scholarly journals Sickle cell Anemia with avascular necrosis of femur being managed as rheumatic fever

2013 ◽  
Vol 34 (1) ◽  
pp. 37-39
Author(s):  
KS Lamsal
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Avascular Necrosis ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Case Reports ◽  
Institute Of Medicine ◽  
History Of ◽  
Penicillin Prophylaxis ◽  
Rheumatic Heart

Sickle cell anemia is a rare hematological problem in Nepal and described only in the forms of case reports. This is a case report of a patient of sickle cell disease from Nawalparasi district of Nepal. The patient had history of recurrent joint pain including both large and small joints. He also had soft systolic murmur in cardiac auscultation for which he had received penicillin prophylaxis three years for clinically suspected rheumatic heart disease. He was later diagnosed to have Sickle cell anemia with avascular necrosis of right femoral head and functional murmur of severe anemia with no evidence of rheumatic heart disease. DOI: http://dx.doi.org/10.3126/joim.v34i1.9121 Journal of Institute of Medicine, April, 2012; 34:1 37-39

scholarly journals Acute Rheumatic Activity in a 49 year old Nepalese adult with established Rheumatic heart Disease: a case report

2016 ◽  
Vol 13 (2) ◽  
pp. 39-40
Author(s):  
Anish Hirachan ◽  
Reeju Manandhar ◽  
Madhu Roka ◽  
Deewakar Sharma
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Case Reports ◽  
High Dose ◽  
Dramatic Improvement ◽  
Severe Aortic Regurgitation ◽  
History Of ◽  
Migratory Polyarthritis ◽  
Rheumatic Heart

Rheumatic fever presenting late in adult beyond 25 years of age is a rare but common phenomena and noted in various case reports .The diagnosis of rheumatic activity is based on the same modified Jones criteria for rheumatic fever and rheumatic heart disease. Here we describe a 49 year old male , known rheumatic heart disease with severe aortic regurgitation and post aortic valve replacement who presented with fever and migratory polyarthritis along with history of preceding sore throat 2 weeks prior to this illness . He was managed with high dose of aspirin therapy along with oral penicillin after which he had dramatic improvement in his symptomatology and was discharged with good recovery.Nepalese Heart Journal 2016; 13(2): 39-40

scholarly journals Sydenham’s Chorea as Presentation of Rheumatic Heart Disease

2017 ◽  
Vol 13 (3) ◽  
pp. 271-273
Author(s):  
A. Joshi ◽  
R.P.B. Shrestha ◽  
P.S. Shrestha ◽  
S. Dangol ◽  
N.C. Shrestha ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Lower Limbs ◽  
Moderate Degree ◽  
Sydenham’S Chorea ◽  
Streptolysin O ◽  
Grade Ii ◽  
Sydenham's Chorea ◽  
Penicillin Prophylaxis ◽  
Rheumatic Heart

Sydenham’s chorea is the most common type of acquired chorea in childhood which is a major neurological manifestation of rheumatic fever. We describe a 13 years old girl who presented with weakness and purposeless involuntary movements of upper and lower limbs. The symptoms slightly affected the child’s daily activities and had an unstable gait on walking which was aggravated during stress. Grade II ejection systolic murmur was noticed on cardiovascular examination. Echocardiography evaluation showed thickened aortic and mitral valve leaflets with mild to moderate degree of mitral regurgitation. Anti-streptolysin O titer was positive (≥200 IU/ml). CT scan of brain was normal. Subsequently child was diagnosed as Rheumatic heart disease with Sydenham’s chorea and kept on regular Benzathine penicillin prophylaxis. Symptoms subsided spontaneously after 3 months without any further complications. Although decreasing, early diagnosis and management of Sydenham’s chorea and Rheumatic heart disease are very crucial and should be considered with such presentation.

Giant left atrium in a woman with mitral prosthetic valve malfunction and history of rheumatic heart disease

2009 ◽  
Vol 4 (5) ◽  
pp. 435-437
Author(s):  
Gaspare Parrinello ◽  
Daniele Torres ◽  
Salvatore Paterna ◽  
Manuela Mezzero ◽  
Pietro Di Pasquale ◽  
...  
Keyword(s):  
Heart Disease ◽  
Left Atrium ◽  
Rheumatic Heart Disease ◽  
Prosthetic Valve ◽  
History Of ◽  
Giant Left Atrium ◽  
Valve Malfunction ◽  
Rheumatic Heart

Abstract 16175: Total Burden of Out-of-Pocket Costs for Penicillin Prophylaxis for Rheumatic Heart Disease in India: Results From the AIIMS Pediatric RHD Registry

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anurag Mehta ◽  
Anita Saxena ◽  
Dhruv S Kazi
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Rural Areas ◽  
Tertiary Hospital ◽  
Drug Costs ◽  
Transportation Costs ◽  
Major Barrier ◽  
Penicillin Prophylaxis ◽  
Rheumatic Heart ◽  
Out Of Pocket Costs

Introduction: Out-of-pocket costs are a major barrier to medication adherence in low and middle income countries and an important target for policy-level interventions. The total economic burden for patients receiving secondary penicillin prophylaxis for Rheumatic Heart Disease (RHD) is uncertain. Methods: We prospectively collected self-reported out-of-pocket drug, transportation, and provider costs from patients in the AIIMS Pediatric RHD Registry. Monthly costs were estimated by adjusting visit costs for frequency of drug administration. Because adverse drug reactions are rare, we did not collect complication-related costs. Mean (±SD) costs are reported in 2013 Indian Rupee (INR) and International Dollars (INT$). Results: In our registry, 230 patients provided cost data over 313 visits. The mean age was 11.8 (±2.9) years, and 83 (36%) were girls. The majority of patients resided in rural areas (n=197, 86%), and were from the lower and upper lower socioeconomic strata (n=160, 70%) on the modified Kuppuswami scale. Nearly all patients hailed from outside Delhi (91%), reflecting the referral population of our tertiary hospital. The monthly out-of-pocket cost was INR 74.92 (±109.00) or INT$ 4.04 (±5.88), drug cost forming 36% of the total costs (INR 26.71 [±11.6]; INT$ 1.44 [± 0.63]). Provider costs (INR 18.21 [±32.48]) and transportation costs (INR 30.00 [±106.51]) comprised 24% and 40% of total costs respectively. Provider and transportation costs exceeded the drug costs for 38% of the patients. Patients traveled 12 (±38) km round trip to obtain penicillin prophylaxis. Conclusions: Drug costs constitute only 36% of the total out-of-pocket cost of penicillin prophylaxis for RHD, with provider costs (24%) and transportation costs (40%) comprising the remainder. Because out-of-pocket costs can be a major barrier to long-term adherence, future efforts must be directed at improving access to and lowering total costs of penicillin prophylaxis for RHD.

scholarly journals Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036827 ◽  
Author(s):  
Bárbara Martins Bechtlufft ◽  
Bruno Ramos Nascimento ◽  
Craig Sable ◽  
Clara Leal Fraga ◽  
Márcia Melo Barbosa ◽  
...  
Keyword(s):  
Heart Disease ◽  
Public Schools ◽  
Rheumatic Heart Disease ◽  
Heart Diseases ◽  
Diagnostic Category ◽  
Secondary Outcome ◽  
Unfavourable Outcome ◽  
History Of ◽  
Rheumatic Heart

ObjectivesEchocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5–18 years) with echocardiography-detected subclinical RHD and to assess the performance of a simplified score consisting of five components of the World Heart Federation criteria, as a predictor of unfavourable echo outcomes.SettingPublic schools of underserved areas and private schools in Minas Gerais, southeast Brazil.ParticipantsA total of 197 patients (170 borderline and 27 definite RHD) with follow-up of 29±9 months were included. Median age was 14 (12–16) years, and 130 (66%) were woman. Only four patients in the definite group were regularly receiving penicillin.Primary and secondary outcome measuresUnfavourable outcome was based on the 2-year follow-up echo, defined as worsening diagnostic category, remaining with mild definite RHD or development/worsening of valve regurgitation/stenosis.ResultsAmong patients with borderline RHD, 29 (17.1%) progressed to definite, 49 (28.8%) remained stable, 86 (50.6%) regressed to normal and 6 (3.5%) were reclassified as other heart diseases. Among those with definite RHD, 13 (48.1%) remained in the category, while 5 (18.5%) regressed to borderline, 5 (18.5%) regressed to normal and 4 (14.8%) were reclassified as other heart diseases. The simplified echo score was a significant predictor of RHD unfavourable outcome (HR 1.197, 95% CI 1.098 to 1.305, p<0.001).ConclusionThe simple risk score provided an accurate prediction of RHD status at 2-year follow-up, showing a good performance in Brazilian schoolchildren, with a potential value for risk stratification and monitoring of echocardiography-detected RHD.

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