Shubha Seshadri

Manipal Academy of Higher Education | MAHE · Department of Medicine

Purpose Pulmonary aspergilloma affects immunocompromised patients but is also a recurrent condition in patients previously treated for pulmonary tuberculosis. Methods and Results We report the case of a 45-year-old patient with a history of cured pulmonary tuberculosis 15 years earlier in whom we visualized pulmonary aspergilloma by transthoracic...

A 63-year-old diabetic woman presented to the outpatient clinic with a 1-week history of abdominal pain. On complete evaluation, she was diagnosed to have essential thrombocythemia. Abdominal imaging revealed portal vein thrombosis with a large splenic infarct. The patient was started on anticoagulant, antiplatelet and cytoreductive therapy. In vie...

Rationale & Objective Rodenticide poisoning, either accidental or intentional, is very common in rural India. Absence of a definite antidote made it a major concern with a high mortality rate. So, we aimed to assess the effectiveness of N-Acetyl Cysteine (NAC) in rodenticide poisoning as there are recent positive shreds of evidence on it. Methodol...

Objective: The objective of this study was to determine the association between antihypertensive drug use and new-onset diabetes (NOD) in patients with hypertension (HTN). Materials and methods: A retrospective observational study was conducted in a tertiary care hospital located in south India. Patients diagnosed with HTN and HTN with diabetes...

Background: Ankle–Brachial Index (ABI) has a proven role in the baseline assessment of the individuals who are at a risk of cardiovascular diseases. Sparse data are available regarding the association of cardiovascular risk factors in type 2 diabetes mellitus (T2DM) and ABI from India. Material and Methods: A cross-sectional study was conducted at...

Progressive non-familial adult onset cerebellar degeneration has been rarely associated with hypothyroidism and is known to be reversible after therapy. We report a case of cerebellar atrophy in a 31 year old female whose detailed evaluation had revealed sub-clinical hypothyroidism secondary to autoimmune thyroiditis with a very high anti-TPO (anti...

Diabetic complications, comorbidities, and cost of treatment affect the quality of life (QoL) of an individual. The QoL assessment is considered an important measure of outcome in chronic disease management. The objective of our study was to assess the quality of life in Type II diabetes mellitus patients with and without complications using the mo...

A patient information leaflet is an educational material for educating patients regarding a disease, medications and lifestyle modifications for better care. The present study aimed at preparing, validating and user-testing of diabetes and hypertension information leaflets in different languages among patients. The patient information leaflets on d...

Infective endocarditis by Methicillin Resistant Staphylococcus aureus (MRSA) bacteraemia is a common association and carries a high mortality. However, rising Minimum Inhibitory Concentrations (MICs) for vancomycin amongst MRSA strains is an emerging threat which carries poor prognosis and higher mortality. Here, we report a case of 41-year-old you...

This study was undertaken to assess the less-known association between subclinical hypothyroidism and severity of diabetic retinopathy in patients with type 2 diabetes mellitus. Among 35 diabetic patients who were subclinically hypothyroid, 20 (57.1%) had retinopathy as compared to 21 patients (30%) in the euthyroid group, which was significant (p=...

A spinal epidural abscess threatens the spinal cord or cauda equina by compression and also by vascular compromise. If left untreated, an expanding suppurative infection in the spinal epidural space can impinge on the spinal cord, producing sensory symptoms and signs, motor dysfunction, and ultimately paralysis, followed by death. Hence, early inte...

Chorea is usually associated with neurological diseases. However, it can also be seen in patients with systemic lupus erythematosus (SLE), rheumatic fever (Sydenham's chorea), polycythemia vera, and thyrotoxicosis. Here, we report an interesting case of hemichorea in a 32-year-old lady, who presented with acute onset of jerky, non-repetitive involu...

Chorea is usually associated with neurological diseases. However, it can also be seen in patients with systemic lupus erythematosus (SLE), rheumatic fever (Sydenham’s chorea), polycythemia vera, and thyrotoxicosis. Here, we report an interesting case of hemichorea in a 32-year-old lady, who presented with acute onset of jerky, non-repetitive involu...

Rhabdomyolysis is a clinical condition characterized by muscle necrosis and the release of intracellular muscle contents into systemic circulation there by leading to asymptomatic elevation of serum muscle enzymes, electrolyte imbalances, and acute renal failure. Hyponatremia is one of the commonest of electrolyte disorder. Hyponatremia causing rha...

Bronchiectasis is a common respiratory disorder, which we come across in clinical practice. Patients with bronchiectasis are prone to infections, especially of Mycobacterium tuberculosis. However, non-tubercular Mycobacterial infections may also set in, though rare. Here, we report an unusual case of Mycobacterium avium complex infection in a case...

Iron deficiency anemia secondary to gastrointestinal bleeding is very common in the elderly, and has to be managed with utmost care. Gastric antral vascular ectasia (GAVE) is a rare cause of gastrointestinal bleeding. Although rare, it can be quite dramatic in its presentation and prognosis. The authors report a case of GAVE presenting with upper g...

Background: Strict glycemic control is critical in preventing adverse maternal and fetal outcomes with gestational diabetes mellitus (GDM), but frequently results in recurrent maternal hypoglycemia and is often impracticable. This study was done to determine whether a more lenient strategy might provide satisfactory outcomes and to formulate a gly...

Background: Mediastinal tumours are uncommon lesions encountered in clinical practice. There has been a significant increase in the incidence of malignant mediastinal tumours over the past four decades. The presentation varies from asymptomatic lesions detected incidentally on imaging to severe life threatening presentations. Aim and Objectives: Th...

A 42-year-old female patient of aplastic anaemia on maintenance blood transfusion presented with a 3-week history of fever, cough, dyspnoea and pedal oedema. Upon examination she was found to have severe pallor, temperature of 101°F, tachycardia, bilateral pitting pedal oedema, raised jugular venous pressure, ejection systolic murmur (grade 2/6) in...

Brucellosis is a chronic infection produced by members of the Brucella family. Diagnosis of this condition requires either isolation of the organism in culture or positive serological tests.We describe a 27-year-old male admitted as a case of pyrexia of unknown origin (PUO), who tested negative for Brucella IgM ELISA test on preliminary evaluation...

Multiple myeloma is the prototype of malignant monoclonal gammopathies. The most common skeletal sites are pelvis, skull, spine, ribs and femoral and humeral shafts. The classic radiographic presentation of multiple myeloma is lytic skeletal lesions. Other types of presentation include sclerotic and porotic changes. Primary sclerotic manifestations...

Ischemic stroke following viper bite is rare. We report a case of posterior circulation ischemic infarction following viper bite in a previously healthy woman. Soon after being bitten by the snake on the left leg, she developed local redness, echymosis and one hour later became drowsy. On examination she had skew deviation of eyes and down gaze pre...

DESCRIPTION A 74-year-old lady was admitted with complaints of breathlessness of 1-week duration. She had been diagnosed as limited scleroderma, 10 years back; however, she was not on any medications. Chest radiograph was suggestive of alveolar oedema; extensive calcifi cation of soft tissue around the shoulder joints was noted bilaterally (fi gure...

Organophosphate (OP) poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of histo...

Pure erythroleukemia is a rare hematopoietic neoplasm, seldom reported in literature. Varied reports suggest a prevalence of 3-5% of all AML. We report one such case, presenting with non classical symptoms in a 65 year old lady. Peripheral smear examination and complete hemogram revealed a pancytopenic profile with circulating basophilic erythrobla...

Hematological abnormalities are frequent among human immunodeficiency virus (HIV)-infected patients and may be directly attributable to the virus or may be caused by opportunistic infections, neoplasms or drugs that cause bone marrow suppression or hemolysis. Pure red cell aplasia (PRCA) is an uncommon hematological disorder that causes anemia. We...

The metabolic alterations caused by hyperaldosteronism are being increasingly recognized and have generated considerable interest among the medical fraternity. Hyperaldosteronism is suspected to have a pivotal role in the patho-physiology of congestive cardiac failure where it has been studied extensively. But its effects on calcium metabolism, par...

Posterior reversible encephalopathy syndrome is a reversible syndrome characterized by headache, seizures, altered mentation, and loss of vision associated with white matter changes on imaging. We report here a 27 year-old lady three weeks postpartum, presenting with posterior reversible encephalopathy syndrome. She was treated successfully with an...

Wolfram syndrome, a rare genetic disorder is characterized by juvenile onset diabetes mellitus and optic atrophy. We describe two cases of wolfram syndrome belonging to same family; 25 year old female and her only 15 year old brother. In female, diabetes mellitus and optic atrophy were manifested in 1(st) decade, diabetes insipidus in 2(nd) decade...

Enteric fever is endemic in this part of the world, and Widal test is one of the time-honored laboratory tests that are being used for years to diagnose the disease. On the other hand, melioidosis is a newly emerging disease from this region, which is most often misdiagnosed or underdiagnosed by clinicians. It is well accepted that false-positive W...

Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infe...

Oxidative stress is involved in the pathophysiology of diabetes mellitus. In the present study, 68 patients with type 2 diabetes mellitus and 31 clinically healthy individuals were evaluated. The patients were divided into two groups. Group 1 included 29 patients without diabetic complications and group 2 consisted of 39 patients with diabetic comp...

Melioidosis is endemic in Southeast Asia and northern Australia, but it has been rarely reported from India. Recent reports have shown that melioidosis is an emerging infection in this part of the world, but enteric fever is more commonly seen in India. We present a 50-year-old male with diabetes who presented with acute onset of febrile illness. P...

Antemortem diagnosis of acute massive pulmonary thromboembolism (PTE) with a large thromboembolus at the bifurcation of the pulmonary trunk (saddle thromboembolus) is difficult, as most patients either die or are too ill for any diagnostic imaging. We report a case of massive PTE where constrast enhanced computed tomographic (CECT) scan of chest de...

Emphysematous pyelonephritis is a rare life-threatening suppurative necrotising infection of the renal parenchyma and perirenal tissue producing abscess formation and intrarenal gas. It is almost always seen in diabetics, making it a concern of the physician. A high index of suspicion is required for diagnosis and a combined approach has significan...

We report on an elderly lady in the sixth decade of life with congenital Gerbode's defect who refused surgery. She has atrial fibrillation, massive cardiomegaly and repeated episodes of lower respiratory tract infection.