Background:Glanzmann's thrombasthenia (GT) is a rare bleeding disorder, which is characterized by a lack of platelet aggregation. It is characterized by qualitative or quantitative abnormalities of the platelet membrane glycoprotein IIb/IIIa. Physiologically, this platelet receptor normally binds several adhesive plasma proteins, and this facilitates attachment and aggregation of platelets to ensure thrombus formation at sites of vascular injury. The lack of resultant platelet aggregation in GT leads to mucocutaneous bleeding whose manifestation may be clinically variable, ranging from easy bruising to severe and potentially life-threatening hemorrhages.Objective:To highlight this rare but potentially life-threating disorder, GT.Case Report:We report a case of GT that was first detected because of the multiple episodes of gum bleeding. The patient was an 18-year-old girl who presented with a history of repeated episodes of gum bleeding since childhood. Till the first visit to our hospital, she had not been diagnosed with GT despite a history of bleeding tendency, notably purpura in areas of easy bruising, gum bleeding, and prolonged bleeding time after abrasions and insect stings. GT was diagnosed on the basis of prolonged bleeding time, lack of platelet aggregation with adenosine di phosphate, epinephrine and collagen.Conclusion:GT should always be considered as differential diagnosis while evaluating any case of bleeding disorder.
COVID-19 derives from infection with Coronavirus [severe acute respiratory syndrome (SARS)-CoV-2] is associated with high morbidity and mortality. These hazardous impacts are due to the release of a storm of pro-inflammatory cytokines and thrombogenic agents. Increasing evidences about multi organ involvement in COVID infection have started pouring in, where patients who either recovered from or had mild symptoms after COVID-19, exhibit diffuse multi organ related symptoms. We describe a case of a 23-year-old male who presented to emergency room with intermittent high-grade fever, sudden onset of breathlessness, giddiness and weakness. His COVID RTPCR was negative. He was unvaccinated but his covid antibodies were increased multifold. Further examination revealed active multi organ involvement which suggestive for multisystem inflammatory syndrome (MIS). With appropriate diagnosis and treatment patient improved clinically over a course of 3 weeks and discharged and is under regular follow up.
This study aimed to evaluate the effect of NAFLD on CIMT as a risk factor for atherosclerosis. The incidence of non-alcoholic fatty liver disease (NAFLD) is escalating worldwide due to mount of obesity and diabetes mellitus (DM) prevalence. Non-invasive appraisal of carotid intima-media thickness (CIMT) by high-resolution carotid B-mode ultrasonography is broadly used for determining atherosclerosis. In this case-control setting, 151 subjects were categorized in three groups: group I counting 49 patients with NAFLD and DM; group II counting 50 non-diabetic NAFLD patients; and the control with 52 normal subjects as group III. The right and left CIMTs and its maximum reading (CIMT max) were deliberated by a skilled sonographist blind to the groups. The sonographic grading of the NAFLD was dogged in groups I and II. Median CIMT max was extensively higher in group I comparing with group II and control group (p<0.001). This disparity between group I and group II were not significant after adjusting for age and history of hypertension and hyperlipidemia (p=0.089). After scheming the confounders, there was a statistically significant between-group I and group II with the control group (p<0.05). There was no significant disparity in median maximal thickness of intima-media in the carotid of group I compare to group II in patients with and without prominent liver enzymes (in both groups, 0.6 mm, p= 0.402). Based on our findings, there is a significant relationship between the presence of NAFLD and atherosclerosis. This association was independent to the Diabetes mellitus presence. The grade of NAFLD and elevated liver function tests had no effect on the severity of atherosclerosis.
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