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Stephanie Bustamante-Mata, Alamgir A. Khan, Joseph Varon, Salim Surani

Ureteral stents, sepsis and acute kidney injury: Iatrogenic imperfecta!

Case presentation A 62-year-old woman with a past history of placement of bilateral ureteral “JJ” stents, presented to the hospital complaining of fever, chills, abdominal pain, oliguria and was found to be hypotensive. She was admitted to the intensive care unit (ICU), with the diagnosis of sepsis secondary to a urinary source. Her white blood […]

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Emmanuel Urquieta, Humayun Anjum, Sheila Zanoria, Joseph Varon, Salim Surani

Mediastinal lipoma with vascular compression

Case description A 56-year-old gentleman presented to the emergency department with shortness of breath and neck swelling of a couple of weeks duration. After a comprehensive physical examination and chest radiograph revealing an upper mediastinal abnormality, a computed tomography (CT) scan of the chest (Figures 1A and 1B) depicted a 8x7x5.7 cm mass with homogenous […]

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Stella Kawilarang, Ketut Surya Negara

Characteristics of the obstetric patients admitted to the Intensive Care Unit of Sanglah General Hospital in 2013-2016

Abstract Background: High risk pregnancy and complication during pregnancy or labor may need multidisciplinary management in the Intensive Care Unit (ICU). This study shows the characteristics of obstetric patients who were admitted to the ICU of Sanglah General Hospital Denpasar, Bali, Indonesia in 2013 to 2016. Objective: Our study was performed to provide database in […]

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Daisy Suriadji, Dyah Kanya Wati, I Gusti Lanang Sidiartha, Ida Bagus Suparyatha, I Nyoman Budi Hartawan

Prevalence and association of cost and hospital malnutrition in Pediatric Intensive Care Unit Sanglah Hospital during 2015

Abstract Background: Early nutritional screening and adequate enteral nutrition for critically ill patients, started 24 hours after admission in pediatric intensive care unit (PICU) are accepted to improve health outcomes. Malnutrition prior to admission worsens the prognosis of severely ill children and it will lead to a higher mortality, a longer length of stay, and […]

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Amit Kansal, Faheem Ahmed Khan, Muhammad Habibullah Rana

“Complete” loss of brain stem reflexes – not always brain death! Beware of amitriptyline overdose

Abstract We present a case of “complete” loss of brain stem reflexes following amitriptyline overdose, which mimicked brain death. This case highlights the complexities associated with clinical brain death determination and calls for close attention to details. Based on previously published case reports, we analyse the relationship with the amitriptyline dose, blood level and timing […]

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Kelly Dewey, Michael Simmons, Fernanda Duarte, Salim Surani

Levamisole tainted cocaine induced vasculitis

Abstract Levamisole has been implicated in the vasculitis and aganulocytosis. It has been pulled from the United States market for human use. Due to its euphoric and bulking properties, it has been used as a bulking agent in cocaine. We hereby present a case of a 56-year-old Hispanic male, who developed vasculitis due to cocaine […]

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Iqbal Ratnani, Faraya Bokhari, Rahim Hirani, Joseph Varon, Salim Surani

Peripherally-inserted central catheters: Watch for retained wires!

An increasing number of patients are being admitted to critical care units with multiple chronic medical conditions. In some of these patients, intravenous access is a challenge. With a concern for indwelling catheter infections, peripherally inserted central catheters (PICC). These lines have been advocated due to their lower rate of complications and comfort to the […]

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Najeh Baccouche, Mabrouk Bahloul, Sabrine Bradai, Kais Regaieg, Fatma Ayedi, Mounir Bouaziz

Prognostic value of serum cholinesterase activity in the septic shock due to bacterial infections

Abstract Context: Kinetics of SChE activity analyses, in our knowledge, was not previously studied in the prediction of prognosis of patients with septic shock. Objective: We aimed to analyse kinetics of SChE activity in 4 patients with septic shock. Materials and methods: Prospective study. Results: The kinetics analyses of SChE activity showed that SChE activity […]

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I Made Darma Yuda, Dyah Kanya Wati, I Nyoman Budi Hartawan, Ida Bagus Suparyatha

The association between delta shock index and mortality in children with shock

Abstract Background: Shock remains one leading cause of morbidity and mortality in hospitalized children. Delta shock index is a simple tool to assess and evaluate shock. Objective: To investigate whether delta shock index might be related to mortality in children with shock. Methods: Prospective cohort study. Setting: Emergency Room (ER) and Pediatric Intensive Care Unit […]

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Amit Kansal, Somnath Chatterjee, Muhammad Habibullah Rana, YeeShay Lee, Ross Freebairn

Is my patient really brain dead?

Abstract The diagnosis of brain death can be fraught with multiple challenges ranging from the presence of complex motor movements to inappropriate patient screening, e.g. patient’s not meeting preconditions. We describe two cases where complex motor movements persisted following clinical death by standard brain death criteria and caused uncertainty with regards to diagnosis of brain […]

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MRSA pneumonia mucus plug burden and the difficult airway

An 80-year-old female with a past medical history of chronic obstructive pulmonary disease (COPD), diabetes, and hypertension was initially admitted to the hospital for surgical repair of an incarcerated inguinal hernia. She underwent successful herniorrhaphy with mesh placement. Her post-operative course was complicated by a pelvic hematoma requiring evacuation during an exploratory laparotomy. The patient […]

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A randomized controlled trial: Changes of serum sodium levels in children with diarrhea moderate dehydration receiving rehydration therapy with standard hypotonic solution or balanced solution

Abstract Background: Hyponatremia is a condition that may cause dangerous clinical manifestations. Diarrhea with dehydration is one of the most common causes for hyponatremia. Intravenous hypotonic fluid is used for children with moderate dehydration and isotonic Ringer lactate is used for severe dehydration in several therapy guidelines for diarrhea. Aims: To investigate the difference in […]

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