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Paper Type | : | Research Paper |
Title | : | Resistant Hypertension in a Patient with "Incidental" Renal Artery Stenosis |
Country | : | |
Authors | : | Dr. Pyara Masiha Topno || Dr. Thakurmani |
: | 10.9790/0853-1907070105 |
Abstract: Renal artery stenosis is considered to be one of the more frequent causes of secondary arterial hypertension. Through its progression renal artery stenosis can cause renal insufficiency, uncontrolled hypertension, and increased cardiovascular morbidity. Renal Artery Stenosis is general term that refers to any vascular lesion causing narrowing of the renal artery thereby impairing blood flow to the kidney. This disease encompasses a broad range of pathophysiologies, the two most common being fibromuscular dysplasia (FMD) and atherosclerotic vascular disease. It is associated with three major clinical syndromes: ischemic nephropathy, hypertension, and destabilizing cardiac syndromes. However, a diagnosis of RAS may also result from an incidental finding in an otherwise asymptomatic patient.
[1]. Renal artery stenosis. National Kidney and Urologic Diseases Information Clearinghouse. https://www.niddk.nih.gov/health-information/kidney-disease/renal-artery-stenosis. Accessed Feb. 21, 2020.
[2]. Ferri FF. Renal artery stenosis. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Feb. 23, 2020.
[3]. Yu ASL, et al., eds. Renovascular hypertension and ischemic nephropathy. In: Brenner & Rector's The Kidney. 11th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Feb. 23, 2020.
[4]. Hermann SM, et al. Renovascular hypertension. Endocrinology and Metabolism Clinics of North America. 2019; doi:10.1016/j.ecl.2019.08.007.
[5]. Chade AR, Rodriguez-Porcel M, Grande JP, et al. Mechanisms of renal structural alterations in combined hypercholesterolemia and renal artery stenosis. Atherioscler Thromb Vasc Biol. 2003;23:1295–.
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Abstract: Background: A 22 year old female presented with the chief complaints of fever for 5 days, rashes since 15 days and yellowish discoloration of eyes and high-colored urine since 20 days. She also complained of arthralgia, myalgia, facial puffiness, itching and loss of weight and appetite. Her past history was significant for a new-onset seizure episode around two months back for which she was started on regular treatment with Tablet Phenytoin 300mg/day, for the past 45 days. Following an asymptomatic period of around 25 days, she initially developed the yellowish discoloration of eyes and urine followed by the generalized rash and finally high-grade fever with which she came to the hospital. General examination revealed a high temperature, icterus, pallor and significant cervical, axillary and inguinal lymphadenopathy. There was also facial puffiness and exfoliative rashes all over the body......
Key words: DRESS syndrome, phenytoin, autoimmune hypothyroidism, prednisolone, regiSCAR, eosinophilia
[1]. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in two young children: the importance of an early diagnosis. Massimo Luca Castellazzi, Susanna Esposito,Laura Elisabetta Claut,Valeria Daccò and Carla Colombo
[2]. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. Sonal Choudhary, MD, Michael McLeod, MS, Daniele Torchia, MD, and Paolo Romanelli, MD
[3]. Drug Reaction with Eosinophilia and Systemic Symptoms Shilpa Khetarpal MD, Anthony Fernandez MD, PhD.
[4]. Ashish Gupta et al (2018) 'Drug rash with Eosinophilia and Systemic Symptoms Syndrome Due to anti-tb Medication', International Journal of Current Advanced Research, 07(10), pp. 15878-15880. DOI: http://dx.doi.org/10.24327/ijcar.2018.15880.2912
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Abstract: INTRODUCTION: The combination of back and facial burns, with or not of upper airway damage, is commonly referred to as "hand-face syndromes." Their seriousness is due to the requirements of timing, the quality of early care, the functional, aesthetic and psycho-social consequences that result. OBJECTIVES: Our study reports on the experience of our department, and highlights the treatments to be taken in the face of the therapeutic difficulties posed by these burns MATERIELS AND METHODE: Descriptive retrospective study of a series of 98 cases followed for a syndrome of hand-face in the service of Resuscitation of the Burns and Plastic Surgery of the Military Hospital of Instruction Mohammed V, over a period of 5 years between.....
[1]. A. Lakhel, J. Pradier and M. Brachet, A. Duhoux, P. Duhamel, and Al. Surgery of severe acute burns. EMC: Surgical techniques - plastic, reconstructive and cosmetic surgery. Paris: Elsevier Masson SAS,2008.
[2]. Murray CJL, Lopez AD. The global burden of disease : a comprehensive assessment of mortality and disability from diseases , injuries and risk factor in 1990 and projected to 2020 [éd] World health organasition.1996.Vol.1.
[3]. Ettalbi S., Ibnouzahir M., Droussi H., Wahbi S., Bahaichar N., Boukind EH. Epidemiological aspect of burns in Marrakech, Morocco, through two observations. [ed.] Annals of Burns and FireDisasters. Vol.XXII.
[4]. A., Abdennour. Hand burns: epidemiological, clinical and therapeutic data. Ph.D. thesis in Medicine. 2018.151.
[5]. L., Bourdais. Primary management of hand burns in adults. Ph.D. Thesis Medicine. Nante: s.n., 2009.122.
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Abstract: La neurofibromatose 1 (NF1), également connue sous le nom de maladie de von Recklinghausen est une génodermatose rare avec une transmission autosomique dominante. Le glaucome congénital constitue une complication ophtalmologique rare. Nous rapportons un cas de glaucome congénital dans le cadre de la neurofibromatose type1.Nous allons discuter la physiopathologie, les modalités de la prise en charge thérapeutique ainsi que le pronostic du glaucome congénital dans le cadre da la maladie de von Recklinghausen..
Key Words: Glaucome congénitale,neurofibromatose type 1, trabéculectomie.
[1]. Vankireddi Mahathi, Sairani Karanam, Malleswari Medikonda. Congenital Glaucoma with Neurofibromatosis Type-I A Rare Occurrence. Delhi J Ophthalmol 2018;28;64-6;
[2]. Michael Kinori, MDa, Nickisa Hodgson, MDb, Janice Lasky Zeid, MDa, Ophthalmic manifestations in neurofibromatosistype 1. survey o f ophthalmology xxx ( 2 0 1 7 ) 1e1 6
[3]. Huson SM, Harper PS, Compston DA. Von Recklinghause neurofibromatosis. A clinical and population study in southeast Wales. Brain. 1988;111(Pt 6):1355e81
[4]. Wright KW, Spiegel PH. Pediatric ophthalmology and strabismus. New York NY, USA, Springer-Verlag; 2003, p 766
[5]. Grant WM, Walton DS. Distinctive gonioscopic findings in glaucoma due to neurofibromatosis. Arch Ophthalmol. 1968;79(2):127e34.
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Abstract: Background: Techniques for providing postoperative analgesia have become an integral part of pediatric anaesthesia. TAP block is a regional anaesthetic technique that blocks the neural afferents of anterolateral abdominal wall whereas in caudal epidural block we place a needle through the sacral hiatus for delivering medications into sacral epidural space. Materials and Methods: It is a prospective randomised controlled study, 60 patients of ASA physical status I and II in the age group of 2-7years undergoing lower abdominal surgery were randomly allocated into 2 groups of 30patients each, The ultrasound-guided caudal block group(group A) &the ultrasound-guided TAP block group(group B) (n = 30) Results: The patients in group.....
Key Word: TAP; caudal epidural block; Postoperative analgesia;ropivacaine; pediatric
[1]. Hurley RW, Wu CL. Acute postoperative pain. In Miller RD (editor). Miller‟s Anaesthesia, 7th ed. Philadelphia: Churchill Livingstone; 2009: 2757-758.
[2]. McDonnell JG, O‟Donnell BD, Tuite D, Farrell T, Power C.The regional abdominal field infiltration (R.A.F.I.) technique: computerized tomographic and anatomical identification of a novel approach to the transversus abdominis neurovascularfascial plane. Anesthesiology 2004;01:A899.28.
[3]. AfEkensatm, Petersson G. Local Anaesthetics: I. N- alkyl pyrrolodine and N-alkyl piperidine carboxylic amides. ActaChem Sand 1957; II: 1183-1190
[4]. Carney J, Finnerty O, Rauf J, et al. Ipsilateral transverses abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. AnaesthAnalg 2010;111:998–1003.
[5]. Aveline C, Le Hetet H, Le Roux A, et al. Comparison between ultrasound-guided transverses abdominis plane and conventional ilioinguinal/ iliohypogastric nerve blocks for day-case open inguinal hernia repair. British J Anaesth 2010;106(3):380–6.foundation.Diabetes Care. 2008;31(4):811–822.
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Abstract: Background: Evaluating dentinal cracks in root canal surface after biomechanical preparation using rotary files systems as ProTaper Next,2 Shape and Race. Methodology:Forty extracted human single canal mandibular premolars were weredecoronated perpendicular to the long axis of the tooth leaving roots (12±1mm) then positioned centrally in a mold using acrylic resin. Roots were randomly divided into 4 main groups(n=10) according to the Nickel Titanium (Ni-Ti) rotary file system used in preparation:Group I: Control group roots were left unprepared. Group II: Canals were prepared using Ni-Ti 2 shape system up.....
Keywords:2 Shape,Dentinal cracks, Nickel Titanium,ProTaperNext,Race.
[1]. Garg E, Sarfi S, Bali D, Garg AK. Comparative evaluation of dentinal defects induced by hand files, hyflex, protaper next and one shape during canal preparation: A stereomicroscopic study. Journal of the International Clinical Dental Research Organization. 2017;9(1):16.
[2]. Passarinho‐Neto JG, Marchesan MA, Ferreira RB, Silva RG, Silva‐Sousa YTC, Sousa‐Neto MD. In vitro evaluation of endodontic debris removal as obtained by rotary instrumentation coupled with ultrasonic irrigation. Australian Endodontic Journal. 2006;32(3):123-8.
[3]. Mishra N QR, Agarwal M, Singh MP, Khullar A. Challenges and current concepts in the preparation of root canal systems in radix entomolaris case reports. Journal of Dental and Medical Science 2016;15:77-81.
[4]. Bier CAS, Shemesh H, Tanomaru-Filho M, Wesselink PR, Wu M-K. The ability of different nickel-titanium rotary instruments to induce dentinal damage during canal preparation. Journal of Endodontics. 2009;35(2):236-8.
[5]. Kansal R, Rajput A, Talwar S, Roongta R, Verma M. Assessment of dentinal damage during canal preparation using reciprocating and rotary files. Journal of endodontics. 2014;40(9):1443-6.
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Abstract:Background and Purpose: The purpose of the study is to compare the Parity level in normal and IUGR pregnancies
Material and Methods- Research study, Department of Anatomy, R.N.T. Medical College, Udaipur. 100 control and 100 IUGR Pregnancies Result- In normal Pregnancies maximum patients studied were primigravidas , some patients were para three, in this group, Primigravida 62 multigravida38 , but in IUGR cases 50 females were Primigravida and 50 were multigravida ,Conclusion- In our study age is not statistically significant factor causing IUGR ,Conclusion: Primigravida were more prone for normal Pregnancies.
Keyword: Parity, Intrauterine Growth Retardation.
[1]. Frederic et al Computerized microscopic morphometry of umbilical vessels from pregnancies with intrauterine growth retardation and abnormal umbilical artery Doppler. Obstet Gynecol. 1997; 28: 1139-45.
[2]. Helen et al J Intensive Care Med November/December 2004 vol. 19 no. 6 307-319
[3]. Vogel P. The current molecular phylogeny of Eutherian mammals challenges previous interpretations of placental evolution. Placenta. 2005;26:591–596.
[4]. Jaya et al. Indian Pediatrics.1995,32(11): 1183-1188
[5]. Hendrix N et al .Non-placental causes of intrauterine growth restriction. Semin Perinatol.2008 Jun: 32(3):161-5
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Abstract: Humeral shaft fractures are common and account for approximately 3% of all orthopaedic injuries.The aim of this study is to analyse and compare the clinical, radiological and functional outcomes of humeral shaft fractures treated with minimally invasive anterior bridge plating (ABP) VS open reduction and internal fixation (ORIF) by posterior approach.A prospective randomised controlled trial study was carried out for a total of 40 cases of humeral shaft fractures.20 cases in minimally invasive ABP and 20 cases in posterior ORIF group. Study population washumeral shaft fractures in skeletally mature patients.All the cases were followed up for a minimum period of six months. Result was assessed usingDASH(The Disabilities of the Arm, Shoulder and Hand)Score. The average age of patients was 36.2 years with 29 males and 11 females.There were 12 excellent results in the anterior bridge.....
Key Words:Humeral shaft fracture;Anterior bridge plating; Open reduction and internal fixation.
[1]. Rose SH, Morrey BF, Ilstrup DM, Riggs BL. Epidemiologic features of humeral fractures. Clinical Orthopaedics and Related Research. 1982 Aug(168):24-30.
[2]. Chapman JR, Henley MB, Agel J, Benca PT. Randomized prospective study of humeral shaft fracture fixation: Intramedullary nails versus plates. Journal of Orthopaedic Trauma 2000 Mar/Apr;14(3):162-6.
[3]. An Z, He X, Zeng B. A comparative study on open reduction and plating osteosynthesis and minimal invasive plating osteosynthesis in treating mid-distal humeral shaft fractures. Chinese Journal of Reparative and Reconstructive Surgery. 2009 Jan;23(1):41-4
[4]. Oh CW, Byun YS, Oh JK, Kim JJ, Jeon IH, Lee JH, Park KH. Plating of humeral shaft fractures: comparison of standard conventional plating versus minimally invasive plating. Orthopaedics& Traumatology: Surgery & Research. 2012 Feb 1;98(1):54-60.
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Abstract: Background: Fistula-in-ano is a granulation tissue lined tract, connecting the perianal skin to another opening inside the anal canal or the lower rectum. Treatment of fistula-in-ano involves the healing of fistula tract with the objective of least recurrence. Objectives: To find out the effectiveness of fibrin glue plug in fistula-in-ano treatment and recurrence rate. Methods:50 patients of fistula-in-ano during the study period 2017 to February 2020 were included in the study, irrespective age and gender. Midline fistulas and sinuses, fistula due to perineal injuries, congenital fistulas and consent withdrawal patients were excluded from the study. Results: Majority of the patients were.....
Key Words:Fistula-in-ano, fibrin glue plug, recurrence of fistula-in-ano, intersphincteric and transsphincteric fistula
[1]. MERCK MANUAL. Consumer Version. Retrieved 2016-06-27.
[2]. Malik Al, Nelson RL. Surgical management of anal fistula :asystematic review. Colorectal Disease. 2008;10(5):420-30.
[3]. Khafagy W, Zedan W, Setiet A, El-Awady S, El-Shobaky MT.Autologous fibrin glue in treatment of fistula in ano. Coloproctology2001;23:17-21.
[4]. Deeba S, Aziz O, Sains PS, Darzi A. Fistula-in-ano: advances intreatment. Am J Surg. 2008 Jul;196(1):95-9.
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Abstract: In the practice of cardiac surgery, anesthesia and surgery per se are both regarded as stress givers to the normal homeostatic mechanism of human body. The effect of drugs, incision, cardiovascular systemic manipulations during surgery and ventilation in ICU which is a cementing element of management of patients after weaning from bypass, all have the potential to alter the blood gas profile. As a sentinel against these effects the practice of taking repeated arterial blood gas samples is followed universally in cardiac surgery. The analysis of ABG samples predominantly focuses on pH, PO2, lactate, PCO2, bicarbonate and electrolyte levels. There have been attempts to predict the outcome of surgery on the basis of these levels by various researchers but more importantly correction of the levels of the mentioned parameters has proven its steel in proper management of cardiac patient both in operation.....
Key Words: pH, Lactate, PO2, Arterial blood gas analysis, Outcome of cardiac surgery.
[1]. Arterial blood gas and pH analysis : Clinical approach and interpretation by Peter H Breen MD, FRCP. Department of anesthesiology, College of Medicine, University of California.
[2]. Importance of pH Homeostasis in Metabolic Health and Diseases: Crucial Role of Membrane Proton Transport by WataruAoi1 andYoshinoriMarunaka2,3. Correspondence should be addressed to Wataru Aoi;waoi@kpu.ac.jp and Yoshinori Marunaka; marunaka@koto.kpu-m.ac.jp
[3]. Pathophysiology of acid base balance : The theory practice relationship by Sharon L Edwards published as Elsevier original article accepted on 13 May 2007.
[4]. METABOLISM OF OXYGEN by Mika Venojärvi. Department of Physiology, Institute of Biomedicine University of Kuopio, Kuopio, Finland and Medical Laboratory Technology, Turku University of Applied Sciences, Turku, Finland.
[5]. ABC of intensive care Respiratory support by Maire P Shelly,Peter Nightingale. The ABC of intensive care is edited by Mervyn Singer,reader in intensive care medicine,Bloomsbury Institute of Intensive Care Medicine,University College London and Ian Grant,director of intensive care,Western General Hospital,Edinburgh.The series was conceived and planned by the Intensive Care Society's council and research subcommittee..
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Abstract: This study was carried out on a population to examine the potential of skin diseases among adolescents. Adolescence is a period of life with its own unique characteristic. They are more prone to many dermatological conditions [1].Among the study participants 80% Patients were unhygienic, socio-economically deprived. On clinical examination of these patients, 55% patients were diagnosed with Bahaq (Pityriasis versicolor).Patients were put on treatment with Unani single drug Nargis (Narcissus tazetta L.) and strict dietary advices for a period of two months. Administration of this drug reduced the signs and symptoms of this disease. This study revealed this Unani drug can be used for the treatment of dermatological disease Bahaq (Pityriasis versicolor)..
Key Words: Adolescence, Bahaq (Pityriasis versicolor), Nargis (Narcissus tazetta L.), Socio-economic status
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[5]. Ibn Sina. Al qanoon fi al tib, Vol-4 (Urdu translation by Kantoori GH) New Delhi: Eijaz Publishing House; 2010: 1425-1428.
[6]. Ibne Rushd. Kitab al Kulliyat. Ed. 2nd. (Urdu translation by CCRUM). New Delhi: Ministry of Health and Family Welfare; 1987: 109-110, 291-299, 305..