Clinical and Echocardiographic Assessment of Patients with Dilated Cardiomyopathy

Introduction: Cardiomyopathy is the disorder of the heart muscles which can be dilated, hypertrophic or restrictive type. Dilated cardiomyopathy is caused by genetic and non-genetic causes but many of the causes are still not known. Echocardiography is an important imaging technique to diagnose and manage dilated cardiomyopathy. Aims: This study aims to assess the clinical and echocardiographic findings among patients with dilated cardiomyopathy. Methods: This is a cross-sectional, observational study conducted in Nepalgunj Medical College from January 2021 to June 2021. A total of 61 patients with dilated Cardiomyopathy were enrolled after obtaining written informed consent. Clinical examination and echocardiographic findings were recorded and data analysis was done using Statistical Package for Social Sciences. Results: The participants included 31 men and 30 women with dilated cardiomyopathy. The mean age of the participants was 58.49 + 15.46 years. The most common complaint was shortness of breath 84.5% and the most common clinical presentation was bilateral basal crepitation 98.4%. The patients mostly had diastolic left ventricle internal diameter of 5.5-6 cm and ejection fraction of 21-30%. Mitral regurgitation was observed among most 58(95.1%) of the patients. Conclusion: This study concludes that shortness of breath and bilateral basal crepitation are the most common presentation. Left ventricle dilation, reduced ejection fraction and mitral regurgitation are seen among majority of the patients.

Non hemorrhagic pericardial effusion from ibrutinib İn a patient without comorbidities

Introduction The most common kind of leukemia in adults is chronic lymphocytic leukemia (CLL). CLL is treated with ibrutinib. During the course of ibrutinib therapy, bleeding and cardiac arrhythmias may occur. Non-hemorrhagic adverse events are extremely infrequent in individuals using ibrutinib. Case report A 64 year-old man was diagnosed with CLL in June 2016. He was treated with 6 courses of FCR, he stayed in remission for 3 years and then relapsed. He achieved partial remission after two months of therapy with ibrutinib. The patient was admitted to the hospital with fever and shortness of breath. Pericardial tamponade and effusion was diagnosed during his evaluation. Management & outcome Non-hemorrhagic exudative effusion was drained by pericardiocentesis and a pericardial catheter was inserted to drain pericardial effusion. In all pleural and pericardial effusion samples, pathological and flow cytometric examination revealed no atypical malignant cells for malignancy, including CLL. Infections, both bacterial and viral, were also undetectable in the samples, as were rheumatological markers of collagen vascular disease. Ibrutinib therapy was discontinued. The pericardial effusion and tamponade were linked to ibrutinib treatment after evaluating the adverse drug reaction probability scale with a total score of 6. Colchicine was administered to reduce the pericardial effusion. The catheter was removed; pericardial effusion did not reoccur during follow up visits. Discussion Serious adverse events of ibrutinib are seen when treating CLL patients. This group of individuals should be closely monitored for potentially serious complications such as pericardial effusion and cardiac tamponade.

Secondhand nicotine vaping at home and respiratory symptoms in young adults

RationaleDespite high prevalence of e-cigarette use (vaping), little is currently known regarding the health effects of secondhand nicotine vape exposure.ObjectiveTo investigate whether exposure to secondhand nicotine vape exposure is associated with adverse respiratory health symptoms among young adults.MethodWe investigated the effect of secondhand nicotine vape exposure on annually reported wheeze, bronchitic symptoms and shortness of breath in the prospective Southern California Children Health Study cohort. Data were collected from study participants (n=2097) with repeated annual surveys from 2014 (average age: 17.3 years) to 2019 (average age: 21.9). We used mixed effect logistic regression to evaluate the association between secondhand nicotine vape and respiratory symptoms after controlling for relevant confounders.ResultsPrevalence of secondhand nicotine vape increased from 11.7% to 15.6% during the study period in this population. Prevalence of wheeze, bronchitic symptoms and shortness of breath ranged from 12.3% to 14.9%, 19.4% to 26.0% and 16.5% to 18.1%, respectively, during the study period. Associations of secondhand nicotine vape exposure with bronchitic symptoms (OR 1.40, 95% CI 1.06 to 1.84) and shortness of breath (OR 1.53, 95% CI 1.06 to 2.21) were observed after controlling for vaping, active and passive exposure to tobacco or cannabis, and demographic characteristics (age, gender, race/ethnicity and parental education). Stronger associations were observed when analysis was restricted to participants who were neither smokers nor vapers. There were no associations with wheezing after adjustment for confounders.ConclusionSecondhand nicotine vape exposure was associated with increased risk of bronchitic symptoms and shortness of breath among young adults.

Myocardial Infarction

Myocardial infarction (MI), commonly known as a heart attack is the disease of the blood vessels supplying the heart muscle (Myocardium) i.e. coronary heart disease. The area of heart muscle that has either zero flow or so little flow that it cannot sustain cardiac muscle function is said to be infracted and the overall process is called a myocardial infarction. MI are of two types; transmural and subendocardial. Mainly it is caused due to oxidative stress and atherosclerosis.Chest pain is the most common symptom of acute MI and is often described as a sensation of tightness, pressure, or squeezing. Other symptoms include diaphoresis (an excessive form of sweating), Shortness of breath (dyspnea), weakness, light-headedness, nausea, vomiting, and palpitations. The most common symptoms of MI in women include dyspnea, weakness, and fatigue, sleep disturbances. It can be treated by using blockers, diuretics, ACE inhibitors, calcium channel blockers and nitrates.

The Thermal Environment of Housing and Its Implications for the Health of Older People in South Australia: A Mixed-Methods Study

Older people are often over-represented in morbidity and mortality statistics associated with hot and cold weather, despite remaining mostly indoors. The study “Improving thermal environment of housing for older Australians” focused on assessing the relationships between the indoor environment, building characteristics, thermal comfort and perceived health/wellbeing of older South Australians over a study period that included the warmest summer on record. Our findings showed that indoor temperatures in some of the houses reached above 35 °C. With concerns about energy costs, occupants often use adaptive behaviours to achieve thermal comfort instead of using cooling (or heating), although feeling less satisfied with the thermal environment and perceiving health/wellbeing to worsen at above 28 °C (and below 15 °C). Symptoms experienced during hot weather included tiredness, shortness of breath, sleeplessness and dizziness, with coughs and colds, painful joints, shortness of breath and influenza experienced during cold weather. To express the influence of temperature and humidity on perceived health/wellbeing, a Temperature Humidity Health Index (THHI) was developed for this cohort. A health/wellbeing perception of “very good” is achieved between an 18.4 °C and 24.3 °C indoor operative temperature and a 55% relative humidity. The evidence from this research is used to inform guidelines about maintaining home environments to be conducive to the health/wellbeing of older people.

Uncommon cause of respiratory failure due to a bezoar in the hypopharynx: a case report

Background Trichotillomania and trichophagia cause trichobezoars, which are masses made of hair. The main presentation of this condition is abdominal pain. However, other complications include gastric outlet obstruction, nausea, vomiting, weight loss, malnutrition, hematemesis, diarrhea, and constipation. Case presentation A 57-year-old woman with trichotillomania was admitted to the Emergency Department with the chief complaints of dyspnea on exertion, shortness of breath, dysphagia, generalized weakness, and hoarseness. Spiral chest computed tomography (CT) scan did not reveal any parenchymal lesions Pulmonary CT angiography did not reveal pulmonary embolism. The patient was admitted to the Surgery Department for hand fasciotomy due to contrast leakage, and during laryngoscopy, a trichobezoar was detected that was removed with Magill forceps. Conclusions Rare cases of trichobezoars can be observed in humans with gastrointestinal and respiratory symptoms. Precise and timely diagnosis are key for the prevention of more invasive diagnostic procedures.

Is SARS-CoV-2 Omicron (B.1.1.529) variant causing different symptoms?

Background: Since preliminary evidence suggests that the new SARS-CoV-2 Omicron (B.1.1.529) variant may cause different symptoms and trigger outbreaks associated with less severe illness compared to previous strains, we conducted and infodemic analysis to verify these suppositions.Methods: We searched Google Trends using the most frequent COVID-19 symptoms, with “United Kingdom” country option and search periods “20-26 December 2020” (predominance of Alpha variant) and “19-25 December 2021” (Omicron prevalence >80%).Results: Seven symptoms (i.e., conjunctivitis, chills, cough, aches, fever, nausea and sore throat) appeared to be more searched in 2021 compared to 2020 (i.e., >15% increase), five symptoms (i.e., anosmia, tiredness, ageusia, sneezing and shortness of breath) were found to be less searched in 2021 compared to 2020 (i.e., >15% decrease), whilst the number of Google searches for headache, diarrhea and runny nose were almost comparable between the two periods (i.e., <15% variation).Conclusion: Actual predominance of Omicron (B.1.1.529) variant in UK is associated with higher number of Google searches for mild symptoms (conjunctivitis, chills, cough, aches and fever), accompanied by considerable lower interest for a severe clinical sign like shortness of breath, which characterizes lower respiratory tract infection.

Post-COVID-19 syndrome

The disease caused by new coronavirus infection (COVID-19) is a global problem not only because of its wide spread occurrance, but also due to the high incidence of post-COVID syndrome. The literature review presents the results of numerous observations of patients, who undergone COVID-19. The most common symptoms are: general weakness, impaired cognitive functions, memory loss, depression, anosmia, dysgeusia, shortness of breath, cough, chest pain, abdominal pain, anorexia, nausea, vomiting, diarrhea, less often — alopecia, skin rashes, etc. The most frequent symptoms of the post-COVID syndrome are described; the reasons and risk factors for its development are analyzed. The lack of views sameness on the term “postCOVID syndrome” makes it diffi cult to evaluate the frequency of certain symptoms development. Variants of the post-COVID syndrome are considered. It is proposed to distinguish between the post-COVID syndrome, developed after acute COVID-19 that lasts up to 12 weeks, and a prolonged variant of post-COVID clinical symptoms that last longer than 12 weeks, which should be distinguished from lingering COVID-19, its complications, and the consequences of intensive care. The questions of prognosis, diagnostics, and treatment of post-COVID syndrome are discussed.

Kegiatan Pemantauan Kasus Covid 19

ABSTRAKCOVID-19 adalah penyakit yang disebabkan Novel Coronavirus 2019. Gejalanya bergejala mirip dengan flu biasa, namun COVID-19 sampai saat ini memiliki fatalitas lebih tinggi dan virus ini juga menyebar dengan sangat cepat karena bisa pindah dari orang ke orang bahkan sebelum orang tersebut menunjukkan gejala. Cara isolasi mandiri dirumah yaitu selalu memakai masker dan membuang masker bekas ditempat yang ditentukan, jika sakit (ada gejala demam, flu dan batuk) maka tetap di rumah. Jangan pergi bekerja, sekolah, ke pasar atau ke ruang publik untuk mencegah penularan masyarakat, manfaatkan fasilitas telemedicine atau sosial media kesehatan dan hindari transportasi publik. Beritahu dokter dan perawat tentang keluhan dan gejala, serta riwayat bekerja ke daerah terjangkit atau kontak dengan pasien COVID-19, selama dirumah, bisa bekerja di rumah. Gunakan kamar terpisah dari anggota keluarga lainya, dan jaga jarak 1 meter dari anggota keluarga, tentukan pengecekan suhu harian, amati batuk dan sesak nafas. Hindari pemakaian bersama peralatan makan dan mandi dan tempat tidur, terapkan perilaku hidup sehat dan bersih, serta konsumsi makanan bergizi, mencuci tangan dengan sabun dan air mengalir dan lakukan etika batuk dan bersin, jaga kebersihan dan kesehatan rumah dengan cairan desinfektan. Selalu berada di ruang terbuka dan berjemur di bawah sinar matahari setiap pagi (±15-30 menit), Hubungi segera fasilitas pelayanan kesehatan jika sakit berlanjut seperti sesak nafas dan demam tinggi, untuk mendapatkan perawatan lebih lanjut. Tujuan pengabdian masyarakat ini adalah untuk melakukan pemantauan kasus covid 19 di Kota Bandung. Kegiatan pengabdian masyarakat ini memberikan pelayanan dengan melakukan pemantauan agar mengetahui keadaan, kondisi dan perkembangan yang dialami oleh warga yang terpapar covid 19 di Kota Bandung. Hasil pengabdian masyarakat diperoleh seluruh warga yang terpapar covid 19 sudah dalam keadaan sehat dan pulih seperti sedia kala. Kata Kunci: Pemantauan kasus covid 19. ABSTRACT COVID-19 is a disease caused by the 2019 Novel Coronavirus. The symptoms are similar to the common cold, but COVID-19 has so far had a higher fatality and this virus also spreads very quickly because it can move from person to person even before the person shows symptoms. . The way to self-isolate at home is to always wear a mask and throw away used masks in the designated place, if you are sick (symptoms of fever, flu and cough) then stay at home. Do not go to work, school, to the market or to public spaces to prevent community transmission, take advantage of telemedicine facilities or health social media and avoid public transportation. Tell doctors and nurses about complaints and symptoms, as well as a history of working in infected areas or in contact with COVID-19 patients, while at home, you can work at home. Use a separate room from other family members, and keep a distance of 1 meter from family members, determine daily temperature checks, observe coughs and shortness of breath. Avoid sharing eating and bathing utensils and bedding, apply healthy and clean living habits, and consume nutritious food, wash hands with soap and running water and practice coughing and sneezing etiquette, keep your home clean and healthy with disinfectant liquid. Always be in an open space and bask in the sun every morning (±15-30 minutes), Contact the health care facility immediately if the illness persists such as shortness of breath and high fever, to get further treatment. The purpose of this community service is to monitor COVID-19 cases in the city of Bandung. This community service activity provides services by monitoring to find out the conditions, conditions, and developments experienced by residents exposed to COVID-19 in the city of Bandung. The results of community service were obtained that all residents who were exposed to COVID-19 were in good health and recovered as usual. Keywords: Monitoring cases of covid 19.

Symptomatology and Clinical Features of Human COVID-19

Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which was identified at the end of December 2019 in China. Symptoms of COVID-19 can appear after an incubation phase of the virus of 2 to 14 days, the most common being fever, cough, and asthenia. Other specific symptoms may include shortness of breath or difficulty breathing, muscle pain, sore throat, chills, loss of smell or sensation, chest pain, headache, nausea, rash, diarrhea, and vomiting. The severity of these symptoms can be mild or even extreme causing serious damage to several organs, directly and indirectly, namely pulmonary, renal, hepatic, cardiac, digestive, neurological. Some people have only mild symptoms, while others are asymptomatic. Seniors or those at risk for certain chronic diseases, such as massive obesity, diabetes, heart disease, lung disease, kidney disease, immune system abnormalities, and liver disease are more susceptible to COVID-19 and can develop more serious and fatal complications.