Department of General Medicine

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    Pleural amyloidosis: timely unmasking of apple- green birefringence in pleural biopsy
    (BMJ, 2026-01-17) Khanduri, Rakhee; Vashishtt, Meghaa; Baveja, Avriti; Pundir, Sammi; Singh, Monika
    8%–25% of cases of pleural effusion remain undiagnosed after routine workup. Some of the causes for pleural effusion are less often considered as a differential diagnosis owing to their rarity. While not all require a pleural biopsy, it remains a valuable tool for the definitive diagnosis of uncommon pleural effusions and guides treatment decisions. This case exemplifies the value of timely intervention in uncovering an unconventional form of pleural amyloidosis. An elderly male presenting with right- sided pleural effusion. The patient underwent timely medical thoracoscopy and was subsequently diagnosed with AL amyloidosis. Following therapy, the patient demonstrated marked clinical improvement, with radiographic resolution of the effusion and a favourable haematologic response.
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    Utility of peripheral blood oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio and arterial partial oxygen pressure (PaO2)/FiO2 ratio in the diagnosis of acute respiratory distress syndrome: A comparative study
    (SAGE Publications, 2025-07) Srishti Rathi; Rajesh Kakkar; Shubhanshu Chawla; Sushant Khanduri; Rajeev Mohan Kaushik; Reshma Kaushik
    Our study determined the reliability of using the ratio of peripheral blood oxygen saturation (SpO2) and the fraction of inspired oxygen (FiO2) rather than the ratio of arterial partial oxygen pressure (PaO2) and FiO2 for diagnosing acute respiratory distress syndrome (ARDS). Pulse oximetry and arterial blood gas analysis were performed to obtain both ratios, respectively, in 70 patients who fulfilled the Berlin definition criteria of ARDS. A detailed history, clinical examination, and relevant evaluation were done. There was a significant correlation between the two ratios. The former had a lower sensitivity and specificity than the latter. Thus, the SpO2/FiO2 ratio is a reliable, straightforward, non-invasive, and readily available marker for diagnosing the presence and severity of ARDS, and may be used as an alternative to the PaO2/FiO2 ratio in resource-limited settings.