Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.020
Vishnu Das, Liza Fumilayo
Heparin-Induced Thrombocytopenia (HIT) is a disastrous, potentially devastating immune-mediated adverse drug reaction resultedin the formation of antibodies which activate platelets in the presence of heparin. Here, we presented an exemplifying case of a45-year-old male patient, a known case of Deep Venous Thrombosis admitted in Emergency Department with complaints of left groinpain along with passing bloody clot in urine for past 5 days. The patient was diagnosed as Renal Artery Thrombosis with the helpof radiological findings and was treated with Inj. Heparin. Thrombocytopenia developed on the first day of therapy and confirmedwith Heparin PF4 IgG ELISA Immunoassay. The patient switched to inj. Argatroban and later changed to oral anticoagulant therapy.Platelet count gradually came to normal upon stoppage of Inj. Heparin. To avoid a catastrophic outcome, heparin should be stoppedbefore initiating proper management.
{"title":"UNFRACTIONATED HEPARIN INDUCED THROMBOCYTOPENIA: A CASE REVIEW","authors":"Vishnu Das, Liza Fumilayo","doi":"10.32677/IJCR.2019.V05.I02.020","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.020","url":null,"abstract":"Heparin-Induced Thrombocytopenia (HIT) is a disastrous, potentially devastating immune-mediated adverse drug reaction resultedin the formation of antibodies which activate platelets in the presence of heparin. Here, we presented an exemplifying case of a45-year-old male patient, a known case of Deep Venous Thrombosis admitted in Emergency Department with complaints of left groinpain along with passing bloody clot in urine for past 5 days. The patient was diagnosed as Renal Artery Thrombosis with the helpof radiological findings and was treated with Inj. Heparin. Thrombocytopenia developed on the first day of therapy and confirmedwith Heparin PF4 IgG ELISA Immunoassay. The patient switched to inj. Argatroban and later changed to oral anticoagulant therapy.Platelet count gradually came to normal upon stoppage of Inj. Heparin. To avoid a catastrophic outcome, heparin should be stoppedbefore initiating proper management.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125783488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.021
K. Mahajan, A. Tyagi, M. Waran, Awani K Srivastava
Hanging is the suspension of a person by a noose or ligature around the neck and has been a common method of capital punishmentsince medieval times. Hanging is also a common method of suicide/homicide worldwide as also in India. We report a case ofattempted suicidal hanging admitted in our intensive care unit. The patient, a 32-year old male, presented with poor clinical status,in gasping condition, hypoxemic and required immediate intubation, resuscitation, assisted ventilation and intensive care treatment.He received standard supportive intensive care and made a full clinical recovery without any neurological deficit. The purpose of thecase report is to emphasize that the cases of near-hanging need to be aggressively resuscitated and managed irrespective of dismalinitial presentation.
{"title":"A CASE OF NEAR-HANGING","authors":"K. Mahajan, A. Tyagi, M. Waran, Awani K Srivastava","doi":"10.32677/IJCR.2019.V05.I02.021","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.021","url":null,"abstract":"Hanging is the suspension of a person by a noose or ligature around the neck and has been a common method of capital punishmentsince medieval times. Hanging is also a common method of suicide/homicide worldwide as also in India. We report a case ofattempted suicidal hanging admitted in our intensive care unit. The patient, a 32-year old male, presented with poor clinical status,in gasping condition, hypoxemic and required immediate intubation, resuscitation, assisted ventilation and intensive care treatment.He received standard supportive intensive care and made a full clinical recovery without any neurological deficit. The purpose of thecase report is to emphasize that the cases of near-hanging need to be aggressively resuscitated and managed irrespective of dismalinitial presentation.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116907265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.027
Surbhi Jain, A. Sachdeva, D. Bansal, R. Mittal
Primary hyperparathyroidism is a recognized, but rare, cause of acute pancreatitis. The pathophysiology of hypercalcemia-induced acute pancreatitis is not well known, but when this combination occurs, pancreatitis is likely to be severe and the degree of hypercalcemia may play an important role in this association. Therefore, the cause of hypercalcemia should be identified early. Surgical resection of the parathyroid adenoma is the ultimate therapy. We report two cases with severe acute necrotizing pancreatitis associated with hypercalcemia. The cause of hyperparathyroidism was a benign parathyroid adenoma. We highlight the drawbacks in delaying the diagnosis of primary hyperparathyroidism in patients with acute pancreatitis as the sole clinical presentation.
{"title":"ACUTE NECROTISING PANCREATITIS AS THE FIRST AND SOLE PRESENTATION OF UNDIAGNOSED PRIMARY HYPERPARATHYROIDISM","authors":"Surbhi Jain, A. Sachdeva, D. Bansal, R. Mittal","doi":"10.32677/IJCR.2019.V05.I02.027","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.027","url":null,"abstract":"Primary hyperparathyroidism is a recognized, but rare, cause of acute pancreatitis. The pathophysiology of hypercalcemia-induced acute pancreatitis is not well known, but when this combination occurs, pancreatitis is likely to be severe and the degree of hypercalcemia may play an important role in this association. Therefore, the cause of hypercalcemia should be identified early. Surgical resection of the parathyroid adenoma is the ultimate therapy. We report two cases with severe acute necrotizing pancreatitis associated with hypercalcemia. The cause of hyperparathyroidism was a benign parathyroid adenoma. We highlight the drawbacks in delaying the diagnosis of primary hyperparathyroidism in patients with acute pancreatitis as the sole clinical presentation.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134335702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.012
A. Edeh, Chukwudi Jude Okezie, R. Ohayi, Okwudili Wilfred Okenwa, C. Nwangwu
Female genital mutilation is the summation of all procedures that involve partial or total removal of the female external genitalia or other injuries to the female genital organs, whether for cultural or other non-therapeutic reasons. Hemorrhage, sepsis and genitourinarydamage are the main early causes of morbidity and occasional mortality associated with this practice. Vulva epidermal inclusioncysts, sexual and birth difficulties occur late and can cause medical, psychological and socioeconomic problems. Here, we presentthe case of a 42-year-old circumcised female, who presented with a huge vulva swelling of 30 years duration that posed somediagnostic challenge because of the presence of other body swellings arising from neurofibromatosis. This was successfully excisedand histology showed it was epidermal inclusion cyst, which we believed was a late complication of her neonatal circumcision.
{"title":"A HUGE EPIDERMAL INCLUSION CYST OF THE VULVA COMPLICATING NEONATAL FEMALE CIRCUMCISION","authors":"A. Edeh, Chukwudi Jude Okezie, R. Ohayi, Okwudili Wilfred Okenwa, C. Nwangwu","doi":"10.32677/IJCR.2019.V05.I02.012","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.012","url":null,"abstract":"Female genital mutilation is the summation of all procedures that involve partial or total removal of the female external genitalia or other injuries to the female genital organs, whether for cultural or other non-therapeutic reasons. Hemorrhage, sepsis and genitourinarydamage are the main early causes of morbidity and occasional mortality associated with this practice. Vulva epidermal inclusioncysts, sexual and birth difficulties occur late and can cause medical, psychological and socioeconomic problems. Here, we presentthe case of a 42-year-old circumcised female, who presented with a huge vulva swelling of 30 years duration that posed somediagnostic challenge because of the presence of other body swellings arising from neurofibromatosis. This was successfully excisedand histology showed it was epidermal inclusion cyst, which we believed was a late complication of her neonatal circumcision.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129335277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.024
R. P. Maheshwarappa, Juhi Bansal
Inferior Concha bullosa (ICB) is the presence of air cells within the inferior turbinates. Superior and middle concha bullosa arefrequently encountered in the clinical practice, however, inferior concha bullosa is rarely seen. ICB is generally asymptomatic butvery rarely can present with nasal obstruction. Few cases of ICB presenting with nasal obstruction have been mentioned in theliterature. We, hereby report the case of a 32-year-old female presented with recurrent sinusitis and nasal blockage. Imaging revealedinferior concha bullosa with thickened turbinate. Treatment with systemic antihistaminics followed by surgery resulted in resolutionof symptoms. On subsequent follow-up for one year, there were to further episodes of nasal obstruction.
{"title":"INFERIOR CONCHA BULLOSA: A RARE CAUSE OF NASAL OBSTRUCTION","authors":"R. P. Maheshwarappa, Juhi Bansal","doi":"10.32677/IJCR.2019.V05.I02.024","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.024","url":null,"abstract":"Inferior Concha bullosa (ICB) is the presence of air cells within the inferior turbinates. Superior and middle concha bullosa arefrequently encountered in the clinical practice, however, inferior concha bullosa is rarely seen. ICB is generally asymptomatic butvery rarely can present with nasal obstruction. Few cases of ICB presenting with nasal obstruction have been mentioned in theliterature. We, hereby report the case of a 32-year-old female presented with recurrent sinusitis and nasal blockage. Imaging revealedinferior concha bullosa with thickened turbinate. Treatment with systemic antihistaminics followed by surgery resulted in resolutionof symptoms. On subsequent follow-up for one year, there were to further episodes of nasal obstruction.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130631143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.011
G. Dharmshaktu
Lateral elbow dislocation is an uncommon injury and more so in pediatric age. Most of the elbow dislocations in children and adults are either posterior or posterolateral. Lateral elbow dislocation cases in the literature are limited to anecdotal reports or few cases in large series of elbow dislocation. Out of two described variants, complete and incomplete dislocation, most of the reported cases are of the complete type. Incomplete lateral elbow dislocation thus is a rare injury. Here, we report the case series of two cases of an incomplete variant of lateral elbow dislocation of the left side in nine and eleven year old male children. The cases were successfully managed with closed reduction and the functional outcome measured by the Mayo Elbow Performance Score (MEPS) was excellent till minimum follow-up of ten and fifteen months respectively.
{"title":"INCOMPLETE LATERAL ELBOW DISLOCATION IN CHILDREN: A REPORT OF TWO CASES","authors":"G. Dharmshaktu","doi":"10.32677/IJCR.2019.V05.I02.011","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.011","url":null,"abstract":"Lateral elbow dislocation is an uncommon injury and more so in pediatric age. Most of the elbow dislocations in children and adults are either posterior or posterolateral. Lateral elbow dislocation cases in the literature are limited to anecdotal reports or few cases in large series of elbow dislocation. Out of two described variants, complete and incomplete dislocation, most of the reported cases are of the complete type. Incomplete lateral elbow dislocation thus is a rare injury. Here, we report the case series of two cases of an incomplete variant of lateral elbow dislocation of the left side in nine and eleven year old male children. The cases were successfully managed with closed reduction and the functional outcome measured by the Mayo Elbow Performance Score (MEPS) was excellent till minimum follow-up of ten and fifteen months respectively.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122094116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.002
P. Palaniappan, F. Amran, F. A. Rashid, Valerie Ting Siau Mei, A. M. Mustafa, L. Yee, H. Ghazali
There were series of proven cases revealing opportunistic fungal infections in the cornea, cutaneous, subcutaneous and renal transplant patients. Renal involvements of opportunistic mold in immunocompromised especially in renal transplant recipients have remained a significant problem and a major cause of death worldwide. However, extensive literature reviews revealed no case of invasion in urolithiasis and rarely reported in endophthalmitis. Here, we report the case series of two rare cases related to a dematiaceous fungus, Aureobasidium pullulans. Both had an atypical presentation. Possible modes of entry and dissemination were discussed. Invasive surgical procedures, frequent uses of antibiotics and steroid could possibly predispose to its invasion in immunocompromised patients. This organism was identified through molecular techniques since culture yielded no growth. There was a good outcome following surgical intervention in both cases.
{"title":"INVASION OF AUREOBASIDIUM PULLULANS IN KIDNEY AND EYES OF IMMUNOSUPPRESSED PATIENTS","authors":"P. Palaniappan, F. Amran, F. A. Rashid, Valerie Ting Siau Mei, A. M. Mustafa, L. Yee, H. Ghazali","doi":"10.32677/IJCR.2019.V05.I02.002","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.002","url":null,"abstract":"There were series of proven cases revealing opportunistic fungal infections in the cornea, cutaneous, subcutaneous and renal transplant patients. Renal involvements of opportunistic mold in immunocompromised especially in renal transplant recipients have remained a significant problem and a major cause of death worldwide. However, extensive literature reviews revealed no case of invasion in urolithiasis and rarely reported in endophthalmitis. Here, we report the case series of two rare cases related to a dematiaceous fungus, Aureobasidium pullulans. Both had an atypical presentation. Possible modes of entry and dissemination were discussed. Invasive surgical procedures, frequent uses of antibiotics and steroid could possibly predispose to its invasion in immunocompromised patients. This organism was identified through molecular techniques since culture yielded no growth. There was a good outcome following surgical intervention in both cases.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123863164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.035
M. Kishore, Vijay Kumar, M. Kaushal, S. Marwah, A. Nigam
{"title":"SUPPURATIVE BCG LYMPHADENITIS IN AN INFANT: AN UNCOMMON CONDITION","authors":"M. Kishore, Vijay Kumar, M. Kaushal, S. Marwah, A. Nigam","doi":"10.32677/IJCR.2019.V05.I02.035","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.035","url":null,"abstract":"","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"77 S43","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113973202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.006
P. Choudhary, T. Salunke, A. Patki
Linear and whorled nevoid hypermelanosis (LWNH), also known as ‘zebra-like pigmentation’ is characterized by linear and swirlingstreaks of hyperpigmentation along the Blaschko’slines without preceding inflammation and atrophy. It is mainly located on trunkand limbs. The hyperpigmentation may be present at birth or may develop by early childhood. Very rarely, familial cases have beendescribed. Here, we are reporting one such rare case of familial LWNH in a 19-year-old female.
{"title":"LINEAR AND WHORLED NEVOID HYPERMELANOSIS: A RARE FAMILIAL CASE REPORT","authors":"P. Choudhary, T. Salunke, A. Patki","doi":"10.32677/IJCR.2019.V05.I02.006","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.006","url":null,"abstract":"Linear and whorled nevoid hypermelanosis (LWNH), also known as ‘zebra-like pigmentation’ is characterized by linear and swirlingstreaks of hyperpigmentation along the Blaschko’slines without preceding inflammation and atrophy. It is mainly located on trunkand limbs. The hyperpigmentation may be present at birth or may develop by early childhood. Very rarely, familial cases have beendescribed. Here, we are reporting one such rare case of familial LWNH in a 19-year-old female.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"417 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122904410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.32677/IJCR.2019.V05.I02.029
Shailesh Kumar, M. Alam, Shazid Akbal, T. Chaudhary
Stress-related gastric ulceration and their perforation have become history because of the research and development of highly effectiveanti-ulcer drug and their affordability and availability across our country. We present an interesting and thought-provoking case of a46-year-old female, with stress-related gastric perforation who developed the complication in a span of only 2 days of physiological insult.
{"title":"HYPERACUTE GASTRIC PERFORATION: A RARE PRESENTATION IN THE POST-OPERATIVE PERIOD","authors":"Shailesh Kumar, M. Alam, Shazid Akbal, T. Chaudhary","doi":"10.32677/IJCR.2019.V05.I02.029","DOIUrl":"https://doi.org/10.32677/IJCR.2019.V05.I02.029","url":null,"abstract":"Stress-related gastric ulceration and their perforation have become history because of the research and development of highly effectiveanti-ulcer drug and their affordability and availability across our country. We present an interesting and thought-provoking case of a46-year-old female, with stress-related gastric perforation who developed the complication in a span of only 2 days of physiological insult.","PeriodicalId":130971,"journal":{"name":"Volume 5, Issue 2, Mar - Apr 2019","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124809993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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