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Kewcharoen J, Basharat S, Bhardwaj R, Shah S, Shu R, Krishnan R, Lan H. Swallowing-induced atrial tachycardia: A rare demonstration on fluoroscopic esophagram. J Cardiovasc Electrophysiol 2023; 34:1761-1763. [PMID: 37354447 DOI: 10.1111/jce.15973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Swallowing-associated arrhythmias are rare and most commonly present as atrial tachycardias. METHODS We present a case of a 45-year-old female who experienced frequent episodes of palpitations and dyspnea occurring immediately after swallowing solid food. She was noted to have atrial tachycardia with deglutition that was recorded on the 12-lead electrocardiogram. She underwent fluoroscopic esophagram that demonstrated atrial tachycardia as the barium passed through the distal esophagus and gastroesophageal junction. CONCLUSION Swallowing induced arrhythmias occur rarely and can be confirmed by EKG obtained during deglutition. Gastroesophageal evaluation is required to rule out primary esophageal disorders. Treatment of such arrhythmias is required if symptoms are intractable and can include pharmacotherapy and radiofrequency ablation.
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Affiliation(s)
- Jakrin Kewcharoen
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
| | - Sohaib Basharat
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
| | - Rahul Bhardwaj
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
| | - Shivang Shah
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
| | - Richard Shu
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
| | - Rajagopal Krishnan
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
| | - Howard Lan
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Division of Cardiology, Riverside University Health Systems, Moreno Valley, California, USA
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Jaber M, Basharat S, Krishnan R, Shah S, Shu R. Ventricular Tachycardia in an Elderly Male With Brugada Syndrome. J Investig Med High Impact Case Rep 2023; 11:23247096231201005. [PMID: 37737574 PMCID: PMC10517598 DOI: 10.1177/23247096231201005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/15/2023] [Accepted: 08/27/2023] [Indexed: 09/23/2023] Open
Abstract
We present a case of Brugada syndrome in a 74-year-old patient who presented with urine retention and incidentally found to have non-sustained ventricular tachycardia (NSVT) on electrocardiogram (ECG) and telemetry. To reveal characteristic type 1 Brugada pattern, right-pericardial lead was placed in the third right intercostal space. No antiarrhythmics were started, a loop recorder was implanted, and on follow-up episodes of self-terminating sustained ventricular tachycardia (VT) were noted. The patient was started on quinidine with resolution of VT.
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Affiliation(s)
- Mohammad Jaber
- Riverside University Health System Medical Center, Moreno Valley, CA, USA
| | | | - Rajagopal Krishnan
- Riverside University Health System Medical Center, Moreno Valley, CA, USA
- Loma Linda University Medical Center, CA, USA
| | - Shivang Shah
- Riverside University Health System Medical Center, Moreno Valley, CA, USA
- Loma Linda University Medical Center, CA, USA
| | - Richard Shu
- Riverside University Health System Medical Center, Moreno Valley, CA, USA
- Loma Linda University Medical Center, CA, USA
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Khan I, Ul-Haq Z, Taj AS, Iqbal AZ, Basharat S, Shah BH. Prevalence and Association of Obesity with Self-Reported Comorbidity: A Cross-Sectional Study of 1321 Adult Participants in Lasbela, Balochistan. Biomed Res Int 2017; 2017:1076923. [PMID: 29159174 PMCID: PMC5660751 DOI: 10.1155/2017/1076923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/31/2017] [Indexed: 11/17/2022]
Abstract
Association of fatness with chronic metabolic diseases is a well-established fact, and a high prevalence of risk factors for these disorders has increasingly been reported in the third world. In order to incorporate any preventive strategies for such risk factors into clinical practice, decision-makers require objective evidence about the associated burden of disease. A cross-sectional study of 1321 adults from one of the districts of Balochistan, among the most economically challenged areas of Pakistan, was carried out for the measures of fatness and self-reported comorbidities. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were measured and demographic information and self-reported comorbidities were documented. The prevalence of obesity was 4.8% (95% CI: [3.8, 6.1]) and 21.7% (95% CI: [19.5, 24.0]), as defined by the World Health Organization (WHO) international and Asia/Asia-Pacific BMI cut-offs, respectively. The proportion exhibiting comorbidity increased with increasing levels of fatness in a dose-response relationship (p value < .001). An interaction of weight status with gender was observed to produce a significantly (p = .033) higher comorbidity among overweight women (odds ratio (OR) = 6.1 [1.2, 31.7]) compared with overweight men (OR = 1.1 [0.48, 2.75], p = .762).
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Affiliation(s)
- I. Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Institute of Public Health, Quetta, Balochistan, Pakistan
| | - Z. Ul-Haq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - A. S. Taj
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - A. Z. Iqbal
- Peshawar Institute of Medical Sciences, Peshawar, Pakistan
| | - S. Basharat
- Health Services Academy, Islamabad, Pakistan
| | - B. H. Shah
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
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Basharat S, Shaikh BT. Primary oral health care: a missing link in public health in Pakistan. East Mediterr Health J 2016; 22:703-706. [PMID: 27966774 DOI: 10.26719/2016.22.9.703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 07/21/2016] [Indexed: 11/09/2022]
Abstract
In Pakistan, the limited availability of oral health care and the high level of unmet oral health care needs are well documented. The recorded prevalence of dental caries is 50-70% and that of oral cancer is among the highest in the world. Although oral health care has been declared to be part of the primary health care system, oral health disparities between rich and poor, and emerging problems of access to and use of appropriate care have never been addressed, reflecting a lack of awareness among both patients and health system decisionmakers. Oral cancer screening and atraumatic restorative treatment for tooth decay could be included in a basic package of oral care that does not require qualified dental surgeons. This article develops an argument, based on literature review and an analysis of the health system in Pakistan, for how a basic oral health programme could be an accessible, affordable and acceptable component of the primary health care system.
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Affiliation(s)
- S Basharat
- Health Systems and Policy Department, Health Services Academy, Islamabad, Pakistan
| | - B T Shaikh
- Health Systems and Policy Department, Health Services Academy, Islamabad, Pakistan
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Abstract
BACKGROUND Naswar is a niche smokeless tobacco product from Pakistan. There is little information about its availability and user characteristics. METHODS This cross-sectional survey identified outlets selling Naswar in two wards of one London borough and interviewed a purposively recruited sample of 73 Naswar purchasers. Data were analysed using descriptive and chi-square tests (significance, P ≤ 0.05). RESULTS Of 65 outlets identified 15 sold Naswar. The purchasers' mean (SD) age was 32 (± 10) years and 63% had completed only secondary education. Naswar consumption was significantly associated with tobacco dependency, whilst starting Naswar use at a younger age, having lower education levels, using Naswar more frequently and being of Pakhtunkhwa origin was associated with high monthly consumption (P ≤ 0.05). CONCLUSIONS Naswar was widely available. Naswar purchasers of Pakistani origin were employed and young, but with limited education and little knowledge of Naswar's health impacts. Naswar dependency and consumption was linked to behavioural and socio-demographic factors. Further evidence is needed to support policy development.
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Affiliation(s)
- S Basharat
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, 4 Newark Street, London E1 4AT, UK
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