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2016 ; 5
(2
): 453-456
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Rhabdomyolysis in Dak-Bum devotees: A case series
#MMPMID27843860
Singh S
; Hans P
J Family Med Prim Care
2016[Apr]; 5
(2
): 453-456
PMID27843860
show ga
INTRODUCTION: India is a land of culture and heritage always known for its
rituals. The devotees offer their prayers in the form of fasting, sacrifices and
many other difficult ways to please Almighty! While doing so they often endanger
their lives. Rhabdomyolysis, in a particular group of devotees of Bihar/Jharkhand
known as Dak-Bum, is a life-threatening clinical entity which occurs in these
devotees who travel a long distance in a short period in a fasting state.
Rhabdomyolysis detected by myoglobinuria can lead to acute kidney injury and
mortality. AIM: To study and identify cases of rhabdomyolysis in devotees
(Dak-Bum) and the role of early diagnosis and management. MATERIALS AND METHODS:
The study was conducted at Ruban Emergency Hospital Patna from August 2010 to
August 2013 over 27 patients - 26 males and 1 female of age group 22-34 years.
They presented with major symptoms such as dehydration, tender swollen calf
muscles and myoglobinuria. The patients were admitted over a period of 2-3 weeks
time in a single year (nine patients in 2010, five patients in 2011 and seven
patients in 2012 and six patients in 2013). The study was restricted to the month
of August every year, as this ritual occurs in a particular season. Inclusion
criteria were all previously healthy devotees. The study period was from
admission till discharge with daily follow-up of each patient. RESULTS:
Rhabdomyolysis developed in 27 Dak-Bum devotees and all had acute renal failure
at the time of admission. RIFLE criteria-Stage F (failure) and acute kidney
injury network criteria (3(rd) stage). However, recovery was good due to early
intervention in the form of haemodialysis and forced alkaline diuresis by soda
bicarbonate infusion. CONCLUSION: Rhabdomyolysis developing in Dak-Bum devotees
because of travelling a long distance in a short period, could be managed well
due of early diagnosis, timely referral, haemodialysis and forced alkaline
diuresis.
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