The State of Child Health and Human Rights in Nepal

Time is running out for the children of Nepal, say the authors. These children will face an uncertain future unless their health and human rights are urgently addressed

Nepal's War on Human Rights: A summit higher than Everest

Nepal has witnessed serious human rights violations including arbitrary arrests, detentions, "disappearances", extra judicial executions, abductions and torture carried out by both the Royal Nepalese Army and the Maoist rebels in the 10 years of the "peoples war". Women and children have borne the brunt of the conflict. Massive displacement has led to adverse social and psychological consequences. While the reasons for the conflict are mainly indigenous and rooted in the social and economic in-equities, remedies for health inequities must come not only from the health sector but also from broad social policies and adopting a participatory and conflict-sensitive approach to development. Meanwhile the international community needs to use its leverage to urge both sides to accept a human rights accord and honor international human rights and humanitarian laws, while investigating allegations of abuse and prosecute those responsible

A case of Brugada Syndrome unmasked by a postoperative febrile state

Abstract Background: Brugada Syndrome (BS) is an inherited ion channelopathy characterized by an electrocardiographic (ECG) pattern of a coved type ST segment elevation in right precordial leads with or without right bundle branch block. Case Presentation: A 23-year old male presented with right lower quadrant abdominal pain. Further evaluation revealed a diagnosis of acute appendicitis. The patient developed a febrile episode on second post-operative day of laparoscopic appendectomy. ECG revealed features consistent with BS. Prompt control of temperature in the patient resolved the ST-segment elevation and prevented potentially life-threatening arrhythmias. Conclusion: Febrile episodes in susceptible patients may unmask a concealed BS. Prompt control of temperature is advocated to reduce the risk of life-threatening arrythmia

Utility of recognizing early electrocardiogram changes in bronchogenic Takotsubo cardiomyopathy: A case report

BACKGROUND: Takotsubo cardiomyopathy (TCM) is a transient reversible systolic dysfunction, estimated to be the culprit in 1%-2% of patients presenting with clinical symptoms of acute coronary syndrome (ACS). TCM was previously thought to be indistinguishable from ACS on the basis of electrocardiogram (EKG) findings; many authors now describe specific EKG changes that distinguish TCM from ACS as well as aid in early recognition of TCM. CASE SUMMARY: This unique case presentation illustrates an uncommon subtype of TCM, and very clearly exemplifies the specific EKG changes meant to aid in distinguishing TCM from ACS. A bronchogenic subtype of TCM has been proposed, given its prevalence and distinguishing features from TCM without pulmonary pathology; this case exemplifies that notion. The specific EKG changes of low QRS voltage and attenuation of the amplitude of the QRS complex are now being noted in the EKGs of TCM patients. This patient presented for worsening shortness of breath and increased productive cough; her EKG revealed ST elevations in leads V3-V6, and low voltage QRS complexes when compared to previous EKG from 12 wk ago; troponin peaked at 5.16 ng/mL. Left heart catheterization did not reveal significant lesions and left ventriculogram findings were consistent with TCM. Patient was treated for COPD exacerbation, her symptoms improved significantly; she was sent home on the appropriate medications. CONCLUSION: This case exemplifies EKG changes noted in TCM patients who may aid in early detection and appropriate treatment of TCM