We report the case of a 24-year-old nondiabetic, nonhypertensive lady with history of fatigue, dyspnoea and limb claudication. She has been diagnosed with Takayasu's arteritis. Subsequently she developed rash, alopecia, joint pain, and various other laboratory abnormalities which led to a diagnosis of SLE. Takayasu's arteritis (TA) rarely coexists with systemic lupus erythematosus (SLE). The absence of specific SLE markers in patients with TA who subsequently develop SLE suggests that the coexistence of these conditions may be coincidental. The antiphospholipid syndrome in patients with SLE may mimic the occlusive vasculitis of TA.
We are presenting two cases of Guillain-Barré syndrome where it is preceded by hepatitis E virus (HEV) and Japanese encephalitis virus (JEV) infection, respectively. Our first case is a forty-three-year-old nondiabetic, nonhypertensive female who was initially diagnosed with acute HEV induced viral hepatitis and subsequently developed acute onset ascending quadriparesis with lower motor neuron type of bilateral facial nerve palsies and respiratory failure. Second patient was a 14-year-old young male who presented with meningoencephalitis with acute onset symmetric flaccid paraparesis. After thorough investigations it was revealed as a case of Japanese encephalitis. Our idea of reporting these two cases is to make ourselves aware about this potential complication of these two common infections.
A young Indian man presented with nine-month history of chronic diarrhea, occasionally mixed with blood and intermittent colicky abdominal pain. He also complained of generalized body swelling for the last three months. On examination, he had diffuse hyperpigmentation of the skin and dystrophic nail changes. Upper and lower gastrointestinal endoscopy revealed multiple sessile polyps in the stomach, small bowel, and colon and rectum. Biopsy of polyps showed adenomatous changes with stromal edema and dilated glands. Cronkhite-Canada syndrome (CCS) was diagnosed and treated with glucocorticoids and enteral nutritional supplementation. There was an associated small intestinal bacterial overgrowth (SIBO) and stool was positive for clostridium difficile toxin. After 12 weeks of treatment, the patient achieved remission. Close correlation with clinical findings, including pertinent ectodermal abnormalities, endoscopic studies, and careful examination of biopsies will ensure a timely and correct diagnosis of CCS.
Background and Study Aim: COVID 19 is the terminology driving peoples life in the year 2020 without a supportive globally high mortality rate. Coronavirus lead pandemic is a new found disease with no gold standard diagnostic and therapeutic guideline across the globe. Amidst this scenario our aim is to develop a prediction model that makes mass screening easy on par with reducing strain on hospitals diagnostic facility and doctors alike. For this prediction model, a neural network based on Chest X-ray images has been developed. Alongside the aim is also to generate a case record form that would include prediction model result along with few other subclinical factors for generating disease identification. Once found positive then only it will proceed to RT-PCR for final validation. The objective was to provide a cheap alternative to RT-PCR for mass screening and to reduced burden on diagnostic facility by keeping RT-PCR only for final confirmation. Methods: Datasets of chest X-ray images gathered from across the globe has been used to test and train the network after proper dataset curing and augmentation. Results: The final neural network-based prediction model showed an accuracy of 81% with sensitivity of 82% and specificity of 90%. The AUC score obtained is 93.7%. Discussion and Conclusion: The above results based on the existing datasets showcase our model capability to successfully distinguish patients based on Chest X-ray (a non-invasive tool) and along with the designed case record form it can significantly contribute in increasing hospitals monitoring and health care capability.
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