Call to Action! Hypertension and Dyslipidemia in Mexico: Underestimated Deadly Duo
Published on: 11th December, 2024
Background: High blood pressure and dyslipidemia are risk factors that begin silently and share many pathophysiological mechanisms of tissue damage.Aim: Draw attention to this binomial (Hypertension and dyslipidemia) that is highly prevalent in Mexico and is mainly responsible for the leading atherothrombotic process as a cause of death in Mexico and the world.Methods: Reflective analysis of the evidence accumulated in the last 20 years. We launch key messages and support why every hypertensive patient should be treated with a statin.Results: We call for awareness to measure lipid levels and blood pressure twice a year from the age of 20 and to detect these devastating nosological entities as soon as possible. We remove the myth that PCSK9 inhibitors as well as the small interfering RNA of its synthesis are only for familial dyslipidemia. Measurement of serum Lp(a) should be routine, especially if you have a history of your own and family cardiovascular events.Conclusion: We should be aware of the little impact that health strategies have had to stop the main cause of death in Mexico. Every hypertensive patient should receive a statin, even if their serum LDLc levels are apparently normal. The great challenge of optimal control of the population with hypertension and/or dyslipidemia continues. The small interfering RNA synthesis PCSK9 should also be considered when conventional therapies are not sufficient and this situation is not infrequent.
The Fundamental Role of Dissolved Oxygen Levels in Drinking Water, in the Etiopathogenesis, Prevention, Treatment and Recovery of Cerebral Vascular Events (Stroke)
Published on: 16th January, 2025
Stroke is a clinically defined syndrome of acute focal neurological deficit attributed to vascular injury (infarction, hemorrhage) of the central nervous system. Stroke is the second leading cause of death and disability worldwide. Stroke is not a single disease but can be caused by a wide range of risk factors, disease processes and mechanisms. Approximately 15% of strokes worldwide are the result of intracerebral hemorrhage, which can be deep (basal ganglia, brainstem), cerebellar or lobar. A minority (about 20%) of intracerebral hemorrhages are caused by macrovascular lesions (vascular malformations, aneurysms, cavernomas), venous sinus thrombosis or rarer causes.
Unveiling the Impostor: Pulmonary Embolism Presenting as Pneumonia: A Case Report and Literature Review
Published on: 5th February, 2025
Pulmonary Embolism (PE) can present with symptoms resembling pneumonia, creating a diagnostic challenge, particularly in patients with comorbidities. We report the case of a 67-year-old male who presented with cough, hemoptysis, shortness of breath, fever, and pedal edema. Initially diagnosed with consolidation based on chest X-ray findings, he was treated with antibiotics. However, persistent symptoms prompted further evaluation, leading to the diagnosis of PE with pulmonary infarction and deep vein thrombosis on computed tomography pulmonary angiography and Doppler ultrasound. This case highlights the need to consider PE in the differential diagnosis of consolidation, particularly in high-risk individuals, to avoid delays in appropriate management.
Anesthetic Management of a Patient with Left Ventricular Thrombus Posted for Emergency Laparotomy
Published on: 2nd April, 2025
Left ventricular thrombus (LVT) is a life threatening complication following acute coronary syndromes but in modern era its incidence has reduced since the introduction of primary percutaneous intervention. LVT is associated with higher morbidity and mortality due to its thromboembolic events and major adverse cardiac events (MACE). This is a case report of 30-year-old male who presented with acute abdomen and left ventricular thrombus. CECT abdomen revealed superior mesenteric artery (SMA) thrombosis and echocardiography revealed severe ventricular dysfunction (ejection fraction, EF<30%) with global hypokinesia and LVT. SMA thrombosis is fatal and if left unattended can lead to intestinal ischemia and gangrene, hence immediate intervention is warranted. This patient had undergone emergency laparotomy under general anesthesia for the resection of gangrenous jejunal segment with mucous fistula . This case report discusses perioperative management considerations in such cases.
The Rarest Case of Acute Bulbar Palsy due to Internal Jugular Vein Thrombosis Secondary to Protein S Deficiency: Vernet Syndrome
Published on: 10th June, 2025
Dural Venous Sinus Thrombosis (DVST) is a rare although serious clinical entity that causes approximately 0.5% of all stroke cases. Head trauma with skull base fracture, aneurysm, CNS infection, thrombophilia, and vasculitis may be identified as a possible cause of DVST. Vernet’s Syndrome is characterized by a constellation of unilateral cranial nerve palsies involving the 9th, 10th, and 11th cranial nerves due to compression or narrowing of the jugular foramen. We herein present a case of 33 years old Bangladeshi worker from Malaysia who had history of severe Traumatic Brain Injury (TBI) following road traffic accident with multiple skull bone fracture and extradural hematoma 3 months back, presented with acute dysphagia, dysphonia, fever and cough for 6 days. Neurologic examination revealed deviation of uvula to the left side and features of consolidation over right upper chest. Magnetic Resonance Venography (MRV) revealed thrombosis involving right transverse sinus, sigmoid sinus extending up to right internal jugular vein. The diagnosis of vernet syndrome with aspiration pneumonia was made. Later thrombophilia screen showed protein S deficiency. He was treated with broad spectrum antibiotics and started anticoagulation with dabigatran. After 6 months of anticoagulation he recovered fully with no residual neurological deficit.
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