RESUMO
Introduction: Anabolic-androgenic steroid (AAS) abuse is routine in athletes to enhance their overall physique. It often leads to detrimental effects, including cardiovascular diseases, hormonal imbalances, and cancer. Our case presentation emphasizes two important aspects: the first is the importance of thorough history taking in correctly diagnosing diseases with multiple etiologies. The second one relates to the reversible and preventable hazards of the increasing incidence of usage of illicit drugs, mainly androgenic anabolic steroids in young adults. Case presentation: We present a case of a 30-year-old male bodybuilder with presenting complaints of increased anxiousness, excessive anger, and dyspnea on minimal exertion. Echocardiogram showed a dilated cardiomyopathy with left ventricular ejection fraction (LVEF) of 20%. The patient was counseled for quitting AAS and symptomatically treated on heart failure management guidelines. He responded well to the management plan and now enjoying a healthy life. Conclusion: It is imperative to raise awareness regarding the substantial adverse effects of AAS abuse that might precipitate severe cardiovascular system complications leading to morbidity and eventual mortality. Most of the times, the pathological changes due to AAS abuse are reversible. This shows a good prognosis and better compliance with the management plan advised to the patients.
RESUMO
Objective To investigate the trends of end-stage renal disease (ESRD) in patients undergoing maintenance hemodialysis (MHD) and find the correlation with effects on the pulmonary system in such patients. Methodology A multicentric prospective study was conducted in the city of Solapur, India. Data were collected from 250 patients through interpersonal interrogation using a questionnaire to capture basic demographic details, the history of ESRD, and relevant respiratory symptoms like breathlessness, cough, fever, etc. related to their disease. Symptoms that are likely associated with the pulmonary system were analyzed and referred to the pulmonology department. Appropriate diagnoses were made using relevant diagnostic tools like X-rays and sputum studies. The association between various disease attributes and pulmonary diagnoses was analyzed using the chi-square (χ2) test, with a p-value of value less than or equal to 0.05 considered statistically significant. Various socio-demographic variables, existing comorbidities, occupation-related risk factors, smoking history, past or current history of any respiratory conditions, the association between the causes of ESRD, time since the first dialysis and sociodemographic factors, and frequency of pulmonary complications were the other covariates in the study. Results Our study reports that 31.6% of our patients had significant impairment in their functioning due to respiratory complaints. The prevalence of respiratory complications was 27.2%. Major contributors were pleural effusion (33.8), pneumonia (25), pulmonary edema (20.58), pleuritis (11.76), collapse (8.8), tuberculosis (5.8), fibrosis (4.4), pericardial effusion (4.4), calcification (2.9), and hydrothorax (1.47). We report one case of Urinothorax as a rare cause of hydrothorax in such patients. Overall, our analysis found a significant association between non-reporting of respiratory complaints and acute admissions to the intensive care unit (ICU) with a respiratory cause at p-value 0.0076 with a greater predilection toward the rural populations. Conclusion Our study results highlight the prevalence of pulmonary complications in ESRD patients. The occurrence of pulmonary complications, irrespective of the presence of symptoms and a greater association between non-reporting of respiratory symptoms and acute admissions to the ICU, is a hallmark to consider the importance of history and clinical vigilance during patient visits.
