Exploring Roemheld syndrome: a comprehensive review with proposed diagnostic criteria.

Roemheld syndrome (RS) is a condition that triggers cardiac symptoms due to gastrointestinal compression of the heart. It is often misdiagnosed as other types of cardiac or digestive disorders, leading to unnecessary treatments and reduced quality of life. Here, we provide a thorough review of RS, covering its pathogenesis, etiology, diagnosis, treatment, and outcome. We found that a number of conditions, including gallstones, hiatal hernia, excessive gas, and gastroesophageal reflux syndrome, can cause RS. The symptoms of RS can include chest pain, palpitations, shortness of breath, nausea, vomiting, bloating, and abdominal pain. Clinical history, physical examination, electrocardiograms, and improvement in symptoms following gastrointestinal therapy can all be used to identify RS. We also propose a set of criteria, the IKMAIR criteria, to improve the diagnostic approach for this condition. Dietary changes, lifestyle adjustments, pharmaceutical therapies, and surgical procedures can all be used to control RS. Depending on the underlying etiology and the outcome of treatment, RS has a varying prognosis. We conclude that RS is a complicated and understudied disorder that needs more attention from researchers and patients as well as from medical professionals. We recommend the inclusion of RS in the differential diagnosis for individuals with gastrointestinal problems and unexplained cardiac symptoms. Additionally, we advise treating RS holistically by attending to its cardiac and gastrointestinal components.

A comparison of intravenous midazolam and diazepam in management of status epilepticus in children.

OBJECTIVE: To compare the efficacy of intravenous midazolam and diazepam in the management of status epilepticus seizures in children. METHODS: The comparative study was conducted in the paediatric neurological emergency unit of The Children's Hospital and the Institute of Child Health, Multan, Pakistan, from December 15, 2018, to May 14, 2019, and comprised paediatric patients of status epilepticus seizures which were divided into Diazepam and Midazolam groups. Data was analysed using Graph-Pad Prism 5. RESULTS: Of the 164 patients, 82(50%) were in each of the two groups. There was no significant difference between the groups in terms of weight, age, residence area of patients and mean duration of seizures (p>0.05). Status epilepticus seizures subsided after intravenous midazolam administration in 77(93.90%) cases, while success in the diazepam group 64(78.05%) (p<0.05). Mean time taken by midazolam to halt seizures was significantly shorter than diazepam (p<0.05) and less cases of treatment failure were observed with intravenous midazolam (p<0.05). Somnolence was observed after diazepam administration in 47(57.3%) cases (p=0.0001). CONCLUSION: Intravenous midazolam was found to be superior in efficacy than intravenous diazepam in controlling status epilepticus seizures.

Burden of communicable diseases and cost of illness: Asia pacific region.

BACKGROUND: Communicable diseases such as AIDS/HIV, dengue fever, and malaria have a great burden and subsequent economic loss in the Asian region. The purpose of this article is to review the widespread burden of communicable diseases and related health-care burden for the patient in Asia and the Pacific. AREAS COVERED: In Central Asia, the number of new AIDS cases increased by 29%. It is more endemic in the poor population with variations in the cost of illness. Dengue is prevalent in more than 100 countries, including the Asia-Pacific region. In Southeast Asia, the annual economic burden of dengue fever was between $ 610 and $ 1,384 million, with a per capita cost of $ 1.06 to $ 2.41. Globally, 2.9 billion people are at risk of developing malaria, 90% of whom are residents of the Asia and Pacific region. The annual per capita cost of malaria control ranged from $ 0.11 to $ 39.06 and for elimination from $ 0.18 to $ 27. EXPERT OPINION: The cost of AIDS, dengue, and malaria varies from country to country due to different health-care systems. The literature review has shown that the cost of dengue disease and malaria is poorly documented.

Increased burden of disease and role of health economics: Asia-pacific region.

Background: Health-care systems in Asian countries are diverse. The economic evaluation provides information on how to make efficient use of the resources available to obtain the maximum benefits. In Asia, diseases such as cardiovascular diseases (CVDs), diabetes mellitus (DM), tuberculosis (TB) and epilepsy generate a heavy economic burden. The objective of this article is to provide a review of the economic burden of health to patients in Asian countries. Areas covered: All data were collected from already published research article and review papers. The databases searched were Science Direct, PubMed, MEDLINE and Google scholar. We found a total of 4456 articles on health economics. After reviewing the title, only 876 relevant articles were considered. Only 92 (n = 92) articles were considered on the basis of inclusion and exclusion criteria. Expert opinion: Available data give evidence that diseases are linked to the low socio-economic status of the Asian population. The cost per capita is high in Asian countries due to insufficient health-care facilities. The cost per capita in Asian countries ranges from $23 (Pakistan) to $1775 (Taiwan). The per capita cost of Malaysia, China, Singapore, and Thailand is $27 $83, $75, and $27, respectively.