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A 24-year-old female presented with status epilepticus following ingestion of a pyrethroid insecticide Deltamethrin. The pathophysiology, clinical features, and management of pyrethroid poisoning are discussed in this article.

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Hepatitis G virus (HGV) is a newly described virus that has been implicated in transfusion-associated hepatitis. HGV-RNA indicating current infection has frequently been isolated from the sera of multi-transfused patients (MTPs) and that of intravenous drug abusers (IVDAs). There is insufficient data on its prevalence among these high-risk groups in India. Hence this study was designed to evaluate the prevalence of HGV infection in MTPs and IVDAs. A total of 90 (57 males and 33 females) MTPs and 65 (44 males and 21 females) IVDAs were recruited in the study. Patients' sera were tested for liver function profile, HGV-RNA, anti-HCV, HCV-RNA, HBsAg, and HBV-DNA. HGV-RNA was detected in 17.7% (16/90) MTPs and 23% (15/65) IVDAs, and 93.5% of our HGV-positive patients were found to be co-infected with either HBV (38.7%) or HCV (74.1%). The sero-prevalence of HBV was found out to be 40% and 21.5%, respectively, in the two groups, that of HCV was 32.2% and 32.3%, respectively, and dual infection was observed in 15.5% and 10.7% of the subjects, respectively. There were no statistically significant differences between the clinical, biochemical, and serological profiles of HGV-positive and negative patients. The prevalence of HGV infection in these high-risk groups is significantly higher than in controls. HGV is found to be co-infected more frequently with HCV than with HBV.

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Cystic lesions of the pancreas are usually pseudocysts (90%); only 10% of them are cystic tumors. These cystic tumors constitute less than 10% of all pancreatic neoplasms, making them an extremely uncommon type of pancreatic malignancy. What is more important is that these tumors are very easily misdiagnosed as pseudocysts because their characteristics are very similar to those of the benign pseudocysts. This gains importance as the cystic tumors have a high cure rate and good prognosis if diagnosed and treated on time. Of all the cystic tumors, the most common are the benign serous cystadenomas, mucinous cystic tumors, intraductal papillary mucinous neoplasms etc. Ductal adenocarcinoma of pancreas presenting in cystic form is an uncommon type of cystic tumor, making it extremely rare among all pancreatic malignancies (solid or cystic). We present the following case report. The review of literature concerning the diagnosis and management has also been discussed.

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This study was designed to evaluate the seroprevalence of hepatitis G virus (HGV) infection, its impact, and its relationship with other hepatotropic viruses among chronic renal failure patients undergoing hemodialysis at the Lok Nayak Hospital, New Delhi. The study group consisted of 100 consecutive cases of patients with chronic renal failure undergoing hemodialysis and equal healthy controls matched for age and sex. The patients were included on the basis of detailed history, clinical examination, and liver function profile. HGV RNA was detected in serum samples of all patients as well as of healthy controls using nested reverse transcription polymerase chain reaction (RT-PCR). The primers used were derived from the NS3 helicase region of the viral genome. Serological assay was used for screening the viral markers for hepatitis B and C (HbsAg and Anti HCV). A history of blood transfusion was recorded in 65% of the cases. HGV RNA was detected in only six out of 100 (6%) cases of chronic renal failure. The seroprevalence of HCV infection was detected in 27 (27%), while HBV infection was seen in 10 (10%) out of 100 cases. The mixed infection of HGV and HCV was seen in 33.3% (two out of six) of the chronic renal failure cases, while the coinfection between HGV and HBV was not observed. In the 100 cases of healthy controls, HGV RNA was detected in only three (3%) subjects. Serological markers for Anti HCV antibody and HbsAg were positive in only one (1%) and two (2%) of the subjects, respectively. The seroprevalence of HGV infection in chronic renal failure was found to be statistically nonsignificant when compared to that of healthy controls. Also, there was no difference in clinical course and liver function profile of HGV-positive and HGV-negative cases. However, alanine aminotransferase (ALT) was significantly out of range in HCV-positive patients compared with HCV-negative patients. The presence of HGV infection reflected a postparental exposure to blood and blood-contaminated products in hemodialysis patients. It is suggested that HGV infection in cases of chronic renal failure is unlikely to influence the course of the disease and may be considered an innocent bystander.

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An Indian male patient with acute quadriplegia with hypokalemia as a rare initial presentation of thyrotoxicosis is presented in this case report.