Saturday, July 22, 2017
Friday, July 21, 2017
Saturday, March 5, 2016
Rabindra sangeet Piano cover-JAZZ STYLE!!!
Introduction:
The name of this song is "Dariye acho tumi amar" written and composed by Rabindranath Tagore. It's a very famous song and one of my favorite too. I arranged it in piano using circle of fifth chord progression on G Major scale and using some experimental chord substitution. It took a lot of hard work to create this type of sound specially for a beginner like me.
Lyrics and chords of this song:
To watch my more videos subscribe to my youtube channel by clicking here "Pianodreams"
Friday, March 4, 2016
"Deep purple"- Urine of an old lady
Those who have not seen anything like this must be thinking whether it is real or not. I was surprised too when I saw this for the first time. Here is the story..
Once during my PG days while I was taking morning round just like other days, I discovered it. The color of the urine catheter bag was so prominent that it immediately caught my attention. In the corner of our female medicine ward I saw an old lady lying in the bed. Her urinary catheter and the drainage bag both deep purple. At the first instance, I could not believe my eyes. The patient was admitted under some other unit so I did not have any clues about disease she was having. I checked her file and found that she had a history of stroke one month back and now she has been admitted with unexplained drowsiness. She was a known diabetic and hypertensive patient and she was on multiple medications.
I started to recapitulate the conditions that can cause purple-like urinary discoloration. Only one condition known to me that can cause this type of urine discoloration was Porphyria. In day to day practice some common causes of discolored urine are-
- Drugs- Antitubercular drugs, among which rifampicin commonly causes orange colored urine. riboflavin and excessive ingestion of carrots can also cause orange urine. Nitrofurantoin and Metronidazole less commonly causes brown urine.
- Porphyria- urine turns to purple on exposure to light
- Myoglobinuria- chocolate colored urine
- Acute tubular necrosis- can cause "muddy brown urine".
Well, none of the above conditions were fitting properly in the clinical background of our patient. So, before starting evaluating her for some rare possibility, I send her urine sample for routine and culture sensitivity testing which is simple and time saving. Her urine report showed alkaline urine with plenty of pus cells in absence of RBCs and any abnormal pigments. After 48 hours of incubation, growth of Proteus mirabilis was detected with colony count >10^5 c.f.u.
I went through the literature to search for the conditions associated with purple colored urine and found a entity named "Purple urinary bag syndrome" which matched perfectly with our patient.
But what exactly does it mean?
Actually, it's a very rarely seen condition where the urine collection bag and/or catheter color changes to purple (the urine color remains unchanged). It's mostly seen in old aged, chronic debilitated, dementic patients with prolonged or permanent urinary catheterization as they remain very vulnerable of acquiring urinary tract infection. Many gram negative bacteria including E.Coli, Klebsiella, Providentia could cause it but the Proteus mirabilis is the most frequently found organism to cause purple urinary bag syndrome.
What is the pathogenesis?
As such it's a benign condition unless associated with severe underlying urosepsis just like our patient. Treatment is cullture sensitivity guided antibiotics and change of urine catheter & urine collection bag.
Subscribe to:
Posts (Atom)