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Neuroleptic malignant syndrome in puerperal women – frozen in summer 产褥期妇女的神经性恶性综合征--夏季冰冻
IF 0.1 Pub Date : 2024-06-05 DOI: 10.33706/jemcr.1420313
Sadesvaran Muniandy
Introduction Neuroleptic malignant syndrome is an rare event, even more so among patient from puerperal period. The incidence risk is of 0.11%. It is often occurs when a patient is prescribed on antipsychotic for long duration of time. Case Report We report a case of a female patient, two weeks in post natal period presented with altered behaviour at home. She has prior admission being treated for post partum psychosis with anti psychotic. However antipschotic was withheld as she developed extrapyramidal symptoms while in ward. At home, she developed fever, altered sensorium and fitting-like-episode. On arrival patient was unresponsive and with features of impaired airway patency. Her had unstable vital sign with elevated blood pressure, heart rate and temperature. Brain imagine came back normal, excluding brain pathology. She was diagnosed as neuroleptic malignant syndrome as fulfilled features of elevated creatine kinase. She was treated symptomatic by providing first aid to reduce temperature and started on benzodiazepines. She was subsequently admitted to intensive ward and responded well to treatment Conclusion Physician must be familiar and have high index of suspicious to identify and treat neuroleptic malignant syndrome. Without prompt treatment, it is highly fatal.
导言神经性恶性综合征是一种罕见病,在产褥期患者中更为罕见。发病风险为 0.11%。当患者长期服用抗精神病药物时,往往会出现这种情况。 病例报告 我们报告了一例女性患者,她在产后两周在家出现行为改变。入院前,她曾因产后精神病接受过抗精神病药物治疗。然而,由于她在病房时出现锥体外系症状,抗精神病药物被暂停使用。在家里,她出现了发烧、感觉改变和类似癫痫发作的症状。到达医院时,患者反应迟钝,呼吸道通畅性受损。她的生命体征不稳定,血压、心率和体温升高。脑部检查结果正常,排除了脑部病变。根据肌酸激酶升高的特征,她被诊断为神经性恶性综合征。对她进行了对症治疗,采取急救措施降低体温,并开始服用苯二氮卓类药物。结论 医生必须熟悉神经安定剂恶性综合征,并对其有高度的怀疑,以便识别和治疗。如不及时治疗,极易导致死亡。
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引用次数: 0
A Case of Pulmonary Embolism after to Receiving a Dose of Sildenafil 一个服用西地那非后发生肺栓塞的病例
IF 0.1 Pub Date : 2024-06-05 DOI: 10.33706/jemcr.1398042
Emin Fatih Vişneci, Tevhid Aydın, F. Tekin, Demet Acar
Introduction: Several studies have posited the potential of PDE5Is to precipitate arterial and venous thrombotic or embolic incidents, albeit rare occurrences. The present investigation documents a case of pulmonary thromboembolism (PTE) in an elderly male patient, aged 81, following the consumption of sildenafil. Case Report: An 81-year-old male patient who was previously diagnosed with syncope was admitted to our Emergency Department. He reported symptoms of dyspnea and vertigo. Approximately two hours before admission, there was a history of accidentally ingesting a total dose of 100 milligrams of sildenafil. Conclusion: The occurrence of PTE after sildenafil administration in this case, albeit rare, underscores the significance of meticulous evaluation of medications during patient history-taking. This case report, the importance of thorough efforts to rule out the diagnosis of PTE and to address even the slightest suspicion.
导言:一些研究认为,PDE5Is 有可能诱发动脉和静脉血栓或栓塞事件,尽管这种情况很少发生。本研究记录了一例 81 岁老年男性患者在服用西地那非后发生肺血栓栓塞(PTE)的病例。病例报告:一名曾被诊断为晕厥的 81 岁男性患者被送入我院急诊科。他报告了呼吸困难和眩晕的症状。入院前约两小时,他曾意外摄入总剂量为 100 毫克的西地那非。结论本病例中服用西地那非后发生 PTE 的情况虽然罕见,但强调了在询问病史时对药物进行细致评估的重要性。本病例报告表明,必须彻底排除 PTE 诊断,并处理即使是最轻微的怀疑。
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引用次数: 0
A case report of non hodgkin lymphoma presenting with upper gastrointestinal tract bleeding 以上消化道出血为表现的非霍奇金淋巴瘤病例报告
IF 0.1 Pub Date : 2024-06-05 DOI: 10.33706/jemcr.1491478
Zekeriya Aksöz
Abstract: Initial evaluation of patients with acute gastrointestinal (GI) tract bleeding includes assessment of hemodynamic stability and resuscitation if necessary Case Report: A 48-year-old male patient was admitted to the emergency department with complaints of dizziness, intense weakness, vomiting in the form of coffee grounds and black diarrhea Conclusion: Aggressive non-hodgkin lymphoma may be among the etiologies of upper gastrointestinal bleeding. In cases where endoscopic and surgical methods are inadequate, chemotherapy may be a life-saving option considering the possible risks.
摘要:对急性消化道(GI)出血患者的初步评估包括评估血流动力学稳定性,必要时进行复苏:一名 48 岁的男性患者因头晕、乏力、呕吐物为咖啡渣和黑色腹泻被送入急诊科:侵袭性非霍奇金淋巴瘤可能是上消化道出血的病因之一。在内窥镜和外科手术无法奏效的情况下,考虑到可能存在的风险,化疗可能是挽救生命的一种选择。
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引用次数: 0
Transient complete right bundle branch block due to lung contusion: case report 肺挫伤导致的一过性完全性右束支传导阻滞:病例报告
IF 0.1 Pub Date : 2024-03-21 DOI: 10.33706/jemcr.1410026
N. Kozaci, İsmail Erkan Aydin, Durmus Ali Ersahi̇n, Yavuz Yüksel
Introduction: Right bundle branch block (RBBB) may occur in lung diseases and cardiovascular diseases. Case Report: A 25-year-old male patient was admitted to emergency department after a motorcycle accident. Contusion was detected in bilateral lungs, and pneumothorax with laceration were detected in the right lung. ECG revealed 103 bpm, right axis deviation, and complete RBBB. ECG revealed 83 bpm, complete RBBB continued at the 6th hour after tube thoracostomy, and high sensitive TnI was normal. Chest X-ray was normal on the 4th day of hospitalization, and ECG revealed 74 bpm, normal sinus rhythm. Conclusion: In thoracic trauma, ECG changes may develop as a result of lung contusion. ECG findings improve as the lung contusion heals.
引言右束支传导阻滞(RBBB)可能发生在肺部疾病和心血管疾病中。病例报告:一名 25 岁的男性患者因摩托车事故被送入急诊科。双肺挫伤,右肺气胸伴撕裂伤。心电图显示 103 bpm、右轴偏离和完全性 RBBB。插管胸腔造口术后第 6 小时,心电图显示 83 bpm,完全性 RBBB 仍在继续,高敏 TnI 正常。住院第 4 天,胸部 X 光片正常,心电图显示为 74 bpm,窦性心律正常。结论在胸部创伤中,肺挫伤可能导致心电图改变。随着肺挫伤的愈合,心电图结果会有所改善。
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引用次数: 0
Cornelia De Lange Syndrome with left heart hypoplasia: a case study 科妮莉亚-德-朗格综合征伴左心发育不良:病例研究
IF 0.1 Pub Date : 2024-02-15 DOI: 10.33706/jemcr.1395190
Elif Sena Ozcan, Sevim Yener, Gulam Hekimoğlu, Nurullah Yücel, Z. İlçe
Cornelia de Lange syndrome (CdLS) is characterized by slow growth that can lead to short stature. Despite mutations in the NIPBL, RAD21 or SMC3 genes, CdLS is thought to be inherited in an autosomal dominant manner. Findings include intellectual disability and bone abnormalities in the upper extremities and distinct facial features. It has similar characteristics to autism spectrum disorder, which is a developmental condition that affects communication and social interaction. The physical and clinical findings of a one-and-a-half-year-old girl patient diagnosed with CdLS were reported. In addition to NIPBL gene mutation, atrioventricular septal defect (AVSD), an overriding aorta, and a hypoplastic left heart (HLH) were observed in our case. This study revealed the patient's physical and clinical findings consistent with the diagnosis of CdLS. Additionally emphasized HLH. The importance of performing corrective surgery immediately following the evaluation of congenital heart diseases in CdLS patients can be emphasized.
科尼莉亚-德-朗格综合征(CdLS)的特点是生长缓慢,可导致身材矮小。尽管 NIPBL、RAD21 或 SMC3 基因发生了突变,但 CdLS 仍被认为是常染色体显性遗传。其症状包括智力障碍、上肢骨骼异常和明显的面部特征。它与自闭症谱系障碍的特征相似,后者是一种影响沟通和社会交往的发育性疾病。本研究报告了一名被诊断为 CdLS 的一岁半女童的身体和临床发现。除 NIPBL 基因突变外,该病例还发现房室间隔缺损(AVSD)、主动脉过长和左心发育不良(HLH)。这项研究显示,患者的体格和临床表现与 CdLS 诊断一致。此外还强调了 HLH。在对 CdLS 患者的先天性心脏病进行评估后,立即进行矫正手术的重要性不言而喻。
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引用次数: 0
Forensic Emergencies In The Context Of Genital Injuries: A Case Report 生殖器损伤的法医急诊:病例报告
IF 0.1 Pub Date : 2024-02-15 DOI: 10.33706/jemcr.1392555
Zafer Li̇man, Uğur Kayhan
Introduction A review of gynecological emergency cases shows that traumatic injuries observed in consensual sexual relations, sexual abuse victims or following an abortion, secondary infections, internal organ injuries, and massive bleeding are gynecological forensic cases that may require an emergency approach. In this case; it is aimed to discuss the case of a child who was diagnosed as sexual abuse and reported as a forensic case. Case report In the evaluation of the case of a 15-year-old girl who applied to the emergency service with a history of the foot of a stool entering her vaginal area, it was seen that she had a complaint of active vaginal bleeding but was referred to Child Monitoring Center(ÇİM) without taking a detailed anamnesis or performing any tests. During the forensic interviews at ÇİM, on account of the fact that the patient complained of dizziness, an emergency forensic vaginal examination and operation was performed. Active vaginal bleeding, 3 cm transverse laceration, and uterine artery injury were found in the area between the upper cervix and lower uterine segment. Conclusion Our study aims to contribute to raising awareness about the importance of medical evaluation and healthy anamnesis in the emergency department regarding these issues.
导言 对妇科急诊病例的回顾表明,在双方同意的性关系、性虐待受害者或人工流产后观察到的创伤、继发性感染、内脏器官损伤和大量出血等妇科法医病例可能需要采取紧急措施。本病例旨在讨论一个被诊断为性虐待并作为法医病例报告的儿童病例。病例报告 在对一名 15 岁女孩的病例进行评估时发现,她有阴道出血的主诉,但被转到儿童监测中心(ÇİM)时没有进行详细的病史询问或任何检查。在 ÇİM 进行法医询问期间,由于患者抱怨头晕,因此进行了紧急法医阴道检查和手术。在宫颈上段和子宫下段之间的区域发现了活动性阴道出血、3 厘米横向裂伤和子宫动脉损伤。结论 我们的研究旨在提高人们对在急诊科就这些问题进行医学评估和健康病史的重要性的认识。
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引用次数: 0
AN UNCOMMON PRESENTATION OF SEPTUM PELLUCIDUM ANATOMICAL VARIATIONS: A CASE REPORT OF GENERALIZED TONIC-CLONIC SEIZURE IN A HEALTHY ADULT 一种不常见的透明隔解剖变异:健康成年人全身强直-阵挛发作病例报告
IF 0.1 Pub Date : 2024-02-11 DOI: 10.33706/jemcr.1421495
Nurullah Parça, I. Atas, Ali Çeli̇k, Özlem Bi̇li̇r
ABSTRACT: Introduction: The septum pellucidum (SP) is a thin, transparent, dual-membrane structure located between the lateral ventricles of the brain. Incidentally identified through imaging modalities, this variation, while rare, may manifest with symptoms such as neuropsychiatric disorders, headache, dizziness, seizures, nausea, and vomiting. In this report, we present the case of a healthy middle-aged man with CV and CSP, who sought medical attention in the emergency department (ED) due to a generalized tonic-clonic seizure (GTCS). Case Report: A 40-year-old male without any known medical history presented to our emergency department with a GTCS. Considering this as the first seizure, blood and imaging tests were conducted, all of which showed no abnormalities. Non-contrast computed tomography revealed sequel cystic encephalomalacic areas in the left occipital and right frontal cerebral hemispheres, consistent with a parapharyngeal epidermoid cyst, and the presence of cavum septum pellucidum et vergae. Emergency consultation from the neurological clinic was sought, and an electroencephalogram showed no seizure activity. He was subsequently discharged with a recommendation for follow-up at the neurology outpatient clinic. Conclusion: This case prompts critical considerations in the emergency medicine realm regarding the potential relationship between anatomical variations in the septum pellucidum and emergent seizure activity. Keywords: Septum pellucidum, seizure, cavum vargae, emergency
摘要:导言:透明隔(SP)是位于大脑侧脑室之间的薄而透明的双膜结构。这种变异是通过影像学方式偶然发现的,虽然罕见,但可能表现出神经精神障碍、头痛、头晕、癫痫发作、恶心和呕吐等症状。在本报告中,我们介绍了一名患有 CV 和 CSP 的健康中年男子的病例,他因全身强直阵挛发作(GTCS)而到急诊科(ED)就医。病例报告:一名无任何病史的 40 岁男性因全身强直-阵挛发作到我院急诊科就诊。考虑到这是首次癫痫发作,患者接受了血液和影像学检查,所有检查均未发现异常。非对比计算机断层扫描显示,左侧枕叶和右侧额叶大脑半球出现续发性囊性脑畸形区,与咽旁表皮样囊肿一致,且存在透明隔膜和蚓部腔。他向神经科诊所寻求紧急会诊,脑电图显示没有癫痫发作活动。他随后出院,建议到神经科门诊进行复诊。结论:本病例提示急诊医学界对透明隔的解剖变异与紧急癫痫发作活动之间的潜在关系进行审慎考虑。关键词透明隔、癫痫发作、变异腔、急诊
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引用次数: 0
AN UNCOMMON PRESENTATION OF SEPTUM PELLUCIDUM ANATOMICAL VARIATIONS: A CASE REPORT OF GENERALIZED TONIC-CLONIC SEIZURE IN A HEALTHY ADULT 一种不常见的透明隔解剖变异:健康成年人全身强直-阵挛发作病例报告
IF 0.1 Pub Date : 2024-02-11 DOI: 10.33706/jemcr.1421495
Nurullah Parça, I. Atas, Ali Çeli̇k, Özlem Bi̇li̇r
ABSTRACT: Introduction: The septum pellucidum (SP) is a thin, transparent, dual-membrane structure located between the lateral ventricles of the brain. Incidentally identified through imaging modalities, this variation, while rare, may manifest with symptoms such as neuropsychiatric disorders, headache, dizziness, seizures, nausea, and vomiting. In this report, we present the case of a healthy middle-aged man with CV and CSP, who sought medical attention in the emergency department (ED) due to a generalized tonic-clonic seizure (GTCS). Case Report: A 40-year-old male without any known medical history presented to our emergency department with a GTCS. Considering this as the first seizure, blood and imaging tests were conducted, all of which showed no abnormalities. Non-contrast computed tomography revealed sequel cystic encephalomalacic areas in the left occipital and right frontal cerebral hemispheres, consistent with a parapharyngeal epidermoid cyst, and the presence of cavum septum pellucidum et vergae. Emergency consultation from the neurological clinic was sought, and an electroencephalogram showed no seizure activity. He was subsequently discharged with a recommendation for follow-up at the neurology outpatient clinic. Conclusion: This case prompts critical considerations in the emergency medicine realm regarding the potential relationship between anatomical variations in the septum pellucidum and emergent seizure activity. Keywords: Septum pellucidum, seizure, cavum vargae, emergency
摘要:导言:透明隔(SP)是位于大脑侧脑室之间的薄而透明的双膜结构。这种变异是通过影像学方式偶然发现的,虽然罕见,但可能表现出神经精神障碍、头痛、头晕、癫痫发作、恶心和呕吐等症状。在本报告中,我们介绍了一名患有 CV 和 CSP 的健康中年男子的病例,他因全身强直阵挛发作(GTCS)而到急诊科(ED)就医。病例报告:一名无任何病史的 40 岁男性因全身强直-阵挛发作到我院急诊科就诊。考虑到这是首次癫痫发作,患者接受了血液和影像学检查,所有检查均未发现异常。非对比计算机断层扫描显示,左侧枕叶和右侧额叶大脑半球出现续发性囊性脑畸形区,与咽旁表皮样囊肿一致,且存在透明隔膜和蚓部腔。他向神经科诊所寻求紧急会诊,脑电图显示没有癫痫发作活动。他随后出院,建议到神经科门诊进行复诊。结论:本病例提示急诊医学界对透明隔的解剖变异与紧急癫痫发作活动之间的潜在关系进行审慎考虑。关键词透明隔、癫痫发作、变异腔、急诊
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引用次数: 0
ISOLATED CRICOID CARTILAGE FRACTURE AFTER BLUNT THORACOCERVICAL TRAUMA: A CASE REPORT 胸颈椎钝挫伤后孤立性环状软骨骨折:病例报告
IF 0.1 Pub Date : 2024-01-30 DOI: 10.33706/jemcr.1316442
Ahmet Aksoy, Kürşat Güreşci̇
ABSTRACT İntroduction: Although cricoid cartilage fracture is rare because of the firm and stable structure of the cricoid cartilage, it can cause fatal complications. Prompt diagnosis and rapid airway safety are incredibly vital. Case Report: A 24-year-old male patient was admitted to the emergency department due to blunt trauma to the thoracocervical region. The computed tomography taken after the first interventions detected a displaced fracture of the cricoid cartilage. Conclusion: In light of the patient's clinical findings, the patient was treated conservatively and non-surgically with close follow-up of the airway safety. Keywords: Cricoid fracture, subcutaneous emphysema, larynx trauma, thoracocervical blunt trauma, conservative treatment
ABSTRACT İntroduction:尽管环状软骨骨折由于环状软骨结构坚固稳定而罕见,但它可能导致致命的并发症。及时诊断和快速保障气道安全至关重要。 病例报告:一名 24 岁的男性患者因胸颈部钝性外伤被送入急诊科。首次介入治疗后进行的计算机断层扫描检测到环状软骨移位性骨折。结论:根据患者的临床表现,对患者采取了保守治疗和非手术治疗,并密切关注气道安全。关键词:环状软骨骨折环状软骨骨折、皮下气肿、喉部创伤、胸颈部钝性创伤、保守治疗
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引用次数: 0
Two Cases of Digoxin Intoxication: Insights into ECG Findings and Visual Disturbances 两例地高辛中毒:洞察心电图结果和视觉障碍
IF 0.1 Pub Date : 2024-01-29 DOI: 10.33706/jemcr.1368189
Zülfi Engi̇ndeni̇z, Busra Nallar, Muhammed Dayi
Digoxin, a widely prescribed cardiac glycoside, is known for its therapeutic benefits in managing various cardiac conditions. However, its narrow therapeutic index poses a significant risk of toxicity. We present two cases of digoxin intoxication with pathognomic electrocardiographic (ECG) findings and visual disturbances. The detailed analysis of ECG abnormalities and visual disturbances associated with digoxin toxicity will aid in prompt diagnosis and appropriate management, ultimately improving patient outcomes
地高辛是一种广泛处方的强心苷类药物,在治疗各种心脏疾病方面具有显著疗效。然而,地高辛的治疗指数较窄,因此存在很大的中毒风险。我们介绍了两例地高辛中毒病例,这两例病例均伴有病理心电图(ECG)结果和视觉障碍。详细分析与地高辛中毒相关的心电图异常和视觉障碍将有助于及时诊断和适当处理,最终改善患者的预后。
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引用次数: 0
期刊
Journal of Emergency Medicine Case Reports
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