Asian Journal of Case Reports in Medicine and Health
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Primary Neural Tube Defects in Pediatrics – A Focus on Lipomeningocele
No full textBackground: Lipomeningocele is a congenital abnormality of the neural tube. It affects approximately one in every 50,000 infants. This is one of the most uncommon varieties of Spina bifida, which happens when a neural tube does not shut completely and sticks out of the Spinal column, forming a sack beneath the skin. During embryonic development, about day 21 or week 3, neural folds fuse to form a neural tube and form a complete neural tube on the 28th day. The unfused part of the spinal cord leads to Spina bifida. Getting enough folic acid, during pregnancy can help to prevent neural tube defects. Mothers who are obese, have poorly controlled diabetes, and mothers who take certain anti-seizure medicines are at more risk of having a baby with a neural tube defect.
Case Presentation: A 6-month-old male child presented with the chief complaints of swelling in the sacral region since birth, non-progressive in size, and was not reducible. Magnetic resonance imaging of the lumbar spine revealed that there is Lipomeningocele at the sacral region and low insertion of the spinal cord with tethering.
Discussion: The primary objective is to reduce the stretching or straining of the spinal cord that occurs as the child grows. Prompt surgical interventions are crucial for the prevention of neurological deterioration.
Conclusion: A neurosurgeon works to "untether" the spinal cord, separating the spinal cord from the back tissues. The idea is to reduce the stretching or straining of the spinal cord that occurs as the child grows
HELLP Syndrome: A Rare but Critical Obstetric Conundrum
No full textBackground: HELLP Syndrome is one of the significant difficulties of pregnancy and the acronym represents H=Hemolysis, EL=Elevated Liver Enzymes, LP=Low Platelets. It is a significant and hazardous type of toxemia, which is a condition where a pregnant lady has hypertension that harms the Liver and Kidney. It typically develops between the 26th to 40th long stretches of Fetal Development, and at times in the week after the child is conceived. Eclampsia is the most extreme type of toxemia joined by seizures. The rate is 0.5-0.9% in most pregnant ladies, however, in extreme Toxemia, 10-20% of cases have been accounted for.
Case Subtleties: A 29-year-old Multigravida lady who was pregnant for the third time, at 35 weeks of pregnancy was presented with the objections of serious stomach torment for one day, and fetal development was not evaluated. She had a known instance of hypertension during her past pregnancy and was dealt with apparently with Labetalol, furthermore gone through a lower Cesarean segment two years earlier. She was given Magnesium Sulfate 4g IV over 5 Minutes.
Discussion: Blood products like platelets, red blood cells, and fresh frozen plasma ought to be transferred. On account of early pregnancy, corticosteroids can be utilized to invigorate the development of fetal lungs. Basic follow-up is expected for patients with HELLP Syndrome.
Conclusion: Early location and treatment of HELLP syndrome, either by inception or by typical work or by cesarean area is valuable for both mother and embryo and forestalls further confusions
Cytomegalovirus (CMV) as a Rare Cause of Gastritis in a Renal Transplant Recipient: A Case Study from Pakistan
No full textCytomegalovirus (CMV) can cause wide spectrum of the diseases with large bowel been most commonly affected. However, it rarely effects the upper part of the alimentary canal including the esophagus and stomach. Here, we present to you a case of renal transplanted recipient with a post-transplant history of non-Hodgkin lymphoma evaluated for dyspepsia and was diagnosed to have CMV gastritis on histopathology
Pulse Oximetry-facilitated Arterial Cannulation in Pediatric Anesthesia for Cardiac Surgery
No full textInvasive blood pressure monitoring is required in cardiac surgery for several reasons. Arterial cannulation in pediatrics is a daily challenge for anesthesiologists. Localization of the artery before catheterization is usually done by palpation or guided by ultrasounds. These two techniques are not always efficient and sometimes generate complications and a considerable loss of time. Through this clinical case, we describe a simple and innovative technique inspired by our daily practice allowing locating the artery with the help of pulse oximetry
Post-Traumatic Occlusion of the Renal Artery: A Case Report
No full textThe present case report highlights about Post-traumatic occlusion of the renal artery. Renal artery thrombosis is a rare complication of blunt abdominal trauma, described for the first time by Von Recklinghausen in 1861. Our case is of a 32-year-old male admitted to the emergency department to manage a polytrauma due to a car accident occurring three hours before admission. The higher mobility of the left kidney on its vascular pedicle is thought to be the cause of the increased frequency of left renal artery injuries. Because of the various therapy choices available, it is especially important to distinguish between these two conditions. The management of traumatic renal artery occlusion is controversial and opinions are divided between immediate surgical revascularization and observation
Acinetobacter baumannii: A Rare Organism Causing Blood Stream Infection in a Five-Year Old Girl in South-East Nigeria
No full textAim: Acinetobacter baumannii is an aerobic Gram-negative coccobacilli found in the environment, which causes predominantly nosocomial infections in humans. However, the incidence of community acquired infections is on the increase. It is characterized high resistance to the environment and the ability to develop resistance to commonly prescribed antimicrobials. Its clinical features are non-specific and range from a benign transient bacteremia to fulminant septic shock. Carbapenems are recommended for first line treatment. This series presentation aims to increase awareness of this condition.
Presentation of Cases: A case of a five-year old girl who presented with features suggestive of an upper respiratory tract infection in Enugu State, South-East Nigeria is reported. She also had a history of recent travel to Europe. Serial haematologic investigations showed evidence of worsening bacteremia and blood culture revealed Acinetobacter baumannii. She was managed with intravenous Meroponem and was discharged sixteen days after presentation.
Discussion: In this case, the finding of Acinetobacter baumannii from blood culture followed an initial non response to conventional antibiotics and the history of recent travel to Europe. This organism has hitherto not been isolated in our environment, and is a significant cause of nosocomial infections with high morbidity and mortality. Isolation of this organism requires BACTEC culture methods. Its high resilience and multidrug resistance makes it difficult to treat.
Conclusion: The incidence of community acquired Acinetobacter baumannii is on the increase. Management involves a high index of suspicion, prompt and accurate isolation of infecting strains and the proper choice of antibiotic regimens
Spontaneous Coronary Dissection Revealed by Ventricular Tachycardia in a Female Patient: A Case Report and Review of Literature
No full textSpontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome or sudden death, typically observed in patients with minimal atherosclerotic risk factors. A 53-year-old female patient presented to the emergency department with episodes of palpitations and sudden, intense chest pain radiating to the back. Following the chest pain, she experienced a brief loss of consciousness. The initial electrocardiogram (EKG) revealed a self-resolving episode of ventricular tachycardia. A transthoracic echocardiogram displayed enlarged ventricles with significant regional wall motion abnormalities and reduced left ventricular ejection fraction. Cardiac catheterization revealed an intimal dissection in the middle segment of the left anterior descending artery. The patient was managed conservatively and exhibited stable angiographic findings during a follow-up evaluation one month later
Terbinafine Induced Stevens Johnson Syndrome Toxic Epidermal Necrolysis Overlap Syndrome
No full textSJS-TEN overlap syndrome is a very rare but severe cutaneous adverse drug reaction that is caused by terbinafine administration. The patient was suffering from vulvovaginal for which she was consuming terbinafine which led to the occurrence of cutaneous eruptions, across the right and left lower limbs, face, upper limbs, chest, back, arms, and abdomen, affecting almost the entire body covering 10- 30% of the body surface which makes it to fall under the category of SJS-TEN overlap syndrome. Although considered safe terbinafine may lead to such severe adverse drug reactions, proper precautions need to be taken while prescribing it. Avoid the drug in patients with a history of any drug reactions. The main goal of this case report is to bring awareness among healthcare professionals, and to make them vigilant against such severe cutaneous drug reactions caused by terbinafine
Ophthalmoplegia Revealing an Orbital Metastasis Secondary to Breast Cancer: Case Report
No full textOrbital metastases are uncommon and breast cancer is the most common primary in women. The clinical presentation varies depending on the location of the metastasis in the orbit. The diagnosis of metastasis is evoked in the context of the patient's background, particularly if there is a known history of cancer, and on the appearance of the lesion on imaging. We report the case of a patient presenting ophthalmoplegia of the left eye revealing orbital metastases of breast cancer
Septicaemia Induced Acute Heart Failure with Elevated Trop I: A Case Report in Fourniers Gangrene
No full textA 42 yrs Diabetic, H/O healthy cardiac status male patient presented as scrotal abscess admitted in surgery ward and debridement done as a case of Fourniers gangrene under regional anaesthesia. Patient had symptoms of cough, dyspnoea, frothy secretions, high color urine and episodes of desaturation preoperatively. 4 hours following debridement patient develops marked dyspnoea, chest heaviness with increased frothy secretions and shifted to intensive care unit. In critical care comprehensive management patient symptomatically improved after 3 days of ICU care and shifted to ward