Browsing by Author "Garg, A."

Now showing 1 - 6 of 6
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    Causal ambiguity: deciphering the etiology of secondary thrombotic microangiopathy with systemic lupus erythematosus and vivax malaria
    (Medip Academy, 2023-10) Soni, J. R.; Garg, A.; Aggarwal, P.; Gupta, A.; Gupta, P.
    Hemolytic uremic syndrome (HUS) falls under the spectrum of thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and thrombi in small vessels leading to end-organ damage. It's classified into typical HUS (caused by Shiga toxin-producing E. coli), atypical HUS (due to uncontrolled complement activation), and secondary HUS (sHUS) linked with coexisting conditions. We present a compelling case of a 21-year-old female with fever, jaundice, anemia, thrombocytopenia, and oliguric acute kidney injury (AKI), ultimately diagnosed with Plasmodium vivax malaria. Despite adequate antimalarial therapy, the patient's clinical trajectory remained intricate, characterized by sustained hematological abnormalities and renal dysfunction. A comprehensive assessment revealed Coombs-negative hemolytic anemia. Subsequently, a renal biopsy confirmed TMA. Considering the rarity of vivax malaria causing TMA, an autoimmune workup was conducted, suggesting systemic lupus erythematosus (SLE). Systemic autoimmune disease-associated HUS (SAID-HUS) is a rare entity that exhibits diverse clinical presentations, with SLE being best-described etiology in literature. SLE-associated HUS was considered and was managed with steroids and hydroxychloroquine resulting in significant renal and hematological improvement. This report underscores significance of assessing autoimmune factors in case of secondary TMA, while also shedding light on evolving understanding of vivax malaria's potential relationship with TMA.
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    Dens Invaginatus in a Supernumerary Tooth: A Rare Entity
    (Dr. Annil Mahajan, 2023-01) Urs, AB; Kumar, P; Garg, A.
    This case report elaborates on the clinical and histopathological features of dens invaginatus in a supernumerary tooth. A 12-year-old female patient had a swelling in the upper jaw associated with mild pain and pus discharge. Intraorally, bony hard and non-tender swelling on the hard palate was present w.r.t., palatally displaced supernumerary tooth. Orthopantomogram revealed tooth-like structure superimposed with mesiodistally inclined 23. Ground and decalcified sections confirmed the diagnosis of dens invaginatus type 2. This study highlights the importance of comprehensive histopathological investigation of such cases along with history and clinical examination, the neglect of which could hamper successful treatment outcomes.
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    May-Thurner syndrome causing venous thromboembolism in a young female with Sturge weber syndrome and connective tissue disease
    (Medip Academy, 2023-10) Narula, S.; Agarwal, P. K.; Garg, A.
    May-Thurner syndrome (MTS) is a rare condition characterized by the compression of the left common iliac vein by the overlying right common iliac artery. It is a unique causal reason for development of deep venous thrombosis (DVT) and pulmonary embolism (PE). Young females developing DVT should be examined and investigated with details as triggers can include trauma, pregnancy, autoimmunity. In this case report we report a case of a young female who had Sturge Weber Syndrome, and how a left hip pain was diagnosed as DVT which led to diagnosis of an underlying MTS and autoimmune trigger for her hypercoagulable state.
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    Rare case of immune mediated cutaneous leucoclastic vasculitis with pancytopenia in a rheumatoid arthritis patient with chronic cytomegalovirus infection
    (Medip Academy, 2024-07) Bajpai, R. G.; Garg, A.
    Acute febrile illnesses with systemic involvement can present significant diagnostic and therapeutic challenges, particularly in patients with multiple comorbidities. This case report highlights a complex presentation of acute febrile illness with pancytopenia and immune-mediated cutaneous vasculitis in a patient with type II diabetes mellitus. A 52-year-old male with a known history of type II diabetes mellitus presented with fever, decreased oral intake, loose stools, oral ulcers, dysphagia, and rashes over the trunk and abdomen for four days. Upon admission to the ICU, extensive diagnostic evaluations were performed, revealing significant hematological, biochemical, and serological abnormalities. Imaging studies and histopathological examinations were conducted to further investigate the underlying etiology. Laboratory findings indicated pancytopenia, acute kidney injury, and hyperkalemia. Infectious disease workup was largely negative, except for a positive CMV IgG. Imaging studies revealed medical renal disease, and a skin punch biopsy confirmed cutaneous leukocytoclastic vasculitis. Bone marrow biopsy suggested bone marrow suppression. Multidisciplinary management, including dialysis, IV fluids, antibiotics, blood transfusions, steroids, and Ganciclovir, led to the patient抯 gradual improvement and stabilization. The comprehensive diagnostic and therapeutic approach in this case underscores the importance of considering immune-mediated etiologies in patients with atypical presentations. Multidisciplinary collaboration was crucial in managing the multifaceted clinical condition of the patient. Early recognition and prompt multidisciplinary management are essential in similar cases. Extensive diagnostic evaluations should be performed to identify the underlying causes, and immune-mediated etiologies should be considered in complex presentations. Further research is recommended to explore optimal management strategies for such multifaceted conditions.
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    Role of cadexomer iodine ointment as debriding agent in 50 cases of skin and soft tissue infections
    (Medip Academy, 2023-03) Sharma, R; Singh, A; Garg, A.
    Background: The management of skin and soft tissue infections is a tedious job to tackle as many factors play important roles in wound healing. Wounds can be better managed and healed faster if infection is removed and the way to eliminate infection is by use of antiseptics, antibiotics and solutions over wounds along with the use of systemic antibiotics. In this study, we used cadexomer iodine ointment for management of various types of wounds. Methods: This study was conducted in a tertiary care hospital. After screening, 50 patients with various types of wounds (venous leg ulcers, postoperative infected wounds, infected traumatic wounds, controlled diabetic wounds, ulcers with slough, abscesses left for healing by secondary intention after operation) were taken and cadexomer iodine was applied when the wound was infected and had visible slough with pus discharge. Results: Majority of the patients (about 88%) were free of visible slough in about a week and in about two weeks, all patients (100%) were free from visible slough. 74% patients have complete closure of the wound and 22% patients have reduction in total wound surface area between 75-99% in 4 weeks period. Conclusions: Under controlled conditions, cadexomer iodine is a good topical agent for debridement of wounds which are infected and have a visible slough along with pus discharge. It also helps in healing the wound.
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    A study of knowledge, attitude and practices regarding biomedical waste management among health care providers in a tertiary care Institute in Punjab
    (MRI Publication Pvt. Ltd., 2022-12) Signh, H; Nagpal, M; Bindra, P; Singh, H; Garg, A.
    The biomedical waste, if not properly managed, can harm the surrounding environment, cause various infections and injuries to the healthcare workers, patients, their attendants. Methods: This cross-sectional study was conducted to assess the knowledge, attitude and practices among different cadres of health care providers in a tertiary care institute. Expecting that 50% of the study population had precise knowledge about the rules and legislation of biomedical waste management, with an allowable error of 10%, at 95% confidence interval, and accounting for the finite population correction for 1700 participants, a minimum sample size of 426 was taken. Data analysis was done by using Microsoft excel and SPSS. Results: Out of 426 subjects, 138 (32.4%) were nurses, 35 (8.2%) were lab technicians and 253 (59.4%) were housekeeping staff. Knowledge, attitude and practices regarding biomedical waste management and handling were significantly (p<0.05) higher among the nurses as compared to other health care providers. Conclusions: Knowledge, attitude and practices regarding the collection, segregation, rules, and disposal of biomedical waste management was more among nursing staff compared to other health care workers. Hence, emphasis on adequate training is required among other health care workers for the safe handling and disposal of biomedical waste management.