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Expanded Dengue Syndrome Presenting as Acute Pancreatitis 扩大登革综合征表现为急性胰腺炎
Pub Date : 2021-11-13 DOI: 10.31579/2690-8794/098
Richmond R Gomes
Dengue is a painful, debilitating mosquito-borne disease(female mosquitoes of the Aedes genus, principally Aedes aegypti)caused by any one of four closely related dengue viruses.It is endemic in tropical and subtropical continent. World health organization (WHO) currently estimates there may be 50 -100 million dengue infections worldwide every year with over 2.5 billion people at risk of dengue. Symptomatic dengue virus infection may manifests as undifferentiated fever, classical dengue fever (with or without unusual hemorrhages), and dengue hemorrhagic fever(with or without shock). Expanded dengue syndrome (EDS) was coined by WHO in the year 2012 to describe cases, which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. The atypical manifestations noted in expanded dengue are multisystemic and multifaceted with organ involvement, such as liver, brain, heart, kidney, central/peripheral nervous system, gastrointestinal tract, lympho reticular system. Here we present a case of 35 years old female without any comorbidities who was serologically diagnosed with dengue developed severe upper abdominal pain on 2ndafebrile day and eventually diagnosed as acute pancreatitis both by raised serum lipase and ultrasonographic evidence of swollen pancreas. She was treated conservatively and improved. Thus, all clinicians should keep in mind the possibility of acute pancreatitis as a part of expanded dengue syndrome.
登革热是一种痛苦的、使人衰弱的蚊媒疾病(伊蚊属雌蚊,主要是埃及伊蚊),由四种密切相关的登革热病毒中的任何一种引起。它是热带和亚热带大陆的地方病。世界卫生组织(世卫组织)目前估计,全世界每年可能有5000万至1亿登革热感染,超过25亿人面临登革热风险。有症状的登革病毒感染可表现为未分化热、经典登革热(伴或不伴异常出血)和登革出血热(伴或不伴休克)。扩大登革热综合征(EDS)是世卫组织在2012年创造的,用来描述既不属于登革热休克综合征也不属于登革出血热的病例。扩张性登革热的不典型表现是多系统和多器官累及,如肝、脑、心、肾、中枢/周围神经系统、胃肠道、淋巴网状系统。我们在此报告一例35岁女性,无任何合并症,经血清学诊断为登革热,发热2天出现严重的上腹部疼痛,最终通过血清脂肪酶升高和胰腺肿大的超声证据诊断为急性胰腺炎。她接受了保守治疗,病情有所好转。因此,所有临床医生应牢记急性胰腺炎作为扩展登革热综合征的一部分的可能性。
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引用次数: 0
Elmer, the army officer in Peru© 埃尔默,秘鲁军官©
Pub Date : 2021-09-25 DOI: 10.31579/2690-8794/101
A. Hague
Gangrene is always considered untreatable and can only be stopped by amputation. Often the surgery fails to remove all the infection and more of the limb has to be cut off. This is a report about stopping gangrene with a non-invasive treatment taking only a few minutes and not using any drugs.
坏疽一直被认为是无法治愈的,只能通过截肢来阻止。手术往往不能消除所有感染,不得不切除更多的肢体。这是一个关于停止坏疽与非侵入性治疗只需要几分钟,不使用任何药物的报告。
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引用次数: 0
Safe Midline Diastema Closure in the Presence of Porcelain Veneered Central Incisors 瓷贴面中门牙中线间隙闭合的安全性
Pub Date : 2021-09-25 DOI: 10.31579/2690-8794/097
Parmjit Singh, Antonio Garrett
Midline maxillary diastemas have been known to have a detrimental effect on facial aesthetics. Orthodontics can successfully close a diastema using fixed appliances. Porcelain restorations bonded with fixed appliances may suffer damage. A case is presented where a fixed appliance was used to close a midline maxillary diastema bypassing porcelain veneered central incisors. Palatal attachments were used to optimise tooth movements and the porcelain veneers were left intact.
上颌中线间隙对面部美观有不利的影响。正畸可以使用固定器具成功地关闭隔膜。与固定器具结合的瓷修复体可能会受到损坏。一个案例提出了一个固定的器具被用来关闭中线上颌间隙绕过瓷贴面中门牙。腭附着体用于优化牙齿运动,瓷贴面保持完整。
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引用次数: 0
COPD, Depression and COVID-19 Pandemic: A Harrowing, Demoralizing and Deleterious Triad 慢性阻塞性肺病、抑郁症和COVID-19大流行:一个令人痛苦、令人沮丧和有害的三位一体
Pub Date : 2021-09-25 DOI: 10.31579/2690-8794/095
Iqbal Akhtar Khan, Hamza Iltaf Malik
COPD is a highly incapacitating global public health problem, with pulmonary and extra-pulmonary manifestations and usually associated with significant concomitant chronic diseases. With enhanced understanding, it has extensively been reported as a complex, heterogeneous and dynamic disease affecting patients’ health beyond pulmones. Depression, with prevalence of 322 million people, is a major contributor to the overall global burden of disease. In various epidemiological and clinical studies, its prevalence among patients with COPD varies from 18% to 80%. This deadly duo leads to excessive health care utilization rates and costs including increased rates of exacerbation, sub-optimal adherence to prescribed medications, increased hospital admissions, longer hospital stays and increased hospital readmissions. Moreover, there is increased risk of suicidal ideation, suicidal attempts, and suicidal drug overdose. It is a pity that, in significant cases, the co-morbidity remains under-recognized and under-treated. The impact of prevailing COVID 19 pandemic, on the dual burden of COPD and depression, and possible remedial measures including “The 6 ways to boost one’s well-being-by Mental Heath UK, “The Living with the Times” toolkit--by WHO” and innovative add-ons like Dance Movement Therapy and Musical Engagement Therapy have been discussed.
慢性阻塞性肺病是一个高度致残的全球公共卫生问题,具有肺部和肺外表现,通常伴有严重的慢性疾病。随着了解的加深,它被广泛报道为一种复杂的、异质性的和动态的疾病,影响患者的肺部以外的健康。抑郁症的患病率为3.22亿人,是造成全球总体疾病负担的一个主要因素。在各种流行病学和临床研究中,其在COPD患者中的患病率从18%到80%不等。这一致命的双重因素导致了过高的医疗保健使用率和成本,包括病情加重率上升、对处方药的依从性欠佳、住院人数增加、住院时间延长和再入院人数增加。此外,自杀意念、自杀企图和自杀药物过量的风险也会增加。遗憾的是,在许多病例中,合并症仍未得到充分认识和治疗。讨论了当前的COVID - 19大流行对慢性阻塞性肺病和抑郁症双重负担的影响,以及可能的补救措施,包括“促进健康的六种方法”(英国心理健康中心),“与时俱进”工具包(世卫组织)以及舞蹈动作疗法和音乐参与疗法等创新附加疗法。
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引用次数: 1
Foetal phenotype of Maat-Kievit-Brunner type Ohdo syndrome Maat-Kievit-Brunner型Ohdo综合征的胎儿表型
Pub Date : 2021-09-25 DOI: 10.31579/2690-8794/088
Gupta Ashutosh, Aneja Anjila, B. Neena, Arora Rupam, Sehgal Renu Raina, Saini Pankaj
MED12 is a member of large Mediator complex; has a very crucial and central role in RNA polymerase II transcription; regulating cell signals involved in growth, development and differentiation. Different MED12 mutations may have different clinical presentation representing an allelic disorder. Maat-Kievit-Brunner (MKB) type Ohdo syndrome; has a typical facial features comprising of blepharophimosis, ptosis, long flat philtrum with thin vermilion, micrognathia with microstomia, scrotal hypoplasia with cryptorchidism, joint hypermobility with clinodactyly with overriding toes, A primigravida on antenatal ultrasound was detected to have growth restriction, corpus callosal dysgenesis, syndactyly and suspected ambiguous genitalia. Invasive testing and exome sequencing revealed hg19chrX:MED12:c.2315A>G: (p.Lys772Arg);MED12(NM_005120.3):c.2315A>G: (p.Lys772Arg) leading to provisional diagnosis of X linked Ohdo syndrome with an overlap with FG. Missense mutation was classified to be PM2; PP3 (ACMG) Clinical presentation, phenotype and mutational analysis led to provisional diagnosis of X linked Ohdo syndrome. Maat-Kievit-Brunner type of Ohdo syndrome is a rare condition and this is probably the first case describing foetal phenotype of MKB type of Ohdo syndrome.
MED12是一个大型Mediator复合体的成员;在RNA聚合酶II转录中起着至关重要的中心作用;调节参与生长、发育和分化的细胞信号。不同的MED12突变可能有不同的临床表现,代表一种等位基因疾病。maat - kieit - brunner (MKB)型Ohdo综合征;典型的面部特征包括眼睑下垂,上睑下垂,长而平的中唇薄朱红,小颌伴小口畸形,阴囊发育不全伴隐睾,关节活动过度伴斜指伴上翻趾,产前超声检查发现a初生儿生长受限,胼胝体发育不良,并指畸形,怀疑生殖器不清。侵入性检测和外显子组测序显示hg19chrX:MED12:c。2315 > G: (p.Lys772Arg); MED12基因(NM_005120.3): c。2315A >g: (p.Lys772Arg)导致与FG重叠的X连锁Ohdo综合征的临时诊断。错义突变归为PM2;PP3 (ACMG)临床表现,表型和突变分析导致X连锁Ohdo综合征的临时诊断。Maat-Kievit-Brunner型Ohdo综合征是一种罕见的疾病,这可能是第一例描述MKB型Ohdo综合征胎儿表型的病例。
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引用次数: 0
Infectious Diarrhea, as a Valid Medical and Public, Worldwide Health Problematic 传染性腹泻是一种有效的医学和公共卫生问题
Pub Date : 2021-08-25 DOI: 10.31579/2690-8794/093
D. Monica
Acute diarrhea of infec­tious etiology, referred to gastroenteri­tis and is associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency disorders [10]. Diarrheal illness is a problem worldwide, with substantial regional variation in the prevalence of specific pathogens [8]. In fact, Infectious diarrheal diseases, are the second leading cause of morbidity and mortality worldwide and can cause real public health problems. Such diarrhea was studied as a medical disorder, in a 3 year period, 2017-2020, in Transylvania region from Romania. It was found 3577 number of cases, almost during July to August. The case incidence for the disease arrived at 65%, in the entire summer season. The data were transmitted by 12 district Sanitary Polices, to the Public Health Center. This all were mostly diagnosed by the territorial family doctors and more than 50% , have need some days of hospitalization, because of several disease disorders. For this disorders it was used a specific adequate fluid and electrolyte replacement as key of the treatment, to managing diarrheal illnesses. Even so, 3 children under 5 year’s age died, because of severe complications. Organic failed was estimate to be the cause of their deaths. Clinical and epidemiological evaluation defined the severity and type of this illnesses. The detected infectious etiology for the acute diarrhea, where determined in authorized Microbiology laboratories, and there were identified: Shigella spp, Salmonella spp, Campylobacter spp, Yersinia spp, Rotavirus, Giardia. Most number of cases appeared in children in 63%, followed by elderly or adult people in 17% each, all data as quantified number of determined infectious diarrheas. Acute diarrheal illness had to be considered a major public health issue, against which control efforts are needed. Public health surveillance of infectious acute diarrhea, includes obligatory strategies of infection control. Good hygiene, hand washing, safe food preparation, and access to clean water are key factors in preventing diarrheal illness
感染性急性腹泻,指肠胃炎,其临床体征和症状包括:恶心、呕吐、腹痛和痉挛、腹胀、胀气、发热、便血、下坠和大便急症[10]。腹泻病是世界范围内的一个问题,在特定病原体的流行率方面存在很大的区域差异。事实上,传染性腹泻病是全球发病率和死亡率的第二大原因,并可能造成真正的公共卫生问题。在罗马尼亚特兰西瓦尼亚地区,将这种腹泻作为一种医学疾病进行了为期3年(2017-2020)的研究。发现3577例,几乎在7月至8月期间。在整个夏季,该病的病例发病率达到65%。这些数据由12个区卫生警察转交给公共卫生中心。这些病例大多是由领土家庭医生诊断的,其中50%以上的患者由于多种疾病需要住院几天。对于这种疾病,它使用了一种特定的充足的液体和电解质替代作为治疗的关键,以控制腹泻疾病。即便如此,仍有3名5岁以下的儿童死于严重的并发症。据估计,他们的死因是有机中毒。临床和流行病学评估确定了这种疾病的严重程度和类型。经授权的微生物学实验室确定的急性腹泻检测到的感染病原有:志贺氏菌、沙门氏菌、弯曲杆菌、耶尔森氏菌、轮状病毒、贾第鞭毛虫。大多数病例出现在儿童中,占63%,其次是老年人或成年人,各占17%,所有数据均为确定的感染性腹泻的量化数量。急性腹泻病必须被视为一个重大的公共卫生问题,需要采取控制措施。传染性急性腹泻的公共卫生监测,包括强制性感染控制策略。良好的卫生、洗手、安全的食物制备和获得清洁水是预防腹泻疾病的关键因素
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引用次数: 0
Observation of Youth in Sociological Context 社会学语境下的青年观察
Pub Date : 2021-08-25 DOI: 10.31579/2690-8794/091
Mohammad Taghi Sheykhi
Sociology as a science of society evaluates the youth from different perspectives. Youth as one-fifth of population in most societies are facing new needs and services. In more developed world, they are almost fulfilled because of the availability of infrastructures, whereas in many developing societies because of such a vacuum, many youth are deprived of their required services and essentials of today's life. However, achievement of modernity has to a large extent provided the youth with new opportunities in many countries. Such a transition has led the youth to growing awareness. When the conditions are favorable, young people will be able to use their ability and capacity much better, or in other words, they will perform their functions/ duties satisfactorily. In such a situation, the society as a whole moves in a positive way. Many have not yet been able to provide their youth to access to education to be used in future creativity and development. Improving the quality of basic education has been highly emphasized by scholars. In many developing countries, many of those who drop out of school in early stages become child-labor; a phenomenon affecting their entire life in a negative manner. Developing societies have a wide need for different skills in various fields, which must be provided by the youth in any society.
社会学作为一门社会科学,从不同的角度对青年进行评价。青年占大多数社会人口的五分之一,正面临新的需求和服务。在较发达的世界,由于有基础设施,这些要求几乎得到满足,而在许多发展中社会,由于这种真空,许多青年被剥夺了所需的服务和当今生活的必需品。然而,现代化的成就在很大程度上为许多国家的年轻人提供了新的机会。这样的转变使年轻人越来越意识到这一点。当条件有利时,年轻人将能够更好地使用他们的能力和能力,换句话说,他们将令人满意地履行他们的职能/职责。在这种情况下,整个社会会朝着积极的方向发展。许多国家尚未能够为其青年提供接受教育的机会,以用于未来的创造力和发展。提高基础教育质量一直受到学者们的高度重视。在许多发展中国家,许多早期辍学的人成为童工;一种以消极方式影响他们整个生活的现象。发展中社会对各个领域的不同技能有广泛的需求,任何社会的年轻人都必须提供这些技能。
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引用次数: 0
Turmeric and Fenugreek - Herbal Agents to Alleviate Sickle Cell Disease 姜黄和胡芦巴-缓解镰状细胞病的草药
Pub Date : 2021-08-25 DOI: 10.31579/2690-8794/082
M. Yunus, Rawda Aljadar, A. Zaher
Introduction: Sickle cell disease (SCD) is a genetic disorder with autosomal recessive inheritance causing abnormal hemoglobin. It is an important medical problem globally as well as in our community at Eastern province of Saudi Arabia. It accounts for large numbers of morbidity and to a lesser extent mortality. Several natural plant products over the world, which were known in some communities and their traditional healers, were studied and found to have properties in improving SCD manifestation. This research was planned to explore if any plant product under our study could prove being an effective anti-sickling agent for therapeutic use in SCD management. Objectives: Studying the effects of some plants on sickled RBCs as well as comparing between efficacies of these different plants. Material and Methods: The 49 fresh whole blood samples, extracted through venipuncture in EDTA tubes, were collected from known SCD patients whose homozygosity were confirmed by hemoglobin electrophoresis. These patients were not on recent blood transfusion or hydroxyurea, and aged 14 years or above of both sexes on clinical follow up. The dried rhizomes of turmeric (curcuma longa) powder and dried seeds flour of fenugreek (trigonella foenum-graecum) were used to evaluate the reversal type of anti-sickling activity on RBCs. Results: Out of 49 blood samples, 28 (57.1%) samples were from males and 21 (42.9%) samples from females. The average (±SD) age of the cases was 28.2 (±9.97) years with range 14 – 60 years. Significant anti-sickling activity was found using Turmeric rhizomes extract treatment with 66.81% reversal effect, and 61.28% anti-sickling action when fenugreek seeds extract was used. Conclusion: The findings of this study suggest that turmeric (C. longa) rhizome extract and fenugreek seed extract could have promising anti-sickling properties for SCD treatment.
镰状细胞病(SCD)是一种常染色体隐性遗传导致血红蛋白异常的遗传病。这是全球以及我们在沙特阿拉伯东部省的社区的一个重要医疗问题。它造成了大量的发病率和较小程度的死亡率。对世界上一些社区及其传统治疗师所知的几种天然植物产品进行了研究,发现它们具有改善SCD表现的特性。本研究计划探索在我们的研究中是否有任何植物产品可以证明是有效的抗镰状细胞病治疗用药。目的:研究几种植物对镰状红细胞的作用,并比较不同植物对镰状红细胞的作用。材料与方法:采集已知SCD患者经EDTA管静脉穿刺提取的新鲜全血49份,经血红蛋白电泳证实其纯合性。这些患者近期未接受输血或羟脲治疗,临床随访年龄均在14岁及以上。以姜黄根茎干粉和葫芦巴籽粉为对照,研究了其抗镰状红细胞的逆转型活性。结果:49份血样中,男性28份(57.1%),女性21份(42.9%)。患者平均(±SD)年龄为28.2(±9.97)岁,年龄范围为14 ~ 60岁。姜黄根茎提取物处理的抗镰刀病效果显著,逆转效果为66.81%,胡芦巴种子提取物处理的抗镰刀病效果为61.28%。结论:本研究结果提示姜黄根茎提取物和胡芦巴籽提取物具有良好的抗镰状病治疗作用。
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引用次数: 0
A Rare Case of Pulmonary Arteriovenous Malformation - A Diagnostic Dilemma 一例罕见的肺动静脉畸形-诊断困境
Pub Date : 2021-08-25 DOI: 10.31579/2690-8794/087
U. Desai, Neenu N, K. Utpat, Ammar Modi, Kishor L. Rajpal, D. Shetty, R. Bharmal
Pulmonary arteriovenous malformations (PAVM) are rare anomalies of pulmonary vascular system which may be incidentally detected or can have manifestations resulting from right to left shunt. PAVM can cause various systemic implications including central nervous system complications like stroke, brain abscess due to paradoxical emboli which mostly seen in previously undiagnosed PAVMs indicating importance of early diagnosis and timely intervention in PAVM. Computed Tomography Pulmonary Angiography (CTPA) is the diagnostic method of choice in PAVM. We present here a unique case of complex multiple PAVM presented with refractory hypoxemia in a middle aged patient diagnosed in our centre initially evaluated for malignancy based on chest radiography & High Resolution Computed tomography(HRCT)thorax findings and symptoms, later on after CTPA was diagnosed to have complex PAVM which showed clinicoradiological improvement following pulmonary vascular plugging. This case shows clinical scenario, diagnostic & management methods and differential diagnosis to be discussed in similar clinicoradiological pattern and peculiarity of PAVM despite advanced age.
肺动静脉畸形(Pulmonary arteriovenous malformations, PAVM)是一种罕见的肺血管系统异常,可能是偶然发现的,也可能是由右至左分流引起的。PAVM可引起各种系统性影响,包括中枢神经系统并发症,如中风,由矛盾栓子引起的脑脓肿,这主要见于先前未诊断的PAVM,这表明早期诊断和及时干预PAVM的重要性。计算机断层肺血管造影(CTPA)是诊断PAVM的首选方法。我们在此报告一个独特的复杂多发性PAVM病例,其表现为难治性低氧血症,这是一位在我们中心诊断的中年患者,最初根据胸片和高分辨率计算机断层扫描(HRCT)的胸部表现和症状评估为恶性肿瘤,后来在CTPA被诊断为复杂的PAVM后,在肺血管堵塞后显示临床放射学改善。本病例的临床表现、诊断和治疗方法及鉴别诊断值得讨论,并与相似的临床放射学模式及高龄PAVM的特殊性相比较。
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引用次数: 0
Mammographic Breast Densities among 200 Nigerian Females in Sokoto, North Western Nigeria 尼日利亚西北部索科托200名尼日利亚女性乳房x线摄影乳房密度
Pub Date : 2021-08-25 DOI: 10.31579/2690-8794/090
Suleiman Baba, Shamaki Amina Muhammad, SA’IDU Sule Ahmed, Sadisu Mohammed Ma’aji, Yunusa Garba Haruna, Gele Ibrahim Haruna, Shirama Yakubu Bababa
Background: Breast density has been reported to be an independent predictor of breast cancer risk. Women with highest mammographic breast density may have four to six fold increased risk of developing cancer. Aim and Objective: This study is aimed at evaluating the various forms of breast densities following screening and diagnostic mammographic examination. Materials and Methods: From December 2010 and November 2012, 200 females had mammographic breast examination. Seventy-seven (77) females had routine screening mammography while 123 had diagnostic mammographic examination in the department with the General Electric (GE) Alpha-RT machine with model number MGF-101(manufactured 2010). All the subjects had to fill a mammographic form consisting of variables like age, sex, occupation, family history of breast cancer, tribe, contraception, parity, and caffeine consumption, history of surgical intervention (lumpectomy, biopsy and/or mastectomy), previous mammography and last child birth. MLO and CC views were done for the breast examination though additional views were occasionally employed. Results: Breast density decreases with increase in age of the female subjects and breast lesions are better detected following mammography on fatty or less dense breast.
背景:据报道,乳腺密度是乳腺癌风险的独立预测因子。乳房x光检查中乳房密度最高的女性患癌症的风险可能增加4到6倍。目的和目的:本研究旨在评估筛查和诊断性乳房x线摄影检查后各种形式的乳腺密度。材料与方法:2010年12月至2012年11月,对200名女性进行乳房x光检查。77名女性在该科使用通用电气(GE) Alpha-RT机器(型号为MGF-101(2010年生产))进行了常规筛查性乳房x光检查,123名女性进行了诊断性乳房x光检查。所有的受试者都必须填写一份乳房x光检查表,包括年龄、性别、职业、乳腺癌家族史、部落、避孕、胎次、咖啡因摄入、手术干预史(乳房肿瘤切除术、活检和/或乳房切除术)、以前的乳房x光检查和最后一次分娩。乳房检查采用MLO和CC视图,偶尔也采用其他视图。结果:女性受试者的乳腺密度随年龄的增加而降低,在脂肪或密度较低的乳房上,乳房x光检查能更好地发现乳腺病变。
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引用次数: 0
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Clinical Medical Reviews and Reports
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