Internal Medicine Commons^™

An Atypical Cause Of Atypical Hemolytic Uremic Syndrome, Abhinav Sharma, Carolina De Elia, Eric Arguelles, Christine L. Gilkerson

Marshall Journal of Medicine

Atypical hemolytic syndrome is an extremely rare, life threatening, progressive disease. Approximately one to two cases per million are seen annually in the US (3,4). It is known to be associated with variety of conditions including infections, drugs, autoimmune conditions, vaccination, malignancy, organ transplantation, pregnancy, and metabolic conditions (11,13).We hereby describe a case of atypical hemolytic uremic syndrome associated with CABG surgery. A 58 year old female presented to the emergency department (ED) with three days of worsening shortness of breath and cold like symptoms including nausea, vomiting and rhinorrhea. Twenty six days prior to presentation she had undergone Coronary …

Spinal Cord Injury And Autonomic Dysreflexia- A Case Report, Apurva Bhatt, Brit Moore, Talal Asif, Kristy E. Steigerwalt, Rebecca R. Pauly

Marshall Journal of Medicine

Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management.

Splenic Infarction: An Uncommon Presentation Of Acute Infectious Mononucleosis, Madhulika Urella, Roma Srivastava, Waseem Ahmed, Yehuda Lebowicz

Marshall Journal of Medicine

Splenic infarction is a relatively uncommon diagnosis. It occurs when the splenic artery or one of its sub-branches is occluded with an infected or bland embolus or clot. Splenic infarction may be caused by atrial fibrillation, bacterial endocarditis, sickle cell disease, antiphospholipid syndrome, and trauma whereas an infectious etiology is uncommon. It is considered a rare presentation of acute infectious mononucleosis. Currently, its pathogenesis is still unclear. We describe a 24-year-old African American female who was admitted for evaluation of left-sided chest pain. Chest imaging, abdominal ultrasound, and initial laboratory data were normal, followed by a negative hypercoagulability panel. Signs …

Partner Disclosure And Early Cd4 Response Among Hiv-Infected Adults Initiating Antiretroviral Treatment In Nairobi Kenya, T. Tony Trinh, Nelly Yatich, Richard Ngomoa, Christine J. Mcgrath, Barbra A. Richardson, Samah R. Sakr, Agnes Langat, Grace C. John-Stewart, Michael Chung

Internal Medicine, East Africa

Background: Disclosure of HIV serostatus can have significant benefits for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response.

Methods: We conducted a retrospective cohort study of newly diagnosed, ART-naïve HIV-infected adults (>18 years) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1^st2009 and July 1^st 2011 and initiated ART within 3 months. Analysis was restricted to adults who reported to have either disclosed or not disclosed their HIV status to their partner. Analysis of CD4 response at 6 and 12 months post-ART was …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Comparison Of The Prevalence And Characteristics Of Inpatient Adverse Events Using Medical Records Review And Incident Reporting, William Macharia, Charles Muteshi, Sikolia Wanyonyi, Abraham Mukaindo, Ahmed Ismail, Herman Ekea, Abdallah Abdulkarim, John Tole, Anthony Ngugi

Paediatrics and Child Health, East Africa

No abstract provided.

Increased Level Of Morning Surge In Blood Pressure In Normotensives: A Cross-Sectional Study From Pakistan, Aysha Almas, Fatehali Tipoo Sultan, Khawar Kazmi

Department of Medicine

Objective: To determine the mean morning surge (MS) in blood pressure, the frequency of increased morning surge in normotensive subjects, and to compare those with morning surge with those without MS.
Study Design: A cross-sectional, comparative study.
Place and Duration of Study: The Department of Medicine, The Aga Khan University Hospital, Karachi, from April 2011 to March 2012.
Methodology: Adult normotensive healthy volunteers aged 35 to 65 years were inducted. Their ambulatory blood pressure (ABP) was measured over a 24-hour period, using digital ambulatory blood pressure monitors. Morning surge was calculated as the average of four readings after waking …

Successful Overtube Assisted Ercp: A Single-Center Case Series, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md, Tanveer Imam Md

Department of Medicine

No abstract provided.

Ampullary Carcinoid: A Case Report, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Dome-Type Carcinoma Of The Ascending Colon: A Case Report, Patrick Hickey Do, Shanth A. Goonewardene Md, Shashin Shah Md, Hiral N. Shah Md, Anthony G. Auteri Md

Department of Medicine

No abstract provided.

Hemophagocytic Lymphohistiocytosis, An Overlooked Culprit Of Disseminated Intravascular Coagulation, Shivtaj Mann Do

Department of Medicine

No abstract provided.

Appearances Can Be Deceiving - Colon Cancer Mimicking Ileocolitis, Abdul Aleem Md, Muhammad Qasim Md, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Idiopathic Hyperammonemia And Rituximab Therapy, Samer Bolis Do, Daniel Schwed-Lustgarten, James Ross Md, Facp

Department of Medicine

No abstract provided.

The Effect Of Long-Term Proton Pump Inhibitor Use On Frailtysyndrome In Elderly Patients, Stephanie Dewi, Purwita W. Laksmi, Ari Fahrial Syam

Jurnal Penyakit Dalam Indonesia

Introduction. Frailty syndrome, the newest elderly health predictor, associated with higher morbidity and mortality. PPI are often used in elderly due to presence of upper gastrointestinal complaints, and relates with polypharmacy as one of the risk factor for frailty syndrome. There is no study of the relationship between long term PPI use and frailty syndrome in elderly. Methods. A case control study included subjects 60 years and above with good cognitive status. All subjects with history of hypersensitivity of PPI were excluded. Elderly who were frail based on FI-40 item were defined as cases, while individuals that were not frail …

Diagnostic And Treatment Problems Of Primary Sclerosingcholangitis, Rezky Aulia Nurleili, Intan Airlina F, Anna Mira Lubis

Jurnal Penyakit Dalam Indonesia

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease with high incidence reported in America (1/100.000 population), but there is still no data available in Indonesia. The best management of this disease is still not found. Thus, in this article author will discuss about the case of PSC in 49-years male patients hospitalized in Cipto Mangunkusumo hospital Jakarta and its treatment.

Change Of Interleukin-6, C-Reactive Protein And Soluble Vascularcell Adhesion Molecule-1 Concentrations In Hemodialysispatients With Reprocessed Dialyzer, Pringgodigdo Nugroho, Aida Lydia, Marulam Mp Panggabean

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular disease is a major cause of morbidity and mortality in hemodialysis patients. In addition to traditional cardiovascular risk factors, non-traditional cardiovascular risk factors such as inflammation were also involved. Reprocessed dialyzer has been showed to induce less inflammation than new dialyzer, but data in diacetate cellulose membrane have not been presented. Methods. Twenty hemodialysis (HD) patients were enrolled. Pre and post study design was conducted to know post dialysis concentration changes of interleukin 6 (IL-6), C-reactive protein (CRP) and soluble vascular cell adhesion molecule-1 (sVCAM-1) at reuse 0, 5 and 10. Patients were recruited if medically stable, on …

The Role Of Hydration And N-Acetyl Cysteine Combination In 48hours Contrast-Induced Nephropaty After Percutaneous Coronaryintervention In Stage Three Chronic Kidney Disease Patients, Lydia D. Simatupang, Endang Susalit, Ika Prasetya Wijaya

Jurnal Penyakit Dalam Indonesia

Introduction. Contrast Induced Nephropathy (CIN) after percutaneous coronary intervention (PCI) is common in stage 3 chronic kidney disease (CKD) patients. While there is no cure for CIN and some cases are fatal for the kidney or even life, it is preventable. Eventhough controversial, hydration and N-Acetyl Cysteine (NAC) are modalities to prevent CIN. Not having a certain guideline to prevent CIN in Integrated Cardiac Services (ICS) Cipto Mangunkusumo Hospital for PCI patients generates interest to study it. Methods. A prospective cohort is conducted to evaluate plasma creatinine before and 48 hours after PCI, meanwhile recording whom is given combined hydration …

Benarkah Dialiser Proses Ulang Memicu Inflamasi?, Suhardjono Suhardjono

Jurnal Penyakit Dalam Indonesia

No abstract provided.

The Difference Of C-Reactive Protein Levels In Acute Fever Causedby Dengue And Typhoid Infections, Adeputri Tanesha Idhayu, Lie Khie Chen, Suhendro Suhendro

Jurnal Penyakit Dalam Indonesia

Introduction. Dengue infection and typhoid fever are endemic disease in Indonesia. But in the early days of onset sometimes it is difficult to distinguish them. A simple modality test is needed to support the diagnosis. C-Reactive Protein (CRP) is an affordable, fast and relatively less expensive diagnostic tool to diagnose the causes of acute fever. This study was aimed to determine the differences of CRP level in the acute febrile caused by dengue infection or typhoid fever. Methods. A cross sectional study has been conducted among acute febrile patients with diagnosis of dengue fever/ dengue hemorrhagic fever or typhoid fever …

Factors Related To Delayed Antiretroviral Therapy Initiation Inhiv Patients, Dwi Rahayu Nlp, Teguh H. Karjadi, Erni J. Nelwan

Jurnal Penyakit Dalam Indonesia

Introduction. Increase access towards antiretroviral therapy (ART) contribute to global decrease of HIV-associated morbidity and mortality. Time to initiation of ART in eligible HIV-infected patients is associated with reduction in mortality and morbidity. Delayed initiation of antiretroviral therapy can lead to increased of mortality rate more than 10% compare to early initiation. Methods. This study was a cross sectional study among adult HIV patients in Out-patient Clinic of HIV Integrated Clinic Cipto Mangunkusumo General Hospital who started ARV therapy for the first time (ART-naïve patients) enrolled from January 2013 to December 2014. The data were extracted from medical records to …