Current Issue : July - September Volume : 2020 Issue Number : 3 Articles : 6 Articles
Background: Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly which has potential for spontaneous\nrupture into other cardiac chambers or the pericardial space (depending on its location). A ruptured SVA has a very\npoor prognosis with high morbidity and mortality. The development of a shunt between the sinus of Valsalva and\nright-sided cardiac chambers results in a continuous murmur on examination. Our case report is a case of SVA\nrupture into the right atrium.\nCase presentation: In this case report, we describe a 23-year-old patient with an acute onset of chest pain,\nshortness of breath, palpitations and dizziness starting 2 days prior to presentation to the emergency department.\nThe patient was initially treated for presumed pulmonary embolism overnight while awaiting CTPA the next\nmorning. However, further examination by the inpatient medical team demonstrated a continuous machinery\ncardiac murmur. Subsequent echocardiography demonstrated an acutely ruptured SVA with shunting to the right\natrium. Emergency surgical repair resulted in an excellent outcome for the patient.\nConclusion: A thorough clinical history and physical examination is the cornerstone of all medical encounters. An\nSVA could be asymptomatic until acute rupture. Echocardiography is the preferred initial diagnostic tool. Additional\nimaging techniques can be used to confirm the diagnosis. In cases of rupture, prognosis is poor and surgical repair\nis always required....
Objective. To investigate the association between the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio\n(AST/ALT ratio, AAR) and intravenous immunoglobulin (IVIG) resistance, coronary artery lesions (CAL), and coronary artery\naneurysms (CAA) in children with Kawasaki disease (KD). Design. We retrospectively studied 2678 children with KD and divided\nthem into two groups: a low-AAR group and a high-AAR group with a median AAR of 1.13 as the cut-off point. The differences in\nlaboratory data, clinical manifestations, and coronary artery damage rates were compared between the two groups. Results. The\nincidence of CAL was higher in the low-AAR group than in the high-AAR group at 2 and 3-4 weeks after illness onset.........................
Background. Malaria is known to cause severe health consequences due to its marked effects and alteration on the haematological\nparameters of infected individuals. This study evaluated the haematological profile of adult individuals infected with the malaria\nparasite. Methods. A retrospective study was conducted using archived data of malaria positive cases from January 2017 to March\n15, 2019. Data retrieved included subjectsâ?? demographics, malaria parasite count, malaria parasite species, and full blood count\nparameters. A total of 236 malaria positive subjects were included in the study. Results. The study showed that more females were\ninfected with the malaria parasite than males (69.07% and 30.93%, respectively). A total of 87.3% of the study population were\ninfected with Plasmodium falciparum as compared to 12.7% infected with Plasmodium malariae. The commonest haematological\nabnormalities that were seen in this study were lymphopenia (56.78%), anaemia (55.51%), thrombocytopenia (47.46%), eosinopenia\n(45.76%), neutropenia (29.24%), monocytosis (21.19%), and leucocytosis (17.37%) in the infected subjects. The mean\nplatelet count of P. falciparum-infected subjects was decreased as compared to the mean platelet count of P. malariae-infected\nsubjects. There was a significant (P value <0.05) decrease in the number of platelet count with every unit increase in parasite\ndensity. Conclusion. Study participants infected with malaria demonstrated vital changes in haematological parameters with\nanaemia, thrombocytopenia, lymphopenia, monocytosis, and eosinopenia being the most important predictors of malaria infection\nespecially with P. falciparum species....
Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare, inheritable cardiac disorder characterized by ventricular tachyarrhythmias, progressive loss of cardiomyocytes with fibrofatty replacement and sudden cardiac death. The exact underlying mechanisms are unclear.\nMethods: This study investigated the possible roles of nucleoside diphosphate kinase B (NDPK-B) and SK4 channels in the arrhythmogenesis of ARVC by using human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs).\nResults: In hiPSC-CMs from a patient with ARVC, the expression levels of NDPK-B and SK4 channels were upregulated, the cell automaticity was increased and the occurrence rate of arrhythmic events was enhanced. Recombinant NDPK-B applied into hiPSC-CMs from either healthy donors or the patient enhanced SK4 channel current (ISK4), cell automaticity and the occurrence of arrhythmic events, whereas protein histidine phosphatase 1 (PHP-1), a counter actor of NDPK-B, prevented the NDPK-B effect. Application of PHP-1 alone or a SK4 channel blocker also reduced cell automaticity and arrhythmic events.\nConclusion: This study demonstrated that the elevated NDPK-B expression, via activating SK4 channels, contributes to arrhythmogenesis in ARVC, and hence, NDPK-B may be a potential therapeutic target for treating arrhythmias in patients with ARVC.\nKeywords: SK4 channel; arrhythmia; arrhythmogenic right ventricular cardiomyopathy; human-induced pluripotent stem cell-derived cardiomyocyte; nucleoside diphosphate kinase....
Objective: To evaluate the relation between epicardial adipose tissue (EAT)\nthickness and also pericoronary fat assessed by Multidetector Computed\nTomography (MDCT) with both calcium score and significance of coronary\nartery disease. Background: Epicardial adipose tissue (the visceral fat of the\nheart present under the visceral layer of the pericardium) has the same origin\nof abdominal visceral fat, which is known to be strongly related to the development\nof coronary artery atherosclerosis. Multidetector CT (MDCT) provides\nan accurate and reproducible quantification of EAT due to its high spatial\nand temporal resolution. Patients and Methods: The current study included\n70 patients with low-intermediate probability of coronary artery disease.\nAll patients were subjected to 256 Multidetectors CT to assess EAT\nthickness, the mean thickness of the pericoronary fat surrounding the three\ncoronary arteries and coronary calcium score. Also coronary CT angiography\nwas done and patients were then divided into 3 groups according to significance\nof coronary atherosclerosis: Group 1: No atherosclerosis (20 patients),\nGroup 2: Non obstructive atherosclerosis (luminal narrowing less than 50%\nin diameter) (25 patients), Group3: Obstructive atherosclerosis (luminal narrowing......................
Background. Red cell Rhesus (Rh) antigen expression is influenced by the genetic polymorphism of RHD and RHCE genes and\nreveals serologically different reactions of RhD variants such as partial D, weak D, and Rh-Del. Serologically, Rh-Del type can only\nbe detected by an adsorption-elution technique, and it might be mistyped as Rh-negative. The prevalence of Rh-Del has not been\nreported yet in Myanmar. Method. A total of 222 Rh-negative blood donors in the National Blood Center were tested for weak D\nand Rh-Del by indirect antihuman globulin and adsorption-elution method, respectively. RhCE typing was performed among Rhnegative\nand Rh-Del. Results. Of them, 75.2% (167/222) were Rh-negative, 15.8% (35/222) were Rh-Del, and 9% (20/222) were\nweak D. Of 202 blood donors (167 true Rh-negative and 35 Rh-Del), all of the Rh-Del positives were C-antigen-positive with 94.3%\nCcee phenotype (33/35) and 5.7% CCee (2/35). Most of the Rh-negative donors (80.2%) were ccee phenotype (134/167).\nConclusion. About half of Rh-Del subjects were repeated donors, and attention was needed to avoid transfusion of truly Rhnegative\npatients to prevent alloimmunization. It is recommended to do Rh-Del typing of Rh-negative donors who are C-antigenpositive\nand consider moving them to the Rh-positive pool. Further study is needed to clarify the alloimmunization status for\ntransfusion of Rh-Del blood to Rh-negative recipients. Molecular markers for RhD-negative and D variants should be established\nin the Myanmar population to improve selection of antisera for Rh typing and enhance safety of the transfusion services....
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