INTRODUCTION: Gastric cancer (GC) is a leading cause of cancer-related mortality worldwide. Perioperative chemotherapy improves tumor downstaging and survival rates. The FLOT regimen was proven superior in the FLOT4-AIO...INTRODUCTION: Gastric cancer (GC) is a leading cause of cancer-related mortality worldwide. Perioperative chemotherapy improves tumor downstaging and survival rates. The FLOT regimen was proven superior in the FLOT4-AIO trial, establishing it as the standard care for resectable gastric adenocarcinoma. Despite these encouraging results from randomized controlled trials, real-world data on the feasibility and outcomes of FLOT in diverse patient populations, particularly in low- and middle-income settings, remain limited. This study aimed to assess the feasibility, safety, and clinical outcomes of perioperative FLOT chemotherapy in patients with resectable gastric adenocarcinoma at a tertiary care center. MATERIALS AND METHODS: We conducted a retrospective review of the medical records of patients diagnosed with resectable gastric adenocarcinoma who received perioperative FLOT chemotherapy between April 2019 and April 2025. The primary outcomes were the feasibility of perioperative FLOT chemotherapy and pathological complete response (pCR). The secondary outcomes were surgical outcomes, treatment adherence, and adverse events (AEs). RESULTS: The results showed that 64.4% of patients completed at least four cycles of neoadjuvant FLOT, while only 24.4% underwent surgical resection. No pathological complete responses were observed. Grade 3-4 AEs occurred in 18.1% of patients, primarily cytopenias. A high rate of loss to follow-up (45.4%) was noted in the preoperative phase. CONCLUSION: While FLOT demonstrated an acceptable safety profile, the lower-than-expected surgical resection rate and high attrition highlight the challenges in managing locally advanced gastric cancer in real-world settings. This study emphasizes the need for strategies to improve treatment adherence and optimize patient selection to maximize the benefits of perioperative chemotherapy for gastric cancer.
BACKGROUND: Thyroid dysfunction of any magnitude is associated with dyslipidemia. But the relationship of thyroid hormones with lipid parameters among euthyroid population is still unclear. MATERIALS AND METHODS: This is...BACKGROUND: Thyroid dysfunction of any magnitude is associated with dyslipidemia. But the relationship of thyroid hormones with lipid parameters among euthyroid population is still unclear. MATERIALS AND METHODS: This is a cross-sectional study to assess relationship between measured [free T3 (fT3), free T4 (fT4), and TSH] and derived (free T3/free T4 ratio, and TSH index) parameters of thyroid profile with different components of lipid profile among euthyroid population. RESULTS: We included 100 patients (60 men and 40 women) in this study. The mean free T3, free T4, and TSH levels of our study population were 2.4 ± 0.5 pg/mL, 1.2 ± 0.2 ng/dL, and 3.0 ± 1.6 µIU/mL, respectively. Overall, fT3 had a significant positive correlation with HDL cholesterol ( = 0.4, = 0.01) and a negative correlation with total cholesterol levels ( = -0.3, = 0.04). While fT4 ( = 0.3, = 0.04) and fT3/fT4 ratio ( = 0.5, = 0.001) showed positive correlation only with HDL levels. In subgroup analysis, positive association of fT3 ( = 0.6, = 0.008), fT4 ( = 0.4, = 0.04), and fT3/fT4 ratio ( = 0.8, = 0.001) with HDL cholesterol was significant only in men. And only in the subgroup with TSH ≥ 3 µIU/mL ( = 48), we found a significant negative correlation of fT3 with total cholesterol ( = -0.5, = 0.01) and LDL levels ( = -0.7, = 0.001) and a positive correlation with HDL levels ( = 0.5, = 0.02). CONCLUSION: Among euthyroid subjects, fT3 seems to have a significant and consistent favorable association with lipid levels, especially with HDL cholesterol. This positive association of fT3 with HDL is more marked in men and in subjects with TSH ≥ 3 µIU/mL.
It is not a rare occurrence where a patient who has been declared dead in the hospital comes alive either during transport back home or while performing the last rites. But in recent times we are witnessing a steady rise...It is not a rare occurrence where a patient who has been declared dead in the hospital comes alive either during transport back home or while performing the last rites. But in recent times we are witnessing a steady rise in such incidences. Though it is a global phenomenon, in our country it has brought a lot of negativity and adverse publicity against medical professionals and hospitals. These incidences are casting serious doubt in the minds of the public about the ability and knowledge of medical professionals in declaring someone dead and have eroded the public trust in doctors. On many occasions it is being perceived as serious negligence or total irresponsibility on the part of a medical professional. A patient who has been declared dead but comes alive could put medical professionals under serious mental stress with long-lasting emotional trauma as well. Beyond the medical realm, such cases raise legal and ethical dilemmas. Families go through unnecessary mental trauma, funeral services are disrupted, and, in some cases, patients wake up in morgues or coffins-an unimaginable horror. In India we have neither any data on such occurrences nor a well-accepted protocol or guidelines for the determination and declaration of death. While cases of the "dead" coming back to life remain rare, they highlight the gaps in medical practices that need urgent attention, and there is a pressing need for a foolproof protocol for pronouncement of death that is acceptable legally and medically and with a pan-India application.
It is 2026, and we have another World Health Day at our doorstep-with a slogan for the betterment of health and well-being of the world at large. This time, the WHO slogan for World Health Day 2026 (April 7) is "Together...It is 2026, and we have another World Health Day at our doorstep-with a slogan for the betterment of health and well-being of the world at large. This time, the WHO slogan for World Health Day 2026 (April 7) is "Together for health, stand with science."
J Assoc Physicians India
· 2026 Mar · PMID 41818127
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Takotsubo cardiomyopathy (TCM) is a type of disorder of cardiomyocytes in which there is apical akinesia and ballooning, whereas the base is hyperkinetic. Reverse Takotsubo cardiomyopathy (rTCM) is a rare variant of TCM...Takotsubo cardiomyopathy (TCM) is a type of disorder of cardiomyocytes in which there is apical akinesia and ballooning, whereas the base is hyperkinetic. Reverse Takotsubo cardiomyopathy (rTCM) is a rare variant of TCM in which the base of the heart is akinetic and ballooned out rather than the apex, which is hyperkinetic. Takotsubo cardiomyopathy is usually seen in postmenopausal women, but a rising number of cases of the reverse variant are being reported in peripartum women. We present a case of a 24-year-old primigravida at 37 weeks of gestation, who presented with an acute onset of breathlessness just after cesarean delivery. A 2D echocardiogram revealed changes of rTCM with an overall ejection fraction of 40%. She was treated for the same, and a 2D echocardiogram repeated after 1 week showed improvement in the ejection fraction to >60%, which supported our diagnosis of peripartum rTCM. Another important objective of this study is to differentiate TCM occurring in the peripartum period from peripartum cardiomyopathy (PPCM), both of which are clinically indistinguishable but have different etiopathogenesis, treatment, and prognosis. While rTCM treatment mostly includes the management of heart failure, such as oxygen supplementation, diuretics, and noninvasive mechanical ventilation, the management of PPCM also includes bromocriptine, along with treating heart failure. The outcome of rTCM is excellent, with recovery of left ventricle function in almost all cases, while a few patients of PPCM have irreversible heart failure, making it imperative to differentiate between the two clinical entities.
J Assoc Physicians India
· 2026 Mar · PMID 41818126
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OBJECTIVES: We present a rare case of Poncet's disease, a sterile reactive arthritis associated with active tuberculosis (TB), mimicking seronegative spondyloarthritis in a young diabetic male. We aim to highlight the di...OBJECTIVES: We present a rare case of Poncet's disease, a sterile reactive arthritis associated with active tuberculosis (TB), mimicking seronegative spondyloarthritis in a young diabetic male. We aim to highlight the diagnostic challenges and emphasize the importance of considering Poncet's disease in patients with inflammatory arthritis, especially in the context of subclinical TB. METHODS: We present a detailed case report of a 28-year-old male with poorly controlled diabetes mellitus type 2 [glycated hemoglobin (HbA1c) 13.9%] who presented with a 3-week history of bilateral ankle pain, swelling, and redness. The pain progressed to involve multiple small joints of the hands, wrists, elbows, and knees, significantly impacting his mobility, with no history of trauma, fever, rash, or urinary symptoms. Physical examination revealed tenderness and swelling in the affected joints with limited range of motion. Laboratory investigations showed an elevated erythrocyte sedimentation rate (ESR) of 74 mm/hour and C-reactive protein (CRP) of 104 mg/L. Chest X-ray revealed bilateral hilar lymphadenopathy, and computed tomography (CT) scan confirmed multiple enlarged lymph nodes in the mediastinum and bilateral hilar regions, suggestive of pulmonary TB. Despite the absence of acid-fast bacilli in bronchoalveolar lavage (BAL), the clinical presentation, imaging findings, exclusion of other causes of reactive arthritis, and a dramatic response to anti-TB therapy within days of initiation strongly supported the diagnosis of Poncet's disease. The patient completed 6 months of anti-TB therapy and achieved complete resolution of joint pain and swelling, regaining his full range of motion. RESULTS: The patient's symptoms, including joint pain, swelling, and inflammatory markers, significantly improved within weeks of starting anti-TB therapy. Serial CRP and ESR readings showed a downward trend, confirming the response to treatment. CONCLUSION: This case report highlights the importance of considering Poncet's disease in the differential diagnosis of seronegative spondyloarthritis, particularly in patients with underlying TB. A high index of suspicion and prompt initiation of anti-TB therapy can lead to rapid improvement in symptoms and prevent unnecessary investigations and potentially harmful immunosuppressive medications.
J Assoc Physicians India
· 2026 Mar · PMID 41818125
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Amyloidosis is an extremely rare condition with a variety of symptoms that, in extreme situations, can be fatal. Basically a protein misfolding disorder, it is characterized by deposition of insoluble polymeric protein f...Amyloidosis is an extremely rare condition with a variety of symptoms that, in extreme situations, can be fatal. Basically a protein misfolding disorder, it is characterized by deposition of insoluble polymeric protein fibrils in tissues and organs. There are different types of amyloidosis; here, we see a case of secondary amyloidosis, which is usually a consequence of a chronic disease. The case is unique, as there are many research projects showing the link of tuberculosis (TB) and secondary amyloidosis, but it is rarely documented because of extrapulmonary TB, which here is tuberculous lymphadenitis, and also here the patient is younger than the mean age. The clinical manifestations of this disease are seen mainly in the renal system, gastrointestinal system, and reticuloendothelial system. For which the management is mainly supportive, along with treatment of the underlying cause.
Chakraborty S, Sengupta S, Bhaumik S
… +1 more, Sen D
J Assoc Physicians India
· 2026 Mar · PMID 41818124
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A 69-year-old gentleman without any previous comorbidities presented with complaints of acute-onset low-grade fever, one episode of loss of consciousness, and weakness of both legs with urinary and stool retention for 1...A 69-year-old gentleman without any previous comorbidities presented with complaints of acute-onset low-grade fever, one episode of loss of consciousness, and weakness of both legs with urinary and stool retention for 1 day. He had an episode of generalized tonic-clonic seizure 3 hours after admission. On examination, he had tachycardia and hypotension; Glasgow Coma Scale (GCS) was E3V2M4, and neurological examination was suggestive of bilateral lower limb upper motor neuron lesion in the shock stage. Blood investigation revealed severe hyponatremia, and magnetic resonance imaging (MRI) with contrast of the dorsolumbar spine revealed longitudinally extensive transverse myelitis (LETM). Blood investigation for antineuromyelitis optica (anti-NMO) antibody was negative. Other investigations revealed low serum osmolality, raised urine osmolality, and spot sodium. Cerebrospinal fluid (CSF) viral panel detected human herpesvirus 6 (HHV6). He was treated with a pulse dose of IV methylprednisolone, hypertonic saline, and IV levetiracetam. He had symptomatic improvement and was discharged with a tapering dose of oral prednisolone. He had a complete recovery after 3 months of regular follow-up. Thus, we report a case of HHV6-induced LETM complicated with cerebral salt wasting syndrome and hyponatremic seizures.
J Assoc Physicians India
· 2026 Mar · PMID 41818123
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A high risk of thrombosis is linked to myeloproliferative neoplasm (MPN) and antiphospholipid syndrome (APS). The systemic autoimmune disorder known as APS is characterized by persistently positive antiphospholipid antib...A high risk of thrombosis is linked to myeloproliferative neoplasm (MPN) and antiphospholipid syndrome (APS). The systemic autoimmune disorder known as APS is characterized by persistently positive antiphospholipid antibodies [anticardiolipin (aCL), lupus anticoagulant, and antibeta 2 glycoprotein 1 IgG and IgM antibodies] in conjunction with obstetrical complications or thrombosis (Chayoua et al.). Polycythemia vera (PV) is a MPN that causes too many red blood cells (RBCs) in the blood and proinflammatory cytokines. In this report, we present a case of a 25-year-old lady with a history of second-trimester abortion who presented with abdominal pain and hepatosplenomegaly. Owing to erythrocytosis, thrombocytosis, and moderate hepatosplenomegaly, workup for MPN was done along with prothrombotic workup including APS, and she turned out to be positive for both. Coexistence of MPN and APS is rare in the literature. The optimal management of patients with coexistent APS and MPN has not been defined so far. Immediate anticoagulation with specific treatment for MPN is essential to prevent further thromboembolic episodes and progression to catastrophic APS.
Kumar SP, Haritha S, Lakshmanan S
… +6 more, Sowmini PR, Velayutham SS, Jeyaraj KM, Kannan V, Saravanan RV, Mugundhan K
J Assoc Physicians India
· 2026 Mar · PMID 41818122
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Elsberg syndrome (ES) is an acute-to-subacute onset, lumbosacral radiculitis, with or without myelitis, confined to lower spinal cord, often caused by herpes simplex virus (HSV)-2. We report a case of a 70-year-old lady...Elsberg syndrome (ES) is an acute-to-subacute onset, lumbosacral radiculitis, with or without myelitis, confined to lower spinal cord, often caused by herpes simplex virus (HSV)-2. We report a case of a 70-year-old lady with ES due to varicella zoster virus (VZV) reactivation, presenting as herpes zoster in right side L5-S2 dermatomes, with radiculitis in the respective roots and myelitis in the conus medullaris region. The diagnosis is often made by considering the clinical picture, as well as the investigations, such as magnetic resonance imaging (MRI) of the spine, cerebrospinal fluid (CSF) analysis, and electroneuromyography (ENMG), as a whole. Through this case report, we re-emphasize the fact that ES is an important differential to consider in patients presenting with acute-to-subacute onset lumbosacral radiculitis with/without myelitis, as the incidence of ES is around 10% in such cases.
Sheth H, Davhale A, Chandrakar S
… +3 more, Jadhav P, Purkar P, Patil S
J Assoc Physicians India
· 2026 Mar · PMID 41818121
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INTRODUCTION: Intracranial hemorrhage, most often intraparenchymal hemorrhage, is an increasingly common and fatal complication of warfarin-induced coagulopathy. Warfarin remains the anticoagulant of choice in valvular a...INTRODUCTION: Intracranial hemorrhage, most often intraparenchymal hemorrhage, is an increasingly common and fatal complication of warfarin-induced coagulopathy. Warfarin remains the anticoagulant of choice in valvular atrial fibrillation. However, warfarin has a narrow therapeutic index. Extra axial hemorrhage due to warfarin-induced coagulopathy is a rare adverse event. We present a rare case of right vestibulocochlear and lower motor neuron (LMN) facial palsy secondary to an intracranial bleed along the cerebellopontine angle. CASE DESCRIPTION: A 36-year-old woman presented with headache, giddiness, sudden onset of right-sided hearing loss, and left-sided deviation of the angle of the mouth. Symptoms had developed acutely over 4 hours. She was diagnosed with mitral stenosis at 8 years of age and had undergone mitral valve repair 2 years before presentation, after which she was started on warfarin. She was lost to follow-up for over a year and on presentation had right-sided sensorineural hearing loss along with features such as difficulty raising her right eyebrow, inability to close her right eye, and water drooling from the right side, all consistent with a right LMN facial palsy and vestibulocochlear nerve palsy. MRI brain showed an extra-axial hemorrhage at the right cerebellopontine angle cisterns. CONCLUSION: Warfarin-induced intracranial bleeds without involving the parenchyma are a rare event, and through this case, we would like to highlight the importance of timely monitoring of the international normalized ratio (INR) of patients on warfarin therapy.
J Assoc Physicians India
· 2026 Mar · PMID 41818120
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Woolly hair with palmoplantar keratoderma (WH-PPK) is a group of four autosomal recessive syndromes. Type 4 WH-PPK is usually associated with KANK2 mutation and does not have cardiac morbidity among its features. Here we...Woolly hair with palmoplantar keratoderma (WH-PPK) is a group of four autosomal recessive syndromes. Type 4 WH-PPK is usually associated with KANK2 mutation and does not have cardiac morbidity among its features. Here we report a 25-year-old woman with woolly hair, palmoplantar keratoderma without any cardiac morbidity. However, she had sensorineural hearing loss and maculopathy. Thus, we present a patient with type 4 WH-PPK with a novel phenotype to highlight the rare WH-PPK syndromes. The association of woolly hair and palmoplantar keratoderma without cardiomyopathy, and with macular deposits and sensorineural hearing loss, has not been reported before.
Singh AK, Sohrab A, Bhattacharjee A
… +1 more, Shaikh A
J Assoc Physicians India
· 2026 Mar · PMID 41818119
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Acute myositis and Guillain-Barré syndrome (GBS) occurring together in a single patient is a rare clinical phenomenon that poses both diagnostic and therapeutic challenges. This article discusses the pathophysiology and...Acute myositis and Guillain-Barré syndrome (GBS) occurring together in a single patient is a rare clinical phenomenon that poses both diagnostic and therapeutic challenges. This article discusses the pathophysiology and clinical presentation of these two neuromuscular disorders. The simultaneous occurrence of infectious myositis and GBS is uncommon, and the identification of Enterococcus as the causative agent is even rarer. In this report, we describe a case involving a middle-aged female who presents with both acute infectious myositis and GBS.
Anandan S, Rajendran SS, Kumar JP
… +2 more, Joy J, Rajan SS
J Assoc Physicians India
· 2026 Mar · PMID 41818118
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Internuclear ophthalmoplegia with ipsilateral horizontal gaze palsy is called one and a half syndrome. There are a number of numerical one and a half spectrum disorders. One such syndrome is nine syndrome, which is chara...Internuclear ophthalmoplegia with ipsilateral horizontal gaze palsy is called one and a half syndrome. There are a number of numerical one and a half spectrum disorders. One such syndrome is nine syndrome, which is characterized by one and a half syndrome, ipsilateral lower motor neuron type facial palsy, and contralateral hemiparesis or hemihypesthesia or hemiataxia. Here we describe a case of nine syndrome with left one and a half syndrome, left lower motor neuron type facial palsy, and right hemiataxia.
Saxena S, Chowdhary PK, Kale SA
… +2 more, Agrawal M, Mehta A
J Assoc Physicians India
· 2026 Mar · PMID 41818117
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Multiple myeloma (MM) is a clonal plasma cell proliferative disorder that accounts for 1% of all cancers (Rajkumar). It is a disease of older adults, presenting with anemia, bone pain, and end-organ damage in the form of...Multiple myeloma (MM) is a clonal plasma cell proliferative disorder that accounts for 1% of all cancers (Rajkumar). It is a disease of older adults, presenting with anemia, bone pain, and end-organ damage in the form of CRAB features. With increasing awareness regarding this entity and the availability of more-sensitive diagnostic modalities, involvement of younger age-groups with atypical presentations is becoming more common. Newer case series report that nearly 50% of MM cases present initially with renal failure of unknown etiology (Shankar et al.), highlighting the unique role of the nephrologist in the diagnosis of this condition. In these two case reports, we wish to highlight two cases presenting with acute renal failure of unknown etiology, who were subsequently diagnosed to have occult MM with light chain deposition disease (LCDD).
Siddineni LA, Panchal M, Sanghvi H
… +2 more, Sachde RB, Marakana P
J Assoc Physicians India
· 2026 Mar · PMID 41818116
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We present a case of a 30-year-old female patient who presented with fever for 1 month. All the causes of pyrexia and all other possible causes were ruled out before diagnosing hemophagocytic lymphohistiocytosis (HLH). A...We present a case of a 30-year-old female patient who presented with fever for 1 month. All the causes of pyrexia and all other possible causes were ruled out before diagnosing hemophagocytic lymphohistiocytosis (HLH). Although it is common in children, a 2% prevalence rate is suggested in adults according to the literature. HLH was confirmed after bone marrow aspiration showing hemophagocytes.
J Assoc Physicians India
· 2026 Mar · PMID 41818115
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BACKGROUND: Drowning is the third leading cause of unintentional injury and death worldwide, accounting for 7% of all injury-related deaths. People who are at higher risk include those who have free accessibility to wate...BACKGROUND: Drowning is the third leading cause of unintentional injury and death worldwide, accounting for 7% of all injury-related deaths. People who are at higher risk include those who have free accessibility to water and younger children lacking supervision. The common complications of drowning are mainly due to hypoxia. It mainly affects the respiratory, cardiac, and central nervous system. Rarely, drowning may cause acute kidney injury (AKI) secondary to rhabdomyolysis. Here, we present a case of near drowning with AKI, rhabdomyolysis, and elevated intracranial tension (ICT) with a false localizing sign (abducent nerve palsy). CASE DESCRIPTION: A 21-year-old female patient was brought with a history of alleged drowning for about 3-5 minutes. The patient presented with loss of consciousness; she was gasping and had diffuse subcutaneous emphysema. On examination, the patient had bilateral coarse crepitations. She was started on mechanical ventilation. After 2 days, the patient developed elevated renal parameters and had an episode of ventricular tachycardia. After 10 days, the patient developed diplopia and blurring of vision. Ophthalmological examination revealed bilateral abducent nerve palsy with established papilledema and hemorrhagic retinopathy. The patient was treated with IV antibiotics, IV fluids, DC shock, inotropes, hemodialysis, and acetazolamide. After 15 days, the patient recovered from bilateral lateral rectus palsy and had no blurring of vision. CONCLUSION: Drowning is a leading cause of accidental death. This patient had diffuse subcutaneous emphysema, rhabdomyolysis with AKI, ventricular tachycardia, and raised ICT. In drowning, raised ICT often has a poor outcome. However, with constant monitoring and timely intervention this patient survived.
J Assoc Physicians India
· 2026 Mar · PMID 41818114
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An immediate need exists for a safe, quick, and effective reversal agent in patients who present with anticoagulant-induced major bleed. Dabigatran, a newer oral anticoagulant and a direct thrombin inhibitor (DTI), can a...An immediate need exists for a safe, quick, and effective reversal agent in patients who present with anticoagulant-induced major bleed. Dabigatran, a newer oral anticoagulant and a direct thrombin inhibitor (DTI), can also induce bleeding risk. Idarucizumab is a specific dabigatran reversal drug that the United States Food and Drug Administration (US FDA) has approved in the event of a significant bleeding caused by this drug. In this particular drug-related bleeding, it can be challenging to precisely dose alternative reversal agents like prothrombin complex concentrates (PCCs) and activated PCCs (aPCCs) depending on coagulation characteristics. Additionally, they may result in thromboembolic problems. Despite these drawbacks, the inability to get idarucizumab may necessitate the use of these medications in cases of life-threatening bleeding. We describe the case of a 65-year-old male who reported to the hospital with coagulopathy, anemia, and fresh bleeding per rectum (Hb: 5.8 gm/dL, PT 20.02 seconds, INR: 1.55). He was on dabigatran for the past 1 month. Even after stopping dabigatran, injection of vitamin K, 4 units of blood transfusion, and 8 units of fresh frozen plasma (FFP), he was still bleeding, with fall in hemoglobin level. Following the administration of PCC, he significantly improved, and no additional transfusion products were needed. He could be sent home after 4 days. After 1 month, he returned for follow-up with no further complications.
Tulpule S, Shah V, Ganapule C
… +2 more, Burande A, Phalgune D
J Assoc Physicians India
· 2026 Mar · PMID 41818113
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Autoimmune hepatitis (AIH) is a long-lasting liver ailment. It causes hepatocellular necrosis and inflammation, leading to fibrosis. It can develop into cirrhosis and liver failure. The disease predominantly affects youn...Autoimmune hepatitis (AIH) is a long-lasting liver ailment. It causes hepatocellular necrosis and inflammation, leading to fibrosis. It can develop into cirrhosis and liver failure. The disease predominantly affects young to middle-aged women more than men. AIH flares up during gestation and is linked with a high rate of embryonic and maternal problems. With maternal and antenatal care becoming advanced, this disorder should be identified and managed for successful maternal and embryonic outcomes. We present a case report of a primigravida diagnosed with AIH at 14 weeks antenatally. Our main aim in reporting this case is to create general awareness for healthcare professionals and thereby for patients and caregivers about this condition in pregnancy.
J Assoc Physicians India
· 2026 Mar · PMID 41818112
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We present a case of a patient with undiagnosed myasthenia gravis presenting in myasthenic crisis. In this case, the patient presented primarily with myocardial infarction with nonobstructive coronary arteries and respir...We present a case of a patient with undiagnosed myasthenia gravis presenting in myasthenic crisis. In this case, the patient presented primarily with myocardial infarction with nonobstructive coronary arteries and respiratory failure and was later diagnosed to be in myasthenic crisis. The myasthenic crisis was treated with intravenous immunoglobulin (IVIg) and corticosteroids. Given the inadequate response to IVIg and glucocorticoids, the patient was subsequently administered an anti-CD20 monoclonal antibody in the form of rituximab. The patient responded well to rituximab, and her cardiac function subsequently improved.