RESUMEN
Pulmonary embolism, peripartum cardiomyopathy, acute myocardial infarction, aortic dissection, anxiety, and gastroesophageal reflux disease are known causes of chest pain during the peripartum period. A cardiac tumor is a rare cause of chest pain during this time period. While cardiac myxomas during pregnancy have been reported, cardiac hemangiomas are exceptionally rare. To the best of our knowledge, there are no existing case reports regarding cardiac hemangiomas in either pregnant or postpartum patients. Here, we present a 23-year-old female who presented with visual changes, headache, and midsternal pain and was subsequently found to have a cardiac hemangioma.
RESUMEN
Sleep terror disorder and chronic alcohol abuse are severe conditions that can significantly impact an individual's quality of life. Sleep terror disorder is characterized by sudden and intense episodes of fear or terror, while chronic alcohol abuse can lead to physical and psychological problems that can negatively impact sleep quality. This patient had terminal insomnia with episodes of terror, screaming, and no memory of arousal. Treatment of sleep terror disorder in chronic alcohol abuse patients involves addressing any underlying medical or psychological issues, medication, and cognitive-behavioral therapy (CBT). CBT can help identify and dispute harmful thought patterns and teach coping mechanisms. We present a case of an adult male who had terminal insomnia with episodes of terror, screaming, and no memory of arousal.
RESUMEN
The safety and efficacy of different anti-diabetic drugs are not clear because of the lack of sufficiently powered clinical trials. This network meta-analysis was conducted to compare the efficacy and safety of three anti-diabetic drugs (insulin, glyburide, and metformin), and rank them as per their efficiency to control glucose levels, pregnancy, and neonatal outcomes. The study design is a systematic review, meta-analysis, and network meta-analysis. After a systematic search of existing databases, 34 randomized controlled trials were selected for inclusion in the analysis. We did pairwise network meta-analysis to calculate standardized mean difference and odds ratio (OR) as the summary measures for numerical and dichotomous variables, respectively, by using random-effects model. Our key outcomes were incidence of neonatal hypoglycemia, respiratory distress syndrome, macrosomia, C-section, admission to neonatal intensive care unit (NICU) and mean differences in the birth weight of neonates, gestational age at birth, HbA1C levels, fasting blood sugar, large at gestational age, and post-prandial glucose. It was found that metformin significantly lowered the post-prandial levels of glucose as compared with both glyburide and insulin in pairwise analysis (SMD = 14.11 [23-4.8]; SMD = 22.45 [30-14]), respectively. There was a significant reduction in birth weights of babies whose mothers were administered metformin as compared with either glyburide or insulin. The proportion of neonates admission to NICU was significantly lower for metformin when compared with insulin [Log OR = 0.334 (0.0184, 0.6814))]. Large at gestational age was significantly lower for metformin as compared with both glyburide and insulin [log OR = 0.6882 (0.171, 1.329), log OR = 0.393 (0.00179, 0.8218)], respectively. Oral anti-diabetic drugs especially metformin performed better than both glyburide and insulin for all neonatal and maternal outcomes except that it significantly lowered the neonatal birth weight.
RESUMEN
An otherwise healthy man in his 40s recently diagnosed with esophageal adenocarcinoma sustained an air embolism during the insertion of a mediport under mild sedation that was noted while using pulse fluoroscopy to ensure good visibility of adequate placement of the catheter tip. Pulse fluoroscopy allowed the early detection of a potentially catastrophic situation caused by air in the right heart and main pulmonary artery, thus allowing prompt correction of the mistake that had allowed the air embolism to occur. Pulse fluoroscopy eliminates or greatly reduces the blurred vision of highly mobile objects and enhances the view of low contrast objects thus enhancing imaging quality.
RESUMEN
INTRODUCTION: With the worldwide spread of SARS-CoV-2 infection, temporary suspension of all the elective dental procedures and an urgent shift to nonaerosol producing dental treatments were observed. This study provides a detailed description of emergency treatments provided in the Department of Endodontics at a tertiary healthcare centre during the period of prelockdown, lockdown, and sequential unlocking from March 1, 2020, to October 31, 2020. METHODS: Access to General and Departmental OPD data along with treatment records was obtained and was segregated based on age, sex, and treatments performed. Treatments were divided into aerosol generating procedures (AGPs) and non-AGPs and further subdivided into palliative treatment (PT), pulp capping (PC), incision and drainage (ID), temporary filling (TF), pulpectomy (PU), and pulpotomy (PO). Data was analysed and subjected to chi-square test. RESULTS: A total of 15052 patients approached general OPD during the period of 8 months of which 5698 (37.86%) were endodontic in origin and treatments offered were PT 858 (15.05%), PO 1560 (27.37%), PU 2018 (35.42%), TF 500 (8.78%), ID 164 (2.88%), and PC 598 (10.94%). Also, more females (57.28% (3264/5698)) visited the department as compared to males (42.72% (2434/5698)). CONCLUSION: The pandemic had turned the tables on over the people around the world, and it has become extremely necessary to rule out the emergencies needed to treat the patients accordingly shifting more towards non-AGPs compared to AGPs among the various age groups of the society.
