Asploro Open Access Publications (2025)

21/06/2025

Survival of Cardiac Arrest with Withdrawal of Mechanical Ventilator: A Case Report

Goutom Chandra Bhowmik1iD*, Sanjib Chowdhury2, Kamrul Hasan3, Muhammad Abdullah3, Jahidul Islam4, Likhon Howlader5, Oishorjo Bala6

1 Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
2 Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
3 Medical Officer, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
4 Assistant Professor, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
5 Emergency Medical Officer, Anabil Hospital & Diagnostic Center, Dhaka, Bangladesh
6 Medical Officer, Khulna City Medical College & Hospital, Khulna, Bangladesh

Asploro Cardiovascular Case Reports and Research
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ACCRR.6104
Asp Cardio Case Rep and Res. 2025 Feb 04;2(1):6-10

PDF:https://asploro.com/wp-content/uploads/2025/02/Survival-of-Cardiac-Arrest-with-Withdrawal-of-Mechanical-Ventilator_A-Case-Report.pdf

HTML: https://asploro.com/accrr/survival-of-cardiac-arrest-with-withdrawal-of-mechanical-ventilator-a-case-report/

Abstract
Background: In-hospital cardiac arrest (IHCA) is a common clinical event with extremely poor outcomes associated with cardiovascular disease. Although IHCA, associated with a high mortality rate, has received little attention compared to other cardiovascular conditions such as myocardial infarction and stroke [1]. The survival rate of IHCA to discharge is approximately 25% [2]. We report a case of cardiac arrest survival in a patient with a history of old MI (anterior), SVD, and uncontrolled DM and HTN. The patient was initially treated with resuscitation according to guidelines due to the unavailability of consent for PCI.
Case Presentation: A 55-year-old South Asian woman presented with massive acute anterior MI with uncontrolled DM and HTN. After proper management of acute MI in the hospital, she was discharged with advice and a suggestion for coronary angiography. Before angiography, an ECHO was done, revealing an LVEF of only 46%, regional wall motion abnormality, and grade II diastolic dysfunction. She was strongly advised to undergo coronary angiography as early as possible. Angiography revealed a massive occlusion of 99% in the mid-LAD. When the cardiac team decided to perform PCI, the patient’s guardian did not give immediate consent. During this time, the patient suffered a cardiac arrest, and an emergency event occurred. ROSC was established through CPR for 30 minutes, followed by intubation and mechanical ventilation. The patient was transferred to the CCU [3]. In the CCU, the patient remained on mechanical ventilation for about 48 hours. After correcting biochemical imbalances, the patient regained hemodynamic stability. She is now undergoing cardiac rehabilitation and has provided consent for PCI.
Conclusion: Cardiac arrest is a sudden event that occurs mostly due to cardiac causes. It is difficult to manage and has a high mortality rate. The key elements of treatment during cardiac arrest include chest compressions, ventilation, early defibrillation when applicable, and immediate attention to potentially reversible causes such as hyperkalemia or hypoxia. There is limited evidence to support more advanced treatments. PCI remains the mainstay of treatment for cardiac arrest caused by thrombus-mediated flow limitation.

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Cardiac arrest in a high-risk patient: A 55-year-old woman with MI, DM, and HTN survived IHCA after CPR and ventilation, now stable and awaiting PCI.

21/06/2025

A Rare Case of Left Circumflex Coronary Artery Fistula to Coronary Sinus

Ioannis Milioglou1*, Steven Ajluni Jr1, Bart Gillombardo2, Mohammed Najeeb Osman2

1 Department of Medicine, , Cleveland, OH, USA
2 Harringthon Heart and Vascular Center, Cleveland, OH, USA

Asploro Cardiovascular Case Reports and Research
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ACCRR.6103
Asp Cardio Case Rep and Res. 2025 Jan 21;2(1):1-5

PDF:https://asploro.com/wp-content/uploads/2025/02/A-Rare-Case-of-Left-Circumflex-Coronary-Artery-Fistula-to-Coronary-Sinus.pdf

HTML: https://asploro.com/accrr/a-rare-case-of-left-circumflex-coronary-artery-fistula-to-coronary-sinus/

Abstract
Arteriovenous coronary malformations are rare in the adult patient population with challenging diagnosis and management. This is a complex case of a left circumflex artery to coronary sinus fistula in a patient with history of bioprosthetic aortic valve replacement presenting with new onset of shortness of breath.

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Rare arteriovenous coronary malformation: a left circumflex artery to coronary sinus fistula in a patient with aortic valve replacement.

21/06/2025

Basically Required Factors for Primary Care Medicine as ACCCC and for Psychosomatic Medicine as HEXACO

Hiroshi Bando1,2iD*, Akiyo Yoshioka1, Masahiro Bando1,2, Yu Nishikiori1

1 Shikoku Division of Integrative Medicine Japan (IMJ), Tokushima, Japan
2 Medical Research/ , Tokushima, Japan

Journal of Health Care and Research
ISSN: 2582-8967
Article Type: Commentary
DOI: https://doi.org/10.36502/2025/hcr.6240
J Health Care and Research. 2025 Jan 29;6(1):8-11

PDF:https://asploro.com/wp-content/uploads/2025/02/Basically-Required-Factors-for-Primary-Care-Medicine-as-ACCCC-and-for-Psychosomatic-Medicine-as-HEXACO.pdf

HTML: https://asploro.com/jhcr/basically-required-factors-for-primary-care-medicine-as-acccc-and-for-psychosomatic-medicine-as-hexaco/

Abstract
Basic concept and common philosophy exist in primary care (PC) medicine and psychosomatic medicine, such as a patient-centered point of view. In PC medicine, some factors have been necessary for actual clinical practice. They are Accessibility, Comprehensiveness, Coordination, Continuity, and Context or Contextual Care, which stand for ACCCC. For medical staff, some factors would be required for adequate management and consideration in clinical practice. They are Honesty-Humility (H), Emotionality (E), Extraversion (X), Agreeableness (A), Conscientiousness (C), and Openness To Experience (O) as HEXACO dimensions. Each dimension shows personal traits, which influence various behaviors and maintain our health and well-being.

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Explore the connection between primary care and psychosomatic medicine through ACCCC and HEXACO traits, shaping patient-centered clinical practice.

07/06/2025

The Baby’s Hearing in the Womb

Jan Myjkowski1*

1 Retired physician, a specialist in otolaryngology – pensioner, Myjkowski Jan, Poland

Journal of Health Care and Research
ISSN: 2582-8967
Article Type: Review Article
DOI: https://doi.org/10.36502/2025/hcr.6239
J Health Care and Research. 2025 Jan 25;6(1):4-7

PDF:https://asploro.com/wp-content/uploads/2025/02/The-Babys-Hearing-in-the-Womb.pdf

HTML: https://asploro.com/jhcr/the-babys-hearing-in-the-womb/

Summary
The paper presents a brief description of developmental stages of the human hearing organ. Attention was brought to the mechanism of receiving and processing auditory information in a child in the womb. Bekesy’s travelling wave theory does not provide a sufficient explanation of these processes. There are no descriptions of auditory mechanisms on a molecular level. Further in the study, attention is drawn to the beneficial effect of early stimulation of the child’s auditory receptor from the second half of pregnancy and after childbirth.

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This paper explores human hearing organ development, emphasizing fetal auditory processing. It highlights early auditory stimulation benefits and research gaps.

07/06/2025

Recognising Nigeria’s Rollout of Malaria Vaccine: A Milestone in Malaria Prevention and Control

Udokang Ephraim Ikpongifono1*, Stephen Chukwuemeka Igwe2, Alatare Abdulrahman Salahudeen2, Abdulmalik Opeyemi Adeyemo2, Toluwalogo Niji-Olawepo2

1 Faculty of Pharmacy, , Nwaniba Road, Uyo, Akwa Ibom State, Nigeria
2 College of Health Sciences, , 1 University Road Ilorin, Nigeria

Journal of Health Care and Research
ISSN: 2582-8967
Article Type: Letter to Editor
DOI: https://doi.org/10.36502/2025/hcr.6238
J Health Care and Research. 2025 Jan 11;6(1): 1-3

PDF:https://asploro.com/wp-content/uploads/2025/02/Recognising-Nigerias-Rollout-of-Malaria-Vaccine-A-Milestone-in-Malaria-Prevention-and-Control.pdf

HTML: https://asploro.com/jhcr/recognising-nigerias-rollout-of-malaria-vaccine-a-milestone-in-malaria-prevention-and-control/

Abstract
Nigeria is one of the African nations with a significant global malaria infection burden. Millions of people, particularly children, have died from this parasitic illness. Recently, Nigeria implemented the malaria vaccine, marking a significant step in addressing this issue. This is a major turning point in Nigeria’s efforts to eradicate the fatal illness. Since the introduction of the RTS,S vaccine, the country’s malaria burden has decreased, and Nigeria deserves praise for its leadership, successful collaboration, and community involvement. This letter highlights the challenges and provides future recommendations while expressing gratitude to the Nigerian government for achieving a significant milestone in the fight to eradicate malaria.

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Nigeria's malaria vaccine rollout marks a major step in reducing infections. This letter highlights challenges, progress, and future recommendations.

07/06/2025

Acute Diffuse Phlegmonous Esophagitis Involving the Entire Esophagus with Septic Shock: A Case Report and Literature Review

Xiaoyan Xian1,2, Binrong Cai1,2, Yiqin Xia1,2iD*

1 Department of Emergency Medicine, West China Tianfu Hospital, , Chengdu, 610023, Sichuan, China
2 Department of Emergency Medicine, West China Hospital, , Chengdu, 610041, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6390
Asp Biomed Clin Case Rep. 2025 Jan 28;8(1):58-63

PDF:https://asploro.com/wp-content/uploads/2025/01/Acute-Diffuse-Phlegmonous-Esophagitis-Involving-the-Entire-Esophagus-with-Septic-Shock_A-Case-Report-and-Literature-Review.pdf

HTML: https://asploro.com/asjbccr/acute-diffuse-phlegmonous-esophagitis-involving-the-entire-esophagus-with-septic-shock-a-case-report-and-literature-review/

Abstract
Background: Acute diffuse phlegmonous esophagitis is a relatively rare bacterial inflammation of the esophagus. It is characterized by an acute, diffuse, purulent infection involving the submucosal and serosal layers, resulting in phlegmonous-like features. There are only a few case reports in the medical literature, and early diagnosis of this condition presents challenges.
Case Presentation: This report presents a 73-year-old male patient with a history of type 2 diabetes, hypertension, gout, and chronic alcohol use, with poorly controlled blood glucose. The patient presented with upper abdominal pain, fever, shortness of breath, and dysphagia. Initial symptoms included severe upper abdominal pain, fever, and respiratory distress. Chest and abdominal enhanced CT scans revealed thickening and swelling along the entire esophagus, with narrowing of the lumen. After contrast enhancement, the esophagus showed ring-like enhancement. Upper gastrointestinal endoscopy showed mucosal swelling. There was no ulceration or perforation. The diagnosis of acute diffuse phlegmonous esophagitis was considered after excluding other common acute abdominal and chest pain conditions. The condition progressed rapidly, leading to septic shock. Next-Generation Sequencing of blood was positive for hypervirulent Klebsiella pneumoniae (hvKp). Despite active treatment, the patient’s condition was initially controlled; however, a follow-up chest CT showed multiple air pockets around the esophagus. The patient subsequently developed septic shock again and died despite active treatment.
Conclusion: Hypervirulent Klebsiella pneumoniae infection causing acute diffuse phlegmonous esophagitis involving the entire esophagus is a rapidly progressing condition that can quickly lead to septic shock. This report aims to alert clinicians to this rare disease and emphasizes the need for heightened awareness in cases of severe upper abdominal pain, where atypical abdominal pain may mask potentially fatal chest pain conditions. Early and accurate diagnosis and timely treatment are essential.

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Acute diffuse phlegmonous esophagitis is rare and rapidly progresses to septic shock. Early diagnosis and awareness are crucial for timely treatment.

31/05/2025

Pattern of Findings in Echocardiography of Cardiovascular Diseases in Geriatric Patients: A Case Study of a Nigerian Tertiary Hospital

Daniel Ifeanyi Obatu1, Benjamin Ikemefuna Ude1iD*, David Ogbonna Onyekachi1, Victor David Obed1

1 Department of Medical Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, , Nsukka (UNN), Nigeria

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Original Article
DOI: https://doi.org/10.36502/2025/ASJBCCR.6389
Asp Biomed Clin Case Rep. 2025 Jan 23;8(1):51-57

PDF:https://asploro.com/wp-content/uploads/2025/01/Pattern-of-Findings-in-Echocardiography-of-Cardiovascular-Diseases-in-Geriatric-Patients_A-Case-Study-of-a-Nigerian-Tertiary-Hospital.pdf

HTML: https://asploro.com/asjbccr/pattern-of-findings-in-echocardiography-of-cardiovascular-diseases-in-geriatric-patients-a-case-study-of-a-nigerian-tertiary-hospital/

Abstract
Background: Echocardiography is a non-invasive technique that provides information about cardiac structure, function, and hemodynamics. Therefore, the knowledge of the echocardiographic pattern is imperative for the effective planning and management of patients with cardiovascular diseases. Unfortunately, there is a lack of data on the pattern of echocardiographic findings among these patients in our locality. Consequently, there is a need for a study aimed at describing the pattern of findings in echocardiography of cardiovascular diseases in geriatric patients.
Methods: This retrospective study was conducted at the Federal Medical Centre, Asaba from January 2018 to March 2021. It involved 130 reports of cardiovascular disease patients selected using a random sampling technique. Only geriatric patients’ echocardiography reports were included in the study and reports with incomplete information were excluded. Data collected were the patient’s age, s*x, indications and echocardiography findings….

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Echocardiography reveals hypertensive heart disease as the most common finding in geriatric patients, emphasizing the need for better management.

31/05/2025

Predictive Value of Shock Index and Age-Adjusted Shock Index for Hypotension after Tracheal Intubation in Critically Ill Patients

Zheng Huang1,2, Zeng Wen MA1,2, Shu Yun Xu1,2*

1 Department of Emergency, West China Hospital, , Chengdu 610041, China
2 Department of Emergency, Shangjin Nanfu Hospital of West China, , Chengdu 611743, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Original Article
DOI: https://doi.org/10.36502/2025/ASJBCCR.6388
Asp Biomed Clin Case Rep. 2025 Jan 11;8(1):44-50

PDF:https://asploro.com/wp-content/uploads/2025/01/Predictive-Value-of-Shock-Index-and-Age-Adjusted-Shock-Index-for-Hypotension-after-Tracheal-Intubation-in-Critically-Ill-Patients.pdf

HTML: https://asploro.com/asjbccr/predictive-value-of-shock-index-and-age-adjusted-shock-index-for-hypotension-after-tracheal-intubation-in-critically-ill-patients/

Abstract
Objective: To evaluate the predictive value of the Shock Index (SI) and Age-Adjusted Shock Index (AASI) for hypotension following tracheal intubation in critically ill patients, providing a theoretical basis for clinical decision-making.
Methods: Clinical data were retrospectively collected and analyzed for patients who underwent tracheal intubation in the Emergency Department of Chengdu Shangjin Nanfu Hospital from January 1, 2021, to December 31, 2022. Patients were divided into hypotension and non-hypotension groups based on post-intubation outcomes. Univariate analysis identified risk factors for post-intubation hypotension, and multivariate logistic regression determined the relationship between hypotension and these risk factors. Receiver Operating Characteristic (ROC) curves were used to determine the optimal thresholds for these risk factors….

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Predictive value of Shock Index (SI) and Age-Adjusted Shock Index (AASI) for post-intubation hypotension in critically ill patients supports clinical decision-making.

31/05/2025

Emergency Treatment and Management Strategies for 79 Patients Involved in a School Mass Bee Sting Incident

E Pan1, Tao Cheng1, Yao Chen1, Bin He1*

1 Emergency Department, West China Hospital, West China School of Medicine, , Chengdu, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2024/ASJBCCR.6387
Asp Biomed Clin Case Rep. 2025 Jan 06;8(1):38-43

PDF:https://asploro.com/wp-content/uploads/2025/01/Emergency-Treatment-and-Management-Strategies-for-79-Patients-Involved-in-a-School-Mass-Bee-Sting-Incident.pdf

HTML: https://asploro.com/asjbccr/emergency-treatment-and-management-strategies-for-79-patients-involved-in-a-school-mass-bee-sting-incident/

Abstract
Objective: To analyze the emergency treatment and triage strategies for patients involved in a mass bee sting incident at a school and to evaluate the effectiveness of optimizing emergency procedures through scoring-based assessment criteria. The aim is to reduce the incidence of severe complications and improve the efficiency of emergency response during mass casualty events.
Methods: A retrospective analysis was performed on the clinical data of 79 patients affected by bee stings during a mass incident at a school. Demographic information, clinical presentations, scoring results, classifications, and treatment measures were collected and analyzed. The severity of each patient’s condition was assessed using the Quick Sequential Organ Failure Assessment (qSOFA) score and an allergy response score. Based on these scores, patients were categorized as mild, moderate, or severe, with emergency treatment tailored accordingly. Mild cases presented with skin symptoms, moderate cases involved respiratory distress or mental disturbance, and severe cases showed multiple organ damage or anaphylactic shock. Emergency interventions, including triage labeling, intravenous access, anti-allergic medication, corticosteroid administration, and dynamic monitoring, were applied based on condition severity. Treatment outcomes and the value of the scoring system were subsequently analyzed….

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Scoring-based emergency triage for mass bee sting incidents improves response efficiency, reduces complications, and guides effective treatment strategies.

24/05/2025

The Latest topics of Standards of Care in Diabetes 2025: Focusing on GLP-1RA

Hiroshi Bando1,2iD*, Michael Wood2, Koji Ebe2,3

1 Medical Research/ , Tokushima, Japan
2 Japan Low Carbohydrate Diet Promotion Association (JLCDPA), Kyoto, Japan
3 Takao Hospital, Kyoto, Japan

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Commentary
DOI: https://doi.org/10.36502/2024/ASJBCCR.6386
Asp Biomed Clin Case Rep. 2024 Dec 31;8(1):34-37

PDF:https://asploro.com/wp-content/uploads/2025/01/The-Latest-topics-of-Standards-of-Care-in-Diabetes-2025_Focusing-on-GLP-1RA.pdf

HTML: https://asploro.com/asjbccr/the-latest-topics-of-standards-of-care-in-diabetes-2025-focusing-on-glp-1ra/

Abstract
The American Diabetes Association (ADA) presented the Standards of Care in Diabetes-2025 online in December 2024. The authors immediately reviewed and provided perspectives on the latest developments regarding glucagon-like peptide-1 receptor agonists (GLP-1RA). Some newly added content about GLP-1RA is included, such as its application for heart failure with preserved ejection fraction (HFpEF), obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction-associated steatohepatitis (MASH). Concurrent use of DPP-4 inhibitors (DPP-4i) with GLP-1RA (GIP/GLP-1RA) is not recommended due to a lack of additional glucose-lowering effects beyond GLP-1RA alone. GLP-1RA is expected to demonstrate various positive clinical effects.

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Discover the ADA Standards of Care in Diabetes-2025, featuring insights on GLP-1RA for HFpEF, obesity, MASLD, MASH, and updates on DPP-4i co-use recommendations

24/05/2025

Possible improvement of Urinary Tract Infection (UTI) by Gatch up positioning in Long-term Acute Care (LTAC)

Riichi Ohfuru1, Hiroshi Bando1iD*, Nobuo Sakata2,3

1 Hakuai Memorial Hospital, Heisei Medical Welfare (HMW) Group, Tokushima, Japan
2 Heisei Medical Welfare Research Group Institute, Tokyo, Japan
3 Setagaya Memorial Hospital, Tokyo, Japan

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2024/ASJBCCR.6385
Asp Biomed Clin Case Rep. 2024 Dec 30;8(1):30-33

PDF:https://asploro.com/wp-content/uploads/2024/12/Possible-improvement-of-Urinary-Tract-Infection-UTI-by-Gatch-up-positioning-in-Long-term-Acute-Care-LTAC.pdf

HTML: https://asploro.com/asjbccr/possible-improvement-of-urinary-tract-infection-uti-by-gatch-up-positioning-in-long-term-acute-care-ltac/

Abstract
Adequate medical practice has been emphasized for the increasing elderly population. The authors have long provided Long-Term Acute Care (LTAC). Concerning clinical problems related to urinary tract infection (UTI), we propose the Gatch-up 45-degree positioning as a preventive measure for UTI. The case involves a 68-year-old female who underwent the Gatch-up procedure for 1 hour, twice a day, over a period of 1 month. Post-void residual (PVR) urine volume was measured and compared between the previous month and the intervention period. The average PVR significantly decreased from 245 mL to 80 mL (p < 0.05), representing a 67.3% reduction. This suggests further indications and potential future development for this procedure.

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Gatch-up 45° positioning reduces UTI risk in elderly patients. A 67.3% decrease in post-void residual urine suggests its potential for broader clinical application.

24/05/2025

Recent Advances in Understanding the Pathophysiology and Risk Stratification of Post-Intubation Hypotension

E Pan1, Yao Chen1*

1 Emergency Department, West China Hospital, West China School of Medicine, , Chengdu, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Review Article
DOI: https://doi.org/10.36502/2024/ASJBCCR.6384
Asp Biomed Clin Case Rep. 2024 Dec 18;8(1):20-29

PDF:https://asploro.com/wp-content/uploads/2024/12/Recent-Advances-in-Understanding-the-Pathophysiology-and-Risk-Stratification-of-Post-Intubation-Hypotension.pdf

HTML: https://asploro.com/asjbccr/recent-advances-in-understanding-the-pathophysiology-and-risk-stratification-of-post-intubation-hypotension/

Abstract
Research indicates that post-intubation hypotension (PIH) is the most frequent complication of intubation, potentially leading to acute myocardial infarction, renal failure, extended hospitalizations, and poor outcomes. Key physiological parameters such as age, body mass index, and baseline blood pressure are closely linked to PIH incidence. Induction drugs significantly influence the mechanisms of PIH, with varying drugs and administration methods impacting hemodynamic stability. Furthermore, the complexity of the intubation procedure exacerbates PIH by stimulating the vagus nerve and affecting cardiac output. Although current research aims to identify risk factors and physiological mechanisms of PIH, the absence of uniform diagnostic criteria impedes the comparability of results. Future studies should focus on establishing clear diagnostic standards, optimizing induction drug choices and procedural techniques, and integrating early warning indicators with personalized intervention strategies to decrease PIH incidence and enhance patient outcomes.

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Post-intubation hypotension (PIH) risks include poor outcomes and complications. Future focus: diagnostic standards, induction drugs, techniques, and personalized strategies.

Asploro Open Access Publications

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