Rayidi Rajesh

Government Medical College and Hospital

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Monica Gupta

King's College London

Samiksha Gupta

Government Medical College and Hospital

Gautam Jesrani

Government Medical College and Hospital

Narinder Kaur

Maharishi Markandeshwar University, Mullana

Aman Garg

The NorthCap University

Anita Tahlan

Government Medical College and Hospital

Tulika Garg

Government Medical College and Hospital

Narinder Kaur

Chandigarh University

Ankit Chhabra

Sher-i-Kashmir Institute of Medical Sciences

Monica Gupta

Gartnavel General Hospital

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Government Medical College and Hospital

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Christie's

October 6 University

Government Medical College

Fundación Juan March

Sharda University

Guru Gobind Singh Medical College and Hospital

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An Unusual Presentation of Dengue Myocarditis

Medical Journal of Babylon (2021)

Samiksha Gupta Gautam Jesrani Rayidi Rajesh Aman Garg Monica Gupta

Dengue fever (DF) is a common mosquito-borne viral illness, with various cardiovascular implications, including electrocardiographic abnormalities, due to profound myocardial involvement (myocarditis) by the dengue virus. Here, we are describing an untraditional presentation of DF, in which a young male encountered with cardiac rhythm abnormalities without fever, thrombocytopenia, or capillary leakage. The patient had symptomatic hypotension, and his electrocardiogram (ECG) demonstrated alternative patterns of ventricular bigeminy and trigeminy. Serum electrolytes, total leukocyte counts, and renal function tests were normal, but cardiac biomarkers were elevated in this patient. Two-dimensional echocardiography demonstrated global left ventricular wall hypokinesia with an ejection fraction of 53%, but the coronary angiography indicated no vascular thrombus or occlusion. Subsequent evaluation found that the dengue IgM antibody by enzyme-linked immunosorbent assay was positive in this patient. He was managed conservatively for this and had a splendid recovery in the form of normal ECG at the time of discharge and echocardiography on follow-up. The case delineates a rare and challenging presentation of cardiac involvement in DF.

Hypokinesia

10.4103/mjbl.mjbl_76_21

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Citations (1)

Mumps Infection With Symptoms of Parotitis, Pancreatitis, and Orchitis Concurrently in an Adolescent Male

Cureus (2022)

Tulika Garg Monica Gupta Samiksha Gupta Narinder Kaur Rayidi Rajesh

Mumps is a highly contagious childhood infectious disease caused by the mumps virus. Clinical symptoms of mumps infection among vaccinated young adults are rarely seen. We present an unusual case of a vaccinated young male who presented with a clinical picture suggestive of mumps infection with symptoms of parotitis, pancreatitis, and orchitis. The waning of vaccine-induced immunity and low efficacy of the mumps component of the measles, mumps, and rubella (MMR) vaccine could be the reasons for the same. Our patient was managed with supportive measures for the complications and made an uneventful recovery. It has been postulated that antigenic differences between the vaccine and strain-causing illness may result in a deficient immune response conferred by the vaccine. This case highlights the concerns regarding the effectiveness of the live attenuated vaccine currently in use.

Parotitis

Mumps vaccine

Orchitis

Mumps virus

Measles-Mumps-Rubella Vaccine

MMR vaccine

Rubella vaccine

10.7759/cureus.21963

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Prevalence of vascular thrombosis in patients with liver abscess

Tropical Doctor (2023)

Rayidi Rajesh Monica Gupta Narinder Kaur Sarabmeet Singh Lehl Anita Tahlan

Thrombotic complications in liver abscess are less commonly identified in the literature. In this prospective observational study, vascular thrombosis was detected in 21.9% cases. However, there was no significant difference in outcome with or without vascular thrombosis, properly treated.

10.1177/00494755231204920

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Evans syndrome and Graves' Disease: An unusual presentation – A case report

Apollo Medicine (2022)

Amtoj Singh Lamba Monica Gupta Samiksha Gupta Rayidi Rajesh

Introduction: Evans syndrome (ES), an infrequently encountered haematological condition, is characterized by coombs-positive autoimmune hemolytic anaemia (AIHA) in association with immune thrombocytopenia (ITP). The association of ES with Graves' disease (GD) is rare, this being probably the first case reported from the Indian subcontinent. Methods: We present the case of a 32-year-old woman diagnosed with AIHA in 2017 and ITP with GD during the current hospitalization. Results: The patient was initiated on immunosuppressive therapy with azathioprine and thiamazole, following which she entered remission. Conclusion: The pathophysiology of ES with Graves' disease seems to encompass hyperthyroidism and autoimmunity. To date, there are no well-defined guidelines for its treatment. Efforts should be made to devise standardized treatment options.

Evans syndrome

Presentation (obstetrics)

Indian subcontinent

10.4103/am.am_79_22

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Transient cardiac rhythm aberrancy in acute pancreatitis: A case report

Journal of Dr NTR University of Health Sciences (2022)

Gautam Jesrani Ankit Chhabra Samiksha Gupta Rayidi Rajesh Monica Gupta

The cardiovascular system is one of the commonly affected systems in various inflammatory and metabolic conditions, and rhythm abnormalities are most vulnerable in this context. Here, we are describing a rare presentation of acute pancreatitis, in which a young male appeared with cardiac rhythm irregularity. The patient presented with localized chest pain of recent onset and had a blood pressure of 88/54 mm Hg initially. On electrocardiogram (ECG), an accelerated idio-ventricular rhythm was identified with the absence of P wave and borderline QRS complex duration. However, his electrolytes were normal, qualitative troponin T was negative, echocardiography ruled out structural cardiac anomalies, and coronary arteries had no occlusion in angiogram. In the absence of any identifiable cause, the recent alcohol intake history made us to measure his serum amylase and lipase levels, and surprisingly, the levels were more than three times the upper value. Additionally, his ultrasound of the abdomen depicted bulky pancreatic head, and thus, the diagnosis of acute pancreatitis was made. Rhythm abnormality subsided with conservative management and the patient was discharged with a normal ECG. The case will shed some light on pancreatitis-associated acute cardiac rhythm abnormality, which is uncommon in emergency department.

Transient (computer programming)

Heart Rhythm

10.4103/jdrntruhs.jdrntruhs_137_21

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