Evidence-Based Homoeopathic Treatment of Acute Herpes Zoster (Shingles): A Case Report

Herpes zoster (HZ), also known as shingles, occurs due to reactivation of varicella zoster. It is manifested by unilateral, painful, vesicular rashes following a dermatome. Homoeopathy is well known for its tremendous results in chronic cases. This article presents the evidence-based significant result of single homoeopathic remedy in an acute case of HZ within a short time period without any post-herpetic neuralgia which usually follows the HZ for months. Three to four doses of Hypericum 30 CH provided significant relief within a day and complete recovery within 10 days. Modified Naranjo score is 9, indicating definite causal attribution. This case proves that by selecting appropriate similimum, promising and positive results are achieved by homoeopathy, be it acute or chronic cases in a safe and gentle way. No such existing homoeopathic literature provides any characteristic information particularly related to HZ in Hypericum. So, future research and clinical trials could be beneficial for better validation of Hypericum as a therapeutic for HZ.

The pathogenesis, epidemiology and biomarkers of susceptibility of pulmonary fibrosis in COVID-19 survivors

Pulmonary fibrosis (PF), a pathological outcome of chronic and acute interstitial lung diseases associated to compromised wound healing, is a key component of the “post-acute COVID-19 syndrome” that may severely complicate patients’ clinical course. Although inconclusive, available data suggest that more than a third of hospitalized COVID-19 patients develop lung fibrotic abnormalities after their discharge from hospital. The pathogenesis of PF in patients recovering from a severe acute case of COVID-19 is complex, and several hypotheses have been formulated to explain its development. An analysis of the data that is presently available suggests that biomarkers of susceptibility could help to identify subjects with increased probability of developing PF and may represent a means to personalize the management of COVID-19’s long-term effects. Our review highlights the importance of both patient-related and disease-related contributing risk factors for PF in COVID-19 survivors and makes it definitely clear the possible use of acute phase and follow-up biomarkers for identifying the patients at greatest risk of developing this disease.

Chimney Grafts in Acute Endovascular Aortic Repair Due to Ruptured Abdominal Aorta Aneurysm

Parallel grafts, or chimney grafts, are at times a good solutions for EndoVascular Aorta repair (EVAR) in ruptured cases. These photoes shows an acute case with uni-chimney left kidney with succesful outcome.

PROBLEM BASED PHYSIOTHERAPY INTERVENTION PROGRAM IN MANAGING CHEST AND MOBILITY ISSUES IN AN ACUTE CASE OF GUILLAIN BARRE SYNDROME

Guillain - Barré syndrome (GBS) is a rare neurological condition described as demyelination of the peripheral nervous system (PNS) as a result of an immune system attack. In about 70 percent of patients, it is characterized by acute paralysis, and when the respiratory system is involved, it could become more life threatening for the patient. A further complication due to peripheral nerve demyelination greatly decreases the functional capacity of the patient to perform everyday activities. The present case report is of a 58-year-old male admitted into the hospital with history of weakness and impaired motor skills. Physiotherapy intervention primarily focussed on strength and functional activities. The primary objective of this case study was to determine the reaction of the patient to physiotherapy for reinforcement and functional tasks. In terms of strength and also functional tasks, we would like to conclude that the patient's response in the initial stages of recovery was profoundly sound.

Long COVID Patient Symptoms and its Evaluation and Management

While the acute case burdens and deaths from the COVID-19 pandemic (in Nepal approaching 700,000 and 10,000 respectively) have been costly, the characteristics and potentially huge dimensions of the chronic disease sequelae of this infectious disease are only slowly becoming apparent. We reviewed Pub Med, major medical meeting and medical journal, and investigative journalist materials seeking to frame and describe COVID-19 chronic disease. The consequences of COVID-19 infections follow major organ damage, and induction of immunological and hormonal systems dysfunction. The first injuries are consequent to direct viral effects on tissues, and vasculitis, endothelialitis, thrombosis and inflammatory events. Pulmonary, cardiac, brain, and kidney tissues incur function-limiting damage, with dyspnea, arrythmias, decreased exercise capacity, cognitive dysfunction, and decreased glomerular filtration rates. The second process is characterized by immune dysregulation and autoimmunity, and dysfunction of hormonal regulation systems, with high, fluctuating levels of physical and mental fatigue, multiple-site pain and ache, and non-restorative sleep, in 10-30% of cases. This communication proposes evaluation and management of chronic COVID-19 patients with efficient assessment of commonest symptoms, targeted physical examination and organ function testing, and interventions based on specific organ functional status, and experience with similar chronic immune syndromes, such as myalgic encephalomyelitis.

Toxoplasma Retinochoroiditis with Chorioretinal Neovascularization in a Young Patient

We present a pediatric case to highlight the clinical appearance and management of choroidal neovascularization in the setting of active toxoplasma retinochoroiditis (TRC). A 17-year-old female presented with 2 days of blurry vision in her left eye. Retinal examination demonstrated a pigmented chorioretinal lesion with associated subretinal fluid, vessel sheathing, and adjacent intraretinal hemorrhage. She was diagnosed with active choroidal neovascularization and successful treatment with bevacizumab revealed an underlying active toxoplasmosis lesion. Choroidal neovascularization may rarely present during an acute case of TRC. Dual therapy with anti-vascular endothelial growth factor antibody and anti-parasitic agents leads to improved visual outcomes.

The role of Toxoplasma gondii in concentration of some sex hormones in infertile individual: أثر الإصابة بطفيلي المقوسة القندية على تراكيز بعض الهرمونات الجنسية عند الأشخاص العقيمين

The main objective: Link the incidence of the Toxoplasma gondii present and manifestations of some sex hormones ‎ at ‎infertile persons.‎ Follicle-stimulating hormone (FSH), 17-β Estradiol (E2), and testosterone are key ‎regulators for the development ‎and progress of germline cells. Also affect many defensive ‎functions to the ‎immune system. Toxoplasma gondii attempts to manipulating these ‎Hormones concentration to their survive. ‎ ‎The study methodology‎‏:‏‎ since October 2018 tell 31th March 2019, 100 samples of the blood of ‎infertile ‎patients have been collected from both sexes from outpatient clinics in ‎different areas of ‎Qadisiyah governorate, Iraq. All there examined with Elisa test to detect IgM and IgG ‎antibodies against T. gondii and to estimate concentration of sex hormones. ‎ Results: ‎ 39 samples (39 %) were positive to T. gondii. IgM positive ‎samples were (6 and ‎‎10) with (12% and 20%) at male and female, Positive IgG samples for male ‎and female were (10 and 13) ‎with (20% and 26%).‎ In male, Testosterone ‎concentrations were increased in infected where were (5.4 and 5) ng/ ml with IgG and IgM ‎test. Also E2 were (33.6 and 35) pg/ ml with IgG and IgM infected men ‎. While FSH concentrations were decreased in (12.1 and 12.3) IU with IgG and ‎IgM. In female, FSH and E2 concentrations were increased in infected female, ‎where were (5.45 and 5.9)IU/ ml and (260 and 250)pg/ ml from both hormones with IgG ‎and IgM test. Testosterone concentration was decreased (0.98)ng/ ml with IgG, ‎but increased (1.35) ng/ ml with IgM in female. ‎ ‎The study has been showed that a significant difference in the concentrations ‎of hormones studied ‎between non-infected and infected samples in ‎the acute case, and did not register a ‎significant difference between ‎chronic infection and non-infection, a significant increase ‎in ‎hormones Testosterone and E2 in male and female while FSH in ‎female only, FSH ‎concentration was lower in male after infection.‎ Conclusion: in light the study results the author see that: Infection with the parasite is associated with significant changes ‎in the ‎concentrations of sex hormones in infertile peoples, therefore ‎it can be said that infection ‎with Toxoplasma gondii is one of the ‎main causes of infertility in both sexes.‎ ‎ ‎Suggestions:‎ ‎Conduct broader studies by examining more people and ‎determine the relationship ‎between infertility and sex hormone ‎concentration with infection by T. gondii in girls and ‎boys before ‎or after puberty.‎

Comparative Study Of Open Cholecystectomy In Acute And Chronic Cholelithiasis In Rural Centre Of India.

The incidence of cholecystitis with cholelithiasis is increasing day by day either acute or chronic cases. Gall stones are the most common cause of acute cholecystitis in 90-95% of the cases. The management of acute cholecystitis is still laparoscopic cholecystectomy in urban area of India but in rural area open cholecystectomy is still preferred method of surgery for acute as well as chronic gall stone. Our study was conducted on 100 patients divided into two groups of 50 of each to compare the results of open cholecystectomy between acute and chronic cases. The overall post-operative morbidity was more in acute cases. But there was significant difference in the total hospital stay and total cost of the therapy in both the groups. drain output was also high in first three days in acute case so, acute case cholecystectomy was found to be more expensive overall and higher length stay and more co morbidities than chronic cases.

Eco-epidemiologic profile of an area of a Chagas disease outbreak: the risk of oral transmissions in the Brazilian northeast

Chagas disease is a neglected tropical disease strongly associated with low socioeconomic status, affecting nearly 8 million people – mainly Latin Americans. The current infection risk is based on acute case reports, most of which are typically associated with oral transmissions. In the semi-arid region of Northeastern Brazil, serious outbreaks of this transmission type have surged in the last years. One of those occurred in the city of Marcelino Vieira (2016), in the state of Rio Grande do Norte. Rural residents of four municipalities surrounding Marcelino Vieira ingested sugar cane juice – which was probably ground with Trypanosoma cruzi infected insects. The structure of domiciliary unities (DUs) in the rural area of Marcelino Vieira was investigated to better understand the factors related to the outbreaks in this region – which was combined with entomological indicators. We found triatomines (mainly Triatoma brasiliensis) in 54% (36/67) of DUs and all rocky outcrops inspected (n = 7). Overall, 26% (119/458) of examined T. brasiliensis were infected by T. cruzi in artificial ecotopes, with almost the same prevalence in the sylvatic environment (23%; 35/154). The local variation in T. cruzi prevalence (variating from 0%-100%) was highly correlated with the presence of some ecotopes where the insects were found; and we identified those linked to high natural triatomine infection prevalence by T. cruzi (mainly wood/tile/brick piles). Ninety-five percent of people interviewed recognized the triatomines and knew the classic route (vector-borne) of transmission of disease. However, only 7.5% admitted knowledge that Chagas disease can also be acquired orally – which poses a risk this transmission route currently recognized. Here, we highlight the physical proximity between humans and infected vector populations as an additional risk factor to oral/vector contaminations, providing recommendations to avoid further outbreaks.