Unusual case of dystrophic calcification and thrombosis of an extra-anatomical graft in a patient with Takayasu's arteritis

We report the case of a thrombotic occlusion of an extra-anatomical aortic bypass graft performed 37 years ago in a 46-year-old male with Takayasu’s arteritis. He presented with uncontrolled upper body hypertension, claudication pain in both the lower limbs, and kidney dysfunction which returned to normal post-surgery. On table we found a pseudoaneurysm at the proximal anastomosis along with calcification of the capsular tissue surrounding the graft. We attempt to explain the mechanism behind the graft occlusion, along with management of this late surgical complication which has not been described in the existing literature.

Detrimental effect of diabetes and hypertension on the severity and mortality of COVID-19 infection: A multi-center case-control study from India

AIMS

This study aims to find a quantitative association between the presence of co-existing diabetes mellitus (DM) and/or hypertension (HTN) with COVID-19 infection severity and mortality.

METHODS

A total of 813 patients with a positive COVID-19 were included. A case-control design was used to dissect the association between DM and HTN with COVID-19 severity and mortality.

RESULTS

According to MOHFW guidelines, 535 (65.7%) patients had mild, 160 (19.7%) patients had moderate, and 118 (14.5%) patients had severe disease outcomes including mortality in 52 patients. Age, Neutrophil%, and Diabetes status were significantly associated with severe COVID-19 infection. After adjusting for age, patients with diabetes were 2.46 times more likely to have severe disease (Chi-squared = 18.89, p-value<0.0001) and 2.11 times more likely to have a fatal outcome (Chi-squared = 6.04, p-value = 0.014). However, we did not find evidence for Hypertension modifying the COVID-19 outcomes in Diabetic patients.

CONCLUSION

COVID-19 severity and mortality both were significantly associated with the status of DM and its risk may not be modified by the presence of HTN.

Temporary remission of tardive dystonia following electroconvulsive therapy

An improvement in tardive dystonia in a patient who had received ECT for a schizophrenic psychosis is reported. The improvement suggests that the pathophysiology of tardive dystonia may involve neurotransmitter receptor changes similar to those seen in schizophrenia.

Structural changes in the brain in schizophrenia a computed tomographic study

Computed tomography of the brain was performed in thirty schizophrenic patients in the age group of 19-45 years and thirty controls matched for age and sex The size of lateral ventricles, the width of the third ventricle and the sylvian fissure were measured in the CT scans. On group comparison, we found that the size of lateral ventricles expressed as ventricular brain ratio, and the width of the third ventricle and sylvian fissure were significantly greater in the schizophrenic patients (P< 0.001) as compared to the control group. No correlation was observed between the duration of illness and the cerebral findings. There was no significant difference between the group of schizophrenic patients with a history of having been treated with electro-convulsive therapy and the group without such a history.