Savio John

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Hyponatremia is frequently seen in patients with ascites secondary to advanced cirrhosis and portal hypertension. The development of ascites in patients with cirrhosis is multi-factorial. Portal hypertension and the associated systemic vasodilation lead to activation of the sodium-retaining neurohumoral mechanisms which include the(More)
Rates of transmission of hepatitis B virus (HBV) infection from organ donors with HBV markers to recipients along with reactivation of HBV during immunosuppression following transplantation have fallen significantly with the advent of hepatitis B immune globulin (HBIg) and effective antiviral therapy. Although the availability of potent antiviral agents and(More)
UNLABELLED Chronic NSAID use can cause diaphragm like strictures within the bowel leading to intestinal obstruction. This rare entity is called diaphragm disease. Preoperative diagnosis is extremely difficult. NSAID related injury should be considered in patient with intestinal obstruction of unclear etiology. We hereby present an interesting case of a 46(More)
INTRODUCTION The causes of diffuse abdominal pain following pelvic surgery are numerous. We present a rare case of acute abdominal pain in a woman in the post-partum period. CASE PRESENTATION A 25-year-old Caucasian woman with neurofibromatosis type 1 presented to our hospital with diffuse abdominal pain immediately after a cesarean section. The patient(More)
Neuroleptic malignant syndrome (NMS) is a life-threatening condition associated with the use of neuroleptic agents and is characterized by a clinical syndrome of mental status change, muscle rigidity, fever, and autonomic instability.1 We present a case of NMS in a patient on neuroleptic therapy who had the atypical presentation of not having muscle(More)
Campylobacter jejuni is one of the most common causes of bloody diarrhoea in the USA. We report a case of a young woman who presented with a clinical picture reminiscent of acute appendicitis. Ultrasonography and CT of the abdomen performed subsequently revealed evidence of colitis. Quite unexpectedly, she had no symptoms of diarrhoea and the stool Gram(More)
Recurrent pneumonia in adults can be due to various etiologies. Congenital bronchoesophageal fistula may go undiagnosed in adult patients for many years. In cases of delayed recognition there is a long history of intermittent bouts of cough and choking after swallowing liquid, which may eventually present as recurrent pneumonia, lung abscess, or(More)
The clinical manifestations of hyperammonemia are usually easily identifiable to the clinician when associated with liver disease and lead to prompt diagnosis and treatment. However, hyperammonemia-induced encephalopathy is rare in adults in the absence of overt liver disease, thus diagnosis is often delayed or missed leading to potentially life threatening(More)
Pleural effusion that develops in a patient with cirrhosis and portal hypertension, in the absence of cardiopulmonary disease, is termed hepatic hydrothorax. Hepatic hydrothorax very rarely presents in the absence of ascites. Although the exact mechanism is somewhat controversial, pleural effusion occurs when ascitic fluid moves through diaphragmatic(More)