We present a case of a 15-year-old boy presenting with a 3-week history of fever whilst visiting relatives in the United Sates (US). Despite extensive workup, a definitive diagnosis was not reached. The clinical history and course of the disease required consideration of broad range of differential diagnosis. This case highlights the importance of clinical history and examination in the assessment of fever of unknown origin (FUO).
Acute coronary syndrome (ACS) encompasses unstable angina and myocardial infarction (MI). MI typically presents as chest pain that may radiate to the arm or jaw and is described as dull, heavy, tight, or crushing. However, it may present atypically with symptoms other than chest pain including epigastric pain, often described as burning in character or like indigestion. This is a case of a 51-year-old patient who presented with symptoms of epigastric pain, nausea and vomiting resembling gastroesophageal disease. The patient was initially evaluated by a physician as a non-urgent case of gastroenteritis. Following further assessment due to ongoing symptoms, he was diagnosed with ST elevation MI (STEMI) and treated according to ACS treatment guidelines. To accurately diagnose ACS, clinicians must demonstrate competent communication, history taking and physical examination skills, identify red flags and make use of appropriate investigations. Correct medications and timely referral to secondary care services is vital to prevent morbidity and mortality.
Background: Hypertension (HTN) is the leading preventable and modifiable cardiovascular risk factor. Diseases well known to be associated with hypertension have been discerned among the adult population within the state of Qatar. These include myocardial infarction (MI), stroke, obesity, diabetes mellitus, heart failure, dyslipidemia and erectile dysfunction. Our literature review aims to provide a review of the current literature on hypertension among the adult population within the State of Qatar. Methods: A review of studies published between 1982-2019 in the area of hypertension was conducted with the use of PubMed, using the key words “hypertension + adults+ Qatar”. We also used the reference list of all articles retrieved, and author names to expand our search that was used for this review. Hypertension in Children and Hypertension in Pregnancy was excluded from our search results. Results: A total of 17 studies were included for review, which included 9 cross sectional studies, 4 retrospective studies, 3 prospective studies and 1 matched case control study. In addition to diseases well known to be associated with hypertension novel associations have been observed. These include hearing impairment, potentially inappropriate prescribing and subclinical magnesium deficiency. There is a significantly greater prevalence of hypertension among individuals with a family history of consanguinity within the indigenous population of Qatar. Furthermore a greater morbidity and mortality from certain conditions associated with hypertension have been noted within this group. Conclusion: Prevalence of hypertension among adults within the State of Qatar is approximately 32% (16.8% - 32.1%) which is in keeping with current overall global estimates. Hypertension in the State of Qatar primarily affects the elderly population (above 50 years) and is associated with a number of morbidities including cardiovascular disease (CVD), congestive heart failure (CHF), obesity, ...........
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