Asian Journal of Case Reports in Medicine and Health
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Primary Cutaneous Malignant Melanoma with Papillary Features: A Case Report Signifying Morphologic Diversity in Malignant Melanoma
No full textAim: The purpose of this work was to describe the way how primary cutaneous malignant melanoma can present with papillary features and hence mimicking malignant tumours which are commonly accompanied with papillary features such as papillary thyroid carcinoma.
Presentation of Case: The case reported in this article was of an African female aged 61 years who presented with a darkish small swelling on the dorsum of the right hand, slightly painful and tender for 3 months since its onset.
Discussion: Malignant melanoma as it is encountered in daily clinical practice ought to be deemed as being a malignant tumour that can sometimes show diverse histomorphological presentation including papillary features as it was in the case herein reported. This kind of presentation can lead to wrong diagnosis, thus, contributing to delaying of proper diagnosis and even jeopardizing the prognosis of the patient.
Conclusion: Malignant melanoma should be included in the differentials of malignant tumours presenting histologically with papillary features
Knowledge and Attitude of Nursing Mothers towards Umbilical Cord Care in Calabar Metropolis, Cross River State
No full textAim: This study assessed the knowledge and attitude of nursing mothers towards umbilical cord care.
Methods: The study was a descriptive and cross sectional in design. 388 respondents were randomly selected using multistage sampling technique. Data was collected using a validated semi-structured questionnaire which was self-administered after a Cronbach-Alpha test was carried out giving a result on 0.713. It was analyzed using the statistical package for social science (SPSS) version 21 to generate descriptive (frequency tables, charts) and inferential statistics (Pearson’s chi-square).
Results: The result gotten from the study showed that the majority of nursing mothers who participated in the study were between ages 20-29 (37.6%) with a mean age of 29.7. majority of the mothers were married 304 (78.4%) with at least one child 181 (46.6%) with infants aged 1 week 301 (77.6%). Most respondents were Efik 202 (52.1%), most being Christians 329 (84.8%). Most mothers received more than 30,000 in income 174 (44.8%). Almost all the respondents 316 (81.4%) heard about umbilical cord care. Majority of the respondents 280 (72.2%) defined umbilical cord care as tying, cutting and cleaning with methylated spirit and cotton bud. However, half 210 (54.1%) of the respondents had not heard of Chlorhexidine digluconate and majority of the respondents 316 (81.4%) did not know it could be used to prevent infection. Virtually all mothers knew that it was important to clean the baby’s cord 386 (99.4%). Mother’s attitude towards care of the umbilical cord was positive with a result of 353 (91%).
Conclusion: The respondents had fair knowledge on cord care, positive attitude and good practice towards umbilical cord care. Poor knowledge can lead to prevalence of cord infection
Tremulousness in a 7-yrs Old Child Diagnosed with Ataxia Telangiectasia: A Case Report
No full textAtaxia telangiectasia is a rare autosomal recessive neurodegenerative disorder primarily characterized by cerebellar degeneration manifested as ataxia, telangiectasia, immunodeficiency, and cancer susceptibility and radiation sensitivity. Clinically A-T cases presents itself with a variability of symptoms but basic primary presentations are almost always present. This case demonstrates a 7yrs old girl who presented with tremulousness of limbs, difficulty to move the eye ball with command and dysarthria. On further clinical examination, a plain MRI of Brain and other relevant investigations suggested this as a case of A-T. Thus rationale of this typical case report gives a glimpse about a variant of A-T which is often misdiagnosed as other ataxic disorders
Neuroblastoma in Early Childhood: A Case Report and Literature Review
No full textIntroduction: Neuroblastoma is an extremely rare pediatric neoplasm whose prognosis becomes poor as the age advances. It can be sporadic or nonfamilial in origin. It is primarily a tumor of abdominal origin from where it metastasis to lymph nodes, liver, intracranial and orbital sites, and central nervous system The purpose of this paper is to report a case in which scalp nodules and inguinal lymph node was the initial presenting sign of disseminated neuroblastoma in a 2 year-old child.
Case Presentation: We report a rare case of metastasis of neuroblastoma in a 2-year-old child presenting complain of fever for several weeks, anorexia, loss of weight , arthralgia and multiple scalp nodules and inguinal lymph node enlargement . Biopsy was receive from the scalp and inguinal lymph nodes showed undifferentiated tumor tissue where medium sized atypical blastoid tumor cells were located in clusters and sheets in an eosinophilic sometimes fibrillary background showing blood vessels. The sinuses were also infiltrated by these tumor cells.
Immunohistochemically, Pan Leucocyte antigen was negative as also myogenin and CD99. However, CD 56 and synaptophysin are strongly positive and the neuroblastoma marker was weakly positive in the neuropil-like structures and the cytoplasm of some tumor cells.
Conclusion: The addition of our case to the literature offers new clinicopathological data useful for better defining the diagnosis. The differential diagnosis of neuroblastoma in a child presenting with multiple scalp nodules and inguinal lymph node enlargement should be consider
An Elderly Patient with Abdominal Pain: Hypereosinophilic Syndrome
No full textHypereosinophilic Syndrome (HES) is diagnosed when there is peripheral hypereosinophilia with eosinophil count of more than >1500/µL. The duration of the illness usually lasts more than 6 months, with evidence of target organ damage, affecting mainly the skin, heart, and neurological system, without apparent aetiology. This case report details a case of hypereosinophilic syndrome in an 80-year-old man with multiple co-morbidities, who presented with unexplained peripheral eosinophilia, intermittent skin rashes, cardiac, respiratory, and abdominal symptoms. It is important to consider the diagnosis of hypereosinophilic syndrome when there is an unexplained peripheral eosinophilia, and thus intervene rapidly to prevent life-threatening complications
Rubinstein Taybi Syndrome - A Case Report from India
No full textRubinstein – Taybi syndrome (RTS) otherwise called as Broad Thumb-Hallux syndrome is considered to be a genetic disorder characterized by facial dysmorphism mental deficiency and growth retardation. Presented here is a case report of the patient with RTS with comprehensive oro-dental treatment. This case report describes the clinical features of a 25-year-old female with RTS, who had multiple dental problems such as multiple missing teeth, dental caries, periodontal disease and severe malocclusion. Physical findings were similar to those previously described in other reports. In this case report, the extraoral and intraoral features of this patient are discussed
Fetal Papyraceus Discovered at Second Stage of Labour in an Unbooked Patient: A Case Report
No full textBackground: Fetus Papyraceus is a rare condition with the intrauterine death and subsequent retention of one or more fetuses of a multiple gestation. Antepartum diagnosis of fetus papyraceus is infrequent and usually it is a chance finding during investigation of some other pregnancy problem on ultrasonography. I report a case of fetus papyraceus in an unbooked patient diagnosed at second stage of labour.
Case Presentation: A 26-year-old, unbooked primigravida, presented to the Labour Ward at a gestational age of 35 weeks with painful uterine contractions of 6 hours duration. On admission, she had features of mild pre-eclampsia, but had good contractions and was in established labour. She had an obese anterior abdominal wall with marked oedema, which made discerning the fetal presentation and auscultating the fetal heart sounds difficult. She was however delivered of a live baby weighing 3300 g with Apgar scores of 8 in one minute and 10 in 5 minutes. This was followed by the delivery of a fetus papyraceus weighing 200 g, with crown rump length of 85mm. subsequent delivery and examination of the placenta revealed a diamniotic-monochorionic twin gestation. Both the mother and live baby were discharged home in good condition.
Conclusion: The antenatal diagnosis of fetus papyraceus is usually a chance finding on obstetric scan for other problems or routinely. The primary concern for fetus papyraceus is its effect on the surviving fetus. Regular antenatal care and routine ultrasonography in pregnancy is mandatory to diagnose and manage possible complications. However, this patient did not enjoy such benefits. Where this is missed, routine placental examination to search for fetus papyraceus and establish chorionicity is mandatory
Epithelioid Sarcoma of Hand Masquerading as Radial Styloid Osteomyelitis: A Case Report
No full textEpithelioid Sarcoma of the hand is a rare, high grade soft tissue sarcoma. It accounts for less than 1% of soft tissue sarcoma. It is often misdiagnosed and is a great mimicker of multiple diseases due to its deceptively harmless appearances during the initial stages of the disease.
We are presenting a case of a 24-year-old gentleman presented to our centre with history of nodular swelling and pus discharge over radial side of left wrist for 3 months. He was diagnosed with osteomyelitis of left radial styloid and treated with 6 weeks of antibiotic after wound debridement. He presented to us 2 months later with worsening wound over surgical site for which he underwent wound debridement and another 6 weeks course of antibiotics. Patient presented to us 2 weeks later with complaint of swelling and bleeding from operative site. On examination we noted a wound measuring 3x3 cm with friable granulation tissues over radial aspect of left wrist and multiple nodular lesions over left palm with haemoserous discharges. X ray of left wrist showed juxta-articular osteopenia with focal bone lysis. Patient underwent wound debridement and intraoperative histopathological sample sent came back as Grade 3 epithelioid sarcoma. Patient underwent above elbow amputation with postoperative radiotherapy after 3 months being treated for osteomyelitis of radial styloid.
This case should alert treating surgeons to include soft tissue sarcoma as differential diagnosis of harmless looking, occasional painful firm nodules localised on the hand and wrist region of young adults especially when there are osteolytic changes in x-rays
Type 2 Myocardial Infarction- A Case Report
No full textType 2 MI (T2MI) was defined as myocardial infarction other than due to coronary artery disease (CAD), produced by disparity between supply and demand of oxygen .Cases were reported in literature where T2 MI was diagnosed even in presence of even 90 % block in coronaries, where recent ischemic changes were shown to be not due to the CAD but to disparity between supply and demand of oxygen. There was considerable overlap with the classical type1 NSTE MI and T2 MI and distinguishing between the two was considered challenging. Though T2 MI constituted about 25% of all cases of MI, the centres reporting Type 2 MI ranged between 0-13% only. Type 2 MI, the new heterogeneous group, was officially recognised by the task force on the universal definition of MI in 2007. The scope and criteria were changing since it was defined in 2007. Further, it appeared that -coronary cause of MI was more important than disparity between supply and demand of myocardial oxygen supply. For instance Sepsis, one of the important causes of T2 MI, could cause Type 2 MI by myocardial depression even in presence of normal oxygen perfusion. A case reported initially as NSTEMI, was retrospectively considered the possibility of T2MI. The reasons there of and the intricacies in the diagnosis of T2 MI are discussed in this article
Metabolic Syndrome Associated with Subclinical Hypothyroidism and Vit D Insufficiency - A Case Report and Discussion
No full textMetabolic syndrome (MetS) associated with hypothyroidism, was reported in literature. Like-wise association between hypothyroidism and Vit. D deficiency was reported. Hypothyroidism, Vit. D deficiency in DM2 patients was also reported, in the literature. But the occurrence of MetS, hypothyroidism and Vit. D deficiency, together occurring in a case was unreported. The author presented such triple association in a male patient aged 54 years. While Met S itself was a risk factor for CVD (cardiovascular vascular disease) and so were independently, the hypothyroidism and hypovitaminosis D, the triple association would have cumulative risk for CVD. So, it would be profitable to screen all MetS cases with hypothyroidism, for Vit. D deficiency also, in view of the possible cumulative risk. Literature was reviewed as to the relationship of MetS to hypothyroidism and Vit D deficiency, as well as the changing diagnostic criteria of MetS and it’s pathogenesis