Pub Date : 1900-01-01DOI: 10.53902/sojcem.2022.02.000515
Bi Zhen Kao
Background: Variceal bleeding (VB) is the most serious complication of liver cirrhosis and carries a high mortality rate. Methods: The retrospective analysis on 263 cirrhotic patients with variceal bleeding in Taipei Medical University Shuang Ho hospital from 2012 to 2018. Aim: determine determinants of re-bleeding and mortality. Results: Patients’ characters were median age (56 years), male (73.4%), HCC (28.1%), ascites (53.2%), portal vein thrombosis (PVT, 6.4%), mean MELD score (17.5); mean Child-Tourette-Pugh score (CTP=8.2) and active bleeding at endoscopy (44.8%). Variceal re-bleeding occurred 4.1% at day-five, 11.0% at week-six and 28.1% at year-one. CTP score>7, MELD score>16, bilirubin>30mg/dL, hepatic encephalopathy and HCC predicted early and late re-bleeding. Old age, renal injury, active bleeding, albumin<2.8 g/dL, ascites, bacterial infection and PVT determined early re-bleeding. The mortality after first VB was 3.8%, 14.1% and 25.8% at day-5, week-6 and year-1 respectively. Old age, CTP>7, MELD>16, renal injury, ascites, hepatic encephalopathy, bacterial infection and HCC were determined early and late mortality. Early variceal re-bleeding was associated with early mortality. Use of non-selective beta-blocker or variceal ligation reduced mortality at year-1 (Odds Ratio; OR 0.03 and OR 0.3) and combination therapy reduced early re-bleeding (OR 7.5). Conclusion: Re-bleeding and mortality rate after VB were substantially high in hepatic decompensation, renal injury, presence of HCC, PVT and infection. Early identification of variceal bleeding patients who are at substantially high risk would probably benefit from early trans-jugular intrahepatic portosystemic shunt or liver transplantation.
{"title":"Determinants of Re Bleeding and Mortality in Cirrhotic Patients after Variceal Bleeding","authors":"Bi Zhen Kao","doi":"10.53902/sojcem.2022.02.000515","DOIUrl":"https://doi.org/10.53902/sojcem.2022.02.000515","url":null,"abstract":"Background: Variceal bleeding (VB) is the most serious complication of liver cirrhosis and carries a high mortality rate. Methods: The retrospective analysis on 263 cirrhotic patients with variceal bleeding in Taipei Medical University Shuang Ho hospital from 2012 to 2018. Aim: determine determinants of re-bleeding and mortality. Results: Patients’ characters were median age (56 years), male (73.4%), HCC (28.1%), ascites (53.2%), portal vein thrombosis (PVT, 6.4%), mean MELD score (17.5); mean Child-Tourette-Pugh score (CTP=8.2) and active bleeding at endoscopy (44.8%). Variceal re-bleeding occurred 4.1% at day-five, 11.0% at week-six and 28.1% at year-one. CTP score>7, MELD score>16, bilirubin>30mg/dL, hepatic encephalopathy and HCC predicted early and late re-bleeding. Old age, renal injury, active bleeding, albumin<2.8 g/dL, ascites, bacterial infection and PVT determined early re-bleeding. The mortality after first VB was 3.8%, 14.1% and 25.8% at day-5, week-6 and year-1 respectively. Old age, CTP>7, MELD>16, renal injury, ascites, hepatic encephalopathy, bacterial infection and HCC were determined early and late mortality. Early variceal re-bleeding was associated with early mortality. Use of non-selective beta-blocker or variceal ligation reduced mortality at year-1 (Odds Ratio; OR 0.03 and OR 0.3) and combination therapy reduced early re-bleeding (OR 7.5). Conclusion: Re-bleeding and mortality rate after VB were substantially high in hepatic decompensation, renal injury, presence of HCC, PVT and infection. Early identification of variceal bleeding patients who are at substantially high risk would probably benefit from early trans-jugular intrahepatic portosystemic shunt or liver transplantation.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132638222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2022.02.000514
Chung-Min Tsai
Parkinson’s disease (PD) is a neurodegenerative disease with global burden. The mechanisms and therapeutic effects of photobiomodulation (PBM) correspond to main mechanisms in the pathogenesis of PD. Numerous research results applying PBM for PD were published during the past two decades. Although several systematic review or review articles provided complete introduction, they are either mainly basic research or clinical research, and the year of the article publication is up to 2020. Comprehensive systematic review or review articles containing basic and clinical studies including those published articles is lacking. Hence, this systematic review aimed to include both basic and clinical studies published up to 2022. Results were obtained by retrieving articles from PubMed with the intersection of the articles derived from the terms of PBM synonyms and Parkinson’s disease followed by exclusion. Sixty-nine articles were included ultimately. Among them, 40 original articles were identified, which were composed of 31 basic research and 9 original articles of clinical research. Twenty-one review articles, a systematic review with focused content on PD, and 7 review articles with the term PD under general illustration of PBM were presented. Mechanisms regarding the therapeutic effects of PBM on the vitro studies were reviewed. Positive outcomes on motor symptoms after PBM treatments were shown in most in vivo and clinical studies. The immunohistochemical examination of in vivo studies reflect the therapeutic effects of PBM on the preservation even reverse of the pathogenic insults of PD on the in vitro studies. The most frequently used wavelength among original articles included was 670nm. Considering the acceptability of PBM for patients with PD, noninvasive transcranial PBM (tPBM) had crucial roles in respect to invasive intracerebral PBM. To match the penetration depth reaching deep brain target, Substantia nigra pars compacta, in human brains of patients with PD, the wavelength 810nm might match the need in the clinical setting of tPBM. More future clinical studies were needed. In conclusion, therapeutic approaches applying PBM for PD are promising. Recent studies revealed positive outcomes. Future clinical practices containing PBM are to be expected.
{"title":"Progress of Photobiomodulation for Parkinson’s Disease","authors":"Chung-Min Tsai","doi":"10.53902/sojcem.2022.02.000514","DOIUrl":"https://doi.org/10.53902/sojcem.2022.02.000514","url":null,"abstract":"Parkinson’s disease (PD) is a neurodegenerative disease with global burden. The mechanisms and therapeutic effects of photobiomodulation (PBM) correspond to main mechanisms in the pathogenesis of PD. Numerous research results applying PBM for PD were published during the past two decades. Although several systematic review or review articles provided complete introduction, they are either mainly basic research or clinical research, and the year of the article publication is up to 2020. Comprehensive systematic review or review articles containing basic and clinical studies including those published articles is lacking. Hence, this systematic review aimed to include both basic and clinical studies published up to 2022. Results were obtained by retrieving articles from PubMed with the intersection of the articles derived from the terms of PBM synonyms and Parkinson’s disease followed by exclusion. Sixty-nine articles were included ultimately. Among them, 40 original articles were identified, which were composed of 31 basic research and 9 original articles of clinical research. Twenty-one review articles, a systematic review with focused content on PD, and 7 review articles with the term PD under general illustration of PBM were presented. Mechanisms regarding the therapeutic effects of PBM on the vitro studies were reviewed. Positive outcomes on motor symptoms after PBM treatments were shown in most in vivo and clinical studies. The immunohistochemical examination of in vivo studies reflect the therapeutic effects of PBM on the preservation even reverse of the pathogenic insults of PD on the in vitro studies. The most frequently used wavelength among original articles included was 670nm. Considering the acceptability of PBM for patients with PD, noninvasive transcranial PBM (tPBM) had crucial roles in respect to invasive intracerebral PBM. To match the penetration depth reaching deep brain target, Substantia nigra pars compacta, in human brains of patients with PD, the wavelength 810nm might match the need in the clinical setting of tPBM. More future clinical studies were needed. In conclusion, therapeutic approaches applying PBM for PD are promising. Recent studies revealed positive outcomes. Future clinical practices containing PBM are to be expected.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129391944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2021.01.000502
C. A. Muniz Caldas
Background: Scientific evidence regarding the best dose of corticosteroids for the treatment for Chikungunya virus (CHIKV) infection in the subacute phase to relieve symptoms is lacking. Objectives: This study aimed to evaluate the effect of corticosteroid therapy on the treatment of subacute Chikungunya. Methods: This prospective cohort study involved patients with subacute CHIKV treated at the Tropical Medicine Center of Pará Federal University, Brazil. The data were collected between January 2019 and January 2020 during the following two periods: the initial consultation of patients and the return visit. A physical examination, in which the occurrence of inflammatory signs was checked and the number of painful and swollen joints was evaluated, was performed by a rheumatologist. Results: Data from 65 subjects were analysed with a predominance of females (80%), a mean age of 53.5±13.5 years and a disease duration of 50.0±20.8 days. In this study, 75.4% of the patients used corticosteroids, 73.8% of whom progressed to chronic disease and 26.2% of whom were cured. Although the re-evaluation consultation showed evident improvement in the initial symptoms, the use of a cumulative dose of corticosteroids above 350 mg of prednisone did not affect the outcomes compared to doses less than or equal to 350mg of prednisone. Conclusion: In conclusion, for patients infected with CHIKV in the subacute phase, doses of prednisone above 350 mg do not affect the outcome, and the preference for the use of corticosteroids at the lowest dose for the shortest possible time should be reinforced.
{"title":"Lack of Additional Benefit with High Doses of Corticosteroids Among Patients with Chikungunya Viral Infection in the Subacute Phase","authors":"C. A. Muniz Caldas","doi":"10.53902/sojcem.2021.01.000502","DOIUrl":"https://doi.org/10.53902/sojcem.2021.01.000502","url":null,"abstract":"Background: Scientific evidence regarding the best dose of corticosteroids for the treatment for Chikungunya virus (CHIKV) infection in the subacute phase to relieve symptoms is lacking. Objectives: This study aimed to evaluate the effect of corticosteroid therapy on the treatment of subacute Chikungunya. Methods: This prospective cohort study involved patients with subacute CHIKV treated at the Tropical Medicine Center of Pará Federal University, Brazil. The data were collected between January 2019 and January 2020 during the following two periods: the initial consultation of patients and the return visit. A physical examination, in which the occurrence of inflammatory signs was checked and the number of painful and swollen joints was evaluated, was performed by a rheumatologist. Results: Data from 65 subjects were analysed with a predominance of females (80%), a mean age of 53.5±13.5 years and a disease duration of 50.0±20.8 days. In this study, 75.4% of the patients used corticosteroids, 73.8% of whom progressed to chronic disease and 26.2% of whom were cured. Although the re-evaluation consultation showed evident improvement in the initial symptoms, the use of a cumulative dose of corticosteroids above 350 mg of prednisone did not affect the outcomes compared to doses less than or equal to 350mg of prednisone. Conclusion: In conclusion, for patients infected with CHIKV in the subacute phase, doses of prednisone above 350 mg do not affect the outcome, and the preference for the use of corticosteroids at the lowest dose for the shortest possible time should be reinforced.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133533718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2022.02.000511
O. Tulp
Brown adipose tissue (BAT) plays a significant role in the expression of non-shivering thermogenesis in response to perturbations in diet and environment in man and animals. The SHR/N-cp rat is an animal model of obesity and T2DM and has been reported to exhibit an impaired thermogenic response to parameters of diet and environment. Groups of lean and obese male SHR/N-cp rats were maintained in hanging wire-bottomed steel cages and fed a nutritionally complete diet containing 54% CHO, 22% protein,16.5% mixed fats, and 4.5% essential fiber, plus vitamins, minerals, and essential micronutrients from 1 to 9 months of age. Measures of body weight were monitored and 24-hour urinary vanil mandelic acid (VMA) were determined at the end of the study. Animals were sacrificed by decapitation and the Interscapular BAT depots excised in their entirety for measures of adipocyte size, number, and lipid content. Bode weights, net weight gain and relative adiposity of Obese was significantly greater than their lean littermates throughout the study. Urinary VMA of lean > obese rats. The IBAT weight and IBAT weight: Body weight of obese >> lean. IBAT cell number, cell lipid content and % lipid of IBAT tissues of obese >> lean rats. The results of this study indicate that while the development of IBAT mass and cellularity becomes exaggerated in the obese-diabetic animals, the superimposition of the T2DM stigmata including likely insulin resistance may further compromise the capacity of the obese diabetic animals to fully express BAT-mediated contributions to nonshivering thermogenesis .
{"title":"A Review of Brown Adipose Tissue Development in T2DM-SHR/N-cp (Corpulent) Rats","authors":"O. Tulp","doi":"10.53902/sojcem.2022.02.000511","DOIUrl":"https://doi.org/10.53902/sojcem.2022.02.000511","url":null,"abstract":"Brown adipose tissue (BAT) plays a significant role in the expression of non-shivering thermogenesis in response to perturbations in diet and environment in man and animals. The SHR/N-cp rat is an animal model of obesity and T2DM and has been reported to exhibit an impaired thermogenic response to parameters of diet and environment. Groups of lean and obese male SHR/N-cp rats were maintained in hanging wire-bottomed steel cages and fed a nutritionally complete diet containing 54% CHO, 22% protein,16.5% mixed fats, and 4.5% essential fiber, plus vitamins, minerals, and essential micronutrients from 1 to 9 months of age. Measures of body weight were monitored and 24-hour urinary vanil mandelic acid (VMA) were determined at the end of the study. Animals were sacrificed by decapitation and the Interscapular BAT depots excised in their entirety for measures of adipocyte size, number, and lipid content. Bode weights, net weight gain and relative adiposity of Obese was significantly greater than their lean littermates throughout the study. Urinary VMA of lean > obese rats. The IBAT weight and IBAT weight: Body weight of obese >> lean. IBAT cell number, cell lipid content and % lipid of IBAT tissues of obese >> lean rats. The results of this study indicate that while the development of IBAT mass and cellularity becomes exaggerated in the obese-diabetic animals, the superimposition of the T2DM stigmata including likely insulin resistance may further compromise the capacity of the obese diabetic animals to fully express BAT-mediated contributions to nonshivering thermogenesis .","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129115712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2021.01.000505
Karen Itzel González Mártinez
We report the clinical case of a 76- year-old patient who was admitted to the emergency department due to respiratory distress. He had a history of Systemic arterial hypertension, type 2 diabetes mellitus and hypothyroidism. The patient reports symptoms that began three days prior to admission, including dyspnea, fever, myalgia, arthralgia, headache and respiratory distress that was exacerbated 1 day prior to admission. Physical examination revealed a conscious patient with the following vital signs: blood pressure 120/62mmHg, heart rate 109bpm, respiratory rate 28rpm, temperature 38.8°C, arterial oxygen saturation 76%, dyspnea, use of accessory muscles, tachycardia, tachypnea, which met the operational definition for Covid-19. Upon admission to the service, a pulmonary ultrasound was performed in which subpleural consolidations were identified, predominantly in the right hemithorax, as well as an air bronchogram and little pleural effusion. Based on these observations, the patient was admitted to the unit, where management with supplemental oxygen was started using a face mask with a reservoir bag. A chest X-ray was performed in which a diffuse interstitial alveolar pattern was identified in both hemithoraxes. Later a simple chest tomography was performed in which changes compatible with CO-RADS 5 were identified. He continued with established management and during his stay in the service, he evolved to deterioration to need advanced management via air. This study suggests that pulmonary ultrasound may be an effective and reliable tool in the initial evaluation of patients with respiratory distress in the context of Covid-19 pneumonia and that the identification of subpleural consolidations represent a prognostic factor of the disease: identifying them quickly after admission suggests a worse evolution of the disease, thus prompting us to make correct and concrete decisions regarding the management and treatment of these patients, without having to wait for complementary studies such as chest radiography and even tomography.
{"title":"Ultrasonically Detected Subpleural Lung Consolidations in The Emergency Room: A Case Report","authors":"Karen Itzel González Mártinez","doi":"10.53902/sojcem.2021.01.000505","DOIUrl":"https://doi.org/10.53902/sojcem.2021.01.000505","url":null,"abstract":"We report the clinical case of a 76- year-old patient who was admitted to the emergency department due to respiratory distress. He had a history of Systemic arterial hypertension, type 2 diabetes mellitus and hypothyroidism. The patient reports symptoms that began three days prior to admission, including dyspnea, fever, myalgia, arthralgia, headache and respiratory distress that was exacerbated 1 day prior to admission. Physical examination revealed a conscious patient with the following vital signs: blood pressure 120/62mmHg, heart rate 109bpm, respiratory rate 28rpm, temperature 38.8°C, arterial oxygen saturation 76%, dyspnea, use of accessory muscles, tachycardia, tachypnea, which met the operational definition for Covid-19. Upon admission to the service, a pulmonary ultrasound was performed in which subpleural consolidations were identified, predominantly in the right hemithorax, as well as an air bronchogram and little pleural effusion. Based on these observations, the patient was admitted to the unit, where management with supplemental oxygen was started using a face mask with a reservoir bag. A chest X-ray was performed in which a diffuse interstitial alveolar pattern was identified in both hemithoraxes. Later a simple chest tomography was performed in which changes compatible with CO-RADS 5 were identified. He continued with established management and during his stay in the service, he evolved to deterioration to need advanced management via air. This study suggests that pulmonary ultrasound may be an effective and reliable tool in the initial evaluation of patients with respiratory distress in the context of Covid-19 pneumonia and that the identification of subpleural consolidations represent a prognostic factor of the disease: identifying them quickly after admission suggests a worse evolution of the disease, thus prompting us to make correct and concrete decisions regarding the management and treatment of these patients, without having to wait for complementary studies such as chest radiography and even tomography.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122507847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2022.02.000516
A. Chattopadhyay
Tolosa Hunt Syndrome is a rare disease often characterized by painful ophthalmoplegia, and severe periorbital headaches which are usually unilateral in presentation, along with features of cranial nerve paralysis such as ptosis, diplopia, facial hypoaesthesia etc. Onset can be seen any age. Although it tagged as a benign condition, but permanent neurologic deficits may occur. Treatment may include use of glucocorticoids or other immunosuppressive therapies according to the standard protocol. A female patient 32 years of age visited National Institute of Homoeopathy OPD presented with complaints of severe left sided headache throbbing in nature since four to five months associated with nausea. The attacks of headache being with very short duration with rising and falling suddenly. She had very plethoric, congestive red facies and complained of dimness of vision of the left eye and of general debility. MRI brain and orbit with IV contrast showed a brilliantly enhancing plaque-like mass lesion measuring 37*18*12mm noted within left orbital apex compressing the orbital contents with extensions also to cavernous sinus and middle cranial fossa compressing adjacent temporal lobe. A detailed case taking was done and based on the totality of symptoms and collaborating with the portrait of disease Belladonna 10M one dose was given followed by rubrum for 1 month. Her paroxysms of headache had considerably decreased with no redness of the face on her first visit. Patient was better with almost no paroxysms of headache for almost five months after first dose then the symptoms reappeared and another dose of Belladonna 10M was repeated on fourthvisit. MRI Brain done almost a year later after commencement of homoeopathic treatment showed the reduction of the lesion upto 17.4mm*11.7*13.7mm seen in the left orbital apex inseparable from lateral rectus and compressing existing optic nerve the lesion extended to the meningeal lining over antero-inferior temporal lobe and parasellar region.MRI result showed significant reduction in the size of the lesion with symptomatic improvement under the homoeopathic treatment with no use of steroids or any other immunosuppressive therapies whatsoever.
{"title":"Homoeopathic Management in a Rare Case of Tolosa Hunt Syndrome: A Case Report","authors":"A. Chattopadhyay","doi":"10.53902/sojcem.2022.02.000516","DOIUrl":"https://doi.org/10.53902/sojcem.2022.02.000516","url":null,"abstract":"Tolosa Hunt Syndrome is a rare disease often characterized by painful ophthalmoplegia, and severe periorbital headaches which are usually unilateral in presentation, along with features of cranial nerve paralysis such as ptosis, diplopia, facial hypoaesthesia etc. Onset can be seen any age. Although it tagged as a benign condition, but permanent neurologic deficits may occur. Treatment may include use of glucocorticoids or other immunosuppressive therapies according to the standard protocol. A female patient 32 years of age visited National Institute of Homoeopathy OPD presented with complaints of severe left sided headache throbbing in nature since four to five months associated with nausea. The attacks of headache being with very short duration with rising and falling suddenly. She had very plethoric, congestive red facies and complained of dimness of vision of the left eye and of general debility. MRI brain and orbit with IV contrast showed a brilliantly enhancing plaque-like mass lesion measuring 37*18*12mm noted within left orbital apex compressing the orbital contents with extensions also to cavernous sinus and middle cranial fossa compressing adjacent temporal lobe. A detailed case taking was done and based on the totality of symptoms and collaborating with the portrait of disease Belladonna 10M one dose was given followed by rubrum for 1 month. Her paroxysms of headache had considerably decreased with no redness of the face on her first visit. Patient was better with almost no paroxysms of headache for almost five months after first dose then the symptoms reappeared and another dose of Belladonna 10M was repeated on fourthvisit. MRI Brain done almost a year later after commencement of homoeopathic treatment showed the reduction of the lesion upto 17.4mm*11.7*13.7mm seen in the left orbital apex inseparable from lateral rectus and compressing existing optic nerve the lesion extended to the meningeal lining over antero-inferior temporal lobe and parasellar region.MRI result showed significant reduction in the size of the lesion with symptomatic improvement under the homoeopathic treatment with no use of steroids or any other immunosuppressive therapies whatsoever.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128041095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2021.01.000507
S. Tabish
Covid-19 catastrophe in India during the first half of 2021 has been a matter of great concern for policy makers, health institutions and the government. A country of 1.4 billion has passed 29m Covid-19 infections and 351,300 deaths. India is likely to have more new cases per day from the beginning of August 2021. Strains of Concern and the Strains of Interest (new and emerging mutants have contributed to increased morbidity and mortality. Emergence of mucormycosis (black fungus) during the ongoing pandemic is a bigger challenge to India, Action on a war-footing is needed to save lives by expanding and upgrading healthcare facilities more so in rural areas. 233 million doses of the COVID vaccine have been given in India. More than 45 million people have received two doses of the vaccine (fully vaccinated). The third Phase of the vaccination has coincided with an acute vaccine supply shortage across the country. India’s monthly COVID vaccine manufacturing capacity is about 60-65 million doses against the final requirement of 1.45 billion doses to cover 70 per cent adults. Investing in health is crucial. India’s health system is overwhelmed. Hospitals are running out of oxygen supplies, ventilators and beds. It is a situation that needs a global approach. Tiding over a pandemic requires detailed preparation at multiple levels on the part of the State. Vaccination drive to cover all is crucial. Global partners have a responsibility to support India in mass production of vaccines. Developed economies must support the scale-up of lab testing and genomic sequencing of virus. Developed nations should also provide technical assistance, help India in training its health professionals and provide logistic support (oxygen canisters/concentrators/cylinders/ medications/PPEs, establishing/operationalising field hospitals/quarantine centres), strengthening surveillance systems, data management like accurate reporting of cases and deaths besides temporality taking out manufacturing of life-saving vaccines/drugs from India to other parts of the world during the crisis.
{"title":"COVID-19 Crisis in India: Threats and Opportunities","authors":"S. Tabish","doi":"10.53902/sojcem.2021.01.000507","DOIUrl":"https://doi.org/10.53902/sojcem.2021.01.000507","url":null,"abstract":"Covid-19 catastrophe in India during the first half of 2021 has been a matter of great concern for policy makers, health institutions and the government. A country of 1.4 billion has passed 29m Covid-19 infections and 351,300 deaths. India is likely to have more new cases per day from the beginning of August 2021. Strains of Concern and the Strains of Interest (new and emerging mutants have contributed to increased morbidity and mortality. Emergence of mucormycosis (black fungus) during the ongoing pandemic is a bigger challenge to India, Action on a war-footing is needed to save lives by expanding and upgrading healthcare facilities more so in rural areas. 233 million doses of the COVID vaccine have been given in India. More than 45 million people have received two doses of the vaccine (fully vaccinated). The third Phase of the vaccination has coincided with an acute vaccine supply shortage across the country. India’s monthly COVID vaccine manufacturing capacity is about 60-65 million doses against the final requirement of 1.45 billion doses to cover 70 per cent adults. Investing in health is crucial. India’s health system is overwhelmed. Hospitals are running out of oxygen supplies, ventilators and beds. It is a situation that needs a global approach. Tiding over a pandemic requires detailed preparation at multiple levels on the part of the State. Vaccination drive to cover all is crucial. Global partners have a responsibility to support India in mass production of vaccines. Developed economies must support the scale-up of lab testing and genomic sequencing of virus. Developed nations should also provide technical assistance, help India in training its health professionals and provide logistic support (oxygen canisters/concentrators/cylinders/ medications/PPEs, establishing/operationalising field hospitals/quarantine centres), strengthening surveillance systems, data management like accurate reporting of cases and deaths besides temporality taking out manufacturing of life-saving vaccines/drugs from India to other parts of the world during the crisis.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129183199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2022.02.000512
M. A. Nasreldin
Cardiovascular disease is a major cause of morbidity and mortality in patients with CKD. This risk is increased fivefold in renal transplant patients when compared to an age-matched population. This study aims to explore and focus on the risk factors, management, and outcomes of cardiorenal syndrome in renal transplant recipients and to estimate its deleterious effect on the heart and renal allograft, opening the door for future randomized clinical trials to look at the problem in more depth. The current literature has little information and data on the impact of cardiorenal syndrome on the renal allograft and heart regardless of the specific type of cardiorenal syndrome. Renal transplant recipients can develop any one of the five types of the cardiorenal syndrome because of having both conventional and established risk factors for developing CRS. These risk factors particularly the established ones or best described as non-traditional risk factors such as immunosuppressive medications, acute renal allograft rejection, suboptimal renal allograft function, anemia, infections, proteinuria, and hyperparathyroidism are usually neglected after renal transplantation. Although the prevalence of CRS is low among renal transplant recipients, we believe that is due to under diagnosis and lack of clinical trials leading to a knowledge gap in this subject area. Methodology: The present study conducted a systematic literature review and selected four Clinical trials of CRS in renal transplant recipients for datasets analysis to gain more knowledge about the risk factors contributing to CRS in renal transplant recipients and to produce a strategy to prevent CRS and manage such patients better. Results: This systematic review of the current literature revealed that the presence of non-traditional risk factors post-renal transplantation when combined with traditional risk factors can significantly increase the risk of developing CRS where the prognosis is almost always poor in such patients. The study also showed no difference in the preventive measures and management of CRS between renal transplant recipients and non-renal transplant recipients. Conclusion: Renal transplant recipients are at increased risk of developing CRS with poor outcomes compared to non-renal transplant recipients because of the additional non-traditional risk factors post-renal transplantation. However, the preventive measures and management of CRS in renal transplant recipients are similar to those used for the general population but more attention should be paid to the correction of non-traditional risk factors.
{"title":"The Impact of Cardio Renal Syndrome (CRS) in Renal Transplant Recipients: A Systematic Review","authors":"M. A. Nasreldin","doi":"10.53902/sojcem.2022.02.000512","DOIUrl":"https://doi.org/10.53902/sojcem.2022.02.000512","url":null,"abstract":"Cardiovascular disease is a major cause of morbidity and mortality in patients with CKD. This risk is increased fivefold in renal transplant patients when compared to an age-matched population. This study aims to explore and focus on the risk factors, management, and outcomes of cardiorenal syndrome in renal transplant recipients and to estimate its deleterious effect on the heart and renal allograft, opening the door for future randomized clinical trials to look at the problem in more depth. The current literature has little information and data on the impact of cardiorenal syndrome on the renal allograft and heart regardless of the specific type of cardiorenal syndrome. Renal transplant recipients can develop any one of the five types of the cardiorenal syndrome because of having both conventional and established risk factors for developing CRS. These risk factors particularly the established ones or best described as non-traditional risk factors such as immunosuppressive medications, acute renal allograft rejection, suboptimal renal allograft function, anemia, infections, proteinuria, and hyperparathyroidism are usually neglected after renal transplantation. Although the prevalence of CRS is low among renal transplant recipients, we believe that is due to under diagnosis and lack of clinical trials leading to a knowledge gap in this subject area. Methodology: The present study conducted a systematic literature review and selected four Clinical trials of CRS in renal transplant recipients for datasets analysis to gain more knowledge about the risk factors contributing to CRS in renal transplant recipients and to produce a strategy to prevent CRS and manage such patients better. Results: This systematic review of the current literature revealed that the presence of non-traditional risk factors post-renal transplantation when combined with traditional risk factors can significantly increase the risk of developing CRS where the prognosis is almost always poor in such patients. The study also showed no difference in the preventive measures and management of CRS between renal transplant recipients and non-renal transplant recipients. Conclusion: Renal transplant recipients are at increased risk of developing CRS with poor outcomes compared to non-renal transplant recipients because of the additional non-traditional risk factors post-renal transplantation. However, the preventive measures and management of CRS in renal transplant recipients are similar to those used for the general population but more attention should be paid to the correction of non-traditional risk factors.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130971453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2022.02.000510
O. Tulp
The highly transmissible Omicron variant of COVID-19 (SARS-CoV-2) emerged in late 2021 in South Africa and has now been found to represent over 70% of current infections in the USA and other Westernized nations. Its rapid spread is likely due at least in part to its apparent ability to escape neutralizing antibodies developed from previous exposure to covid and its variant subspecies. Currently over 1.35 million new COVID-19 cases were reported in the USA on Monday Jan 10th, 2022, accounting for the highest daily total for any country in the world since the onset of the pandemic. Among those individuals recently infected with the Omicron variant are included many previously vaccinated individuals and others who have gained natural immunity having recovered from COVID-19. Although the Omicron variant has been determined to be up to five-fold more contagious than its covid progenitor. it has a larger but overlapping molecular genome and the apparent capability to evade antibodies formed following prior exposure. To date it has resulted in only milder non-life-threatening illness compared to earlier forms of the virus, and consequently no deaths directly caused by the Omicron variant have been reported to date in contrast to more severe often dire outcomes for earlier forms of COVID-19. Thus, the question arises, can the Omicron variant produce a more broad-spectrum immune response to COVID-19 and its variants, and generate a longer-lasting immunity than current global vaccination and public health efforts, and finally, compared to earlier variant of COVID-19, will Omicron, should it become endemic or fully pandemic, finally contribute to the defeat of the COVID-19 pandemic in those regions where it may remain prevalent in 2022 due to its ability to result in only milder symptoms of covid-related illness while developing a broader based spectrum of protective neutralizing antibodies ?
{"title":"An Editorial overview and Perspective: Can the attenuated Omicron variant of Covid-19 virus resolve the pandemic in 2022?","authors":"O. Tulp","doi":"10.53902/sojcem.2022.02.000510","DOIUrl":"https://doi.org/10.53902/sojcem.2022.02.000510","url":null,"abstract":"The highly transmissible Omicron variant of COVID-19 (SARS-CoV-2) emerged in late 2021 in South Africa and has now been found to represent over 70% of current infections in the USA and other Westernized nations. Its rapid spread is likely due at least in part to its apparent ability to escape neutralizing antibodies developed from previous exposure to covid and its variant subspecies. Currently over 1.35 million new COVID-19 cases were reported in the USA on Monday Jan 10th, 2022, accounting for the highest daily total for any country in the world since the onset of the pandemic. Among those individuals recently infected with the Omicron variant are included many previously vaccinated individuals and others who have gained natural immunity having recovered from COVID-19. Although the Omicron variant has been determined to be up to five-fold more contagious than its covid progenitor. it has a larger but overlapping molecular genome and the apparent capability to evade antibodies formed following prior exposure. To date it has resulted in only milder non-life-threatening illness compared to earlier forms of the virus, and consequently no deaths directly caused by the Omicron variant have been reported to date in contrast to more severe often dire outcomes for earlier forms of COVID-19. Thus, the question arises, can the Omicron variant produce a more broad-spectrum immune response to COVID-19 and its variants, and generate a longer-lasting immunity than current global vaccination and public health efforts, and finally, compared to earlier variant of COVID-19, will Omicron, should it become endemic or fully pandemic, finally contribute to the defeat of the COVID-19 pandemic in those regions where it may remain prevalent in 2022 due to its ability to result in only milder symptoms of covid-related illness while developing a broader based spectrum of protective neutralizing antibodies ?","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129562972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.53902/sojcem.2021.01.000503
José Menezes Gomes
This article deals with the relationship between the growing military and financial expenditures of the states and how this process led to the sacrifice of public policies, facilitating the spread of this pandemic throughout the world. All this results from the deepening of neoliberalism, which in a synchronized manner contributed to the process of privatization and dismantling of the public machinery. We point out that the wealthiest countries that have higher military spending experienced the highest number of deaths and infections. In this direction, we observe that the USA has the largest military expenditure on the planet, while the health sector is privatized, which makes it difficult to combat the covid 19. At the same time, we observe that part of the countries' public debt results from the effects of the 2008 crisis that used public money to save private enterprises while deepening the privatization of public services.
{"title":"Military and Financial Expenses Commit Combat to COVID 19","authors":"José Menezes Gomes","doi":"10.53902/sojcem.2021.01.000503","DOIUrl":"https://doi.org/10.53902/sojcem.2021.01.000503","url":null,"abstract":"This article deals with the relationship between the growing military and financial expenditures of the states and how this process led to the sacrifice of public policies, facilitating the spread of this pandemic throughout the world. All this results from the deepening of neoliberalism, which in a synchronized manner contributed to the process of privatization and dismantling of the public machinery. We point out that the wealthiest countries that have higher military spending experienced the highest number of deaths and infections. In this direction, we observe that the USA has the largest military expenditure on the planet, while the health sector is privatized, which makes it difficult to combat the covid 19. At the same time, we observe that part of the countries' public debt results from the effects of the 2008 crisis that used public money to save private enterprises while deepening the privatization of public services.","PeriodicalId":146372,"journal":{"name":"SOJ Complementary and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124910794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：