u0000 \u0000 BNP levels could be a useful single prognostic marker for pneumonia. BNP levels correlated with the clinical severity of pneumonia.\u0000","PeriodicalId":504011,"journal":{"name":"APIK Journal of Internal Medicine","volume":"57 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140965610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/ajim.ajim_102_23
S. Jashwanthgowda, N. H. Rekha, Syed Sadiq Ameen, Premkumar Krishnappa
The ability to produce secondary metastatic deposits at a distant site is the single most essential biological process that symbolizes a malignant tumor. Metastasis to adrenal glands is known to spread from the primaries of the lungs, breast, melanoma, Gatro Intestinal Tract (GIT), pancreas, and kidneys. Here, we report a case of an elderly woman presenting with features of metastasis to subcutaneous tissue, lungs, liver, lymph nodes, and bilateral adrenal gland with symptomatic adrenal insufficiency and primary being in left kidney-renal cell carcinoma-clear cell type. The presence of bilateral synchronous adrenal metastasis with symptomatic adrenal insufficiency with evidence of metastasis to subcutaneous tissue is catastrophic since it marks disseminated cancer.
{"title":"Bizarre Bilateral Adrenal Metastasis: A Sinister of Internal Malignancy","authors":"S. Jashwanthgowda, N. H. Rekha, Syed Sadiq Ameen, Premkumar Krishnappa","doi":"10.4103/ajim.ajim_102_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_102_23","url":null,"abstract":"\u0000 The ability to produce secondary metastatic deposits at a distant site is the single most essential biological process that symbolizes a malignant tumor. Metastasis to adrenal glands is known to spread from the primaries of the lungs, breast, melanoma, Gatro Intestinal Tract (GIT), pancreas, and kidneys. Here, we report a case of an elderly woman presenting with features of metastasis to subcutaneous tissue, lungs, liver, lymph nodes, and bilateral adrenal gland with symptomatic adrenal insufficiency and primary being in left kidney-renal cell carcinoma-clear cell type. The presence of bilateral synchronous adrenal metastasis with symptomatic adrenal insufficiency with evidence of metastasis to subcutaneous tissue is catastrophic since it marks disseminated cancer.","PeriodicalId":504011,"journal":{"name":"APIK Journal of Internal Medicine","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139791571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/2666-1802.395390
{"title":"Erratum: To Study Demographic Profile, Risk Stratification, and Response to Treatment in Chronic Myeloid Leukemia Patients","authors":"","doi":"10.4103/2666-1802.395390","DOIUrl":"https://doi.org/10.4103/2666-1802.395390","url":null,"abstract":"","PeriodicalId":504011,"journal":{"name":"APIK Journal of Internal Medicine","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/ajim.ajim_102_23
S. Jashwanthgowda, N. H. Rekha, Syed Sadiq Ameen, Premkumar Krishnappa
The ability to produce secondary metastatic deposits at a distant site is the single most essential biological process that symbolizes a malignant tumor. Metastasis to adrenal glands is known to spread from the primaries of the lungs, breast, melanoma, Gatro Intestinal Tract (GIT), pancreas, and kidneys. Here, we report a case of an elderly woman presenting with features of metastasis to subcutaneous tissue, lungs, liver, lymph nodes, and bilateral adrenal gland with symptomatic adrenal insufficiency and primary being in left kidney-renal cell carcinoma-clear cell type. The presence of bilateral synchronous adrenal metastasis with symptomatic adrenal insufficiency with evidence of metastasis to subcutaneous tissue is catastrophic since it marks disseminated cancer.
{"title":"Bizarre Bilateral Adrenal Metastasis: A Sinister of Internal Malignancy","authors":"S. Jashwanthgowda, N. H. Rekha, Syed Sadiq Ameen, Premkumar Krishnappa","doi":"10.4103/ajim.ajim_102_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_102_23","url":null,"abstract":"\u0000 The ability to produce secondary metastatic deposits at a distant site is the single most essential biological process that symbolizes a malignant tumor. Metastasis to adrenal glands is known to spread from the primaries of the lungs, breast, melanoma, Gatro Intestinal Tract (GIT), pancreas, and kidneys. Here, we report a case of an elderly woman presenting with features of metastasis to subcutaneous tissue, lungs, liver, lymph nodes, and bilateral adrenal gland with symptomatic adrenal insufficiency and primary being in left kidney-renal cell carcinoma-clear cell type. The presence of bilateral synchronous adrenal metastasis with symptomatic adrenal insufficiency with evidence of metastasis to subcutaneous tissue is catastrophic since it marks disseminated cancer.","PeriodicalId":504011,"journal":{"name":"APIK Journal of Internal Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139851338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/2666-1802.395390
{"title":"Erratum: To Study Demographic Profile, Risk Stratification, and Response to Treatment in Chronic Myeloid Leukemia Patients","authors":"","doi":"10.4103/2666-1802.395390","DOIUrl":"https://doi.org/10.4103/2666-1802.395390","url":null,"abstract":"","PeriodicalId":504011,"journal":{"name":"APIK Journal of Internal Medicine","volume":"26 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139793972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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