SUDDEN ARRYTHMIC DEATH SYNDROME

Sudden arrhythmic death syndrome (SADS)

This syndrome corresponds to the abrupt death in adults and teenagers, generally during sleep (also known as nocturnal death). Such kinds of deaths occur in the people with complete distinction on the basis of genetic structure.

Reasons for such sudden deaths

According to the research people with such kind of syndrome may have-

1)        Past history of heart disease which could be associated with congenital reasons, defective myocardium structure and can also be related to drugs which heavily affects myocardial muscle layers and connective tissue and thus decrease conductivity and pumping ability of heart.

2)        As per the name of this syndrome arrhythmia which can be tachycardia or bradycardia is detected in these peoples is also the main cause; sudden increase in the diameter of myocardium (hypertrophy of ventricles) cause these symptoms.

Symptoms

+high blood pressure

+chest pain

+sudden palpitations

+radiating pain left side

+hyper excitability

+loss of consciousness due to heavy exercises

Diagnosis

-ECG

-CT scan

-echocardiography

Treatment

• Treatment depends upon the symptomatic state of the patient for instance patient is facing arrhythmia; propanolol, metaprolol like medications can be for relief purpose.

• Regular check should be considered for sportsperson who experience exercise related chest pain.                                        

                                           -by Dr.Ravi Ranjan

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CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Chronic obstructive pulmonary          disease (copd)

It is a combination of clinical signs of chronic obstructive bronchitis(inflammation of narrowing of bronchi) and emphysema(changes of lung tissue structure).COPD is irreversible disease increasing worldwide because of the increase in smoking in developing countries, the reduction in mortality due to infectious diseases and the widespread use of biomass fuels. Prevalence, incidence and mortality rates increase with age. Prevalence is higher in men, but total mortality is similar in both sexes.

ETIOLOGY

•       Cigarette smoking

•       Genetic factors (alpha1-antitrypsin deficiency)

•   Air pollution, airway infections

PATHOPHYSIOLOGY

*Inflammation –It generally occurs in our body due to foreign particle irritation after getting in contact with our epithelium, in this disease COPD inflammatory response is triggered by increase in activity of protease activity and decrease in anti protease activity which thus cause break down of elastin and connective tissue in our lungs and this causes problems in normal repair processes of tissues. In patients with COPD activated neutrophils and other inflammatory cells release proteases as a part of inflammatory process; protease activity exceeds anti protease activity and tissue destruction and mucous hyper secretion starts.

* Infection – Smoking and airflow obstruction may lead to impaired mucus clearance in lower airways, which predisposes to infection.

* Airflow limitation – due to mucus hyper secretion, mucus plugging, mucosal edema, bronchi spasm all these mechanism occur due to airway obstruction. As alveolar wall destroy due to loss of elastic recoil and lung hyperinflation.

CLINICAL SIGNS

- Productive cough

- Dyspnea

- Wheezing

- Lung hyperinflation

- Decreased heart and lung sounds

- Increased anteroposterior diameter of the thorax

- Cyanosis of skin and lips

DIAGNOSIS

+ Pulmonary function tests- that is forced expiratory volume test (FEV1), Forced vital capacity test (FVC).

+ Instrumental and laboratory tests-chest x-rays, CT scan.

+Adjunctive tests –alpha1-antitrypsin levels, ECG, CBC, Sputum analysis.

TREATMENT

·     Inhaled bronchodilators –these includes beta agonists like Fenoterol , salbutamol and anti cholinergic; tiotropium bromide is used over ipratropium as powder formulation , corticosteroids; fluticasone and beclamethasone are used

·     Supportive care(stopping smoking, oxygen therapy, pulmonary rehabilitation)

·     Metered dose inhalers (MTIs) or dry powder inhaler is preferred over nebulizer home treatment.

·     Theophylline, oxygen therapy, vaccinations and pulmonary rehabilitations are widely used.

·     Expectorants and mucosolvents lasolvan ,acetylcysteine are used in order to dissolve the drainage function of bronchi

·     Antibiotics are recommended for exacerbation in patients with purulent sputum. If the infectious organism is resistant, amoxicillin, fluoroquinolones, cephalosporin’s of 2^nd generation and extended spectrum macrolides are indicated.

  

                                                                                                             

                                                                                                             -by Dr. Ravi Ranjan

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Treatment of novel corona virus

Treatment of  novel Corona Virus 

The Taizhou government in Zhejiang province in china announces on Sunday the treatment of most dangerous novel corona virus.

First antiviral drug approved for fighting against corona virus known as Favilavir. It is the first anti-viral drug that has been approved for marketing by the National Medical Products Administration since its outbreak. Developed by Zhejiang Hsian Pharmaceutical Company, the drug is expected to play an important role in preventing and treating the epidemic, the government said on its official WeChat account.

Favilavir is one of three drugs that have shown significantly efficiency in treating the novel corona virus in clinical trials, the minister of science and technology said on Saturday.

The Favilavir antiviral drug approved on Sunday.

China has launched a few trials that test chloroquine, a malarial drug that killed off the new corona virus in cell culture. About 15 trials listed in china’s registry expect to enroll a total of more than 2000 people in studies on a variety of traditional Chinese medicines .one of the largest among them assesses shuanghuanglian , a Chinese herbal medicine that contains extract6s from the dried fruit ,which is purported to have been used for treating infections for more than 2000 years. The trial has 400 participants including a control group given standard care but not a placebo therapy
                                                                                                   -BY DR. RAVI RANJAN

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RHEUMATIC DISEASE

                RHEUMATIC DISEASE

They are characterized by affect of collagen or connective tissue due to disturbances of immune homeostasis . Disturbances of immune homeostasis leads to development of autoimmune reactions,formation of the toxic immune complexes and sensibilizated cells ,injury of microcirculation with following systemic progressive disorganization of connective tissue.

What are the characteristics of this diseases?

Presence of chronic infectious focus.

Presence of early systemic changes of microcirculation.

Presence of hypersensitivity of immediate type with development of exudative-necrotic reactions and hypersensitivity of delayed type with formation cellular infiltration.

Systemic progressive disorganization of connective tissue that includes : some cellular reactions like swelling and sclerosis.

Genetic and environmental factors are important for development of these diseases.

                                          

Ø So much rheumatic diseases are defined in medicine some of which we are going to discuss and get to know about are rheumatic fever ,rheumatic heart disease ,rheumatic valvulitis and about the extra cardiac lesions.

•   RHEUMATIC FEVER(RF)

Rheumatic fever is an inflammatory process which can involve the heart joints ,central nervous system ,skin and subcutaneous tissues. It generally effects children from 5-15 years age.

·      The chronic stage of RF involves all the layers of the heart causing major heart diseases known as rheumatic heart disease; this may lead to some other connected diseases such joint pains and many more.

What is its etiology

 The bacteria which causes this disease this is beta-hemolytic streptococci group A. But only a some proportion of patients with this infection may get affected with rheumatic fever; the attack rate generally very low.

The symptoms of RF appear after a delay of 2-3 weeks and are not due to direct infection, these lesions have immune pathogenesis that is due to type 2 hypersensitivity reactions.

   

• RHEUMATIC HEART DISEASE

RHD or cardiac lesions –inflammation that involve the interstitial tissue of all the three layers of the heart (pancarditis).

This includes :

1.  Rheumatic endocarditis

2.  Rheumatic myocarditis

3.  Rheumatic pericarditis

What are its symptoms?

ü Fever

ü Arthralgia that is pain in joints

ü Prolonged PR interval

ü Increased ESR

ü Leucocytosis

ü Nodules formation in joints

ü Erythematic

ü chorea

How can it be diagnosed?

•     Blood tests

•       X ray

•       ECG

•      MRI  and CT scans

•      Fluid test from joints

Finally how could we treat this diseases

§  Majorly anti inflammatory drugs(ibuprofen, naproxen) and corticosteroids are used as medications for treating joint pain and inflammation.

§  We can also do some physical therapies in patients such as hot and cold therapy 

§  Specific exercises can be done to regain  joint flexibility and muscle strength  

                                          

                                                                          -BY DR.ravi ranjan
                                            -Dr.tanya sharma

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