[Sudden death in Kawasaki disease, a case report]

Kawasaki disease is an acute febrile vasculitis of childhood in which the coronary artery aneurysm is considered as a common complication. Proper treatment of kawasaki patients plays an essential role in prophylaxis against dangerous complications. The case was a boy of three and half years old with high fever, anorexia, sore throat, bilateral bulbar conjunctival injection, palpitation, unilateral cervical lymphadenopathy, strawberry tongue, cracked lips, erythema, swelling and peeling of hands and feet, abdominal pain, and dysuria treated with penicillin 6.3.3, cefixime and serum infusion. The patient, visited by different doctors, was finally hospitalized and diagnosed as having kawasaki disease. He was treated with adequte doses of IVIG and aspirin based on recommended therapy protocol. At the beginning of treatment and also 2 months after the treatment, the patient was referred to a cardiologist and found to have normal EKG, C. Xray and echo cardiography. Approximately 7 months later, the patient was re-hospitalised with cordiopulmonary arrest and died afterwards. At autopsy, giant aneurysm in LAD artery as the result of Kawasaki disease was observed. Having described the complications above, scrupulous attention in diagnosing Kawasaki disease and immediate referral of the patient to pediatric cardiologist is of prime importance

[ case of left ventricular pseudo aneurysm following silent myocardial infarction at an unspecified time]

Rupture of the free wall of the heart is one of the dangerous complications of myocardial infarction that usually results in death of the patient. Only a few limited number of cases have been reported to have survived for a long period after myocardial infarction, free cardiac wall rupture and the following pseudo aneurysm. In this case report, a rare case of pseudo aneurysm following silent MI in a 60-year-old diabetic woman that had occurred at an unspecified period of time is reported and on referral, the patient only complained of palpitations. With timely surgical intervention, the patient has returned to normal life

[Paraplegia due to traumatic dissection of the aorta: a case report]

Non-penetrating injuries have become one of the leading causes of death as the number of accidents involving motor vehicles iscreases every day. Dissection of the descending thoracic aorta is the most dangerous injury in trauma surgeries and because of its numerous clinical presentations it mimics various medical and surgical conditions. Paraplegia is one of its rare presentations and has been reported in only 0.3% of cases. Distinguishing this condition from other common traumatic lesions with paraplegia is very important as the treatment differs greatly. In this article, a case of paraplegia due to traumatic aortic dissection is presented

Early outcome of acute myocardial infarction

Introduction: Previos studies indicated that generally after acute myocardial infarction women have a poorer outcome thane men. Further studies with complete adjustements for coexisting condition are needed to determin whether the older age of the women who studied or the presence of other unfavorable prognostic factors or both explains this difference

Material and Method: We studied 817 consecutive patients [556 men and 261 women] hospitalized in all CCUs in city of Yazd due to acute myocardial infarction from May 2000 to October 2001

Results: In this survey, women were older than men [67.50 +/- 11 Vs 60 +/- 13] and had higher prevalence of hypertension, diabetes, dyslipidemia and in-hospital mortalities. The unadjusted odds ratio for death among women compared to men was 2.7[95 percent confidence interval, 1.79 to 4.28]. After adjustment for age the odd ratio reduced to 2.03 [95 percent confidence interval, 1.3 to 3.1]. Adjustmen for other differences in the base line characteristics reduced the odds ratio to 1.91 [95 percent confidece interval, 1.03 to 3.5]. These differences were significat, but after adjustment for treatment the odds ratio reduced to 1.51 [95 percent confidence interval, 0.6 to 3.7], and it wasn't Statistically significant

Conclusin: Women have worse prognosis after acute myocardial infarction and on the treatment may be contributing to this, and for correct judgement the difference of mortality after acute myocardial infarction, both sexes should under go the same approach for treatment