Severe acute respiratory syndrome coronavirus–2 (SARS-CoV-2) is the novel coronavirus initially detected in Wuhan, China, and is responsible for the worldwide pandemic coronavirus disease 2019 (Covid-19). Influenza is a common endemic respiratory virus that causes seasonal outbreaks of respiratory illness. There are currently few reports in the literature describing patients with coexisting infections. This case series of 4 patients identified at our single institution in Louisiana highlights the patient characteristics, laboratory findings, and outcomes in patients with both Covid-19 and influenza infection.

Background: Dengue is an exceedingly common infection of the tropics. The aim of the research to study the biochemical parameters of serologically proven dengue cases.Methods: The study included Dengue patients admitted in PSG Hospital between January 2011and December 2012.Results: Analysis of aspartate aminotransferase results showed that 19.1% had two-fold rise, 13.3% had three-fold rise and 19.6% had more than threefold rise. Analysis of alanine aminotransferase showed that 35.7% had normal values, 14.95% had two-fold rise, 11.1% had three-fold rise and 11.5% had more than threefold rise. Serum proteins were normal in 35.7% and low in 19.6%. Analysis of serum albumin showed low values in 10.6% Serum sodium levels were low in 11.1% of patients. Albuminuria was positive in 53% of patients. Serum ionised calcium levels were low in 26.8% of patients.Conclusions: The biochemical abnormalities noted in our study included include elevated liver enzymes, low sodium and ionised calcium levels, hypoalbuminemia and increased urine albumin excretion.

ECG can be used as a tool for prognostication in acute STEMI. The presence of reciprocal changes in the ECG can signify poorer outcome on follow up. Lower QRS amplitude can be used as a predictor of larger infarct.

Background. John Cunningham virus (JCV) is known to cause progressive multifocal leukoencephalopathy (PML) in immuno-compromised patients due to lytic infection of oligodendrocytes and astrocytes. Rarely, it may also present as granule cell neuronopathy (GCN), leading to degeneration of cerebellar granule cell neurons. It is described in patients with underlying conditions or medication contributing to immune compromise. Case Presentation. A 73-year-old man presented with ataxia and difficulty in speech which began 3 months after initiation of treatment for idiopathic thrombocytopenic purpura with rituximab. Neurological examination was significant for torsional nystagmus, motor aphasia, right-sided dysmetria, and dysdiadochokinesia with gait ataxia. Magnetic resonance imaging (MRI) showed right cerebellar lesion and cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was positive for JC virus. Conclusion. The diagnosis of JC virus-related cerebellar disease can be missed, due to the subacute to chronic onset and challenges in detection. Clinicians should have a high degree of suspicion for development of these symptoms, even a few months after initiation of immune-modulatory therapy because the progression and outcomes can be disastrous.

Background: Dengue is an extremely important tropical disease transmitted by the Aedes aegypti mosquito. Aim of the study: to study the white blood cell levels in serologically proven dengue cases; to study hematocrit levels in cases of dengue fever.Methods: The present study is a retrospective observational analysis of white blood cell count (WBC count) and hematocrit in 235 serologically proven Dengue cases admitted in the years 2011-2012Results: 107 cases (45.5%) had leukopenia, 111 cases (47.2%) had normal WBC counts and 12 cases had leukocytosis (5.1%).  23 cases had increased hematocrit (9.8%), 76 cases had a low hematocrit (32.3%) and 128 cases had a normal hematocrit (54.5%).Conclusions: A significant proportion of patients had leukopenia which may be an early marker of dengue infection. Only a small percentage of patients had raised hematocrit. It may be that rise from baseline levels of haematocrit which may be more significant than absolute values.