SudaMediCa, The Sudanese Medical Community

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Diuretics in heart failure Diuretics are used for the symptomatic treatment of fl uid overload (either pulmonary congestion or peripheral edema). With the exception of aldosterone antagonists, there are no randomized, controlled trials that have shown any prognostic benefi t. However, they do impro...

Acute vs. chronic heart failure The clinical manifestations depend on the speed with which the syndrome develops. Acute heart failure is often used to describe the patient with acute-onset dyspnea and pulmonary edema, but it can also apply to cardiogenic shock where the patient is hypotensive and ol...

Clinical features of acute porphyria The clinical manifestations of an acute attack are very diverse and the condition may be indistinguishable from many other disorders. The common neurovisceral symptoms of acute porphyric attacks are listed in Table 12.5.7 and, of these, abdominal pain is the most...

A primary spontaneous pneumothorax (PSP) is a pneumothorax that occurs without a precipitating event in a person who does not have known lung disease. In actuality, most individuals with PSP have unrecognized lung disease, with the pneumothorax resulting from rupture of a subpleural bleb [1-5]. In t...

Low-dose/overnight dexamethasone suppression tests In normal subjects, administration of a supraphysiological dose of a glucocorticoid results in suppression of ACTH and hence cortisol secretion. In Cushing’s syndrome of whatever cause there is failure of this suppression when low doses of the synth...

Endocrine features The heterogeneity of the clinical features of PCOS extends to the endocrine abnormalities associated with it As a result, specific endocrine parameters are not a requirement for diagnosis, although measurement can be helpful to support it and, importantly, to exclude other conditi...

Pituitary apoplexy Pituitary apoplexy is a clinical syndrome resulting from acute haemorrhage or infarction of the pituitary gland. It is potentially life-threatening and is characterized by the sudden onset of headache, vomiting, visual disturbance, ophthalmoplegia, and altered consciousness. This ...