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Our research objectives involved investigating the link between fasting and GERD symptoms in Saudi Arabia, as well as evaluating the influence of fasting on the severity and presentation of GERD symptoms.

This longitudinal investigation of GERD patients used consecutive sampling. The questionnaires were answered by the patients, first during Ramadan and then again after Ramadan. A self-administered survey, validated for assessing the impact of gastroesophageal reflux disease (GERD) on health-related quality of life (HRQL), was employed in the study.

Post-Ramadan, there was a substantial decrease in the intensity of heartburn symptoms, especially when lying down. During Ramadan, the heartburn score was 179; subsequently, it fell to 143, a reduction of 45 points. Following Ramadan, a statistically significant (P = .049) reduction was observed in regurgitation scores, decreasing from 123 to 99. Following Ramadan, satisfaction showed a marked increase (17% versus 151%), but this change was not statistically significant (P = .422). Compared to the 34% satisfaction rate reported after Ramadan, a remarkable 453% of patients expressed satisfaction with their health status during Ramadan. Food type, meal time, and food quantity had no impact on the severity of GERD symptoms, prior to or subsequent to fasting.

Ramadan fasting, the results indicated, might show an effect in mitigating GERD symptoms. While these outcomes are intriguing, more rigorous studies are required to confirm their validity and elucidate the mechanisms responsible for this effect.

The observed results suggest that Ramadan fasting practices could favorably influence GERD symptom presentation. Nevertheless, additional research is crucial to corroborate these outcomes and fully understand the fundamental mechanisms at play.

Trazodone, a drug, is administered to patients suffering from major depressive disorder (MDD). The drug falls into the serotonin-antagonist-and-reuptake-inhibitor category, accompanied by anticholinergic activity. Patients with Major Depressive Disorder (MDD) and concomitant insomnia often receive trazodone due to its sedative effects, making it a frequently prescribed medication. Despite their scarcity, reports suggest trazodone overdoses may lead to QTc prolongation, a condition that can precipitate dangerous arrhythmias, such as torsades de pointes and variable atrioventricular blocks, ultimately causing fatalities. A 45-year-old female patient, with a history of major depressive disorder (MDD) and anxiety, experienced dizziness, transient ataxia, and urinary incontinence following the ingestion of five 100 mg trazodone tablets. Although her admission vitals remained stable, her electrocardiogram demonstrated a problematic QTc interval extension of 502 milliseconds. Following a few hours, she presented with hypotension and a gradual worsening of the QTc interval, peaking at 586 milliseconds. Given the considerable risk of her condition deteriorating, the patient was admitted to the Intensive Care Unit for further treatment, receiving supportive care such as fluid restoration, electrolyte correction, serial electrocardiograms every hour, and telemetry monitoring for any arrhythmias, eventually leading to an improvement in her clinical condition. While not common, trazodone poisoning can be fatal and hence requires constant observation to prevent complications from arising. Managing cases of trazodone toxicity necessitates clinicians’ awareness of these possible adverse outcomes.

The distinctive ECG pattern of Wellens syndrome typically indicates a critical narrowing of the left anterior descending (LAD) coronary artery. This pattern frequently emerging during symptom-free periods signifies a pre-infarction stage and necessitates early intervention by providers. We report the case of a 39-year-old male patient, with a history of hypertension, who presented to the emergency department with two months of progressive, recurring intermittent squeezing pain, situated on the left side of the chest. Cardiac enzyme levels exhibited no deviation from the standard limits. At the triage station, an ECG showed significant biphasic T waves in leads V2 through V5, corresponding to type A Wellens syndrome. After a consultation with the cardiology team, the patient’s treatment course included a percutaneous coronary intervention targeting the mid and proximal portions of the left anterior descending artery. Guided by medical therapy guidelines, the patient’s discharge occurred on the third day of their hospitalization. Close follow-up with the cardiology clinic is scheduled. The presence of Wellens syndrome characteristics in this case demonstrates their critical importance for both diagnosis and prognosis. This article was designed to increase awareness of Wellens syndrome, its implications within clinical practice, and the critical role of timely acute management.

Following a near-fall on stairs, a 51-year-old male presented with left flank pain at the emergency department. The computed tomography, utilizing contrast, of the abdomen and pelvis presented a non-enhancing left kidney, a possible consequence of acute traumatic dissection of the left renal artery. Renal artery dissection is frequently a consequence of blunt abdominal trauma, but spontaneous instances do sometimes present themselves. Unrecognized renal artery dissection after minor trauma is often a consequence of mild initial symptoms. Treatment strategy will adapt based on the age of the injury, the kidney’s condition, and the degree of accompanying trauma. Finally, a coordinated effort between trauma surgery, vascular surgery, urology, and interventional radiology is essential for determining the best course of action. By comprehending the injury’s mechanism and the patient’s risk profile, accurate identification and treatment can be facilitated, leading to reduced care delays and potentially lessening the occurrence of organ injury.

The presence of a hypoglycemic disorder is established by Whipple’s triad, comprising a blood glucose level below 55 mg/dL, accompanied by autonomic and neuroglycopenic symptoms resolving after glucose administration. Endogenous hyperinsulinemia’s leading cause is, without a doubt, insulinoma. A 73-year-old male, who collapsed and lost consciousness, was brought to the emergency department. After the initial assessment, severe hypoglycemia was ascertained and treated effectively. Initial blood tests, physical examination, abdominal ultrasound, and computed tomography (CT) of the thorax, abdomen, and pelvis did not reveal any unusual findings. Subsequent to the patient’s symptomatic hypoglycemia, blood tests confirmed the presence of endogenous hyperinsulinism. The administration of diazoxide to the patient was intended to prevent any additional incidents of hypoglycemia. A nodular area within the head of the pancreas was evident on MRI scans, leading to the patient’s discharge with diazoxide and flash glucose monitoring. In the subsequent medical evaluation, he manifested the characteristic symptoms and physical findings of congestive heart failure. stat signals receptor In light of the need for endoscopic ultrasound, the patient’s congestive heart failure created a high risk for complications under anesthesia during the scheduled procedure. A 68Gallium-DOTA-NOC PET-CT scan was performed to evaluate for a suspected lesion in the pancreas; the result confirmed a nodular area in the cephalic region. His definitive treatment was to be addressed by general surgery, thus the referral. Despite advancements, insulinoma diagnosis and management remain difficult. Subsequently, a management structure that includes diverse specializations is of utmost importance. This specific case highlights the potential consequences of unwanted side effects arising from the medication utilized for this ailment. To address the severe, recurring hypoglycemia, Diazoxide was administered; however, the patient’s condition deteriorated with congestive heart failure, preventing an endoscopic ultrasound for lesion localization, ultimately delaying diagnosis and definitive treatment. Diazoxide, a drug that effectively raises blood sugar levels, can unfortunately also trigger a cascade of side effects, including fluid retention, nausea, increased hair growth (hypertrichosis), a decline in neutrophils (neutropenia), and a reduction in the count of platelets (thrombocytopenia).

Takayasu arteritis, a condition characterized by large vessel vasculitis, extends to the aorta and its crucial branches. A noteworthy feature of this disease is its disproportionate effect on women, presenting with diverse symptoms, including skin manifestations specifically ulcerative nodules, pyoderma gangrenosum, and lesions comparable to erythema nodosum. We document a case involving a 50-year-old female who attended the outpatient department with a multitude of ulcerating lesions across both her upper limbs and chest. A physical examination revealed the absence of pulse in the patient’s upper limbs. The laboratory’s assessment uncovered positive antinuclear antibodies (ANA) and a surge in inflammatory markers. The CT angiographic examination of the aorta showcased a thickened aortic arch, with the left common carotid and left subclavian arteries’ lumina completely obliterated. A biopsy of the skin lesion unveiled surface ulceration and densely inflamed granulation tissue, characterized by a fibroblastic proliferation within the deeper tissue structures. The patient’s diagnostic evaluation, in light of the 1990 American College of Rheumatology (ACR-1990) criteria for TA, revealed the presence of three of the six features necessary for the diagnosis of TA, which was made in conjunction with pyoderma gangrenosum. The patient’s care involved the use of steroids and immunosuppressants, as well as gentle wound debridement and skin-grafting procedures. TA’s variable presentations often complicate its diagnosis, requiring a holistic strategy encompassing both clinical features and results from laboratory and radiological tests. The disease’s course, involving cycles of remission and relapse, mandates a prolonged period of follow-up care.

Mucosa-associated lymphoid tissue (MALT) extranodal marginal zone lymphoma (EMZL), while prevalent in the gastrointestinal (GI) system, exhibits a limited presence in the colon.