Asian Journal of Case Reports in Medicine and Health
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Ankylosed Pubic Symphysis: A Case Report of an Idiopathic Clinico-radiological Mismatch in an Emergency Trauma
No full textThe aim of the case presented was to highlight the assessment of an incidental radiographic finding of fused symphysis for emergency clinicians and trauma surgeons involved in the assessment and management of emergency trauma cases. The objective was to understand the symphyseal affections and to review the literature for approach and management strategy for an ankylosed pubis symphysis. A road traffic accident case of a 62-year old male presented with head, face and pelvic trauma. Standard trauma protocol evaluation was done. Computerised tomography of head revealed basal ganglia bleed and facial tomographic reconstruction was normal. No fractures were evident on the radiography of the pelvis however, an incidental ankylosed symphysis pubis was revealed. Head injury required intensive care management. The incidental radiographic finding had no history suggestive of any possible aetiological cause leading to the ankylosis of pubic symphysis. A clinico-radiological mismatch presented with an idiopathic asymptomatic symphyseal ankylosis. A broader clinician’s perspective during the radiological evaluation of an emergency trauma is needed. The case highlights the necessity of taking a detailed and thorough clinical history. The trauma surgeon and the emergency physician need to be aware of the pathological affections of the pubis symphysis leading to ankylosis to strategize for an effective management
A Case Study on Acute Fatty Liver of Pregnancy
No full textAcute fatty liver of pregnancy (AFLP) is a rare disease. Usually affecting women in the third trimester pregnancy or post-partum period and with high risk of mortality. The diagnosis AFLP is based on exclusion. In addition, the Swansea criteria is commonly used to diagnosis AFLP.
At the end of this case report we will focus on the diagnosis of acute fatty liver of pregnancy as well as its management
The State Programmed Preparedness for COVID-19 Speedy Transmission Controlling
No full textThis paper is constructed on the secondary data mostly taken from recent publications, organizational webpage information publicity, and online newspaper articles in order to make a case study on the COVID-19 preparedness from the state authority of Bangladesh. This paper takes two- tiers study: Pre-incident arrangement and during- incident arrangement for normalization of rapid transmission of coronavirus pandemic across the country. This paper critically evaluates what the demographic setup the country possesses to justify the galvanizing critical concerns for coronavirus infection, how the state authority delayed at precautionary stage to make all concerned sectors prepared against any mass infection, and how the state authority acted amid the considerable cases identification tackling crowding of people, ensuring social distancing etc. This paper tends to highlight the grieving situation on three dimensions: the impact of mass entry of Expatriate Bangladeshis from viral infected countries, the deplorable preparations of health sectors and the apparent suicidal impact of lock down on the people of Bangladesh. Few recommendations emerged through the case study which has been attached as time befitting steps which should be taken for granted amid this surging concern
Study the Relationship between Practice of Yoga with Physical and Mental State
No full textThe word yoga originates from the Sanskrit for union and aims to harmonize mind, body, and spirit. Patanjali, the father of philosophy of Yoga, wrote a Yoga Sutras in which he formalized this discipline. Traditional yoga incorporates the eight limbs. Physical health is the well-being of the body and the proper functioning of the organism of individuals. The mental status examination is a structured assessment of the patient's behavioral and cognitive functioning. Physical Health is correlated with Mental Health because good physical health leaves a better personal feeling in the long term. Objective of this study was to find out the descriptive analysis of Practice of yoga with physical state and Mental state. This study was retrospective survey was conducted on 165 in Ayurvedic Internal Medical Officers under the Bachelor of Ayurveda Medicine and Surgery(BAMS) .They were between the age group of 20-50 years, both male and female were included in the training program at the National Institute of Education. We have used the closed ended “Self-assessment questionnaire”. Results of this study ,majority were included to the age group between 20-30years(95.8%)females were high in proportion (85.5%). Buddhist (89.1%) and Sinhalese (93.3%) were also high. Most of them are unmarried (63%) and monthly income was Sri Lankan Rupees below 60000(95.2%). Majority are living in suburban area (60,6%) and education level was graduate (100%). Most of not having children (89.7%) According to the Physical state in this study most of them were Normal body weight (76.4%)In thus study according to the mental state most of them were normal mental state (79.4%).but 15.1% in mild mental status Impairment as well as 5.5% in moderate Mental status Impairment. There were no severe Mental status impairment. Most of them were not practicing yoga (75.8%). Conclusion of the study was mentioned according to the results Practicing of yoga was not significantly associated with Mental and Physical status of this study group. Although in this study15.1% in mild mental status impairment as well as 5.5% in moderate mental status impairment and Underweight 9.1%, Over weight 12.1%, Obesity 1.8% and Obesity II 6%. It is necessary to commence the programs to improve physical state, mental state and the Quality of life in internal medical doctors
Fatal Undiagnosed Adult Idiopathic Hypertrophic Pyloric Stenosis: An Autopsy Case Report
No full textPrimary adult hypertrophic pyloric stenosis is an uncommon cause of gastric outlet obstruction in adults [1]. It is a benign condition caused by hypertrophy of the muscularis propria and resembles the congenital pyloric stenosis seen in infants.
We report a case of a middle-aged woman who presented in extremis at our facility with eye witness account of sudden collapse and loss of consciousness. She had adult hypertrophic pyloric stenosis complicated by acute lung injury following aspiration of gastric contents that was diagnosed at post mortem examination following a coroner inquest.
Adult idiopathic hypertrophic stenosis true incidence is not known as the clinical presentation is non-specific and thus diagnosis is difficult and could be missed. Depending on the severity a missed case can present with severe life-threatening complications such as aspiration pneumonitis
Increased Arterial Stiffness in Moyamoya Disease Presenting with Hypertension and Stroke: A Novel Finding in a Very Rare Condition in Singapore
No full textWe present a rare case of a 42 year old lady who presented initially with hypertensive emergency and episodes of transient ischemic attacks who was later diagnosed to have Moyamoya disease (MMD). She continued to have hypertension after left external carotid-internal carotid bypass. We followed her case for evaluation of hypertension. She was found to have increased arterial stiffness on SphygmoCor. The prevalence of hypertension MMD is high, but most notably associated with renal artery stenosis (RAS). Case studies of hypertension in patients with MMD without RAS are rare. We did a literature search on the histopathology and genes involved in MMD. RNF213 and ACTA2 gene mutations are identified to be related to MMD. Interestingly, ACTA2 gene mutation carriers are seen to have a variety of vascular diseases. We postulate that the genes involved in causing intimal thickening and media attenuation of the intracranial vasculature seen in MMD exerts systemic implications. We think this could possibly present with increased arterial stiffness and hypertension. In summary, we would like to highlight increased arterial stiffness as a cause of hypertension in patients with MMD. We postulate that the underlying histopathological changes affecting Moyamoya vessels might also affect systemic blood vessels presenting as increased arterial stiffness
Intensity Modulated Radiotherapy [IMRT] in a Rare Case of Infratemporal Chondrosarcoma with Intracranial Extension in a Young Adolescent Patient
No full textMesenchymal chondrosarcoma is a malignant neoplasm of cartilaginous origin. It is an uncommon subtype of chondrosarcoma which is described in the young adolescent population. We present a rare case of chondrosarcoma in a teenage group-a 16yr old pediatric patient. This 16 year old patient came to us with progressive, painless, right facial asymmetry of 3 months duration .MRI scan showed a large lobulated enhancing lesion in right infratemporal fossa and masticator space with destruction of right mandibular bone with intracranial extension. She underwent subtotal excision [R2 resection] followed with adjuvant radiotherapy by Intensity modulated radiotherapy technique (IMRT) and remains disease free for 1.5 years on follow up. Role of chemotherapy is not defined. Combined modality approach including surgery and radiotherapy maximizes the chances of cure despite the aggressive biology of mesenchymal chondrosarcomas
An Unusual Cause of Bilateral Stroke
No full textBackground: Essential Thrombocythemia is one of the myeloproliferative disorders characterised by elevated platelet counts leading to an increased tendency for vessel thrombosis and hemorrhage affecting various organ systems. It is most common in the elderly but can occur at any age. The cerebral circulation is one of the systems affected and acute ischaemic stroke is a rare but described presentation of this disorder. This is a major cause of morbidity and mortality in these patients.
Objective: To describe a case of acute ischaemic stroke in a patient who was subsequently diagnosed as Essential Thrombocythemia.
Presentation of Case: We describe here a case of a 74 year old male who presented with acute ischaemic stroke and left hemiparesis. Investigations revealed high platelet counts and genetic analysis was positive for calr mutation seen in Essential Thrombocythemia. He was started on treatment for stroke along with cytoreductive therapy with hydroxyurea with improvement in symptoms. Through this report, we wish to highlight the importance of early identification and treatment of this uncommon cause of stroke in the elderly
Monomorphic T-Cell Post-Transplant Lymphoproliferative Disorder: A Case Report
No full textThe study reports a case of T-cell PTLD in a kidney recipient with a review of literature. Solid organ or bone marrow transplantation is the only curative treatment for a variety of diseases. Paradoxically, it accounts for several potentially life-threatening complications for the recipient that are often inevitable. A 53-year-old male patient presented to our hospital with dry cough and high-grade fever of 1 day duration. The patient had a history of diabetes mellitus and hypertension that were complicated by end-stage renal disease and hemodialysis until he underwent kidney transplant 3 years prior to presentation. Diagnostic thoracentesis was performed, and according to light’s criteria, the pleural fluid was consistent with lymphocytic exhudate. This result raised the concern of an underlying malignancy (PTLD in particular) which necessitated a tissue biopsy in order to be confirmed. The patient was started on chemotherapy with CHOP protocol (Doxorubicin, cyclophosphamide, Vincristine, and Prednisone)
Bilateral Huge Ovarian Mature Cystic Teratoma in a Primipara: A Case Report
No full textBackground: Mature cystic teratoma (MCT) also known as dermoid cyst is the commonest benign neoplasm of the ovary constituting 10-20% of all the ovarian tumours. They are also the most common ovarian germ cell tumour commonly seen between 20-40 years. They are bilateral in 8-15% of cases.
Objective: To report a rare case of bilateral ovarian mature cystic teratoma occurring in a primipara.
Methods: The case note of the patient was retrieved, relevant information about the patient, her clinical presentation and management were reviewed. Relevant review of the literature on the subject was also done.
Case Report: The patient was a 23 year old primipara (alive) referred from a general hospital. She presented at the gynaecological clinic of Rivers State University Teaching Hospital (RSUTH) with a month history of abdominal distension and lower abdominal pain. There was associated nausea, vomiting and passage of watery stool. There was no history of fever, weight loss, vaginal discharge, urinary frequency or retention of urine. There was generalized abdominal tenderness more marked in the lower abdomen. She had exploratory laparotomy and bilateral ovarian cystectomy. She did well post operatively and was discharged home with a two weeks appointment to the gynaecological clinic.
Conclusion: Diagnosis of dermoid cyst is made earlier with pelvic ultrasonography when it is usually small. Unusual finding of a mature huge ovarian cystic teratoma is possible due to delayed presentation for diagnosis and treatment