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monary disease patients in Pakistan.

Despite the fact that the goals for the management of hypertension are well-defined and effective therapies are available, control of hypertension remains poor in countries with low resources including Ethiopia. This study aimed to determine blood pressure control rate and its determinants among ambulatory adult hypertensive patients at Jimma University Medical Center.

A general prospective cohort study was conducted among adult hypertensive patients who had regular follow-up at Jimma University Cardiac Clinic from 20 March to 20 June 2018. Hypertensive patients who fulfilled the inclusion criteria were selected in the first month of the data collection period. Then, only those patients who visited the clinic at the first month were consequently followed-up for the next 3 months. The Eighth Joint National Committee guideline was used to categorize controlled and uncontrolled blood pressures. Patients' specific data were collected using a structured data collection tool. Data were analyzed using the statisicians' non-adherence to international guidelines, and patients' non-adherence to medications were independent predictors of blood pressure control. Physicians and clinical pharmacists should adhere to guidelines for better treatment and care of hypertensive patients.

The rate of blood pressure control among hypertensive patients was suboptimal. Age, clinicians' non-adherence to international guidelines, and patients' non-adherence to medications were independent predictors of blood pressure control. Physicians and clinical pharmacists should adhere to guidelines for better treatment and care of hypertensive patients.Trichorrhexis invaginata and ichthyosiform erythroderma are pathognomic for Netherton Syndrome.The identification of BBS is crucial to avoid serious complications including sepsis and peritonitis. The diagnosis can be made clinically or from endoscopy. The exact site of the migrated PEG internal bumper can be demonstrated on imaging study.As long-term outcomes of congenital heart diseases improve, the probability of adult patients presenting for heart transplantation for late failure of congenitally corrected heart disease also increases. In patients with dextro-transposition of the great arteries (d-TGA) who were initially treated in the era of Mustard or Senning procedures and before Jatene procedure was introduced, progressive systemic right ventricular failure represents a problem in the very long-term follow-up. We report a rare case of heart transplantation as a third operation 36 years after Mustard procedure in a patient with d-TGA experiencing late failure of the systemic right ventricle.The systemic toxicity of lidocaine is an extremely rare complication of thyroid RFA procedure, and it can be life-threatening. The quick recognization of its symptoms and intravenous use of lipid emulsion are essential to preventing mortality.Clinicians should closely monitor patients on calcimimetics for hypocalcemic symptoms and arrhythmia, even though asymptomatic hypocalcemia typically resolves without intervention.Primary pulmonary Ewing sarcoma can present as a massive mass in the left hemithorax covering the entire lung and can press the pulmonary artery and cause a significant mediastinal shift.Hemorrhage in patients with hematologic malignancies is often difficult to manage as many of these patients also have coagulopathy and thrombocytopenia of varying severity. Recombinant factor VIIa is a FDA-approved agent for management of bleeding in hemophilia patients with inhibitors. Use of recombinant FVIIa has also been used as a last resort in various clinical settings such as trauma, alveolar hemorrhage, gastrointestinal bleeding, and intracranial hemorrhage for control of bleeding with variable outcomes. This paper presents a case of recombinant FVIIa administration in a patient with multiple myeloma and profound transfusion refractory thrombocytopenia suffering from traumatic subdural hematoma.Over 10% of COVID-19 convalescents report post-COVID-19 complications, namely, 'long COVID' or 'post-COVID syndrome,' including a number of neuro-psychiatric symptoms. The pathophysiology of COVID-19 in the central nervous system is poorly understood but may represent post-COVID injury, ongoing sterile maladaptive inflammation, or SARS-CoV-2 persistence. We describe a long COVID patient with SARS-CoV-2 RNA in the cerebrospinal fluid, which seems important, specifically due to recent reports of gray matter volume loss in COVID-19 patients. Further studies of SARS-CoV2 RNA, markers of inflammation, and neuronal damage in the CSF of patients with long COVID would be useful and should address whether the CNS can serve as a reservoir of SARS-CoV-2, clarify the pathway by which COVID-19 contributes to CNS dysfunction, and how best to therapeutically address it.In this article, I examine the case of a viral film entitled "Plandemic," its sequel, and the epidemiologist that is its main subject, and develop a cultural sociology of conspiracy theorizing through the concept of "performative conspiracy." I argue that the Plandemic case represents a cultural performance within the (ongoing) serious social drama of the Covid-19 pandemic. I focus primarily on the "alternative" narrative put forth by the Plandemic case; however, the (Western/US) "mainstream" narrative becomes clear as well. Both call upon the same sets of binary oppositions, chief among them, science vs. blind faith, truth vs. deception, and evidence vs. supposition. Audiences, who are themselves fragmented and differentiated, are exposed to multiple narrative paths. Within the mainstream, they encounter an apocalyptic-turned romantic story, in which science, evidence, and the truth, the sacred trio, will lift humanity out of perilous danger. Plandemic's alternative narrative begins in a tragic tone and builds apocalyptically into a tale of terror, waged by the very same forces of science, truth, and evidence, to create a "plague of corruption" that will "kill millions." To conclude, I reflect on the potential implications of the increasing popularity of conspiracy theorizing about Covid-19.

the COVID-19 pandemic still accounts for thousands of cases every day. It's neurological involvement has been well documented most likely due to auto-immune mechanisms than the virus itself.

we report the case of a 38 years old women who developed an Acute Disseminated Encephalomyelitis following a COVID-19 infection, with a favorable outcome after immunosuppressive therapy.

In this chapter, we discuss ADEM's pathogenesis as well as its clinical and radiological features before detailing its relationship with infectious and vaccination episodes. We also discuss how our patient disease evolved.

Acute Disseminated Encephalomyelitis is an immune-mediated disorder in which the widespread inflammation of the brain and spinal cord is responsible for a variety of symptoms. The novel COVID-19 virus and its vaccine are both a newly incriminated etiologies of this demyelinating disorder.

Acute Disseminated Encephalomyelitis is an immune-mediated disorder in which the widespread inflammation of the brain and spinal cord is responsible for a variety of symptoms. The novel COVID-19 virus and its vaccine are both a newly incriminated etiologies of this demyelinating disorder.

and importance COVID-19 has been associated with thrombotic events in a variety of organs and systems, with pulmonary embolism being the most prevalent. Splenic infarction, renal infarction, and intestinal ischemia have all been documented recently as abdominal visceral infarctions.

A 59 years old female patient with a history of COVID-19 disease was admitted to our hospital due to her left upper quadrant abdominal and left flank pain. She had a history of left heel color change in few days. We perform an ultrasound and it was shown vein thrombosis. So, heparin infusion was started for her. We also performed a thoraco-abdominopelvic computed tomography (CT) with intravenous and oral contrast. Total evidence suggests a splenic system infarction. A regular clinical examination for malignancy was performed on the patient and there was no evidence of cancer. Other probable reasons were ruled out. The patient was diagnosed with splenic infarction, Due to coagulopathy caused by SARS-Cov-2 infection. Treatment with heparin was continued for 5 days and she was discharged home on day 9 with oral agents. The patient was asymptomatic when she returned. The spleen had decreased in size on the follow-up CT, and there were no clinical complications.

Spleen artery thrombosis is a rare complication of COVID-19. In this report, we described a 59 years old female with a history of COVID-19. She was discharged home and in follow-up, there was no evidence of thrombosis anymore.

Spleen artery thrombosis is a rare complication of COVID-19. In this report, we described a 59 years old female with a history of COVID-19. She was discharged home and in follow-up, there was no evidence of thrombosis anymore.

The purpose of this study is to assess how the COVID-19 pandemic affected cancer screening at a large tertiary care setting in the city of Karachi, the third largest city in the world, and to identify if there has been any decrease in cancer screening during the ongoing pandemic.

A retrospective observational study was conducted at the clinical chemistry laboratory at the Department of Pathology & Laboratory Medicine, Aga Khan University Hospital (AKUH), Karachi Pakistan. Data for test volumes was extracted from the Integrated Laboratory Management System (ILMS) for the following tumor markers CA19 Carbohydrate Antigen 19-9 (CA 19-9), Calcitonin, Prostate Specific Antigen (PSA), from 2017 to 2020. Data from January 1st, 2017 till December 31st, 2019 was recorded and compared with the test volume data from January 1st, 2020 till December 31st, 2020. Number of tests performed in the prior 3 years were compared with tests performed in 2020, specifically looking at changes during the lockdown period in 20 performed in Karachi, Pakistan has drastically reduced due to the lockdown that was mandated due to the COVID-19 outbreak. It is crucial that despite an imposed lockdown, regular cancer screening must continue.Currently, the adaptation of scientific evidence in clinical problem solving is based on the evidence-based medicine method. Medical students and health professionals should have an adequate knowledge of this method and thus provide adequate health care and increasingly provide high quality scientific publications that can be subsequently integrated in different clinical scenarios. Several scales and tools have been proposed as guides to recognize the different levels of quality of the available evidence, their degrees of recommendation and the biases and fallacies that may occur both in the clinical and research areas, with the aim of identifying the best available evidence. However, few students and professionals are aware of them and make proper use of them. Therefore, it is necessary to synthesize these tools in an understandable and practical way.

The deadly coronavirus disease 2019 (COVID-19) wreaked havoc globally in early 2020 and caused lives to a standstill. Healthcare workers (HCW) handling patients infected with COVID-19 wore protective equipment to defend themselves from cross infection and curbing further spread. Nevertheless, these do hamper their dexterity, especially during surgical procedures.

A child presented to our centre needing an emergency open appendicectomy during the coronavirus disease 2019 (COVID-19) pandemic in June 2021. Prior to the surgery, her initial test for COVID-19 was negative but subsequently became positive on the second test. Fortunately, all HCW during the care for the patient, donned full personal protective equipment (PPE), and avoided cross-infection.

HCW handling patients with COVID-19 should wear adequate PPE to. However, these pose detrimental effects to their dexterity during routine care of such patients. Good teamwork and communication among HCW and parents are important during the safe management of a young child with COVID-19.

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