Pub Date : 2022-08-27DOI: 10.14419/ijm.v10i1.32096
Dr. Vivek R. Chaudhari, Dr. Jigar Mankad, Dr. Janki Lavingia, Dr. Manisha Panchal
Homocystinuria follows an autosomal recessive pattern and transpires due to Cystathionine beta-synthase enzyme deficiency. This condition is associated with thrombotic and thromboembolic complications due to an increase in homocysteine and methionine levels in the plasma and urine. We present a case of an Indian adolescent boy who presented to us with generalized tonic clinic seizure and Broca's aphasia he was diagnosed as having homocystinuria type 1, and he responded well to treatment.Background: Stroke and seizure disorders in young adults have increased substantially and are a relatively common disorder that presents in the emergency department in all age groups. Secondary seizures are more common and manifest as a result of another underlying pathology. This case demonstrates the importance of considering rarer causes of thrombosis such as arterial thrombosis, even in younger patients, with no obvious risk factors or comorbidities. A detailed medical history and thorough investigations need to be taken to identify a potentially treatable underlying cause.Objective: To increase awareness about this rare etiology and help clinicians to have a higher level of suspicion to diagnose this condition and prevent future life-threatening complications in younger patients with thrombotic and thromboembolic events.  Â
同型半胱氨酸尿遵循常染色体隐性模式，由于胱硫氨酸-合成酶缺乏而发生。由于血浆和尿液中同型半胱氨酸和蛋氨酸水平升高，这种情况与血栓形成和血栓栓塞并发症有关。我们报告一个印度青少年男孩的病例，他向我们提出了全身性强直性癫痫发作和布罗卡失语症，他被诊断为1型同型半胱氨酸尿症，他对治疗反应良好。背景:年轻成人中风和癫痫的发病率显著增加，是所有年龄组急诊科出现的一种相对常见的疾病。继发性癫痫发作更常见，表现为另一种潜在病理的结果。这一病例表明，即使在没有明显危险因素或合并症的年轻患者中，考虑动脉血栓形成等罕见原因的重要性。需要详细的病史和彻底的调查，以确定潜在的可治疗的根本原因。目的:提高对这一罕见病因的认识，帮助临床医生对诊断这一疾病有更高的怀疑，并预防未来危及生命的血栓和血栓栓塞事件的年轻患者并发症。Â Â Â
{"title":"Homocystinuria presents with generalized tonic-clonic seizure and Broca's aphasia","authors":"Dr. Vivek R. Chaudhari, Dr. Jigar Mankad, Dr. Janki Lavingia, Dr. Manisha Panchal","doi":"10.14419/ijm.v10i1.32096","DOIUrl":"https://doi.org/10.14419/ijm.v10i1.32096","url":null,"abstract":"Homocystinuria follows an autosomal recessive pattern and transpires due to Cystathionine beta-synthase enzyme deficiency. This condition is associated with thrombotic and thromboembolic complications due to an increase in homocysteine and methionine levels in the plasma and urine. We present a case of an Indian adolescent boy who presented to us with generalized tonic clinic seizure and Broca's aphasia he was diagnosed as having homocystinuria type 1, and he responded well to treatment.Background: Stroke and seizure disorders in young adults have increased substantially and are a relatively common disorder that presents in the emergency department in all age groups. Secondary seizures are more common and manifest as a result of another underlying pathology. This case demonstrates the importance of considering rarer causes of thrombosis such as arterial thrombosis, even in younger patients, with no obvious risk factors or comorbidities. A detailed medical history and thorough investigations need to be taken to identify a potentially treatable underlying cause.Objective: To increase awareness about this rare etiology and help clinicians to have a higher level of suspicion to diagnose this condition and prevent future life-threatening complications in younger patients with thrombotic and thromboembolic events.  Â","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48959850","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 : 2022-06-07DOI: 10.14419/ijm.v10i1.32070
Eriko Mitsutome, K. Une, Ryuichi Nakanuno
Casilivimab/imdevimab, called antibody cocktail therapy, is a treatment for mildly and moderately ill COVID-19 patients. In our care facility, we encountered an elderly patient treated with an antibody cocktail after being diagnosed with a moderate disease at the initial presentation that became severe. An 80-year-old man with a history of diabetes, hypertension, and cerebral infarction presented with a 5-day history of fever and was diagnosed with coronavirus disease 2019. He was diagnosed with moderate disease and immediately ad-ministered the antibody cocktail therapy. However, his respiratory status deteriorated rapidly, and mechanical ventilation was initiated. We performed lung-protective ventilation, centered on low tidal volume and prone position therapy, with good outcomes. Throughout the pandemic, his case, as well as others, highlighted that immediate intervention for mild and moderate cases and intensive treatment, such as lung-protective ventilation and prone position, for severe cases improved patient outcomes.  Â
casilvimab /imdevimab被称为抗体鸡尾酒疗法，是一种用于治疗轻度和中度COVID-19患者的疗法。在我们的护理机构中，我们遇到了一位接受抗体鸡尾酒治疗的老年患者，他最初被诊断为中度疾病，后来病情变得严重。80岁男性，有糖尿病、高血压、脑梗死病史，发热5天，确诊为2019冠状病毒病。他被诊断为中度疾病，并立即接受了抗体鸡尾酒疗法。然而，他的呼吸状况迅速恶化，并开始机械通气。我们进行了肺保护性通气，以低潮气量和俯卧位治疗为中心，效果良好。在整个大流行期间，他的病例以及其他病例突出表明，对轻度和中度病例的立即干预以及对重症病例的强化治疗，如肺保护性通气和俯卧位，改善了患者的预后。Â Â Â
{"title":"Coronavirus disease 2019 in an elderly patient who became severely ill despite antibody cocktail therapy but improved with lung-protective management: A case report","authors":"Eriko Mitsutome, K. Une, Ryuichi Nakanuno","doi":"10.14419/ijm.v10i1.32070","DOIUrl":"https://doi.org/10.14419/ijm.v10i1.32070","url":null,"abstract":"Casilivimab/imdevimab, called antibody cocktail therapy, is a treatment for mildly and moderately ill COVID-19 patients. In our care facility, we encountered an elderly patient treated with an antibody cocktail after being diagnosed with a moderate disease at the initial presentation that became severe. An 80-year-old man with a history of diabetes, hypertension, and cerebral infarction presented with a 5-day history of fever and was diagnosed with coronavirus disease 2019. He was diagnosed with moderate disease and immediately ad-ministered the antibody cocktail therapy. However, his respiratory status deteriorated rapidly, and mechanical ventilation was initiated. We performed lung-protective ventilation, centered on low tidal volume and prone position therapy, with good outcomes. Throughout the pandemic, his case, as well as others, highlighted that immediate intervention for mild and moderate cases and intensive treatment, such as lung-protective ventilation and prone position, for severe cases improved patient outcomes.   ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42297324","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 : 2022-06-07DOI: 10.14419/ijm.v10i1.32032
Shoaib Ali, Mubina Ifat, Javeria Amin, S. Jamil, Sahira Aaraj, Hamza Naeem, S. Javed, Shahida Nazir Siddiqui, Hamza Saeed Khokhar, Sarmad Zahoor
Introduction: Immunization strengthens the defense mechanism of the body and offers protection against potential diseases. The rate of immunization is one of the best measures of public health management and quality. To increase the rate of immunization, parental decisions about vaccinations are very necessary. Parents' knowledge and attitude towards immunization influence the prevalence of infectious diseases. Moreover, vaccination is considered one of the most cost-effective public health tools to prevent infectious diseases.Objective: The objective of this study is to assess the frequency of adequate knowledge, positive attitude and good practices of mothers regarding immunization.Materials and Methods: It was a cross-sectional study which was conducted in The Children's Hospital & Child Health Institute, Lahore. A total of 125 children who met the selection criteria were enrolled. Parents were then questioned and validated by vaccination card status regarding various Expanded Immunization Policy (EPI) vaccinations and complete previous records. The awareness and attitude of mothers regarding vaccination was also considered that either they were aware of the vaccination status or not. All the data was collected and reported in the form of a questionnaire.Results: In this study93 mothers had a good understanding, 77 mothers had a good practice, and 66 mothers had a positive attitude towards immunization. Childs’ gender, mothers’ educational status, socio-economic status, good practice, and positive attitude had no significant impact on adequate knowledge about vaccination.Conclusion: It was concluded from this study that mothers’ knowledge about immunization was adequate, however good practice and positive attitude were not up to the mark. Â
{"title":"Knowledge, attitude and practices of mothers regarding immunization","authors":"Shoaib Ali, Mubina Ifat, Javeria Amin, S. Jamil, Sahira Aaraj, Hamza Naeem, S. Javed, Shahida Nazir Siddiqui, Hamza Saeed Khokhar, Sarmad Zahoor","doi":"10.14419/ijm.v10i1.32032","DOIUrl":"https://doi.org/10.14419/ijm.v10i1.32032","url":null,"abstract":"Introduction: Immunization strengthens the defense mechanism of the body and offers protection against potential diseases. The rate of immunization is one of the best measures of public health management and quality. To increase the rate of immunization, parental decisions about vaccinations are very necessary. Parents' knowledge and attitude towards immunization influence the prevalence of infectious diseases. Moreover, vaccination is considered one of the most cost-effective public health tools to prevent infectious diseases.Objective: The objective of this study is to assess the frequency of adequate knowledge, positive attitude and good practices of mothers regarding immunization.Materials and Methods: It was a cross-sectional study which was conducted in The Children's Hospital & Child Health Institute, Lahore. A total of 125 children who met the selection criteria were enrolled. Parents were then questioned and validated by vaccination card status regarding various Expanded Immunization Policy (EPI) vaccinations and complete previous records. The awareness and attitude of mothers regarding vaccination was also considered that either they were aware of the vaccination status or not. All the data was collected and reported in the form of a questionnaire.Results: In this study93 mothers had a good understanding, 77 mothers had a good practice, and 66 mothers had a positive attitude towards immunization. Childs’ gender, mothers’ educational status, socio-economic status, good practice, and positive attitude had no significant impact on adequate knowledge about vaccination.Conclusion: It was concluded from this study that mothers’ knowledge about immunization was adequate, however good practice and positive attitude were not up to the mark.  ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45975607","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 : 2022-05-15DOI: 10.14419/ijm.v10i1.32035
Dr. Vivek Chaudhari, Dr. Harshvardhansinh Chauhan, Dr. Manisha Panchal
Thyrotoxic periodic paralysis is a unique disorder that causes episodic proximal lower extremity muscle weakness in a patient who already has a hyperthyroid state and is not treated for the underlying disease state. The affected population mostly includes Asian in origin specifically the male gender (vs most thyroid disorder affects the women gender). Precipitating factors include in addition to a hyperthyroid state are strenuous exertion, a high-carbohydrate meal, and drugs like diuretics, insulin, high dose of steroids, antiretrovirals, and interferon therapy. Other genetic causes include the decreased activity of Kir2.6 mutation increased activity of Na+/K+ ATPase causing an intracellular shift of potassium that leads to hypokalaemia. The other challenging part for the physician is to differentiate it from Familial periodic paralysis an autosomal disorder seen in Caucasians and Western countries because both the disorders present similarly and differentiate between them by the presence of hyperthyroid state with hypokalaemia in Thyrotoxic periodic paralysis. The mortality is associated with respiratory paralysis hence the acute intervention includes giving nonselective beta-blockers followed by anti-thyroid medications. We present a case of an Indian adolescent who presented to us with lower muscle weakness with an underlying thyrotoxicosis state. This help physician with early diagnosis and appropriate treatment.  Â
{"title":"Thyrotoxic periodic paralysis mimicking hypokalemic periodic paralysis","authors":"Dr. Vivek Chaudhari, Dr. Harshvardhansinh Chauhan, Dr. Manisha Panchal","doi":"10.14419/ijm.v10i1.32035","DOIUrl":"https://doi.org/10.14419/ijm.v10i1.32035","url":null,"abstract":"Thyrotoxic periodic paralysis is a unique disorder that causes episodic proximal lower extremity muscle weakness in a patient who already has a hyperthyroid state and is not treated for the underlying disease state. The affected population mostly includes Asian in origin specifically the male gender (vs most thyroid disorder affects the women gender). Precipitating factors include in addition to a hyperthyroid state are strenuous exertion, a high-carbohydrate meal, and drugs like diuretics, insulin, high dose of steroids, antiretrovirals, and interferon therapy. Other genetic causes include the decreased activity of Kir2.6 mutation increased activity of Na+/K+ ATPase causing an intracellular shift of potassium that leads to hypokalaemia. The other challenging part for the physician is to differentiate it from Familial periodic paralysis an autosomal disorder seen in Caucasians and Western countries because both the disorders present similarly and differentiate between them by the presence of hyperthyroid state with hypokalaemia in Thyrotoxic periodic paralysis. The mortality is associated with respiratory paralysis hence the acute intervention includes giving nonselective beta-blockers followed by anti-thyroid medications. We present a case of an Indian adolescent who presented to us with lower muscle weakness with an underlying thyrotoxicosis state. This help physician with early diagnosis and appropriate treatment.   ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42729479","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}
We report a case of ethylene glycol poisoning in a 70-year-old man with headache and dysarthria. Blood tests showed a marked increase in the anion gap (29.8 mOsm/kg) and osmotic gap (14 mOsm/kg). The estimated blood concentration of ethylene glycol was 86.8 mg/dL. Ethanol was administered and he underwent haemodialysis for 7 cycles, which was discontinued on day 12. Fomepizole, which competes with alcohol dehydrogenase, is an effective treatment for ethylene glycol poisoning. However, it is usually prescribed within 24 h after poisoning, and studies on its use in cases of severe acute renal injury over time are limited. We were able to obtain good results with haemodialysis without using fomepizole. Conventional treatments such as haemodialysis may be more useful than fomepizole in terms of cost benefits in patients with addiction who have been taking the drug for a long time or who have advanced renal injury.
{"title":"Ethylene glycol poisoning treated using combination of ethanol and haemodialysis therapy instead of fomepizole: a case report","authors":"K. Une, Y. Kishi, Yuichiro Hidaka, T. Esaki","doi":"10.14419/IJM.V9I2.31706","DOIUrl":"https://doi.org/10.14419/IJM.V9I2.31706","url":null,"abstract":"We report a case of ethylene glycol poisoning in a 70-year-old man with headache and dysarthria. Blood tests showed a marked increase in the anion gap (29.8 mOsm/kg) and osmotic gap (14 mOsm/kg). The estimated blood concentration of ethylene glycol was 86.8 mg/dL. Ethanol was administered and he underwent haemodialysis for 7 cycles, which was discontinued on day 12. Fomepizole, which competes with alcohol dehydrogenase, is an effective treatment for ethylene glycol poisoning. However, it is usually prescribed within 24 h after poisoning, and studies on its use in cases of severe acute renal injury over time are limited. We were able to obtain good results with haemodialysis without using fomepizole. Conventional treatments such as haemodialysis may be more useful than fomepizole in terms of cost benefits in patients with addiction who have been taking the drug for a long time or who have advanced renal injury. ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46289945","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}
S. Jamil, Sara Munir, Javeria Amin, Shazia Nourin, Alia ., Zill E huma, Hamza Saeed Khokhar, Sultan Ul Moazzam, Muhammad Sohail Afzal
Background: Post Partum Hemorrhage (PPH) is a life threatening emergency that needs to be managed timely. Refractory PPH is treated surgically. Bilateral internal iliac artery ligation is one of the surgical procedures performed to control bleeding.Objective: We analyzed the effectiveness of Bilateral IIAL in controlling bleeding in PPHMethodology: It was a retrograde cross-sectional study conducted at Lady Aitchison hospital, Lahore from data during January 2018 to December 2020. After applying inclusion and exclusion criteria, data of patient including demographics, history, examination, ultrasound, procedure details and post-operative complications were recorded. All the data was analyzed using SPSS version 23.0.Results: All the patients (44) survived and success rate was 100 %. Uterine atony was present in 29 (65.9%) patients as a cause of PPH, placental abnormality, uterine rupture and coagulopathy in 7(15, 9), 4 (9.1%) and 4 (9.1%) patients respectively. 17 patients did not develop any complication. Most common Post-operative complication was wound infection (22.75%) followed by pneumonia (20.5%), paralytic ileus (9.1%) and DIC with renal failure (9.1%).Conclusion: Bilateral IIAL was found to be an effective and preferred life saving procedure, preserving fertility.
{"title":"Role of bilateral internal iliac artery ligation in controlling refractory post partum hemorrhage","authors":"S. Jamil, Sara Munir, Javeria Amin, Shazia Nourin, Alia ., Zill E huma, Hamza Saeed Khokhar, Sultan Ul Moazzam, Muhammad Sohail Afzal","doi":"10.14419/ijm.v9i2.31693","DOIUrl":"https://doi.org/10.14419/ijm.v9i2.31693","url":null,"abstract":"Background: Post Partum Hemorrhage (PPH) is a life threatening emergency that needs to be managed timely. Refractory PPH is treated surgically. Bilateral internal iliac artery ligation is one of the surgical procedures performed to control bleeding.Objective: We analyzed the effectiveness of Bilateral IIAL in controlling bleeding in PPHMethodology: It was a retrograde cross-sectional study conducted at Lady Aitchison hospital, Lahore from data during January 2018 to December 2020. After applying inclusion and exclusion criteria, data of patient including demographics, history, examination, ultrasound, procedure details and post-operative complications were recorded. All the data was analyzed using SPSS version 23.0.Results: All the patients (44) survived and success rate was 100 %. Uterine atony was present in 29 (65.9%) patients as a cause of PPH, placental abnormality, uterine rupture and coagulopathy in 7(15, 9), 4 (9.1%) and 4 (9.1%) patients respectively. 17 patients did not develop any complication. Most common Post-operative complication was wound infection (22.75%) followed by pneumonia (20.5%), paralytic ileus (9.1%) and DIC with renal failure (9.1%).Conclusion: Bilateral IIAL was found to be an effective and preferred life saving procedure, preserving fertility. ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49431761","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}
Patient autonomy is one of the most important ethical values in the health care practice. Patients’ autonomy means the right of patients to make decisions about their medical care without their health care provider trying to influence the decision. Patients’ autonomy allows health care providers to educate the patients but do not allow them to make the decision for the patients.
{"title":"Patient autonomy","authors":"Muneerah Lbugami, Usamah El Alem","doi":"10.14419/ijm.v9i1.31526","DOIUrl":"https://doi.org/10.14419/ijm.v9i1.31526","url":null,"abstract":"Patient autonomy is one of the most important ethical values in the health care practice. Patients’ autonomy means the right of patients to make decisions about their medical care without their health care provider trying to influence the decision. Patients’ autonomy allows health care providers to educate the patients but do not allow them to make the decision for the patients. ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44137747","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}
S. Jamil, Hafiz Muhammad Sajid Jehangir, H. Naeem, Mahliqa Maqsud, Mehwish Ayyaz, Tayyaba Kanwal, Sarmad Zahoor, Muhammad Umer Mukhtar, Malik Muhammad Atif, Raza Manzoor Haideri
Background: Hepatitis E Virus (HEV) is the major cause of morbidity and mortality in pregnancy. The virus was detected about three decades ago. The incidence and severity during pregnancy vary widely around the world.Material & Methods: This observational retrospective study was conducted from March 2019 to February 2020 in Obstetrics & Gynecology Department of Lady Aitchison Hospital, Lahore. 70 pregnant women with hepatitis E were subjected to detailed history taking. The diagnosis was based on positive Hepatitis E IgM (Anti HEV IgM) antibody on laboratory test in current pregnancy in antenatal period up to 42 days post partum were included.Results: Out of 70 pregnant women with Hep E IgM+ve, 3 (4.3%) women had Obstetrical hysterectomy as complications, with mean age of 26.0 ± 4.69 years. The mean gestational age when infection occurred was 31.12 ± 5.18 weeks. Among all females 9 (13%) patients expired due to fulminant hepatic failure, 12 (17.14%) females gave birth via spontaneous vaginal delivery (SVD),17(24.2%) females gave birth via C-Section. 30 (42.8%) females were manage conservatively.Conclusion: Hepatitis E viral infection in pregnant females is a life threatening condition. The study showed that pregnant women with jaundice and hepatitis E virus infection had a high mortality rate during third trimester. Early diagnosis and management will help in the control of the disease and prevents its complications.
背景:戊型肝炎病毒(HEV)是妊娠期发病和死亡的主要原因。这种病毒是大约30年前发现的。怀孕期间的发病率和严重程度在世界各地差别很大。材料与方法:本观察性回顾性研究于2019年3月至2020年2月在拉合尔艾奇逊夫人医院妇产科进行，对70名戊型肝炎孕妇进行详细的病史记录。诊断基于实验室检测戊型肝炎IgM(抗HEV IgM)抗体阳性，包括当前妊娠产前至产后42天。结果:70例妊娠Hep E IgM+ve患者中，有3例(4.3%)合并产科子宫切除术，平均年龄26.0±4.69岁。感染发生时平均胎龄为31.12±5.18周。女性因暴发性肝功能衰竭死亡9例(13%)，阴道自然分娩(SVD)死亡12例(17.14%)，剖腹产死亡17例(24.2%)。保守治疗30例(42.8%)。结论:孕妇戊型肝炎病毒感染是一种危及生命的疾病。研究表明，黄疸和戊型肝炎病毒感染的孕妇在妊娠晚期死亡率很高。早期诊断和治疗将有助于控制疾病并预防其并发症。
{"title":"Hepatitis E viral infection in pregnant ladies, a challenge for obstetricians and physicians","authors":"S. Jamil, Hafiz Muhammad Sajid Jehangir, H. Naeem, Mahliqa Maqsud, Mehwish Ayyaz, Tayyaba Kanwal, Sarmad Zahoor, Muhammad Umer Mukhtar, Malik Muhammad Atif, Raza Manzoor Haideri","doi":"10.14419/ijm.v9i1.31468","DOIUrl":"https://doi.org/10.14419/ijm.v9i1.31468","url":null,"abstract":"Background: Hepatitis E Virus (HEV) is the major cause of morbidity and mortality in pregnancy. The virus was detected about three decades ago. The incidence and severity during pregnancy vary widely around the world.Material & Methods: This observational retrospective study was conducted from March 2019 to February 2020 in Obstetrics & Gynecology Department of Lady Aitchison Hospital, Lahore. 70 pregnant women with hepatitis E were subjected to detailed history taking. The diagnosis was based on positive Hepatitis E IgM (Anti HEV IgM) antibody on laboratory test in current pregnancy in antenatal period up to 42 days post partum were included.Results: Out of 70 pregnant women with Hep E IgM+ve, 3 (4.3%) women had Obstetrical hysterectomy as complications, with mean age of 26.0 ± 4.69 years. The mean gestational age when infection occurred was 31.12 ± 5.18 weeks. Among all females 9 (13%) patients expired due to fulminant hepatic failure, 12 (17.14%) females gave birth via spontaneous vaginal delivery (SVD),17(24.2%) females gave birth via C-Section. 30 (42.8%) females were manage conservatively.Conclusion: Hepatitis E viral infection in pregnant females is a life threatening condition. The study showed that pregnant women with jaundice and hepatitis E virus infection had a high mortality rate during third trimester. Early diagnosis and management will help in the control of the disease and prevents its complications. ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46246352","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}
Kizito Omona, Yasin Ssewanyana, Badru Ssekitooleko, Daniel Ongaro
Abdominal cocoon syndrome (ACS) is a rare cause of small bowel obstruction characterized by partial or complete encasement of small bowel loops in a thick fibro-collagenous sac. It poses diagnostic difficulties due to the non-specific nature of its presentation and thus in most cases, diagnosed incidentally at laparotomy.The researchers present a case of a 27-year old female Ugandan who presented to a rural hospital in Northern Uganda with complaints of central abdominal pain, failure to pass stool and bilious vomiting for three days. She also had feelings of a peri-umbilical mass. She had several episodes of related obstructive symptoms that would be self-limiting for a year. She had unremarkable past surgical, past medical and past gynecological history. Laboratory investigations were unremarkable.Preoperative diagnosis of small bowel intussusception was made basing on examination and ultrasonography report and the patient was managed operatively. At laparotomy, almost all the small bowel loops were found encased in a thick, whitish, fibrous membrane. There was also marked inter-loop adhesions. The membranous sac was incised and completely removed using both sharp and blunt dissection. Inter-loop adhesions were released solely by blunt dissection.The patient recovered postoperatively and was discharged on the seventh postoperative day.
{"title":"A Case of Abdominal Cocoon Syndrome: A Rare Cause of Small Bowel Obstruction At Aber Hospital in Northern Uganda","authors":"Kizito Omona, Yasin Ssewanyana, Badru Ssekitooleko, Daniel Ongaro","doi":"10.14419/ijm.v9i1.31508","DOIUrl":"https://doi.org/10.14419/ijm.v9i1.31508","url":null,"abstract":"Abdominal cocoon syndrome (ACS) is a rare cause of small bowel obstruction characterized by partial or complete encasement of small bowel loops in a thick fibro-collagenous sac. It poses diagnostic difficulties due to the non-specific nature of its presentation and thus in most cases, diagnosed incidentally at laparotomy.The researchers present a case of a 27-year old female Ugandan who presented to a rural hospital in Northern Uganda with complaints of central abdominal pain, failure to pass stool and bilious vomiting for three days. She also had feelings of a peri-umbilical mass. She had several episodes of related obstructive symptoms that would be self-limiting for a year. She had unremarkable past surgical, past medical and past gynecological history. Laboratory investigations were unremarkable.Preoperative diagnosis of small bowel intussusception was made basing on examination and ultrasonography report and the patient was managed operatively. At laparotomy, almost all the small bowel loops were found encased in a thick, whitish, fibrous membrane. There was also marked inter-loop adhesions. The membranous sac was incised and completely removed using both sharp and blunt dissection. Inter-loop adhesions were released solely by blunt dissection.The patient recovered postoperatively and was discharged on the seventh postoperative day. ","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46048516","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}
Loneliness is a silent social epidemic that affects more than one third of the US population. Cardiovascular diseases impart a huge morbidity, mortality, and financial burden on our society. The detrimental role of loneliness in cardiovascular diseases is being increasingly recognized. Besides having a direct molecular effect on cardiovascular diseases, loneliness also encourages poor compliance with healthy lifestyles, that play a significant role in preventing and improving cardiovascular diseases. This brief review highlights the ominous effects of loneliness on cardiovascular diseases.
{"title":"Loneliness and Cardiovascular Disease","authors":"S. Agarwal","doi":"10.14419/ijm.v9i1.31462","DOIUrl":"https://doi.org/10.14419/ijm.v9i1.31462","url":null,"abstract":"Loneliness is a silent social epidemic that affects more than one third of the US population. Cardiovascular diseases impart a huge morbidity, mortality, and financial burden on our society. The detrimental role of loneliness in cardiovascular diseases is being increasingly recognized. Besides having a direct molecular effect on cardiovascular diseases, loneliness also encourages poor compliance with healthy lifestyles, that play a significant role in preventing and improving cardiovascular diseases. This brief review highlights the ominous effects of loneliness on cardiovascular diseases.","PeriodicalId":91290,"journal":{"name":"International journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44024559","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：