European Journal of Cardiovascular Medicine

:  Background: Present study was done to describe the frequency of undiagnosed diabetes mellitus in patients of non alcoholic fatty liver disease at a tertiary care centre. Material & Methods: This was a hospital based observational cross-sectional study conducted in the Department of community Medicine. Data was entered on MS Excel spreadsheet. Results were summarized in tables and percentages. Quantitative data was summarized using means +/- & standard deviation. Cross tabulation with outcome variable of interest was done using statistical SPSS software version 22.0. Results: Total of 120 cases, ultrasonographically diagnosed as NAFLD were included in this study. Mean age of the cases was 53.62±10.69 years. Mean age in males was 55.33±10.19 years while in female it was 51.04±10.92 years. Maximum number of patients was in 5th and 6th decades. Out of 120 total patients, total males were 29 and females were 91. According to BMI, no patient was underweight, 18(15%) were normal, 48(40%) patients were overweight and 54(45%) patients were obese. 20(16.67%) patients were hypertensive. 18(15%) patients had diabetes mellitus. Out of 18 total diabetic patients, 12 were females and 6 were males. Impaired fasting glucose were found in 55(45.83%) of patients. Increased serum Cholesterol level were seen in 56(46.66%) patients. Increased serum triglyceride level was seen in 68(56.67%) patients. Low serum HDL level was seen in 78(65%) patients. Increased serum LDL levels were 37(30.83%) of patients. ALT and AST levels were elevated in 63(52.5%) and 61(50.83%) of patients. Total of 120 cases, 64(53.33%), 52(43.33%) and 4(3.33%) of cases had grade I, II, and III fatty liver respectively. Conclusion: The prevalence of several components of metabolic syndrome is higher in NAFLD patients, according to our findings

Background And Objectives: Seizures are the most distinctive manifestation of neurologic dysfunction in newborn infant. Incidence varies from 0.5 to 0.8 percent in term babies and 6 to 12 percent in babies weighing less than 1500g. A variety of biochemical disturbances have been observed in neonatal seizures prominent among them is hypoglycemia, hypocalcemia, hypomagnesemia, hyponatremia. The objective of our study was to see the relationship of etiologyof neonatal convulsion with the age of their onset.

Materials And Methods: A total of 60 neonates were included in this study from period of February 2017 – January 2018 and divided into three gestational age groups 34-37 weeks, 37-41 weeks, 34-41 weeks and were observed to establish relationship of etiologyof neonatal seizures with age of onset.

Results: The result of study showed that seizures due to birth asphyxia occurred in 53.8% cases within 24 hours and in 46.15% between 24-48 hours, due to hypoglycemia in 100% cases within 24 hours, due to hypocalcemia in 33.3% cases within 24 hours and in 66.6% cases between 3-28 days and due to septicemiain 44.4% cases during 48-72 hours and in 55.5% cases during 3-28 days.

Interpretation And Conclusion: The present study showed that time of onset of seizures could be a clue to the aetiology of neonatal seizures.

Background- Cervical Lymphadenopathy is a common problem in children and it is considered significant if the diameter exceeds 1 cm for cervical and 1.5 cm for axillary lymph node. Common pathology is infective and mostly benign and self limiting.

Objective- To study the clinicopathological profile of significant cervical lymphadenopathy in age group 1 month to 12 year

Methodology- This is a prospective observational study of 75 patients with significant cervical lymphadenopathy. This study was conducted at Department Of Paediatrics & Neonatology, RIMS, Ranchi, Jharkhand from April 2018 to March 2019. History, clinical examination, Mantoux test,  Hemogram, Fine Needle Aspiration Cytology (FNAC) were performed in maximum cases. USG and CT were done in some cases.

Result- Out of 75 cases, cervical lymphadenopathy was maximum in 4 to 8 years  (42.7%), 8 to 12 years (36%), and least in 1 month to 4 years (21.3%). Neck swelling (89.3%), fever (90.7%), cough (50.7%), loss of weight (26.7%), and ear discharge ( 10.7%). Most common site of cervical lymphadenopathy was cervical and least was in occipital. Lymph node consistency was firm ( 89.4%), soft (93%) and rubbery (1.3%). Associated findings were tonsillitis and/or pharyngitis, hepatosplenomegaly.

Conclusion- Lymphadenopathy is a sign of many underlying disorders and mostly benign. Few are serious which should be ruled out through examination . FNAC should be done in doubtful cases. Reactive Lymphadenitis due to bacterial or viral pathogens were the most common cause.

Abstract: Introduction: Lower urinary tract symptoms (LUTS) is a common condition, with Benign prostatic hyperplasia (BPH) being a frequent condition in men over 50 years of age. The natural history of BPH is characterized by an age-dependent increase in histological changes and an increase in prostate size. Cystoscopy is often used in the diagnosis and treatment. This study aims to assess the relative use of cystoscopy in patients with LUTS. Methods: The study design is a descriptive, prospective study design. The targeted group were male patients above the age of 50 years who presented with lower urinary tract infection in Yastabshiron, and Ibn Sina hospitals between the periods of (August 2015-January 2016). Primary data collected from sampling units using a questionnaire containing questions of the variables of interest. The data was analyzed by using Statistical Package for Social Science (SPSS) and chi square for analysis with alpha level of significance 95%. All appropriate permission and consents were taken.Results: BPH was diagnosed in 90% of cases. 60% of patients had complications. The most common complications was Orchitis/Epididymitis and found to be in 26% in study participants, followed by hematuria in 18%, dysuria in 12% and stricture in 4%. The mean reduction in IPSS score for those receiving medical treatment was 4.8, while in the cystoscopy group it was 3.8. Independent sample t test analysis shows that there is a statistical difference between the cystoscopy and medical treatment groups (p=0.016). Conclusion: A trial of medical treatment was found to be significantly better at treating the symptoms of patients with LUTS as compared to cystoscopy. Since cystoscopy is associated with a high rate of complications, a trial of medical treatment should be the first line treatment.

Covid-19 caused a pandemic in the world in 2020 and also caused the collapse of many medical systems. In order to keep the virus out of the hospital, it is very important to design a good "traffic control" and policy. Through the control of the entrance, our hospital initially screened people with fever or upper respiratory symptoms or foreign travel history, and shunted to the emergency epidemic diagnosis area. When the patient entered the epidemic diagnosis area, the dedicated medical staff that completed the protective equipment, after preliminary consultation X-ray examination is carried out in the outdoor X-ray irradiation area to assess whether there are Acquisition conditions of the inspection, and then go to the outdoor negative pressure inspection and inspection station to complete the inspection and inspection operations. After distributing the medicine from the special medicine receiving window, all treatments will not enter the hospital area and be handled in a one-stop service. The patient will not move back and forth in the area to reduce cross-infection. When the doctor assesses the need for hospitalization, it will be directly admitted to the negative pressure isolation ward through a certain planned movement line to reduce exposure in the hospital and ensure the safety of inpatients and medical staff. The outdoor moving line design can be used for general chest X-ray examination, basic blood drawing and collection of COVID-19 related specimens. If the patient needs to be temporarily placed in the hospital, there are also planned outdoor compartments to accommodate the patient. When need use the toilet, it can use the outdoor mobile toilet (Figure 1). The design of this is mainly for risk management and diversion shunt. High-risk cases are treated through a specially designed one-stop service visit to effectively control the virus outside the hospital area and prevent patients from entering the hospital and other patients cross infection.

COVID-19 was declared by the World Health Organization as a “Public Health Emergency of International Concern” [1]. These patients may develop shock due to sepsis or cardiac injury; however, hemodynamic characteristics have not been described. We analyzed the hemodynamic profile of 2 ventilated patients (critical cases), 2 non-ventilated patients with severe pneumonia (severe cases) and 1 patient with pneumonia (moderate cases) admitted to the ICU of the Tropical Medicine Institute “Pedro Kouri”, Havana, Cuba. SARS-CoV-2 infection was confirmed in all cases by reverse-transcriptase-polymerase-chain-reaction at hospital admission. Non-invasive hemodynamic measures (within the first 24 h of ICU admission) were used in order to minimize viral transmission to health-care provider. Arterial and central venous samples were simultaneously collected for testing. Fick method was used to calculate the Cardiac Output (CO) as CO=VO2/Ca-CVO2, where VO2 is the oxygen consumption (using the Bergstra's formula) and Ca-CVO2 is the arterial-to-central venous oxygen content difference. We observed a hyperdynamic profile, characterized by high CO and low systemic vascular resistance, in critical and severe cases; conversely, moderate cases have a normal hemodynamic pattern (Table 1). Of note, hyperdynamic changes were markedly higher for critical cases compared to those for severe cases, suggesting that a poor clinical course is associated with a more severe imbalance in hemodynamic parameters. Despite these finding, impairment in the mean arterial pressure was not observed in severe cases and low-dose norepinephrine was required in critical cases, indicating that tissue perfusion was guaranteed by the increased CO (Table 1). Serum concentrations of inflammation-related biochemical markers were higher in patients with critical disease than those in patients with severe or moderate disease (Table 1), suggesting a close relationship between inflammation and hemodynamic imbalance. Angiotensin II effects are increased in COVID-19 patients because of a reduced activity in the angiotensin-converting enzyme 2, but inflammation-induced vasodilatation may overcome the Angiotensin II - associated vasoconstriction. In fact, Angiotensin II may be an inductor of inflammation and oxidative damage in early phases [2]. All patients had a central venous oxygen saturation >70% and central venous-to-arterial carbon dioxide difference (Pcv-aCO2) <6.0 mmHg, indicating an adequate tissue oxygen supply and CO2 wash-out, respectively; however, biological markers of anaerobic metabolism such as hyperlactatemia and Pcv-aCO2/Ca-cvO2 ratio >1.8 were observed in critical patients (Table 1). These founds suggest microcirculatory or mitochondrial disturbances [3]. In summary, this report highlights that in early phase of COVID-19-assocaited critical illness, patients show a hyperdynamic profile with microcirculatory/mitochondrial disturbances. These abnormalities may contribute to mortality.

Infection with Helicobacter pylori (H. pylori) is a prevalent global infection that is a leading cause of peptic ulcer disease and stomach cancer. Determine the prevalence of H. Pylori in the province of Thi-Qar from 2017 to 2018. Data was collected utilizing a periscope on the second floor of Educationa Al Hussein Hospital's Gastroenterology Unit for patients with gastrointestinal ulcers on the basis of age, gender, housing area, and month. A survey of the therapies utilized throughout the world was performed to get information on ulcer therapy. The current study found that the number of people infected with H. pylori in 2017 was higher than the number of people infected in 2018, in both sexes, with the overall number of people infected in 2017 being higher than the total number of people infected in 2018. (250). Females between the ages of 15 and 35, living in the countryside during the month of May, had a significant frequency of H. pylori with gastric ulcer. The treatment of stomach ulcers employed in the gastrointestinal unit of the patients was positive tests for H.pylori infection, Treatments were pretty similar with the global sources, but were not categorized into standard or alternative therapy, and did not employ Levofloxacin in treatment. This demonstrates the doctor's ability in selecting proper treatment in Educational Al Hussein Hospital as an alternative therapy.

COVID-19 has been declared a global pandemic by the World Health Organization and is responsible for hundreds of thousands of deaths worldwide. COVID-19 is caused by SARS-CoV-2, and common clinical symptoms include fever, cough, sore throat, headache, and fatigue. The cardiovascular system is affected in this infection, with complications including myocardial injury, myocarditis, acute myocardial infarction, heart failure, dysrhythmias, and venous thromboembolic events. Current therapies for COVID-19 may interact with cardiovascular medications. Myocardial injury is relatively common in patients with COVID-19, accounting for 7%-23% of cases, and is associated with a higher rate of morbidity and mortality [1]. In patients with COVID infection clinical suspicion is necessary to diagnose myocarditis as an important complication of this infection. Here we present a patient who developed shortness of breath and orthopnea following sore throat and myalgia and was eventually treated with a diagnosis of myocarditis and discharged from the hospital in relatively good general condition.

If tricuspid regurgitation (primary and secondary) is left untreated, it will be associated with significant complications and death, even if left ventricular dysfunctions are corrected, TR does not decrease in many cases. Since many studies have not been conducted in this area, we decided to evaluate the results of tricuspid repair. In this retrospective study conducted since 2006 to 2011, 448 patients undergoing tricuspid surgery with different methods with or without surgery were studied. Statistical analysis was performed by Friedman, Fisher exact and Pearson chi-square methods. In the Mod and Severe RV dysfunction section, the mean age of the patients was 52 years, 289 were female (64%), 343 (76%) had rheumatic pathology, 79 (17%) had myxomatous pathology, 12 (2%) had endocarditis pathology, and 14 had an unknown pathology. Before surgery, Mod and Severe dysfunction was seen in 226 patients (40%) and after surgery (follow up), it was seen in 85 patients (19%). Before surgery, Mod and Severe TR was seen in 356 patients (79%) and after surgery, it was seen in 91 patients (20%). The mean of PAP before surgery was 54 mmHg and after surgery, it was 37 mmHg, which was significant in all cases (P<0.05). Out of 282 people with Mod to Sever TR before the surgery by bicuspidization method, 37 people reached follow up and out of 156 people operated by devega method, 22 people reached follow up and out of 65 people operated by ring method, 9 people reached follow up. Based on the results obtained in this study, all the methods used for tricuspid repair are useful, but the results of ring use and bicuspidization were better than devega method and had less residual TR after surgery. Therefore, it is recommended to use the Ring method in cases of TR with or without involvement of other valves, since it showed better results and bicuspidization method and devega method are not recommended.

Addiction involves continuous use of a substance with neglect of other things in life. It essentially incorporatesconceptslikeCraving, Tolerance, Withdrawal, Abuse etc., developing a sense of Dependence in the person. With the increasing civilization and modernization, abuse of various substances has been rampant across all age groupsspecially youth. Recent National Crime Record Bureau (NCRB) dataindicates that maximum crime against society conducted by Youth were under drug or substance influence. With an overall increase in understanding, towards managingpersons with substance abuse, various treatment modalities were in place. However, review of existing literature indicates that, use ofbehavioraland/or pharmacologicaltreatment modalities, though targeting Craving issues are,at best yielding mixed outcomes.Relapses are commonly seen in person with addiction problems as the sense of Craving- meaning the urge to take a substance, is not well tolerated by the addict. Further, it also poses challengeseven with use of cognitive therapeutic techniques to induce a sense of comfort in the substance/drug addiction,for, craving is not for the intake of substance/drug, but for the pleasure(pleasurable sensations) that the person gets after intake of a particular substance/drug. So here Vipassana Meditation can be effective, for, it helps the person to understand the impermanence nature of all (bodily) sensations, be it unpleasurable or pleasurable ones. Thereby with practice of Vipassana, the person gradually develops a sense of perfect Equanimity of mind, so there will be no aversion for unpleasurable sensations and no Craving for pleasurable sensations. Thus, with practice of Vipassana the addict can come out of his addiction, permanently.