Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1671277484
R. Panda, Pratosh Paul, S. Mishra, S. Mishra
Introduction: Medulloblastoma is a midline posterior fossa mass that typically develops from the vermis in children. It shows up on a CT scan as a hyperdense, homogeneously enhancing mass and is linked to the clinical profile of posterior fossa syndrome. Although this distinct clinical-radiological pattern is regarded as "typical," medulloblastomas frequently do not follow the normal clinico-radiological pattern. Methods: To identify the abnormal clinical-radiological features, 28 patients were retrospectively analyzed and 12 cases were prospectively studied. Only 21 of the 40 patients showed the typical radiological feature of a hyperdense homogeneously enhancing mass, while the other four had hypodense nonenhancing masses, 12 had cystic alterations, and five had calcifications in their tumors. Three patients arrived with tumors in the cerebellopontine angle cistern, which is a rather rare position. Results: Patients who underwent follow-up for a minimum of 6 months and a maximum of 1 year returned with metastases in very odd places. There were 2 patients who had a cervical intramedullary metastasis, and there were 4 occurrences of metastases in the frontal and subfrontal area. One year following final surgery and ventriculoperitoneal shunting, abdominal metastases and ascites occurred in 3 individuals. But after surgery, each of these 3 patients had had a complete course of craniospinal irradiation. Conclusion: There were other cases that had atypical clinical, radiological, and metastatic patterns.
{"title":"ATYPICAL INTERPRETATION OF MEDULLOBLASTOMA","authors":"R. Panda, Pratosh Paul, S. Mishra, S. Mishra","doi":"10.5455/ijmrcr.172-1671277484","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1671277484","url":null,"abstract":"Introduction: Medulloblastoma is a midline posterior fossa mass that typically develops from the vermis in children. It shows up on a CT scan as a hyperdense, homogeneously enhancing mass and is linked to the clinical profile of posterior fossa syndrome. Although this distinct clinical-radiological pattern is regarded as \"typical,\" medulloblastomas frequently do not follow the normal clinico-radiological pattern. Methods: To identify the abnormal clinical-radiological features, 28 patients were retrospectively analyzed and 12 cases were prospectively studied. Only 21 of the 40 patients showed the typical radiological feature of a hyperdense homogeneously enhancing mass, while the other four had hypodense nonenhancing masses, 12 had cystic alterations, and five had calcifications in their tumors. Three patients arrived with tumors in the cerebellopontine angle cistern, which is a rather rare position. Results: Patients who underwent follow-up for a minimum of 6 months and a maximum of 1 year returned with metastases in very odd places. There were 2 patients who had a cervical intramedullary metastasis, and there were 4 occurrences of metastases in the frontal and subfrontal area. One year following final surgery and ventriculoperitoneal shunting, abdominal metastases and ascites occurred in 3 individuals. But after surgery, each of these 3 patients had had a complete course of craniospinal irradiation. Conclusion: There were other cases that had atypical clinical, radiological, and metastatic patterns.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88924775","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}
Background: Omental infarction is a rare cause of acute abdominal pain. While the clinical presentation and diagnostic workup of omental infarction have been well-described in the literature, there is currently no published data on the relationship between omental infarction and Electrocardiogram (ECG) changes. Case presentation: A 37-year-old male presented with acute onset of epigastric pain, He had associated ECG changes, including ST elevation in V1 (1 mm), ST depression in leads II, aVF, and V4 so he was diagnosed with omental infarction after exclusion of acute coronary syndrome (ACS) via cardiac catheterization and echocardiography. The patient was managed conservatively with pain control and close observation and was discharged home in stable condition, The ECG changes resolved on follow-up 2 weeks later. Conclusion: Omental infarction should be considered in the differential diagnosis of patients presenting with acute abdominal pain and ECG changes. Further studies are needed to elucidate the pathophysiology of ECG changes in omental infarction and to develop optimal management strategies for these patients.
{"title":"Lesser Omental Infarction Presenting with ST-Segment Changes on Electrocardiography in A 37-Year Old Male: Coincidence or Causation?","authors":"Lila Hilal, Yumna Njoum, Suha Sulaiman, Bilal Adwan, Farah Jabbarin, S. Mtour","doi":"10.5455/ijmrcr.172-1684347260","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1684347260","url":null,"abstract":"Background: Omental infarction is a rare cause of acute abdominal pain. While the clinical presentation and diagnostic workup of omental infarction have been well-described in the literature, there is currently no published data on the relationship between omental infarction and Electrocardiogram (ECG) changes. Case presentation: A 37-year-old male presented with acute onset of epigastric pain, He had associated ECG changes, including ST elevation in V1 (1 mm), ST depression in leads II, aVF, and V4 so he was diagnosed with omental infarction after exclusion of acute coronary syndrome (ACS) via cardiac catheterization and echocardiography. The patient was managed conservatively with pain control and close observation and was discharged home in stable condition, The ECG changes resolved on follow-up 2 weeks later. Conclusion: Omental infarction should be considered in the differential diagnosis of patients presenting with acute abdominal pain and ECG changes. Further studies are needed to elucidate the pathophysiology of ECG changes in omental infarction and to develop optimal management strategies for these patients.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91484832","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 : 2023-01-01DOI: 10.5455/ijmrcr.172-1667489653
Dakin Paul, D. Rajan, D. Chokkalingam, Dr Gnaneswaran, Dr Matheen
Background: During the COVID-19 pandemic, there was a major change in the mode of education from offline to online classes for the school students. Objectives: To determine if school students have developed symptoms related to dry eye. Methodology: Its descriptive cross-sectional study. This study was conducted in a reputed school in the city and 1000 students who had attended online classes during the covid-19 pandemic by the Department of Ophthalmology, Chettinad hospital and research institute, Kelambakkam, Tamil nadu, India Results: About 41% experienced redness of eye, 38% experienced blurring of vision, 36.6% had eye pain, 32% had burning sensation of eyes signs of dryness of eye. 50.2% had adequate distance between your gadget and eyes, 36.1 % had too close to eyes and 13.7 % had too far from eyes. Regarding the eye checkup, 43.7% never checked up their eyes, 11.6% does annual examination and 44.7% does rarely. Comparison between duration of Electronic Gadget usage per day during online class and offline class was significantly reduced after the offline class commencement. P value is 0.000001. Conclusion: There is significant Digital screen exposure time difference is observed during online and in offline classes. And its impact in visual refractive errors and computer vision syndrome
{"title":"Assessing visual symptoms related to dry eye and refractive error in school students before and after online classes during COVID-19 pandemic","authors":"Dakin Paul, D. Rajan, D. Chokkalingam, Dr Gnaneswaran, Dr Matheen","doi":"10.5455/ijmrcr.172-1667489653","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1667489653","url":null,"abstract":"Background: During the COVID-19 pandemic, there was a major change in the mode of education from offline to online classes for the school students. Objectives: To determine if school students have developed symptoms related to dry eye. Methodology: Its descriptive cross-sectional study. This study was conducted in a reputed school in the city and 1000 students who had attended online classes during the covid-19 pandemic by the Department of Ophthalmology, Chettinad hospital and research institute, Kelambakkam, Tamil nadu, India Results: About 41% experienced redness of eye, 38% experienced blurring of vision, 36.6% had eye pain, 32% had burning sensation of eyes signs of dryness of eye. 50.2% had adequate distance between your gadget and eyes, 36.1 % had too close to eyes and 13.7 % had too far from eyes. Regarding the eye checkup, 43.7% never checked up their eyes, 11.6% does annual examination and 44.7% does rarely. Comparison between duration of Electronic Gadget usage per day during online class and offline class was significantly reduced after the offline class commencement. P value is 0.000001. Conclusion: There is significant Digital screen exposure time difference is observed during online and in offline classes. And its impact in visual refractive errors and computer vision syndrome","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81114341","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 : 2023-01-01DOI: 10.5455/ijmrcr.172-1681728141
Gupteswar Mishra, S. Mohanty, Prabir Biswal
{"title":"A cross-sectional study in a tertiary care facility examined the prevalence, risk factors, mother health, and perinatal outcomes in eclampsia","authors":"Gupteswar Mishra, S. Mohanty, Prabir Biswal","doi":"10.5455/ijmrcr.172-1681728141","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1681728141","url":null,"abstract":"<jats:p />","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81237019","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 : 2023-01-01DOI: 10.5455/ijmrcr.172-1651109705
Prakash sanniboyina, thejaswi R, C. L., S. S
ABSTRACT Background- Nerium oleander (common oleander grown as an ornamental plant) and Cerbera Thevetia (yellow oleander grows wildly on the roadside). All parts of these plants, including nectar, are potentially lethal. Suicidal poisoning by the products of these plants is a toxicologic emergency in tropical and subtropical regions. They contain cardiac glycosides, namely Oleandrin, Oleandrigenin, Nerifolin, ThevetinA, and ThevetinB, which act like digoxin in addition to gastrointestinal symptoms. Ingestion of oleander results in nausea, vomiting, abdominal pain, diarrhoea, dysrhythmias, and hyperkalemia. Cardiac toxicity includes a variety of ventricular dysrhythmias and A-V Blocks, muscular twitching, tetanic spasms, lockjaw, coma and respiratory paralysis. The cause of death is usually cardiogenic shock and respiratory arrest. Some cases have been reported with acute kidney injury and hepatic damage. Case report – We have successfully managed 3 cases of acute oleander poisoning. All three patients were young and did not have comorbid conditions. 2 patients presented with mainly abdominal pain and vomiting and had hyperkalemia. The third patient had symptomatic bradycardia and several episodes of vomiting. Most cases can be managed by Multidose activated charcoal and supportive care with IV fluids and symptomatic treatment. Some patients require respiratory support, atropine and pacing for symptomatic bradycardia. Insulin-dextrose is the most effective method of treating hyperkalemia. Calcium chloride is contraindicated in this instance. Specific management is digoxin specific Fab fragments. As emergency physicians may encounter these cases, they should have sound knowledge about symptoms and management. Oleander poisoning should be considered in the differential for any young patient presenting with bradycardia.
{"title":"Acute oleander poisoning treated successfully without Fab fragments- a case series and literature review","authors":"Prakash sanniboyina, thejaswi R, C. L., S. S","doi":"10.5455/ijmrcr.172-1651109705","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1651109705","url":null,"abstract":"ABSTRACT Background- Nerium oleander (common oleander grown as an ornamental plant) and Cerbera Thevetia (yellow oleander grows wildly on the roadside). All parts of these plants, including nectar, are potentially lethal. Suicidal poisoning by the products of these plants is a toxicologic emergency in tropical and subtropical regions. They contain cardiac glycosides, namely Oleandrin, Oleandrigenin, Nerifolin, ThevetinA, and ThevetinB, which act like digoxin in addition to gastrointestinal symptoms. Ingestion of oleander results in nausea, vomiting, abdominal pain, diarrhoea, dysrhythmias, and hyperkalemia. Cardiac toxicity includes a variety of ventricular dysrhythmias and A-V Blocks, muscular twitching, tetanic spasms, lockjaw, coma and respiratory paralysis. The cause of death is usually cardiogenic shock and respiratory arrest. Some cases have been reported with acute kidney injury and hepatic damage. Case report – We have successfully managed 3 cases of acute oleander poisoning. All three patients were young and did not have comorbid conditions. 2 patients presented with mainly abdominal pain and vomiting and had hyperkalemia. The third patient had symptomatic bradycardia and several episodes of vomiting. Most cases can be managed by Multidose activated charcoal and supportive care with IV fluids and symptomatic treatment. Some patients require respiratory support, atropine and pacing for symptomatic bradycardia. Insulin-dextrose is the most effective method of treating hyperkalemia. Calcium chloride is contraindicated in this instance. Specific management is digoxin specific Fab fragments. As emergency physicians may encounter these cases, they should have sound knowledge about symptoms and management. Oleander poisoning should be considered in the differential for any young patient presenting with bradycardia.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81302537","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 : 2023-01-01DOI: 10.5455/ijmrcr.172-1656142184
L. Castro, F. Coelho, R. Mendes, Andreia Silva, Leonor Santos
Primary Hyperparathyroidism (PHPT) is a frequent cause of hypercalcaemia and parathyroid adenoma is the most frequent aetiology. Most patients are now diagnosed incidentally or with slightly symptomatic disease, however PHPT can cause extremely elevated calcium levels leading to hypercalcaemic crisis, a life-threatening clinical scenario associated with calcium-related organ failure. We present a case of a woman with long-lasting neuropsychiatric symptoms caused by PHPT, misdiagnosed as a depressive syndrome, which ultimately develops hypercalcaemic crisis. After parathyroidectomy, patient fully recovered organ failure and previous depressive symptoms within six months. Early diagnosis, adequate resuscitation and organ support associated with parathyroidectomy can lead to a better prognosis in comparison with the elevated mortality reported in the past.
{"title":"Life-threatening Hypercalcaemic Crisis Due to Benign Primary Hyperparathyroidism, a Case Report","authors":"L. Castro, F. Coelho, R. Mendes, Andreia Silva, Leonor Santos","doi":"10.5455/ijmrcr.172-1656142184","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1656142184","url":null,"abstract":"Primary Hyperparathyroidism (PHPT) is a frequent cause of hypercalcaemia and parathyroid adenoma is the most frequent aetiology. Most patients are now diagnosed incidentally or with slightly symptomatic disease, however PHPT can cause extremely elevated calcium levels leading to hypercalcaemic crisis, a life-threatening clinical scenario associated with calcium-related organ failure. We present a case of a woman with long-lasting neuropsychiatric symptoms caused by PHPT, misdiagnosed as a depressive syndrome, which ultimately develops hypercalcaemic crisis. After parathyroidectomy, patient fully recovered organ failure and previous depressive symptoms within six months. Early diagnosis, adequate resuscitation and organ support associated with parathyroidectomy can lead to a better prognosis in comparison with the elevated mortality reported in the past.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81665899","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 : 2023-01-01DOI: 10.5455/ijmrcr.172-1671075092
Iswina Baharuddin, Pendrik Tandean, Idar Mappangara, S. Bakri, H. Rasyid, A. Aman, A. Seweng
Background : Hyponatremia is the most common electrolyte disturbance in hospitalized heart failure patients, with a prevalence of around 19%-25%. The relationship between hyponatremia and cardiac conduction disorders has not been demonstrated yet. When there is a decrease in extracellular Na+ levels, there is a delay in the depolarization phase. This study was conducted to observe the ECG pattern in hyponatremic patients with heart failure (particularly in the P wave, PR interval, and QRS complex) and ECG changes after 24 hours of therapy. Methode: This study used a longitudinal observational descriptive method. Patients who were included in this study were hyponatremic patients with heart failure at the Wahidin Sudirohusodo Hospital Makassar from April to September 2021. The patient's electrocardiogram data when first admitted and after 24 hours of therapy. Statistical test using McNemar and Wilcoxon Signed Rank Test, where the test results are statistically significant when the p value <0.05. Result : This study included 51 subjects with a distribution of 68.6% men with an age range of 18-85 years. Pre-therapy ECG pattern showed 12 patients with prolonged P-R interval, and 4 patients with widening of the QRS complex. After 24 hours of therapy, 12 people became normonatremia and the mean P wave and P-R interval were lower than pre-therapy, while the QRS complex did not show any changes. Conclusion : The ECG pattern in hyponatremia with heart failure are prolonged P-R interval and widening of the QRS complex, but the ECG changes were not significant to Na+ levels changes.
背景:低钠血症是住院心力衰竭患者中最常见的电解质紊乱,患病率约为19%-25%。低钠血症与心脏传导障碍之间的关系尚未得到证实。当细胞外Na+水平降低时,去极化期延迟。本研究旨在观察低钠血症合并心力衰竭患者在治疗24小时后的心电图模式(特别是P波、PR间期和QRS复合体)及心电图变化。方法:本研究采用纵向观察描述性方法。本研究纳入的患者是2021年4月至9月在望加锡Wahidin Sudirohusodo医院就诊的低钠血症心力衰竭患者。患者入院时和治疗24小时后的心电图数据。统计检验采用McNemar and Wilcoxon sign Rank检验,当p值<0.05时,检验结果具有统计学意义。结果:本研究纳入51例受试者,年龄在18-85岁之间,男性占68.6%。治疗前心电图显示12例P-R间期延长,4例QRS复合物增宽。治疗24小时后,12例患者变为正常血钠,平均P波和P- r间期均低于治疗前,而QRS复合体无变化。结论:低钠血症合并心力衰竭的心电图表现为P-R间期延长、QRS复合体增宽,但心电图变化与Na+水平变化无显著性关系。
{"title":"ELECTROCARDIOGRAM PATTERN PRE AND 24 HOURS POST THERAPY \u0000IN HYPONATREMIA WITH HEART FAILURE PATIENT","authors":"Iswina Baharuddin, Pendrik Tandean, Idar Mappangara, S. Bakri, H. Rasyid, A. Aman, A. Seweng","doi":"10.5455/ijmrcr.172-1671075092","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1671075092","url":null,"abstract":"Background : Hyponatremia is the most common electrolyte disturbance in hospitalized heart failure patients, with a prevalence of around 19%-25%. The relationship between hyponatremia and cardiac conduction disorders has not been demonstrated yet. When there is a decrease in extracellular Na+ levels, there is a delay in the depolarization phase. This study was conducted to observe the ECG pattern in hyponatremic patients with heart failure (particularly in the P wave, PR interval, and QRS complex) and ECG changes after 24 hours of therapy. Methode: This study used a longitudinal observational descriptive method. Patients who were included in this study were hyponatremic patients with heart failure at the Wahidin Sudirohusodo Hospital Makassar from April to September 2021. The patient's electrocardiogram data when first admitted and after 24 hours of therapy. Statistical test using McNemar and Wilcoxon Signed Rank Test, where the test results are statistically significant when the p value <0.05. Result : This study included 51 subjects with a distribution of 68.6% men with an age range of 18-85 years. Pre-therapy ECG pattern showed 12 patients with prolonged P-R interval, and 4 patients with widening of the QRS complex. After 24 hours of therapy, 12 people became normonatremia and the mean P wave and P-R interval were lower than pre-therapy, while the QRS complex did not show any changes. Conclusion : The ECG pattern in hyponatremia with heart failure are prolonged P-R interval and widening of the QRS complex, but the ECG changes were not significant to Na+ levels changes.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74182756","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}