RESUMEN
Background: Crimean Congo hemorrhagic fever virus is a fatal infection that has a very high case fatality rate. It is highly infectious and there is no recommended treatment for it. Oral ribavirin is the most commonly used drug and has variety of side effect profile
Objective: To determine the frequency of side effects in cases taking oral ribavirin for post Crimean Congo virus exposure prophylaxis
Methodology: This cross sectional study study was conducted at Medical and Emergency Department, Sheikh Zayed Hospital, Rahim Yar khan from 1 January to 31 December 2016 on suspected cases of Crimean Congo Hemorrhagic Fever [CCHF] virus exposure. The cases were suspected on this basis of signs and symptoms of hemorrhagic fever and negative Dengue serology. Oral Ribavirin was given in 2 grams [gm] loading dose, 4 gm/ day for 4 days and then 2 gm/ day for next 6 days in divided doses. The cases were then followed for development of nausea/ vomiting, anemia, jaundice, generalized aches and pains and insomnia. The results were collected and recorded and analyzed by using SPSS version 22
Results: In this study, there were total 32 cases that were started on ribavirin prophylaxis. Two cases quit prophylaxis early. Out of total 30 cases left that completed the prophylaxis, 17 [56.67%] were males and 13 [43.33%] females. The mean age and weight were 32.86 +/- 7.05 years and 45.66 +/- 7.74 kg respectively. Side effect profiles were seen in 24 [80%] cases. The most common side effect was nausea/vomiting seen in 18 [60%] cases, generalized aches and pains in 17 [56.67%], anemia in 12 [40%] cases, jaundice in 11 [36.67%] and insomnia in 4 [13.33%] cases. There was no significant difference of side effects in terms of age, gender, and weight group with p values of 0.63, 0.49, and 0.25 respectively
Conclusion: Oral ribavirin is commonly used for CCHF virus exposure prophylaxis and has a very high side effect profile among which GI side effect and generalized aches and pains are the most common
RESUMEN
Background: Ischemic heart disease especially inferior wall myocardial infarction [IWMI] is an important health issue. It can further add to morbidity and mortality when it is associated with right ventricular [RV] infarction
Objective: To determine the frequency of right ventricular infarction in cases with acute inferior wall myocardial infarction
Methodology: This cross sectional study was conducted at Department of Cardiology, Sheikh Zayed Hospital, Rahim Yar Khan in January to 31 December 2015. The cases with age range of 30 to 80 years of IWMI; assessed by ST segment elevation of at least half mm in lead II. III and aVF, were included in this study. The co-morbidities in the form of DM, HTN, smoking, family history of IHD and dyslipidemia were also considered. However, the cases with renal failure, trauma, electrolyte imbalance and MI other than inferior wall were excluded from the study. The diagnosis of RV infarct was made by the elevation of at least 1 mm in V4R lead in cases with IWMI changes. These cases were followed during their hospital stay to look for development of any complication. The data was entered and analyzed by using SPSS version 21
Results: In this study, there were 30 cases of IWMI. Out of which 22 were males and 8 females. The mean age was 48.87 +/- 11 years. Nineteen [63.33%] cases has door to needle time less than 30 minutes. DM, HTN, smoking, family history of IHD and dyslipidemia were seen in 10 [33.33%], 9 [30%], 13 [43.33%], 01 [3.33%] and 2 [6.67%] cases respectively. Thrombolysis was done in 23 [73.33%] cases. RVinfarct was seen in 11 [36.67%] cases. RVinfarct was seen in 7 out of 22 males while it was seen in 4 out of 8 females [p= 0.36]. There was no significant association of RV infarct with any age group [p=0.60]. There was again no significant association with door to needle time, duration of symptoms, thrombolysis status and any of the risk factors with RV infarct. The most common in hospital complication was different types of arrhythmia which rd were found in 9 [30%] cases
Conclusion: Inferior wall MI is reported in good number of cases. Every 3 case of inferior wall MI also has right ventricular MI
RESUMEN
Background: Acute coronary syndrome [ACS] is an acute emergency. It covers a wide spectrum of symptoms ranging from anginal pain to life threatening emergencies of myocardial infarctions. ACS can end up in various complications
Objective: To determine the patterns of acute coronary syndrome, in cases presenting to chest pain unit of Sheikh Zayed Hospital, Rahim Yar Khan
Methodology: This cross sectional study was carried out at chest pain unit at [CPU], Emergency Department, Sheikh Zayed Hospital, Rahim Yar Khan from 15[th] January to 16th July 2015. The cases with age range of 30 to 80 years with typical chest pain and ECG changes were included. The case with end stage renal failure, electrolyte imbalance, trauma, and documented cases of IHD were excluded from the study. The cases with ST segment elevation were labeled as STEMI while with ST-T changes with raised cardiac enzymes as NSTEMI and normal enzymes as unstable angina. They were also assessed for in hospital complications. The data was entered and analyzed by SPSS version 22
Results: In this study there were 50 cases, out of which 33 [66%] were males and 17 [34%] females. The mean age was 49+/- 10 years. STEMI was seen in 35 [70%] cases followed by NSTEMI in 9 [18%] and UA in 6 [12%] cases. All the components of ACS were more common in males as compared to females with [P= 0.76]. The most cases of ACS were seen in age groups of 41 to 49 years [p=0.54]. There was no significant association of any of the risk factors with any type of ACS. Recurrent angina and arrhythmia were the two most common complications
Conclusion: ACS is well-reported entity and STEMI is the most common subtype found, at chest pain unit