International Medical Case Reports Journal最新文献

Background: Oral cavity is the gateway to the digestive system and a window to general human health. Anemia is one of the health problems in the world characterized by various clinical conditions, including in the oral cavity.

Purpose: This case report aims to present the results of a clinical investigation of a patient who had oral hematoma and anemia with indigestion symptoms.

Case presentation: A 59-year-old male complained of a lump on his tongue two months prior, which was painless and frequently bleeding. The complaint was followed by abdominal discomfort, difficulty defecating, weight loss, and decreased appetite. The patient only ate porridge and lacked water intake. Intraoral examination showed a blackish-red, irregularly shaped, painless hematoma on the dorsum of the tongue and a negative diascopy test. Hematology examination showed anemia with hemoglobin 6.7g/dL, hematocrit 21.4%, erythrocytes 3.08 x 106/µL, MCV 69.5fL, MCH 21.8pg, and MCHC 31.3g/dL. The diagnosis of the tongue lesion was an oral hematoma.

Case management: Pharmacologic therapy included antifibrinolytic agents and hematinic supplementation. Non-pharmacologic therapy included dental health education, a balanced lifestyle, and avoiding triggers for tongue bleeding. Management in other fields was also carried out in parallel, including oral surgery and internal medicine. The general condition of the patient general condition improved through multidisciplinary monitoring.

Conclusion: Clinical investigations that include signs and symptoms of disease in a patient with bleeding disorders such as hematoma and anemia need to be carried out in detailed aid examinations, especially if other symptoms are found, such as digestive disorders.

We present on a patient with complex regional pain syndrome (CRPS) following ankle surgery. Pain was refractory to both conservative and surgical measures including neurotomies, ankle fusion, hardware removal, and spinal cord stimulation (SCS) trial. A dorsal root ganglion (DRG) stimulation trial with lead placements at L4, L5, and S1 provided significant pain and functional improvement. However, during the implantation, we were able to place only two DRG leads at L4 and L5 and not S1 due to difficulties with advancing the lead to the desired location. Nonetheless, the two DRG leads provided 90% pain relief and 75% functional improvement for 9 months. However, the patient experienced pain symptoms similar to that of pre-implant without a clear trigger after 9 months despite no DRG stimulator hardware malfunction or lead migration. A decision was made to re-try implanting the S1 DRG lead, which was successful and provided significant pain relief.

Congenital rubella syndrome (CRS) is a serious condition with a high rate of morbidity. It is currently a rare disorder, especially in developed countries, because of universal vaccination campaigns. However, it remains a public health concern in developing countries. Here, we report a case of congenital rubella syndrome in a mother who did not receive any prenatal care or had a known history of vaccination. He is a term male infant, and the infant's positive rubella IgM confirmed the diagnosis. The baby had a bilateral cataract, convulsions, Patent ductus arteriosus (PDA)-related cardiomegaly, and bilateral hearing loss. The only known preventive measure for congenital rubella syndrome is vaccination.

Introduction: Incessant Ventricular Tachycardia is a condition characterized by multiple episodes of Ventricular Tachycardia (VT) in 24 hours, persisting despite efforts to stop the arrhythmia. In this condition, sympathectomy as the surgical procedure is considered a permanent intervention and the last resort when medications prove ineffective. This procedure comprises the cutting or clamping of sympathetic nerves to prevent the transmission of nerve signals. Therefore, this study aims to present a case report of post-sympathectomy nursing management in a patient with Incessant Ventricular Tachycardia.

Case presentation: A 59-year-old female patient was admitted to the high-care unit with a diagnosis of post-sympathectomy, Incessant Ventricular Tachycardia due to Arrhythmogenic Cardiomyopathy. Nursing problems based on NANDA included decreased cardiac output, gas exchange impairment, and activity intolerance. Furthermore, the nursing interventions for the condition included self-care management and collaboration with an anesthesiologist and cardiologist. The interventions encompassed cardiac care, airway management, and activity therapy. Tele-nursing was also conducted through video calls to monitor the patient after hospital care.

Results: The planned nursing care was effective in preventing common complications that often occur after the surgical procedure. The most important key aspect is regular maintenance and monitoring. The patient was discharged on the third day after the surgery with no complaints of shortness of breath, palpitations, and gradual resumption of activities.

Conclusion: Sympathectomy procedures could successfully be used to treat patients through multidisciplinary collaboration. Furthermore, nurses could emphasize post-operative care management to expedite recovery and improve patient quality of life.

Radiation for head and neck cancer (HNC) can lead to neck fibrosis, commonly known as "woody neck", limiting neck mobility. We report the case of a 46-year-old male with a history of tonsillar squamous cell carcinoma, with a "woody neck" following multiple radiation treatments. Facial swelling and impending airway loss prompted emergent intubation. Despite nasotracheal tube placement, bilateral internal jugular vein occlusion led to a difficult tracheostomy. An airway exchange catheter (AEC) facilitated multiple attempts at tracheal cannulation, but due to challenging anatomy, prolonged nasotracheal intubation was maintained. Tracheostomy was attempted again with extracorporeal membrane oxygenation (ECMO) support, which resulted in successful tracheal cannulation.

Severe sickle retinopathy is commonly known in adults but not in children, hence any related treatment for sickle retinopathy in children was not well described. We reported 2 paediatric sickle patients (aged 12 and 13) presented with severe sickle retinopathy and described details of their disease progression and treatments over 2-3 years, along with the challenges faced when managing this particular group of young age sickle cell patients. Our case reports also demonstrated the benefits of laser photocoagulation treatment to early sickle proliferative disease, and how complications from advanced severe retinopathy hindered effective treatments.

This case report describes the case of a female infant hospitalized for severe pneumonia. During the treatment process, various antibiotics are used to treat and prevent further infection. The child had a weak physical condition, combined with neuroblastoma, paraneoplastic syndrome, and low immune function, leading to Tsukamurella tyrosinosolvens infection. The treatment was eventually abandoned owing to poor prognosis. This study aims to through the medium, dyeing, electron microscope observation, 16s rRNA and high-throughput sequencing investigated the morphological characteristics, staining properties, electron microscope morphology, antibiotic resistance, and genomic characteristics of Tsukamurella tyrosinosolvens. The aim of the study is to provide data reference for clinical laboratory staff in bacteria identification research, and to provide relevant help for clinicians in diagnosis and treatment.

Transcatheter aortic valve replacement (TAVR) has been recently indicated for the treatment of patients with severe aortic stenosis in all risk profiles. At present, TAVR has become mature at home and abroad, but the relevant experience is deficient in the treatment of aortic valve stenosis with outflow tract stenosis. One case of a high-risk surgical patient was included in this paper who suffered from severe aortic valve stenosis with left ventricular outflow tract (LVOT) stenosis. In this case, TAVR was performed with deep implantation of a new valve and both aortic valve stenosis and LVOT stenosis were treated through a single TAVR procedure. This case highlights the vital role of such treatment in dealing with both aortic valve stenosis and LVOT stenosis through a single TAVR procedure, thus providing valuable information for similar cases.

We report the case of a 53-year-old man who was diagnosed with Holmes tremor and underwent deep brain stimulation of the ventro-intermediate thalamic nucleus and posterior subthalamic area. We assessed the patients' tremor with the Fahn-Tolosa-Marin Tremor Rating Scale at 1, 3, 6, 12 and 24 months after deep brain stimulation. Deep brain stimulation relieved the patient's tremor during the 24-month follow-up period.

Posterior capsular opacification (PCO), also known as "secondary cataract", is a common complication following cataract surgery that can significantly impair visual acuity. The incidence of PCO varies widely in the literature, influenced by intraocular lens (IOL) type and patient risk factors. Neodymium-doped yttrium-aluminum-garnet (YAG) laser posterior capsulotomy is the standard treatment for PCO-related visual impairment. Recurrence of PCO after initial treatment with YAG capsulotomy, though more common in children, is rare in adults. Its underlying pathophysiological mechanisms are similar to that of primary PCO, which includes proliferation, migration, and/or clustering of lens epithelial cells (LECs), with subsequent reclosure of the posterior aperture. Potential risk factors for PCO recurrence that have been speculated through a comprehensive search of the current literature include younger age, female sex, high myopia, diabetes, vitrectomized status, uveitis, low-diopter IOLs, and certain IOL types with higher water content. We present a case of recurrent PCO in a highly myopic 48-year-old male following cataract surgery and implantable collamer lens (ICL) explantation who received a hydrophobic acrylic lens with 4% water content. Surgical techniques that may reduce recurrent PCO occurrence and appropriate postoperative care are emphasized to assist surgeons in their approach to patients at high-risk for this complication.