Vitreous Haemorrhage Associated with Combined Antiplatelet Agents

2020 ◽  
Author(s):  
Machtache Rihab
Keyword(s):  
Previous History ◽  
Antiplatelet Agents ◽  
Posterior Pole ◽  
Vitreous Haemorrhage ◽  
University Hospital ◽  
Coronary Syndrome ◽  
System Disease ◽  
History Of ◽  
St Elevation ◽  
Lost To Follow Up

We present here a rare case vitreous Haemorrhage associated with combined antiplatelet agents: the aspirin and clopidogrel. The patient was a Moroccan female aged 44 years old, with no previous history of hypertension or diabetes and takes no drugs. She has been admitted to the emergencies of our teaching university hospital for an acute coronary syndrome ST-elevation anterior. Chromatography was performed after the admission. She benefited from the successful stenting of the anterior interventricular artery. The patient was put on double antiplatelet agents for 12 months: aspirin and clopidogrel and benefited from system disease review. Unfortunately, the patient was lost to follow up and has continued the treatment for almost 25 months after what she was admitted in the ophthalmic emergencies for sudden reduction of visual acuity of the left eye for what an echography was performed and showed a vitreous Haemorrhage. A complimentary MRI was realized in T2 sequences, showing normal massless orbits at the posterior pole that can explain the vitreous Haemorrhage.

scholarly journals Registry Study of Clinical Data and in Hospital Outcome in Patients Admitted with Acute Coronary Syndrome at Tanta University Hospital in 2019

2020 ◽  
pp. 65-77
Author(s):  
Doaa Abdelfattah Helal ◽  
Fatma Aboalsaoud Taha ◽  
Sameh Samir Khalel ◽  
Mohammed Elsayed El Setiha
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Previous History ◽  
University Hospital ◽  
Hospital Death ◽  
Killip Class ◽  
Hospital Outcome ◽  
Coronary Syndrome ◽  
History Of

Background: A quick but thorough assessment of the patient’s history and findings on physical examination, electrocardiography, and cardiac biomarker tests permit accurate diagnosis and aid in early risk stratification. This work aimed to analyze the diagnostic and prognostic tools, the modalities of management, and the hospital outcome of patients with acute coronary syndrome (ACS) at Tanta University Hospital in one year. Methods: This ACS registry at Tanta university hospital is a prospective observational registry for 200 consecutive admitted patients with proven ACS from January 2019 to January 2020. Results: A higher percent of hypertension, family history of ischemic heart disease and SCD, previous history of chronic kidney disease (CKD), and lower percent of a previous history of IHD in STEMI compared to NSTEMI/UA. In-hospital death, in-hospital reinfarction, and reduced ejection fraction are higher in STEMI than in NSTEMI/UA patients. (P value = 0.015, 0.018 and 0.001 respectively) without significant differences regarding in-hospital congestive heart failure (CHF) and ischemic stroke. History of CKD, higher Killip class, and in-hospital stroke were independently affecting in-hospital mortality. Also, the history of higher Killip class was independently affecting in-hospital reinfarction and in-hospital CHF. Old age and occurrence of in-hospital reinfarction were independently affecting in-hospital stroke. Conclusion: Hypertension, diabetes, dyslipidemia, and smoking are the major risk factors for ACS so, controlling these risk factors will improve in-hospital outcomes. In STEMI, most patients underwent PPCI, which was reflected in the outcome. In NSTEMI/UA patients, both conservative and invasive management was done, taking into consideration the risk stratification of each patient, making management easier and with a good outcome.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

scholarly journals Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

2019 ◽  
Vol 8 (1) ◽  
pp. 344
Author(s):  
Bushra . ◽  
Ambreen Ghori ◽  
Azra Ahmed ◽  
Najma Dalwani ◽  
Mushtaque Ali Shah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Previous History ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Prior History ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

Abstract 17207: Cardiovascular Risks in Acute Leukemia Patients Treated With Anthracyclines

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Yu Kang ◽  
Srinivas Denduluri ◽  
Bruna M Assuncao ◽  
Marielle Scherrer-Crosbie
Keyword(s):  
Heart Failure ◽  
Ischemic Stroke ◽  
Acute Leukemia ◽  
Lymphoblastic Leukemia ◽  
Multivariable Analysis ◽  
Previous History ◽  
Major Adverse Cardiovascular Events ◽  
Symptomatic Heart Failure ◽  
Coronary Syndrome ◽  
History Of

Introduction: The incidence of acute leukemia has been increasing by about 1.6% per year in the last decade. Anthracyclines remain a standard of care for patients with acute leukemia; survival is increasing at about 1.0% per year. However, little is known about the incidence and risk of major adverse cardiovascular events (MACE) in patients with acute leukemia. Hypothesis: To investigate the incidence of MACE and the risk factors for MACE in patients with acute leukemia treated with anthracyclines. Methods: All adult patients with acute leukemia treated with anthracyclines between January 2005 and April 2018 at the hospital of University of Pennsylvania were studied. MACE were defined as cardiovascular death, symptomatic heart failure, non-fatal acute coronary syndrome, non-fatal ventricular arrhythmia and non-fatal ischemic stroke. Differences between patients with or without MACE were compared by Student’s t test or the Wilcoxon rank comparison. Cox proportional hazard analysis was used to determine significant clinical and echocardiographic parameters associated with MACE. Results: Six hundred and seventy-four patients (234 acute lymphoblastic leukemia (ALL), 440 acute myeloid leukemia (AML), age range: 22 to 93 years) were studied. Seventy-one patients (10.5%) experienced MACEs during a median follow-up period of 16 months (4 to 146 months) after the initiation of chemotherapy. The median time to MACE was 13 months (5 to 107 months). In the patients with MACE,59 (8.8%) developed symptomatic heart failure, 7 (1.0%) died of cardiovascular causes, 3 (0.4%) experienced non-fatal acute myocardial syndrome and 2 (0.3%) had an ischemic stroke. The Table summarizes the characteristics of patients with and without MACE. In a multivariable analysis, a previous history of heart failure (HR: 4.632, P=0.000, 95% CI: 2.572-8.341), leukemia type (HR: 3.155, P=0.002, 95% CI: 1.544-6.446) and baseline LVEF (HR: 0.973, P=0.000, 95% CI: 0.955-0.991) remained associated with MACE. Conclusion: Patients with acute leukemia treated with anthracyclines have a high rate of MACE after chemotherapy. A previous history of heart failure, baseline LVEF and type of leukemia may help to stratify acute leukemia patients at highest risk for MACEs after anthracycline therapy.

scholarly journals Xeroderma Pigmentosum: Ocular Findings in an Isolated Brazilian Group with an Identified Genetic Cluster

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Claudia Schelini ◽  
Luis Fernando O. B. Chaves ◽  
Marcia C. Toledo ◽  
Francisco W. Rodrigues ◽  
Tauan de Oliveira ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Xeroderma Pigmentosum ◽  
Genetic Disorder ◽  
Skin Pigmentation ◽  
Previous History ◽  
Case Series ◽  
Corneal Neovascularization ◽  
University Hospital ◽  
Ocular Symptoms ◽  
History Of

Purpose. Xeroderma pigmentosum (XP) is a rare autosomal recessive genetic disorder characterized by increased susceptibility to UV radiation- (UVR-) induced skin pigmentation, skin cancers, ocular surface disease, and, in some patients, sunburn and neurological degeneration. Eight different genes are affected, and the prevalence of the disease differs across the world. The present study describes the main ophthalmologic features and symptoms in patients with XP in this case series. Methods. Patients were examined consecutively at the University Hospital of the Federal University of Goias between January 2016 and June 2018. All patients underwent ophthalmologic examination and were asked about their ophthalmological history and the presence of ocular symptoms. Results. Twenty-one patients with genetic confirmation were evaluated. The genetic variants XPV and XPC were detected in the patients. The most prevalent findings include eyelid changes, observed in 80.9% of the patients, and ocular surface changes as punctate keratopathy, occurring in 16 patients (76.2%), corneal neovascularization, and corneal opacities. Six patients (28.5%) presented corneoconjunctival tumor. More than half of patients had previous history of treatment of ocular neoplasia. Ocular burning was the most reported symptom. Conclusions. The ocular characteristics identified in this study corroborate the existing literature, mainly related to the surface. Concerning the XP variant and the gravity of ocular signs, XPC has earlier and more severe symptoms than XPV. Due to their relative rarity, publications of XP cases are important to understand the possible damages caused by the disease in the eyes and surrounding area.

scholarly journals Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)—Two-Year Follow-Up Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Leila Yazdanpanah ◽  
Hajieh Shahbazian ◽  
Iraj Nazari ◽  
Hamid Reza Arti ◽  
Fatemeh Ahmadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Previous History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Population Based ◽  
University Hospital ◽  
Foot Deformity ◽  
History Of

Aim/Introduction. This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU). Materials and Methods. In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression. Results. Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89–8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13–43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37–14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33–7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40–8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10–8.29), P value = 0.032] had a statistically significant relationship with DFU incidence. Conclusion. Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU.

Symptoms and Type of Symptom Onset in Acute Coronary Syndrome in Relation to ST Elevation, Sex, Age, and a History of Diabetes

2005 ◽  
Vol 14 (12) ◽  
pp. 4
Author(s):  
M. Thuresson ◽  
M. Berglin Jarlöv ◽  
B. Lindahl ◽  
L. Svensson ◽  
C. Zedigh ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Symptom Onset ◽  
Coronary Syndrome ◽  
History Of ◽  
St Elevation

scholarly journals PRETERM LABOUR:

2017 ◽  
Vol 24 (09) ◽  
pp. 1376-1379
Author(s):  
Tasneem Azher ◽  
Iram Aslam ◽  
Saadia Bano ◽  
Uzma Shahzad
Keyword(s):  
Bacterial Vaginosis ◽  
Preterm Labour ◽  
Previous History ◽  
Health Care Facilities ◽  
University Hospital ◽  
Intrauterine Death ◽  
Inclusion Criteria ◽  
Lower Segment Cesarean Section ◽  
History Of ◽  
Independent University

Objectives: (1) to find out of aetiological factors of preterm labour. (2) To makea proposed remedy for prevention of preterm lobour. Material and Methods: This study wascarried out at Independent University Hospital. This is located at richly populated area ofFaisalabad, providing health care facilities to poor socioeconomic group. The patient who fitinto inclusion criteria was included in study and a well designed Proforma was used to collectthe sample. Duration of study: One year study from 1 May, 2014 to 30 April, 2015. Studydesign: It is a descriptive study. Sampling technique: A purposive random sample techniquewas used to collect the sample. Sample size: A total of 80 cases ware collected who wereadmitted through antenatal outdoor and emergency of IUH. Inclusion Criteria: All patients withdiagnosed preterm labour who had attended outdoor or emergency of Independent UniversityHospital were included in study. Exclusion Criteria: (1) Patients with Iatrogenic preterminduction of labour due to maternal factors like patients on chemo therapy or any debilitatingillness causing threat to maternal life. (2) Patients with congenitally abnormal foetus & intrauterine death of fetus. Results: A total of 80 cases with preterm labour were included in studyat Independent University Hospital. In current study 30 (37.5%) patients had age between 18 –25 years, 30 (37.5%) patients had age between 26-35 years and rest of the 20 (25%) patientshad age > 35 years. Among 80 patients 25 (31.3%) patients had parity b/w 1-3 while 28 (35%)patients had parity b/w 4-5 and rest of the 27 (33.8%) had parity > 5. More patients i.e 50(62.5%) patients were admitted through emergency while 30 (37.5%) patients were admittedthrough Out Patient Department (OPD). 37 (46.3%) patients had Spontaneous vaginal deliveryand 43 (53.8%) patients underwent lower segment cesarean section. In our study, the mostcommon risk factor associated with preterm labour was bacterial vaginosis 20 (25%) patientshad bacterial vaginosis. 10 (12.5%) patients had chorioamniotis. Previous history of pretermbirth was present in 10 (12.5%) patients. History of Preterm Premature ruptures of membranesin 8 (10%) patients. 11(13.5%) patients has history of previous C-section and impending scardehiscence. History of anti partum hemorrhage and pregnancy induce in hypertension waspresent in 5 (6.5%) patients. FGR with oligohydramnios was present in 6 (7.5%) patients. 3((3.75%) patients presented with preterm breech

scholarly journals Predictors and Management of Antiplatelet-Related Bleeding Complications for Acute Coronary Syndrome in Chinese Elderly Patients

2018 ◽  
Vol 50 (3) ◽  
pp. 1164-1177 ◽  
Author(s):  
Jindong Wan ◽  
Peijian Wang ◽  
Peng Zhou ◽  
Sen Liu ◽  
Dan Wang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Antiplatelet Therapy ◽  
Chronic Total Occlusion ◽  
Previous History ◽  
Bleeding Complications ◽  
Short Term ◽  
Total Occlusion ◽  
Coronary Syndrome ◽  
History Of

Background/Aims: Bleeding complications after percutaneous coronary intervention (PCI) are strongly associated with adverse patient outcomes. However, there are no specific guidelines for the predictors and management of antiplatelet-related bleeding complications in Chinese elderly patients with acute coronary syndrome (ACS). Methods: A retrospective analysis of 237 consecutive patients (aged ≥ 75 years) with ACS who had undergone successful PCI from January 2010 to December 2016 was performed to identify predictors and management of antiplatelet-related bleeding complications. Multivariate logistic regression analysis was conducted to investigate independent predictors of antiplatelet-related bleeding complications. We defined antiplatelet-related bleeding complications as first hospitalization received long-term oral antiplatelet therapy and required hospitalization, including gastrointestinal and intracranial bleedings. Results: After multivariable adjustment, independent risk predictors of antiplatelet-related bleeding complications included female gender (odds ratio [OR]: 2.96; 95% confidence interval [CI]: 1.98 to 4.15; P = 0.011), body mass index (OR: 1.54; 95% CI: 1.06 to 1.94; P = 0.034), previous history of bleeding (OR: 4.03; 95% CI: 1.84 to 6.12; P = 0.004), fasting blood glucose (OR: 2.79; 95% CI: 1.23 to 4.46; P = 0.025), and chronic total occlusion lesion (OR: 4.69; 95% CI: 2.19 to 7.93; P = 0.007). Of 46 patients with antiplatelet-related bleeding complications, 54.3% were treated short-term dual antiplatelet therapy (DAPT) cessation (0–7 days) and 45.7% underwent long-term DAPT cessation (> 7 days). Among these, 14 patients presented major adverse cardiac and cerebrovascular events (MACCE), whereas no re-bleeding happened over all available follow-up. The incidence of MACCE was not significantly different between the two groups one year after PCI (36.0% for short-term DAPT cessation versus 23.8% for long-term DAPT cessation, P = 0.522). Conclusion: For elderly patients with ACS, multiple factors were likely to contribute to antiplatelet-related bleeding complications, especially previous history of bleeding and chronic total occlusion lesion. Better individualized, tailored and risk-adjusted antiplatelet therapy after PCI is urgently needed in this high-risk population.

Reasons why patients with tuberculosis in South Korea stop anti-TB treatment: a cross-sectional study

2020 ◽  
Vol 24 (10) ◽  
pp. 1016-1023
Author(s):  
H. W. Kim ◽  
J. Min ◽  
A. Y. Shin ◽  
H-K. Koo ◽  
S. Y. Lim ◽  
...  
Keyword(s):  
Adverse Effects ◽  
South Korea ◽  
Previous History ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Specialist Nurses ◽  
Lost To Follow Up

BACKGROUND: As there had been no reduction in the TB burden in South Korea since 2000, a public-private mix (PPM) strategy was launched in 2011. The purpose of this study was to investigate the reasons for lost to follow-up (LTFU) among TB patients and their clinical characteristics.METHOD: A multicentre, cross-sectional study based on in-depth interviews with patients and their families by TB specialist nurses was conducted. Patients who were reported with a final outcome of LTFU in 2015–2017 at all PPM hospitals across the country were enrolled. Enrolled patients were classified into six subgroups by age and three major reasons for LTFU (adverse effects, refusal of treatment, marginalisation) and their clinical features were compared.RESULTS: Among 780 patients, those who were lost to follow-up due to adverse effects accounted for the largest proportion (n = 387). LTFU in those aged <65 years who refused treatment (n = 189) and those aged <65 years who were marginalised (n = 108) were related to having smear-positive TB and a previous history of unfavourable outcomes.CONCLUSION: To reduce LTFU in South Korea, comprehensive strategies, including management of adverse effects, systematic counselling and education, should be implemented.

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