No abstract

ObjectiveTo study the in-hospital outcome of adult patients who had undergone surgical repair for Tetralogy of Fallot.MethodsA retrospective descriptive study was conducted at the Punjab Institute of Cardiology searching the hospital records. All those adult patients who had undergone repair for Tetralogy of Fallot from January 2012 to December 2014 were included in the study. All the patients were operated by the same surgical team. Patients who underwent primary repair as well as those with previous palliative procedures were included in the study. Thirty days outcome was studied by recording variables from the database. Data was analysed using Statistical Package for Social Sciences version 16.ResultsA total of 80 patients was included in the study, in which there were 48 (60%) male patients and 32 (40%) female patients. Mean age was 21±0.21 years. Those with previous palliation were 15 (18.75%). The associated problems observed were: atrial septal defect 27 (33.75%), right aortic arch 30 (37.5%), patent ductus arteriosus 6 (7.5%) and double outlet right ventricle 3 (3.75%). In-hospital mortality recorded was 7 (8%). Postoperative complications encountered were low cardiac output syndrome 9 (11.25%), pleural effusion requiring tapping 3 (3.75%), reoperation for bleeding 3 (3.8%), pulmonary regurgitation (moderate to severe) 20 (25%) which occurred in the transannular patch group only and atrial arrhythmia 4 (5%).ConclusionA large number of adult patients are still operated for tetralogy of Fallot in Pakistan. With increasing experience in the technique the mortality and morbidity is comparable to international literature.

Patient: Male, 40Final Diagnosis: CMV colitisSymptoms: Abdominal pain • diarrhea • jaundiceMedication: —Clinical Procedure: Flexible sigmoidoscopy • colonoscopySpecialty: Family MedicineObjective:Rare co-existance of disease or pathologyBackground:Infection with gastrointestinal cytomegalovirus in an immunocompetent host is a rather rare occurrence in the literature. There are a few reports of gastrointestinal infection in the immunocompetent who are then subsequently given a new diagnosis of inflammatory bowel disease. It is speculated that the initial cytomegalovirus colitis infection triggers the onset of inflammatory bowel disease.Case Report:Herein we report a case of cytomegalovirus colitis and new diagnosis of inflammatory bowel disease identified in a 40-year-old immunocompetent adult man who presented with gastrointestinal symptoms and disseminated cytomegalovirus infection requiring anti-viral therapy, which successfully treated the episode of cytomegalovirus infection. He then went on to have persistent symptomatic inflammatory bowel disease confirmed by pathology.Conclusions:In this paper we will review the literature and explore the rare case of cytomegalovirus colitis in the immunocompetent host and discuss the pathology, physiology, diagnosis, and treatment of cytomegalovirus colitis.

The Backpack Medicine Program (BPM) at Ventura County Medical Center, in partnership with the Ventura County Health Care Agency, created the BPM COVID Response Team to address health care needs exacerbated by the COVID-19 pandemic among individuals experiencing homelessness. Over four weeks, the BPM COVID Response Team tested more than 150 patients and identified 24 positive results. The Ventura County Health Care Agency has provided temporary housing to more than 400 people among three different cities across Ventura, California. (Am J Public Health. Published online ahead of print November 19, 2020: e1–e3. https://doi.org/10.2105/AJPH.2020.305956 )