A pregnant lady with intermittent vaginal bleeding (2007: 3b)

Placenta percreta is a potentially life-threatening complication of pregnancy, which is increasing in incidence. Ante-natal diagnosis with ultrasound and magnetic resonance imaging aids the obstetric team in planning further management. We present a case of placenta percreta with imaging and a brief review of the literature.     

SILENT MYOCARDIAL ISCHEMIA IN HEMODIALYSIS PATIENTS — FACTOR FICTION?

Thirty eight patients underwent Holter ECG monitoring for a 48 hour period covering dialysis and intermediate period to detect incidence of myocardial ischemia manifesting as ST segment changes. Seventeen patients (44.7%) had 165 episodes of dynamic ST segment changes lasting from 1 to 177 minutes, with maximum ST depression of 4 mm. The mean age of patients was 45 ± 14 years and 14 (82.6%) of them were males. Ten (58.8%) patients had hypertension, and 5 (29.4%) patients each had diabetes mellitus and pre-existing coronary artery disease. Six (35.3%) patients with dynamic ST segment changes had ventricular ectopics ranging from isolated ventricular premature contractions to episodes of ventricular tachycardia. No significant hypotension or angina was documented during these episodes of ST segment deviation. We concluded that hemodialysis plays an important role in the genesis of the above ECG changes.KEY WORDS: Ischemic heart disease, Holter monitoring, Renal dialysis     

新生大鼠腰交感神经节凋亡细胞的电镜观察

目的 :观察出生后早期大鼠腰交感神经节细胞凋亡超微结构变化特点。方法 :大鼠按出生后 1d、1w、2w和3w分组 ,取L3、L4交感神经节常规超薄切片 ,铅轴染色 ,透射电镜观察。结果 :1d 2w组腰交感神经节内可见到明显的神经节神经细胞胞体凋亡和突起的退变 ,同时可观察到包绕上述突起的雪旺细胞也发生凋亡。早期凋亡细胞的超微结构特点为核染色质在核膜下的凝集。结论 :出生后早期部分腰交感神经节神经细胞因未能与其靶区建立联系而凋亡 ,随后包绕凋亡神经细胞突起的雪旺细胞也发生凋亡。     

Hypocalcemia and massive pulmonary embolism in SLE patient with COVID‐19 infection: A case report

A 16‐year‐old female patient presented to our ED with fever and coughing of blood for 3 days. She is known to have SLE for 5 months and takes oral prednisone. She was tested positive for COVID‐19. She developed hypocalcemia with clinically diagnosed massive pulmonary embolism. She was treated with heparin and recovered.