Subclinical Infection

OBJECTIVE: To determine frequency of subclinical hypothyroidism and hyperthyroidism in patients with congestive heart failure (CHF). METHODOLOGY: This descriptive cross-sectional study was conducted from 05-07-2010 to 04-07-2011, at cardiology department of Hayatabad medical complex, Peshawar. Adult patients of >15 years, diagnosed as CHF by using echocardiography were included. Exclusion criteria included patients taking thyroxin or antithyroid medications, dopamine, glucocoticoides, metoclopramide & phenothiazines; thyroxine level <9pmol/L, triiodothyronine level <95 ng/dl or thyroxine level >24 pmol/L & Triiodothyronine level >190ng/dl and diagnosis of sub-acute, painless or postpartum thyroiditis. History was taken and thorough clinical examination was performed. Diagnosis of CHF was confirmed through echocardiography by using Simpson's method for calculating ejection fraction and by using pulse wave Doppler of mitral inflow and pulmonary venous flow. Serum TSH, free T4 and T3 levels were determined. Presence or absence of subclinical hypothyroidism and hyperthyroidism was ascertained in heart failure patients. RESULTS: Out of 753 patients, there were 431 (57.2%) male and 322 (42.8%) female patients. The mean age was 57.66±12.81 years. Subclinical thyroid disease was found in 46 (6.1%) patients including 26 (3.45%) males and 20 (2.65%) females. Subclinical hypothyroidism was found in 30 (3.98%) patients of CHF including 19(2.52%) males and 11(1.46%) females. Subclinical hyperthyroidism was found in 16 (2.12%) patients with CHF including 7(0.92%) males and 9(1.19%) females. Majority of subclinical hypothyroid (66.7%) and subclinical hyperthyroid (81.25%) patients were <60 years of age. CONCLUSION: Subclinical hypothyroidism and hyperthyroidism are not very common in CHF patients. Hypothyroidism was more frequent than hyperthyroidism.

Periapical abscesses are common but may rarely be a subclinical infection in dental clinics. If an infection progresses rapidly or slowly as a tooth ache of chronic periodontitis with clinical features misleading the diagnosis, the dentists are able to recognize the salient signs and identify the patients at risk. This article reviews a case of a rare innocuous periapical abscess presenting as angioedema of upper lip with history of consuming nonsteroidal anti-inflammatory drugs such as diclofenac sodium whenever needed for arthralgia on a short-term basis.

Systemized data on epidemiology, pathogenesis, clinical manifestation, diagnostics and therapy of VZV-vasculopathy--a disease, occurring due to damage of arteries of the central nervous system by Varicella Zoster virus, are presented in the review. A special attention in the paper is given to the effect of vaccine prophylaxis of chicken pox and herpes zoster on the frequency of development and course of VZV-vasculopathy.

Background Acute and agent-specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections on cardiovascular disease is limited. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD). Methods In a cross-sectional study, we assessed the relation of recurrent infections and carotid artery intima-media thickness (IMT) in 1946 disease-free women from the Mexican Teachers’ Cohort. Through 2012–2016, participants answered structured questions on respiratory, urinary and vaginal infections during the previous year and their IMT was measured using ultrasound by standardized neurologists. We defined sCVD as mean right and left IMT ≥0.8 mm or the presence of atheromatous plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting ...