Saroj Lohani's research while affiliated with Reading Health System and other places
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Publications (29)
Background: Clozapine is a second-generation antipsychotic used in refractory schizophrenia. Clozapine can lead to pulmonary embolism (PE) by various mechanisms including immobility, weight gain and increased platelet aggregation.
Objectives: We performed a systematic review on published cases of PE associated with clozapine.
Methods: Comprehensive...
A 20 year old male with past medical history of Type 1 Diabetes and Hypothyroidism presented to our hospital with severe hypocalcemia. His calcium was 5.8 mg/dl (normal range 8.6–10.3 mg/dl). He had been complaining of generalized weakness for weeks. Vital signs were within normal limits. Physical exam was significant for positive Chvostek sign. Ot...
Introduction: Transcatheter mitral valve-in-valve (ViV) & valve-in-ring (ViR) are relatively novel therapeutic alternatives for patients with degenerated bioprostheses or failed annuloplasty rings whose reoperative risk is too high. The predominant procedural access for both procedures is transapical or transseptal. However, whether there are diffe...
Introduction:
Cosmetic injections with silicone and polymethylmethacrylate are not FDA approved for augmentation of body parts such as breast, buttock or legs, but they have been widely used for decades. Cosmetic injections can cause foreign body granulomas and occasionally severe and life-threatening hypercalcemia. We aimed to systematically anal...
A 41-year-old female presented to the hospital with sore throat and shortness of breath. She was hypoxic with an oxygen saturation of 87% in room air. Physical examination revealed swollen uvula with exudates. She had been started on topiramate for treatment of migraine few months ago. The dose of topiramate was increased to 100 mg twice daily 2 we...
Supplementary file 1. Search starategy
Supplementary file 2 contains Table S1.
Background:
Statins are a group of drugs that reduce the levels of triglycerides and cholesterol in blood by inhibiting HMG-CoA reductase, an enzyme involved in rate limiting step in cholesterol synthesis. About 2-20% patients on statins develop toxic myopathies, which usually resolve on discontinuation of statin. More recently, an immune-mediated...
Background:
Antiphospholipid antibody syndrome (APS) is a disorder associated with both arterial and venous thromboembolic disease, including acute myocardial infarction (AMI). Given that management with anticoagulants is critical and differs from usual AMI care, identification of key discriminators of patients with AMI with APS is important.
Met...
Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis is often delayed or misdiagnosed due to its rarity in the western world and subtle features of hyperthyroidism on initial presentation. Here we present the case of a 25-ye...
We describe a case of 40-year-old woman who presented to our hospital with symptoms of non-radiating epigastric pain for 4–5 days associated with nausea and vomiting. Her history was significant for asthma with recurrent exacerbations, polyneuropathy and recurrent sinus infections. Liver function tests revealed cholestasis. Antinuclear antibody and...
Thrombosis is a frequent cause of morbidity and mortality in patients with nephrotic syndrome (NS). Though venous thromboses are common in NS, arterial thromboses are relatively rare. Commonly involved arteries include coronary, iliac, femoral, renal, cerebral, pulmonary, mesenteric, and axillary arteries, and the aorta. Arterial thromboses are ass...
Pylephlebitis or infective suppurative thrombosis of the portal mesenteric venous system is an uncommon condition that can potentially be deadly if not recognized and treated early. Although most commonly associated with pancreatitis and diverticulitis, any intra-abdominal or pelvic infection occurring in the region drained by the portal venous sys...
Disseminated mucormycosis endocarditis is extremely rare, and only a few cases have actually been reported in the literature. It is almost universally fatal despite aggressive surgical and medical management. In this article, we present the case of a 48-year-old immunocompromised male with mucormycosis endocarditis, who presented with acute bilater...
Epiploic appendagitis (EA) is an uncommon cause of abdominal pain. It is a benign condition but may mimic other serious causes of acute abdomen such as appendicitis, diverticulitis, and gynecological emergency in severe cases. Knowledge of this condition in the differential diagnosis of abdominal pain can save unnecessary hospital admission, antibi...
Background:
Takotsubo cardiomyopathy is a syndrome of transient cardiac dysfunction that is frequently associated with sudden emotional or physical stress. Epinephrine use has been implicated in precipitating Takotsubo cardiomyopathy in multiple case reports and case series. We sought to systematically review the current English literature on this...
Isolated pulmonary valve endocarditis in intravenous drug users is a rarely reported phenomenon. We present the case of a 25-year-old male with history of intravenous drug use who presented with respiratory symptoms after failing outpatient treatment for community-acquired pneumonia. Further investigations identified multiple lung lesions with earl...
Generalized pruritic rash in Hodgkin's disease is most commonly due to paraneoplastic manifestation. It can sometimes precede other manifestations of Hodgkin's disease by weeks or months. Hence, if other possible causes have been ruled out, Hodgkin's disease should be considered a possible cause of generalized pruritic rash. Consideration of Hodgki...
Glioblastoma is a highly aggressive and generally lethal brain tumor despite aggressive treatment. Treatment to ensure prolonged survival while maintaining quality of life has always been challenging, as glioblastoma occurs mostly in elderly population who already have multiple comorbidities. We present the case of a 75-year-old male who was evalua...
Strongyloidiasis is a parasitic infestation caused by Strongyloides stercoralis. Most cases are asymptomatic; however, symptomatic patients may present with a wide range of non-specific cutaneous, pulmonary, or gastrointestinal symptoms posing a diagnostic dilemma and delay in diagnosis. We report a case of a 58-year-old female who presented with m...
Gonococcus typically affects the mucosal surfaces but in rare cases can spread to bloodstream causing disseminated gonococcal infection (DGI). The usual presentation of DGI is rash, polyarthralgia, and tenosynovitis. We present the case of a 23-year-old female who presented to our hospital with pustular rash and tenosynovitis of hand and was sent h...
We report a case of a 37-year-old woman who presented to our hospital with retrosternal chest pain following intramuscular administration of epinephrine due to presumed anaphylaxis. On arrival, she was found to have ST segment depression in the anterolateral leads on ECG and elevated cardiac troponins. She was diagnosed with stress cardiomyopathy b...
Vertebral osteomyelitis due to Streptococcus viridans following a dental procedure is a rarely reported phenomenon. We discuss the case of a 67-year-old immunocompetent woman who presented with low back pain of 3 weeks duration associated with subjective fever and chills. On admission, the MRI of the lumbar spine showed L5-S1 vertebral osteomyeliti...
Citations
... An interesting data was found in a recent systematic review where a 34 cases of pulmonary embolism documented after exposure to clozapine and almost 50% of these patients did not have significant risk factor or co-morbidities for VTE denoting that the use of clozapine significantly increases risk of pulmonary embolism. 8 The pathophysiologic mechanisms explaining the increased risk of VTE among patient receiving antipsychotic medication remains unclear. The factors that may contribute to the occurrence of VTE include the Psychotic disorders itself and the exposure to antipsychotic drugs. ...
... CC is an urgent and life-threatening complication of CD (2, [18][19][20][21]. The incidence of CC is not exactly known. ...
... Several studies in the field of TAVR have shown deleterious effects of transapical access, possibly related to inherent myocardial damage and the need for a longer recovery period after left-sided thoracotomy [10]. A recent review comparing two approaches to TMVIV showed no significant differences in mortality or other major events [11]. The J-Valve system is currently implanted via the transapical approach, and the operating system via transfemoral vein approach is still in the clinical trial stage, so we can only choose the transapical approach. ...
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... However, in this initial description, despite dilatation of the interatrial septum (IAS) with a 10-mm-diameter balloon, the Sapien XT on the Novaflex system (Edwards Lifesciences) failed to cross the septum, requiring the transcatheter heart valve (THV) to be removed from the body and further septal dilatation with a larger balloon before a successful reattempt. 5 Although earlier systematic reviews did not identify a procedural success or mortality advantage of transseptal over transapical procedures, 6 more recent data from the Society of Thoracic Surgeons e American College of Cardiology, Transcatheter Valve Therapy (STS-ACC TVT) Registry in 1529 patients undergoing transseptal or transapical procedures have shown a lower 1-year mortality rate with transseptal access, leading to a recommendation for transseptal access in most patients. 7 The technique for transseptal delivery of the Sapien 3 valve (Edwards Lifesciences) for mitral VIV and valve-in-ring (VIR) procedures has been described in detail and recommends placement of a single 0.035" delivery wire in the left ventricle (LV) and dilatation of the interatrial septum with a 12-mm or 14-mm balloon before the THV is advanced into the body. ...
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... There are cases described in the literature of patients who made use of injectable fillers, such as silicone, mineral oil, paraffin, and polymethylmethacrylate, for aesthetic reasons and later developed hypercalcemia (8,10,11,16,17). The clinical condition is frequently diagnosed years after initial cosmetic injection and can be severe enough to cause renal failure and death (7). Patients tend to present with diffuse subcutaneous calcifications and hardening of the muscles involved (10,11,17). ...
... Often, the etiology is not due to a single cause but rather a combination of electrolyte derangements. Several cases in the literature describe the development of tetany in young females with malabsorption due to inflammatory bowel disease, celiac disease, or bulimia, who are found to have multiple electrolyte abnormalities [1][2][3]. The majority of published cases of tetany describe non-life-threatening symptoms. ...
... In the present study, all six patients had serum albumin levels lower than 25 g/L, which also supported the findings of previous studies [18]. However, arterial thrombosis still occurs in some NS patients with serum albumin levels greater than 30 g/L [19]. Apart from the abovementioned characteristics, one of the outstanding features of NS is hyperlipidemia. ...
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... In our patient, the CK level at admission was 9185 U/L (i.e., 45 times the ULN). A systematic review by Nazir et al. revealed that 83.33% and 92.8% of the patients presented with symmetrical and bilateral proximal muscle weakness, respectively [9]. Extra-muscular symptoms such as rashes, weight loss, dysphagia, dysarthria, and dyspnea, have also been reported [10]. ...
... Le CAPS, et plus généralement le SAPL, devraient être intégrés dans le diagnostic différentiel en cas d'insuffisance cardiaque aiguë ou d'ischémie myocardique, surtout en présence d'autres atteintes d'organes et lors d'atteinte de type MINOCA («Myocardial Infarction with Non-Obstructive Coronary Arteries»).les deux phénomènes conduisant à une dysfonction ventriculaire via l'ischémie myocardique. Selon le dernier «position paper» de l'«European Society of Cardiology» (ESC) en 2019 concernant le «Myocardial Infarction with Non-Obstructive Coronary Arteries» (MINOCA), le SAPL est suggéré comme étiologie de MINOCA pouvant provoquer une atteinte thromboembolique de la microcirculation coronarienne, mais reste cependant non investigué systématiquement dans la population étudiée en cas de MINOCA[8].Dans leur revue de littérature, Nazir et al.[9] ont étudié 40 cas d'infarctus du myocarde associé au SAPL, dont 18 de type STEMI. Chez 28 patientes et patients, une coronarographie a été effectuée. ...
... La parálisis periódica hipocalémica puede tener causas primarias o ser secundaria a tirotoxicosis, hiperaldosteronismo, cetoacidosis diabética, síndrome nefrótico, drogas, necrosis tubular aguda, abuso de diuréticos o de laxantes, diarrea y vómito. 1 De éstas, la tirotóxica se caracteriza por la triada clásica de episodios recurrentes de debilidad muscular, hipertiroidismo e hipocalemia. 2 Se trata de una emergencia médica subdiagnosticada por la baja sospecha clínica, prevalencia e incidencia en el hemisferio occidental. ...
Reference: Parálisis periódica hipocalémica tirotóxica
