scholarly journals Sydenham’s Chorea as Presentation of Rheumatic Heart Disease

2017 ◽  
Vol 13 (3) ◽  
pp. 271-273
Author(s):  
A. Joshi ◽  
R.P.B. Shrestha ◽  
P.S. Shrestha ◽  
S. Dangol ◽  
N.C. Shrestha ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Lower Limbs ◽  
Moderate Degree ◽  
Sydenham’S Chorea ◽  
Streptolysin O ◽  
Grade Ii ◽  
Sydenham's Chorea ◽  
Penicillin Prophylaxis ◽  
Rheumatic Heart

Sydenham’s chorea is the most common type of acquired chorea in childhood which is a major neurological manifestation of rheumatic fever. We describe a 13 years old girl who presented with weakness and purposeless involuntary movements of upper and lower limbs. The symptoms slightly affected the child’s daily activities and had an unstable gait on walking which was aggravated during stress. Grade II ejection systolic murmur was noticed on cardiovascular examination. Echocardiography evaluation showed thickened aortic and mitral valve leaflets with mild to moderate degree of mitral regurgitation. Anti-streptolysin O titer was positive (≥200 IU/ml). CT scan of brain was normal. Subsequently child was diagnosed as Rheumatic heart disease with Sydenham’s chorea and kept on regular Benzathine penicillin prophylaxis. Symptoms subsided spontaneously after 3 months without any further complications. Although decreasing, early diagnosis and management of Sydenham’s chorea and Rheumatic heart disease are very crucial and should be considered with such presentation.

Abstract 16175: Total Burden of Out-of-Pocket Costs for Penicillin Prophylaxis for Rheumatic Heart Disease in India: Results From the AIIMS Pediatric RHD Registry

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anurag Mehta ◽  
Anita Saxena ◽  
Dhruv S Kazi
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Rural Areas ◽  
Tertiary Hospital ◽  
Drug Costs ◽  
Transportation Costs ◽  
Major Barrier ◽  
Penicillin Prophylaxis ◽  
Rheumatic Heart ◽  
Out Of Pocket Costs

Introduction: Out-of-pocket costs are a major barrier to medication adherence in low and middle income countries and an important target for policy-level interventions. The total economic burden for patients receiving secondary penicillin prophylaxis for Rheumatic Heart Disease (RHD) is uncertain. Methods: We prospectively collected self-reported out-of-pocket drug, transportation, and provider costs from patients in the AIIMS Pediatric RHD Registry. Monthly costs were estimated by adjusting visit costs for frequency of drug administration. Because adverse drug reactions are rare, we did not collect complication-related costs. Mean (±SD) costs are reported in 2013 Indian Rupee (INR) and International Dollars (INT$). Results: In our registry, 230 patients provided cost data over 313 visits. The mean age was 11.8 (±2.9) years, and 83 (36%) were girls. The majority of patients resided in rural areas (n=197, 86%), and were from the lower and upper lower socioeconomic strata (n=160, 70%) on the modified Kuppuswami scale. Nearly all patients hailed from outside Delhi (91%), reflecting the referral population of our tertiary hospital. The monthly out-of-pocket cost was INR 74.92 (±109.00) or INT$ 4.04 (±5.88), drug cost forming 36% of the total costs (INR 26.71 [±11.6]; INT$ 1.44 [± 0.63]). Provider costs (INR 18.21 [±32.48]) and transportation costs (INR 30.00 [±106.51]) comprised 24% and 40% of total costs respectively. Provider and transportation costs exceeded the drug costs for 38% of the patients. Patients traveled 12 (±38) km round trip to obtain penicillin prophylaxis. Conclusions: Drug costs constitute only 36% of the total out-of-pocket cost of penicillin prophylaxis for RHD, with provider costs (24%) and transportation costs (40%) comprising the remainder. Because out-of-pocket costs can be a major barrier to long-term adherence, future efforts must be directed at improving access to and lowering total costs of penicillin prophylaxis for RHD.

scholarly journals Rheumatic Fever and Rheumatic Heart Disease at the Department of Child Health, School of Medicine University of North Sumatera/ Dr. Pirngadi Hospital, Medan (1983 - 1985)

2018 ◽  
Vol 29 (3-4) ◽  
pp. 64-71 ◽  
Author(s):  
Mahruzzaman Naim ◽  
Guslihan Dasa Tjipta ◽  
A. Afif Siregar ◽  
Sahat Halim
Keyword(s):  
Heart Disease ◽  
Retrospective Study ◽  
Child Health ◽  
Rheumatic Fever ◽  
Functional Status ◽  
Rheumatic Heart Disease ◽  
Medical Professionals ◽  
School Of Medicine ◽  
Grade Ii ◽  
Rheumatic Heart

A retrospective study on rheumatic fever and rheumatic heart disease in children was conducted at the Department of Child Health, Dr. Pirngadi Hospital Medon, during 1983 - 1985. The patients consisted of 43 females and 30 males. Most of the patients were over 12 years of age. Of the 73 patients there were 60 patients (82,19%) accompanied by valvular disorders. The most frequent major criteria of Jones found in this study were carditis and polyarthritis. Thirty one patients (42.46%) had functional status (NYHA) of grade II - IV, and 43 patients (58.90%) had cardiomegaly. The major ECG findings were enlargement of the atria or ventricles and first degree A V block. Compliance was only achieved in 25 (34.24%) cases. Rheumatic fever and rheumatic heart disease are still remain a challenge for the medical professionals in tireregion to cope with.

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