scholarly journals Incidentally discovered Kawasaki disease in an adult man

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Kamel H. Haider ◽  
Sultan Abdulwadoud Alshoabi ◽  
Abdulaziz A. Qurashi ◽  
Abdullgabbar M. Hamid
Keyword(s):  
Kawasaki Disease ◽  
Coronary Disease ◽  
Systemic Vasculitis ◽  
Treatment Options ◽  
Small Children ◽  
Once Daily ◽  
Creative Commons ◽  
Anticoagulant Drugs ◽  
History Of ◽  
Open Access Article

Kawasaki disease (KD) is a systemic vasculitis of unknown cause which usually diagnosed in small children. However, KD can be present as coronary disease in adults even with no history of the disease in childhood. Here, we describe a case of KD in a 42-year-old male patient presented with severe retrosternal chest pain radiating to the left arm and provisionally diagnosed as acute coronary disease. Coronary artery ectasia and multiple aneurysms have been confirmed by coronary angiography that led to the diagnosis of KD. The patient was treated with Aspirin 81 mg orally once daily, Apixapan 5 mg orally twice daily, Rosuvastatin 40 mg orally once daily, Bisoprolol 5 mg orally once daily, and omeprazole 20 mg orally once daily. The patient was improved and discharged with anticoagulant drugs for life. Physicians should be aware that KD can be present as coronary disease in adults even with no history of the disease in childhood and has a limited treatment options due to unfavorable coronary anatomy. doi: https://doi.org/10.12669/pjms.37.7.4199 How to cite this:Haider KH, Alshoabi SA, Qurashi AA, Hamid AM. Incidentally discovered Kawasaki disease in an adult man. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4199 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Association of anti-HCV sero-prevalence with blood transfusion and practice of haemodialysis from multiple centres in patients on maintenance haemodialysis

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Umbreen Amjad ◽  
Saqib Qayyum Ahmad ◽  
Saima Mir ◽  
Moazam Ayub
Keyword(s):  
Blood Transfusion ◽  
Original Work ◽  
Categorical Variables ◽  
Chi Square ◽  
Creative Commons ◽  
Maintenance Haemodialysis ◽  
High Prevalence ◽  
History Of ◽  
Open Access Article ◽  
Transfusion History

Objectives: To determine the frequency of anti-HCV in patients on maintenance haemodialysis (HD) and its association with history of blood transfusion and with the practice of HD from more than one center. Methods: All the patients on maintenance HD at Bahria International hospital (BIH) Rawalpindi from March 2019 to May 2019 were included. Demographic details, history of blood transfusions and history of HD from any other center in addition to BIH, were recorded. Anti-HCV was done by chemiluminescent assay. Chi-square was used to compare the categorical variables. Odds ratio (OR) and relative risk (RR) for the groups exposed to risk were calculated. Results: Of 96 patients, 40 (41.6%) were anti-HCV positive. Sixty–two (64.6%) had transfusion history. Thirty-one (50%) of these 62 were anti–HCV positive as compared to 9 (26.5%) of 34 with no history of transfusion (p=0.025); OR=2.78 (p=0.0278), RR=1.89 (p=0.0420). Among 66(68.7%) of 96 who had HD from other centres in addition to ours, 33(50%) were anti-HCV positive as compared to 7(23.3%) of 23 who had HD from BIH only (p=0.014); OR=3.29 (p=0.0167), RR=2.14 (p=0.0309). Conclusion: There was a high prevalence (41.6%) of anti-HCV in our HD patients and anti-HCV positivity had significant association with history of blood transfusion as well as with history of HD from multiple centres. doi: https://doi.org/10.12669/pjms.36.2.1343 How to cite this:Amjad U, Ahmad SQ, Mir S, Ayub M. Association of anti-HCV sero-prevalence with blood transfusion and practice of haemodialysis from multiple centres in patients on maintenance haemodialysis. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1343 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Giant bilateral axillary artery aneurysms with left complete obstructive thrombus in intravenous immunoglobulin-sensitive Kawasaki disease: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chen Chu ◽  
Lan He ◽  
Yi-xiang Lin ◽  
Li-ping Xie ◽  
Fang Liu
Keyword(s):  
Kawasaki Disease ◽  
Upper Limb ◽  
Axillary Artery ◽  
Systemic Vasculitis ◽  
Systemic Artery ◽  
Low Dose Aspirin ◽  
History Of ◽  
Normal Ultrasound ◽  
Collateral Vessels ◽  
The Right

Abstract Background Kawasaki disease (KD) is a systemic vasculitis that predominantly affects medium-sized arteries. In addition to well-known coronary artery aneurysms (CAAs), peripheral systemic artery aneurysms (SAAs) have also been sporadically reported. In the literatures, SAAs occurred mainly in untreated, intravenous immunoglobin (IVIG)-resistant, or severe refractory KD, and thrombotic events in SAAs were rarely reported. Case presentation A 10-month-old boy with a history of KD was referred to our hospital for suspected pseudoaneurysm of the axillary arteries. Four months prior to presentation, he had persistent fever, conjunctival congestion, and rash. On the 10th day of fever echocardiogram showed biliteral CAAs. He was then diagnosed with KD and given IVIG 2 g/kg and aspirin at a local hospital. His fever and symptoms soon subsided and he was discharged with low dose aspirin and dipyridamole. One month prior to presentation, his parents incidentally palpated swellings in his bilateral axillae. On admission, physical examination revealed a pulsatile swelling in his right axilla and a non-pulsatile swelling in the left with impalpable left brachial and radial pulses, cooler and less active left upper limb than the right one. While the pulses of other three limbs were normal. Ultrasound examination revealed giant bilateral axillary artery aneurysms (AAAs) with massive thrombus in the left. Angiography confirmed giant bilateral AAAs with left AAAs completely occluded and fine collateral vessels connecting to the distal brachial artery, in addition to giant bilateral multiple CAAs without stenoses. The patient was given intravenous prostaglandin for 10 days to allow for formation of collateral circulation, as well as aspirin, low molecular weight heparin (which was switched to warfarin before discharge) and metoprolol. At discharge, the temperature and movement of his left upper limb improved significantly. On follow-up at 7 months, his left upper limb further improved and was similar to the right with no occurrence of cardiovascular events. The images of CAAs and AAAs on echocardiogram and computerized tomography remained the same. Conclusions This case highlights the importance of evaluating peripheral SAAs in KD patients with CAAs, even if their course of treatment appears smooth. For both large non-aortic SAAs and CAAs in KD patients, antithrombotic therapy is of utmost importance.

Newly discovered Staphylococcus aureus serine hydrolase probe and drug targets

ADMET & DMPK ◽  
2021 ◽  
Author(s):  
Matthias Fellner
Keyword(s):  
Staphylococcus Aureus ◽  
Open Access ◽  
Drug Development ◽  
Drug Targets ◽  
Treatment Options ◽  
Bacterial Pathogen ◽  
Serine Hydrolase ◽  
Creative Commons ◽  
New Diagnosis ◽  
Open Access Article

There is an urgent need for new diagnosis and treatment options for the bacterial pathogen Staphylococcus aureus. This review will summarize data on ten recently discovered biofilm-associated serine hydrolases called fluorophosphonate-binding hydrolases (FphA-J). Based on the summarized findings, many of these proteins represent intriguing new targets for probe and drug development. ©2021 by the authors. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).

scholarly journals Prominent gallbladder enlargement: Kawasaki disease or other congenital or acquired gallbladder disease? A case report

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110415
Author(s):  
Liang Zhao ◽  
Yimin Hua ◽  
Kaiyu Zhou
Keyword(s):  
Abdominal Pain ◽  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
Gallbladder Disease ◽  
Clinical Manifestations ◽  
Acute Stage ◽  
High Dose ◽  
Glucocorticoid Treatment ◽  
Intravenous Immunoglobulin Therapy ◽  
History Of

Kawasaki disease (KD) is a common systemic vasculitis in childhood that can result in damage to multiple body systems. However, prominent gallbladder (GB) enlargement in the acute stage is especially rare. A 5-year-old boy was admitted to the hospital with an 8-day history of a cervical mass, 7-day history of fever, and 5-day history of abdominal pain and rash. The child was diagnosed with KD. After treatment with high-dose intravenous immunoglobulin therapy (2 g/kg), all clinical manifestations were relieved except the abdominal pain. Enhanced computed tomography showed distinct enlargement of the GB, and a congenital choledochal cyst was strongly suspected. After high-dose glucocorticoid treatment, his obviously enlarged GB returned to normal size in the subacute phase. No abnormality was found during 2 years of follow-up. Prominent GB enlargement may emerge in the acute stage of KD. The enlarged GB can return to normal size within the subacute stage by standard treatment for KD. Proper diagnosis, thorough differential diagnosis, and active anti-inflammatory treatment of KD are crucial to avoid surgery.

scholarly journals Ametropia in children with headache

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Mohammad Asim Mehboob ◽  
Haider Nisar ◽  
Memoona Khan
Keyword(s):  
Refractive Error ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Creative Commons ◽  
Initial Symptoms ◽  
History Of ◽  
Study Population ◽  
Persistent Headache ◽  
Open Access Article

Objective: To measure the frequency of uncorrected ametropia in children with 2 to 8 weeks of persistent headache referred to ophthalmic outpatient department for evaluation. Methods: This cross sectional study was conducted at CMH Gujranwala from March 2018 to November 2018.A total of 262 children, aged from 5 to 16 years, with 2 to 8 weeks history of persistent headache underwent detailed ophthalmic assessment for refractive errors, and other ophthalmic evaluation. Children with ametropia, confirmed with cycloplegic refraction and post-mydriatic testing were prescribed with glasses. Patients without any ophthalmic findings were referred back to pediatrics department for further evaluation. Results: Mean age of study population was 8.97 ± 3.16 years. Mean duration of headache was 5.03 ± 1.81 weeks. Ametropia was found in 56 (21.4%) children, while 206 (78.6%) had no refractive error. Out of children with ametropia, 20 (35.7%) had myopia, 24 (42.8%) had astigmatism and 12 (21.5%) had hypermetropia. There was no difference in ametropic children and children without ametropia with respect to gender (p=0.73), age (p=0.54) and duration of headache (p=0.71). Conclusion: A significant proportion of children with ametropia have initial symptoms of headache. Any child with un-explained headache must undergo ophthalmic evaluation to diagnose refractive error, if any. doi: https://doi.org/10.12669/pjms.35.3.268 How to cite this:Mehboob MA, Nisar H, Khan M. Ametropia in children with headache. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.268 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Kawasaki-like syndrome in children from Greater Poland during the first wave of COVID-19 pandemic

2020 ◽  
Vol 16 (4) ◽  
pp. 396-403
Author(s):  
Katarzyna Mazur-Melewska ◽  
◽  
Anna Mania ◽  
Paweł Małecki ◽  
Iwona Klimecka ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
Developed Countries ◽  
Kawasaki Syndrome ◽  
Incomplete Kawasaki Disease ◽  
Viral Aetiology ◽  
History Of ◽  
The Mean ◽  
Artery Disease ◽  
Inflammatory Syndrome

Kawasaki disease is an acute disease caused by systemic vasculitis, which predominantly affects children younger than 5 years of age. It is the leading cause of acquired coronary artery disease in childhood in developed countries. Currently, in the era of COVID-19, an increased number of cases, most likely related to SARS-CoV-2, are being observed. Our study aimed to describe the incidence and course of Kawasaki-like syndrome in patients admitted to the Polish department of infectious diseases during the first wave of COVID-19 pandemic. We identified 6 children with Kawasaki disease within almost 6 weeks of the pandemic. Medical history of 3 children showed contact with a person suspected of SARS-CoV-2 infection. One patient had confirmed SARS-CoV-2 serology (a female patient who lived in the epidemic centre). We did not confirm any bacterial or viral aetiology in 3 patients. Conclusions: Based on the conducted analysis comparing the number of cases during the “spring wave” of SARS-CoV-2 pandemic compared to previous years, an increased incidence of Kawasaki syndrome among children from the Greater Poland was found, similar to that reported by doctors from various European countries. The mean age of patients with Kawasaki disease was higher than previously reported. Analysis of clinical forms in our patients showed the entire spectrum from incomplete Kawasaki disease to full blown Kawasaki disease shock syndrome and multisystem inflammatory syndrome in children. The risk assessment of immunoglobulin resistance using the Kobayashi and Egami scores had no predictive value in patients with Kawasaki disease during the COVID-19 period.

scholarly journals Bilateral Giant Axillary Artery Aneurysms with Left Complete Embolism in Intravenous Immunoglobulin-Sensitive Kawasaki Disease: A Case Report

2021 ◽  
Author(s):  
Chen Chu ◽  
Lan He ◽  
Yi-xiang Lin ◽  
Fang Liu
Keyword(s):  
Kawasaki Disease ◽  
Upper Limb ◽  
Axillary Artery ◽  
Systemic Vasculitis ◽  
Recurrent Fever ◽  
Systemic Artery ◽  
Left Limb ◽  
History Of ◽  
Collateral Vessels ◽  
The Right

Abstract Background: Kawasaki disease (KD) is a systemic vasculitis that predominantly affects medium-sized arteries. In addition to well-known coronary artery aneurysms (CAAs), peripheral systemic artery aneurysms (SAAs) have also been sporadically reported. In the literatures, SAAs occurred mainly in untreated, intravenous immunoglobin (IVIG)-resistant, or severe refractory KD, and thrombotic events in SAA were rarely reported.Case presentation: A 10-month-old boy with history of KD was referred to our hospital for suspected pseudoaneurysm of the axillary arteries. Four months prior to presentation, he had recurrent fever, conjunctival congestion, and rash. On the 10th day of fever echocardiography showed biliteral CAAs. He was then diagnosed with KD and given IVIG 2g/kg and aspirin at a local hospital. His fever and symptoms soon subsided and he was discharged with low dose aspirin and dipyridamole. One month prior to presentation, his parents incidentally palpated swellings in his axillae bilaterally. On admission, physical examination revealed a pulsatile swelling in his right axilla and a non-pulsatile swelling in the left. His left brachial and radial pulses were not palpable, while the pulses of other three limbs were normal. His left upper limb was cooler and less active compared to the right. Ultrasound examination revealed bilateral giant axillary artery aneurysms (AAAs) with massive thrombus in the left. Angiography confirmed bilateral giant AAAs with left AAAs completely embolized and fine collateral vessels connecting to the distal brachial artery, in addition to bilateral multiple giant CAAs without stenoses. The patient was given intravenous prostaglandin for ten days to allow for formation of collateral circulation, as well as aspirin, low molecular weight heparin (which was switched to warfarin before discharge) and metoprolol. At discharge, the temperature and movement of his left upper limb improved significantly. On follow-up at three months, his left limb improved and was similar to the right with no cardiovascular event having occurred. The images of CAAs and AAAs on ultrasound and computerized tomography remained the same.Conclusions: This case highlights the importance of evaluating peripheral SAAs in KD patients with CAA, even if their clinical course appears uncomplicated. For both large non-aortic SAAs and CAAs in KD patients, antithrombotic therapy is of utmost importance.

scholarly journals The history of surgery and surgical training in the UK

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Thomas Payne ◽  
Joseph D. Toms ◽  
Ahsan Zaidi ◽  
Sri G. Thrumurthy
Keyword(s):  
Open Access ◽  
Surgical Training ◽  
Original Work ◽  
History Of Surgery ◽  
Creative Commons ◽  
The United Kingdom ◽  
History Of ◽  
The Uk ◽  
Rich History ◽  
Open Access Article

Surgery has a rich history, and in order to understand the various training pathways for aspiring surgeons one must have an appreciation of the evolution of surgery. This manuscript aims to deliver a brief review of the history of surgery, and explore the historical moments that have shaped the training pathway of surgeons in the United Kingdom (UK), and in doing so disseminate the latest information about surgical training in the UK. doi: https://doi.org/10.12669/pjms.37.5.4628 How to cite this:Payne T, Toms JD, Zaidi A, Thrumurthy SG. The history of surgery and surgical training in the UK. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4628 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Asma H. Almaghrebi
Keyword(s):  
Treatment Options ◽  
Young Female ◽  
Similar Reaction ◽  
Careful Monitoring ◽  
Treatment Resistant ◽  
Blood Cell Count ◽  
Antipsychotic Medications ◽  
Case Presentation ◽  
Clozapine Treatment ◽  
History Of

Background: The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia. Case Presentation: We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient’s symptoms, the limited effective treatment options, and a lack of guidelines on this issue. Result: Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 &#215; 10<sup>9</sup> L, and her neutrophils decreased to 0.1 &#215; 10<sup>9</sup> L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol). Conclusion: The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.

Sign in / Sign up

Export Citation Format

Share Document