The CREATE-ECLA Randomized Controlled TrialThe CREATE-ECLA Trial Group Investigators* See also pp 427 and 489.
Introduction: Acute myocardial infarction is the most important and feared consequence of coronary artery disease. STEMI is the one of that kind and it occurs by formation of a vulnerable plaque from atherosclerosis and transforms into coronary artery thrombosis in the end. Streptokinase has been used as a thrombolytic agent in patients with acute STEMI. It combines with the circulatory plasminogen to form an activator complex and it converts into plasmin, where, the plasmin breaks the fibrin complex in the blood clot. Streptokinase can be given as 1,500,000U a slow I.V infusion over 30 min. Each STEMI subject is different with the aetiology, pain, ST segment elevation. By considering these factors the clinical efficacy of streptokinase will be evaluated. Materials and Methods: A total number of 75 subjects presenting with acute STEMI to the department of cardiology, King George Hospital, Visakhapatnam, and, those were thrombolysed with streptokinase are included in the study. pain was assessed before and 90 min after administration of streptokinase on numerical pain rating scale from 0-10. ST segment resolution was assessed as percentage reduction in ST segment elevation before administration of streptokinase and the reduction of ST segment elevation 90 min after administration of streptokinase. Student t-test and chi-square test were applied to evaluate the results by using software SPSS. Results: A significant resolution in the pain and ST segment elevation were identified by comparing the numerical pain rating scale and ST segment elevation on pre and post streptokinase administration. Conclusion: Streptokinase has been shown to have significant effect on pain resolution and ST segment resolution in subjects with acute ST segment elevation myocardial infarction.
The World Health Organization declared the 2019–2020 COVID Emerging coronaviruses are constant global public health threats to society Governments are under increased pressure to stop the outbreak of a global health emergency. In this situation, preparedness, transparency, and sharing of information are crucial. Multiple ongoing clinical trials are conducted for the development of vaccines and antivirals against CoVs. Up to date, there is no specific treatment proven effective against this COVID19. In addition, no vaccine has been licensed by the WHO to prevent MERS-CoV infection thus far. This spillover event is pandemic and a Public Health Emergency of International Concern. Due to its emerging cases day by day there is a need for everyone to act responsibly by taking preventive measures like wearing the masks and avoiding unnecessary outings as possible. There are certain reasons not to get panic regarding a situation like We to know why at it is - we had been identified the virus; We know how to detect-there had many tests to identify; Most cases are mild -about 81% of cases are mild and high recovery rate is seen; Symptoms are mild in young; The virus can be destroyed on the surface; Vaccines are in progress; Many drugs are effective in treating the COVID19. Voluntary reporting of the symptoms helps to prevent the spread of disease. this review details about the origin of the virus, introduction to the anatomical features and pathology, clinical manifestations, its diagnostics, treatment, preventive measures to health workers, and to public.
Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder that involves any part of the colon starting in the rectum in a continuous fashion presenting typically with symptoms such as bloody diarrhea, abdominal pain, and rectal urgency.The clinical presentation of the disease usually dictates the choice of pharmacologic therapy, where the goal is to first induce remission and then maintain a corticosteroid-free remission. UC is diagnosed based on clinical presentation and endoscopic evidence of inflammation in the colon starting in the rectum and extending proximally in the colon. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding.
Portal hypertension is an increase in the blood pressure within the system of veins called the Hepatic portal venous system. Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver. If the vessels in the liver are blocked due to liver damage, blood cannot flow properly through the liver. As a result, high pressure in the portal system develops. This increased pressure in the portal vein may lead to the development of large, swollen veins (varices) within the esophagus, stomach, rectum, or umbilical area (belly button). Varices can rupture and bleed, resulting in potentially life-threatening complications. We present a case of portal hypertension with massive ascites- A 43-year-old female was admitted with chief complaints of abdominal distension, abdominal pain, and shortness of breath prior to 15 days of presentation and the symptoms were gradually progressive in nature. Her past medical history reveals she had similar complaints in the past and known cases of chronic liver disease. After admission, she has been diagnosed with portal hypertension along with Refractory ascites. The management included antihypertensives and human albumin, A high protein diet with salt and fluid restrictions, large-volume paracentesis procedure was carried out daily.
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