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Report
Catching Congenital Heart Disease in Adulthood with Mirror-like Arrhythmias
Issue:
Volume 14, Issue 3, June 2025
Pages:
44-48
Received:
4 April 2025
Accepted:
18 April 2025
Published:
19 May 2025
Abstract: This present casework concerns CHD with mirror like arrhythmias in a 64-year-old male which is accompanied by a large thrombus in right atrial chamber as seen through echocardiography. It isn’t a common presentation and since the patient came with signs that are not characteristic of CHD, several tests were done to arrive at the diagnosis of CHD through various images and examinations. The arrhythmogenic substrate for any adult CHD is versatile and encompasses all the variations of arrhythmias seen in normal adults, and however specific to congenital malformations such as WPW and Ebstein’s anomaly. The management of these arrhythmias depends on the severity; a walker may require an occasionally follow-up while one with symptoms like syncope will require invasive tests like cardiac catheterization and programmed electrical stimulation. Chronic VFIB/PVFIB is treated by antiarrhythmic medications and AICDs, while IART is treated by catheter ablation. This case shows that there is a need to improve public aw.reness regarding CHD in adults particularly when complicated by atypical arrhythmias. International and local approaches should be tailored to increase survival rates of patients and improve the diagnostic processes.
Abstract: This present casework concerns CHD with mirror like arrhythmias in a 64-year-old male which is accompanied by a large thrombus in right atrial chamber as seen through echocardiography. It isn’t a common presentation and since the patient came with signs that are not characteristic of CHD, several tests were done to arrive at the diagnosis of CHD th...
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Research Article
Comparative Analysis of Clinical Situation, Pathogen Distribution, and Antibiotic Resistance in Urinary Tract Infections Between Outpatients and Inpatients
Issue:
Volume 14, Issue 3, June 2025
Pages:
49-57
Received:
19 April 2025
Accepted:
3 May 2025
Published:
29 May 2025
DOI:
10.11648/j.cmr.20251403.12
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Abstract: Urinary tract infections (UTIs) are among the most prevalent bacterial infections in both community and healthcare settings. In this study, we conducted a retrospective analysis of 1,516 urinary tract infection (UTI) patients (1,179 inpatients and 337 outpatients) at the Fourth Affiliated Hospital of Soochow University between January 1, 2021, and December 31, 2024. The study aimed to compare clinical characteristics, pathogen distribution, and antibiotic resistance profiles between outpatient and inpatient UTI cases. Key findings revealed a significantly higher urine culture positivity rate in females compared to males, with this gender disparity being more pronounced among outpatients. The peak age of UTI onset varied between groups: inpatients (both sexes) and male outpatients exhibited the highest incidence in the 70-79-year age group, whereas female outpatients peaked earlier (50-59 years). Escherichia coli (E. coli) remained the predominant pathogen in both cohorts, though its prevalence was higher in outpatients. In contrast, inpatients displayed greater microbial diversity, with a broader spectrum of isolated pathogens. E. coli and Enterococcus isolates from inpatients demonstrated higher overall antibiotic resistance than those from outpatients. These findings underscore distinct epidemiological and resistance patterns between outpatient and inpatient UTI cases, providing critical insights for optimizing empirical antibiotic therapy and reinforcing the need for tailored antimicrobial stewardship strategies in these populations.
Abstract: Urinary tract infections (UTIs) are among the most prevalent bacterial infections in both community and healthcare settings. In this study, we conducted a retrospective analysis of 1,516 urinary tract infection (UTI) patients (1,179 inpatients and 337 outpatients) at the Fourth Affiliated Hospital of Soochow University between January 1, 2021, and ...
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Research Article
Tumor Lysis Syndrome, Frequency and Outcome Among Acute Leukaemia Paediatric Patients in Sudan
Alaa Atef Hamed Yasin,
Mayasa Ibrahim Ali Mohamed,
Mustafa Magbol*,
Ahmad Izzoddeen
Issue:
Volume 14, Issue 3, June 2025
Pages:
58-64
Received:
10 March 2025
Accepted:
21 April 2025
Published:
6 June 2025
DOI:
10.11648/j.cmr.20251403.13
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Abstract: Tumor lysis syndrome (TLS) is a haemato-oncological emergency syndrome characterized by metabolic and electrolyte imbalances that are associated with tumor cells. The syndrome is observed when starting chemotherapy for haematological malignancies, while the incidence of spontaneous tumor lysis prior to the start of tumor therapy is rare. A descriptive cross-sectional study conducted over a period of six months. A total of 91 patient records were totally covered from the University Diagnostic Center in Algezir, Sudan. For the determination of the frequency and outcome of TLS among acute leukemia paediatric patients. Of the total 91 leukemia cases retrieved from the hospital records, 60.4% were males while those from the center (Gezira, Sinar and Khartoum) represented 68.1% of the participants. ALL was found in 57.1% however, 51.6% had splenomegaly and lymphadenopathy. 18.7% of cases developed TLS. 5.5% of cases died while 4.4% had complete recovery. A considerable number of patients developed TLS. ALL was affecting more patients than AML. Males were affected more common in comparison to females, with all the cases reported in ALL. Additionally, clinically identified cases was far more than laboratory one. Also, a significant association was discovered between occurrence of TLS and comorbidities. Further future researches are highly recommended.
Abstract: Tumor lysis syndrome (TLS) is a haemato-oncological emergency syndrome characterized by metabolic and electrolyte imbalances that are associated with tumor cells. The syndrome is observed when starting chemotherapy for haematological malignancies, while the incidence of spontaneous tumor lysis prior to the start of tumor therapy is rare. A descript...
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Research Article
Characteristics and Dynamics of Thyroid Dysfunction in the Bulgarian Population - Screening 2024
Anna-Maria Borissova
,
Boyana Trifonova*,
Lilia Dakovska,
Mircho Vukov
Issue:
Volume 14, Issue 3, June 2025
Pages:
65-79
Received:
21 April 2025
Accepted:
3 May 2025
Published:
12 June 2025
DOI:
10.11648/j.cmr.20251403.14
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Abstract: In 1994 universal iodization of salt was introduced on the whole Bulgarian territory. In 2005, аn international expert group gave the country credit for solving the problem of iodine deficiency. The last screening of pregnant Bulgarian women in 2019 confirmed the presence of iodine sufficiency among the population. The current study aimed at updating the data on the prevalence of thyroid dysfunction (hypothyroidism and hyperthyroidism) in the country under conditions of iodine sufficiency in the Bulgarian population. The last population screening was conducted 12 years ago, allowing us to make a comparison with the current one in 2024, as both screenings were carried out under the conditions of systematic and continuous universal iodization of salt across the entire territory of Bulgaria. Material and Methods: 936 subjects were distributed into three age groups: 20-44 years - 342 (36.5%), 45-59 years - 301 (32.2%) and 60-79 years - 293 (31.3%). TSH (ECLIA-sandwich method), FT4 (competitive ECLIA method), TPOAb (ECLIA-method of the Cobas e601 analyzer) were examined. Thyroid dysfunction, which includes subclinical and clinical forms, was analysed regarding the frequency of each type and form in the studied population, as well as its distribution according to gender and among the three age groups. The data gathered in 2012 and 2024 were compared. Results: Hypothyroidism is the dominant disorder - 14.4% (135/936), while hyperthyroidism is 1.81% (17/936), p < 0.05. The highest number of patients have subclinical hypothyroidism - 13.67% (128/936). The prevalence of increased TPO antibodies is 14.4% (133/936) and as expected, it is more common in women - 71.4% (95/133) compared to men - 28.6% (38/133), p < 0.001. The current thyroid dysfunction in our country has significantly increased - from 6.91% (166/2402) in 2012 to 16.23% (152/936) in 2024, p < 0.01. The relative share of known diagnosed cases during this 12-year period shows a marked rise - from 44.51% (73/164) to 63.16% (96/152) - p < 0.02 > 0.01, while the relative share of newly diagnosed cases during screening has a significant drop - from 55.49% (91/164) to 36.84% (56/152) - p < 0.02. Conclusion: These favorable trends in the reduction of undiagnosed cases of thyroid dysfunction are the result of increased diagnosis of thyroid pathology, ongoing regular screening campaigns, and raised awareness among the population, which is proof of the medical community beneficial work in the country.
Abstract: In 1994 universal iodization of salt was introduced on the whole Bulgarian territory. In 2005, аn international expert group gave the country credit for solving the problem of iodine deficiency. The last screening of pregnant Bulgarian women in 2019 confirmed the presence of iodine sufficiency among the population. The current study aimed at updati...
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Case Report
Legius Syndrome Vs Neurofibromatosis Type 1, About a Case Report
Yordania Velázquez Avila,
Carmen Rosa Rodríguez Valenciano
Issue:
Volume 14, Issue 3, June 2025
Pages:
80-84
Received:
26 March 2025
Accepted:
10 April 2025
Published:
16 June 2025
DOI:
10.11648/j.cmr.20251403.15
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Abstract: The genodermatoses is genetic diseases that affect to the skin and their old ones, in those which alone they influence hereditary mechanisms linked to the genes. The neurofibromatosis type 1 are a genodermatoses that belongs to the group of the Rasophaties, with brown formation of stains with milk and tumours in skin and nervous system. This diseases can be diagnose clinically with the presence of two clinical approaches. In the year 2001 a Rasophatie was described that previously it was considered a clinical form of the neurofibromatosis, but it was demonstrated by means of molecular studies that it is a different diseases and it was designated as Legius syndrome. This syndrome completes two of the current diagnostic approaches of the neurofibromatosis type 1, when presenting coffee with milk macula and axillary or inguinal ephelides, being difficult to differentiate them. Although at the moment molecular studies of sequence exist for the diagnosis of both rasopatías, in some countries it is a non-available technology. In Cuba, like part of a methodology for the attention to patient with genodermatoses, the proposal of modification of diagnostic approaches of neurofibromatosis type 1 were included, unifying in one single approach the presence of coffee with milk macula and axillary or inguinal ephelides. The presentation is made with the purpose of standing out the importance of modifying the diagnostic approaches of neurofibromatosis type 1, proposed in the methodology. An adolescent is described that presented coffee with milk macula, axillary ephelides and overturn for deficit of attention with hyperactivity, assisted in specialized consultation of genodermatoses in the Pediatric Hospital “Martyrs of Tunas” with diagnostic presumptive of neurofibromatosis type 1. In the presented case the proposed approaches and the molecular study of neurofibromatosis type 1 negative, they guided toward the diagnosis of Legius syndrome. This case demonstrates the importance of the modification of the diagnostic approaches of neurofibromatosis type 1, proposed in the methodology for the attention to patient with genodermatoses that avoids the diagnostic error.
Abstract: The genodermatoses is genetic diseases that affect to the skin and their old ones, in those which alone they influence hereditary mechanisms linked to the genes. The neurofibromatosis type 1 are a genodermatoses that belongs to the group of the Rasophaties, with brown formation of stains with milk and tumours in skin and nervous system. This diseas...
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Research Article
Variation of Retinal Vascularisation Post Bevacizumab for Treatment of Type 1 Retinopathy of Prematurity: A Dose Comparison Based on Retinal Fluorescein Angiography
Cindy Yue-Ying Liu,
Nader Beshay FRANZCO,
Shaheen Shah FRANZCO,
Shuan Dai FRANZCO*
Issue:
Volume 14, Issue 3, June 2025
Pages:
85-89
Received:
5 May 2025
Accepted:
19 May 2025
Published:
19 June 2025
DOI:
10.11648/j.cmr.20251403.16
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Abstract: Retinopathy of prematurity (ROP) is increasingly treated with intravitreal bevacizumab (IVB) but consensus on the optimal dose remains to be determined. Peripheral avascular retina (PAR) and fluorescein leakage are recognised sequelae following anti-vascular endothelial growth factor (VEGF) therapy. The impact of IVB dose on the frequency of these outcomes requires further investigation. This study aimed to compare the prevalence of these two findings on fundus fluorescein angiography (FFA) in infants post treatment of ROP with either 0.625 mg or 0.3125 mg IVB. This was a retrospective study of 74 eyes to compare the prevalence of PAR, fluorescein leak and length of temporal retinal vascularisation (LTRV) after receiving IVB as primary therapy for severe ROP. PAR was observed in almost all eyes treated with IVB (P=1). The number of eyes demonstrating fluorescein leak was double in those receiving 0.3125 mg (6 out of 34) compared to 0.625 mg (3 out of 40) though this difference was not statistically significant (OR 2.61, 95% CI 0.50-17.53, P=0.286). Eyes treated with 0.625 mg IVB had a non-significantly greater mean LTRV by 0.37 disc diameters (P=0.573). Despite lacking statistical significance, the doubled fluorescein leakage rate and trend towards lower LTRV in patients receiving 0.3125 mg may warrant caution in high-risk cases.
Abstract: Retinopathy of prematurity (ROP) is increasingly treated with intravitreal bevacizumab (IVB) but consensus on the optimal dose remains to be determined. Peripheral avascular retina (PAR) and fluorescein leakage are recognised sequelae following anti-vascular endothelial growth factor (VEGF) therapy. The impact of IVB dose on the frequency of these ...
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