RESUMEN
Left ventricular noncompaction (LVNC) is a rare genetic cardiomyopathy postulated to be a defect in endomyocardial morphogenesis due to the embryonic arrest of the compaction of myocardial fibers. It could be isolated, without other structural heart defects; or associated with congenital heart defects. It is characterized by prominent ventricular myocardial trabeculations and deep intertrabecular recesses. The clinical manifestations, i.e., heart failure, arrhythmias or thromboembolism, overlap with those of other cardiac disorders. It is often misdiagnosed as restrictive or dilated cardiomyopathy. The high mortality and morbidity associated with it and familial occurrence make diagnosis important. Only 3 pediatric cases have been reported from India. We present 2 cases, that of an 11-year-old girl (familial case) with embolism (documented but rare in children) and atrial flutter (not yet reported), with mother having asymptomatic LVNC; and that of a 4-month-old girl. Both presented with heart failure. The 11-year-old child had sudden death, known to occur in LVNC.
Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Anticoagulantes/uso terapéutico , Arritmias Cardíacas/diagnóstico , Captopril/uso terapéutico , Cardiomiopatía Dilatada/diagnóstico , Cardiomiopatía Restrictiva/diagnóstico , Cardiotónicos/uso terapéutico , Niño , Diagnóstico Diferencial , Resultado Fatal , Femenino , Humanos , Lactante , No Compactación Aislada del Miocardio Ventricular/diagnóstico , No Compactación Aislada del Miocardio Ventricular/tratamiento farmacológico , Miocardio/patologíaRESUMEN
BACKGROUND: Workplace bullying is an important and serious issue in a healthcare setting because of its potential impact on the welfare of care-providers as well as the consumers. AIMS: To gauge the extent of bullying among the medical community in India; as a subsidiary objective, to assess the personality trait of the bullying victims. SETTINGS AND DESIGN: A cross-sectional, anonymous, self-reported questionnaire survey was undertaken among a convenient sample of all the trainee doctors at a Government Medical College in Tamil Nadu, India. MATERIALS AND METHODS: A questionnaire, in English with standard written explanation of bullying was used. Basic information like age, sex, job grade and the specialty in case of Postgraduates (PGs) were also collected. Statistical Analysis: The results were subjected to descriptive statistical analysis and Chi-square test for comparison of frequencies. RESULTS: A total of 174 doctors (115 PGs and 59 junior doctors), took part in the study with a cent percent response. Nearly half of the surveyed population reported being subjected to bullying. Nearly 54 (53%) of the men and 35 (48%) of women were subjected to bullying. Significant proportions (P < 0.0001) of medical personnel and paramedical staff bullied the PGs and junior doctors, respectively. More than 85 (90%) of bullying incidents went unreported. A significant (P < 0.0001) percentage of PGs and junior doctors revealed a personality trait towards bully. CONCLUSIONS: Workplace bullying is common among trainee doctors and usually goes unreported.