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Ruptured Renal Angiomyolipoma Presenting with Isolated Flank Pain: A Case Report
Get PDFIntroduction: Ruptured renal angiomyolipoma (AML) is a life-threatening condition that may mimic other diagnoses in the clinical presentation, and if not diagnosed promptly, it can lead to life-threatening bleeding and shock. Case Report: In this article, we report the case of a 56-year-old previously healthy Saudi man who presented with isolated left flank pain. The patient was initially treated as a case of renal colic, possibly caused by renal stones. However, the imaging revealed the clinical picture to be caused by a ruptured renal AML of the left kidney and successfully treated with angiographic embolization by an interventional radiologist. Conclusion: Despite its rare occurrence, rupture of the renal AML may mimic other diagnoses and lead to life-threatening hemorrhagic shock. Prompt diagnosis and management can improve outcomes. By reporting this case, we want to highlight the importance of considering alternative differential diagnoses and including all the substantial life-threatening conditions while dealing with patients presenting with isolated flank pain, even with no other risk factor
Unexpected Preoperative Regression of a Thymoma: A Case Report
No full textWe report a case of unexpected spontaneous regression of thymoma in a 44-year-old patient, referred with clinical, biological, and electrophysiological findings of Myasthenia gravis. The patient was stable on synthetic Acetylcholesterase inhibitors, immunosuppressants, and corticosteroids. A chest computed tomography (January 2020) revealed a well-defined tumor in the anterior mediastinum. Surgical removal was decided. Unfortunately, because of the covid 19 pandemic, the surgical activity of the department of thoracic surgery was suspended. The patient was discharged and re-admitted nine months later. A new chest computed tomography (September 2020) was performed, revealing a net regression of the anterior mediastinal tumor. The long axis of the tumor decreased from 97mm to 28mm. A Video-assisted thoracoscopic thymothymectomy was performed. The histopathological study of the specimen revealed a Thymoma B3, according to the world health organization (WHO) classification, without any necrosis, hemorrhagic or sclerotic cells. The spontaneous regression of thymic epithelial tumors is reported as rare. Surgical excision should be performed, even if tumor volume regression is observed. After surgical resection, the anatomopathological studies of the specimens could sometimes find some elements that explain the regression of these tumors. In our case, we suppose that the intake of corticosteroids by our patient could have played a role in this tumor regression
Types of Fingerprint Characteristics and Their Association with Gender and Blood Groups in Sudan
Get PDFBackground: Studies have shown different results on the association between fingerprints, gender, and blood groups in different settings. There is one published article in Sudan. Objectives: This study investigates the prevalence of fingerprint characteristics and assesses if there is an association between fingerprints and gender or ABO blood groups and rhesus blood types in Sudan. Results: A total of 394 participants were enrolled in the study. Their age ranged between 19 and 24 years, with a mean (standard deviation) of 21 (3) years. Of these 394, 114 (28.9%) and 280 (71.1%) participants were males and females, respectively. Moreover, 111 (28.2%), 63 (15.9%), 13 (3.3%), and 207 (52.5%) belonged to blood group A, blood group B, blood group AB, and blood group O, respectively. While 373 (94.7%) participants had rhesus-positive blood, only 21 (5.3%) had rhesus-negative blood. Of the 394 fingerprints, 2476 (62.84%) were loops, 1278 (32.44%) were arches, and 186 (4.72%) were whorls. Fingerprints significantly differed between males and females, blood groups, and rhesus factors. Conclusion: Loops (62.84%) and arches (32.44%) were common fingerprints. Fingerprint characteristics were significantly different between males and females, different blood groups, and rhesus factors
Removable Partial Denture Design in Dental Practice: Epidemiological Study in the Rabat-Sale-Kenitra Region (Part 1)
No full textIntroduction: Despite the enrichment of our therapeutic panoply by integrating implants and CAD/CAM techniques, the removable partial denture (RPD) with metallic infrastructure (RPD) will remain an unavoidable alternative in the rehabilitation of partial edentulous teeth. The purpose of this survey, divided into three parts, is to evaluate the knowledge, attitudes, and practices of dentists in private practice in the Rabat-Sale-Kenitra region regarding the design of RPDs, to provide information on the means of communication with laboratory technicians, and investigate possible correlations between the failure of the prosthetic project and certain adopted practices.Materials and Methods: The study had a sample of 101 dentists practicing in the Rabat-Sale-Kenitrato region to whom we sent an anonymous 4-page printed questionnaire containing 28 questions on the design of metal frames in PAPM. A descriptive and analytical statistical study was conducted to process the data.Results: Following the results of the statistical study, only 8% of the practitioners performed more than ten partial removable prostheses per month, 17% did not perform a clinical examination, 20% did not perform a study model, and 69% did not perform the RPD design by themselves and entrusted this task to the dental technician. In comparison, 89% did not use a Dental Surveyor.Conclusion: This survey showed that many practitioners do not follow the rules of good practice and lack knowledge of the RPD design. Therefore, postgraduate training is envisaged to help practitioners implement these good practices and improve this knowledge. However, it was noted that only 58% of the practitioners in our sample were interested in such training
Outcomes of Oxytocin on Hemodynamic Change during Cesarean Section under Spinal Anesthesia
Get PDFBackground: Oxytocin is generally used in obstetric exercise as a uterotonic drug for induction and augmentation of labor and stays the drug of desire for facilitating uterine contractions through vaginal and operative delivery. It is now spreading up to far-flung areas. The infusion method of oxytocin is protected in the cesarean area under spinal anesthesia. Objective: This study evaluates the hemodynamic modifications precipitated by oxytocin given as an I/V bolus or infusion to limit uterine bleeding in cesarean section. Methods: This prospective interventional study was carried out at the Department of Anesthesiology, 250 Bed General Hospital, Noakhali, Bangladesh, from January to December 2020. A total of 50 patients with ASA grade I have been selected, with 25 affected people in every group. In group A, the parturients were given oxytocin 5 IU I/V bolus; in group B, an infusion of oxytocin 5 IU diluted with 5 ml everyday saline given I/V over 2 min using an infusion pump. The learning about duration started out simply earlier than oxytocin is given, and it used to be persisted for an additional 10 min. Systolic and diastolic BP, MAP, coronary heart rate, and uterine bleeding have been recorded every 1 min. Results: In our study, every group had n=25. All outcomes are expressed as mean ± standard deviation. The studied groups were statistically matched for age, gestational age, weight, coronary heart rate, systolic and diastolic blood pressure, and arterial pressure. The implied distinction of all hemodynamic parameters at 2 to 5 minutes of oxytocin administration has been statistically significant (p < 0.05). Conclusion: Oxytocin remains the first-line uterotonic drug after vaginal and cesarean delivery. The hemodynamic changes were more marked in the I/V bolus of oxytocin than infusion technique. Recent research elucidates the therapeutic range of oxytocin during cesarean delivery and receptor desensitization. A slower injection of oxytocin can effectively minimize cardiovascular side effects and equally effectively reduce blood loss without compromising the therapeutic benefits. Evidence-based protocols for preventing and treating uterine atony during cesarean delivery are recommended
Ethnic Dental Biprotrusion: A Clinical Case
Get PDFThe dental biprotrusion characteristic of certain ethnic groups raises the question of treatment or abstinence. In many situations, it is accompanied by an open bite concerning the lingual volume or lingual support during pronunciation. The therapeutic solution must be considered and individualized. This article describes an anterior open edge of functional origin orthodontic treatment in a 23-year-old adult patient embarrassed by the cosmetic defect
Challenging Surgery of a Large Chest Wall Chondrosarcoma - A Case Report
No full textChondrosarcoma of a rib is a very rare malignant tumor of the bone. Most patients are present with an enlarging painful anterior chest wall tumor. We present a case of 32-years old female with a thoracoabdominal tumor size of 20 cm × 16cm involving the left 9th rib. Since chondrosarcoma is less sensitive to chemotherapy and radiotherapy, surgical treatment with extensive resection with a sufficient margin is considered first-line treatment. Sufficient soft-tissue reconstruction of the thoracic wall after extensive resection represents a formidable challenge. This article aims to illustrate the possibility of resection of the six last ribs with no complicated reconstruction technique
Removable Partial Denture Design in Dental Practice: Epidemiological Study in the Rabat-Sale-Kenitra Region (Part 3)
No full textIntroduction: Despite the enrichment of our therapeutic panoply by integrating implants and CAD/CAM techniques, the removable partial denture (RPD) with metallic infrastructure (RPD) will remain an unavoidable alternative in the rehabilitation of partial edentulous teeth. The purpose of this survey, divided into three parts, is to evaluate the knowledge, attitudes, and practices of dentists in private practice in the Rabat-Sale-Kenitra region regarding the design of removable partial dentures, to provide information on the means of communication with laboratory technicians, and to investigate possible correlations between the failure of the prosthetic project and certain adopted practices.Materials and Methods: The study concerned a sample of 101 dentists practicing in the region of Rabat-Sale-Kenitra to whom we sent an anonymous 4-page printed questionnaire containing 28 questions on the design of metal frames in PAPM. A descriptive and analytical statistical study was conducted to process the data.Results: Following the results of the statistical study, only 8% of the practitioners performed more than ten partial removable prostheses per month, 17% did not perform a clinical examination, 20% did not perform a study model, and 69% did not perform the RPD design by themselves and entrusted this task to the dental technician. In comparison, 89% did not use a Dental Surveyor.Conclusion: This survey showed that many practitioners do not follow the rules of good practice and that they lack knowledge of RPD design. Therefore, postgraduate training is envisaged to help practitioners implement these good practices and improve this knowledge. However, it was noted that only 58% of the practitioners in our sample were interested in such training
Pattern of Otitis Externa in ENT Outpatient Department of BSMMU, Dhaka, Bangladesh
Get PDFIntroduction: Otitis externa is an acute or chronic reaction of the whole or a part of the skin of the external ear arising from local or general causes or a combination of both. It is a widespread medical problem affecting 5%–20% of patients who visit otolaryngologists in the tropical and subtropical regions. Objective: This study assesses the pattern of otitis externa in the ENT Outpatient Department. Methods: A prospective study was carried out in the Outpatient Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) among 200 patients (220 affected ears) with the aural symptoms suggestive of otitis externa and 110 healthy controls (220 ears) from July 2002 to December 2003 to find out the pattern of the disease among patients suffering from otitis externa in Bangladesh. Results: The maximum number (35%) of patients were within the 21–30 age group. Most patients were male (56%), with a male-female ratio of 1.3:1. The higher numbers of patients fall within the lower- and middle-income family groups (up to 2,500 and 3,501–4,000 taka per month, respectively). Most patients (30%) were laborers, and most patients were literate. The majority lived in a paka (44%) or semi-paka (38%) house and used tap water for bathing (53.5%). Most patients used cotton buds (49%) for cleaning of ears. Otitis externa was primarily found in the summer and rainy season (69%), with maximum occurrence during June (18.2%) and July (16.4%). In most patients, symptoms persisted for less than two months (76.3%), of which itching, pain in the ear, and a sense of blocking are the commonest triad of symptoms. Itching is the predominant symptom (98.2%) in fungal otitis externa, and pain is the dominant symptom (92.8%) in the bacterial type. Acute infection is commonly painful, whereas chronic disease is mostly itchy. The right ear was more involved (60%) than the left one, and the ear canal was more commonly diffusely involved (84.5%). Among the predisposing factors for the causation of otitis externa, ear cleaning by self or others ranked in the top 42 causes, 7% of the list. It was mainly associated with acute cases. The fungus was isolated from the affected ear in most instances (49.1%), followed by bacteria (31.8%). Moreover, bacteria were often associated with acute cases, and fungus was found more in chronic cases. Aspergillus was found in 89.7% of the fungal species, and Candida was found in 7.5% of cases. Pseudomonas was the predominant organism (40%), and Staphylococcus was the second most common (37.1%) among the bacterial species isolated. The microbiological finding among the healthy controls showed that the external ear canal is less commonly harboring pathogenic organisms. Bacteria were isolated from 18.2% of cases, and fungus was isolated from only 6.3%. Conclusion: From this study, it is also evident that although bacteria could be detected from control cases, fungus isolation was negligible. Most of the bacteria were normal commensals. On the other hand, in the diseased ear, the presence of fungus in the ear canal was highly significant (p < 0.001), which signifies the prerequisite of an altered aural flora and fauna for the development of fungal infection
