Dr. D.S. Merchant's Articles in Health

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Atrial fibrillation (AF) with a rapid ventricular response A previously healthy 22-year-old woman presents to the emergency department (ED) with acute shortness of breath. Her shortness of breath became worse with exertion and was associated with pleuritic chest pain for 2 days. She has had a fever, nonproductive cough, nausea, vomiting, and arthralgia. On presentation, she is febrile with a temperature of 101.5°F (38.6°C), a blood pressure of 88/54 mm Hg, a pulse of 104 bpm, a respiratory rate of 28 breaths/min, and an oxygen saturation of 88% while breathing room air. Her oxygen saturation improved to 92% with supplemental oxygen given at 2 L/min. She is in moderate respiratory distress; however, she can speak in full sentences. Her physical examination reveals absent breath sounds throughout the right thorax, with decreased breath sounds halfway up the left thorax. Other findings include egophony, decreased fremitus, and dullness to percussion on the right thorax. She has no jugular venous distention, edema on her lower extremity, or rash. Acute Liver Failure Acute liver failure (ALF), also known as fulminant hepatic failure, is a rare manifestation of liver disease and constittes a medical emergency. The syndrome arises from loss of hepatic parenchyma that may result from a variety of insults to the liver. Despite advances in medical management and the availability of liver transplantation, mortality rates in patients with ALF remain substantial. It has been estimated that in the United States, 2000 deaths a year are attributable to ALF. Pulmonary Sarcoidosis Vs Tuberculosis Sarcoidosis may present atypically as Lofgrens and HeerFordt’s syndrome.¹ Sarcoidosis in younger patients with spontaneous remission and less than two years duration of symptoms are classified as subacute while chronic form have more than two years duration with insidious onset and presents with constitutional symptoms, pulmonary fibrosis and nephrocalcinosis.¹ Advanced Lipoprotein Fingerprinting Utilize a system encouraging patients to attend classes if laboratory results suggest benefit from changing nutritional and/or exercise behaviors. Doctors somethimes also make visits to offices and schools for conducting lipid screenings. Tuberculosis (TB) Part 3 Recommended regimens in patients with HIV infection include pyrazinamide plus rifampin daily for 2 months, rifampin alone daily for 4 months, or 9 months of INH (daily or twice weekly). Patients on antiretroviral therapy may need rifabutin in place of rifampin. Tuberculosis (TB) Part 2 tuberculosis is a slow-growing organism, requiring 4-8 weeks for visible growth on solid medium. The organism grows in parallel groups called cords (see Image 1). It retains many stains after decoloration with acid-alcohol, which is the basis of acid-fast stains. Tuberculosis (TB) Part I Tuberculosis (TB) is the number one infections disease killer worldwide. The World Health Care Organization estimates that 2 billion people have latent TB, while another 3 million people worldwide die each year due to TB.

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