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  • ISSN: 2476-2016
    Current Issue
    Volume 3, Issue 2
    Case Report
    Ang Kai Yun, and Ooi Chee Kheong*
    Idiopathic megacolon refers to the permanent dilatation of the colon without an identifiable cause. Patients usually present with chronic constipation. Volvulus is a known complication of this condition. We present a case of a 31-year-old woman who presents with abdominal pain and distension. She was initially diagnosed with sigmoid volvulus based on clinical and abdominal radiograph findings. Computed tomography of the abdomen and pelvis showed abnormal dilatation of the colon with no signs of volvulus. A colonoscopy revealed no obvious obstructive causes. Her symptoms resolved with medical treatment. A follow up colonography two months later showed persistent colonic dilatation, hence idiopathic megacolon was diagnosed. The radiographic findings of idiopathic megacolon may be dramatic and mimic the appearance of large bowel volvulus. It is a reasonable diagnosis to consider since both diagnoses may present with abdominal symptoms. It is prudent for the emergency physician to consider the more serious diagnosis of volvulus by further imaging and surgical consult.
    Tanya Chadha*, Shamsur Chowdhury, Eric Ceithaml, and Michael Shillingford
    Problems with spinal curvature are a common occurrence in patients with Beal's syndrome, a variant of Marfan's syndrome. Here we describe a case of an infant with Beal's syndromein whom cardiovascular surgical intervention was needed for management of his severe kyphoscoliosis. To the best of our knowledge, this is the first reported case of the use of aortopexy in the management of Beal's syndrome.
    Tanya Chadha MD*, Arun Chopra MD, and Jason Fisher
    In the Haemophilus influenza vaccine era, non-typeable Haemophilus influenza remains a source of significant invasive disease. Here we report a case of non-typeable Haemophilus influenza sepsis in a pediatric patient successfully treated with extracorporeal life support therapies.
    Research Article
    Dawod Sharif*, Mohamad Watad, Yasmine Sharif, Amal Sharif-Rasslan and Uri Rosenschein
    Background: Primary percutaneous coronary artery intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI) leads to myocardial salvage. Objectives: To test whether shorter periods to primary PCI improve coronary flow, myocardial perfusion and left ventricular systolic function. Methods: 170 patients with acute anterior STEMI treated by primary PCI were evaluated. Time periods from onset of chest pain to first medical contact (FMC) and from FMC to primary PCI (FMC- PCI) and from pain to primary PCI (Pain - PCI) were recorded. Results: Patients with pain-PCI<300 min, tended to achieve TIMI grade III more frequently (51%vs 33%), p=0.06 and more frequent MBG≥2, (53% vs 36%), p=0.08. Partial ST-elevation resolution was achieved more frequently in patients with pain- PCI<180min (87% vs 65%), p<0.05. Lower peak troponin levels were found in patients with pain- PCI<300 min (49.2±45.2 vs 84.2 ±43 ng/ml), p=0.03. In patients with pain-PCI< 180min, left ventricular ejection fraction (LVEF) increased by 10±8% vs 5.5±5%, p<0.05. In patients with pain-FMC < 90 and < 120 min the increase in LVEF was larger than in others, p<0.05. FMC- PCI less< 180min was associated with larger increase in LVEF, p<0.05. Conclusion: Decreasing pain to PCI intervals, improves myocardial perfusion and LVEF.
    Mariam Mostafa Al-Werdani*, Abdalrhman Mostafa Mokhtar, Ahmed Khaled Ebead, Enas El-Sherbeny, Abdel-Hady El-Gilany
    Aim of the study: To measure the levels of Basic Life Support (BLS) knowledge in medical students, Mansoura University, Egypt.
    Methods: Our cross-sectional study was carried out in Mansoura School of Medicine, Mansoura University, Egypt. Only Egyptian medical students from the subject-based learning system were allowed to participate. Using a self-reported questionnaire, we measured the number of students with good BLS knowledge, attending BLS courses, self-perceived ability to handle emergency situations, previous exposure to emergency situations, and the number of students wanting to learn more about BLS as a part of their curriculum.
    Results: With a response rate of 85%, only 5% of the participants scored 50% or more in the questionnaire. Using a cut-off point of 8 (added 1 SD to the mean BLS knowledge score), clinical students were 2.2 times (95% CI: 1.5 -3.1) more likely to achieve good BLS knowledge scores than preclinical students. Attending BLS courses, self-perceived ability to manage emergency situations, and being male were all independent predictors of good BLS knowledge scores, with adjusted Odd’s ratios of 1.7 (95% CI: 1.2-2.4), 2 (95% CI: 1.2-3.3), and 1.8 (95% CI: 1.3-2.6) respectively. Ninety-six percent of the study participants wanted to learn more about BLS as a part of their curriculum.
    Conclusions: Ninety-five percent of the students achieved poor BLS knowledge scores. Revisiting the BLS teaching strategies in the subject based system is strongly encouraged. We advise medical students to take BLS courses to raise their knowledge levels.
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