Pak J Med Sci
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Case Reports
A 'benign' extrapyramidal side effect masking a life-threatening neuroleptic malignant syndrome.
The neuroleptic malignant syndrome is a rare, life-threatening idiosyncratic reaction to neuroleptic medication. The use of newer antipsychotics combined with its rare incidence has made NMS seem as a complication of the past. Here we report a patient in his early 20s suffering from a psychotic disorder developing a life-threatening neuroleptic malignant syndrome on an inpatient psychiatric ward in Canada without the characteristic overt change in autonomic stability. We review the clinical characteristics to facilitate the early recognition of neuroleptic malignant syndromes and discuss why this condition still is highly relevant for practising physicians.
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To investigate the effect of vitamin D deficiency on the levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab), interleukin-1 (IL-1) and high-sensitivity C-reactive protein (hs-CRP) in pregnant women with early pregnancy complicated by subclinical hypothyroidism. ⋯ Vitamin D deficiency in the first trimester is associated with in an increased level of TSH in the first trimester, thereby aggravating subclinical hypothyroidism. The mechanism may be associated with the impact of vitamin D deficiency on hs-CRP and other body inflammation indicators, as well as on thyroid autoantibodies and other immune indicators, but has no effect on IL-1 levels.
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This study aims to establish the 99th percentile upper reference limits of high sensitive cardiac troponin I in a healthy Pakistani population. ⋯ High sensitivity cardiac troponin I 99th percentile URL in our study population was found to be 33.9 ng/L with gender specific values being 38.41 ng/L and 15.73ng/L for males and females respectively. Troponin I in males was substantially high in comparison with females.
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The impact of extended antral resection (AR) after laparoscopic sleeve gastrectomy (LSG) on clinical results is still not clearly elucidated with conflicting results. Our study aimed to determine whether AR is superior to antral preservation (AP) regarding clinical results. ⋯ Both AR and AP seem to be equally effective in resolution of metabolic response. Although statistically not significant- AR provided more %EWL and %TBWL at the end of 12 months.
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To report here, case series of women developing acute kidney injury (AKI) in association with hemolytic uremic syndrome (HUS) during pregnancy or within days postpartum. ⋯ AKI with background of Hemolytic Uremic Syndrome (HUS) may remain irreversible in many of these young women. Plasmapheresis should be offered to patients with established diagnosis of HUS.