No abstract

SARS-CoV2 started as pneumonia of unknown aetiology in Wuhan, China. Considered a respiratory pathogen primarily initially, COVID 19 is now identified as a systemic infection with significant effects on the hematopoietic system. Lymphopenia, peak platelet/ lymphocyte ratio and neutrophil/lymphocyte ratio are some of the parameters that could be considered as prognostic markers of the disease. Disseminated intravascular coagulation, along with elevated D-dimer levels, are commonly encountered and are usually associated with a worsening clinical picture. IL-6, C reactive protein and Lactate Dehydrogenase with high serum prolactin and serum ferritin levels project a dismal outcome. Venous thromboembolism occurs in both ambulatory and bedridden patients making thromboprophylaxis with LMWH popular. To correlate haematological parameters like lymphopenia, deranged coagulation profile and elevated d- dimer levels with the outcome (recovery or death) of the patients infected with SARS-CoV-2. In this prospective cross-sectional study, data will be gathered from patients found to be positive for COVID 19 with the duration of the study being four months. Lymphopenia, elevated D-dimer levels and deranged coagulation profile are expected in patients with COVID-19. Haematological parameter like lymphopenia raised D-dimer levels, and deranged coagulation profile are associated with poor prognosis in COVID 19.

Artery of Percheron (AOP) is a unique anatomical variant of blood supply to the paramedian thalamus and also to the rostral part of the midbrain. It arises from the P1 part of the posterior cerebral artery. Obstruction of this artery accounts for the infarction of the bilateral thalamus with or without the involvement of the midbrain. Symptoms of artery of Percheron infarction may differ with respect to the portion of the brain it supplies and its different anatomical variations. The various symptoms include memory loss, altered consciousness, vertical gaze palsy, and others. Diagnosis is difficult due to a variety of clinical presentations and differential diagnoses like viral infections or tumors. Artery of Percheron infarction rarely occurs, and early diagnosis is a challenge as it is often missed on a conventional CT scan and even on an MRI scan of the brain. Delay in diagnosis and initiation of treatment must be avoided in such cases. We report a case of this 57-year-old male who had vertical gaze palsy and irrelevant talks, which was evaluated further and found to be the artery of Percheron infarct on MRI brain and treated with antiplatelets after which the symptoms of the patient ameliorated, and he was discharged after five days of admission.

Dengue hemorrhagic fever (DHF) is a common syndrome of dengue viral infection but complications such as sub-capsular splenic hematoma leading to capsular rupture in dengue are rare. We report a case of a young male who presented with fever, breathlessness, and acute abdomen. His CT of the abdomen revealed subcapsular splenic hematoma measuring 16.7 cm × 13.0 cm × 11 cm. His laboratory parameters were suggestive of anemia, thrombocytopenia, acute kidney injury, coagulopathy, and hepatopathy because of which instead of splenectomy, splenic artery embolization with ultrasound-guided splenic hemorrhage drainage was performed for his management as his clinical condition deteriorated. This case report sensitizes newer modalities of treatment of subcapsular splenic hematoma with splenic arterial embolization.