ABSTRACT
Complete heart block also known as third-degree atrioventricular block [AV block] is a condition in which there is no conduction of the impulse produce in the sinoatrial node [SA node] in the atrium to the ventricle.[1] Complete heart block may be congenital or acquired. There are certain conditions which can lead to third-degree heart block, commonest being the coronary ischemia. Initially there may be first degree atrioventricular block [AV block], second degree atrioven-tricular block [AV block], bundle branch block or bifasicular block ultimately leading to complete heart block. In most cases third-degree AV block presents with acute myocardial infarction.[2,3] A 45 years old male with no known comorbids and without any risk factors for coronary heart disease coming with a short duration of complaints of dizziness and vertigo was diagnosed as a case of complete heart block without any functional and anatomical impairment in conduction system
Subject(s)
Male , Humans , Middle Aged , Atrioventricular Block , Sinoatrial Node , Ischemia , Heart Conduction SystemABSTRACT
Autoimmune pancreatitis is a rare fibroinflamatory disorder of the pancreas with immunoglobulin G 4[IgG4] associated systemic disease which is steroid responsive.1,2 It has a variable clinical presentation ranging from obstructive jaundice, abdominal pain, steatorrhea and diabetes mellitus. In general presentation of autoimmune pancreatitis as acute pancreatitis is considered to be uncommon. The article presents a case of a 30 years old female newly diagnosed as diabetes mellitus presented with obstructive jaundice with raised lipase and amylase treated as acute pancreatitis. Due to persistent elevation of amylase and lipase and deranged liver function test she was further evaluated her CT findings were typical of autoimmune pancreatitis with raised serum IgG4 levels diagnosed as autoimmune pancreatitis. She was treated with steroids and responded well and after few months presented with relapse
ABSTRACT
Background: Urinary tract infection [UTI] remains a common clinical problem in both the community and health care associated settings. In Pakistan, this is also a common issue and each patient should be carefully assessed to ensure that a correct diagnosis is made and that antimicrobial therapy is appropriately prescribed. UTI is a common problem and it effect's both gender and all ages
Objective: To determine typical symptoms of urinary tract infection locally employing urine test for diagnosis and outcome after use of antibiotics against isolated bacteria
Methods: The cross-sectional descriptive, observational study was conducted at the department of emergency medicine, Ziauddin University Hospital, Karachi from June 2013 to November 2013. Adult patients of either gender with painful and/or frequent maturation were queried for symptoms [history] of urinary tract infection and underwent urine test. Clean catch mid stream urine was collected and the specimens were cultured for isolation of microbial agents of urinary tract infection. The isolated bacteria were identified using biochemical test. The diffusion susceptibility test was used to determine susceptibility of bacterial agents to antibiotics. Data was analyzed by descriptive statistics using SPSS software version 19
Results: In this study, 251 [83.7%] out of 300 patients presented numerous [positive] leucocytes in urine detail report. For these 251 [83.7%] patients, the urine culture and sensitivity was performed. Out of these, E-coli was the most common bacteria found in about 150 [59.8%]. The other bacteria are Pseudomonas 18 [7.2%], Proteus 37 [14.7%], Kabsella16 [6.4%], enterococcus 20 [8.0%], and staphylococcus aureus 10 [4.0%]. Most of the patients were sensitive to cephalosporin's, amikacnine, and third generation cifixime and ceftrixon. The outcome of patient with appropriate antibiotics was higher at 97.3% for 5 days compared to 83.3% for 3 days
Conclusion: Gram negative bacilli is responsible for urinary tract infection and most frequent isolated bacteria was E-coli. The most effective antibiotics are cepholine, amikacin, and third generation cefixem and ceftrexone in patients. Urinary tract infection occurs within 5 days in our local settings comparing to 3 days in developed communities which can enable emperical use antibiotics with typical symptoms of uncomplicated urinary tract infection for about 5 days in our community
ABSTRACT
Background: Dengue fever and malaria both can present with thrombocytopenia and is regarded as a strong predictor of dengue fever. Thrombocytopenia is also considered criterion of disease severity, bad prognostic factor and its presence is associated with increase probability of malaria
Objective: To determine frequency of co-existence of dengue fever and malaria in thrombocytopenic patients presented with acute febrile illness in tertiary care hospital
Methods: Cross-sectional, observational study conducted at the department of Emergency Medicine, Ziauddin University Hospital, Karachi from April 2013 to January 2014. A total of 159 patients meeting inclusion criteria were included in this study. 5ml of blood by venupuncture in EDTA anti-coagulant for platelet count and preparing thick and thin films and 2 ml of blood in plain bottle for detection of dengue specific IgM was collected from all patients. Thick films are used to identify malarial parasites and thin films to identify specie. Dengue fever was diagnosed on positive dengue IgM. Co-existence was labeled as positive if malarial parasites and dengue IgM found to be present at the same time. This diffusion susceptibility test was use to determine susceptibility of bacterial agents to antibiotics. Data was analyzed by descriptive statistics using SPSS software version 19
Results: Overall mean [+/- SD] age was 38.3 [+/- 7.9] years, with Male to female ratio was 1.1: 1. Coinfections [Dengue and Malaria] were diagnosed in 5 [5.6%] of cases. From 5 cases, 3 [60%] were male and 2 [40%] were female. Mean [+/- SD] age of 5 positive cases of co-infection was 37.8 [+/- 8.3] years
Conclusion: Concurrent infections were found 5.6% in this study, however, this percentage is slightly low; and special consideration should be given to the likelihood of co-infection with dengue and malaria Co-existence of dengue fever and malaria in thrombocytopenic patients presented with acute febrile illness