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Occurrence regarding delirium pursuing stay in hospital of seniors along with breaks: risks as well as fatality rate.
Stroke is one of the commonest causes of mortality among the world. Hemorrhagic stroke accounts nearly 15% of all the strokes. Different risk factors have been identified, of them hypertension, anti-coagulation therapy and previous history of ischemic strokes are significant. Regarding the genetic causes of intracerebral hemorrhage (ICH) monogenic causes play a small role. It was found that Apolipoprotein E (APOE) gene has a strong association with ICH. This is a 299 amino acids long protein located in chromosome 19. APOE has three alleles, they are epsilon 2, 3 and 4. Total 10 meta-analysis were reviewed in this article which involved 52,705 participants. When looking for the association, ∈2 and ∈4 showed positive and ∈3 showed negative association with ICH. Association of ∈4 (OR mean 1.77) was stronger than that of ∈2 (OR mean 1.71).We would like to describe the clinical course of a 61-year-old gentleman with the background history of Stage IV left lower lobe lung adenocarcinoma who presented to the outpatient department at Changi General Hospital, Singapore on March 2019 with unintentional loss of weight, easy fatigability and breast pain while showering for last four months. He was started on pembrolizumab immunotherapy about 9 months before presentation which he tolerated well. Subsequent endocrine work ups revealed features consistent with hypophysitis that lead to hypopituitarism in the form of secondary adrenal insufficiency and hypothyroidism. While more and more patients are receiving novel anti-cancer treatment for example immunotherapy, we should never forget and address the side effects it brings along. This study certainly supports above mentioned suggestion.Hypopituitarism is a rare entity with reported incidence, 4 per 100,000 and about 50% of such patients present with three to five pituitary hormone deficits. A slow onset of symptoms is typical. But, diversified presentations from absence of symptoms to vague clinical features to lethal effects leading to mortality are not uncommon in such disorder. In adults, in such cases symptoms of hypogonadism may be the first noticeable illness for reporting to physicians, but it is often under evaluated or even ignored. Here, we present a case of 40-year-old adult male with panhypopituitarism, who presented with loss of generalized body hair and loss of libido for about last five years but the problem was not evaluated adequately. Later, he developed lethargy, generalized weakness, weight loss and then the underneath cause detected was panhypopituitarism due to pituitary macro adenoma. So, suspicion and hormonal evaluation for hypogonadism would help in early detection and management of progressive hypopituitarism in symptomatic adult patients. Cases of panhypopituitarism need lifelong hormone replacement and follow-up and if pituitary adenoma is present, surgical removal by trans-sphenoidal approach is preferable.Holoprosencephaly is a rare spectrum of congenital malformation associated with midline facial defects and absence of olfactory tract. Selleck AZ 3146 Sequence occurs at 4th to 8th week of gestational age due to failure or incomplete diverticulation and cleavage of primitive prosencephalon. It is most common brain malformation with an incidence 1250 in conceptuses and associated with a high rate of spontaneous abortion, and prevalence of 116000 in live borns. The etiopathogenesis of holoprosencephaly is heterogeneous and multifactorial, may be environmental, metabolic factors or teratogenic including insulin-dependent maternal diabetes, alcohol consumption. In this study, we described a case of holoprosencephaly neonate with 34 weeks gestational age and antenatal ultrasonography diagnosed as congenital defects in the central nervous system, asymmetric growth of head. After birth the infant was presented with multiple congenital anomalies (cleft lip, cleft palate, microphthalmia, absent philtrum, absent nasal septum with single naris) similar to holoprosencephaly sequence.Noonan's syndrome is a developmental disorder characterized by short stature, typical facial dysmorphia, congenital heart defects and skeletal deformity. It may be sporadic or inherited as an autosomal dominant or recessive trait which occurs, one in 1000-2500 live births. We report a case of 16 years young girl presented to the hospital with short stature, Shortness of breath, morphologic features and congenital heart defect of Noonan Syndrome who has no similar history in the family and admitted in Bangabandhu Sheikh Mujib Medical University on 12th August 2018.Vas deferens calcification is a very rare condition. The causes can be categorized as inflammatory and non-inflammatory type. We are presenting such a non inflammatory type of bilateral vas calcification in a diabetic chronic kidney diseases (CKD) patient. Presented patient a 50 years old man admitted in Samorita Hospital Ltd., Dhaka, Bangladesh on 03 August 2014 in cabin - 537 with registration number 1904/14. He was labeled as Diabetes mellitus (DM), Hypertension (HTN), CKD & Urinary tract infection (UTI). Vas deferens calcification was diagnosed incidentally by X-ray KUB. Subsequently we have discussed all possible causes in this report. The purpose of presenting this rare imaging finding is to emphasize the under diagnosis of the disease and causes. It can also be diagnosed by simple, easily available and cheap investigations like Plain X ray KUB.The incidence of acute kidney injury (AKI) during the treatment with gentamicin (GM) is very common in hospitalized patients. Green coffee bean, containing chlorogenic acid (CGA) has been reported to improve non communicable diseases. In the present study, CGA enriched fraction of green coffee bean was evaluated on GM induced nephrotoxicity in rats. It was a preclinical case-controlled experimental intervention conducted in the Department of Pharmacology, R G Kar Medical College, Kolkata, India from 2016-2019 using animal model. CGA content of green coffee bean extract (GCBE) was isolated and quantified by high performance thin layer chromatography (HPTLC) (6.426%). The rats were treated with GCBE at the dose of 100, 200 and 400mg/kg in gentamicin (GM) induced AKI for five consecutive days. At day 6, the renal function was assessed through analysing urine, blood and renal tissues. GCBE dose dependently and significantly (p less then 0.001) lowered blood urea, creatinine and potassium while, enhanced sodium compared to AKI control.
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