Qatar Medical Journal - Volume 2007, Issue 2

Brugada Syndrome is a distinct form of an arrhythmic disease characterized by right bundle branch block an ST segment elevation in the right pericardial leads (VI - V3) of the electrocardiogram (ECG). This syndrome is clinically important because of the high incidence of sudden death by ventricular fibrillation (VF) without any structural heart disease, and is seen especially in the Asian population including Japanese people. Recently, it has been demonstrated that Brugada Syndrome is generally linked to the mutation of the alpha subunit of the sodium channel gene, SCNSA, and the use of certain anti-arrhythmic sodium channel blockers (Class IA au IC) is the sole the Medical intervention which effectively protects patients with Brugada Syndrome from sudden cardiac death.

Lipid-lowering agents such as HMG-CoA reductase inhibitors (also known as statin drugs) are generally well tolerated. But a recognized side effect still can happen, We report a case of 47-year-old Iraqi male patient previously known hypothyroid, was not on replacement therapy, as he did not appear after his thyroid functions was checked came in with severe body pain for 10 months got worse in the last three months, started on lipostat (ten months ago) found to have myopathy as evident by high CPK which improved gradually clinically and biochemical after stopping lipostat.

We report a case of a tightly circumcised woman who bled irregularly throughout her first year of marriage but failed to conceive. The detection and management of a large but hidden cervical polyp solved her problems. We suggest that such cases, especially in immigrant women, require deeper investigation than might at first appear to be needed.

Xanthomas are localized infiltrates oftipid-containing cells found within the dermis. Cutaneous xanthomas are mostly cosmetic disorders but xanthomas can indicate the presence of an underlying generalized disturbance in lipid metabolism possibly associated with coronary artery disease. Because hyperlipidemia may present as xanthomatosis, a dermatologist might be the first to diagnose these associated lipid abnormalities, We report a 36-year-old male who presented with four classic types of xanthomas (Xanthelasma, Tuberous, Eruptive and Plane xanthomas) at the same time. Laboratory tests confirmed hypercholesterolemia and hypertriglyceridemia of dysbetalipoprotein Type III of the Fredrickson classification. The occurrence of four clinical types of xanthomas simultaneously in the same patient is rarely reported in the literature. The clinical, histopathology, laboratory investigation and management of hyperlipidemia and cutaneous lesions is fully discussed together with a review of the literature.

A 62-year-old Pakistani man presented with fever and chest pain of five-day duration. He was non-smoker and he had no history of hemoptysis, wheezing, loss of weight or exposure to tuberculosis. Other history was unremarkable. Physical examination revealed a heart rate of 116 beats/min, BP of 121/ 58 mm Hg, temperature of 38.5°C, and a room air oxygen saturation of 92 %. There was no cervical, axillary, or inguinal lymphadenopathy. Chest examination revealed bronchial breath sounds in the right middle and lower zones. Cardiac examination revealed tachycardia with no gallops or murmurs. Abdomen was nontender without hepatosplenomegaly. Extremities were free of cyanosis, edema, and clubbing. There were no skin lesions

A sixty years old patient, known case of chronic renal failure on regular hemodialysis through long term intravascular catheter was admitted with fever. Blood culture revealed staphylococcus aureus bacteremia (MSSA).

Objective: To investigate cross-sectional associations among blood pressures (BPs), arterial stiffness, and open-angle glaucoma (OAG). Methods: Study participants came from the population-based Rotterdam Study. The baseline examination phase took place after an extensive home interview from March 20, 1990, to June 17,1993, and the third phase between March 19,1997, and December 16,1999. Cases were classified into high-tension OAG (htOAG) and normal-tension OAG (ntOAG), according to an intraocular pressure greater than 21 mm Hg or 21 mm Hg or less. Pulse pressure was the difference between systolic and diastolic BP. Diastolic perfusion pressure was the difference between diastolic BP and the intraocular pressure; indicators of arterial stiffness were carotidfemoral pulse wave velocity and carotid distensibility. Associations were evaluated with logistic regression analysis, adjusted for age, sex, body mass index, smoking, diabetes mellitus, serum cholesterol level, and BPlowering treatment.

Heart failure (HF) is a major killer. Many die due to uncontrolled HF, but many die even when HF is well controlled, principally due to major ventricular arrhythmia. In Framingham study, one third of patients with HF died suddenly (SCD). While diuretics have made a major impact on the main symptoms of HF, edema and breathless, they did no change mortality. It was only with introduction of vasodilators and ACE Inhibitors that the total mortality was altered as shown by many trials like VHeFT and CONSENSUS etc. However, sudden cardiac death (SCD) remained unreduced. This is because HF is not only a syndrome of excess fluids. Hopes were transiently raised by Angiotensin-II Blockers (AT-II blockers) when ELITE-I trial showed reduced SCD as compared to ACE-Inhibitors. These hope soon vanished by ELITE -II, which confirmed that neither ACE-Inhibitors nor AT- II blocker reduced SCD. The major impact on SCD was only consistently shown with Implantable Defibrillators (ICD) that have become a cornerstone in management of selected patients at risk of SCD.