Medical Reports最新文献

This case report delineates the adjunctive utilization of Ozone Therapy in a 73-year-old patient presenting with severe bone atrophy and sinusitis, undergoing subperiosteal dental implant surgery. The perioperative regimen incorporated ozonized saline solutions and visible laser treatment, strategically implemented to expedite the healing process and mitigate discomfort. Post-surgical observations included minimal bleeding and initial slight swelling, followed by a remarkably rapid improvement in the healing trajectory, characterized by the absence of pain and subsidence of swelling within a week, facilitating an expedited resumption of regular dietary practices. The outcomes of this case underscore the potential role of Ozone Therapy in augmenting postoperative recovery, primarily through its antimicrobial attributes and the facilitation of enhanced tissue oxygenation.

This case exemplifies the potential utility of Ozone Therapy as a cost-effective, minimally invasive adjunct in the realm of dental implantology, positing a promising avenue for improving patient outcomes in similar clinical settings. Nevertheless, the necessity for extensive empirical research, particularly through randomized controlled trials, remains imperative to validate and elucidate the comprehensive efficacy and safety profile of Ozone Therapy in diverse dental surgical contexts.

Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) is a rare genodermatosis characterized by multiple cutaneous leiomyomas, uterine myomas, and a potential association with papillary renal cell carcinoma. We present a case of a 59-year-old woman diagnosed with HLRCC based on the presence of multiple cutaneous piloleiomyomas and a fumarate hydratase (FH) gene deletion. The patient had undergone hysterectomy for uterine myomas two years earlier.Histological examination confirmed piloleiomyomas, and genetic testing revealed a FH gene deletion consistent with HLRCC. No treatment was required for the asymptomatic cutaneous lesions. The patient underwent screening for renal cell carcinoma, showing no neoplasms after three years.FH mutations are important in HLRCC etiology, causing a pseudohypoxic state promoting tumorigenesis. Uterine leiomyomas are common in HLRCC, occurring earlier than sporadic cases, while cutaneous leiomyomas exhibit distinct characteristics.Management involves ruling out neoplasms, genetic counseling, and annual imaging for early detection. Imaging preferences include contrast-enhanced computed tomography or gadolinium-enhanced magnetic resonance for renal screening. This case underscores the importance of a multidisciplinary approach to HLRCC emphasizing skin examination for early detection and management.

Understanding the anatomy of the anterior neck is critical in invasive thyroid and airway procedures; however, there are a variety of possible deviations from textbook anatomy that may be present in this region. The thyroid ima artery is a variant supplying the thyroid gland that follows a medial course over the anterior trachea. Therefore, if not accounted for, it is a potential hemorrhage risk in emergency airway procedures and thyroid surgeries. Another anatomical variant in this region, a pyramidal lobe, is an extra thyroid lobe that typically extends superiorly from the isthmus and is attributable to incomplete involution of the thyroglossal duct during embryonic development. The pyramidal lobe can interfere with cricothyrotomy and can also make thyroid surgeries more difficult. For example, in complete thyroidectomies the presence of a pyramidal lobe could result in incomplete removal of the glandular tissue. To further document clinically relevant anatomical variation in this region, the present study examined 84 body donors for these two variations. Of these individuals, 14.3% had a thyroid ima artery, which is higher than previous estimates and suggests that this artery is at greater risk during thyrotomy than previously thought. Alternately, 20.2% of donors had a pyramidal lobe, which is a lower frequency than previous studies. Additionally, 6.0% of the sample exhibited both anatomical variants. Roughly three-quarters (71.4%) of the sample exhibited neither variant. This high occurrence of anatomical variation in the thyroid region suggests that caution is warranted during emergency airway procedures. The use of medical imaging prior to conducting a non-emergent procedure near the thyroid may reduce risks of iatrogenic damage.

Hydatidosis, caused by Echinococcus granulosus, is a zoonotic disease transmitted between animals and humans. While commonly affecting the liver and lungs, it can manifest in rare sites such as the spleen. Herein, we present a case of a 39-year-old male with isolated splenic hydatid cysts who presented with fever and abdominal pain. Laboratory investigations revealed elevated inflammatory markers and positive Echinococcus serology. Imaging studies confirmed a large splenic cyst, prompting treatment with Albendazole and a surgical splenectomy. This case underscores the importance of considering splenic hydatid cysts in the differential diagnosis of patients with splenomegaly associated with abdominal symptoms. It highlights the necessity of a multidisciplinary approach for effective management.

Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is a rare autosomal recessive metabolic liver disease caused by mutations in the SLC25A13 gene. This study presents three cases of NICCD in Thai infants, all of them exhibited cholestatic jaundice as their primary clinical presentation, with varying degrees of severity. Their symptoms spontaneously resolving between 5 and 20 months of age. Interestingly, citrulline levels in these infants did not consistently indicate elevated levels as seen in previous studies, highlighting the need for more sensitive newborn screening tests. Additional molecular testing is crucial for accurate diagnosis, with the most common mutation being p.Met285Profs*2. Implementing a second-tier molecular test based on common mutations can enhance diagnostic accuracy. Further research into genotype-phenotype correlations within the Thai population is essential to refine NICCD screening and diagnostic strategies.

A case of severe COVID-19 ARDS with severe parenchymal damage mainly on the right lung complicated by bacterial and fungal Infection. A follow up was done throughout his hospitalization and post hospitalization showed remarkable radiological and clinical improvement. An impressive radiological and clinical improvement that would highlight on the importance of lung repair post severe acute lung injury and perhaps would enhance future research.

Introduction

Hemiplegic gait is a mix of errors and compensatory movements that are caused by those areas of the body that are still working. Proprioceptive input has been used a lot in kinesiotaping to trigger (or inhibit) muscles. However, limited information is available on the potential impact of applying kinesiotape on weak or paralysed muscles, on the gait of poststroke gait dysfunction patients. Also, the fact that kinesiotape is hard to find and costly keeps it from being used widely. Therefore, the investigation of elastic adhesive bandage as an easily accessible and low-cost substitute for kinesiotape is investigated in this study.

Methodology

Thirty post stroke walking dysfunction patients were recruited, whose ages were between 55 and 65 years, and the subjects were randomly assigned into two groups for the experimental study. The first group received kinesiotaping and the second group received an elastic adhesive bandage. The Berg Balance Scale (BBS) and Wisconsin Gait Scale (WGS) were used for assessment.

Results

It was evident that the first test group outcomes were similar to that of the second test group. The Berg Balance Scale (BBS) and the Wisconsin Gait Scale (WGS) did not show any changes between the groups. However, this study found that kinesiotaping improves gait dysfunction post-stroke relatively better than elastic adhesive bandaging.

Conclusion

The application of kinesio taping and elastic adhesive bandaging taping showed significant functional improvement to rehabilitation in patients. However, kinesiotaping had a better response in gait and balance than that of elastic adhesive bandage.

Dermal cylindroma is the benign neoplasm of eccrine sweat glands which present as skin coloured to bluish-red nodule(s) ranging in size from a few millimeters to many centimeters. They commonly present in head and neck areas as solitary or multiple painless nodules. Solitary tumours occur sporadically but multiple tumours are observed to be inherited in a predominantly dominant manner. We report a rare case of isolated dermal cylindroma on right side of the face over the cheek region in a 62-years-old male patient.

Laparoscopic sleeve gastrectomy is a common bariatric procedure with potential complications such as leaks and fistulas. We present a case of a chronic gastro-gastric (GG) fistula occurring nine years post-surgery, manifesting with chronic pain, food intolerance, and vomiting. Conversion to laparoscopic Roux-en-Y gastric bypass successfully addressed the issue. This case highlights the importance of recognizing and managing complications following sleeve gastrectomy.

Calcifying odontogenic cysts (COCs) are rare developmental odontogenic cystic lesions, accounting for < 1% of all odontogenic cysts. First described by Gorlin in 1962, it usually affects the anterior jaw segments. Owing to its considerable diverse histopathologic presentations and biological behaviour, the true nature of this lesion has been long debated. The “dualistic” concept & classification proposed by Praetorius et al. categorises it into two entities: a cyst & a neoplasm. Its infamous association with other odontogenic tumors has been well established but less frequently reported. We document a case report of massive COC type 1c in the posterior mandible of a 58-year-old patient, evolving over a period of 5 months. Enucleation followed by histopathologic evaluation led to the diagnosis of COC Type 1c. Patient is asymptomatic & is under follow up. We emphasise that COCs may remain asymptomatic or may clinicoradiographically simulate other more common jaw pathologies, thus a meticulous knowledge of its enigmatic histological variants plays a crucial role in definitive diagnosis & better treatment outcome.