Journal of Acute Disease

45-50

Authors: Maryam Ziaei, Hojjat Rastegari Najafabadi, Mahjoubeh Keykha, Mehdi Galavi, Ali Abdolrazaghnejad, Alireza Bahmani

Objective: To investigate the therapeutic effects of supplemental oxygen on patients with myocardial infarction. Methods: This study was a randomized, double-blind clinical trial. The study population included all patients who were admitted to the emergency room of Ali-ibn-Abitaleb and Khatam-al-Anbia hospitals in Zahedan within six hours of the onset of classic symptoms of myocardial infarction. The patients (n=47) were divided into two groups: the case group (with oxygen therapy) and the control group (without oxygen therapy). The initial follow-up was evaluated after one month and the second follow-up was evaluated after three months in the target population in terms of mortality caused by acute myocardial infarction, mortality caused by any other cause, and re-hospitalization caused by acute myocardial infarction. Results: Out of the 47 patients, 27 were male (57.4%). The average age of the patients was (60.9±8.1) years. One month after admission, 2 patients (8.7%) in the case group and 2 patients (8.3%) in the control group died due to acute myocardial infarction. A total of 7 patients (14.9%) died three months after admission. There was no significant difference between the control and case groups in terms of mortality caused by acute ischemia within one and three months. After one month, 2 patients (8.7%) in the case group and 1 patient (4.2%) in the control group died of other causes. After three months, 4 patients (8.5%) in total died for other causes. There was no significant difference between the control and case groups in terms of mortality due to other causes within one and three months. One month after admission, 5 patients (21.7%) of the case group and 4 patients (16.7%) of the control group were re-hospitalized due to acute myocardial ischemia. During the next three months, 3 patients (13.0%) of the case group and 5 patients (20.8%) of the control group were re-hospitalized. There was no significant difference between the control and case groups regarding the rate of re-hospitalization caused by acute myocardial infarction within one and three months after admission. Conclusions: There is no significant relationship between oxygen therapy and death by acute myocardial ischemia, or any other causes. The relationship between oxygen therapy and the rate of re-hospitalization caused by acute myocardial ischemia is not found within one and three months after admission. The results show that oxygen therapy does not affect patients with acute myocardial ischemia within three months after admission.

57-60

Authors: Pankaj Jain, Manoj Sharma, Manoj Seval, Pramod Meena

Objective: To study epidemiology, clinical manifestations, and laboratory parameters of scrub typhus in Hadoti region of Rajasthan, India. Methods: A cross-sectional study was conducted on 50 patients with scrub typhus between August 2022 and November 2022. Scrub typhus was diagnosed by ELISA IgM scrub typhus antibody. The data about demography, vital parameters, and lab investigations were collected and analyzed. Results: Ninety-two percent of the patients were from a rural background (92%), 86% were farmers and the majority were females. Most patients were 40-60 years old. The major complaints were fever (100%), myalgia (100%), headache (82%), and body swelling (80%). Major complications were pneumonia (68%), multiple organ dysfunction syndrome (62%), hepatitis (44%), and acute kidney injury (42%). Triglyceride levels were >200 mg/dL in 80% of patients, albumin <3.5 g/dL in 98% and eschar mark was present in 24% of patients. Conclusions: Scrub typhus is a serious acute febrile illness that can lead to multi-organ dysfunction and is associated with significant mortality. Increasing awareness regarding disease in endemic regions, early screening of patients, and treatment as early as possible could help prevent the patient from severe life-threatening complications.

67-72

Authors: Mudita Sharma, Digpal Singh Chundawat, Rohit Richhariya, Sunil Kumar Tailor, Shatrughan Pareek

Objective: To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic. Methods: This cross-sectional study conducted from May to July 2021 enrolled 694 participants. An online questionnaire based on Google Forms was developed to collect the data. Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale. Results: The age of participants were 27 (23-52) years old. The majority of respondents (73.5%) felt moderately stressed. Of the 694 participants, 83.0% of the 576 participants had average stress management skills. Sex, marital status, and profession were significantly associated with perceived stress. In addition, marital status and profession were significantly associated with coping capacity. Conclusions: The majority of participants have moderate stress levels and average coping skills. Frontline healthcare workers have to maintain mental and physical health. Achieving this requires early screening and stress management for healthcare workers.

80-82

Authors: Eduardo Esteban-Zubero, Cristina García-Muro, Moisés Alejandro Alatorre-Jiménez, Carlos Arturo López-García, Alejandro Marín-Medina

Rationale: Thrombosis of the internal jugular vein is an infrequent and underdiagnosed pathology due to the absence of symptoms. If present, the symptoms are frequently manifested as a sensation of pain and cervical tension. Its etiology is variable, including trauma, central catheterization, and hypercoagulable states, among others. Patient’s Concern: A 41-year-old female, previously healthy, was admitted to the emergency room for worsening pain in the left cervical area of 5 d. Previously, she was treated for suspected acute pharyngotonsillitis yet without improvement. Diagnosis: Physical examination revealed a 2 cm in length cervical mass of hard consistency that was painful on palpation and non-fluctuating. Ultrasound study showed thrombosis of the left internal jugular vein. A computed tomography scan revealed that the thrombosis occurred at the cervical portion of the left internal jugular vein as well as the left transverse sinus. Interventions: Hospital admission and treatment with low molecular weight heparin at a dose of 1.5 mg/kg every 24 h. Outcomes: The patient was discharged after 3 d of treatment with vitamin K antagonists. Lessons: Venous thrombosis at the level of the internal jugular vein is an infrequent entity. Clinical suspicion is necessary for the diagnosis given the possibility of absence of symptoms.

87-88

Authors: Majed Abdul Basit Momin, Rathore Rahul Dev Singh, Rubina Hassan

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