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George T.,Pondicherry Institute of Medical science | Viswanathan S.,Indira Gandhi Medical College and RI | Karnam A.H.F.,Pondicherry Institute of Medical science | Abraham G.,Pondicherry Institute of Medical science
Critical Care Research and Practice | Year: 2014

Objectives. Etiology and outcomes of acute lung injury in tropical countries may be different from those of western nations. We describe the etiology and outcomes of illnesses causing acute lung injury in a rural populace. Study Design. A prospective observational study. Setting. Medical ICU of a teaching hospital in a rural-urban fringe location. Patients. Patients ≥13 years, admitted between December 2011 and May 2013, satisfying AECC criteria for ALI/ARDS. Results. Study had 61 patients; 46 had acute lung injury at admission. Scrub typhus was the commonest cause (7/61) and tropical infections contributed to 26% of total cases. Increasing ARDS severity was associated with older age, higher FiO2 and APACHE/SOFA scores, and longer duration of ventilation. Nonsurvivors were generally older, had shorter duration of illness, a nontropical infection, and higher total WBC counts, required longer duration of ventilation, and had other organ dysfunction and higher mean APACHE scores. The mortality rate of ARDS was 36.6% (22/61) in our study. Conclusion. Tropical infections form a major etiological component of acute lung injury in a developing country like India. Etiology and outcomes of ARDS may vary depending upon the geographic location and seasonal illnesses. © 2014 Tarun George et al.

Dorairajan G.,JIPMER | Hima Bindu N.,Indira Gandhi Medical College and RI | Bhat R.V.,Indira Gandhi Medical College and RI
Journal of Clinical and Diagnostic Research | Year: 2014

Polycystic ovarian disease in adolescents is not uncommon. Usually underlying ovarian tumours can cause hirsutism and ovulation. A 15 year old girl presented with infrequent cycles and hirsutism. Her baseline evaluation ruled out ovarian tumour and other endocrinological problems. She was treated with insulin sensitizers and hormone treatment. After more than a year of treatment she developed a large ovarian tumour which turned out to be a juvenile granulose cell tumour at laparotomy a year after treatment with insulin sensitizers. The authors recommend continued surveillance of ovaries of adolescent girls undergoing treatment for polycystic ovarian disease to monitor for formation of ovarian tumours.

Raveendran K.M.,Indira Gandhi Medical College and RI | Wanathan S.,Indira Gandhi Medical College and RI
Journal of Clinical and Diagnostic Research | Year: 2016

Genital ulcers occur due to infective, inflammatory, malignant and drug-related causes. In tropical countries such as India, such ulcers are due to parasitic, tubercular, rickettsial and bacterial (sexually transmitted infections) aetiologies. Typhoid fever is endemic in the tropics. Except “rose spots”, skin manifestations in typhoid fever are unusual, and they are missed due to pigmented skin. Patients do not often complain of genital ulcers due to shame or fear. Genital examination is not routinely performed in typhoid fever. We describe scrotal ulcers as the presenting symptom of typhoid fever, which subsided with appropriate therapy. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.

Jain D.,Indira Gandhi Medical College and RI | Viswanathan S.,Indira Gandhi Medical College and RI | Shanmugam J.,Indira Gandhi Medical College and RI
Journal of Infection and Public Health | Year: 2014

We report an unusual case of varicella zoster in a 19-year-old, who presented with persisting fever even after her lesions began forming scabs. Fever workup for secondary complications was negative. A re-examination revealed an axillary eschar. She recovered completely with doxycycline. This report suggests the importance of keeping in mind, epidemiological data of common diseases in the locality, as well as the significance of a thorough physical examination in patients with fever. © 2014 King Saud Bin Abdulaziz University for Health Sciences.

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