European Journal of Medical and Health Sciences https://www.ejmed.org/index.php/ejmed European Journal of Medical and Health Sciences European Open Access Publishing en-US European Journal of Medical and Health Sciences 2593-8339 Fatal Case Of Solid Organ Infarcts In a Case Of Myelodysplastic Syndrome (MDS) With Refractory Anaemia https://www.ejmed.org/index.php/ejmed/article/view/230 <p>Myelodysplastic syndrome (MDS) usually presents with cytopenias&nbsp; because of bone marrow failure. Solid organ infarcts in myelodysplastic syndrome (MDS) is rarest complication. We report an elderly male, admitted with complaints of pain abdomen mainly in both flanks and swelling all over the body. Peripheral&nbsp; blood smear, bone marrow aspirate for cytology were suggestive of myelodysplastic syndrome(MDS) with refractory anaemia. Fluorescence in situ hybridization(FISH) were negative for any chromosomal abnormalities. His CECT abdomen was done which revealed hepatosplenomegaly with hyperdense liver with multiple splenic and renal infarcts and patient was treated as a case of MDS with refractory anaemia with solid organ infarcts. Over a period of 3 days, he had Acute Kidney Injury (AKI).&nbsp; Patient succumbed on fifth day.</p> Kolluru Karthik Raja Yash Gupte Parth Godhiwala Sharad Sonawane Shilpa Gaidhane Sunil Kumar Quazi syed Zahiruddin Copyright (c) 2020 Kolluru Karthik Raja, Yash Gupte, Parth Godhiwala, Sharad Sonawane, Shilpa Gaidhane, Sunil Kumar, Quazi syed Zahiruddin http://creativecommons.org/licenses/by/4.0 2020-05-01 2020-05-01 2 3 10.24018/ejmed.2020.2.3.230 Endoscopic Sleeve Gastrectomy Conversion to Roux-en-Y Gastric Bypass https://www.ejmed.org/index.php/ejmed/article/view/232 <p>Endoscopic Sleeve Gastroplasty (ESG) is a restrictive endoscopic bariatric procedure that provides a reduction of the gastric volume and an alteration of the gastric motility. The volume of the stomach is reduced by approximately 70% through plication of the greater curvature of the stomach using an endoscopic suturing device. In case of failure, the surgical conversion is possible. We present a case of a patient with previous ESG with insufficient weight loss and gastro-oesophageal reflux. We performed a conversion to Roux-en-Y Gastric Bypass with satisfactory results.</p> Sorin Cimpean Marechal Marie-Therese Benjamin Cadiere Guy-Bernard Cadiere Copyright (c) 2020 Sorin Cimpean, Marechal Marie-Therese, Benjamin Cadiere, Guy-Bernard Cadiere http://creativecommons.org/licenses/by/4.0 2020-05-09 2020-05-09 2 3 10.24018/ejmed.2020.2.3.232 Cytokine Storm of SARS-CoV-2, the Virus that Causes COVID-19 https://www.ejmed.org/index.php/ejmed/article/view/245 <p>The ongoing pandemic of COVID-19 has spread to the entire globe and is a public health emergency of international concern. The clinical picture of the disease is seen to be related to previously encountered beta-coronaviruses i.e. SARS-CoV and MERS-CoV. Most common symptoms include fever and cough and less commonly diarrhea, myalgias, nausea, sputum production. Still, other patients can present with multi-organ failure. Mortality risk is related to patient’s age and comorbidities. Laboratory and radiologic investigations are crucial for diagnosis and monitoring the prognosis of patients. The pathophysiology of COVID-19 is related to pulmonary inflammation and lung damage caused by the cytokine storm induced by local infection in the lung alveolar space. The cytokine storm is evident from an increase in the amount of several cytokines like IL1B, IL6, IL7, IL8, IL9, IL10, TNF, an INFγ. At present, a proper treatment for COVID-19 is unavailable. However, supportive care is being given to patients with anti-viral, anti-inflammatory, anti-bacterial, anti-fungal and artificial oxygen respiration. This paper focuses on the cytokine storm observed following SARS-CoV-2 infection and the current treatment strategies for the infection.</p> Hassan S. Naji Copyright (c) 2020 Hassan S. Naji http://creativecommons.org/licenses/by/4.0 2020-05-11 2020-05-11 2 3 10.24018/ejmed.2020.2.3.245 Ampiginous Choroiditis https://www.ejmed.org/index.php/ejmed/article/view/260 <p>Ampiginous choroiditis is a rare inflammatory disease that progressively alters the chorio-capillary, pigmented epithelium (PE) and neurosensory retina. We report the case of a 43-year-old patient with decreased visual acuity at finger count (CF) in both eyes, with multiple yellowish-white lesions of varying size, mostly in the peri-papillary region.</p> Joumany Brahim Salem Imane Tarib Mahdi Khammaily Sidi Dahi Yassine Mouzari Fouad El Asri Karim Reda Abdelbarre Oubaaz Copyright (c) 2020 Joumany Brahim Salem, Imane Tarib, Mahdi Khammaily, Sidi Dahi, Yassine Mouzari, Fouad El Asri, Karim Reda, Abdelbarre Oubaaz http://creativecommons.org/licenses/by/4.0 2020-05-11 2020-05-11 2 3 10.24018/ejmed.2020.2.3.260 Intraperitoneal Inclusion Cyst Presenting as Intestinal Obstruction: A Clinical Dilemma https://www.ejmed.org/index.php/ejmed/article/view/252 <p>Peritoneal inclusion cysts have been described in females of reproductive age. It is a rare cause of intestinal obstruction. Causes include pelvic inflammatory disease and prior abdominal surgery. We here present a case of young female of peritoneal inclusion cyst who presented with intestinal obstruction.</p> Amit Gupta Utkarsh Kumar Durga Sowmya S Rishit Mani Jaydeep Jain Ashok Singh Sweety Gupta Copyright (c) 2020 Amit Gupta, Utkarsh Kumar, Durga Sowmya S, Rishit Mani, Jaydeep Jain, Ashok Singh, Sweety Gupta http://creativecommons.org/licenses/by/4.0 2020-05-11 2020-05-11 2 3 10.24018/ejmed.2020.2.3.252 Determinants of Under-five Mortality in South Africa: Results from a Cross-Sectional Demographic and Health Survey https://www.ejmed.org/index.php/ejmed/article/view/244 <p>Under-five mortality remains a public health challenge in South Africa and other developing countries where children are likely to die before reaching five years. This paper aimed to identify factors associated with under-five mortality in South Africa taking into account clustering using the 1998 South African Demographic and Health Survey data. Survival analysis techniques were used to understand under-five mortality and its determinants. Frailty models incorporating family and community frailty effects were implemented. The results revealed that preceding birth interval, birth type, breastfeeding and dwelling unit type were significant determinants of under-five mortality. The findings further confirmed that children belonging to the same family and children belonging to the same community shared certain unobserved characteristics that put them at risk of death.</p> Tshaudi Motsima K. Zuma E. Rapoo Copyright (c) 2020 Tshaudi Motsima, K. Zuma, E. Rapoo http://creativecommons.org/licenses/by/4.0 2020-05-14 2020-05-14 2 3 10.24018/ejmed.2020.2.3.244 The Sea Star Invertebrate Primitive Antibody (IPA):Rosetting And PFC (Plaque-Forming Cell). Anti-SRBC Antibodies https://www.ejmed.org/index.php/ejmed/article/view/269 <p>Next to the sea star T and B lymphocytes, we find the IPA (Invertebrate Primitive Antibody). Rosetting test and PFC test&nbsp; after Injection of SRBC (Sheep red blood cells)were performed in the sea starAsterias rubens (Echinodermata). Positive results were obtained and summarized in this work. They indicated the presence of anti-SRBC antibodies in the sea star, according to the method of Cunningham.</p> Michel Leclerc Copyright (c) 2020 Michel Leclerc http://creativecommons.org/licenses/by/4.0 2020-05-17 2020-05-17 2 3 10.24018/ejmed.2020.2.3.269 A Silent Attacker SARS-CoV-2 - A Review https://www.ejmed.org/index.php/ejmed/article/view/246 <p>The recent coronavirus (known as COVID-19 or SARS-CoV-2) has created a pandemic of unheard proportions affecting virtually every country and region of the world. As of April 15, 2020 the virus has resulted in over 2 million infections, and over 100,000 deaths and has brought world economic activities to a standstill, and has led to social isolation and massive unemployment with possible economic recessions on an unprecedented scale around the corner. Till now, the virus shows no signs of abatement. Also till now, scientists have not been able to come out with an effective drug or vaccine against the virus. This review attempts to give a comprehensive view of the origin of the virus, the mode of its entry and infecting human beings, and further discusses the possibility of new drugs and vaccines against the virus.</p> Khoshnur Jannat Nusratun Nahar Md Shahadat Hossan Tohmina Afroze Bondhon Anamul Hasan Anita Paul Rownak Jahan Mohammed Rahmatullah Copyright (c) 2020 Khoshnur Jannat, Nusratun Nahar, Md Shahadat Hossan, Tohmina Afroze Bondhon, Anamul Hasan, Anita Paul, Rownak Jahan, Mohammed Rahmatullah http://creativecommons.org/licenses/by/4.0 2020-05-17 2020-05-17 2 3 10.24018/ejmed.2020.2.3.246 A Comparative in Vivo Study on Bambusa Polymorpha, Mentha Piperita and Clitoria Ternatea as Alternative Anxiolytic https://www.ejmed.org/index.php/ejmed/article/view/266 <p>This is a continuation of our “Stress Management with Herbal Alternatives” project whereby we are testing traditionally used herbs to scientifically establish their efficacy as anxiolytics for the 1<sup>st</sup> time. For the current study Bamboo leaf tea, Mint leaf tea and Clitoral bush petal tea were compared for their anxiolytic potency. Male Swiss albino mice were used to test on Open Field test (OFT) and Elevated Plus Maze (EPM) anxiety model. Diazepam (at the dose of 0.25mg/kg body weight) was used as&nbsp; standard and Bangladeshi indigenous bamboo aka <em>Bambusa polymorpha </em>or Bamboo<em>, Mentha piperita </em>or Mint and<em> Clitoria ternatea</em> or Clitoral Bush (at doses of 1g/kg body weight) were the sample. The control group had no intervention. For OFT we tested line crossing, time spent in center, time spent in thigmotaxis and for EPM we measured the number of entry in open and closed hands, time spent in the open and closed hands. Parameters such as rearing, grooming, urination and defecation were also monitored for both tests.The trial results showed Clitoral bush and Mint leaves to have greater anxiolytic activity than Bamboo and Diazepam. Bamboo and Clitoral Bush helped in weight loss, wherelse Diazepam caused weight gain. Based on all criteria, Clitoral bush tea showed highest potential to reduce stress as well as stress related obesity. Results were followed by mint, diazepam and bamboo respectively in their potency for anxiolytic effect.</p> Tasnuva Tunna Mst. Sharmin Akter Mahmuda Parvin Md. Jilhaz Shamema Jahan Zaidul ISM Copyright (c) 2020 Tasnuva Tunna, Mst. Sharmin Akter, Mahmuda Parvin, Md. Jilhaz, Shamema Jahan, Zaidul ISM http://creativecommons.org/licenses/by/4.0 2020-05-22 2020-05-22 2 3 10.24018/ejmed.2020.2.3.266 Case Report : Multiple Stress Fractures (hamate, triquetrum, 2nd, 3rd, and 4th Metacarpal bones) in an Amateur Tennis Player https://www.ejmed.org/index.php/ejmed/article/view/274 <p class="Abstract"><em><span lang="EN-US">Background</span></em><span lang="EN-US">: upper extremity stress fractures are infrequent events in tennis sport. According to our literature, we have only identified 6 case reports of upper limb stress fractures among amateur or professional tennis players. To the best of our knowledge, this is the only case report where stress fractures occur in: hamate, triquetrum, 2nd, 4th, and 5th metacarpal bones simultaneously. </span></p> <p class="Abstract"><em><span lang="EN-US">Case presentation</span></em><span lang="EN-US">: 27 years old lady, presented with acute burning pain at the base of her right thumb. There was not a history of direct trauma. Her symptoms start to appear after 3 days of playing tennis. Physical examination was negative for tenderness, swelling and erythema. The rheumatoid factor was elevated (20.3 iu/ml). the diagnosis of multiple stress fractures was made by the suggestive MRI findings. </span></p> <p class="Abstract"><em><span lang="EN-US">Conclusion</span></em><span lang="EN-US">: Although stress fractures of the upper limbs are not common, it is of a great value to keep the clinical suspicion high towards it. Especially in amateur or professional athletes with persistent or worsening symptoms. The best modality to confirm such fractures is MRI.</span></p> Hatim Mohammed A. AlShareef Alhusain Mohammad Alshareef Mohammed Hussein AlKaff Copyright (c) 2020 Hatim Mohammed A. AlShareef, Alhusain Mohammad Alshareef, Mohammed Hussein AlKaff http://creativecommons.org/licenses/by/4.0 2020-05-22 2020-05-22 2 3 10.24018/ejmed.2020.2.3.274 Primary Leiomyosarcoma Of Inferior Vena Cava : An Uncommon Entity https://www.ejmed.org/index.php/ejmed/article/view/271 <p>Primary vascular leiomyosarcoma is a rare tumor that arises mainly from the inferior vena cava (IVC). It is usually a slow-growing progressive tumor. It shows mainly three type of growth patterns; 62% of cases demonstrate extraluminal pattern, 5% cases show intraluminal pattern, and 33% extra- and intraluminal growth patterns.</p> Kruti Dave Shwetang Solanki Ritesh Prajapati Copyright (c) 2020 Kruti Dave, Shwetang Solanki, Ritesh Prajapati http://creativecommons.org/licenses/by/4.0 2020-05-28 2020-05-28 2 3 10.24018/ejmed.2020.2.3.271 New Trends in Medical Education During and Post COVID-19 Pandemic https://www.ejmed.org/index.php/ejmed/article/view/275 <p>This sudden emerged crisis of COVID-19 pandemic has forced the medical units globally with practical and logistical trial and apprehensions for patient wellbeing. In addition, it has affected medical education by forcing them to stay away from the institutes for preventing potential spread of virus.&nbsp; Mean time conventional classroom teaching and in-hand experience in training are affected. This short communication discusses the current transformation in medical education by adoption of newer trends, describes how COVID-19 may affect the standard curriculum and learning milieus, and scouts impending consequences in Post COVID-19 era for the future of medical education.</p> Pushpa Potaliya Surajit Ghatak Copyright (c) 2020 Pushpa Potaliya, Surajit Ghatak http://creativecommons.org/licenses/by/4.0 2020-05-30 2020-05-30 2 3 10.24018/ejmed.2020.2.3.275 Effect of Moderate Intake of Ethanol on Lipid Profile of Wistar-Albino Rats Fed High Fat Diet https://www.ejmed.org/index.php/ejmed/article/view/283 <p>Many evidences suggest that light to moderate alcohol drinking may provide some cardiovascular benefits. The present study examined the impact of how moderate ethanol consumption provides a protective effect against high blood cholesterol. Wistar-Albino rats were divided into a control group (I) and test groups (II, III, IV). The test groups (II, III, IV) were administered with a predefined dosage of 10%, 20% and 30% ethanol respectively following twenty days of high fat routine however, control animals were managed with normal saline for the next fifteen days. Significant difference in lipid profile parameters witnessed before and after ethanol administration between the control and test groups. Findings from the study suggests that 10% moderate ethanol is adequately least enough to reduce the risk of cardiovascular disease by improving the blood cholesterol in Wistar-Albino rats.</p> Kathiravan Vayanaperumal Ravindran Rajan Copyright (c) 2020 Kathiravan Vayanaperumal, Ravindran Rajan http://creativecommons.org/licenses/by/4.0 2020-05-30 2020-05-30 2 3 10.24018/ejmed.2020.2.3.283 Comparative Modulation of the Reproductive System by Ethanolleaf Extracts of Asystasia Gangetica Andanthocleista Vogelli in Male Wistar Rats https://www.ejmed.org/index.php/ejmed/article/view/287 <p>A number of medicinal plants have been found to influence the level of reproductive hormones and thus affect fertility in the overall. This work evaluated the effects of ethanol leaf extracts of <em>A. gangetica</em> and <em>A. vogelli</em> respectively on some reproductive system parameters in male Wistar rats. A total of sixteen (16) male albino rats were grouped into four (four rats in each group): group A served as normal control, group B received Immunace (Vitabiotics) group C and D received 400 mg/kg body weight of A. gangetica and A. vogelli extracts respectively. Extracts were administered orally to rats for 21 days, after which they were sacrificed by cervical dislocations and blood samples drawn by cardiac puncture. The effect of the extracts on testosterone, follicle stimulating hormone, luteinizing hormone and semen analysis of the test rats were determined using enzyme linked immunosorbent assay (ELISA) and standard techniques. Data collected were analyzed using Graph pad prism V6 and p values &lt; 0.05 were adopted as significant. There was no significant (p&gt;0.05) change in testosterone, FSH and luteinizing hormones in the group administered A. gangetica plant extract relative to the control. There was also no visible difference in the testes weight and sperm morphology relative to the control group. In contrast, administration of <em>A. vogell</em>i extract caused significant (p&lt;0.05) decrease in testosterone and follicle stimulating hormone concentrations from: 1.12 ± 0.20 to 0.89 ± 0.05 and 1.41 ± 0.07 to 1.35 ± 0.12 respectively relative to the control group. While significant (p&lt;0.05) decrease in luteinizing hormone (1.71 ± 0.15) was observed relative to the standard drug group (1.76 ± 0.05). A significant (p&lt;0.05) decrease in sperm count and testes weight was also observed in rats treated with <em>A. vogelli</em> extract relative to the normal control.The results suggest that, <em>A. vogelli</em> extract may cause decreased fertility in male albino rats and could be developed further into potent male contraceptives. <em>A. gangetica</em> on the other hand, had no effect on male reproductive hormones.</p> Simeon I. Egba C. O. Okonkwo H. C. Omeoga I. E. Ekong Copyright (c) 2020 Simeon I. Egba, C. O. Okonkwo, H. C. Omeoga, I. E. Ekong http://creativecommons.org/licenses/by/4.0 2020-05-30 2020-05-30 2 3 10.24018/ejmed.2020.2.3.287 Gene Mutations in Hereditary Breast Cancer- A Review https://www.ejmed.org/index.php/ejmed/article/view/286 <p>The most prevalent form of cancer in females is breast cancer. Roughly 5%-10% of breast cancers are hereditary, and they are associated with Germline gene mutations, inherited from parents. Germline gene mutations increase the risk of developing cancer earlier in life compared to noninherited cases (sporadic cancer). <em>BRCA1</em> and <em>BRCA2</em> are well-studied tumour suppressor genes associated with hereditary breast cancer. Even though mutations in BRCA1 and BRCA2 are assumed to responsible the majority of hereditary breast cancers cases, many other breast cancer susceptibility genes have been identified in the last few decades. Identification of many germline mutations was possible due to advance sequencing technologies. Most of these genes are belongs to tumour suppressors and DNA damage repair gene families (DNA double-strand break repair and DNA mismatch repair). These genes play a vital role in genomic stability and cell cycle control suggesting that any alteration in these genes trigger uncontrolled growth and tumour formation. These genes are categorized according to the penetrance level, the proportion of carriers express the associated trait of the mutated gene. Mutations in high penetrance genes such as <em>BRCA1, BRCA2, TP53, PTEN, </em>and<em> SKT11</em> greatly increase the risk of developing breast cancer. Moderate penetrance gene such as <em>PALB2, ATM, CHEK2, BARD1, BRIP1</em> and low penetrance gene such as <em>PARP4</em>, <em>CASP8, TOX3 </em>confer moderate to low increase risk of developing breast cancer. Aim of this review is to summarize genes associated with hereditary breast cancer according to their penetrance level (high, moderate and low penetrance).</p> Pathima Fairoosa Chamindri Witharana Copyright (c) 2020 Pathima Fairoosa, chamindri Witharana http://creativecommons.org/licenses/by/4.0 2020-05-30 2020-05-30 2 3 10.24018/ejmed.2020.2.3.286 Origin of Life’s Chirality https://www.ejmed.org/index.php/ejmed/article/view/268 <p>The phase transition at 72K in ice XIc accommodating water molecules’ irregular tetrahedral shape I discovered in 1967 restores the confidence in science measuring <em>c</em> challenged. Forming in polar pools of N<sub>2</sub> during a primordial ice-age, fluctuating temperatures released latent energy as λ ~4µ laser light. Multiple reflection polarized it and deoxynucleotides on tropical water surfaces were polymerized, creating chiral DNA, uniquely explaining life’s origin.&nbsp;&nbsp;</p> <p>‘Transport DNAs’ sharing tRNA’s H-bond-lined pores concentrated life’s ingredients in coacervates. Replicate tDNAs originated life. DNA’s stability makes it life’s likely precursor. ‘Differentiation DNAs’ selecting tDNAs control cell diet and tissue specialization. Nine pathways deploying trace elements as carriers control metabolism. Mutant tDNAs and dietary deficits account for morbidity.</p> <p>‘Minion’ DNA/oligopeptide complexes optimize chromosomes replication. They function as biological clocks, chips-in-the-brain and nuclear fusion reactors.&nbsp; Minion logic reinterprets 20<sup>th</sup> century scientific axioms. Resonant cavities coupling chemical to mechanical energy efficiently.</p> Michael Deans Copyright (c) 2020 Michael Deans http://creativecommons.org/licenses/by/4.0 2020-05-30 2020-05-30 2 3 10.24018/ejmed.2020.2.3.268 Sudden Mono-ocular Vision Loss in An Adolescent Female: A Case Report and Review of the Literature https://www.ejmed.org/index.php/ejmed/article/view/289 <p>Psychogenic blindness remains a bewildering medical condition with very little information known about its exact etiology and pathophysiologic mechanism. While complaints of reduction in visual acuity are most common, occasionally patients present with complaints of total loss of vision which after extensive clinical examination and electrophysiological investigations cannot be linked to any pathology of the visual pathway. In such cases, a diagnosis of psychogenic blindness is usually considered. Here we present the case of a teenage girl who presented to the ophthalmology department with complaints of complete monocular loss of vision and was referred to the child and adolescent psychiatry team for expert management. This case showcases the importance of a multidisciplinary approach to care and importance of quick and effective referral systems in proper management of complex cases. It also provides more insight into the manner of presentation of cases of psychogenic blindness and the role of psychotherapy and counseling in its successful treatment.</p> Oluwafolajimi Adetoye Adesanya Boluwatife Adeleye Adewale Ifeoluwa Oluwasegun Oduguwa Joseph Ajiroghene Onumeguolor Copyright (c) 2020 Oluwafolajimi Adetoye Adesanya, Boluwatife Adeleye Adewale, Ifeoluwa Oluwasegun Oduguwa, Joseph Ajiroghene Onumeguolor http://creativecommons.org/licenses/by/4.0 2020-05-30 2020-05-30 2 3 10.24018/ejmed.2020.2.3.289 A Turn for the Better – The Benefit of Doing A Limited Prone Rescan to Confirm the Exact Location of an Equivocal Vesicoureteric Junction Calculus Detected on Supine Abdominopelvic CT Scan https://www.ejmed.org/index.php/ejmed/article/view/249 <p class="Abstract"><em><span lang="EN-US">Background</span></em><span lang="EN-US">: In this case report, a calculus was seen at the vesicoureteric junction (VUJ) on computed tomography (CT), in an equivocal location. The subsequent urological management is based on the precise location of the calculus (ureteric orifice at the VUJ versus urinary bladder lumen). A simple manoeuvre of doing a limited prone CT rescan of the urinary bladder confirmed the location of the calculus within the urinary bladder, thus allowing conservative management.</span></p> <p class="Abstract"><em><span lang="EN-US">Case Presentation</span></em><span lang="EN-US">: A middle-aged male with known urolithiasis presented with right sided abdominal pain, nausea and vomiting. Differentials included a right ureteric calculus and appendicitis. A CT scan of the abdomen and pelvis in the supine position revealed a 0.4 cm calculus at the right VUJ with mild right hydronephrosis. It was not certain whether this calculus was impacted at the VUJ or within the bladder lumen. A limited prone CT re-scan of the pelvis was performed, which confirmed that the calculus was within the urinary bladder, as it migrated to a dependent position in the lumen of the bladder when in the prone position. Patient was managed conservatively and passed the calculus via the urethra the next day. </span></p> <p class="Abstract"><em><span lang="EN-US">Conclusion</span></em><span lang="EN-US">: Prone CT is the gold standard for the evaluation of stone disease and can differentiate a vesical calculus from a vesicoureteric junction calculus. In cases where a supine abdominopelvic CT is performed (e.g. in institutions which do not routinely scan in prone position or in cases where a supine scan is done to exclude other pathologies), an additional limited prone CT is needed in equivocal cases for a suspected VUJ calculus. This additional limited prone CT can prevent unnecessary urologic intervention.</span></p> Fidel Rampersad Satyendra Persaud Adrian C. Chan Jason Diljohn Paramanand Maharaj Ashton Ramsundar Copyright (c) 2020 Fidel Rampersad, Satyendra Persaud, Adrian C. Chan, Jason Diljohn, Paramanand Maharaj, Ashton Ramsundar http://creativecommons.org/licenses/by/4.0 2020-05-31 2020-05-31 2 3 10.24018/ejmed.2020.2.3.249 Clinical Characteristics and Outcomes of First 100 Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2) Patients: A Single Center Experience https://www.ejmed.org/index.php/ejmed/article/view/277 <p>Since December 2019, the world has witnessed the Coronavirus disease caused by the Severe Acute Respiratory Syndrome Coronavirus-2, which has been declared a pandemic by the World Health Organization in March 2020. We share our initial experience at a center in Dubai, UAE, with a diverse ethnic population and present the clinical characteristics of the first 100 laboratory-confirmed coronavirus disease patients. In this retrospective, single center study, we included all adult (≥12 years old) laboratory-confirmed COVID-19 patients who presented at Al Kuwait Hospital, Dubai, UAE between 21 February 2020 and 15 April 2020. We extracted data on the demograhics, clinical presentation, laboratory and imaging results, treatment, complications and outcomes from the electronic medical records. Results are expressed as counts and percentages for categorical variables, and mean (with range) for continuous variables. A total of one hundred patients were studied. Mean age was 44 years (range 13-82 years); 16% were aged more than 60 years. 69% were males. Most of the patients (41%) belonged to South Asia, while 33% belonged to the Middle East. 21% were diabetics, 20% were hypertensives, 10% were active smokers and 6% were known cases of asthma/chronic obstructive lung disease. Upon admission, fever (46%) and dry cough (41%) were the most common symptoms, while&nbsp; 24% were asymptomatic on admission. Mean duration of symptoms before hospital admission was 5.1 days (range 1-14 days). Upon admission, 8% had low platelets, 7% had lymphopenia, 61% had high C-reactive protein, 48% had high ferritin, 37% had high lactate dehydrogenase, and 31% had high D-dimers. 63% had normal chest radiography upon presentation. Computed tomography chest showed ground glass opacification in 80%, consolidation in 21% while 14% had ill defined patchy opacities. All lesions were located peripherally and 79% had bilateral involvement with predominantly lower lobe disease. 8% had critical illness. Chloroquine/hydroxychloroquine (93%) and the protease inhibitor lopinavir-ritonavir (86%) were the most commonly prescribed treatment. 8% needed non-invasive ventilation and 7% were intubated and ventilated invasively. 7% developed acute repiratory distress syndrome, 5% went into septic shock and needed vasopressor support, 2% developed acute cardiac injury, 17% had acute kidney injury, 11% had acute liver injury and 2% developed disseminated intravascular coagulation. Almost half of the patients (49%) were declared recovered after having two negative COVID-19 PCR tests while 5% died. We concluded that the Coronavirus disease 2019 (COVID-19) presents with different clinical characteristics in the UAE with an ethnic diverse background. Majority affected were young, males and diabetic. One-fourth were asymptomatic on admission, while fever and dry cough were the most common symptoms. High C-reactive protein and ferritin on admission was common. Most of the patients had normal chest radiograph on admission, while computed tomography chest showed the characteristic findings in over two-thirds. Almost half of our patients recovered while 5% died. This is an intial experience only and increased patient cohort will provide further information.</p> Kashif Naeem Vinod Choondal Mahmoud Hamouri Ahmed Abbas Sreevidya Machingal Farzeela Fahad Kusay Almusa Mona Osman Afaf Ashoor Mahdi Sial Mohammad Ali Eslam Siddiq Waleed Flayyih Najiba Abdulrazzaq Copyright (c) 2020 Kashif Naeem, Vinod Choondal, Mahmoud Hamouri, Ahmed Abbas, Sreevidya Machingal, Farzeela Fahad, Kusay Almusa, Mona Osman, Afaf Ashoor, Mahdi Sial, Mohammad Ali, Eslam Siddiq, Waleed Flayyih, Najiba Abdulrazzaq http://creativecommons.org/licenses/by/4.0 2020-05-31 2020-05-31 2 3 10.24018/ejmed.2020.2.3.277