In most of the medical conferences whether National, State or regional, it has been found that most of the speakers do not finish their talk in the allotted time there by causing delays in the program. The causes for this are one too many. This view point tries to analyze the reasons for this overshooting and possible measures to curb this so that the activities run on time.
Placental dysfunction has traditionally been regarded as a pregnancy-specific disorder; however, growing evidence suggests its implications extend well beyond the perinatal period. This systematic review aimed to synthesize current evidence linking preeclampsia and fetal growth restriction to long-term maternal cardiovascular and renal outcomes, and to examine the potential contribution of emerging biomarkers and multiomics approaches to risk assessment. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 principles. A comprehensive search of PubMed/MEDLINE, PubMed Central, Embase, Scopus, Web of Science, and the Cochrane Library identified 42 eligible studies published between 2000 and 2025. Included studies encompassed systematic reviews, meta-analyses, nationwide cohort studies, diagnostic investigations, and molecular profiling research. The evidence consistently demonstrated that placental dysfunction is associated with persistent cardiovascular and renal vulnerability after pregnancy. Women with a history of preeclampsia or fetal growth restriction showed increased risks of hypertension, coronary artery disease, stroke, heart failure, chronic kidney disease, and end-stage kidney disease during long-term follow-up. Mechanistically, abnormal placentation was linked to angiogenic imbalance, endothelial dysfunction, inflammation, and oxidative stress, providing a biological basis for these associations. Emerging multiomics platforms, including transcriptomics, metabolomics, proteomics, and cell-free RNA profiling, further revealed molecular heterogeneity and showed promise for earlier identification of women at increased risk. The findings support a life-course perspective in which placental dysfunction functions as an early indicator of future cardiovascular and renal disease rather than a complication confined to pregnancy. Integration of clinical characteristics with validated biomarker and multiomics data may enhance postpartum risk stratification and support more individualized preventive strategies.
Introduction: Patients with chronic kidney disease (CKD) are most burdened by recurrent hospitalizations. We planned this study to identify the reasons for hospitalization among patients with CKD. Materials and Methods: This was a hospital-based cross-sectional observational study of patients with CKD at any stage, per the KIDGCO criteria, aged >18 years, and admitted for >24 h. Patients with acute kidney injury, those admitted for routine hemodialysis, renal biopsy, or AV fistula creation, and those who died or were discharged within 24 h were excluded. All patients underwent clinical evaluation for any precipitating illness. Complete hemogram, renal parameters, electrolytes, electrocardiogram, chest X-ray, abdominal ultrasound, blood gas analysis, and urinalysis were performed in all patients. Results: We included 227 patients (162 males and 65 females) with a mean age of 55.2 ± 13.9 years. Eighty-five (37.4%) patients were on regular maintenance dialysis, and 117 (51.5%) were in CKD stage V and not on regular dialysis. Urinary tract infections were the most common, affecting 46 (20.2%) patients, followed by respiratory infections 26 (11.4%), skin and soft tissue infections 16 (7.0%), and tropical infections 35 (15.4%). Uremic symptoms were present in 120 (52.8%) patients, fluid overload in 60 (26.4%), accelerated hypertension in 25 (11%), and hyperkalemia in 60 (26.4%). 64.3% of patients had previous hospitalization for CKD-related complications, and 21.1% had a history of multiple (>2) hospital admissions. Conclusion: As uremia and infections are the main reasons for hospitalization in our setting, early diagnosis and treatment of infections in an outdoor setting, proper care of the catheter site, education of the patient and caregivers regarding the need for regular and adequate dialysis, and immunization may reduce the need for hospitalization.
Abstract This case report presents a rare manifestation of systemic lupus erythematosus (SLE) in a female patient in her late 20s. The patient initially presented with bilateral hip pain and was diagnosed with Grade II bilateral avascular necrosis (AVN) of the femoral heads. Concurrent severe autoimmune cytopenias were discovered, including autoimmune hemolytic anemia and immune thrombocytopenia. Laboratory findings revealed positive antinuclear antibody, anti-dsDNA, and other SLE-specific antibodies, along with hypocomplementemia and proteinuria. The patient met both the 2019 European Alliance of Associations for Rheumatology and the American College of Rheumatology and the 2012 Systemic Lupus International Collaborating Clinics classification criteria for SLE. Notably, this presentation occurred without prior corticosteroid use or antiphospholipid syndrome, which are typically associated with AVN in SLE patients. Treatment included high-dose intravenous methylprednisolone, oral prednisone, mycophenolate mofetil, packed red blood cell transfusions, and intravenous immunoglobulin. While cytopenias and proteinuria improved with treatment, the advanced stage of AVN necessitated bilateral total hip arthroplasty. This case highlights the potential for SLE to cause AVN through mechanisms such as vasculitis or hypercoagulable states, independent of steroid use. It also demonstrates the importance of considering SLE in patients presenting with concurrent AVN and severe autoimmune cytopenias, even in the absence of typical risk factors.
Abstract Intravenous immunoglobulin (IVIG) is widely used for the treatment of autoimmune disorders such as Guillain–Barré syndrome (GBS) and is generally considered safe. However, rare but severe complications such as thromboembolic events, including myocardial infarction (MI), have been reported secondary to IVIG therapy. We describe a 16-year-old previously healthy female diagnosed with GBS who developed acute chest pain 1 h after initiation of IVIG infusion. The electrocardiogram revealed ST-segment elevation in the anterior leads, and cardiac biomarkers were markedly elevated. Thrombolysis with Tenecteplase was successful. Coronary angiography showed normal coronary arteries. IVIG was discontinued, and plasmapheresis was initiated for the management of GBS. This case highlights the rare but life-threatening complication of IVIG-induced MI, even in young patients without cardiovascular risk factors.
