Risk Factors for Atrial Fibrillation following a Cardiac Surgery

Background: Atrial fibrillation (AF) following cardiac surgery is common and has clinical impact on morbidity. The preoperative and intraoperative risk factors are still not well defined. The objective of the study was to examine preoperative and intraoperative risk factors for AF following cardiac surgery. Methods: A retrospective analysis of a database of cardiac surgeries was performed during 2017-2019 at Poriya Medical Center. Preoperative factors and intraoperative were recorded. Results: 208 patients were included in this analysis. Overall AF following cardiac surgery was detected in 50 (24%) patients. Of 175 patients who did not have history of AF prior to surgery, 27 (15.5%) had post-operative AF. In the 33 patients with previous AF, AF following surgery was detected in 23 (70%). Patients with AF following surgery who were older (66.2±8.0 vs. 60.7± 11.4 years, p=0.002), were treated more with anti-arrhythmic drugs (18.9% vs 4.5, p<0.001), and had higher rates of pre-operative AF (46% vs 6.3%, p=0.0001), prior cerebral vascular accidents (14% vs 4.4%, p=0.019), and prior valve replacement (10% vs 1.9%, p=0.009) compared to patients without AF following surgery. In multivariate Cox regression analysis, age (HR 1.04, CI 1.01-1.07, P=0.006) and history of preoperative AF (HR 6.01, CI 3.42-10.57, P<0.001) were predictors of AF following cardiac surgery. The probability of being free of postsurgical AF was 80% among patients without history of AF compared to 30% in patients with previous AF history (p<0.001). Conclusion: Preoperative AF and age were predictors of AF following cardiac surgery

Using fresh frozen plasma as an emergency treatment modality for hypertriglyceridaemic acute pancreatitis in a resource-constrained environment: A case report and review of literature

Hypertriglyceridaemia is associated with severe disease such as coronary disease, cerebral vascular accidents and acute pancreatitis. Severe hypertriglyceridaemia is defined as a serum triglyceride value of >55 mmol/L. Hypertriglyceridaemic acute pancreatitis, often found in pregnancy, has a higher mortality rate than the other causes of acute pancreatitis. The cornerstone of treatment is to lower the triglyceride level as quickly as possible. In a resource-constrained environment, plasma exchange is not a viable option. Therefore, exploring the possible efficacity of directly infusing fresh frozen plasma is applicable to rural emergency medicine and may lead to more definitive research. In our case study, we used fresh frozen plasma to enhance the removal of triglyceride because it contains lipoprotein lipase.

Congenital Anomalies of the Gastrointestinal Tract

The gastrointestinal system anomalies in the newborn infants are not uncommon and are due to either embryogenesis defects or intrauterine vascular accidents resulting in a compromise of fetal blood circulation to specific system organs. The symptoms generally present within first 1–2 days of life and are mostly referable to intestinal obstruction, manifesting as vomiting, feeding difficulty and distension of abdomen. Other defects may have distinct signs and symptoms and variable time of onset. Some defects may be diagnosed antenatally during prenatal maternal care. The investigations include radiography, magnetic resonance imaging and ultrasound and in a majority of cases clinical presentation and plain radiography may provide adequate diagnostic information. The outcomes of surgical repair are variable and depend upon the original pathological defect. Here, the common anomalies are described with their clinical presentation, surgical repair techniques and outcomes.

In-utero segmental volvulus around vitellointestinal duct remnants leading to ileal atresia and stenosis: A case series

Background: The etiology of intestinal atresia is multifactorial with vascular accidents being the most common event in its development. In-utero volvulus is a well-known type of vascular accident leading to intestinal atresia. Segmental volvulus around vitellointestinal duct remnants is rarely described vascular accident leading to ileal atresia. Case Series: We report two cases of segmental ileal volvulus around vitellointestinal duct remnants in neonates leading to ileal atresia in one case and intestinal stenosis in the other one. Both neonates presented with signs of neonatal intestinal obstruction. X-ray abdomen performed in both neonates showed air-fluid levels. Both neonates were operated with suspicion of intestinal atresia. At surgery, a segment of the small bowel was found twisted around vitellointestinal duct remnants in both cases. The first case also had intestinal atresia whereas the second one had intestinal stenosis secondary to the segmental volvulus. Conclusion: Segmental volvulus around vitellointestinal duct remnants can also cause ileal atresia or stenosis.

Study of the Impact of Brain Vascular Accidents on Memorization in Man

BACKGROUND: The search for disruption of memory in patients with stroke has been performed, in order to better understand the behavior of these patients and optimize their neuropsychological accompaniment. AIM: To evaluate memory disturbances following stroke in patients; in order to better understand the attitudes of these patients.MATERIALS AND METHOD: Fifty-five (55) patients with stroke participated in a spatial memory test. This test consists in studying the arrangement, the designation and the evocation of images during learning a spatial arrangement. RESULTS: Of the 55 patients, 54.54% of patients passed the test but with later learning. And 45.45% failed at different events, they present real memory problems.CONCLUSION: Our study, confirms that stroke patients face difficulties which often include cognitive impairments, such as memory deficits. Our results indicate that these memory disorders manifest themselves to varying degrees. Indeed, the working memory disorders would be more marked in group II patients than in group I patients or they can be considered transient

ANALISIS PERILAKU BELAJAR SISWA DALAM PERSPEKTIF NEUROPSIKOLOGI DI PAUD PELITA GUNUNGPUYUH KOTA SUKABUMI JAWA BARAT

ABSTRACTThe purpose of this study is to analyze student learning difficulties in a neuropsychological perspective. The approach of this research is quantitative descriptive. Data was collected through library studies. The source of information is the City Library of Sukabumi. Based on understanding, study and descriptive analysis, in this study it was found that the factors that influence student achievement in PELITA Gunungpuyuh PAUD, Sukabumi City so that it is suspected to be the cause of Minimal Brain Disfunction (DMO) are: 1) Trauma, which is very external trauma , from the worst (car crash) to the lightest (falling from the bed). There are 3 terms for trauma to the brain, namely concussion (concussion), cerebral hemorrhage (contusion), and torn brain (laceration); 2) Vascular accidents, namely the occurrence of blockage or rupture of the cerebral blood vessels; 3) Tumors, tumors in the brain, symptoms that appear sometimes seem mild (headaches, impaired vision), but if they do, the consequences can be fatal; 4) Degenerative diseases, namely diseases that cause deterioration, such as Alzheimer's dementia, etc.; 5) Nutritional deficiencies (malnutrition); 6) Poisoning, which can cause a person to delirium (delirium). Tujuan dari penelitian ini adalah untuk menganalisis kesulitan-kesulitan belajar siswa dalam perspektif neuropsikologi. Pendekatan penelitian ini adalah deskriptif kuantitatif. Data dikumpulkan melalui studi kepustakaan. Sumber informasi adalah Perpustakaan Kota Sukabumi. Berdasarkan pemahaman, kajian dan analisis deskriptif, dalam penelitian ini ditemukan bahwa faktor-faktor yang mempengaruhi prestasi belajar siswa di PAUD PELITA Gunungpuyuh, Kota Sukabumi sehingga diduga menjadi penyebab Disfungsi Minimal Otak (DMO) adalah: 1) Trauma, yang dimaksud dengan trauma sangat luar, mulai paling parah (tabrakan mobil) hingga yang paling ringan (jatuh dari tempat tidur). Ada 3 istilah untuk trauma pada otak, yaitu gegar otak (concussion), pendarahan otak (contusion), dan robek otak (laceration); 2) Vascular accidents, yaitu terjadinya penyumbatan atau pecahnya pembuluh darah otak; 3) Tumor, tumor di otak, gejala yang ditampil kadang-kadang terkesan ringan (sakit kepala, gangguan penglihatan), tapi kalau memang ada, akibatnya dapat fatal; 4) Penyakit degeneratif, yaitu penyakit yang menyebabkan terjadinya kemunduran, misalnya dementia jenis Alzheimer, dan lain-lain; 5) Defisiensi nutrisi (kurang gizi); 6) Keracunan, yang dapat menyebabkan seseorang mengigau (delirium).

Rare case of paraneoplastic cerebellar degeneration secondary to high-grade serous carcinoma of tubo-ovarian origin

This case describes a 69-year-old woman, who presented with rapidly progressive cerebellar symptoms and unintentional weight loss. Full neurological assessment excluded space-occupying lesions, vascular accidents and infection. Surprisingly, a chest, abdomen and pelvis CT showed a left hemipelvis mass, which was subsequently biopsied. A high-grade serous carcinoma of tubo-ovarian origin was found, diagnosing paraneoplastic cerebellar degeneration (PCD) secondary to this. The exact mechanism is not known, but is thought to be immune-mediated. In cases of PCD, after cancer treatment, the neurological disability stabilises to a severe level and will unfortunately be lifelong. Our patient continues to make great progress with intensive rehabilitation for her ongoing balance issues. Early recognition of PCD can lead to a prompt diagnosis of the underlying malignancy and hence subsequent management. This can at least limit the extent of the neurological disability of the disease and increase the survival rate from cancer.