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Coarctation of AORTA – A Case History 主动脉缩窄1例
Pub Date : 2022-10-30 DOI: 10.47363/jccsr/2022(4)233
Elakiya Manopriya
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引用次数: 0
A Rare Presentation of Second Branchial Cleft Cysts in Adult Patient: Case Report with Literature Review 罕见的成人第二鳃裂囊肿1例报告并文献复习
Pub Date : 2022-09-30 DOI: 10.47363/jccsr/2022(4)229
Mohamed El Hafed Radhi
Second branchial cleft cysts are the most common type of branchial cleft cysts as they make up approximately 95% of all cases. These are congenital conditions that occur in the upper lateral neck just anterior to the sternocleidomastoid muscle and caused by fluids filling spaces during early embryonic development. We present a case of atypical presentation of second branchial cleft cysts in 40 year’s patient, A surgical intervention was performed with complete excision of the cysts. Many of branchial cleft cysts would go unnoticed. However, upper respiratory tract infection can cause a sudden and significant increase in the size of the cyst because of the lymphoid tissue beneath the epithelium, The Differential diagnosis would include lymphadenopathy, lipoma, nerve sheath tumor, inflammatory lesions, carotid body tumor, external laryngocele, cystic hygroma, metastatic squamous cell carcinoma, tuberculosis-related, HIV-related lymphadenopathy, sarcoidosis, cat-scratch disease, lymphoma, and papillary thyroid carcinoma metastasis. Surgical excision is the only known treatment for second branchial cleft cysts; moreover, a complete removal of second bronchial cyst cleft is of paramount importance since it is key to preventing any recurrence of the disease.
第二鳃裂囊肿是最常见的鳃裂囊肿类型,约占所有病例的95%。这是先天性疾病,发生在胸锁乳突肌前方的上外侧颈部,由早期胚胎发育期间液体填充间隙引起。我们报告一个40岁病患的第二鳃裂囊肿的不典型表现,手术介入并完全切除囊肿。许多鳃裂囊肿会被忽视。然而,上呼吸道感染可引起囊肿的突然和显著的增大,因为上皮下的淋巴组织。鉴别诊断包括淋巴结病、脂肪瘤、神经鞘瘤、炎性病变、颈动脉体肿瘤、喉外囊肿、囊性水瘤、转移性鳞状细胞癌、结核相关、hiv相关淋巴结病、结节病、猫抓病、淋巴瘤、甲状腺乳头状癌转移。手术切除是唯一已知的治疗第二鳃裂囊肿;此外,完全切除第二支气管囊肿是至关重要的,因为它是防止疾病复发的关键。
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引用次数: 0
Impact of Functional Gastrointestinal Disorders in Infancy and the Role of Nutrition 婴儿期功能性胃肠疾病的影响和营养的作用
Pub Date : 2022-09-30 DOI: 10.47363/jccsr/2022(4)230
Said el Deib
Functional gastrointestinal disorders (FGIDs) such as infantile colic, constipation and colic occur in almost half of the infants. Functional gastrointestinal disorders (FGID) are common among children and may cause a significant symptom burden. The Rome criteria are symptom-based guidelines for the assessment of FGID among children and adults. The most common FGID for children aged 0–12 months was infant regurgitation, the most common FGID for those aged 13–48 months were functional constipation and cyclic vomiting, and, for those aged over four years, functional constipation, functional dyspepsia, and irritable bowel syndrome. This reported overall incidence of FGID may be used as a benchmark of normative data among the general population and comparative data for those with comorbid disease. The aim of this mini review article is to provide a critical and updated review on the management of FGIDs and their impact on the health of the infant and family to health care physicians. Guidelines and expert recommendations were reviewed. FGIDs are a frequent cause of parental concern, impairment in quality of life of infants and relatives, and impose a financial burden to families, health care, and insurance. Therefore, primary management of the FGIDs should be focused on improving the infants’ symptoms and quality of life of the family. If more than parental reassurance is needed, available evidence recommends nutritional advice as it is an effective strategy and most of the time devoid of adverse effects. The role of healthcare providers in reassuring parents and proposing the correct behavior and nutritional intervention by avoiding inappropriate use of medication, is essential in the management of FGIDs.
功能性胃肠疾病(fgid),如婴儿绞痛,便秘和绞痛发生在几乎一半的婴儿。功能性胃肠疾病(FGID)在儿童中很常见,并可能引起显著的症状负担。Rome标准是评估儿童和成人FGID的基于症状的指南。0-12月龄儿童最常见的FGID是婴儿反流,13-48月龄儿童最常见的FGID是功能性便秘和周期性呕吐,4岁以上儿童最常见的FGID是功能性便秘、功能性消化不良和肠易激综合征。这一报告的FGID总发病率可作为一般人群的规范性数据和共病患者的比较数据的基准。这篇小型综述文章的目的是为医疗保健医生提供关于fgid管理及其对婴儿和家庭健康影响的关键和最新综述。审查了准则和专家建议。fgid经常引起父母的关注,损害婴儿和亲属的生活质量,并给家庭、医疗保健和保险带来经济负担。因此,FGIDs的初级管理应侧重于改善婴儿的症状和家庭生活质量。如果需要的不仅仅是父母的保证,现有证据建议提供营养建议,因为这是一种有效的策略,而且在大多数情况下没有不良影响。医疗保健提供者的作用是让家长放心,并通过避免不当使用药物提出正确的行为和营养干预,这在fgid的管理中至关重要。
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引用次数: 0
A Case Study on Anaesthesia of a Patient with Pancreatic Necrosis in Bangladesh 孟加拉1例胰腺坏死患者麻醉案例研究
Pub Date : 2022-07-31 DOI: 10.47363/jccsr/2022(4)224
M. Hossain
Acute pancreatitis causes devastating changes in body involves organ dysfunction, metabolic imbalance, electrolyte disturbance as well as acid base disorder. Pancreatic necrosis complicates the condition. Patient may develops systemic inflammatory response syndrome (SIRS) followed by sepsis. Laparotomy and removal of necrotic part along with peritoneal toileting is the surgical management. We present a case of a 45 years old male admitted with a diagnosis of pancreatic necrosis is scheduled for exploratory laparotomy followed by peritoneal toileting along with excision of necrotic portion. Maintaining a smooth anesthesia is a challenge during surgery. Disease and its complications along with surgery produce extreme condition for anesthesiologist. Patient sometimes response badly therefore may need postoperative intensive care support. Meticulous fluid administration, inotrope support, choice of proper intraoperative drugs, monitoring vital signs including urine output, blood gas analysis- these should be focused during anaesthesia
急性胰腺炎可引起机体的破坏性变化,包括器官功能紊乱、代谢失衡、电解质紊乱和酸碱紊乱。胰腺坏死使病情复杂化。患者可能会出现全身炎症反应综合征(SIRS),随后出现败血症。手术治疗方法为剖腹手术,切除坏死部分并腹膜排便。我们报告一例45岁男性患者,诊断为胰腺坏死,计划行剖腹探查术,随后行腹膜排便并切除坏死部分。在手术中保持麻醉的平稳是一个挑战。疾病及其伴随手术的并发症给麻醉师带来了极端的条件。患者有时反应不良,因此可能需要术后重症监护支持。细致的液体管理,肌力支持,选择适当的术中药物,监测生命体征,包括尿量,血气分析-这些都应该在麻醉期间重点关注
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引用次数: 0
The use of Human Intestine to Deliver Recombinant Proteins Which Macroorganism Needs 利用人肠输送大型生物所需的重组蛋白
Pub Date : 2022-07-30 DOI: 10.47363/jccsr/2022(4)225
M. Tyurin
The Author has performed the partial body fat removal in the volunteer who has tendency to increase the body weight. The Author investigated the problem of food fat digestion on rabbits and successfully used it for the design and use of the proprietary fat removal column. The observations of the fat transport in the rabbit blood had brought the Author to understanding that the intestine is a wide and open gate for the recombinant proteins, if inhabit the intestine with the genetically engineered members of the normal human intestinal; microflora. It is paramount to do the genetic engineering of the component of the human normal intestinal microflora for about 200 hours, not longer, as otherwise long cultivated in vitro the engineered microorganisms do not adhere to the intestinal cells of the host thus making the whole procedure the waste of the very well paid time (patient/ health insurance pays). The Author has designed the procedure to cure the Diabetes II and anemia in another volunteer. The success determined the need for the look in the future, when the overcrowded Earth population might start relocating to other planets: vaccines for the relocating people.
作者对有体重增加倾向的志愿者进行了部分体脂切除。作者对家兔的食物脂肪消化问题进行了研究,并成功地将其用于专有的脂肪去除柱的设计和使用。对家兔血液中脂肪转运的观察使作者认识到,如果重组蛋白与正常人肠道的基因工程成员一起居住在肠道中,肠道是一个广阔而开放的大门;微生物区系。最重要的是对人类正常肠道菌群的组成部分进行大约200小时的基因工程,而不是更长时间,否则在体外长期培养的工程微生物不会粘附在宿主的肠道细胞上,从而使整个过程浪费了非常有价值的时间(患者/健康保险支付)。作者为另一名志愿者设计了治疗II型糖尿病和贫血的程序。这一成功决定了未来的需要,当过度拥挤的地球人口可能开始迁移到其他星球时:为迁移的人接种疫苗。
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引用次数: 0
A Progressive Loading Supervised Exercise Program and Manual Therapy for The Management of Lateral Elbow Tendinopathy: A Case Report 渐进式负荷监督运动计划和手动治疗肘关节外侧肌腱病变:一例报告
Pub Date : 2022-06-30 DOI: 10.47363/jccsr/2022(4)222
D. Stasinopoulos
The purpose of the case study was to find out the effect of a supervised exercise program combined with Transverse Friction (TF) and Mulligan Mobilization With Movement (MMWM) on disability and pain in a patient experiencing chronic Lateral Elbow tendinopathy (LET). A patient with unilateral LET for 6 months was included in the present study. The patient followed the exercise program five times per week for 4 weeks. The programme was individualized on the basis of the patient’s description of pain experienced during the procedure. TF and MMWM were applied 3 times per weeks for 4 weeks, 12 sessions totally. Outcome measures were function using the Patient-Rated Tennis Elbow Evaluation, a visual analogue scale and the pain-free grip strength and pain using a visual analogue scale. The patient was evaluated at baseline (week 0), at week 4 (end of treatment), at week 8 (1 month after the end of the treatment) and at week 32 (six months after the end of treatment). At the end of the treatment and at the follow – up there was a rise in function and a decline in pain. The findings of the case report suggest that a physiotherapy approach as described in the present case report can produce significant improvements in terms of disability and pain in a patient with chronic LET
本案例研究的目的是发现一个有监督的运动计划结合横向摩擦(TF)和Mulligan运动动员(MMWM)对慢性肘关节外侧肌腱病变(LET)患者的残疾和疼痛的影响。本研究包括1例单侧LET患者,持续6个月。患者每周进行5次锻炼,持续4周。该方案是根据患者在手术过程中所经历的疼痛的描述进行个性化的。TF和MMWM每周应用3次,连续4周,共12个疗程。结果测量是使用患者评分网球肘评估功能,视觉模拟量表和无痛握力和疼痛使用视觉模拟量表。在基线(第0周)、第4周(治疗结束)、第8周(治疗结束后1个月)和第32周(治疗结束后6个月)对患者进行评估。在治疗结束和随访时,患者的功能有所改善,疼痛有所减轻。病例报告的结果表明,本病例报告中描述的物理治疗方法可以显著改善慢性LET患者的残疾和疼痛
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引用次数: 0
Two Cases of BRASH Syndrome BRASH综合征2例
Pub Date : 2022-06-30 DOI: 10.47363/jccsr/2022(4)223
Sylvain Nainanirina
BRASH syndrome is a rare entity that is often underdiagnosed. Recently known in 2016, it falls within the scope of drug toxicity. BRASH syndrome consists of bradycardia, renal failure, shock, and hyperkalemia, secondary to atrioventricular node blocking drugs. We report two cases of BRASH syndrome in order to encourage the physician to think about it in front of bradycardia associated with hyperkalemia in chronic renal patients and to intensify the monitoring of renal insufficiency under atrio-ventricular node blocker. The first case was a 59-year-old man, hypertensive-diabetic, suffering from a stage IV chronic renal disease not dialyzed, having taken as antihypertensive drugs: Carvedilol 12.5 mg and Amlodipine 10 mg, presenting a picture of BRASH syndrome triggered by the intake of diuretic. The second case was a 64-year-old hypertensive-diabetic man, presenting a mixed vascular and diabetic nephropathy stage V not dialyzed, under Carvedilol 12,5 mg and Amlodipine 10 mg making a picture of shock and severe bradycardia with aggravation of a hyperkalemia labeled as BRASH syndrome on bacterial pneumonia.
BRASH综合征是一种罕见的实体,经常被误诊。2016年才被发现,属于药物毒性范畴。BRASH综合征包括心动过缓、肾功能衰竭、休克和高钾血症,继发于房室结阻断药物。我们报告了2例BRASH综合征,以鼓励医生在慢性肾病患者伴高钾血症的心动过缓前考虑它,并在房室结阻滞剂下加强对肾功能不全的监测。第一例患者为59岁男性,高血压合并糖尿病,患有未透析的IV期慢性肾脏疾病,曾服用降压药卡维地洛12.5 mg和氨氯地平10 mg,表现为利尿剂摄入引发的BRASH综合征。第二个病例是一名64岁的高血压-糖尿病男性,表现为混合血管和糖尿病肾病V期,未透析,卡维地洛12.5 mg和氨氯地平10 mg,表现为休克和严重心动过缓,伴有高钾血症加重,标记为细菌性肺炎BRASH综合征。
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引用次数: 0
Effect of SMS reminders on Attendance Rates for Healthcare Appointments: A Systematic Review & Meta-Analysis 短信提醒对医疗预约出勤率的影响:一项系统回顾和荟萃分析
Pub Date : 2022-05-31 DOI: 10.47363/jccsr/2022(4)217
Bobby Tang
Purpose: Non-attendance for healthcare appointments can adversely affect patients’ clinical outcomes as well as being costly to healthcare systems. The aim of this study is to assess the role of mobile health (mHealth) interventions in tackling this problem. Methods: A systematic review was conducted on several databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PubMed. Overall 12 articles were selected for the review. A random effects model was used to estimate an overall effect size. Results: SMS reminders significantly decreased the rate of non-attendance compared to no reminders (Risk ratio [RR] 0.77; 95% Confidence Interval [CI] 0.71, 0.84) with moderate heterogeneity (I2=32%) between studies. A funnel plot indicated no evidence of reporting bias. Conclusions: SMS reminders significantly improve healthcare attendance rates across a wide range of clinical and socioeconomic settings. Utilization of SMS reminders are a cheap and effective method of improving patient attendance rates.
目的:不参加医疗保健预约会对患者的临床结果产生不利影响,同时也会给医疗保健系统带来高昂的成本。本研究的目的是评估移动医疗(mHealth)干预措施在解决这一问题中的作用。方法:对Cochrane Central Register of Controlled Trials (Central)、MEDLINE、Embase和PubMed等数据库进行系统评价。总共选择了12篇文章进行综述。随机效应模型用于估计总体效应大小。结果:与没有提醒相比,短信提醒显著降低了缺勤率(风险比[RR] 0.77;95%可信区间[CI] 0.71, 0.84),研究间存在中等异质性(I2=32%)。漏斗图显示没有报告偏倚的证据。结论:短信提醒显着提高医疗出勤率在广泛的临床和社会经济环境。利用短信提醒是一种廉价而有效的提高病人出勤率的方法。
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引用次数: 1
Kissing Pterygium : when the Delay in Diagnosis Leads to a Tragic Ending 接吻翼状胬肉:当诊断延误导致悲剧结局
Pub Date : 2022-05-31 DOI: 10.47363/jccsr/2022(4)218
Elise Taieb
Pterygium occurs mostly on the nasal side, which can be attributed to light coming to the temporal cornea and being focused on the nasal Cornea [4]. Double head pterygium or Kissing pterygium , that is, nasal and temporal pterygia in the same eye is rare. Through this case, we present the case of a kissing pterygium which is a rare situation, and the importance of early diagnosis and care to avoid loss of visual acuity.
翼状胬肉多发生在鼻侧,这可能是由于光线到达颞角膜,聚焦在鼻角膜上[4]。双头翼状胬肉或吻状翼状胬肉,即同时发生在同一只眼睛的鼻部和颞部翼状胬肉是罕见的。通过这个病例,我们介绍了一种罕见的情况,接吻翼状胬肉的情况下,早期诊断和护理的重要性,以避免视力丧失。
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引用次数: 0
Bardet Biedl Syndrome-Report of three Cases and Review of Recent Articles Bardet Biedl综合征3例报告及近期文献综述
Pub Date : 2022-04-30 DOI: 10.47363/jccsr/2022(4)213
Dr. Jasmin Ahmad
Purpose: To report three cases of a rare inherited familial disorder of Bardet-Biedl Syndrome (BBS). Study Design: Observational case report. Method: Two out of eight siblings presented in their second decade of life with dimness of vision in both eyes since birth. The third one is the only person of the family presented also in second decade of life with gradual blurring of vision in both eyes and outward deviation of left eye. Detail clinical history was taken. Physical, anthropometric, ophthalmic, psychological examination was done and appropriate clinical investigations were performed to exclude other systemic disorder. Review of recent literatures was done. Result: First two cases were brothers, who were mentally retarded child with delayed developmental mile stone. They were short, obese and had polydactyly, gynecomastia, hypogonadism. Their vision was poor and had retinitis pigmentosa with optic atrophy. The third one was also mentally retarded and had polydactyly, trunkal obesity, atypical retinitis pigmantosa with optic atrophy. They did not had deafness or any systemic abnormalities. Depending on clinical findings they were diagnosed as a case of BBS.
目的:报告3例罕见的遗传性Bardet-Biedl综合征(BBS)。研究设计:观察性病例报告。方法:8名兄弟姐妹中有2名在出生后的第二个十年出现双眼视力模糊。第三个是家庭中唯一出现在第二个十年的人,双眼视力逐渐模糊,左眼向外偏。记录详细的临床病史。进行了体格、人体测量、眼科、心理检查,并进行了适当的临床调查以排除其他全身性疾病。对最近的文献进行了综述。结果:前2例为兄弟,均为发育迟缓的智障儿童。他们身材矮小,肥胖,有多指畸形,男性乳房发育不良,性腺功能减退。他们视力差,有色素性视网膜炎伴视神经萎缩。第三例智力低下,多指畸形,躯干肥胖,不典型色素性视网膜炎伴视神经萎缩。他们没有耳聋或任何系统性异常。根据临床表现,他们被诊断为BBS病例。
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引用次数: 0
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Journal of Clinical Case Studies Reviews & Reports
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