Progress in Medical Sciences最新文献

{"title":"Unstable Coronary Angina with EKG changes due to LAD Coronary Artery Dissection","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)151","DOIUrl":"https://doi.org/10.47363/pms/2021(5)151","url":null,"abstract":"","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127788036","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}

{"title":"Congenital Heart Disease (CHD) & Pregnancy","authors":"Samah Alasrawi","doi":"10.47363/pms/2021(5)130","DOIUrl":"https://doi.org/10.47363/pms/2021(5)130","url":null,"abstract":"Both pregnancy & Congenital Heart Disease affect each other, due to hemodynamics changes, which may affect both mother & fetus. In this article we are going to talk about pre-pregnancy assessment, complications, drugs & mode of delivery in pregnancy with Congenital Heart Disease. Mother’s complications: Heart failure, arrhythmias, bleeding or thrombosis, and rarely maternal death [1]. Fetus complications: Birth defects, prematurity, low birth weight, abortion, and stillbirth [1]. Conclusion: All CHD female patients must receive pre-pregnancy counseling, thus preventing all pregnancy-related avoidable risks and complications for both mother and fetus.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"3 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115495222","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}

{"title":"Urinary Tract Infection: A Common Problem in Pediatrics","authors":"Vivel Zareth Arrieta Diaz","doi":"10.47363/pms/2021(5)149","DOIUrl":"https://doi.org/10.47363/pms/2021(5)149","url":null,"abstract":"","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116339721","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}

{"title":"Marijuana Induced Troponinemia- An Unusual Case of Elevated Troponins","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)134","DOIUrl":"https://doi.org/10.47363/pms/2021(5)134","url":null,"abstract":"Marijuana (pot, weed, hashish), a very renowned drug, used initially as a medicinal herb, now to ease pain and inflammation is abused worldwide. In the context of the easy availability, easy affordability, the popularity and the rising use of this recreational drug, we review a case where the use of marijuana caused elevated troponins that were alarming and interventional procedures were done to find out the cause, but when the catheterization failed to reveal any evidence of obstruction, marijuana-induced vasospasm was considered the possible culprit of the elevated troponins.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130555018","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}

{"title":"Anti-Hypercholesterolemic and Anti-Atherogenic Potential of Aqueous Extract of Dansonia Digitata Stem Bark Induced By Heated Palm Oil Supplemented With Egg in Rat","authors":"Bonabe Christian","doi":"10.47363/pms/2021(5)128","DOIUrl":"https://doi.org/10.47363/pms/2021(5)128","url":null,"abstract":"Aim: To investigate the antihypercholesterolemic and anti-atherogenic effects of Adansonia digitata (AD.) in in heated palm oil/cholesterol supplemented with egg in rat. Methods: Quantitative phytochemical screening of aqueous extract of A. digitata was carried out to identify the phytoconstituents. In vitro and in vivo antioxidant potential was evaluated. The antihypercholesterolemic and anti-atherosclerosis activity of A. digitata was evaluated by inducing hypercholesterolemia in rats with heated palm oil/cholesterol diet supplemented with egg for 10 weeks. At the end of induction period, animals were divided into 5 groups of 8 rats each after 6 weeks of induction: Group I (normocholesterolemic rat, NCR), Group II (hypercholesterolemia rat, HCR), Group III (Atorvastatin 2 mg/kg), Groups IV (AD. 100 mg/kg) and V (AD. 200 mg/kg). Hemodynamic parameters, lipid profile, atherogenic indices and oxidative stress markers were evaluated. Results: A digitata significantly reduced the systolic arterial blood pressure (SBP), diastolic arterial blood pressure (DBP), pulsatile pressure (PP) and heart rate. Plant extract reveal important flavonoids and phenolic contents and has significant in vitro and in vivo antioxidant efficacy. Both doses 100 and 200 mg/kg of A. digitata or atorvastatin significantly attenuated the lipid levels, atherogenic indices and histological abnormalities and significantly (p < 0.01) increased increase the high-density lipoprotein cholesterol (HDL-c) level. Conclusion: The aqueous extract of A. digitata possessed antihypercholesterolemic and anti-atherogenic effects via modulation overproduction of reactive oxygen species and endothelial dysfunction.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126727727","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}

{"title":"Fitz-Hugh-Curtis Syndrome, A Underly Studied Complication in Pelvic Inflammatory Disease","authors":"J. Gómez","doi":"10.47363/pms/2021(5)148","DOIUrl":"https://doi.org/10.47363/pms/2021(5)148","url":null,"abstract":"Introduction: Fitz-Hugh-Curtis syndrome is a perihepatitis product of a complication of pelvic inflammatory disease, this entity mostly affects women of childbearing age, its main clinical manifestation is pain in the right upper quadrant that may or may not be associated with chronic pain in the pelvic region and a history of clinical or subclinical PID. Methodology: For this article, a narrative review was carried out in different indexed journals and others, using keywords such as Fitz-Hugh-Curtis Syndrome, Pelvic Inflammatory Disease, in order to obtain original and review articles whose publication had been carried out between 2005 and 2020 Initially 28 articles were obtained but after applying our inclusion and exclusion criteria, we were left with 10 of which we collected the most applicable and relevant information possible. Results: Fitz-Hugh-Curtis syndrome is a complication present in about 14% of patients diagnosed with PID. The way in which microorganisms spread from the upper genitalia to the hepatic level is through the movement of peritoneal fluids from the pariotocolic leak to the subphrenic space, but other routes of dissemination such as hematogenous and lymphatic have also been described. Conclution: Despite having been described almost a century ago, it is little known within general practitioners and specialists, for which reason it is almost never seen in differential diagnoses, and the finding of its characteristic sign (adhesions on violin strings) ends up being incidental.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123302317","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}

{"title":"Subacute Cardiac Tamponade in a Patient with Malignancy","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)135","DOIUrl":"https://doi.org/10.47363/pms/2021(5)135","url":null,"abstract":"We hereby present a 57-year-old woman with a history of asthma and hypertension who presented to the emergency department with shortness of breath, syncope and loss of consciousness. Patient complained of decreased appetite, constipation and 20lbs weight loss over one month. Patient denied fever, chills, chest pain, nausea, vomiting, headache, pain or swelling in lower extremity, trauma, hemoptysis. Vitals at presentation: temperature 99.8 F, pulse 124 bpm, BP 135/93 mm Hg, respiratory rate 18 pm, oxygen saturation 96% on room air. Non-contrast CT scan of the brain was unremarkable. Cervical spine CT did not show any acute bony fracture or subluxation or central canal stenosis. Chest xray showed right upper lung infiltrate and very small right pleural effusion. Chest CT showed: small pulmonary emboli involving right lower lobe and left upper lobe sub segmental pulmonary arteries, large pericardial effusion, right upper lobe ground glass pulmonary infiltrates, right upper lobe pulmonary mass with multiple bilateral pulmonary nodules concerning for metastatic process, small right-sided pleural effusion, bilateral hilar and mediastinal lymphadenopathy concerning for metastatic disease, multiple ill-defined hepatic lesions. EKG showed sinus tachycardia without electrical alternans. Echocardiogram showed: left ventricular ejection fraction 50- 55%, grade 1 diastolic dysfunction consistent with impaired relaxation and normal filling pressures. There is a large circumferential pericardial effusion and right ventricular diastolic collapse suggesting tamponade physiology evident on echocardiogram. Pericardiocentesis was done, about 700 cc of fluid was removed and the patient’s symptoms improved. This patient had pericardial effusion most likely due to malignancy. Pericardial fluid buildup and subsequent tamponade in a malignancy is usually subacute. In malignancy, fluid accumulates slowly, pericardium stretches with time allowing ample fluid to be accumulated vs in an acute tamponade as there is very rapid, large pericardial effusion, pericardium does not have time to stretch and may present with more alarming signs and symptoms. Sub-acute tamponade as is seen in malignancy presents with less alarming signs and symptoms and might be missed. Patients with subacute tamponade may be asymptomatic or complain of fatigability, chest discomfort, dyspnea caused by decreased cardiac output and increased filling pressures.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121584259","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}

{"title":"Pulmonary Embolism in a Patient with Well’s Score of Zero","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)137","DOIUrl":"https://doi.org/10.47363/pms/2021(5)137","url":null,"abstract":"Pulmonary embolism is a condition in which a blood clot blocks a vessel in the lungs. It is a venous thromboembolism that is common and sometimes may prove to be life threatening. Well’s score/Well’s criteria calculates the risks of developing deep vein thrombosis and subsequently pulmonary embolism. Well’s score is based on clinical symptoms of DVT (leg swelling, pain with palpation)(3.0 points each), other diagnosis less likely than pulmonary embolism (3.0 points each), heart rate more than 100 (1.5 points each), immobilization or surgery in the last four weeks (1.5 points each), previous DVT/PE (1.5 points each), hemoptysis (1.0 points), malignancy (1.0 points). If the patient scores 3 or higher there is a high risk of DVT. 1 or 2 score is a moderate risk of DVT. In patients with moderate or higher probability for DVT (cut-off scores of 2), the Well’s score was able to detect patients at risk of developing DVT with a sensitivity of 67% and specificity of 90%. We hereby present a 40-year-old lady with no significant past medical history, who presented to the emergency department with sudden onset of non-radiating right sided chest pain and shortness of breath worsened with walking. Patient denied smoking, recent travels, OCP, recent surgeries, immobilization, previous DVT, pulmonary embolism, hemoptysis, malignancy, miscarriages, lupus. No family history of coagulopathies. Vitals were stable with Blood pressure of 101/60 mmHg, heart rate of 77 beats/minute, afebrile, Respiratory rate of 18, saturating 99% on room air. On examination no leg swelling or tenderness noted, no Intercostal Retraction, no use of accessory muscles, lungs clear to auscultation bilaterally. Venous Doppler study was unremarkable. Chest x ray did not show any cardio-pulmonary disease. The Well’s score came out to be zero with pulmonary embolism very low in the differential. We decided to do CT chest which showed small pulmonary emboli involving bilateral lower lobe sub-segmental pulmonary arteries. D-dimer came out to be 1938. All the rest of the labs and the coagulation factors were within normal limits. We started the patient on lovenox subQ 60 mg Q12 hourly with improvement in the shortness of breath. Patient was discharged on Xarelto. The possibility of DVT should still be considered if the patient presents with shortness of breath with zero Well’s Score.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125565856","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}

{"title":"Telephone Consultations by Medical Scheme Patients for Covid-19 Related Diagnosis-2020, South Africa","authors":"Michael M. Willie","doi":"10.47363/pms/2021(5)143","DOIUrl":"https://doi.org/10.47363/pms/2021(5)143","url":null,"abstract":"Background: The COVID-19 epidemic has adversely affected health systems globally. The utilisation of technology and other innovative channels link up with patients has evolved drastically in the COVID-19 climate. Lockdown measures and COVID-19 regulations and the fear of contracting the virus at a health care facility has also changed health seeing behaviour among patients. The COVID-19 climate has seen a significant increase in the utilisation of virtual platforms to consult with providers. Objectives: The primary objective of this study was to conduct the descriptive analysis of telephonic consultations by members of medical schemes. Methods: The study entailed a descriptive comparative analysis of medical schemes’ claims data. This was mainly outpatient claims information with the service date between March – December 2020. The inclusion criteria were all NAPPI codes associated with a telephonic consultation. The study included only COVID-19 related ICD-10 code primary diagnosis. Results: The analysis covered claims data from a total of 12 medical schemes. The schemes analysed accounted for 1,6 million lives, on 2019 beneficiaries. The total number of COVID-19 confirmed diagnosisrelated telephonic consultations was 8 939 and those related to suspected diagnosis accounted for 12 608, (41% vs. 59%, p<0.001). The median claims amount for a COVID-19 confirmed diagnosis and that of a suspected diagnosis was IQR: R293 (R283-R400) and R288 (R283-R390), respectively. Conclusion: The study found evidence of patients utilising digital platforms to consult the respective practitioners during the COVID-19 pandemic. Greater utilisation patterns were seen in disciplines such as general medical practice, specialists’ family medicine, independent practice specialist medicine and group practices. The main finding of the study was disparities between the scheme tariff amount and the claimed amount. The findings of this study depicted multidisciplinary management of COVID‐19, particularly at a primary health care level, where patients could consult with a practitioner virtually. However, we warn of ethical considerations and risk-related issues such as fraudulent activities that could arise when consulting medical practitioners virtually.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130210183","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}

{"title":"Importance of Knowing the Chilaiditi Sign","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)138","DOIUrl":"https://doi.org/10.47363/pms/2021(5)138","url":null,"abstract":"Chilaiditi sign is a rare radiological finding. The knowledge of which is important to prevent unwanted procedures in patients.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127011740","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}