ABSTRACT
Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope. She was found to have a third-degree atrioventricular block, with pulseless polymorphic ventricular tachycardia. Patient was resuscitated and a temporary trans-venous pacemaker was placed. She reverted back to normal sinus rhythm after 4 days of syncope and was subsequently discharged from the hospital after complete resolution of symptoms, without the need for a permanent pacemaker. Physicians are warranted to have high index of suspicion for dengue virus infection as an etiology in patients with acute cardiovascular compromise, especially in tropical areas.
Subject(s)
Female , Humans , Arrhythmias, Cardiac , Atrioventricular Block , Dengue Virus , Dengue , Emergency Service, Hospital , Exanthema , Fatigue , Fever , Headache , Heart Block , Heart , Hypotension , Myocardial Infarction , Pulmonary Edema , Serogroup , Severe Dengue , Shock, Cardiogenic , Syncope , Tachycardia, VentricularABSTRACT
Background: Acne vulgaris is treated by topical and or systemic antibiotics, vitamins and some keratolytics. Micro dermabrasion, a modified technique, useful for scar removal is more natural, gentler and less invasive tool for doing exfoliation
Objective: To observe the comparative effects of diamond dermabrasion on post acne/inflammatory scaring with or without oral Isotretinoin and its probable side effects
Patients and Methods: A total of 232 patients of post acne/inflammatory scaring were randomly enrolled. In this experimental study out of which 159 females were divided into two groups, Fl of 80 and F2 of 79 females. The F1 was prescribed on Isotretinoin 20 mg/day for 45 successive days after diamond dermabrasion performed by NOVA NV60. F2 received no further treatment after the procedure. The males were divided into Ml and M2, of 37 and 36 in each group respectively and were given isotretinoin 20mg/day in Ml group and no treatment in M2 group
Results: In female groups, 82.55% experienced non-inflammatory lesions, erythema in 80%, desquamation in 21.25%, mild to moderate inflammatory lesions in 17.5%, dryness in 88.75%, pruritus in 32.50% and stinging /burning in 13.75% was observed in Group F1. In group F2 these percentages were 74.68%, 77.2%, 17.72%, 25%, 79.74%, 43.03%, and 24.05% of the same parameters, respectively. F1were graded for progress, 02 females were of grade 0, 13 women obtained grade 1, 41 patients of Grade 2 and 24 females were of Grade 3. The progress grades for F2 were, Grade O had 11 females, Grade 1 had 27, Grade 2 had 38 while Grade 3 had only 03 females. In male group Ml, 78.37% experienced non-inflammatory lesions, erythema in 83.78%, 29.72% had desquamation, 21% had mild to moderate inflammatory lesions, dryness in 89.18%, pruritus in 78.37% and stinging/burning in 16.20% in Group Ml. In group M2 these percentage s were 83.33%, 94.44%, 36.11, 25%, 83.33%, 77% and 27.77% of the same parameters, respectively. Progress grades for M1 were; Grade O for 04, Grade 1 for 10, Grade 2 for 16 and Grade 3 for 07. For M2 the same grading system was followed and Grade O had 02, Grade 1 for 19, Grade 2 were 11 and Grade 3 was 04
Conclusion: The suggestion of prescription oflsotretinoin following Diamond Dermabrasion is due to the powerful epithelial generation by the vitamin A analogue. This effect provides good and early healing of the abraded skin. However further studies are suggested with larger sample size
ABSTRACT
To see the effect of combined oral contraceptive pills on Body Mass Index [BMI] of women. A descriptive study. The study was conducted at Family Planning Centers at social obstetrical unit Baqai Medical University and Reproductive and Health Sciences [RHS] Institute, a family planning unit, at Jinnah Post Graduate Medical Center Karachi, from November 2010 to April 2011. This study was carried out on 50 patients of reproductive age 20-40 years. Patients with Cardiac, Renal and Liver syfunction were excluded. Diabetic women taking sedative and hypnotics, anti-tubercular treatment were also excluded. All routine investigations were performed. BMI was done on initial visit re-evaluated after one, three and six months and data was analyzed. Fifty women were selected. They were divided into four categories, Control [category 0] i.e. before the start of COCPs, after 1 month [category 1], 3 months [category 2] and 6 months [category 3]. On initial visit mean BMI of control is found to be 22.53 +/- 1.92. Category 1 showed mean BMI of 22.53 +/- 1.92 kg/m2 while BMI of category 2 is 22.53 +/- 1.92 kg/m2 category 3 is 22.91 +/- 1.87. After completion of study mean increase in BMI of category 3 was 0.38 kg/m[2]. Mean increase in BMI of category 3 is negligible