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Hanging, ligature strangulation, and manual methods can all result in fatal injuries such as fractures, dislocations, and brain swelling. This case involves a 30-year-old woman who survived a hanging incident but subsequently developed pulmonary and brain swelling. Post-obstructive pulmonary edema (POPE) is characterized by sudden onset non-neurogenic, non-cardiogenic fluid accumulation in the lungs following the removal of an acute upper respiratory tract obstruction. This report explores the patient's clinical presentation, disease progression, management strategies, and potential complications that clinicians may encounter during treatment, thereby enriching their understanding of possible outcomes and challenges in patient care., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Parepalli et al.)

Chronic kidney disease (CKD) is a progressive condition characterized by a gradual loss of kidney function, leading to significant health complications and an increased risk of cardiovascular events. Early detection and effective management are crucial for slowing disease progression and improving patient outcomes. Biomarkers are valuable tools in CKD diagnosis, prognosis, and treatment. Traditional biomarkers, such as serum creatinine and urine protein, are widely used, but emerging biomarkers like cystatin C, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) offer enhanced diagnostic precision and insights into disease severity. These advanced biomarkers are particularly important in older adults, who may present with age-related physiological changes and comorbid conditions that complicate CKD management. This review explores the current state of biomarker research in CKD, focusing on their application in older populations. It highlights the role of traditional and emerging biomarkers, discusses their relevance for early detection and prognosis, and examines future directions in biomarker research, including technological innovations and personalized medicine approaches. By integrating biomarkers into clinical practice, healthcare providers can achieve more accurate diagnoses, tailor treatments to individual patient needs, and potentially improve the overall management of CKD. Continued research and development in this field are essential for addressing the complexities of CKD and advancing patient care., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gupta et al.)

Atypical hemolytic uremic syndrome (aHUS) is a rare and complex disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. This case report details the clinical presentation, diagnosis, and management of a 49-year-old female who developed aHUS following elective hip arthroplasty. The patient, with a history of cardiovascular events and no prior renal disease, presented with elevated LDH levels, thrombocytopenia, and acute renal failure on the first postoperative day. A diagnostic workup confirmed aHUS, and the patient was successfully treated with therapeutic plasma exchange (TPE) and hemodialysis. The case underscores the importance of early recognition and aggressive management of aHUS, especially in the perioperative setting, and highlights the need for a multidisciplinary approach to optimize patient outcomes. Through this case, we aim to raise awareness about the potential for surgical stress to trigger aHUS and emphasize the critical role of TPE and supportive care in the treatment of this rare condition., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bedi et al.)

Adenoid cystic carcinoma (ACC) is an aggressive form of salivary gland cancer that mostly affects the accessory, parotid, and submandibular salivary glands. This tumor is characterized by slower development, perineural invasion, and possible local recurrence in clinical and pathological findings. A male patient, aged 71, who was from a remote area, appeared with a lesion affecting the right submandibular gland and had been experiencing discomfort in the same region for four months. Following a biopsy and the histological confirmation of ACC in the right submandibular gland, the tumor was widely excised locally., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dadgal et al.)

Objective: This study aimed to examine the impact of leukemia and other cancers in India and to observe any changes over time., Methodology: Detailed estimates of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for 30 types of cancers in India were analyzed for 29 years from 1990 to 2019 as part of the Global Burden of Diseases (GBD) study. Data from all available sources were used to gather information on the overall burden of disease in India., Results: Cancer is a leading cause of death worldwide, with varying rates of incidence in India, making prevention and treatment a challenge. Because cancer is not a reportable disease in India, the overall burden estimate is still a work in progress. This study analyzed the impact of leukemia and other cancers in India, including trends in incidence, DALYs, and mortality related to all cancers and various malignancies. The causes of leukemia in India were also explored., Conclusions: The study found the trends of cancer types that account for the majority of leukemia-related and cancer-related DALYs, death, prevalence, and incidence in India. Among the four most frequent malignancies, such as leukemia, there was significant variation based on age. Over the last 29 years, mortality from chronic myelogenous leukemia (CML) and acute lymphocytic leukemia (ALL) has decreased, while deaths from acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL) have increased steadily., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nalage et al.)

Hemophagocytic lymphohistiocytosis (HLH) associated with dengue infection presents a unique challenge in clinical practice due to its rarity, rapid progression, and overlapping clinical features. This comprehensive review navigates the complexity of HLH-dengue syndrome by examining its pathophysiology, clinical manifestations, diagnostic criteria, and therapeutic strategies. HLH, characterized by uncontrolled immune activation and cytokine dysregulation, can occur as a secondary complication of dengue infection, leading to severe multiorgan dysfunction and high mortality if not promptly recognized and treated. The review underscores the significance of early diagnosis through vigilant clinical monitoring and appropriate diagnostic tests, such as bone marrow examinations and genetic studies. Collaboration between infectious disease specialists, hematologists, and critical care teams is essential for optimal management. Despite advancements in understanding HLH-dengue syndrome, further research is needed to elucidate its underlying mechanisms and explore novel treatment approaches. This review provides insights into the clinical implications of HLH-dengue syndrome and emphasizes the importance of a multidisciplinary approach to improve patient outcomes in this challenging clinical scenario., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Gupta et al.)

Renal infarction is an uncommon illness that can have serious side effects. Patients may be predisposed to the disease by factors including smoking, atrial fibrillation, thrombus, infective endocarditis, myocardial infarction, and prosthetic valves. Patients are most susceptible from 24 hours to 15 days after myocardial infarction, with an increased rate of left ventricular (LV) thrombus development, which raises the probability of thromboembolic events in the cerebrovascular system and might exacerbate morbidity and mortality rate. This can be diagnosed by two-dimensional echocardiography. Different risk factors can contribute to the development of an LV thrombus. Renal infarcts from LV clots are less common but can occur bilaterally in certain situations. A 30-year-old male diagnosed with anterior wall myocardial infarction presented at our hospital and was suspected to have bilateral renal infarcts, possibly due to the LV thrombi. The patient was managed on anti-thrombolytics and was reported to be doing well at a follow-up of one month., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Daiya et al.)

Status asthmaticus is a severe form of aggravation of asthma, whereas myasthenia gravis (MG) is a rare neuromuscular condition characterised by exhaustion and muscle weakness. Myasthenic crisis can occasionally manifest with symptoms that resemble status asthmaticus, which can result in an incorrect diagnosis and ineffective therapy. In addition to discussing the therapeutic implications, this abstract attempts to draw attention to the difficulties in distinguishing between status asthmaticus and myasthenia crisis and the importance of diagnosing subtle signs of MG. In this case, we present a 55-year-old female, with a misdiagnosed case of bronchial asthma, who presented with shortness of breath at rest for two to three days and was suspected to have an acute exacerbating episode of asthma. She was later evaluated for non-respiratory causes of dyspnea on noticing subtle signs of ptosis and was found to have an active myasthenic crisis. Although this case presented typically as status asthmaticus, it did not respond to conventional treatment of it, and on the contrary, it worsened. Hence, it is necessary to look for subtle signs of MG and promptly differentiate it from other similar emergency events to help administer accurate treatment which can prove life-saving., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Toshniwal et al.)

The article explores the significance of the timely transition of a child living with congenital heart disease (CHD) to adult care and the role played by multidisciplinary care. Due to recent healthcare advances, more children with CHD survive to adulthood without surgical intervention. This survival is mainly due to the lesion being compatible with life and its management being done medically. However, further management requires meeting the child's needs and helping him transition to become a healthy, independent adult with almost equal life expectancy as his counterparts. The article reviews the comprehensive framework of transition through multidisciplinary care. Highlighting the necessity of training physicians to acquire expertise in the management of CHD is a foundational aspect of this review article. Introduction to transition requires assessment of the child's needs through all phases of life and informative counseling of both parents and child. It highlights the approach to educating patients and families with the knowledge to safeguard compliance. Multidisciplinary collaboration from various fields such as cardiology, pediatric physiatrist, nursing, and psychology has been stressed. Patients also need to cultivate skills in self-management and independence and be educated to comprehend their condition, including the potential health issues. This collaborative and multidisciplinary process necessitates the cooperation of patients, families, and the adult congenital heart disease (ACHD) team. Emphasis has been given to individualized counseling for girls to address their sexual health. The article also highlights the possible obstacles and how to tackle them to improve healthcare adherence. Timely transition and follow-up can be measured using various tools or through indices measuring the quality of life and average life expectancy. The global patterns of transition to ACHD care have also been emphasized, as well as the need for research studies to develop reliable indicators for assessing transition success., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Tyagi et al.)

Cerebral palsy (CP) is one of the most common disorders in pediatric patients. The prevalence of CP is 2-3 in 1,000 live births, but various changes in some trends are seen in different groups. This article is a systematic review of multiple sources available for interventions and new adaptive techniques used for treating patients for their better lifestyles. With recent advancements, it is possible to diagnose a child who is below six months to two years. For achieving goals, proper interventions and techniques are necessary in the early stages of the disease. This article summarizes the rehabilitation and interventions available for treating these children with the best procedures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Guru et al.)

Chorea is a disorder characterized by irregular, involuntary movements affecting the limbs, trunk, neck, or face. It can be a significant symptom in various neurologic diseases, including metabolic, autoimmune, and neurodegenerative conditions. The neural foundation that underlies the genesis of chorea appears to be fairly diverse, even though its pathophysiology is frequently associated with the malfunctioning of inhibitory circuits within the basal ganglia. Movement disorders such as tremors, myoclonus, ataxia, chorea, and Parkinsonism may arise due to renal dysfunction or complications from management like renal transplant and hemodialysis. Uremic encephalopathy is a rare but potentially life-threatening neurological complication of chronic kidney disease. We present a case of a 50-year-old male with a known history of chronic kidney disease and chronic alcoholism, who exhibited abnormal movements resembling chorea upon presentation. Initially suspected as alcohol withdrawal-related chorea, further evaluation revealed concurrent rising creatinine levels, acidosis, and hyperkalemia. Hemodialysis was initiated, resulting in a significant improvement in choreoathetoid movements. This case implies the importance of considering uremic encephalopathy in the differential diagnosis of movement disorders in patients with underlying kidney dysfunction, even in the context of chronic alcoholism., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Saboo et al.)

Epilepsy is a neurological disorder characterized by recurrent seizures affecting millions worldwide. Medically intractable seizures in epilepsy patients are not only detrimental to the quality of life but also pose a significant threat to their safety. Outcomes of epilepsy therapy can be improved by early detection and intervention during the interictal window period. Electroencephalography is the primary diagnostic tool for epilepsy, but accurate interpretation of seizure activity is challenging and highly time-consuming. Machine learning (ML) and deep learning (DL) algorithms enable us to analyze complex EEG data, which can not only help us diagnose but also locate epileptogenic zones and predict medical and surgical treatment outcomes. DL models such as convolutional neural networks (CNNs), inspired by visual processing, can be used to classify EEG activity. By applying preprocessing techniques, signal quality can be enhanced by denoising and artifact removal. DL can also be incorporated into the analysis of magnetic resonance imaging (MRI) data, which can help in the localization of epileptogenic zones in the brain. Proper detection of these zones can help in good neurosurgical outcomes. Recent advancements in DL have facilitated the implementation of these systems in neural implants and wearable devices, allowing for real-time seizure detection. This has the potential to transform the management of drug-refractory epilepsy. This review explores the application of ML and DL techniques to Electroencephalograms (EEGs), MRI, and wearable devices for epileptic seizure detection. This review briefly explains the fundamentals of both artificial intelligence (AI) and DL, highlighting these systems' potential advantages and undeniable limitations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Singh et al.)

Background Organophosphorus poisoning (OPP) is a prevalent mortality rate that varies from 2% to 25% method of suicides worldwide. ICUs commonly employ various scoring systems such as the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), and International Programme on Chemical Safety (IPCS) Poison Severity Score (PSS) tools for risk stratification for mortality prediction scores and prognosis. This study aims to compare the predictive validity of these systems in hospitalized patients suffering from pesticide poisoning in a teaching hospital located in central India. Methods A prospective study design was utilized to gather relevant variables for calculating the GCS, APACHE II, SAPS II, and IPCS scales in patients affected by pesticide poisoning. Data on the administered doses of atropine and pralidoxime (PAM) were also recorded. Results We have identified several independent predictors of mortality among patients suffering from pesticide poisoning. The GCS (P=0.001), tracheostomy (P=0.001), APACHE II score (P=0.01), and SAPS II score (P=0.001) were all found to be significant indicators of mortality. Interestingly, the GCS demonstrated comparable predictive ability for mortality when compared to the APACHE II (0.82 (95% confidence interval (CI) 0.70 to 0.94)) and SAPS II (0.83 (95% CI 0.72 to 0.94)) scores, with no statistically significant difference (P=0.75) observed. Among the variables used in the IPCS PSS (GCS, heart rate, systolic blood pressure (BP), intubation, and pupil size), only GCS (P=0.05), and intubation (P=0.01) exhibited a significant association with mortality. Conclusions Our study determined that the GCS score, SAPS II, IPCS PSS, and APACHE II exhibited equal efficacy in predicting mortality. Notably, the GCS offered an added advantage due to its simplicity and minimal time requirements compared to the other scales., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sontakke et al.)

Coccidiosis is a significant parasitic disease in goats, with significant impacts on animal health, productivity, and economic losses for producers. Although various management practices can help control and prevent coccidiosis, a growing body of research suggests that genetics play an important role in determining resistance to the disease. This review explores the current understanding of the genetics of coccidiosis resistance in goats, including the potential genetic factors and mechanisms involved, and the implications for breeding and selection programs. The review will also discuss current research and future directions in this field, including the use of genomic tools and technologies to better understand the genetics of resistance and to improve breeding programs for coccidiosis resistance in goats. This review will be of interest to veterinary practitioners, goat producers, animal breeders, and researchers working in the field of veterinary parasitology and animal genetics., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Diffuse alveolar hemorrhage (DAH) is bleeding into the alveolar spaces of the lung. DAH is often associated with systemic autoimmune diseases, coagulation disorders, drugs, inhaled toxins, or transplantation. This study describes a rare case of acenocoumarol-induced DAH, a pulmonary disorder, which has not been reported before. A 48-year-old male presented with a history of rheumatic heart disease with mitral stenosis with moderate mitral regurgitation status post mitral valve replacement. He was taking acenocoumarol but did not keep his prothrombin time-international normalized ratio (PT-INR) monitoring and came to the hospital with complaints of cough, hemoptysis, and breathlessness. Chest x-ray and high-resolution computed tomography (HRCT) thorax were done which revealed diffuse patchy opacities and pulmonary hemorrhage, respectively. After nine days of hospital stay with appropriate management with corticosteroids, antibiotics, and intravenous fluids, the patient was doing well., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Pawar et al.)

Hemophagocytic lymphohistiocytosis (HLH) is an autoimmune phenomenon characterized by reactive hyperactivity of cytotoxic T cells and histiocytes, leading to hypercytokinemic injury to cells and organ system, which leads to multiorgan dysfunction and ultimate failure. Epstein-Barr virus (EBV) is most commonly associated with secondary HLH with high mortality, but increasing evidence suggests the association of the dengue virus. When associated with dengue infection, it carries a grave prognosis and correlates with the disease severity. Furthermore, it overlaps with dengue sepsis, so it can often be misdiagnosed as sepsis. Typically the patients have hyperferritinemia, hypertriglyceridemia, transaminitis, and marrow features suggestive of hemophagocytosis. The treatment is usually systemic corticosteroids, intravenous immunoglobulin, and chemotherapy with etoposide. We present a case of a 25-year-old male patient who had a dengue infection and further developed HLH with pulmonary infiltrates. Clinical suspicion alerted us to look for other evidence of HLH on the fourth day of admission, and appropriate investigations were done. Diagnosis of HLH was confirmed by HLH-2004, HScore criteria, and bone marrow aspirate examination. Treatment was given in the form of corticosteroids and chemotherapy along with other supportive measures. The patient responded to the line of management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Acharya et al.)

Introduction  Prompt recognition and aggressive management of acute intoxication due to organophosphorus poisoning are essential to minimize the morbidity and mortality. The present study was undertaken to know the prognosis and outcome of organophosphorus poisoning patients with the estimation of low-cost enzymes like the serum amylase level in a population with financial constraints. Methods  In this cross-sectional study, we had enrolled 100 cases that had a history of exposure to organophosphorus compounds, and the serum amylase level was measured in all the patients. We assessed the outcome of all the patients in the form of discharge, need of ventilators, intensive care unit stay, and death. Results  The mean serum amylase level in discharge patients was 335.40 ± 192.45, and in the patients who died it was 843.37 ± 22.60. It was significant to predict the outcome ( t -value 7.07, p -value 0.0001, statistically significant). Conclusion  Serum amylase level shows significant correlation with clinical outcomes in organophosphorus poisoning., Competing Interests: Conflict of Interest Nil., (The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Symmetrical peripheral gangrene (SPG) is a rare clinical entity. It was first described in late 19(th) century and since then has been reported with array of medical conditions mainly those complicated with shock, sepsis, and disseminated intravascular coagulation (DIC). Here in, we describe a parturient with peripartum cardiomyopathy (PPCM) and SPG. Clinicians should be aware of this entity as early recognition can help in reducing morbidity and mortality.