Introduction: Wellens syndrome or anterior interventricular artery (AIV) disease is an electrocardiographic abnormality defined by the presence, apart from painful episodes, of biphasic T waves in the anterior leads (type 1), or deeply inverted T waves (type 2) in association with critical stenosis of the proximal AIV. It warrants aggressive management given the rather high incidence of death and re-infarction. Objectif: To report an atypical form of this syndrome through this observation and to provide an update on this rare entity through a literature review. Case report: A 48-year-old patient, chronic smoker with 40 BPs still active, admitted following an episode of infarct chest pain. At admission, the patient was asymptomatic. The clinical examination was unremarkable. The ECG showed biphasic T waves, negative in its terminal part in V2-V3-V4, without planed R waves, nor Q waves of necrosis or significant ST abnormality evoking a WELLENS type 1 syndrome. Ultrasensitive troponin was measured at 260 ng/L. The evolution was marked by the appearance of a fleeting negativation of T waves, without chest pain. Chest echocardiography showed a non-dilated left ventricle with preserved systolic function and no detectable segmental or global kinetic disorders, associated with concentric left ventricular hypertrophy. The coronary angiography performed in emergency shows tritroncular lesions, a very tight stenosis of the middle interventricular and the first diagonal, a tight stenosis of the middle circumflex and the middle right coronary, revealing a coronary artery bypass graft. Discussion and conclusion: Wellens syndrome is characterized by T-wave abnormalities that often fluctuate (from type 1 to type 2 or vice versa) during pain-free intervals, reflecting spontaneous reperfusion and the unstable nature of the coronary lesion found, which is represented mainly by involvement of the proximal AVI. Involvement of the middle IVA associated with other lesions is rarely observed. It is associated with a greater risk of anterior infarction or sudden death if not recognized and treated rapidly, so it seems essential to recognize the electrocardiographic criteria of this syndrome in order to propose coronary angiography for early revascularization.
Case Report
May 20, 2022
Wolff-Parkinson-White Syndrome during Pregnancy, What Risk and What Management: About 03 Cases with Literature Review
Abdelilah Ben El Makki, Meriem Benani, Malilki Alaoui Mohamed, Hicham Bouzelmat, Atif Benyas, Ali Chaib
Page Numbers : 282-285
DOI : 10.36348/sjm.2022.v07i05.007
Wolff-Parkinson-White (WPW) syndrome is a relatively rare cardiac rhythm disorder entity encountered during pregnancy. However, its exacerbation under this physiological condition could be responsible, in certain cases, for life-threatening arrhythmias compromising both maternal and foetal prognosis. We report the observations of 03 pregnant women, without past medical history, presenting to the emergency room for palpitations related to a Wolff-Parkinson-White syndrome, complicated in one case with foetal death. The substantial severity of the WPW syndrome during pregnancy requires a prompt and adequate management strategy, based on a multidisciplinary cooperation between obstetricians, cardiologists and neonatologists.
Original Research Article
May 20, 2022
Non-Valvular Atrial Fibrillation Cardioversion: Experience of the Cardiology department of Mohammed V Military Teaching Hospital
Abdelilah Ben el Makki, Meriem Benani, Jaouad Ngadi, Hicham Bouzelmat, Atif Benyas, Ali Chaib
Page Numbers : 278-281
DOI : 10.36348/sjm.2022.v07i05.006
anticoagulation therapy would be the removal of this arrhythmia and any future recurrence, a goal often difficult to achieve.The aim of this work is to evaluate the efficacy of atrial fibrillation cardioversion as well as the success predictive factors of sinus rhythm maintenance at one year following a successful cardioversion. Materials and methods: 50 patients with non-valvular atrial fibrillation underwent cardioversion: 70% by electrical shock and 30% by pharmacological means, the clinical characteristics of the patients the results of cardioversion and follow-up were collected and analyzed. Results: The average age of our patients was 53 years with a sex ratio of 2. 30% of patients had hypertensive heart disease, 8% ischemic heart disease, 8% dilated cardiomyopathy and the rest had no underlying heart disease. The average diameter of the left atrium was 41 mm and the average surface area was 20 cm². Primary success rate of cardioversion was 82% with better efficacy of electric shock compared to pharmacological cardioversion. The maintenance rate of sinus rhythm at 1 year was 70%. Predictive factors of failure and / or recurrence at 1 year were old atrial fibrillation and significant dilation of the left atrium. Conclusion: This study confirms the interest of atrial fibrillation cardioversion and underlines the importance of preliminary selection of the patients, such a selection must be made on the basis of the predictive factors of success usually recognized in the literature.
Original Research Article
May 17, 2022
Epidemiology of Biliary Lithiasis in a Moroccan Rural Population: Results of a Screening Survey Including 1358 Citizens
Sarra Bahja, Wafae Hammoumi, Mouna Figuigui, Hakima Abid, Mounia El Yousfi, Dafr Allah Benajah, Mohammed El Abkari, Sidi Adil Ibrahimi, Nada Lahmidani
Page Numbers : 272-277
DOI : 10.36348/sjm.2022.v07i05.005
Biliary lithiasis is a very frequent and benign pathology but can be the cause of rich and varied symptomatology as well as serious complications. Our study aims to estimate the prevalence and some risk factors of biliary lithiasis and especially to look for the correlation between this pathology and anthropometric measurements. Therefore, we conducted a campaign that included 1358 citizens to perform ultrasound screening for biliary lithiasis, hepatic steatosis, and hydatid cyst. In our study, the prevalence of biliary lithiasis was 19.2%. The average age was 47.7 years with a predominance of women, i.e. a percentage of 76.6%. The risk factors significantly associated with gallstones were abdominal obesity, male sex, and age below 40 years were protective factors, however, neither diabetes nor a history of hypercholesterolemia was associated with the risk of gallstones.
Original Research Article
May 17, 2022
Tetanus Toxoid Vaccination Status of Women in Baghdad
Background: Immunization remains one of the paramount public health interventions and a cost effective method to reduce both the ailment and death associated with infectious diseases. Uptake of vaccination is dependent not only on providing of the vaccination services but also on other influences including awareness and practice of women. Objectives: To assess tetanus toxoid immunization status of mother’s. In addition, to address the factors influencing their immunization status. Method: Cross sectional study conducted in ten primary health care centers in Baghdad for the period from February until the end of October 2020. Convenient sample of mothers, who had delivered a live baby within the previous 12 months from the study and attended the selected primary health care centers in Baghdad were recruited. An interview questionnaire used to collect data regarding history of tetanus toxoid vaccine up take of the mothers during their last pregnancy. Results: The total number of mothers enrolled in the study was 400, 214(53.5%) of them were received tetanus toxoid vaccine (TTV) during their last pregnancy. 127(59.3%) of the mothers were uptake two doses of TTV. Among the study group, 31.75% of mothers were considered as immunized according to WHO classification. Age of mother, education, and respondents’ working status; alongside with antenatal care attendance and place of delivery all had insignificant impact on the immunization status. Lack of time was the main reason for not vaccination (22.6%). Conclusion: Tetanus toxoid immunization coverage was inadequate. For that reason, immunization campaigns targeting enhanced utilization of immunization services by mothers and women of childbearing age are highly recommended.
Original Research Article
May 14, 2022
Influence of Family Structure and Parental Occupation on Examination Stress of Secondary School
Adegboro JS , Ajayi NO
Page Numbers : 254-263
DOI : 10.36348/sjm.2022.v07i05.003
Background: Parents do experience stress from their family structure and occupation, and these stress can be transferred to their children. Since the stress imposed by the different occupations and the different family structures are different, the stress transferred to the children will depend on the occupation and family structure of their parents. Objective: This study was therefore designed to understand the influence of the stress incurred by parents from their family structure and occupation on the academic/examination stress of their children in Oroke High School Akungba -Akoko, Ondo State, SW Nigeria. Method: The population of the study comprises all the students of Oroke High School, Akungba Akoko (650) out of which a sample of 313 that satisfied our criteria was selected, using purposive sampling technique. Digital sphygmomanometer was used to measure the actual blood pressure readings of the respondents twice, with at least thirty minutes interval in sitting positions. The mean reading was used. The measurements were carried out three times during the study: two weeks after resumption for the second term of the 2017/2018 academic year, two weeks before the second term examination and four weeks after exam. Results: Students were grouped according to their family structure and also according to the occupation of their fathers or their mothers. The study finds that the systolic blood pressure generally increases as students go from the beginning of the term to two weeks before the terminal examination and decreases after the exam for the different types of family structure and occupation of their fathers or their mothers when the academic stress is removed. Conclusion and recommendation: Under whatever stress that parents may be, it is recommended that they should make the home environment congenial and stress less for study so that the children can go to school the next day with little or no transferred stress.
Original Research Article
May 10, 2022
Perception of Faculty and Students Regarding Effectiveness of Online Experience, a Cross-Sectional Study
Saba Iqbal, Rehan Uddin, Naeem Naqi, Tahir Mukhtar Sayed, Gul Muhammad Shaikh
Page Numbers : 249-253
DOI : 10.36348/sjm.2022.v07i05.002
Background: The Education system has taken a 180-degree paradigm shift since Covid-19 wrapped up the prevailing global system. Now educational system used made electronic communication devices the prerequisite. Not only were the students, parents, and teachers dragged out of their comfort zone to learn and stretch their expertise in the digitalization of education and work. The endeavor has brought us to set standards and meet the needs of new standers. This study aimed to discover the suggestions of students and faculty to deal with the resentment that is being experienced with this online facade. Methodology: Cross-sectional study from March to May 2020, total participants was 523 including male and female medical students and faculty. Ethical approval was obtained from Ethical committee CMH Lahore Medical College and Institute of Dentistry (CMH LMC & IOD). Verbal informed consent was obtained. Self-administered questionnaires were given to the participants. Results: E-Learning opportunities need to be taught explicitly. Modern tools are the need of time. The faculty needs to understand student psychology as well as the application of modern tools and gadgets. Conclusions: E-learning posed a technological divide among the faculty members and students. The pandemic allowed us an opportunity to explore the realms of the digital world and expand our horizons to challenge the already existing medical education system, curriculum, and mode of its execution.
