Primary left atrial angiosarcoma mimicking pericarditis: A case report and review of the literature

A 45-year-old male presented with symptoms mimicking pericarditis, including rapidly worsening dyspnea and retrosternal chest pain. On imaging workup, an abnormal mass of 50x53 mm in size was detected at the left atrium, which partially obstructed blood flow through the mitral valve. PET/CT was done in searching for the probable site of origin but revealed no abnormal uptake lesions. The tumorectomy and excision of the posterior wall of the left atrium were then performed with curative intent. The postoperative histology of the tumor was in favor of a spindle cell sarcoma, originating from the left atrium, grade 2, which was confirmed as epithelioid angiosarcoma by immunohistochemistry. The patient denied adjuvant radiation, thus we treated him with six cycles of Paclitaxel monotherapy, which was completed six months ago. At present, he is doing well with no signs of recurrence on the imaging technique. This paper illustrates the rarity of cardiac angiosarcoma, its complex presentation, and a brief review of available treatment options for this devastating disease.

A modified SEIR model to predict the behavior of the early stage in coronavirus and coronavirus-like outbreaks

COVID-19 is a highly infectious disease that emerged in China at the end of 2019. The COVID-19 pandemic is the first known pandemic caused by a coronavirus, namely, the new and emerging SARS-CoV-2 coronavirus. In the present work, we present simulations of the initial outbreak of this new coronavirus using a modified transmission rate SEIR model that takes into account the impact of government actions and the perception of risk by individuals in reaction to the proportion of fatal cases. The parameters related to these effects were fitted to the number of infected cases in the 33 provinces of China. The data for Hubei Province, the probable site of origin of the current pandemic, were considered as a particular case for the simulation and showed that the theoretical model reproduces the behavior of the data, thus indicating the importance of combining government actions and individual risk perceptions when the proportion of fatal cases is greater than $$4\%$$ 4 % . The results show that the adjusted model reproduces the behavior of the data quite well for some provinces, suggesting that the spread of the disease differs when different actions are evaluated. The proposed model could help to predict outbreaks of viruses with a biological and molecular structure similar to that of SARS-CoV-2.

Bouveret’s syndrome: a strategic approach for management

An 81-year-old woman, diabetic and hypertensive, presented with nausea and intermittent vomiting. She had dysphagia and loss of appetite for over 6 weeks and significant weight loss over 3 weeks and was admitted in general surgery unit on emergency basis. Investigations revealed dilated stomach and a stone in first part of duodenum, with probable site of obstruction at level of first part of duodenum, secondary to a cholecystoduodenal fistula. With a preoperative diagnosis of Bouveret’s syndrome, she underwent laparotomy and subtotal cholecystectomy. Postoperative recovery was delayed due to gastroparesis and delayed gastric emptying which resolved with conservative management. Successful management of this case required a multidisciplinary team approach. Early diagnosis was the key to management. Mode of treatment and management of Bouveret’s syndrome should be tailored to suit patient’s age, comorbidities and performance status.

Pilot Study: Long-Term Shedding of SARS-CoV-2 in Urine: A Threat for Dispersal in Wastewater

Only 4 months after the beginning of SARS-CoV-2 epidemic, the world is facing a global pandemic due to a complex and insidious virus that today constantly poses new challenges. In this study, we highlight a persistent shedding of SARS-CoV-2 RNA into the urine, even in patients with a negative nasopharyngeal swab and in patients considered recovered. What does it mean? Besides the fact that the kidney is a probable site of viral replication, the prolonged viral excretion is a matter of great concern for our drainage system contamination.

How can neurophysiological studies help with movement disorders characterization in clinical practice? A review

ABSTRACT Background: Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system. Objective: We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice. Methods: Non-systematic review of the literature published up to June 2019. Results: A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus. Conclusion: These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.

Innovations of Housing Finance Systems and the Implication in Bangladesh – A Categorical Study on Financial Markets

An evolution in the system of investment and fi nance, is being seen everywhere not only in the emerging economy but also in the economy of developing countries including Bangladesh, is housing investment. A feature by its nature is a long term investment arena that requires cash or cash equivalent to grab the real asset legally. Now a country with a lot of human resources like Bangladesh is under the frustration raised by the security investment which just is going to crash down the probable site of investment by its negative feedback. Now housing investment is the last resort of investment that gives reasonable outcome and that’s why it is exigent to analyzing the framework of housing fi nance system in Bangladesh. This paper addresses the parley relating to the fi nancial system and the sources of housing fi nance in the commercial sector of Bangladesh. A group of model here represents the developing scenario of real estate fi nancing and how to assure of the sources of fi nance, how to get the services provided by the fi nancial institutions and overall, to measure the results according to market transparency.