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  Citation statistics : Table of Contents
   2014| April-June  | Volume 4 | Issue 2  
    Online since April 10, 2014

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The diabetic patient in Ramadan
Hassan Chamsi-Pasha, Khalid S Aljabri
April-June 2014, 4(2):29-33
DOI:10.4103/2231-0770.130341  PMID:24761380
During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan.
  4 4,546 676
Renal confined sarcoidosis: Natural history and diagnostic challenge
Azam Ghafoor, Akram Almakki
April-June 2014, 4(2):44-47
DOI:10.4103/2231-0770.130346  PMID:24761384
A 69 year old male referred to nephrology clinic for uncontrolled hypertension. During his follow up over two years, he developed renal disease and hypercalcemia. He was found to have monoclonal gammopathy (MGUS). Urinalysis was negative except for Monoclonal IgG on immunoelectrophoresis. Workup for malignancy was negative including chest X-ray and bone marrow biopsy. He progressed into renal failure and ended up on dialysis. Interestingly, the renal biopsy showed non-caseating granulomas, and the patient was diagnosed with renal confined sarcoidosis which is extremely rare. PPD was negative. He was treated with Prednisone 60 mg daily. Surprisingly, his kidney disease was not responsive to steroids. Despite improvement in his calcium with treatment, his kidney function did not improve and he remained on hemodialysis but needed to stay on small dose of Prednisone to keep his calcium under control. Our case is the first in the literature that demonstrates the natural history of renal-confined sarcoidosis. In addition, the presence of MGUS created a diagnostic challenge and delayed diagnosis of sarcoidosis. Although the renal biopsy did not show direct damage from MGUS, a potential relation between renal sarcoidosis and MGUS is worth studied.
  3 3,267 361
A concurrent episode of two neoplasms in a toddler-age child
Muaz A Alrazzak, Jenny ZablahAlabi, Baraa Alrazzak, Guillermo De Angulo
April-June 2014, 4(2):48-50
DOI:10.4103/2231-0770.130347  PMID:24761385
Childhood neoplasms are relatively rare and represent only about 1- 2% of the total incidence of neoplasms in United States. Concurrent episode of childhood cancer is uncommon and usually related to a cancer genetic syndrome. Li Fraumeni Syndrome refers to an autosomal dominant condition that is manifested by the development of certain cancers in early childhood and an increased lifetime risk for developing multiple primary cancers including sarcoma, breast cancer, leukemia, bone cancer, and others. We report a case of a 21-month-old girl who was found to have orbital embryonal rhabdomyosarcoma and adrenocortical tumor concurrently.
  1 2,173 202
Simultaneous hepatosplenic T-cell lymphoma and myelofibrosis
Ali M Gabali, Tarek Jazaerly, Chung-Che (Jeff) Chang, Ronald Cleveland, Lawrence Kass
April-June 2014, 4(2):34-36
DOI:10.4103/2231-0770.130343  PMID:24761381
Hepatosplenic T-cell lymphoma (HSTL) is a rare T-cell neoplasm of the lymphoid system. This type of lymphoma is characterized by sinusoidal infiltration of spleen, liver, bone marrow and lymph nodes by neoplastic lymphocytes. Here, we discuss a patient who had a left axillary lymph node biopsy with characteristic histological and immunohistochemical features of HSTL. In addition, infiltrating neoplastic T-cells and simultaneous characteristic features of myelofibrosis (MF) were also present in the bone marrow biopsy specimen. In contrast to secondary MF, primary MF is a progressive disease and may significantly affect the prognosis of coexisting HSTL. There are few reports in the literature talking about mild bone marrow fibrosis in association with T cell lymphoma, however marked increase in bone marrow fibrosis and HSTL never being reported. This case is shedding light on HSTL and marked increase in bone marrow fibrosis.
  1 2,612 305
Preoperative splenic artery embolization in klippel-Trenaunay syndrome with massive splenomegaly: A case report
Zishu Zhang, Narasimham L Dasika, Michael J Englesbe, Scott R Owens, Ranjith Vellody, Paula M Novelli, James J Shields
April-June 2014, 4(2):40-43
DOI:10.4103/2231-0770.130345  PMID:24761383
The authors describe a case of Klippel-Trenaunay syndrome (KTS) with massive splenomegaly in a 29-year-old woman. Preoperative splenic artery embolization using the "double embolization technique" (a combination of distal selective splenic artery embolization and proximal splenic artery occlusion) facilitated open splenectomy.
  1 4,061 250
Acinetobacter baumannii bacteremia, a rare complication of endoscopic retrograde cholagiopancreatography!
Hadoun Jabri, Devang Sanghavi, Sarbajit Mukherjee, Ema Dzaka-Dizdarevic, Nkemakolam Iroegbu
April-June 2014, 4(2):37-39
DOI:10.4103/2231-0770.130344  PMID:24761382
Bacteremia is a severe and sometimes fatal complication following endoscopic retrograde cholagiopancreatography (ERCP). Several bacteria have been implicated, with Enterobacteriaceae being the most common. We report a case of post-ERCP multi-drug resistant Acinetobacter baumannii bacteremia.
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