Chirag Gurbani - Academia.edu (original) (raw)
Papers by Chirag Gurbani
International Journal of Community Medicine and Public Health, Feb 24, 2021
Acute respiratory distress syndrome (ARDS) is a life threatening complication of many infectious ... more Acute respiratory distress syndrome (ARDS) is a life threatening complication of many infectious diseases like malaria, H1N1, bacterial pneumonia, and leptospira. Malaria is an important treatable cause of ARDS. ARDS can develop either at initial presentation or after initiation of treatment when the parasitaemia is falling and patient is improving. 58 year old female presented with high grade fever and breathlessness since 5 days. Arterial blood gas (ABG) on admission showed type 1 respiratory failure and chest X-ray was suggestive of ARDS. Thus patient was shifted to intensive care unit and was put on non-invasive ventilation. PBS was positive for Plasmodium vivax malaria and patient was started on antimalarial drugs. Considering the epidemic of H1N1 swab was sent for polymerase chain reaction (PCR) which turned out to be negative. Thus antimalarial and supportive treatment for ARDS was continued. Patient was discharged on day 11 and started on tablet primaquine to prevent relapse. ARDS is a hard to predict late complication of severe malaria. ARDS in malaria is a disease with high mortality. Early diagnosis and institution of specific antimalarial treatment along with assisted ventilation can be life-saving.
Journal of Clinical and Diagnostic Research, 2022
A 75-year-old male patient, known hypertensive, reported to the Emergency Department with complai... more A 75-year-old male patient, known hypertensive, reported to the Emergency Department with complaints of an episode of sudden onset of giddiness the previous night, in the washroom. The episode lasted for a few minutes followed by which the patient had a fall. However, there was no head injury. According to the companions, the patient had developed incoherent speech after this incident and was not able to identify the people around him. The patient had no weakness of any limbs, there was no sensory loss or involuntary movements. No history of loss of consciousness, headache, fever, vomiting, bowel or bladder disturbances. The patient was diagnosed to have cerebrovascular accident and seizure disorder in 2018 since when he is on regular medication. He is a known hypertensive taking tablet amlodipine 5 mg twice daily. All vitals like temperature (98°F), pulse rate (72/min), blood pressure (150/90 mmHg), and respiratory rate (20/minute) were within normal limits. No signs of respiratory distress was seen. There were no pallor, icterus, cyanosis, clubbing, lymphadenopathy and pedal oedema. On Central Nervous Examination (CNS) examination, the patient was conscious. His sensorium was altered and he was not oriented to time, place, and person. Glasgow Coma Scale was 13/15. However, there were no cranial nerve palsies and no motor weakness or sensory loss in any of the limbs. Both plantars were down going and meningeal signs were absent. Initially, the differential diagnosis of meningoencephalitis or a form of posterior circulation stroke was made in view of altered sensorium and vertigo. Routine investigations, on the day of admission, revealed an elevated total count (57000 cells/mm 3) with normal hemoglobin and platelet count. Hyponatremia was present (107 mEq/L) with normal potassium. Both serum and urine osmolality were low (226.5 and 135 mOsm/kg) respectively. Urinary sodium was low (35 mmol/L). Serum cortisol was normal (15.6 mcg/dL) which was normal. Peripheral blood smear was suggestive of marked leukocytosis, atypical lymphocytes, and few smudge cells. Chest X-ray and electrocardiogram did not show any obvious abnormality. Serum Adrenocorticotrophic Hormone (ACTH) was 49.49 pg/ mL, serum aldosterone was 40.67 pg/dl, and he was Coronavirus Disease-2019 (COVID-19) Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)-negative. Computed Tomography (CT) brain revealed no fresh bleed. The Magnetic Resonance Imaging (MRI)
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Chronic lymphocytic leukaemia is a haematological malignancy that occurs due to an increased prol... more Chronic lymphocytic leukaemia is a haematological malignancy that occurs due to an increased proliferation of mature B lymphocytes. It is considered to be the most common leukaemia in adults. Hyponatremia is commonly seen in such patients. This case report is about a 75-year-old male, who presented with giddiness, followed by altered sensorium. However, the patient had no motor weakness or sensory loss. Initially, a diagnosis of posterior circulation stroke was made but Magnetic Resonance Imaging (MRI) brain did not show associated signs. The routine investigations showed highly elevated total leukocyte count and hyponatremia. The patient was worked up for malignancy and diagnosed with Chronic lymphocytic leukaemia. Oncology reference was taken and treated with tablet Ibrutinib. On discharge, the patient’s mentation improved, and he is on regular follow-up.
Background: Coronary heart disease is one of the most common causes of disability and mortality i... more Background: Coronary heart disease is one of the most common causes of disability and mortality in the world and is a major preventable cause of death in India. Evidence showed role of dyslipidemia and Coronary artery disease (CAD) among type 2 diabetes but there is less evidence among non-diabetic CAD subjects. Present research is an attempt to Study of Clinico-demographic parameters and dyslipidemia among non-diabetic coronary artery disease patients. Material and Methods: A cross sectional study was carried out among 100 subjects with coronary artery disease without diabetes at a tertiary care centre. Dyslipidemia and Clinicodemographic parameters using anthropometric measurements studied among non diabetic coronary artery disease patients. Results: Maximum (32) subjects were in age group of 51-60yrs followed by 29 in 61-70yrs of age. Male were slightly predominant (53). Most (97) of the subjects were obese. There was no statistically significant difference in mean value of fasti...
The American Journal of Tropical Medicine and Hygiene, 2008
Acute respiratory distress syndrome is a well-known complication in Plasmodium falciparum infecti... more Acute respiratory distress syndrome is a well-known complication in Plasmodium falciparum infection. It is less frequently described in Plasmodium vivax, and only one case is reported in Plasmodium ovale. Here we present the second description of this pulmonary complication in a P. ovale acute infection.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Tubercular Meningitis (TBM) is caused due to the seeding of meninges with mycobacterium tuberculo... more Tubercular Meningitis (TBM) is caused due to the seeding of meninges with mycobacterium tuberculosis and about one-third of the world’s population is infected with it. The risk of contracting the infectionincreases in immunocompromised states which includes diabetes mellitus, chronic use of steroids, chronic alcoholism and Human Immunodeficiency Virus (HIV) co-infection. Here, a case of 47-year-old female has been presented, who reported to the Department of Medicine with complaints of weakness overthe leftside of the face associated with diminished hearing and tinnitus in the left ear and subjective vertigo since 20 days. Initially, all the above involvement was attributed to bell’s palsy but no improvement was seen with its treatment. Incidentally, she was found to be HIV positive and lumbar puncture was done and eventually, she was diagnosed as a case of TBM. The patient was successfully treated with antitubercular medications and supportive measures and she responded well. She w...
International Journal of Community Medicine and Public Health, Feb 24, 2021
Acute respiratory distress syndrome (ARDS) is a life threatening complication of many infectious ... more Acute respiratory distress syndrome (ARDS) is a life threatening complication of many infectious diseases like malaria, H1N1, bacterial pneumonia, and leptospira. Malaria is an important treatable cause of ARDS. ARDS can develop either at initial presentation or after initiation of treatment when the parasitaemia is falling and patient is improving. 58 year old female presented with high grade fever and breathlessness since 5 days. Arterial blood gas (ABG) on admission showed type 1 respiratory failure and chest X-ray was suggestive of ARDS. Thus patient was shifted to intensive care unit and was put on non-invasive ventilation. PBS was positive for Plasmodium vivax malaria and patient was started on antimalarial drugs. Considering the epidemic of H1N1 swab was sent for polymerase chain reaction (PCR) which turned out to be negative. Thus antimalarial and supportive treatment for ARDS was continued. Patient was discharged on day 11 and started on tablet primaquine to prevent relapse. ARDS is a hard to predict late complication of severe malaria. ARDS in malaria is a disease with high mortality. Early diagnosis and institution of specific antimalarial treatment along with assisted ventilation can be life-saving.
Journal of Clinical and Diagnostic Research, 2022
A 75-year-old male patient, known hypertensive, reported to the Emergency Department with complai... more A 75-year-old male patient, known hypertensive, reported to the Emergency Department with complaints of an episode of sudden onset of giddiness the previous night, in the washroom. The episode lasted for a few minutes followed by which the patient had a fall. However, there was no head injury. According to the companions, the patient had developed incoherent speech after this incident and was not able to identify the people around him. The patient had no weakness of any limbs, there was no sensory loss or involuntary movements. No history of loss of consciousness, headache, fever, vomiting, bowel or bladder disturbances. The patient was diagnosed to have cerebrovascular accident and seizure disorder in 2018 since when he is on regular medication. He is a known hypertensive taking tablet amlodipine 5 mg twice daily. All vitals like temperature (98°F), pulse rate (72/min), blood pressure (150/90 mmHg), and respiratory rate (20/minute) were within normal limits. No signs of respiratory distress was seen. There were no pallor, icterus, cyanosis, clubbing, lymphadenopathy and pedal oedema. On Central Nervous Examination (CNS) examination, the patient was conscious. His sensorium was altered and he was not oriented to time, place, and person. Glasgow Coma Scale was 13/15. However, there were no cranial nerve palsies and no motor weakness or sensory loss in any of the limbs. Both plantars were down going and meningeal signs were absent. Initially, the differential diagnosis of meningoencephalitis or a form of posterior circulation stroke was made in view of altered sensorium and vertigo. Routine investigations, on the day of admission, revealed an elevated total count (57000 cells/mm 3) with normal hemoglobin and platelet count. Hyponatremia was present (107 mEq/L) with normal potassium. Both serum and urine osmolality were low (226.5 and 135 mOsm/kg) respectively. Urinary sodium was low (35 mmol/L). Serum cortisol was normal (15.6 mcg/dL) which was normal. Peripheral blood smear was suggestive of marked leukocytosis, atypical lymphocytes, and few smudge cells. Chest X-ray and electrocardiogram did not show any obvious abnormality. Serum Adrenocorticotrophic Hormone (ACTH) was 49.49 pg/ mL, serum aldosterone was 40.67 pg/dl, and he was Coronavirus Disease-2019 (COVID-19) Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)-negative. Computed Tomography (CT) brain revealed no fresh bleed. The Magnetic Resonance Imaging (MRI)
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Chronic lymphocytic leukaemia is a haematological malignancy that occurs due to an increased prol... more Chronic lymphocytic leukaemia is a haematological malignancy that occurs due to an increased proliferation of mature B lymphocytes. It is considered to be the most common leukaemia in adults. Hyponatremia is commonly seen in such patients. This case report is about a 75-year-old male, who presented with giddiness, followed by altered sensorium. However, the patient had no motor weakness or sensory loss. Initially, a diagnosis of posterior circulation stroke was made but Magnetic Resonance Imaging (MRI) brain did not show associated signs. The routine investigations showed highly elevated total leukocyte count and hyponatremia. The patient was worked up for malignancy and diagnosed with Chronic lymphocytic leukaemia. Oncology reference was taken and treated with tablet Ibrutinib. On discharge, the patient’s mentation improved, and he is on regular follow-up.
Background: Coronary heart disease is one of the most common causes of disability and mortality i... more Background: Coronary heart disease is one of the most common causes of disability and mortality in the world and is a major preventable cause of death in India. Evidence showed role of dyslipidemia and Coronary artery disease (CAD) among type 2 diabetes but there is less evidence among non-diabetic CAD subjects. Present research is an attempt to Study of Clinico-demographic parameters and dyslipidemia among non-diabetic coronary artery disease patients. Material and Methods: A cross sectional study was carried out among 100 subjects with coronary artery disease without diabetes at a tertiary care centre. Dyslipidemia and Clinicodemographic parameters using anthropometric measurements studied among non diabetic coronary artery disease patients. Results: Maximum (32) subjects were in age group of 51-60yrs followed by 29 in 61-70yrs of age. Male were slightly predominant (53). Most (97) of the subjects were obese. There was no statistically significant difference in mean value of fasti...
The American Journal of Tropical Medicine and Hygiene, 2008
Acute respiratory distress syndrome is a well-known complication in Plasmodium falciparum infecti... more Acute respiratory distress syndrome is a well-known complication in Plasmodium falciparum infection. It is less frequently described in Plasmodium vivax, and only one case is reported in Plasmodium ovale. Here we present the second description of this pulmonary complication in a P. ovale acute infection.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Tubercular Meningitis (TBM) is caused due to the seeding of meninges with mycobacterium tuberculo... more Tubercular Meningitis (TBM) is caused due to the seeding of meninges with mycobacterium tuberculosis and about one-third of the world’s population is infected with it. The risk of contracting the infectionincreases in immunocompromised states which includes diabetes mellitus, chronic use of steroids, chronic alcoholism and Human Immunodeficiency Virus (HIV) co-infection. Here, a case of 47-year-old female has been presented, who reported to the Department of Medicine with complaints of weakness overthe leftside of the face associated with diminished hearing and tinnitus in the left ear and subjective vertigo since 20 days. Initially, all the above involvement was attributed to bell’s palsy but no improvement was seen with its treatment. Incidentally, she was found to be HIV positive and lumbar puncture was done and eventually, she was diagnosed as a case of TBM. The patient was successfully treated with antitubercular medications and supportive measures and she responded well. She w...