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Cattra, Chiara, and Laur Evans. "Edu-couch-ing the masses: an online, multi-disciplinary psychiatry teaching programme." BJPsych Open 7, S1 (June 2021): S128. http://dx.doi.org/10.1192/bjo.2021.369.
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AimsIn response to medical students expressing concer at limited access to psychiatric placements, particularly on-the-ground teaching or witnessed patient cases, we established “Psych From The Couch” – an open-access, free, Zoom-based, interactive teaching programme. We sought to:Explore new means of psychiatric education, assess needs of multiple “categories” of student – medical, nursing, or PA students, junior doctors, wider MDT – and meet those needs in a creative, yet virtually-limited format.Assess disparities between students' self-declared learning deficits and objective knowledge gaps.To explore the use and value of virtual programmes as a structured means for inclusive multi-disciplinary education of psychiatric practice.MethodWe gathered information on students' self-declared learning needs and deficits, location, role, training level, and confidence at the outset of the programme, with data from ~180 “students”.We experiemtned with learning styles and methods of online interaction, running a series of 10 sessions - recorded for those unable to attend - incorporating the bredth of psychiatric curricula:Diagnostic Principles“Organic” PsychiatrySubstance MisusePsychotic DisordersAffective DisordersOld Age PsychiatryCAMHSEmergencies & LegalitiesExaminations in PsychiatryReal World PsychiatryWe utilised initial sign-up forms and repeated feedback requests to assess wider student needs, establish overarching structure to our programme, and ensure learning objectives were appropriate and met.We collated final feedback and scores at the close, assessing via examination questions and self-defined Likert scale, and incentivising feedback with a final portfolio certificate.ResultDemographics of open-access teaching varied broadly, from senior medical staff to access to medicine students; 92.9% were medical students. Students were diversely sourced from all years', with ~50% collectively in their penultimate or final years' of study.Most common self-defined decficits reported were understandably anxiety regarding practical examinations or assessment given recent placement restrictions, however many reflected on anxieties regarding psychiatric emergencies, substance misuse, legal frameworks, personality disorders as a diagnostic category, and pharmacological management.Our cohort responded warmly to our teaching style and techniques, with feedback and consequent improvements to teaching technique weekly. We were able to evidence improvements to global confidence, and confidence in key areas of prior learning anxiety.ConclusionCategorising self-defined deficits yielded fasctinating information on students' perception of their learning needs and deficits; these data may offer insight into potential deficits in the scope of nationwide psychiatric teaching.We were able to separately identify international students' or professionals' self-defined needs as distinct from UK students and graduates, with further rich data on the potential needs of those entering the NHS workforce.We also evidenced – with data regarding increased confidence, fewer self-defined learning deficits, significant Twitter social interaction, and in practical application of a virtual teaching methodology – proof of the concept of “Psych From The Couch”.
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Pfeiffer, Bock, Hohenberger, and Kröger. "The arteriomobil project for peripheral arterial disease." Vasa 37, no. 4 (November 1, 2008): 345–52. http://dx.doi.org/10.1024/0301-1526.37.4.345.
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Background: Peripheral Arterial Disease in Germany is underestimated with regard to incidence and the consequences. In 1997 the Federal Association of the Peripheral Arterial Disease Self Help Groups started the Arteriomobil Project to increase the awareness for venous and arterial diseases in the general population. We report peripheral arterial disease (PAD) prevalence rates and discuss the unique concept of this project. Patients and methods: The Arteriomobil is a mobile home modified to a simple investigation room with an examination couch, a Doppler equipment and a computer for data acquisition. From April 1997 to April 2007, a total of 14.785 volunteers aged 18 to 102 years (mean age ± SD: 64 ± 11 years, 63% females) were investigated. Patients were recruited as a result of their active visit to the Arteriomobil and their active participation in the investigation. In all participants the medical history was documented according to a standardized computer-assisted interview and a standardized Ankle Brachial Index (ABI) determined. Results: PAD prevalence in females (ABI < 0.9) increased from 2% in the 5th decade of life to 33% in 10th decade and in males from 4.8% to 41% accordingly. Age- and gender-adjusted odds ratios for PAD were highest in smoker: Odds ratio 2.85 (95% Confidence interval 2.5–3.2) and Diabetes mellitus 1.91 (95%CI 1.7–2.2). Hypertension and hypercholesterolemia had a lower impact. Family history of known PAD, CHD or CVD had no impact. Although 49.5% of all participants complained of "leg disorders during exercise" intermittent claudication turned out to be the most discriminating symptom for PAD 5.87 (95%IC 5.18–6.66). Previous myocardial infarction (MI) was the most frequently reported vascular co-morbidity in those with PAD (OR 2.23, 95%IC 1.9–2.7) followed by stroke (2.12, 1.7–2.7), angina pectoris (1.50, 1.3–1.8) and paresis (2.01, 1.6–2.6). The incidence of anti-platelet treatment was significantly higher in participants with coronary heart disease than in those with PAD or cerebrovascular disease. Conclusions: The Arteriomobil Project is the largest database regarding the prevalence of PAD in the German population. and the data underlines the high prevalence of PAD in Germany.
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Anaev, E. Kh. "Modern approaches to the management of patients with bronchoectasia." Russian Pulmonology 30, no. 1 (April 21, 2020): 81–91. http://dx.doi.org/10.18093/0869-0189-2020-30-1-81-91.
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The bronchoectasia (BE) is a chronic heterogeneous lung disease characterized by recurrent infection, inflammation, persistent cough and sputum discharge. The early BE diagnosis is one of the main recommendations of the European Respiratory Society (ERS) guidelines, which requires medical history collection and multispiral computed tomography (MSCT) of thoracic organs. Despite the complex examination, in most patients BE is classified as idiopathic. The minimum set of tests, including serum immunoglobulins, allergic bronchopulmonary aspergillosis tests and hematology is proposed in ERS guideline for detection of BE causes. Other examinations are recommended to perform based on disease history and radiological characteristics, indicating the importance of BE clinical phenotype identification by different healthcare specialists, for which special examinations are required. Initial examination algorithms and management of patients with BE, in particular, MSCT-semiotics and clinical features, which could help to identify specific reasons are presented in the article.
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Enache, Raluca, and Dorin Sarafoleanu. "The chronic cough syndrome." Romanian Journal of Rhinology 6, no. 22 (June 1, 2016): 69–73. http://dx.doi.org/10.1515/rjr-2016-0008.
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Abstract Cough is a common symptom encountered in medical practice and can occur throughout the life of a person. From a physiological point of view, it represents a mechanism responsible for the elimination of secretions from the airways. At the same time, cough may be the first symptom of an illness. There are many causes that may lead to the emergence of a chronic cough syndrome, the most frequent being pulmonary diseases. Besides the bronchopulmonary pathology, there are a number of extrapulmonary disorders that may manifest with coughing. The first step in evaluating the patient with chronic cough is performing a correct and complete anamnesis, followed by the physical examination of the patient. The treatment of the chronic cough syndrome must address mainly the underlying disease but, in case of failure of the established treatment, the antitussive therapy is used.
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Lindsley, William G., William P. King, Robert E. Thewlis, Jeffrey S. Reynolds, Kedar Panday, Gang Cao, and Jonathan V. Szalajda. "Dispersion and Exposure to a Cough-Generated Aerosol in a Simulated Medical Examination Room." Journal of Occupational and Environmental Hygiene 9, no. 12 (December 2012): 681–90. http://dx.doi.org/10.1080/15459624.2012.725986.
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Bhattacharjee, Swapna, Shekhar Bhattacharjee, and Rukhsana Parvin. "Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh." Journal of Enam Medical College 3, no. 1 (February 20, 2013): 29–31. http://dx.doi.org/10.3329/jemc.v3i1.13871.
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Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31
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Koch, Andrea, and Jürgen Behr. "Husten – Differenzialdiagnosen." DMW - Deutsche Medizinische Wochenschrift 143, no. 17 (August 2018): 1258–71. http://dx.doi.org/10.1055/s-0043-109521.
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AbstractA thorough anamnesis and the physical examination of a patient with cough mostly lead the way to the further diagnostic and therapeutic procedure. As far as there are no obvious reasons for the cough symptoms, any case of persisting chronic cough needs a diagnostic clarification – including computed tomography of the thorax and bronchoscopy as the final step. If clinical findings make them necessary, also invasive diagnostic procedures – such as bronchoscopy, thoracoscopy and surgical biopsy of the lung – must not be avoided. According to the clinical presentation appropriate medical disciplines have to be consulted for the diagnostic clarification of chronic cough. Besides pulmonology und allergology these are ENT medicine, gastroenterology, cardiology, infectiology, neurology and possibly psychiatry. The therapy of chronic and acute cough should be aimed at a causal treatment approach.
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Islam, Md Safiqul, and Md Mahmudur Rahman Siddiqui. "Sarcoidosis - A Case Report." Anwer Khan Modern Medical College Journal 10, no. 1 (October 20, 2019): 92–95. http://dx.doi.org/10.3329/akmmcj.v10i1.43668.
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Sarcoidosis is a chronic granulomatous disorder of unknown etiology, commonly affecting the lungs, skin and eyes. Although lungs and lymph nodes are involved in more than 90% of patients, virtually any organ can be involved. We describe a 36 years old lady presented with fever, skin rashes, cough, polyarthralgia, bodyache, wt. loss for 3 months. Examination revealed Fever, Erythema Nodosum, Cervical Lymphadenopathy. Investigations revealed high ESR (80 mm in 1st hour), high CRP, Hilar Lymphadenopathy on Chest X ray, Non-caseous Granuloma, Giant cell and Asteroid body on Lymph node Biopsy. All of her history, clinical examinations and Investigations are suggestive of Sarcoidosis. With symptomatic treatment and watchful observation, now she is completely symptoms free and leaving a healthy life.
Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 92-95
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Widiasmaran, Wulan, Ayu Anggraini Kusumaningrum, Fitri Amalia, and Dimas Tri Anantyo. "BRONKHOPNEUMONIA AS COMORBIDITIES OF CMV INFECTION : STUDY CASE ON 1 YEAR 9 MONTHS OLD BOY." DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) 10, no. 1 (January 31, 2021): 55–59. http://dx.doi.org/10.14710/dmj.v10i1.28187.
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Background. Pneumonia is an acute lung parenchyma inflammation, which includes the alveoli and tissues. According to RISKESDAS 2018, pneumonia prevalence of children under five years old in Indonesia has increased from 1.6% in 2013 to 2% in 2018. Cytomegalovirus infection (CMV) is the most common congenital infection and causes high morbidity in newborns. The purpose of this case is to report a case in Semarang and conduct a discussion of pneumonia cases and a history of CMV infection so that proper treatment can immediately start.Method. Anamnesis carried out on February 1, 2020, at Government Hospital in Semarang. Data obtained from allonamnesis with the patient's mother, physical examination, supporting examinations, and medical records of patients. Case. Patient of a boy aged one year nine months that come to the ER with a chief complaint of fever and cough.Discussion. A boy aged one year nine months with fever and cough complaints about five days before entering the hospital. Sputum culture examination revealed the presence of Klebsiella pneumonia, then treated with cefoperazone sulbactam. The patient had a history of cytomegalovirus infection but not optimally treated because of the high avidity value.Conclusion. Patient has diagnosed with bronchopneumonia et causa Klebsiella pneumonia.
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Pimenova, A. S., O. Yu Borisova, M. S. Petrova, N. T. Gadua, A. B. Borisova, L. I. Kafarskaya, and S. S. Afanasiev. "COMPARISON OF RAYON AND FLOCKED SWABS FOR COLLECTION AND TRANSPORT OF DEEP THROAT SWABS FOR DETECTION OF BACTERIA CAUSING WHOOPING COUGH BY MULTIPLEX REAL-TIME PCR ASSAY." Russian Clinical Laboratory Diagnostics 64, no. 8 (October 7, 2019): 493–96. http://dx.doi.org/10.18821/0869-2084-2019-64-8-493-496.
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The aim of the work was to comparison of rayon and flocked swabs for collection and transport of deep throat swabs for detection of bacteria causing whooping cough by multiplex real-time PCR assay. The study included 87 patients aged from 1 month to 37 years, hospitalized in Infectious Diseases Clinical Hospital No. 1 of the Moscow Department of Healthcare. 68 (78,2 %) people had a diagnosis of whooping cough, the main group of which consisted of children aged 1 to 12 months (median 4 months); 17 (19,5 %) - other diseases of the respiratory tract; 2 (2,3 %) - contact with sick whooping cough. The initial examination of patients was carried out on the 1 - 8th week of the onset of the disease. The material from the patients was taken at one-day interval with commercial rayon swabs and flocked swabs. Identification and differentiation of specific genome fragments of the causative agents of whooping cough in biological material was carried out by real-time PCR using the «AmpliSens® Bordetella multi-FL» reagent kit. The efficiency of PCR-based diagnostics of whooping cough using flocked swabs at the preanalytical stage was 83,8 %, and rayon swabs - 82,3 %. The use of a flocked swabs at the preanalytical stage increased the research efficiency by 1,5 %. Thus, when collecting biological material for PCR-based diagnostics of whooping cough it is possible to use flocked swabs.
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Barua, Uttam Kumar, Santosh Kumar Saha, Dilip Kumar Ghosh, and Md Mesbahul Karim Ruble. "Epidemiological Study on Bronchial Asthma at Shaheed Suhrawardy Medical College Hospital, Dhaka." Journal of Shaheed Suhrawardy Medical College 5, no. 2 (December 1, 2013): 77–80. http://dx.doi.org/10.3329/jssmc.v5i2.20759.
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Background: In Bangladesh more than 100 million people are suffering from cough and shortness of breath. Still people are getting unplanned treatment and taking unscientific, indigenous and sometimes harmful products to get relief.Objective: The present study was conducted to estimate the prevalence of different types of bronchial asthma in Shaheed Suhrawardy Medical College Hospital.Methodology: One hundred patients from respiratory medicine out patient department were included in this study using a well designed questionnaire, clinical examination by physician which was carried out from January, 2012 to June, 2012. The key questions were related to the type of asthma, family history, presence of atopic dermatitis and diabetes, information on smoking and alcoholic habits, domestic cooking fuel used, dwelling area, age, religion, socioeconomic status and age of onset of disease.Result: Out of 100 subjects surveyed, 42 were females and 58 were males. The type of asthma is distributed as cough-variant-asthma (8%), intermittent asthma (52%), persistent asthma (16%), seasonal asthma (22%) and occupational asthma (2%). Regarding family history, 26% showed genetic predisposition irrespective of sex. Among asthmatics, 6% were having atopic dermatitis. Forty percent were smokers, 5% were alcoholics and 28% were with diabetics. Advancing age, usual residence in urban area and lower socio-economic status were associated with significantly higher odds of having asthma.Conclusion: It showed that cough- variant-asthma, diabetes and smoking habit increase the incidence of asthma attacks.DOI: http://dx.doi.org/10.3329/jssmc.v5i2.20759J Shaheed Suhrawardy Med Coll, 2013;5(2):77-80
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Tsyganko, D. V., N. G. Berdnikova, and V. A. Ekaterinchev. "Clinical and pharmacological approaches to the optimisation of therapy in a coughing patient." Meditsinskiy sovet = Medical Council, no. 4 (April 20, 2021): 112–19. http://dx.doi.org/10.21518/2079-701x-2021-4-112-119.
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Cough is considered as an unconditional reflex adaptive defense response to irritating agents such as aeropollutants, foreign bodies, sputum, and is supposed to ensure adequate airway patency for normal gas exchange. Unfortunately, this mechanism is often transformed from a protective to a pathological one, lacking an adaptive function, causing suffering to the patient and exacerbating his poor condition. The line between physiological and pathological cough is often blurred and is perceived differently by both patients and physicians. In most cases, cough, including persistent cough, is treated with neglect by the general population - as an everyday occurrence with no major problems, and with a lack of awareness of tuberculosis, cancer and a number of other serious diseases. There are a large number of medicines on the market that are positioned as effective cough medicines. However, the wide variety of ways to treat this pathology demonstrates that there is no ideal cough medicine that combines universality, high efficacy and safety. Many drugs can cause serious side-effects, imposing severe restrictions on their use. Another difficulty is that the triggers and pathways of the cough reflex are extremely varied. Identifying the causes of persistent cough requires a thorough medical history, often with a multidisciplinary approach: extended examination, doctors such as otorhinolaryngologist, cardiologist, gastroenterologist, pulmonologist, oncologist, phthisiatrician, clinical pharmacologist (druginduced cough, drug-drug interactions). This article focuses on the differential diagnosis of cough and the selection of cough medicines based on their proven efficacy and safety. This information becomes particularly relevant during the seasonal increase in the incidence of acute respiratory infections.
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Oyedokun, Taofiq, and Kevin Durr. "Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation." Clinical Practice and Cases in Emergency Medicine 4, no. 4 (June 14, 2020): 634–35. http://dx.doi.org/10.5811/cpcem.2020.7.48695.
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Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway. Discussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.
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Islam, Mirza Md Ziaul, Md Kamruzzam, BH Nazma Yasmeen, Nasreen Begum, and AFM Ashik Imran. "Evaluation of Chronic Cough in Children: A Prospective Study in a Tertiary Care Hospital." Northern International Medical College Journal 9, no. 1 (March 12, 2018): 264–66. http://dx.doi.org/10.3329/nimcj.v9i1.35925.
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Background : Chronic cough is a common complaint in children which causes distress, and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity.Objective : To evaluate the specific diagnosis and prognosis of chronic cough in children.Methods : A prospective study was done on children with chronic cough (history of cough>8 weeks) referred to Dhaka Shishu (Children) Hospital, a tertiary hospital.Children aged 2 to 8 years with chronic cough referred by the general physicians, pediatricians and other peripheral hospitals were the study subjects. Exclusion criteria were children with immune-deficiency,congenital anomalies of lung,congenital heart disease, gastro-intestinal disorders (e.g. gastro-esophageal reflux, peptic ulcer disease), in born error of metabolism (e.g. cystic fibrosis) and other chronic conditions (e.g. gross neurodevelopmental delay). The evaluation of chronic cough was based on simple principles: careful history-taking concerning the characteristics of the cough, full clinical examination to look for any associated symptoms and relevant investigations done. Underlying diagnoses and outcomes were ascertained after follow-up for a period of six months and treatment was given as per the management protocol of the hospital.Results : The most common final diagnosis was allergic rhinitis (31%), followed by asthma (28.6%), rhinitis coexisting with asthma (23.8%), post viral cough (16.6). Cough resolved in 54.8%, partially improved in 40.5% and persisted in 4.7% of patients.Conclusion : Allergic rhinitis with or without co-existing asthma was the commonest cause of chronic cough in children referred to this hospital.Northern International Medical College Journal Vol.9(1) July 2017: 264-266
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Shaheduzzaman, AKM, Devendra Nath Sarkar, Md Ismail Hossain, Md Rehan Habib, Md Mahfuzer Rahman, Shah Md Sarwer Jahan, and Md Zakir Hossain. "Bronchoscopy in Rangpur Medical College Hospital Our Experience of 02 Years." Bangladesh Journal of Medicine 27, no. 1 (June 5, 2016): 16–21. http://dx.doi.org/10.3329/bjmed.v27i1.28070.
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Background: Bronchoscopy can play a major role in both diagnosis and treatment. Diagnostic bronchoscopy is a useful tool for the diagnosis of pulmonary lesions particularly bronchogenic carcinoma and pulmonary tuberculosisAim: To find out the role of fibre-optic bronchoscopy in the diagnosis of pulmonary diseases.Methods: This observational study was conducted in the Indoor patient, Department of Medicine in Rangpur Medical College Hospital. Of all patients aged 18 years and above Undiagnosed pulmonary lesion in the medical wards between October 2012 to October 2014.Results: Out of 256 cases, mean age ±SD was 61.01(±11.51), minimum age was 23 and maximum age was 86 years. Majority 84% were male and 16% were female. Most of the respondent were smoker whereas (82%). Most common presenting complains were cough, dyspnoea, haemoptysis and fever 83%, 59.3%,53% and 36% respectively. General Physical examination findings, 97% were anamia and clubbing were 41% and cyanosis 02%. Respiratory system examination findings, 54% were features suggestive of complete collapse, 15% features suggestive of consolidation and 31% normal chest findings. Chest x-ray findings of the study population, 25.8% were dense homogenous opacity involving right or left lung field, 17.9% were complete collapse of affected lungs , 5.5% were right middle lobe collapse, 4.3% Unilateral hilar lymphadenopathy, 7.03% were elevation of hemidiaphragm of affected site and 7.03% were pleural effusion. 6.6% patient had normal CxR. In present study shows bronchoscopic findings in patients studied, Vocal cord paralysis were 9.3%, Right main bronchus were 15.6% , Right upper lobe bronchus were 7.03% , Right middle lobe bronchus were 7.8%, Right lower lobe bronchus were 9.8%, Left main bronchus were 14% , Left upper lobe 4.3%, Left lingular were 1.9% and Left lower lobe bronchus were 9.3%.In this study shows histologhical findings majority 18% were squamaus cell carcinoma,8.2% were small cell carcinoma,2.3% were adeno carcinoma,6.6% infiltration of Inflammatory cell and granuloma 1.2%.Conclusion: In this study male are predominant. Most of the respondent was smoker. Most common presenting complains were cough, haemoptysis, fever and chest pain. Most of general physical examination findings were anamia and clubbing. Respiratory system examination findings were features suggestive of complete collapse, features suggestive of consolidation and normal chest findings. chest x-ray findings of the study population were complete collapse of affected lungs, rtight middle lobe collapse, Dense homogenous opacity involving right or left lung field, Unilateral hilar lymphadenopathy. Bronchoscopic findings were vocal cord paralysis, right main bronchus, right upper lobe bronchus, right middle lobe bronchus, right lower lobe bronchus, left main bronchus, left lingual and left lower lobe bronchus. Histologhical findings majority were squamaus cell carcinoma. Most of the patient poorly differentiated carcinoma among the study subjectsBangladesh J Medicine Jan 2016; 27(1) : 16-21
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Popova, O. P., T. S. Skirda, I. M. Fedorova, and S. I. Koteleva. "Features of the specific humoral response and cytokine regulation in whooping cough in children." Epidemiology and Infectious Diseases 20, no. 5 (October 15, 2015): 42–48. http://dx.doi.org/10.17816/eid40956.
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In the article there is presented the comparative analysis of the character of the specific humoral response to pertussis in dependence on the age, terms of the disease and vaccination history in 279 patients, among which 114 patients were under 1 and 165 patients - over 1 year of the age. In the study of the level of the production of antibodies of different isotypes in unvaccinated patients of different age in dependence on the terms of medical examination it has been revealed that in the patients under the age of 1 year there was typical the low production of all the classes of antibodies in any time of the disease, especially IgM. It has been shown that in babies aged from 0 to 3 and from 4 to 6 months old the production level of these immunoglobulins in examination at the early stages of the disease was established to be considerably lower than in the patients at the age from 7 to 12 months, and was equal to 1,1 ± 0,4 and 1,5 ± 0,1 U/ml versus 9,1 ± 3,8 U/ml correspondingly, (p
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Kundu, Susmita, Aparup Dhua, Saswata Ghosh, and Rajesh Agarwal. "Concurrent multiple brain tuberculomas with miliary tuberculosis - A rare presentation." Asian Journal of Medical Sciences 6, no. 2 (September 15, 2014): 118–20. http://dx.doi.org/10.3126/ajms.v6i2.10279.
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A 45 year old immunocompetent female presented to us with fever, dry cough, vomitingand headache. There was a single episode of convulsion after hospital admission. ChestXray was normal. After through clinical examination and relevant investigations we came toknow that it was a case of concurrent multiple brain tuberculomas with miliary tuberculosis.Patient was managed with antitubercular drugs and other supportive therapy promptly and sheresponed well. Occurence of tuberculoma in the brain in a patient with miliary tuberculosisis a rare phenomenon.DOI: http://dx.doi.org/10.3126/ajms.v6i2.10279Asian Journal of Medical Sciences Vol.6(2) 2015 118-120
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Roy, Kuntal, Syed Khairul Amin, Mumtahina Setu, Tarannum Khondaker, and Nandita Sur Chowdhury. "An Unusual Case of Foreign Body Aspiration: A Case Report." Anwer Khan Modern Medical College Journal 6, no. 2 (February 13, 2017): 47–49. http://dx.doi.org/10.3329/akmmcj.v6i2.31593.
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Foreign body aspiration most commonly affects young children, with respiratory symptoms such as wheeze and cough after a choking episode. A careful history and clinical examination can identify those children that need additional investigation including bronchoscopy. However foreign body aspiration can mimic other conditions. The link between choking and subsequent symptoms may not be made by parents. We present a case with a delay in diagnosis, and discuss the appropriate management of suspected foreign body aspiration.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 47-49
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O’Connor, Raymond, Jane O’Doherty, Andrew O’Regan, Aoife O’Neill, Claire McMahon, and Colum P. Dunne. "Medical management of acute upper respiratory infections in an urban primary care out-of-hours facility: cross-sectional study of patient presentations and expectations." BMJ Open 9, no. 2 (February 2019): e025396. http://dx.doi.org/10.1136/bmjopen-2018-025396.
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ObjectivesThe purpose of this study was to examine the expectations of patients attending an urban primary care out-of-hours (OOH) facility with acute upper respiratory tract infection (acute URTI) regarding clinical examination, symptom management, information on their condition, reassurance, antibiotic treatment and other possible options including referral.DesignCross-sectional design.SettingOne urban primary care OOH facility located in the midwest of Ireland.Participants457 patients filled out a questionnaire while waiting in the OOH facility; 22 surveys were excluded as the patients did not present with symptoms of acute URTI resulting in 435 patients’ data being included in this study. There were 59.5% female participants and 40.5% male participants.Results435 patients with acute URTI symptoms participated in the survey, representing 25.4% of those attending the single branch where the survey was conducted (n=1715). Of the study participants, 43% were aged under 6 years and 60% were women. The most common presenting symptoms were cough (72%), throat ache (46%) and common cold (26%). The most common expectations were for further examination (53%), reassurance (51%), information (49%) and medication for cough (47%), with 34% expecting an antibiotic.ConclusionsOnly one in three patients attending this primary care OOH facility with acute URTI symptoms had an expectation of antibiotics, with most seeking further assessment, information and reassurance. Recognition of such expectations may be important considerations for clinicians when deciding on management options for patients with acute URTI.
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Bhasin, N., and DJA Scott. "How Should a Candidate Assess Varicose Veins in the MRCS Clinical Examination? A Vascular Viewpoint." Annals of The Royal College of Surgeons of England 88, no. 3 (May 2006): 309–12. http://dx.doi.org/10.1308/003588406x98595.
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INTRODUCTION Varicose veins are a common problem and, therefore, regularly feature in the vascular bay of the MRCS clinical examination. Candidates are still being instructed to perform tests in the examination that are considered by many to be obsolete and inaccurate. Using the current cohort of vascular examiners, we aim to clarify which tests a candidate should be performing when assessing varicose veins. We also aim to assess basic surgical trainees' experience in the use of hand-held Doppler (HHD). MATERIALS AND METHODS Postal questionnaires were sent to all English College Court examiners with a declared vascular interest to gain their opinion on what tests should be used in the vascular bay to assess primary varicose veins. E-mail questionnaires were also sent to basic surgical trainees to assess their experience in the use of hand-held Doppler to assess varicose veins. RESULTS There was a 100% response rate from the examiners with 93%, 86% and 79% feeling that clinical examination, HHD examination of the SFJ and HHD examination of the SPJ, respectively, should form part of the examination of primary varicose veins in the vascular bay. Only 50% indicated the Trendelenburg test and cough impulse and 57% believed the tap test should form part of the examination of varicose veins. Of the BSTs, 53% believed they could examine varicose veins with HHD. Of the BSTs who could use HHD, 74% had held a vascular SHO post. DISCUSSION Published data and opinion show many consultant surgeons have totally abandoned the use of the Trendelenberg, cough, tap and Perthes tests and support the opinion that HHD increases the accuracy of the examination of varicose veins. This study shows the opinions of the examiners supports the evidence-based recommendations that, in the light of easily accessible HHD, the older tests are now outdated. The majority of BSTs who were able to use HHD had held a vascular SHO post (74%) but otherwise it was unlikely that the BST would be comfortable with this skill. CONCLUSIONS The Brodie-Trendelenburg (tourniquet) test, cough impulse and tap test are outdated but candidates should be aware of the principles and failings behind them. In the MRCS clinical examination, candidates should examine varicose veins by means of clinical examination and HHD as this is now accepted standard practice. To aid candidate education, the HHD technique should replace traditional clinical tests which continue to be taught in medical school and remain within the classical surgical text books.
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Mondal, Mohuya, Md Rukunuzzaman, A. K. M. Fazlul Bari, Parisa Marjan, and Dipanwita Saha. "A 12-year-old boy presented with fever and left-sided upper abdominal pain." Bangabandhu Sheikh Mujib Medical University Journal 11, no. 4 (December 25, 2018): 310–14. http://dx.doi.org/10.3329/bsmmuj.v11i4.38662.
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This article has no abstract. The first 100 words appear below:
A 12-year-old boy of non-consanguineous parents presented with the history of fever and left sided upper abdominal pain for 1 month. His fever was high grade, intermittent, associated with chills and rigor. The abdominal pain was dull aching in nature without any radiation, aggravating or relieving factors. His bowel habit was normal. The child had no history of jaundice, cough, respiratory distress, burning sensation during micturition, earache, skin infection, contact with tubercular patient, blood transfusion or parenteral medica-tion. On examination, she was fretful, febrile, mode-rately pale, and anicteric. Tachycardia was present. Per abdominal examination revealed tenderness at the left hypochondriac region.
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Mallet, ML. "Basic ultrasound skills should be a core component of training in the acute medicine curriculum." Acute Medicine Journal 7, no. 2 (April 1, 2008): 92–94. http://dx.doi.org/10.52964/amja.0206.
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6.30 pm Friday, and you are doing the afternoon intake round. A 33-year-old African woman presents with 2 months malaise, cough and dyspnoea. Her CXR shows an enlarged globular heart. HIV and TB are your first thoughts, but do you need to call in the cardiologist? 11 am Saturday on the Acute Medical Unit (AMU). A 35 year old man has been seen earlier this morning following a collapse, after being assaulted 2 days previously; the diagnosis is unclear. You spot him looking pale and tachycardic. Further examination shows bruising in the flanks. Is he bleeding internally?
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Bardenikova, S. I., N. K. Shumeyko, O. V. Zaitseva, S. Y. Snitko, E. A. Melnikova, E. V. Kulikova, and O. B. Dovgun. "Reflux-associated respiratory syndrome in children: a survey of algorithms in medical practice." Russian Journal of Allergy 15, no. 5 (December 15, 2018): 64–75. http://dx.doi.org/10.36691/rja127.
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Purpose. Based on the clinical analysis of the course of BOS with GER, rational diagnostic algorithms are available in practical medicine. Materials and methods. The study included BOS children examined in the pulmonology department of the DGKB St. Vladimir in 2010-2017 years: patients with asthma (annually from 850 to 1000) and children with obstructive bronchitis (annually from 122 to 400). General clinical, laboratory, serological, instrumental studies were conducted. In cases of insufficient control of asthma and recurrent (or prolonged) BOS esophagogastroduodenofibroscopy and radiopaque examination of the esophagus was performed for revealing GER. Results. The mutual risks of weighting the symptoms of combined asthma with GERD in children are discussed. Attention is focused on the peculiarities of complaints, history and the status of patients with BOS in combination with comorbid diseases. Pulmonology department statistics data demonstrate the growing need for gastroenterological research. The rational algorithms for examination of BOS patients for the detection of GERD are discussed. Conclusion. Due to the high frequency of GER in patients with bronchial asthma and its influence on disease control, a comprehensive study of its symptoms is necessary. The presence of recurrent BOS, ETN comorbidity, night cough demands to exclude the role of GER in etiology of respiratory disorders.
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Cheng, Dan, and Xuhong Ding. "Rare misdiagnosed case of penicilliosis marneffei in an immunocompetent patient." Journal of International Medical Research 48, no. 10 (October 2020): 030006052095948. http://dx.doi.org/10.1177/0300060520959484.
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Background Penicilliosis marneffei is a rare disease caused by Talaromyces marneffei, which is endemic in Southeast Asian countries, and usually occurs in immunocompromised or immunodeficient hosts. We report an unusual misdiagnosed case of penicilliosis marneffei in an immunocompetent patient from a non-endemic area of China. Case presentation: A 59-year-old man presented to hospital with a cough and progressive hemoptysis for a 3-month period. Clinical characteristics, radiological abnormalities, and prognosis were analyzed. Detailed examinations, chest computed tomography, and bronchoscopy were performed. The patient was misdiagnosed as having lung cancer and provided anti-tumor treatment for 1 month in the early stage. Imaging and bronchoscopy showed a neoplasm in the basal segment in the left lung, but a tissue biopsy did not establish a diagnosis. He subsequently underwent lobectomy for the lesion. The final pathological diagnosis was penicilliosis marneffei based on immunohistochemical staining. He was then prescribed specific anti-fungal treatment of voriconazole 200 mg twice daily for 12 weeks. Conclusion Timely fungal culture and pathological examination of clinical specimens are critical for the diagnosis of penicilliosis marneffei, especially in non-endemic regions and immunocompetent patients.
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Gundavaram, Hemanth. "EMTALA: Screening Can Satisfy EMTALA, Despite Misdiagnosis." Journal of Law, Medicine & Ethics 31, no. 1 (2003): 169–70. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00075.x.
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In Del Carmen Guadalupe v. Agosto, the U.S. Court of Appeals for the First Circuit held that a hospital fulfills its statutory duty to screen patiens in is emergency room if it provides for a “screening examination reasonably calculated to identify critical medical conditions” that may be afflicting symptomatic patients and if it “provides that level of screening uniformly to all those who present substantially similar complaints.” The First Circuit affirmed the lower court's decision to grant summary judgment to the hospital in a claim raised under the Emergency Medical Treatment and Active Labor Act (EMTALA).Maria del Carmen Guadalupe brought her husband, Narciso Figueroa, to the Hospital Interamericano De Medicina Avanzada, Inc., (HIMA) on October 3, 1998, with symptoms of urinary retention, edema in the legs, high blood pressure, pain, increased respiratory difficulty, a dry cough, fever, and drowsiness.
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Goldberg, Elliott, Bathai Edwards, and Kaleigh Krill. "Atypical case of syphilitic hepatitis." BMJ Case Reports 14, no. 3 (March 2021): e237851. http://dx.doi.org/10.1136/bcr-2020-237851.
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A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1 week of jaundice, abdominal pain, cough and headache. Examination revealed scleral icterus, right upper quadrant tenderness and hepatomegaly. Initial investigations revealed hyperbilirubinaemia and elevated transaminases. Serum studies were positive for antinuclear antibodies, antimitochondrial antibodies, and herpes simplex virus IgM. Despite being started on intravenous acyclovir, his bilirubin and transaminase levels continued to rise. He was subsequently tested for syphilis given his maculopapular rash on the soles of his feet and it returned positive. He improved clinically with the initiation of penicillin. In this case, we will discuss the presentation, diagnosis and treatment of syphilitic hepatitis.
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Mahmutov, I. F., R. A. Zalyaliev, G. Yu Batrhanova, N. E. Kondratieva, and L. I. Kamalov. "Chronic tuberculous rhinosinusitis in a patient with widespread destructive pulmonary tuberculosis." Kazan medical journal 82, no. 3 (June 15, 2001): 209. http://dx.doi.org/10.17816/kazmj72141.
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We observed a case of chronic left-sided maxillary rhinosinusitis of tuberculous etiology. K., 57 years old, has been registered with the State Medical Institution "Phthisiology" for infiltrative pulmonary tuberculosis since 1998.He was repeatedly treated in a tuberculosis hospital and outpatient with short courses. In January 2000, he was admitted to the Kazan City Tuberculosis Hospital due to complaints of cough with scant sputum, weakness, shortness of breath during physical exertion; negative X-ray dynamics was also observed. After clinical, radiological, laboratory and bacteriological examination methods, he was clinically diagnosed with infiltrative tuberculosis of the upper lobe of the left lung in the phase of decay and contamination of CD (+).
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Shaheduzzaman, AKM, Devendra Nath Sarkar, Md Ferdous Wahid, Md Shafiul Alam, Md Mahfuzer Rahman, Md Ashraful Haque, Md Kumruzzaman Sarker, et al. "Role of pleural biopsy in diagnosis of unilateral pleural effusion:study of 50 cases in Rangpur Medical College & Hospital, Rangpur." Bangladesh Journal of Medicine 27, no. 2 (August 3, 2016): 62–67. http://dx.doi.org/10.3329/bjmed.v27i2.29051.
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Background: Pleural effusion remains the most common manifestation of pleural pathology. Sometime it is difficult to differentiate between tuberculous and malignant pleural effusion on routine cytological and biochemical examination. So pleural biopsy is an important tool for evaluating undiagnosed pleural effusion.Aim: To find out the role of pleural biopsy in the diagnosis of unilateral pleural effusion.Methods: This observational study was conducted in the Indoor patient department of Medicine in Rangpur Medical College Hospital from 01.01.2014 to 30.06.2014. All patients having unilateral pleural effusion above the age of 15 years irrespective of sex, race and religion was enrolled in this study.Results: Total fifty cases were enrolled in this study. Age of the patients varied from 16 to 78 years (Mean ±SD, yrs: 47±31.0). Thirty six (72%) patients were male and fourteen (28%) were female. 9 patients (18%) were of higher socio-economic status, 13 (26%) patients were from lower class, and 28 (56%) were from middle class. Majority (36%) of the patients were farmer, followed by 22% were businessman, 18% were service holder and 16% were housewives. Out of 50 patients, Nineteen patients (38%) were smoker and rests (62%) were non-smoker. Common presenting complaints were fever (78%), respiratory distress (62%), cough (56%), chest discomfort (38%) and weight loss (32%). General physical examination findings revealed 62% having different grades of anaemia followed by clubbing in 22% cases. Respiratory system examination revealed 56% having left sided pleural effusion followed by 44% right sided pleural effusion. 36% shows shifting of trachea. Regarding pleural fluid analysis, color of pleural fluid was straw in most cases (42%) and sixteen cases (32%) had hemorrhagic fluid. Mean total cell count in pleural fluid was 1449.1/c.mm. Most (88%) had lymphocyte predominance. Mean protein in pleural fluid was 5.6 gm/liter. Radiological examination revealed that maximum patient (56%) having left sided effusion and total 18 patients having shift of trachea. Close pleural biopsy for histopathological study revealed maximum (36%) were different types of malignancy, 24% chronic granulomatous inflammation consistent with tuberculosis, 16% shows non-specific chronic inflammation and 24% cases showed no abnormal findings or pleural tissue not available or inadequate tissue for histological report. Out of total 18 cases of malignancy, 08 revealed adenocarcinoma, 03 revealed metastatic adenocarcinoma, 02 revealed non-hodgkins lymphoma, 02 malignant mesothalioma and 03 of them revealed poorly differenciated carcinoma.Conclusion: In this study male are predominant. Most of the respondent was non-smoker. Most common presenting complains were fever, respiratory distress, cough, chest discomfort and weight loss. Most of general physical examination findings were anamia and clubbing. Respiratory system examination findings were features suggestive of pleural effusion (56% left sided and 44% right sided), 36% having shift of trachea. chest x-ray findings of most (56%) of the study population were left sided pleural effusion. Close pleural biopsy for histopathological study revealed maximum (36%) were different types of malignancy followed by chronic granulomatous inflammation consistent with tuberculosis (24%).Bangladesh J Medicine Jul 2016; 27(2) : 62-67
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Rahim, SBA, T. Maruthamuthu, LL Chooi, A. Singh, and MRBM Yunus. "A White Board Needle in the Trachea." Bangladesh Journal of Medical Science 12, no. 4 (October 26, 2013): 449–52. http://dx.doi.org/10.3329/bjms.v12i4.16668.
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Foreign body aspiration often occurs amongst extreme age. Most of aspirated object are; nuts, nails, pins, coins, metal piece and dental appliances. Foreign body aspiration can be life threatening. Patients with foreign body aspiration may present with choking, coughing, wheezing, haemoptysis, asphyxia and even death. The symptoms and severity depend on the site of obstruction. This is a case of 9 year old boy provided the history of aspiration of white board needle. He had persistent cough but examination revealed normal vital signs. Radiological examination confirmed needle like radio opaque material in his trachea. This case report depicts the management and bronchoscope as diagnostic procedure of this case and role of X-ray and CT scan in dealing with foreign body in the tracheobronchial tree. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16668 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 449-452
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Meena, Poonam, Pankaj Kumar Jain, Abhishek Sharma, and B. S. Sharma. "A study on clinical profile and etiological agents of empyema in hospitalised children in Jaipur, India." International Journal of Contemporary Pediatrics 6, no. 6 (October 21, 2019): 2433. http://dx.doi.org/10.18203/2349-3291.ijcp20194712.
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Background: Objective is to study the clinical profile and etiological agents of empyema in hospitalised children in Jaipur.Methods: This hospital based prospective study was carried out in the Department of Pediatrics, SMS Medical College, Jaipur between April 2016 to March 2017. Children between 1 month to 18 year of age having empyema thoracis (pleural tap showing pus cells under microscopy or on gross examination purulent exudates) were included in the study. Children with Empyema secondary to post-surgical or post-traumatic cause and with tubercular effusion were excluded from the study. Relevant history, clinical examination and investigation were done. Pleural fluid studies were done for cytology, biochemical analysis , culture and antibiotic sensitivity pattern.Results: Total 100 patients were included in study. Out of total 100 patients 62 (62%) were between 1 month to 5 years. Most common symptoms were fever (94%), breathlessness (87%) and cough (85%). 27% patients were severely malnourished as per IAP classification of PEM. Pleural fluid culture was positive in 29 (29%) patients. Most common organism isolated was Staphylococcus aureus (27%), 87.5% isolates of Staphylococcus aureus had sensitivity to vancomycin and linezolid.Conclusions: Empyema thoracis is frequently encountered complication of bacterial pneumonia. Fever, cough, and respiratory distress were the most common presenting complaints and severe acute malnutrition was an important risk factor. Staphylococcus aureus was found to be the most common organism for childhood empyema.
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Zhu, Mingchao, Diliang Chen, Ya Zhu, Xusheng Xiong, Yan Ding, Feibo Guo, Mingan Zhu, and Junyang Zhou. "Long-term sero-positivity for IgG, sequelae of respiratory symptoms, and abundance of malformed sperms in a patient recovered from severe COVID-19." European Journal of Clinical Microbiology & Infectious Diseases 40, no. 7 (February 8, 2021): 1559–67. http://dx.doi.org/10.1007/s10096-021-04178-6.
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AbstractPatients with severe coronavirus disease in 2019 (COVID-19 pneumonia) may have many sequelae, which seriously affect their quality of life and work. Here, we report a case of infection in China, reviewed the course, treatment, and rehabilitation of a patient suffering from severe COVID-19 pneumonia, and collected his examination reports, including chest CT, laboratory examination results, lung function examination, sleep monitoring report, sex hormones, sperm morphology and activity. The patient’s antiviral immunoglobulin G (IgG) continued to be positive for more than 11 months, and his small airway function was abnormal, and he suffered from respiratory problems (cough, chest pain, chest tightness, and shortness of breath), unstructured sleep apnea hypopnea syndrome, and nocturnal sleep hypoxemia. His abnormal sperm rate increased obviously, and sperm activity decreased obviously. Patients with severe COVID-19 pneumonia may have respiratory sequela, the abnormal sperm rate is obviously increased, and IgG positive can last for a long time.
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Haque, Nazmul, Narayan Saha, Md Badrul Alam, Quazi Deen Mohammad, Sk Azimul Hoque, Ariful Islam, Yamin Shahriar Chowdhury, and Bithi Debnath. "Isovaleric Acidemia in a 5 Years of Boy: A Case Report." Journal of Current and Advance Medical Research 6, no. 1 (March 27, 2019): 64–66. http://dx.doi.org/10.3329/jcamr.v6i1.40788.
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Isovaleric acidemia (IVA) is an autosomal recessive disease of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase (IVD). In this case report a five years old boy was admitted to National Institute of Neurosciences and Hospital, Dhaka Bangladesh with the history of fever, cough, vomiting, diarrhea, stupor and extreme sleepiness for 3 days. Second degree consanguinity was documented between the parents. Neurological examination revealed exaggerated reflexes and ankle clonus was present bilaterally. EEG and MRI of brain had normal results. Urine organic acid analysis by gas chromatography-mass spectrometry showed slight increment in concentration of 3 hydroxyisovaleric acid and an elevated concentration of isovalerylglycine. Tandem mass spectrometry of acylcarnitines in dried blood spots showed elevated C5-carnitine isovalerylcarnitine (10.3umol/l). Based on history, clinical examination and laboratory results, a diagnosis of isovaleric academia was ascertained. Patient was treated accordingly with rehydration fluid, correction of metabolic acidosis, antibiotic and supportive care
Journal of Current and Advance Medical Research 2019;6(1):64-66
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Kanaujia, Dr Binita, Dr Anand AS, and Dr Sagar Mhetre. "Study on specific species of malaria in relation to haematological changes." Tropical Journal of Pathology and Microbiology 7, no. 1 (February 20, 2021): 1–8. http://dx.doi.org/10.17511/jopm.2021.i01.01.
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Background: As malaria is a potential medical emergency, prompt and accurate diagnosis is criticalfor its effective management. Conventional microscopic examination of peripheral thick and thinblood smear examination remains the “gold standard” for malaria diagnosis. Material: A 2 yearprospective study from 2011 to 2013 was conducted at Navodaya Medical College Hospital andResearch Centre, Raichur. The study comprised of a total number of 150 cases positive for Malaria,collected from above mentioned centre and those referred from peripheral referral centres. Clinicalhistory regarding age, sex, nature and duration of illness were elicited. Blood sample forhaematological study was taken before starting anti-malarial drugs in all these cases. Result: Out oftotal cases, P. vivax infected cases (62%) were common than P. falciparum (34%) and mixedinfection cases [PV & PF] (4%). Most common presenting symptom of cases affected by PV, PF andmixed infection were fever and chills & rigors and least common symptom was cough. Mostimportant haematological changes observed were anaemia and thrombocytopenia (77.3% each) andleucopenia (31.3%). All the above mentioned changes in haematological parameters were speciesspecific and statistically significant, except for red cell indices, DLC and ESR. Conclusions: Inconclusion, changes in haematological profile can help in early diagnosis of specific species ofmalaria for timely and appropriate treatment that can reduce the severity and prevention ofadditional consequences.
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Jain, Sonal. "Clinical study of community acquired pneumonia at MNR medical college and hospital, Sangareddy." International Journal of Clinical Trials 5, no. 1 (January 23, 2018): 73. http://dx.doi.org/10.18203/2349-3259.ijct20180134.
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<p class="abstract"><strong>Background:</strong> This study is done<strong> </strong>to study the clinical profile of community acquired pneumonia in patients admitted in medical wards at MNR Hospital, Sangareddy and<strong> </strong>to find out the associated risk factors of community acquired pneumonia.</p><p class="abstract"><strong>Methods:</strong> 75 Patients admitted in the department of medicine of MNR Medical college and Hospital, Sangareddy with clinical manifestations of Community acquired pneumonia from august 2012 to January 2015 (Two years and 6 months) were taken into the study. All adult patients of both genders aged above 14 yrs, who presented with acute onset of fever associated with chills and rigors, having cough with expectoration and/ or chest pain and breathlessness were included in the study. All the patients were subjected for detailed clinical examination to make a provisional diagnosis of community acquired pneumonia (CAP). Patients with hospital acquired pneumonia, aspiration pneumonia and PCP pneumonia in patients with HIV were excluded.</p><p class="abstract"><strong>Results:</strong> Among 75 cases studied, the mean patient age was 52.1 years with Male: Female patient ratio 3.17:1. The associated diseases in this study are COPD (30.67%) and DM (12.0%).The most common presenting symptoms were fever (100%), cough (100%), and expectoration (100%); other symptoms included chest pain (60%), dyspnoea (61.33%). The respiratory signs included bronchial breath sounds, increased VF and VR, and presence of whispering pectorolique in all subjects. </p><strong>Conclusions:</strong> Identification and determining the clinical patterns of community acquired pneumonia helps in adoption of regionally optimized diagnostic approach.
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Amin, Shayla, Nazrul Islam, ASM Ruhul Quddush, Kamruzzaman, Badruzzaman, Sabiha Parvin, and Faria Sultana. "Identification of risk factors associated with umbilical hernia in under 5 children: A hospital based study." Community Based Medical Journal 7, no. 2 (September 5, 2018): 4–8. http://dx.doi.org/10.3329/cbmj.v7i2.55449.
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Umbilical hernia is one of the most commonly encountered abnormalities in early months of infancy and childhood. Though umbilical hernia is a common benign condition which resolves spontaneously during first 5 years of life, it may be a great concern to the parents and other caregivers. Therefore, the high index of suspicion, prompt recognition and thorough understanding of common factors are necessary to ensure their correction and convince the parents to treat. A hospital based cross sectional observational study was conducted in the paediatrics unit of Community Based Medical College & Hospital from March 2013 to September 2013 to determine the factors associated with umbilical hernia. A total of 160 cases of umbilical hernia admitted in paediatrics unit and outpatient department of Community Based Medical College & Hospital were enrolled in the study. Necessary information were collected by detailed history taking, clinical examination and close follow up of the hospital course, using pre-designed questionnaire. Among 160 patients, malnutrition were observed in 21.8% , severe malnutrition was the most common abnormality (45%) followed by moderate malnutrition 28.05%, mild malnutrition 28.05%. Low birth weight were found to have 21.3%, among medical condition, excessive crying were 18.7%, chronic cough were 18.7%, constipation were 17.5%, positive family history 1.9%. Malnutrition and low birth weight are more common association of umbilical hernia.Malnutrition has great impact on developing umbilical hernia. Chronic cough, excessive crying, constipation more or less equally responsible. So early identification of risk factors and proper management and close monitoring are important to reduce the risk of developing umbilical hernia.
CBMJ 2018 July: Vol. 07 No. 02 P: 04-08
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Korableva, Natalya N. "Apparent life-threatening events in neonates and infants of the first year of life." Russian Pediatric Journal 19, no. 5 (April 30, 2019): 302–8. http://dx.doi.org/10.18821/1560-9561-2016-19-5-302-308.
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There are presented data on the apparent life-threatening event (ALTE) that may develop as a sudden, frightening episode with the cessation of breathing (apnea), skin discoloration (cyanosis, pallor, redness), violation of muscle tone: lowering (more often) or rigidity, with the presence of cough or breathlessness in the first year infant. ALTE incidence ranges from 0.46 to 10 per 1000 live births. Common causes of ALTE are established to be gastroesophageal reflux disease, viral infections of the lower respiratory tract, convulsions, whooping cough, sepsis and/or meningitis, arrhythmias or congenital malformations of the heart and respiratory hypoxic-ischemic brain damage, cases of child abuse. There are described history characteristics and features of the examination of ALTE survivors. Most of the ALTE babies are indicated to require hospitalization for cardiorespiratory monitoring within 24 hours after the event. A child older than 30 days suffered from first ALTE clearly associated with feeding, can be observed and examined on an outpatient basis. There is notes particular importance of the new medical and organizational technologies for the improvement of newborn health care, which will significantly promote the prevention of these conditions.
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Rodríguez Hidalgo, Luis Alejandro, Luis Alberto Concepción-Urteaga, Julio Hilario-Vargas, Jorge Luis Cornejo-Portella, Diana Cecilia Ruiz-Caballero, and Deysi Leslie Rojas-Vergara. "Case report of recurring pneumonia due to unusual foreign body aspiration in the airway." Medwave 21, no. 02 (March 31, 2021): e8136-e8136. http://dx.doi.org/10.5867/medwave.2021.02.8136.
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Foreign body aspiration is a rare but life-threatening event. Most accidental aspiration events occur in children. In adults, it can represent up to 25% of cases. Bronchoscopy remains the gold standard for diagnosing and treating foreign body aspiration from the lower respiratory tract. A 63-year-old female smoker with a history of chronic alcoholism and exposure to pyrotechnic smoke presented a productive cough, with whitish expectoration, dyspnea and pleuritic chest pain on the right side. On chest X-ray, she presented opacity in 2/3 of the right hemithorax. Computed axial tomography revealed consolidation with an air bronchogram on the right hemithorax, cylindrical bronchiectasis, ground glass pattern and centrilobular nodules. Bronchoscopic examination revealed a foreign body covered with granulation tissue in the right segmental bronchus (B6). The granulation tissue was integrated into the foreign body. In a second attempt, the foreign body could be removed, which was of bone consistency, seemingly a bird bone, confirmed by pathological anatomy results. After further questioning, the patient reported that two years before, she had choked when eating chicken. She had a cough and an episode of hemoptysis, but she chose not to ask for medical advice.
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Suzuki, Moeko, Haruhiko Higashi, Shuntaro Ikeda, and Osamu Yamaguchi. "Methylephedrine-induced heart failure in a habitual user of paediatric cough syrup: a case report." European Heart Journal - Case Reports 4, no. 3 (April 27, 2020): 1–4. http://dx.doi.org/10.1093/ehjcr/ytaa095.
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Abstract Background For relief of cold symptoms, methylephedrine is considered to be safer than ephedrine, particularly when used at the predetermined dose. It is often present in various over-the-counter (OTC) drugs for cold, including paediatric cough syrups. Case summary A 52-year-old man presented with worsening dyspnoea and anorexia for 2 weeks. He was a night shift worker and had been habitually taking large doses of methylephedrine-containing paediatric cough syrup for 20 years for sleep averting. On admission, his chest X-ray revealed pulmonary congestion and electrocardiogram showed sinus tachycardia with left-axis deviation. Echocardiography revealed diffuse hypokinesis with a reduced ejection fraction (EF) of 25%. The B-type natriuretic peptide level was elevated to 1092 ng/L. Even after treatment with low-dose dobutamine and furosemide in intensive care unit, right-heart catheterization demonstrated a ‘wet and cold’ profile. Coronary angiography revealed normal coronary arteries. Pathological examination by endomyocardial biopsy revealed cardiomyocyte hypertrophy with moderate interstitial and replacement fibrosis. In addition, cardiac magnetic resonance imaging revealed diffuse hypokinesis with mid-wall late gadolinium enhancement, which suggested fibrosis. Discontinuation of the cough syrup and optimal medical treatment with an angiotensin-converting enzyme inhibitor and a β blocker resulted in improvement in the heart failure symptoms to New York Class Association Class II. The EF also improved to 50% at 4 months after discharge. Discussion Methylephedrine is considered to have adrenergic effects; it has milder side effects on the cardiovascular system than ephedrine. However, the long-lasting excessive intake of methylephedrine, even through OTC paediatric cough syrups, has the potential to cause heart failure.
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Setyoningrum, Retno Asih. "PROFILE OF COMMUNITY ACQUIRED PNEUMONIA IN CHILDREN AT SOETOMO HOSPITAL SURABAYA IN 00–00." Indonesian Journal of Tropical and Infectious Disease 2, no. 1 (May 27, 2015): 12. http://dx.doi.org/10.20473/ijtid.v2i1.92.
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Background: Community Acquired Pneumonia (CAP) is one of the most important health problem affecting children all over the world. Clinical findings, laboratory and radiological examination of CAP may largely vary from mild to severe. Objective: To report profile of CAP in children hospitalized at Soetomo Hospital Surabaya in 2007–2008 Methods: This research was a retrospective study. Data of children with primary diagnosis of CAP in 2007–2008 were obtained from medical records of the Department of Child Health Soetomo Hospital Surabaya. The diagnosis CAP was based on WHO criteria (pneumonia clinical syndrome). The clinical features of illness, laboratory and radiological examination were recorded and presented descriptively. Results: During the study period, 438 patients were diagnosed as CAP. More than half (83.4%) patients aged 3 months– 3 year. Beside cough and tachypnea, most common symptom and signs were chest indrawing (76.2%) and fever (23.8%). Leucocytosis (39.6%). Bacteria was found in 8.2%. Accompanying diseases (i.e congenital heart disease, neurological and gastroenterological disorders) were found in 36.4%. One hundred fifty seven patients (35.8%) had malnutrition. Patchy infiltrate was found in 80.8% chest X-ray examination. Mortality was found in 4.3%. Conclusions: Community acquired pneumonia in children still count as a major problem at Soetomo Hospital Surabaya.
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Valieva, Z. S., E. G. Valeeva, S. I. Glukhova, T. V. Martynyuk, and I. E. Chazova. "The development of a screening questionnaire to improve the early detection of pulmonary arterial hypertension." Systemic Hypertension 11, no. 4 (December 15, 2014): 62–67. http://dx.doi.org/10.26442/sg29061.
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Objective: development of a questionnaire for the early detection of pulmonary arterial hypertension (PAH), and its further introduction for a broad routine medical practice.Were identified clinical symptoms, allowing differentiate various forms of the disease (IPAH and PAH-CHD), because these forms of PAH most frequent in cardiology practice.Material and methods. The questionnaire includes 6 sections: clinical symptoms, physical examination, anamnestic information, diseases associated with pulmonary hypertension; signs of PAH according to electrocardiography, chest radiography, echocardiography. All sections of the questionnaire filled by physician. Was held a retrospective analysis of the clinical symptoms, physical examination, anamnestic information, methods of instrumental examination of 70 patients with IPAH in comparison with 29 patients with PAH-CHD and the control group - 48 patients with arterial hypertension (AH).Results. The leading complaints in patients with PAH are dyspnea (99%), palpitations (58%), fatigue (59%), syncope (21%), dry cough (28%), peripheral edema (38%). The physical signs of PAH include an accentuated pulmonary component of second heart sound (93%), cyanosis (40%). Most often, the development of pulmonary hypertension precipitated by stress, pregnancy, acute respiratory infections.Conclusion. According to the results we concluded that the developed questionnaire may be offered for wide use in routine clinical practice and recommended not only for screening patients with IPAH, but also with PAH-CHD.
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Sharma, Aman, Rajender Kumar, Adarsh MB, G. S. R. S. N. K. Naidu, Vikas Sharma, Apurva Sood, Varun Dhir, et al. "Fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis, assessment of disease activity and therapeutic response in relapsing polychondritis." Rheumatology 59, no. 1 (June 24, 2019): 99–106. http://dx.doi.org/10.1093/rheumatology/kez243.
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Abstract Objective To evaluate 18F-fluorodeoxyglucose (FDG) PET/CT in the assessment of disease activity, extent of the disease and response to therapy in relapsing polychondritis. Methods Twenty-five patients (9 men, 16 women) with a mean age of 38.2 years (s.d. 13.7; range 18–62), diagnosed to have relapsing polychondritis according to Damiani and Levine’s modification of McAdam’s criteria, who underwent PET/CT examination were included. Ten patients underwent a second PET/CT examination after therapy or during follow-up. Clinical symptoms and auxiliary examination findings were recorded. PET/CT findings were reviewed and correlated with the clinical symptoms. Results The major symptoms were aural pain (n = 21), nasal pain (n = 10), stridor (n = 5), cough (n = 9), fever (n = 8) and laryngeal tenderness (n = 8). The initial PET/CT was positive in 23/25 patients. PET/CT revealed involvement of auricular (n = 14), nasal (n = 8), laryngeal (n = 7), tracheobronchial (n = 6) and Eustachian (n = 3) cartilages with a mean maximum standardized uptake value (SUVmax) of 4.1 (s.d. 2.5; range 1.7–12.7). Fair correlation of aural/nasal pain/stridor with FDG avidity of cartilage involvement on PET/CT was noted. The key finding was detection of asymptomatic large airway involvement in seven patients (28%). Re-examination PET in 10 patients revealed complete therapeutic response (n = 5), partial response (n = 1), stable disease (n = 1), progressive disease (n = 1) and disease recurrence (n = 2). Conclusion FDG PET/CT is a useful tool for the assessment of the disease activity and extent. It identified activity in clinically inaccessible sites that are of clinical significance. It is also useful in assessing treatment response and finding relapse.
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Ivanovic-Krstic, Branislava, Dimitra Kalimanovska-Ostric, Bosiljka Vujisic-Tesic, Dragana Jovanovic, Predrag Petrovic, and Danica Cvetkovic-Matic. "Cardiac echinococcosis." Srpski arhiv za celokupno lekarstvo 130, no. 5-6 (2002): 217–21. http://dx.doi.org/10.2298/sarh0206217i.
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Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm) in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.
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Jha, Vishal, and Aditi Jha. "Swine-influenza (H1N1 influenza) mimicking a case of high altitude pulmonary oedema (HAPO)." BMJ Case Reports 13, no. 6 (June 2020): e232564. http://dx.doi.org/10.1136/bcr-2019-232564.
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Here we present a case of a 37-year-old soldier of Indian Army, posted in high altitude area of Ladakh region (>4200 m), who after rejoining after a month leave, presented with dry cough, low-grade fever and dyspnoea on exertion while undergoing acclimatisation, and on examination, was detected to have hypoxaemia, fever and bilateral fine crepitations on chest auscultation. He was started on treatment for high altitude pulmonary oedema at a medical aid post, and later referred to General Hospital at Leh. The course of the illness was complicated by worsening hypoxaemia, continuous high-grade fever, leucopenia and hypotension. Focused medical history revealed that he had travelled to the state of Gujarat during his leave, where high incidence of H1N1 influenza was being reported during the ongoing pandemic. Oseltamivir was empirically started, in addition to parenteral antibiotics and he was started on inotropic support. In view of severe hypoxaemia, not responding to non-invasive ventilation, he was intubated and placed on mechanical ventilation. The patient turned out to be H1N1 positive and succumbed to his illness 3 days later.
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Ghosh, Chanchal Kumar, Fakhrul Alam, M. Mahmuduzzaman, AKM Shamsul Kabir, M. Saif Uddoula, and Quazi Tarikul Islam. "Clinical Pattern of Liver Abscess among the Patients Admitted in Rajshahi Medical College Hospital." Bangladesh Journal of Medicine 26, no. 2 (November 10, 2015): 55–60. http://dx.doi.org/10.3329/bjmed.v26i2.25449.
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Introduction: Liver abscess is an important clinical problem in tropical regions of the world. Current assessment of liver abscesses should allow for better understanding of the aetiopathogenesis of the disease. This study was conducted to find the clinical pattern and aetiopathogenesis of liver abscess in patients admitted in Rajshahi Medical College Hospital.Methodology: The present cross-sectional study was carried out in the Department of Medicine, Rajshahi Medical College Hospital (RMCH) on consecutive 34 patients of liver abscess admitted between the period of July 2002 and June 2003. Detailed history and clinical examination were performed in all patients. All routine investigations were done. Liver abscess was confirmed by ultrasonography (USG). Aspiration of liver abscess was done under sonographic guidance in the Nuclear Medicine Department of RMCH to diagnose the cause of liver abscess. Aspirated materials were sent for microscopical examination and culture and sensitivity in the Department of Microbiology of the same Institute.Result: The findings showed that early middle-aged population were usually affected by liver abscess followed by middle aged (mean age around 40 years). The patients were predominantly male with males being 16 times more likely to suffer from the disease than the females. Most of the patients belong to low socioeconomic status (82.4%). All patients had fever and malaise. Other common manifestations were loss of appetite, lump in the abdomen, intercostal tenderness, nausea/ vomiting, loss of weight. Less common presentations were diarrhoea (29.4%), jaundice (23.5%), cough (11.8%), chest pain (11.8%) and breathlessness (2.9%). Liver span of the patients measured by ultra-sonogram showed hepatomegaly in all cases. All patients with pyogenic liver abscess and 75% of the patients with amoebic abscess had the history of prolonged intake of fermented palm juice (palm wine). Microscopic examination of the pus/aspirate drawn from the liver revealed trophozoite in 7(20.6%) cases. However, on culture of the specimen, 12(35.3%) were culture positive and 22(64.7%) were culture negative.Conclusion: Middle-aged male with low socioeconomic status with the history of prolonged palm wine intake are the most common characteristic of patients with liver abscess. Multi-center study with large sample size is recommended to verify the findings of the present study.Bangladesh J Medicine Jul 2015; 26 (2) : 55-60
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Khan, Inamullah, Hassan Rehman, Shafaq Naz, and Zafar Haya. "FALCIPARUM MALARIA." Professional Medical Journal 21, no. 02 (December 6, 2018): 253–57. http://dx.doi.org/10.29309/tpmj/2014.21.02.2045.
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Objective: To determine how Falciparum Malaria can present clinically in various ways. A study conducted on 150 admitted patients. Subjects and Methods: This descriptive case-series, single center study was conducted in Medical B Unit, Khyber Teaching Hospital, Peshawar from November 2012 to June 2013. A total of 150 patients admitted with falciparum malaria were studied. A detailed history and clinical examination was performed. The falciparum malaria was diagnosed by examining peripheral blood film. All patients were thoroughly investigated to find out the complications of falciparum malaria. Results: Out of 150 patients, 95 (63.33%) were males 55 (36.67%) were females with mean age of 30 years. Fever was present in all patients, rigors and chills in 93%, headache and vomiting in 60%, jaundice in 50%, confusion in 37 %, abdominal pain in 26% were main presentations. Other presentations were Oliguria, hypotension, cerebral malaria, dyspnea and cough, hypoglycemia and seizures. Clinical examination showed splenomegaly (58%), hepatomegaly (46%), hepato-splenomegaly (22%) of patients. Laboratory investigation showed Hemoglobin < 10gm% in 22% and leukocytosis > 12000/μl in 10% of patients. Conclusions: As Falciparum Malaria presents in multiple ways clinically, it should be considered as a possibility in all febrile illnesses.
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Valieva, Z. S., S. I. Glukhova, T. V. Martyniuk, and I. E. Chazova. "The validation of the questionnaire for the early detection of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension." Systemic Hypertension 13, no. 1 (March 15, 2016): 34–38. http://dx.doi.org/10.26442/sg29125.
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The objective: to identify pathognomonic symptoms and signs of different groups of pulmonary hypertension (PH), analyze the possibility of early diagnosis of patients with PH and the validity of the questionnaire.Material and methods. The questionnaire consists of 6 sections: clinical symptoms, physical examination, anamnestic information; diseases associated with PH; signs of pulmonary arterial hypertension (PAH) according to electrocardiography, chest radiography, echocardiography. All sections of the questionnaire were filled by physician. Was held an analysis of clinical symptoms, medical history, physical examination, methods of instrumental examination of 81 patients with idiopathic PH in comparison with 29 patients with PAH due to congenital heart defects - PAH-CHD, 36 patients chronic thromboembolic PH - CTEPH and the control group - 48 patients with essential hypertension. In addition, the validity of the questionnaire was evaluated: structural, the criterion and discriminant validity.Results. The leading complaint in IPAH patients was syncope; in patients with PAH-CHD the most often detected signs were cyanosis and accentuated pulmonary component of 2d heart sound; in patients with CTEPH - cough, they had a history of venous thrombosis of the lower limbs and the debut of the disease has been associated with pregnancy.Conclusion. Development and validation of a screening questionnaire allows to improve approaches to early detection of various forms of PH, allows identify specific symptoms that more typical of definite forms of PH.
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Sah, Vijay Kumar, Arun Giri, and Niraj Niraula. "Prevalence and Clinico- Laboratory Profile of Tuberculosis in Children in Nobel Medical College, Biratnagar." Journal of Nepalgunj Medical College 17, no. 1 (August 22, 2019): 47–49. http://dx.doi.org/10.3126/jngmc.v17i1.25317.
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Introduction: Tuberculosis infection is very common, and it continues to be the major public health problem in Nepal. Published data about the epidemiology of TB in children is scarce in Nepal, though it is considered one of the most common causes of childhood morbidity in the country.
Aims and objectives: To calculate the prevalence of tuberculosis in children aged 0-15 years and to study their clinico-laboratory profile.
Methodology: This is a hospital based study conducted in Nobel Medical College Teaching Hospital, Biratnagar over a period of one year. We analyzed 289 children aged 0-15 years suspected of having tuberculosis on clinical grounds and subjected to further screening tests.
Results: Majority of the children were males and most of the children were 5-15 years of age. 15 of the cases were diagnosed as tuberculosis out of which one case was bacteriologically confirmed pulmonary tuberculosis and be 5.2 %. Fever and cough were the most common clinical presentations and mantoux test and chest X-ray were most suggestive in majority of the cases.
Conclusions: This study supports the use of history and thorough clinical examination and high index of clinical suspicion for diagnosis of childhood tuberculosis.
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Hamada, Mayumi, Noha Elshimy, and Hatem Abusriwil. "Infective Exacerbation ofPasteurella multocida." Case Reports in Infectious Diseases 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/2648349.
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An 89-year-old lady presented with a one-day history of shortness of breath as well as a cough productive of brown sputum. Her medical history was significant for chronic obstructive pulmonary disease (COPD). She was in severe type one respiratory failure and blood tests revealed markedly raised inflammatory markers; however her chest X-ray was clear. On examination there was bronchial breathing with widespread crepitations and wheeze. She was treated as per an infective exacerbation of COPD. Subsequent blood cultures grewPasteurella multocida, a common commensal in the oropharynx of domesticated animals. The patient was then asked about any contact with animals, after which she revealed she had a dog and was bitten on her left hand the day before admission. We should not forget to enquire about recent history of injuries or animal bites when patients present acutely unwell. She made a complete recovery after treatment with penicillin.
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Nabi, Shahzaib, Abhijit Saste, and Rohit Gulati. "A Rare Case of Metastatic Desmoplastic Small Round Cell Tumour: Diagnosis and Management." Case Reports in Oncological Medicine 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/925453.
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A 26-year-old male without any significant past medical history presented to the hospital with shortness of breath, cough, pleuritic chest pain, and weight loss for the past 3 months. On chest CT, he was found to have extensive mediastinal and hilar lymphadenopathy and multiple pulmonary nodules. On physical examination, a right groin mass was noted which had been slowly growing for the past 2 years. Ultrasound of the groin showed complex solid mass with internal vascular channels. CT guided biopsy of the mass showed desmoplastic small round cell tumour. His hospital course was complicated by hypoxic respiratory failure requiring emergent intubation and ICU admission where he completed one cycle of vincristine, cyclophosphamide, and doxorubicin with subsequent improvement, followed by extubation. His condition continued to improve after second cycle of chemotherapy and he was ultimately discharged in a stable condition to continue outpatient chemotherapy after a 2-month inpatient stay.
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Ekladious, A., L. Fish, C. De Chaneet, and C. Cox. "Nodular Pulmonary Amyloidosis: A Case over Fourteen Years." Journal of Biomedical Research & Environmental Sciences 2, no. 2 (February 8, 2021): 038–41. http://dx.doi.org/10.37871/jbres1185.
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A 75-year-old man presented with pleuritic chest pain, haemoptysis and dyspnoea. Imaging found multiple pulmonary nodules, concerning for malignancy. CT-guided biopsy was consistent with amyloid. The patient has a history of pulmonary amyloidosis, with a single nodule resected 14 years prior. This case allows comparison between imaging fourteen years apart, providing insight into the progressive nature of these benign nodules. Nodular pulmonary amyloidosis is a rare condition with few case reports published. Of those published, few are of nodular amyloidosis in the absence of underlying neoplastic aetiology. This case presents a 14-year interval of a patient with nodular amyloidosis, allowing insight into disease progression which has not previously been well described. A 75-year-old man presented to a regional hospital in Australia with right sided pleuritic chest pain, and a 2-week history of productive cough, haemoptysis, dyspnoea and reduced exercise tolerance. Further questioning revealed a 3-month history of worsening dyspnoea, haemoptysis and cough, with no orthopnoea, paroxysmal nocturnal dyspnoea or weight loss. The patients’ past medical history included resection of an amyloid tumour from the left lower lobe of the lung in 2004, ex-smoker with a 30-pack year history, significant occupational asbestos exposure through work as a diesel mechanic, and hypercholesterolaemia. The patient lives at home with his partner and is independent with the activities of daily living. On examination, the patient appeared well, in no respiratory distress. Observations were within normal limits, with oxygen saturations of 94% on room air, respiration rate of 18. On auscultation, there were late inspiratory crackles, as well as decreased hepatic dullness to percussion. There was a central trachea and no palpable cervical lymphadenopathy. Cardiovascular examination was unremarkable, and the patient was euvolaemic. Abdominal examination was unremarkable with no palpable organomegaly, and he did not have a rash or skin abnormalities seen. The initial investigations were conducted to investigate a potential lung malignancy underlying malignancy, based on the appearance on CT scan. The patient advised us that he had a previous diagnosis of primary pulmonary amyloidosis, first diagnosed 14 years ago. The diagnosis was made after a chest x-ray and CT showed a nodule, suspicious for cancer. Pulmonary function tests were performed and he was referred to a Cardiothoracic surgeon for consideration of a left lower lobectomy. He was treated with a wedge resection. Histopathology from this specimen showed primary pulmonary amyloidosis. There was a delay in the understanding of how the patient came to have this rare diagnosis, as it took five days for the medical records to be sourced from the archive.