We report a case of idiopathic tubulointerstitial nephritis associated with bilateral uveitis(TINU syndrome) in an elderly lady,who with non-specific systemic associations developed acute renal failure,is described to increase awareness of the condition and also suggest a change in The Royal College of Ophthalmologists guidelines on Investigation of patients with Uveitis'.KEYWORDS: Idiopathic tubulointerstitial nephritis associated with bilateral uveitis; renal failure; guidelines; uveitis

Curculigo orchioides Gaertn. (family Amarylladaceae) is an endangered rasayana herb which is popularly known as "Kali Musli". The plant is native to India, and holds a special position as a potent adaptogen and aphrodisiac in Ayurvedic system of medicine. It is an important ingredient of many Ayurvedic preparations and is considered to have aphrodisiac, immunostimulant, hepatoprotective, antioxidant, anticancer and antidiabetic activities. Various chemical constituents like mucilage, phenolic glycosides, saponins and aliphatic compounds from the plant have been reported. The plant is also considered as an important component of various herbal preparations of the Chinese and Kampo medicine. The present review is an attempt to enumerate various biologically tested activities and evaluation of different phytochemicals present in this important medicinal plant.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

BACKGROUND/AIMS: Pyomyositis is an infective condition with primary involvement of the skeletal muscles. There is sparse recent literature on patients with pyomyositis. METHODS: This study was carried out at emergency services of a tertiary care center located in subtropical area of Indian subcontinent. RESULTS: Sixty-two patients of primary pyomyositis formed the study cohort. Mean age of occurrence was 29.9 ± 14.8 years. There were 54 men. Twelve patients had underlying medical diseases. Muscle pain was seen in all 62 patients. Forty-eight patients (77.4%) had the fever. Most common site of involvement was thigh muscles (n = 29, 46.8%). Forty-nine patients (79%) presented in the suppurative stage of illness. Patients with comorbidities were older (age: median 36 years [interquartile range (IQR), 25 to 47] vs. 24 years [IQR, 16 to 35], p = 0.024), had higher culture positivity with gram-negative organisms (8/9 [88.89%] vs. 6/29 [20.69%], p = 0.001). Importantly, higher number of these patients received inappropriate antibiotics initially. Patients with positive pus culture result had higher complication rate (32/38 [84.21%] vs. 10/18 [55.56%], p = 0.044). Six patients (9.7%) had in-hospital mortality. Lower first-day serum albumin, initial inappropriate antibiotic therapy, and advanced form of the disease at presentation were associated with increased in-hospital mortality. CONCLUSIONS: Primary pyomyositis is not an uncommon disease entity. Patients with comorbidities were more likely to receive initial inappropriate antibiotic therapy. Patients with positive pus culture report had the higher rate of complications. Lower first-day serum albumin, initial inappropriate antibiotic therapy and advanced form of the disease at presentation were associated with increased in-hospital mortality.
Anti-Bacterial Agents ; Cohort Studies ; Comorbidity ; Emergencies ; Fever ; Hospital Mortality ; Humans ; India* ; Male ; Muscle, Skeletal ; Muscles ; Myalgia ; Outcome Assessment (Health Care)* ; Pyomyositis* ; Serum Albumin ; Suppuration ; Tertiary Care Centers ; Thigh

Adult ; Aneurysm, Dissecting ; diagnostic imaging ; Humans ; Male ; Multidetector Computed Tomography ; Pulmonary Artery

BACKGROUND: Hip fractures are a significant cause of morbidity and mortality in the elderly. Fast-track multidisciplinary co-management of these patients, rapid preoperative optimization, early surgery, and expeditious rehabilitation may minimize morbidity and mortality. In this study, we evaluated outcomes of fixation of hip fractures in the elderly patients managed by Geriatric Hip Fracture Program at a military hospital in India. METHODS: A total of 114 patients above 60 years of age with hip fractures were enrolled. They were comanaged by a team of specialists and fast-tracked to surgery. Independent ambulation with support of a walker was achieved before discharge to home. Patients were followed up for 1 year. RESULTS: The average age of the 114 patients was 77 years; 24 patients were octogenarian. Eighty-four percent of injuries were due to a domestic fall. Hypertension (41%) and diabetes (22%) were the most common comorbidities. All patients were optimized before surgery. The average delay from injury to admission was 1.7 days (range, 0 to 14 days) and that from admission to surgery was 1.8 days (range, 0 to 19 days). Hence, the average time from injury to surgery was 3.5 days. The length of stay in hospital was, as per rehabilitative milestones achieved, 2 to 5 days in 40% of the patients and 6 to 15 days in 60% of the patients. At 1 year after surgery, 95 patients were independently ambulant (56 patients with support and 39 patients without support). Twenty-three percent of the patients had postoperative complications and eight patients died (7.7%) at 1-year follow-up; 11 patients were lost to follow-up. CONCLUSIONS: Elderly hip fracture has a high risk of mortality (14%–58%). Thus, expeditious surgery within 24 hours of admission has been advocated in the Western literature to minimize mortality. Mortality rate at 1 year after surgery remains at 10% to 24%. In our study, even with aggressive co-management, the average delay to hip fracture fixation was more than 3 days; however, the 1-year mortality was relatively low (7.7%). This indicates the importance of preoperative optimization and postoperative rehabilitation for independent ambulation and mortality reduction in the elderly population.
Aged ; Aged, 80 and over ; Comorbidity ; Follow-Up Studies ; Fracture Fixation ; Hip Fractures ; Hip ; Hospitals, Military ; Humans ; Hypertension ; India ; Length of Stay ; Lost to Follow-Up ; Mortality ; Postoperative Complications ; Rehabilitation ; Specialization ; Veterans ; Walkers ; Walking

No abstract available.
Research Report*