Sudhagar Mookkappan

Pondicherry Institute of Medical Sciences | PIMSMMM · Department of General Medicine

Introduction: Urosepsis is life threatening, unless treated immediately. Empirical treatment with appropriate antibiotics lowers the risk of a poor outcome. However, with increasing resistance among common uropathogens, there is a need for continuous review of the existing protocol to determine whether there is a correlation between empirical anti...

BACKGROUND One of the most common forms of central nervous tuberculosis is tubercular meningitis and has high morbidity and mortality. The natural course of TBM is subacute in nature; hence, the symptoms may persist for weeks before diagnosis. The diagnosis of tuberculosis is based on clinical presentation and cerebrospinal fluid analysis. GeneXper...

BACKGROUND Metabolic syndrome is an important risk factor for cardiovascular disease and type 2 diabetes mellitus. According to International Diabetes Federation, the risk factor associated with metabolic syndrome are central obesity, hypertension, increased fasting glucose, triglyceride level and decreased HDL. Recent studies also found that hyper...

Scrub typhus, caused by the proteobacterium, Orientia tsutsugamushi, is re-emerging in several regions of Asia, particularly in India. Severity of infection and clinical presentations are known to vary with the infecting prototype/ genotype. Hence genotypic characterization and distribution of various genotypes is of clinical and epidemiological im...

Background: Concurrent infection with multiple pathogens is common in tropics, posing diagnostic and treatment challenges. Although co-infections of dengue, malaria, leptospirosis and typhoid in various combinations have been described, data on dengue and scrub typhus co-infection is distinctly limited. Methodology: This study was a retrospectiv...

Background: Cutaneous hyperpigmentation is an often overlooked clinical sign in megaloblastic anemia (MA) which has been sporadically reported in the literature. Methods: We describe the bone marrow (BM) changes and clinicolaboratory characteristics of 25 of 198 adult cases (>16 years) with cutaneous hyperpigmentation who underwent BM evaluation...

Background: Concurrent infection with multiple pathogens is common in tropics, posing diagnostic and treatment challenges. Although co-infections of dengue, malaria, leptospirosis and typhoid in various combinations have been described, data on dengue and scrub typhus co-infection is distinctly limited. Methodology: This study was a retrospective a...

Introduction: Artery of percheron (AOP) stroke is a rare cause of posterior circulation stroke leading to bilateral thalamic infarct with or without upper midbrain involvement. The triad of clinical presentation involves altered mentation, vertical gaze palsy and memory impairment. We describe a case of AOP stroke where the infarction extends to br...

Background: Although communication skills are important for a good physician-patient relationship, Indian medical curricula give very little emphasis on training medical students in this aspect. Aims: To determine the change in communication skills of final-year medical students following focused training. Methods: This was an educational inte...

Assessment of communication skill amog UG

Background and Objectives: Organophosphorous compound [OPC] poisoning is an acute medical emergency , more commonly encountered in India and other developing countries. Due to its easy availability and usage as a pesticide in agricultural fields , OPC poisoning is seen more among farmers. The present study aims to describe the clinico-epidemiologic...

Scrub typhus is an acute febrile illness caused by the intracellular parasite Orientia tsutsugamushi. Although most cases present with mild symptoms and signs and recover spontaneously, some cases can be severe with multi-organ dysfunction and a protracted course, which may be fatal if left untreated. Apart from fever and constitutional symptoms, a...

Introduction: Anthrax remains endemic to some parts of southern India including Pondicherry. Among various forms of the infection, gastrointestinal anthrax appears to be the least common. Cases of inhalational anthrax causing sepsis and disseminated intravascular coagulation have been reported in the literature. Case presentation: We report the fi...

Background: Enteric fever, a common infection in the tropics and endemic to India, often manifests as an acute febrile illness. However, presentation as fever of unknown origin (FUO) is not uncommon in tropical countries. Methods: We aim to describe the clinical, laboratory and pathological features of patients hospitalized with fever of unknown or...

Toxicity from accidental and intentional ingestion of yellow phosphorus, ubiquitously present in fireworks and rodenticides, has recently become more frequent. Gastrointestinal, renal, neurologic, and cardiovascular manifestations are common, with mortality of 23 per cent to 73 per cent. Reports of haematological abnormalities are rare. We report o...

Japanese encephalitis ( JE) is a potentially serious form of viral encephalitis with varied clinicoradiological manifestations. We report the case of a 19-year-old girl admitted with headache, vomiting and altered sensorium in the absence of fever, whose cerebrospinal fluid analysis showed lymphocytic pleocytosis with significant protein content an...

Tuberculoma of the brain is a major neurological problem in developing countries accounting for 12 to 30 per cent of all intracranial masses. It often presents with focal neurological symptoms or seizures. Simultaneous occurrence of brain tuberculoma with miliary mottling in the lungs is uncommon in the immunocompetent patient. We report only the s...

Hemophagocytic lymphohistiocytosis (HLH) has a well known association with lymphomas, especially of T cell origin. Prognosis of lymphoma associated HLH is very poor, especially in T cell lymphomas; and, therefore, early diagnosis might alter the outcome. Though association of HLH with systemic anaplastic large cell lymphoma (ALCL) is known, its occ...

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the commonest cause of euvolemic hyponatremia. Several drugs are known to cause this syndrome. Pregabalin, a drug now used widely for a number of neurologic disorders, may cause hyponatremia secondary to salt wasting nephropathy. However, SIADH induced by pregabalin has been report...

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the commonest cause of euvolemic hyponatremia. Several drugs are known to cause this syndrome. Pregabalin, a drug now used widely for a number of neurologic disorders, may cause hyponatremia secondary to salt wasting nephropathy. However, SIADH induced by pregabalin has been report...

We aim to describe the clinicohaematological profile of an elderly male with plasmablastic multiple myeloma (MM) (IgG λ, International System Stage II) with an unfavourable outcome following chemotherapy. The serum interleukin-6 level was found to be markedly elevated (2464 pg/mL, reference; <50 pg/mL). Thirty-six months prior to MM diagnosis, he u...

Choroid plexus papillomas are rare neoplasms that arise from choroid plexus epithelium. Most of these lesions appear in children, mainly located in the lateral ventricles. We report a case of a 40 year old male with rapidly progressive dementia and gait ataxia who was found to have choroid plexus papilloma. This condition predominantly affects chil...

Haemotoxic snakebite, presenting with coagulopathy and bleeding manifestations, is quite common. Thrombotic manifestations are infrequently observed. We describe the unusual case of a young male who developed deep vein thrombosis (DVT) of the left lower limb following snakebite, despite an ongoing coagulopathy. Investigations revealed leucocytosis,...

Scrub typhus appears throughout the Asia-Pacific rim. This disease is known for its diverse clinical manifestations and complications. There is no literature on the association of scrub typhus with adrenal insufficiency. Relative bradycardia has been reported in scrub typhus during the febrile phase but not during convalescence. We report the case...

Organophosphorus poisoning is common in rural Asia. Clinical features result from overactivity of acetylcholine receptors. Blackish discoloration of urine is not a feature of organophosphorus poisoning. Only one case of black colored urine following quinalphos poisoning has been reported in literature. We report two cases of organophosphorus poison...

Acute transverse myelitis is a rare clinical entity characterized by sudden onset of sensori-motor paralysis due to complete spinal cord dysfunction below a definite level, usually on the trunk. It may be precipitated by a number of conditions, especially vaccinations. Though hepatitis B vaccination can result in transverse myelitis, its occurrence...

Melioidosis is an emerging disease in India. Cases have also been reported from South East Asia, Australia and Japan. Major risk factors for melioidosis are diabetes mellitus, preexisting renal disease and thalassemia. Exposure to contaminated soil and water are also significant occupational hazards associated with the disease. A patient with diabe...

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