A Rare Presentation of Systemic Sclerosis.

Systemic sclerosis (SSc) is a persistent autoimmune disorder. While it commonly impacts the cardiac valves, particularly the mitral valve, involvement of the aortic valve has been seldom documented. We report a case of a 47-year-old male with a history of progressive SSc who displayed complications related to cardiac issues, which were verified through a left atrial appendage biopsy revealing thickening due to fibrosis. This cardiac involvement led to a condition necessitating the replacement of the aortic valve due to aortic regurgitation. This instance underscores the importance of identifying this uncommon association, enabling the delivery of appropriate patient treatment, and reducing complications linked to the underlying condition.

Knowledge about asthma: A cross-sectional survey in 4 major hospitals of Karachi, Pakistan.

OBJECTIVE: To determine knowledge and misconceptions about asthma among the local population.. METHODS: This cross-sectional study was conducted at four tertiary care hospitals; Aga Khan University Hospital, Civil Hospital Karachi, Jinnah Postgraduate Medical Centre and Ojha Institute of Chest Diseases, Karachi, from October to November 2016, and comprised hospital attendants. The questionnaire used in the study comprised 26 questions answered with a true, false or not sure answer.SPSS 20 was used for data analysis. RESULTS: There were 400 participants. The overall mean age was 41.2±14.2 years, and 214(53.5%) of the participants were males. Moreover, 75(19%) participants thought that asthma was a psychological disorder while 181(45%) considered it an infectious disease. Nearly 174(43.5%) believed that inhaled medications had significant side effects. Besides, 264(66%) participants considered steam inhalation to be an effective treatment for asthma, 269(67%) thought that patients with asthma should avoid rice in their diet and 167(42%) considered milk as a common trigger. CONCLUSIONS: Participants' knowledge about asthma was poor and misconceptions were common about the condition.

Retrograde bullet migration from inferior vena cava into right common iliac vein following gunshot: A case report.

Bullet embolization cases are rare and even rarer are its retrograde migration in the veins. We report the case of a 14 year old male with a gunshot wound to the left side of his chest. CT scan revealed bilateral haemothorax and foreign body in the right common iliac vein. The patient was immediately taken to the operating theatre and median sternotomy performed. Bullet entry tear was found in the inferior vena cava however, the bullet was found lodged in the right common iliac vein and slipped down against the flow of blood. The bullet was left in situ and after the necessary repair the chest was closed and the patient shifted to the CICU and discharged after 4 days in stable condition. Patient was followed after 1 week and reassured and advised for one year follow-up.