Abstract:
Aim of the study: Clarification of the effect of management of diabetic ketoacidosis on both hypocalcemia and electrocardiographic “Wavy triple sign or Yasser’s sign” is the target for the current study.
Background: Hypocalcemia is a well-known serious electrolyte disturbance characterized by calcium deficiency. Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes that is usually associated with electrocardiographic and electrolytes changes such as hypocalcemia. An electrocardiographic Wavy triple sign (Yasser’s sign) of hypocalcemia is a new diagnostic sign seen in 97.3% of hypocalcemia.
Method of study and patients: The author reported retrospective-observational 27-case report series. The study was conducted in Fraskour Central Hospital in the intensive care unit for nearly 15 months, starting on Jan 14, 2019, and, ending on Jul 12, 2020. All included cases were latent hypocalcemia. Oral calcium and vitamin D preparation on discharge was supplied.
Results: The mean age was: 44.6 years, with female sex predominance (63%). The main complaints in the study were tachypnea (81.48 %) vs. and tachypnea with chest pain (18.5%). Diabetic ketoacidosis (70.37%) and combined diabetic ketoacidosis with ischemic heart disease (11.11%) are the most common risk factors. All cases were latent tetany. Complete electrocardiographic recovery without calcium administration in 85.19% vs. nearly normalized response in 11.11% and non-response in 3.7%.
Conclusions: The wavy triple electrocardiographic sign (Yasser’s sign) and hypocalcemia are commonly seen in diabetic ketoacidosis. Dramatic spontaneous improvement of both wavy triple an electrocardiographic sign (Yasser’s sign) and hypocalcemia simultaneously after the management of diabetic ketoacidosis in most cases.
Keywords: Wavy triple an electrocardiographic sign, Yasser’s sign in hypocalcemia, Hypocalcemia, Tetany, Diabetic ketoacidosis, Reversal effect
Biography:
Dr. Yasser Mohammed Hassanain Elsayed is a scientist, critical care physician, cardiologist, and independent researcher at the Ministry of Health in Egypt. He has (160) publicized articles with (36) Innovations. They included (7) "Yasser’s sign", (8) "Yasser’s phenomenon", (1) "Yasser’s modification", (2) "Yasser’s maneuver", (1) “Yasser’s method”, (1) “Yasser’s test”, (8) “Yasser’s syndrome”, (1) "Yasser’s fibrillation", (1) "Yasser’s procedure", (1) Yasser’s ECG palpitations wave, (1) Factitious Yasser's infarction, (1) "Yasser’s criterion", (1) "Yasser's conversions", (1) "Amiodarone off-phenomenon, and (1) "Yasser’s classification". He was an international speaker in (46) Conferences, (8) Keynote speaker, and reviewed (more than 352 articles) for (105) Journals and (2) Conferences. He was an honorable editor for (275) Journals, (16) Conferences OCM, and was an instructor in (15) official and (150) non-official training. He has accepted abstracts in Conferences with no presentation (28). He has (54) COVID-19 publicized articles; He was nominated for big prizes such as the Breakthrough Prize, the Einstein Prize, the Shoman Award, Mostafa Prize, etc. He gained (more than 191) excellence certificates. The most famous articles are: 1. Wavy triple, an electrocardiographic sign (Yasser’s sign). 2. Wavy double Electrocardiographic sign (Yasser’s sign). 3. Graded phenomenon (Yasser’s phenomenon). 4. Connected aircraft squadron electrocardiographic sign (Yasser’s sign). 5. Electrocardiographic Passing phenomenon (Flying phenomenon or Yasser’s phenomenon). 6. Movable weaning off an electrocardiographic phenomenon (Yasser’s phenomenon of hypocalcemia). 7. Yasser’s COVID-19 discrepancy phenomenon. 8. Yasser’s maneuver in the psychogenic coma. 9. Yasser’s modification or oxygen test. 10. Three and one method (Yasser’s method). 11. Yasser's stressor test (Fear and calm test). 12. Triphasic Yasser's stressor syndrome (Fear, calm, and fear syndrome). 13. Right-to-left angina Yasser’s syndrome (Swinging Yasser’s central heart syndrome) or Dancing Yasser’s heart syndrome. 14. Sinusoidal atrial fibrillation (Yasser’s fibrillation). 15. Yasser’s triple discoloration sign. 16. Yasser’s procedure. 17. Yasser's Wenckebach reversal phenomenon. 18. Yasser’s cup of coffee stress syndrome (Single cup of coffee stress syndrome). 19. Yasser’s ECG palpitations wave. 20. Bilobed apical floating heart Yasser’s syndrome. 21. Amiodarone off-phenomenon. 22. Factitious Yasser's infarction. 23. Yasser’s criterion of Inferior ST-Segment Discrepancy Deviations in AF. 24. Yasser's pressure maneuver in Left Facial Palsy with Monopelgia. 25. Retrograde Yasser's Flushing Phenomenon in Left Facial Palsy with Monopelgia. 26. Yasser's conversions. 27. Yasser's coving sign. 28. Yasser's squaring saddling syndrome. 29. Partial modified Yasser's WPW syndrome. 30. Yasser's lateral halo sign. 31. Ephemeral Yasser's scooping ST-segment depression and giant T-wave phenomenon. 32. Yasser's migration sign. 33. Tail apex syndrome. 34. Yasser’s V1-aVR rhythm syndrome. 35. Diagonal biting compressive radiological Yasser’s sign. 36. Yasser’s classification of QRS fragmentation.
