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A Case of Severe Adenomyosis in a Young Adolescent
Ahmed Abdulwahab Abdulkarim
Issue:
Volume 10, Issue 4, December 2021
Pages:
85-88
Received:
16 June 2021
Accepted:
8 July 2021
Published:
30 October 2021
Abstract: Adenomyosis refers to a disorder in which endometrial glands are present within the uterine muscle which can be either diffuse or localized that may cause heavy menstrual bleeding, dysmenorrhea, and infertility. The disease usually affects multiparous women. Around 70-80% of the cases are reported in women of age between 40 and 50 years. Very few cases of adenomyosis in young adolescent are reported, and the diagnosis in such case becomes notoriously difficult, but still can be highly suspected with the help of ultrasound (USS) and Magnetic Resonance Imaging (MRI). Here, we present a case of 15-year old girl attending the emergency care with acute abdominal pain. The patient underwent diagnostic laparoscopy which revealed bleeding in the peritoneal cavity and a big hypertrophied uterus. Erosion and active bleeding was observed from the surface of the uterus; the case was advanced to laparotomy. The uterus was uniformly enlarged and boggy that was completely eroded and bled actively. Multiple biopsies were taken from different parts of uterine lesion and sent for frozen section histopathology examination. The blood was sucked from the peritoneal cavity, followed by placement of multiple hemostatic stitches. The results revealed severe adenomyosis. Only very few cases of adenomyosis in adolescents are reported to date and since fertility preservation is considered as an important goal, the traditional treatment of endometriosis may not be applicable to treat adenomyosis in case of young adolescent for fear of jeopardizing the reproductive life. Preserving the fertility in the adolescent and young adult patients poses a major challenge keeping in mind the adequate treatment required without affecting the general health of the patient.
Abstract: Adenomyosis refers to a disorder in which endometrial glands are present within the uterine muscle which can be either diffuse or localized that may cause heavy menstrual bleeding, dysmenorrhea, and infertility. The disease usually affects multiparous women. Around 70-80% of the cases are reported in women of age between 40 and 50 years. Very few c...
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Effects of Amniotic Membrane Transplantation in Ocular Burns: A Meta-Analysis
Hua Wang,
Jun-Jie Tang,
Qing Zhou,
Jian Chen
Issue:
Volume 10, Issue 4, December 2021
Pages:
89-96
Received:
10 October 2021
Accepted:
28 October 2021
Published:
5 November 2021
Abstract: Background: Ocular burns is a serious eye injury with a high rate of blindness, efforts should be made to eliminate the serious complications, prevent from lifelong disability, and improve emergency interventions and treatment. Objective: To evaluate the effectiveness of amniotic membrane transplantation (AMT) in ocular burns. Methods: The following electronic databases were searched: PubMed, Web of Science, and Cochrane Library. With the keyword “amniotic membrane” and “ocular burn”. No limitation of year, language, gender, age, nationality, etc. Animal trials, patients with other ocular surface diseases, and amniotic membrane transplantation combined with other surgeries were excluded. We evaluated the corneal epithelium healing time (CEHT), tear break-up time (TBUT), Schirmer test (ST), corneal neovascularization, the formation of symblepharon, and lid abnormalities after conventional treatment (CT) and AMT. The differences were tested by referring to the Cochrane Handbook. Pooled estimates were determined with RevMan software, version 5.3. Results: 5 studies with 310 eyes of 282 participants suffering from ocular burns were included. There was no significant difference between CT and AMT among the following outcomes: CEHT, TBUT, ST, formation of symblepharon, and lid abnormalities, except the extent of corneal neovascularization, which was less in patients treated with AMT (RR 0.81; 95% CI 0.68, 0.96; I2 = 40%, p = 0.02). Conclusions: Compared to CT, AMT does not show better advantages in promoting epithelial healing, improving tear film status, and preventing complications such as symblepharon formation and eyelid abnormalities except reducing corneal neovascularization.
Abstract: Background: Ocular burns is a serious eye injury with a high rate of blindness, efforts should be made to eliminate the serious complications, prevent from lifelong disability, and improve emergency interventions and treatment. Objective: To evaluate the effectiveness of amniotic membrane transplantation (AMT) in ocular burns. Methods: The followin...
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Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease
Shaila Siraj,
Carlos Sanchez Parra,
Jasmine Jordan,
Ashish Shah,
Ernest Amankwah,
Jeffrey Fadrowski
Issue:
Volume 10, Issue 4, December 2021
Pages:
97-101
Received:
14 July 2021
Accepted:
30 July 2021
Published:
5 November 2021
Abstract: Kawasaki Disease (KD) is the leading cause of acquired heart disease among children in the developed world. Consensus-based guidelines from the American Heart Association (AHA) recommend echocardiograms be performed at the time of diagnosis, at two weeks, and again at 4-6 weeks for uncomplicated KD. This study examines the frequency of cardiac abnormalities on follow-up echocardiograms in patients with uncomplicated KD. We performed a retrospective chart review using the electronic health record at a tertiary care freestanding children's hospital, non-KD referral center. Patients with KD hospitalized from 1/1/2005 to 10/31/2016 were screened for uncomplicated disease (defined as normal echocardiogram upon diagnosis and fever resolution with initial therapy). Ninety-four patients with uncomplicated KD were included in this study. Fifty-seven percent were male, and the median age was 2.6 years (range=0.15-12). Fifty patients had an echocardiogram performed at two weeks, revealing no (0%) coronary abnormalities. Fifty-six patients had an echocardiogram performed at 6-8 weeks, revealing no coronary anomalies (0%). This study revealed that patients with uncomplicated KD did not develop coronary abnormalities on follow-up echocardiograms, providing additional evidence to help inform current KD guidelines. Further studies are needed to evaluate the optimal frequency of recommended echocardiograms for patients with uncomplicated KD.
Abstract: Kawasaki Disease (KD) is the leading cause of acquired heart disease among children in the developed world. Consensus-based guidelines from the American Heart Association (AHA) recommend echocardiograms be performed at the time of diagnosis, at two weeks, and again at 4-6 weeks for uncomplicated KD. This study examines the frequency of cardiac abno...
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Role of MRI in Hypertrophic Cardiomyopathy with Midventricular Obstruction and Apical Aneurysm: Uncommon High-risk Variant
Divyesh Dadhania,
Jineesh Valakada,
Anoop Ayyappan,
Ansan Joseph
Issue:
Volume 10, Issue 4, December 2021
Pages:
102-105
Received:
24 May 2021
Accepted:
13 July 2021
Published:
10 November 2021
Abstract: Hypertrophic cardiomyopathy (HCM) is characterized by cardiac muscle hypertrophy, unexplained by loading conditions with a nondilated left ventricle and normal or increased ejection fraction Midventricular obstruction of the left ventricle is an increasingly recognized phenotypic variant of hypertrophic cardiomyopathy due to the widespread availability of Cardiac Magnetic Resonance Imaging (CMR). Mid ventricular obstruction with apical aneurysm is a high risk variant of HCM which can lead to higher risk of arrhythmia and SCD. This variant is clinically and prognostically significant with MRI playing a major role in detection. CMR has nearly 100 % sensitivity in diagnosis and also helps in identifying other high risk features. CMR is helpful in detecting Late gadolinium enhancement (LGE) and apical aneurysm for which echocardiography is less sensitive. LGE represent area of replacement fibrosis which can act as a source for life threatening arrhythmia. Although this variant is not considered high risk feature for sudden cardiac death (SCD) in HCM cohort according to standard guideline, it is increasingly being recognized as a high risk feature by recent studies. Treatment is controversial however patients with multiple risk factors of SCD can be treated with ICD implantation to prevent catastrophic events. Herein we present a case of HCM with midventricular obstruction where MRI showed apical aneurysm with scarring and midventricular gradient. Incidence, pathophysiology, diagnosis role of CMR and treatment of this variant of HCM is discussed.
Abstract: Hypertrophic cardiomyopathy (HCM) is characterized by cardiac muscle hypertrophy, unexplained by loading conditions with a nondilated left ventricle and normal or increased ejection fraction Midventricular obstruction of the left ventricle is an increasingly recognized phenotypic variant of hypertrophic cardiomyopathy due to the widespread availabi...
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Social Restrictions and the COVID-19 Pandemic in Families of Special Students
Issue:
Volume 10, Issue 4, December 2021
Pages:
106-112
Received:
16 June 2021
Accepted:
9 August 2021
Published:
10 November 2021
Abstract: Working with special education is diving into an ocean of diverse and stimulating behaviors, challenging us daily and, the pandemic made us review routines, change attitudes and use more creativity. This experience report, in a context of insertion of psychologists in a multidisciplinary team, Unified Health System (SUS), in the modality of Special Schools (APAEs), approaches the psychological clinical experience, during the exercise of technical and ludic activities with the clientele and their respective families. It deals with two APAEs, in the Southwest Region of the State of Paraná-BR. This is a small sample, a differentiated work with specific psychological tools, involving the whole educational context. The goal here is to give visibility to a clientele that is sometimes marginalized, excluded and hidden in a fog of distorted beliefs and values, and how psychology contributes. We work with an inclusive methodology between school and family, in the Conversation Round format, with a theoretical focus on Cognitive-Behavioral Therapy and Systemic Approach. A brief context of the routine before and during the pandemic (COVID-19) is presented, which behaviors emerged and how they experience the current context. The preventive importance, of the psychological health program with the inclusion of families since 2016, to face the restrictions and social isolation is evidenced. Two cases of overcoming difficulties in the midst of the pandemic (COVID-19) are presented, converging with the theme of the National Week of the Person with Multiple and Intellectual Disabilities 2020 (Protagonism potentiates and materializes social inclusion). There were tense moments, program changes, methodological reinventions (Social Networks) mainly at the beginning of the pandemic. School, teams, and families started to communicate, mainly, through the cell phone (WhtsApp), with the teams making routine home visits, mobilized on different fronts, to provide all the help and guidance possible. We conclude this report with satisfactory results that, despite all the restrictive social suffering, the apaean families of the two schools, up to the present date (August/2021), had no losses and were able to adapt to the new reality: remote classes.
Abstract: Working with special education is diving into an ocean of diverse and stimulating behaviors, challenging us daily and, the pandemic made us review routines, change attitudes and use more creativity. This experience report, in a context of insertion of psychologists in a multidisciplinary team, Unified Health System (SUS), in the modality of Special...
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Epidemiological Characteristics in Patients with Diphtheria in the Autonomous Service University Hospital of Maracaibo
Issue:
Volume 10, Issue 4, December 2021
Pages:
113-119
Received:
29 August 2021
Accepted:
9 November 2021
Published:
17 November 2021
Abstract: Diphtheria is a notifiable infectious disease caused by Corynebacterium diphtheriae. Objective: To establish the epidemiological characteristics in patients with diphtheria in the Autonomous Service University Hospital of Maracaibo. Methodology: Descriptive, cross-sectional, prospective and field research. The sample was represented by patients older than 15 years admitted to the Internal Medicine service. Results: Between January 2018 and December 2018, 67 patients were included, the incidence was 25 cases per million inhabitants, 58,2% were female, aged between 15 - 65 years. 92,5% did not travel in the last month, 19,4% reported having had contact with diphtheria. Most of the cases came from the Maracaibo municipality in 46,3%. The predominant educational status was complete secondary with 59,7%. 86,6% do not know their vaccination history. The current occupation that prevailed was merchant in 34,3%, followed by housewife 23,9% and student 17,9%. The socioeconomic status by the Method of Graffar Méndez Castellano, the working class stratum IV predominated with 77,6%. The time elapsed from the onset of symptoms to hospitalization was 1-15 days. Tonsillitis-like respiratory form as a typical clinical presentation in all cases; fever, dysphagia, and presence of adherent pseudomembrane predominated in most patients. 22,4% presented complications. Most of the cases were confirmed clinically 77,6% while 4,5% were laboratory confirmed. The fatality rate was 19,4%. Conclusion: Diphtheria is a re-emerging disease in Venezuela in recent years, it affects any age and sex, in addition, it has been associated with low vaccination coverage and low socioeconomic status, so prevention and control is essential to eradicate the disease.
Abstract: Diphtheria is a notifiable infectious disease caused by Corynebacterium diphtheriae. Objective: To establish the epidemiological characteristics in patients with diphtheria in the Autonomous Service University Hospital of Maracaibo. Methodology: Descriptive, cross-sectional, prospective and field research. The sample was represented by patients old...
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Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria
Kinikanwo Green,
Collins Amadi
Issue:
Volume 10, Issue 4, December 2021
Pages:
120-125
Received:
25 October 2021
Accepted:
10 November 2021
Published:
23 November 2021
Abstract: Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nigeria. Methods: The current study was designed as a retrospective cross-sectional one and was conducted among women diagnosed with c3HELLPs in the University of Port Harcourt Teaching Hospital (UPTH) from 2011-2020. Relevant data from all eligible cases were abstracted from case notes, nurses’ charts, laboratory, and medical records using well-structured research pro forma and analyzed using the Statistical Package for Social Sciences version 25. Results: During the study period, 84 cases of c3HELLPs presented; 58 progressed while 26 did not progress while on management. The progressed cases had higher mean and abnormal levels of plasma uric acid (UA), creatinine, but low and abnormal levels of plasma albumin compared to the non-progressed c3HELLPs cases (p<0.05). The abnormally high UA, creatinine, and abnormally low albumin levels were associated with increased risk of c3HELLPs progression on crude/adjusted logistic regression (LR) and ROC analysis. However, the UA had a superior LR (crude=OR: 4.097; 95%CI: 2.917-5.753; p<0.001; adjusted=OR: 4.723; 95%CI: 3.199-5.763; p<0.001) and ROC (AUC: 0.978; 95%CI: 0.887-1.000; <0.001) predictive potentials. Conclusion: The study showed that rising plasma UA, creatinine levels but falling plasma albumin levels may indicate an increased risk of c3HELLPs progression. This finding should be considered along with clinical features and other HELLP-defined laboratory markers during the management of c3HELLPs. However, we recommend further studies to evaluate conclusions from this study.
Abstract: Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nige...
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The Pattern of Poisoning and It’s Management and Outcome in a Tertiary Care Hospital, Bangladesh: An Observational Study
Rozana Rouf,
Raihan Rabbani,
Tahmina Rahman,
Pratik Dewan,
Shihan Mahmud Redwanul Huq
Issue:
Volume 10, Issue 4, December 2021
Pages:
126-130
Received:
13 October 2021
Accepted:
23 November 2021
Published:
2 December 2021
Abstract: Introduction: In 2020, during the epidemic of corona, this study was done to see the patterns of the cases of Poisoning, in a tertiary hospital in Dhaka city. Poisoning exposure in adults and teenagers are more often intentional (recreational or suicidal), may involve multiple agents, which are commonly pharmaceuticals, and may be delayed in diagnosis and treatment. Objective: To assess the pattern of cases of poisoning found in 2020 January to February 2021, management and outcome. Methods: This Observational study was performed at Square Hospital, Dhaka, exclusively over 40 poisoned patients. It included the cases of poisoning, admitted in 2020 January to 2021 February. The collected cases are of commuter poisoning, suicidal poisoning, methyl alcohol poisoning and poisoning with sedative agents by housemaids. All these cases were admitted initially in the ICU after the initial management given in the Department of emergency. Results: In total we managed 40 cases. Among the 22 cases of suicidal poisoning, sedative poisoning was 10, antidepressant were 4, anti-schizophrenic was 1, anticonvulsant were 2, paracetamol poisoning was 1, propranolol poisoning 1. We found 1 case of paracetamol poisoning, 1 case of mixed oral anti diabetic agents (dapagliflozin, sitagliptin, glimeperide, added with metformin) 1 case of unknown poisoning (as blood level of drugs revealed nothing may be because of late presentation). We also found 12 cases of methanol poisoning and 6 patients of unknown poisoning. Among them 3 patients was poisoned by housemaid, 3 patients were cases of street poisoning. Benzodiazepine was found in all these 6 cases. In other studies it is found that, street poisoning by sedative hypnotic drugs were the highest percentage (37%) and all were male. E. Most of the victims of street poisoning were business man (67.56%) rest were normal/domestic travelers (16.2%) and few were service holders (10.81%). E. There were financial loss (loss of money or expensive things) of the patients. In analysis of the causes behind suicidal poisoning in other studies it is also found that, 57% were due to familial disharmony, 23% were poverty related, 15% were due to failure in affairs, 11% were due to failure in the examination, 4% were due to sexual abuse and 5% due to chronic illness and unknown cause. E. Conclusion: In the year of 2020, January to December, it was observed that the cases of alcohol poisoning was reduced. But in 2021 January to February there was a rapid rise of cases (8 cases in 2 months, the number we found in whole year of 2020 was only 4).
Abstract: Introduction: In 2020, during the epidemic of corona, this study was done to see the patterns of the cases of Poisoning, in a tertiary hospital in Dhaka city. Poisoning exposure in adults and teenagers are more often intentional (recreational or suicidal), may involve multiple agents, which are commonly pharmaceuticals, and may be delayed in diagno...
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Preventing Surgical Site Infections and Colorectal Surgery: Creating an Interdisciplinary Culture of Safety and Excellence
Christopher Wolff,
Stephen Brandstetter,
Wanda Mullins,
Mark Horattas
Issue:
Volume 10, Issue 4, December 2021
Pages:
131-137
Received:
4 November 2021
Accepted:
25 November 2021
Published:
7 December 2021
Abstract: Background: Surgical site infections (SSI) are an undesirable surgical complication that leads to negative patient and system outcomes. SSI risk correlates with various intrinsic (patient) and extrinsic (system) factors. Colorectal surgeries are especially susceptible. In 2013, the incidence of postoperative colorectal SSI rates was noted to be elevated at our institution with respect to national benchmarks. We developed and implemented an evidence based Colorectal Bundle (CRB) as our targeted intervention to reduce SSI. Methods: A multidisciplinary team was formed to develop and implement a CRB. The bundle was created using interventions established in the literature while also accounting for institutional biases. After a period of implementation, data was then analyzed using baseline and post implementation statistics. Additionally, infection rates were compared to national expected incidences using two national programs, the NSQIP and NHSN. Bundle compliance was encouraged over time to achieve sustained results. Results: We performed a total of 519 colorectal surgeries over a span of two and a half years and limited our infection rate to only 12 cases (2.3%). This was a significant reduction in SSI rates (RR 0.28, p < 0.001) and according to NSQIP, placed our system in the top decile with respect to SSI incidence. Conclusions: Implementation of our CRB resulted in a sustained decrease in SSI rates with respect to colorectal surgeries. We hope this manuscript can serve as a recipe for change. We highlight steps that were crucial to the success of our CRB from inception onward. We believe these key elements include the presence of a surgical champion, multi departmental buy-in, and continued compliance leading to a culture of excellence.
Abstract: Background: Surgical site infections (SSI) are an undesirable surgical complication that leads to negative patient and system outcomes. SSI risk correlates with various intrinsic (patient) and extrinsic (system) factors. Colorectal surgeries are especially susceptible. In 2013, the incidence of postoperative colorectal SSI rates was noted to be ele...
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Prescribing Pattern and Cost of Fluoroquinolones in Pyelonephritis Patients Hospitalized in Tertiary Care Hospital
Hafsa Sohail,
Maqsood Ahmed Khan,
Aslam Solangi,
Shazia Alam,
Mehwish Murad Ali,
Muhammad Gulraiz
Issue:
Volume 10, Issue 4, December 2021
Pages:
138-142
Received:
26 October 2021
Accepted:
22 November 2021
Published:
10 December 2021
Abstract: Complicated urinary tract infections (cUTIs) impose a high burden on healthcare systems and are a frequent cause of hospitalization. Urinary tract infection (UTI) is a common illness affecting both males and females in almost all age groups. The objective was to determine the prescription pattern of antibiotics and cost of fluoroquinolones antibiotics in patients of UTI (pyelonephritis). We finalized the most significant 66 pyelonephritis patient’s documents. All the information, related to the prescription cost of fluoroquinolones of antibiotics needed to treat the disease was arranged. Patient medication record was obtained from the patients’ medical file, and added with the unit cost of services obtained from the hospital record mainly medication, to determine the prescription cost. Concomitant medication and medication of complications was not recorded. All costs were calculated in Pakistani rupees and in US dollar (average exchange rate in year 2018 was 1US$=121.574 PkRs. The most commonly prescribed fluoroquinolone in our study for the treatment of pyelonephritis was ciprofloxacin. Average highest Cost of antibiotic combination of ciprofloxacin/levofloxacin was PKRs 8650 ($71.150) and the average least antibiotic cost for treating pyelonephritis was PKRs1008 ($8.291) with the combination of ceftriaxone 500gm/ciprofloxacin 400mg oral. The average flouroquinolones prescription cost per hospitalized case of UTI (Pyelonephritis) varied from case to case, depending upon the type and combination of antibiotics used. A better knowledge of the reasons for variations in length of stays could facilitate a better standardised quality of care for patients with UTI (Pylonephritis) and allow a more efficient allocation of healthcare resources.
Abstract: Complicated urinary tract infections (cUTIs) impose a high burden on healthcare systems and are a frequent cause of hospitalization. Urinary tract infection (UTI) is a common illness affecting both males and females in almost all age groups. The objective was to determine the prescription pattern of antibiotics and cost of fluoroquinolones antibiot...
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Essential Thrombocytosis Detected in Pregnancy: A Case Report
Behshad Pazooki,
Ailar Ahangari
Issue:
Volume 10, Issue 4, December 2021
Pages:
143-146
Received:
22 October 2021
Accepted:
11 December 2021
Published:
24 December 2021
Abstract: Essential thrombocytosis is a myeloproliferative disease of unknown reason that causes progressive platelet overproduction, which this high counts of platelets appear to be associated with intravascular thrombosis and related event. There are several medications to prevent thrombosis formation in these patients, such as hydroxyurea, and aspirin. We do not have much information about the duration of the medication. Our case was a 28-year-old woman without any history of medical problem, who gave birth recently, presented to the emergency department with epigastric abdominal pain, nausea/vomiting, loss of appetite, chills and diarrhea. On initial examination, huge splenomegaly about 20 cm below the edge of the ribs in the midclavicular line were detected. All lab data were within normal ranges. Pregnancy behaves as a trigger for undiagnosed essential thrombosis in this patient. She underwent anticoagulant therapy which still continuous. It seems that pregnancy became a triggering factor for ET in our case to show up with the symptoms like thrombosis. There is lack of evidence about duration of treatment. We don’t know when we should stop the anticoagulant therapy or we should continue the medications lifelong. This issue should be considered as the basis of future studies.
Abstract: Essential thrombocytosis is a myeloproliferative disease of unknown reason that causes progressive platelet overproduction, which this high counts of platelets appear to be associated with intravascular thrombosis and related event. There are several medications to prevent thrombosis formation in these patients, such as hydroxyurea, and aspirin. We...
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Fallout Following Unproven Prophylactic Use of Exogenous Vitamin D for COVID-19
Collins Amadi,
Bright Amadi
Issue:
Volume 10, Issue 4, December 2021
Pages:
147-151
Received:
27 November 2021
Accepted:
15 December 2021
Published:
24 December 2021
Abstract: The ongoing COVID-19 (Coronavirus Disease of 2019) pandemic has devastated the human race socially, psychologically, mentally, medically, and economically. It has greatly impacted both developed and developing societies. No region of the earth has been spared of the adverse consequences of the disease. To date, the treatment of the disease has remained ill-defined. Additionally, there are no standard preventive regimens for the disease except for non-pharmacologic interventions and vaccinations. However, several unproven preventive medications are awash in social media including the use of chloroquine, Zinc, Ivermectin, Vitamin D, and so many others as prophylactic agents for COVID-19. This has led to the unregulated/unsupervised self-induced consumption of these unproven medications that may be deleterious to health if taken in excess. Herein is a case of a 24-year-old undergraduate who self-medicated with a high dosage of exogenous Vitamin D for unproven COVID-19 prophylaxis for 2 months. He developed Vitamin D Toxicity (VDT) and manifested with varying clinical (dehydration, hypertension, acute abdomen) and metabolic (hypercalcemia, hypokalemia, alkalosis, hyperphosphatemia, hypoparathyroidism, hypercalciuria, and crystalluria) consequences all related to VDT. However, hypercalcemia was the initiating metabolic disorder for all the clinical and the other metabolic derangements. He was admitted, managed accordingly, and discharged home in good clinical condition. Regulations and public health enlightenment of these unproven medications, including Vitamin D, for COVID-19 prophylaxis, should be prioritized to stem the deleterious effect of these agents. These measures will limit the current pandemic to a viral pandemic rather than a pandemic of drug misuse and overdose.
Abstract: The ongoing COVID-19 (Coronavirus Disease of 2019) pandemic has devastated the human race socially, psychologically, mentally, medically, and economically. It has greatly impacted both developed and developing societies. No region of the earth has been spared of the adverse consequences of the disease. To date, the treatment of the disease has rema...
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US COVID-19 State Mortality and Case Progression – A Second Midterm Report Card (Delta Surge)
Vernon Wen-Hau Lin,
Daniel Lin,
Xiaoming Zhang
Issue:
Volume 10, Issue 4, December 2021
Pages:
152-163
Received:
17 November 2021
Accepted:
16 December 2021
Published:
29 December 2021
Abstract: The US has led the world with over 667,000 deaths due to COVID-19, partly fueled by the spread of the Delta Variant since the spring of 2021. The “Delta Surge” has especially impacted the southern states, despite the rolling out of three effective vaccines (Pfizer/BioNTech’s Comirnaty, Moderna, and Johnson & Johnson’s Jansen) since early 2021. This is an interim report of each state (50 states, Washington DC, and Puerto Rico), in terms of mortality rate (MR, the number of cumulative deaths per 100,000 population due to COVID-19 by July 27th, 2021) and Case Rate Progression (CRP, the percent change in the number of cumulative cases per 100,000 population increased from June 1st to August 1st, 2021). The study provided an A-F grade report card for each state when compared to one another. The results showed that the states that received F’s in MR are the following (starting from the worst): New Jersey, New York, Massachusetts, Rhode Island, and Mississippi. The 3 states that received an A rating were (starting from the best): Hawaii, Vermont, and Alaska. The following states received F’s in CRP (starting from the worst): Louisiana, Arkansas, Florida, Missouri, Nevada, and Mississippi. A poor CRP grade reflects rampant increases in new COVID-19 cases, followed by resulting increases in hospitalization, health resource utilization, and mortality. It is critical that we as a nation remain vigilant to observe these lingering effects of COVID-19 by participating in public health efforts, continuing to vaccinate the public, and observing social distancing, healthy hygiene practices, and masking as per CDC guidance.
Abstract: The US has led the world with over 667,000 deaths due to COVID-19, partly fueled by the spread of the Delta Variant since the spring of 2021. The “Delta Surge” has especially impacted the southern states, despite the rolling out of three effective vaccines (Pfizer/BioNTech’s Comirnaty, Moderna, and Johnson & Johnson’s Jansen) since early 2021. This...
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Association Between Clinical-biological Factors and Hypertension in the Urban-rural Population of Boma in the Democratic Republic of the Congo
Blaise Makoso Nimi,
Martin Phanzu Ngoma,
Benjamin Longo Mbenza,
Firmin Mbambi Nsungu,
Aliocha Nkodila,
Carine Nkembi Nzuzi,
Gedeon Longo Longo,
Etienne Mokondjimabe
Issue:
Volume 10, Issue 4, December 2021
Pages:
164-173
Received:
3 December 2021
Accepted:
23 December 2021
Published:
31 December 2021
Abstract: Hypertension is the main preventable risk factor for cardiovascular disease. Knowledge and control of multiple risk factors for hypertension will reduce its prevalence, better management and therefore a reduction in the burden of disease. This study targeted other risk factors for high blood pressure in Boma, Democratic Republic of Congo. Methods: This was an analytical cross-sectional study. The study population consisted of individuals of the inhabitants of Boma aged at least 18 years living in rural and urban areas for at least one year. This study is a continuation of two previous studies. The sampling was randomized to several degrees which made it possible to select the neighborhoods, avenues, households and then adults to be examined. A total of 1,781 households were listed and 3,800 people were expected, but only 3,510 people were examined and whose blood samples were kept and biological analyzes are being carried out gradually. Data were analyzed using SPSS version 21 software for Windows. They were expressed in mean standard deviations (SD) for continuous variables and in frequencies (n) and percentages (%) for categorical variables. The percentages were compared using the chi-square test. Logistic regression was used to identify independent factors associated with hypertension. The threshold of statistical significance was set at a value of p <0.05. Results: Information from 252 first blood collection samples from Congolese adults living in Boma and over 18 years of age was included in this analysis. The mean age of the study participants was 40.9 ± 15.4 years, of which 71.4% were female. Tobacco, alcohol, diabetes mellitus, and physical inactivity were the most common histories. BMI (p = 0.001), TT (p = <0.001), TH (p = <0.001), TT/Height (p = 0.001) and Uric acid (p = <0.001) values were significantly higher in urban areas than rural. In multivariate analysis, the probability of being associated with hypertension was almost times higher, respectively, AIP≥0.24 (p = 0.357) and Smoking (p = 0.693). It was almost 2 times higher, respectively, for Age≥50 years (p = 0.007), Physical inactivity (p = 0.015), Obesity (p = 0.103). It was nearly 4 times higher, respectively, for Uric Acid> 420 mg/dl (p = 0.001) and CRP> 3 mg/dl (p = 0.015). In the end, it was 10 times higher for Subclinical atherosclerosis (p = 0.001). Conclusion: The results revealed that high blood pressure has several modifiable risk factors such as CRP, uric acid and non-modifiable.
Abstract: Hypertension is the main preventable risk factor for cardiovascular disease. Knowledge and control of multiple risk factors for hypertension will reduce its prevalence, better management and therefore a reduction in the burden of disease. This study targeted other risk factors for high blood pressure in Boma, Democratic Republic of Congo. Methods: ...
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