Articles: ninos.
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Case Reports
Quarantine-induced Stress Cardiomyopathy (Takotsubo syndrome) during the COVID-19 pandemic.
Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy characterized by an acute reversible left ventricular dysfunction with typical apical ballooning, usually with subsequent complete spontaneous recovery. TTS may be triggered by several physical and emotional stressors. The name Covidsubo was recently adopted to describe this emerging entity. TTS during quarantine may be a reasonable outcome of the overwhelming stress and fear of this pandemic. However, according to the current literature, conflicting results have been reported regarding the incidence of this syndrome during the first wave of the pandemic, and further studies are needed. High index of suspicion is needed to identify patients during the next waves of the pandemic, particularly given the need for minimizing imaging modalities and contact with the patients. ⋯ The only prominent stressor in the two cases in this article was the stress accompanying quarantine.
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J Coll Physicians Surg Pak · Mar 2021
Correlation of Blastocyst Quality and Pregnancy Outcome during Freeze - Thaw Cycle.
To explore the relationship between the blastocyst quality and biochemical pregnancy or early embryonic cessation of development during the freeze-thaw cycle of in vitro fertilisation embryo transfer (IVF-ET). ⋯ Embryos with Grades excluding C in the score had better developmental potential and better prognosis. The rate of early embryonic development arrest in the ICM Grade C group was higher than that in the TE Grade C group. Key Words: Embryo quality and score, Blastocyst, Biochemical pregnancy, Early embryonic cessation of development.
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J Coll Physicians Surg Pak · Mar 2021
Relation of External Beam Radiotherapy Dose with Subclinical Hypothyroidism in Patients undergoing Adjuvant Neck Radiation after Surgery for Squamous Cell Carcinoma of Head and Neck.
The objective of this study was to find out the radiation dose relationship with subclinical hypothyroidism in the postoperative head and neck squamous cell carcinoma patients, who underwent adjuvant neck external beam radiotherapy. It was a prospective cohort study done between June 2018 and January 2020. One hundred patients, who were fulfilling the criteria of histological proven postoperative head and neck squamous cell carcinoma (SCC) of AJCC 2018 stage I to III, were enrolled. ⋯ After one year of completion of treatment, 27.8% patients (n = 25) developed subclinical hypothyroidism among those patients (n = 90), who received radiation dose more than 30 Gy to thyroid gland. None of the patients had subclinical hypothyroidism among those patients (n =10), who received radiation dose below 30 Gy to thyroid gland (p= 0.062). Key Words: Head and neck cancer, Neck radiotherapy, Subclinical hypothyroidism.
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This project was developed because residents need to gain knowledge and experience in promptly recognizing patients with suicidal ideation. Our study allowed pediatric interns the opportunity to manage a simulated 16-year-old actively suicidal patient in the resident continuity clinic for a well-child visit. ⋯ Practicing this crucial but somewhat rare primary care mental health emergency for all interns was possible when structured monthly. Feedback was extremely positive, with learners' feeling more prepared postsimulation. Our simulation experience also allows supervisors to assess intern's individual abilities to communicate in a difficult patient scenario which is an important physician competency as defined by the Accreditation Council for Graduate Medical Education.
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The current SARS-CoV-2 pandemic has brought a number of major global clinical, sociological and economic issues into sharp focus. We address some of these issues, focusing on short-term factors such as virus mutations and vaccine efficacy, and also considering the longer-term implications of the current pandemic. We discuss societal responses to the presence of a pathogen that will probably remain in circulation for decades or longer, and to future new emergent viruses.