Tuberculosis (TB) is a deadly disease that still remains a global burden despite of worldwide measures to curb the disease. As of 2015, the goals of the WHO STOP TB Strategy (2006-2015) have been met and the new WHO End TB Strategy (2015-2030) has been implemented with aim of eradicating the disease. Following that, further studies have demonstrated that TB is a disease that cannot be controlled purely by anti-tuberculous medication alone. It is widely understood that various factors such as rising income inequality, overcrowding populations, compliance to healthcare and resistance pose great barriers to the eradication of disease. In many developing countries including Malaysia, TB is showing or re-emerging trend in both reported cases and resistance. Various predictors for poor disease outcome have been mentioned in the literature such as demographic factors, socioeconomic instability and severe comorbidities amongst the population. Therefore, a prompt review and understanding of the factors at play in the sequestration of TB cases in high risk groups may better inform preventative measures in the future.
Introduction: Wolff-Parkinson-White (WPW) syndrome type B is a congenital condition involving abnormal electrical conduction between the atria and the ventricles that provide an accessory pathway (AP) for a re-entrant tachycardia circuit. Background: This case report illustrates a 28-year-old male who presented with multiple episodes of rapid, regular palpitations associated with dizziness and nausea. These episodes of palpitations often resolve spontaneously. Physical examination revealed normal first and second heart sounds with no audible murmurs. Other systemic examinations were unremarkable. A 12 lead electrocardiogram showed an atrioventricular re-entrant tachycardia (AVRT) of 210 beats per minute. Intravenous amiodarone was given to which he responded. Post pharmacological cardioversion, the repeated ECG showed shortened PR interval and broad QRS complexes associated with negative delta waves in lead V1, T-wave inversion in inferior leads and precordial leads of V5-V6 which represented a Type B pattern. He was then referred to the electrophysiology unit at the National Heart Institute for radiofrequency ablation (RFA) and Holter monitoring. Conclusion: Wolff-Parkinson-White (WPW) Type B should be considered as a differential diagnosis for a young individual who presents with frequent palpitations. RFA is well known as a permanent solution to the prevention of tachyarrhythmia.
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