A. Boustany, Hadi Khaled Abou Zeid, Somtochukwu Onwuzo, A. Almomani, Imad Asaad
Background: Reported cases of Intraductal papillary mucinous neoplasm (IPMN) are becoming more and more frequent. The risk of hypercoagulability associated with IPMN is not clearly established in the literature as it was only reported in four cases. Therefore, we present a unique case of a patient with IPMN who subsequently developed acute pulmonary embolism (PE) and deep venous thrombosis (DVT). Case presentation: A 70-year-old healthy female patient complained of palpitation, chest pain, and dyspnea at rest. She had normal vital signs and findings on physical examination. Laboratory tests showed an increase in the D-Dimer level of 3,730 ng/mL fibrinogen equivalent unit (FEU). Bilateral DVT ultrasound (DVT-US) of the lower extremities was positive for acute calf DVT in the right lower extremity involving the soleal vein. CT-PE chest with IV contrast was remarkable for segmental and subsegmental pulmonary arteries thrombosis. She was started on a heparin drip and then transitioned to rivaroxaban for the treatment of PE and DVT. She was discharged in stable condition with outpatient follow-up. Conclusion: IPMN of the pancreas is an exocrine pancreatic neoplasm often detected on Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI). It is usually non-malignant but was found to be more prone to progress into cancer in contrast to the other types of pancreatic cysts. An increased risk of hypercoagulability with pre-malignant pancreatic lesions such as IPMN has not yet been well established. As far as we know, this case report is the first article presenting IPMN associated with both acute DVT and PE in a relatively healthy individual with no prior risk factor for hypercoagulability. Although there is scattered evidence suggesting an increased risk of thromboembolic events with IPMN, this unique case of DVT and PE associated with IPMN highlights the importance of close monitoring of these patients, especially those who have risk factors for thrombosis.
{"title":"The First Reported Case of Pulmonary Embolism and Deep Vein Thrombosis Associated with Intraductal Papillary Mucinous Neoplasm: A Case Report","authors":"A. Boustany, Hadi Khaled Abou Zeid, Somtochukwu Onwuzo, A. Almomani, Imad Asaad","doi":"10.38179/ijcr.v3i1.247","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.247","url":null,"abstract":"Background: Reported cases of Intraductal papillary mucinous neoplasm (IPMN) are becoming more and more frequent. The risk of hypercoagulability associated with IPMN is not clearly established in the literature as it was only reported in four cases. Therefore, we present a unique case of a patient with IPMN who subsequently developed acute pulmonary embolism (PE) and deep venous thrombosis (DVT).\u0000Case presentation: A 70-year-old healthy female patient complained of palpitation, chest pain, and dyspnea at rest. She had normal vital signs and findings on physical examination. Laboratory tests showed an increase in the D-Dimer level of 3,730 ng/mL fibrinogen equivalent unit (FEU). Bilateral DVT ultrasound (DVT-US) of the lower extremities was positive for acute calf DVT in the right lower extremity involving the soleal vein. CT-PE chest with IV contrast was remarkable for segmental and subsegmental pulmonary arteries thrombosis. She was started on a heparin drip and then transitioned to rivaroxaban for the treatment of PE and DVT. She was discharged in stable condition with outpatient follow-up.\u0000Conclusion: IPMN of the pancreas is an exocrine pancreatic neoplasm often detected on Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI). It is usually non-malignant but was found to be more prone to progress into cancer in contrast to the other types of pancreatic cysts. An increased risk of hypercoagulability with pre-malignant pancreatic lesions such as IPMN has not yet been well established. As far as we know, this case report is the first article presenting IPMN associated with both acute DVT and PE in a relatively healthy individual with no prior risk factor for hypercoagulability. Although there is scattered evidence suggesting an increased risk of thromboembolic events with IPMN, this unique case of DVT and PE associated with IPMN highlights the importance of close monitoring of these patients, especially those who have risk factors for thrombosis.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84870635","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}
M. Farhat, H. Abtar, Abbas Shibli, Zakaria Dika, Moustafa Diab, A. Taha, M. Hijazi, Z. Moussawi
Introduction: Colorectal cancer (CRC) is a rare entity in children and adolescents compared to adults. In the young, it is mostly detected in the right and transverse parts of the colon. Among the variants of CRC are the uncommon Signet Ring Cell Carcinoma (SRCC) which has a late presentation and pessimistic prognosis. Patients are asymptomatic for a long time and suddenly develop changes in bowel habits or obstruction. Case Report: A 15-year-old boy with no known health issues presented with recent rectorrhagia and weight loss. He was stable but pale with abdominal tenderness and no rectal mass on digital rectal examination (DRE). Colonoscopy unveiled a 13 centimeters segment of circumferential ulcerated blackish mucosa extending from the upper rectum to the rectosigmoid junction. Pathology studies revealed SRCC of the rectum and sigmoid. Metastatic workup showed rectosigmoid wall thickening and denoted the tumor a stage IV with ascites and intraperitoneal implants. Palliative treatment with chemotherapy was initiated, and a follow-up CT was done later to assess disease progression and response to treatment. The disease had worsened and the patient deteriorated. Conclusion: In children, colorectal SRCC is scarce and usually presents at a late stage due to the lack of characteristic symptoms and findings. It is then usually missed by physicians and not considered in the differential thus delaying the diagnosis and rendering the prognosis poorer. To improve the outcome, pediatricians ought to keep CRC in mind when facing obstructive symptoms or refractory abdominal pain.
{"title":"Diagnosis and Progression of Rectal Signet Ring Cell Carcinoma in a 15 Year Old Lebanese Boy: A Case Report","authors":"M. Farhat, H. Abtar, Abbas Shibli, Zakaria Dika, Moustafa Diab, A. Taha, M. Hijazi, Z. Moussawi","doi":"10.38179/ijcr.v3i1.162","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.162","url":null,"abstract":"Introduction: Colorectal cancer (CRC) is a rare entity in children and adolescents compared to adults. In the young, it is mostly detected in the right and transverse parts of the colon. Among the variants of CRC are the uncommon Signet Ring Cell Carcinoma (SRCC) which has a late presentation and pessimistic prognosis. Patients are asymptomatic for a long time and suddenly develop changes in bowel habits or obstruction.\u0000Case Report: A 15-year-old boy with no known health issues presented with recent rectorrhagia and weight loss. He was stable but pale with abdominal tenderness and no rectal mass on digital rectal examination (DRE). Colonoscopy unveiled a 13 centimeters segment of circumferential ulcerated blackish mucosa extending from the upper rectum to the rectosigmoid junction. Pathology studies revealed SRCC of the rectum and sigmoid. Metastatic workup showed rectosigmoid wall thickening and denoted the tumor a stage IV with ascites and intraperitoneal implants. Palliative treatment with chemotherapy was initiated, and a follow-up CT was done later to assess disease progression and response to treatment. The disease had worsened and the patient deteriorated.\u0000Conclusion: In children, colorectal SRCC is scarce and usually presents at a late stage due to the lack of characteristic symptoms and findings. It is then usually missed by physicians and not considered in the differential thus delaying the diagnosis and rendering the prognosis poorer. To improve the outcome, pediatricians ought to keep CRC in mind when facing obstructive symptoms or refractory abdominal pain.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90518854","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}
Dany k. Aouad, Nagham Azar, M. Daher, N. Dib, George S El Rassi
Background: Bisphosphonate therapy is used to manage osteoporosis and decrease the risk of vertebral and hip fractures. These drugs act by suppressing osteoclast activity by inducing the inhibition of bone resorption and increasing bone mineral density. It has been shown that long-term use of bisphosphonate is correlated to a higher incidence of atypical femoral fractures. Case report: This is a case report of an 81-year-old female, on bisphosphonate therapy for 12 years and with chronic left thigh pain for two and a half years who developed an incomplete atypical left femur fracture. What’s special about this case is that the fracture was ignored and then progressed after three months into a complete displaced spiral fracture that required surgical fixation. Conclusion: The benefits of bisphosphonate treatment in preventing osteoporotic fractures outweigh the risk of the occurrence of these atypical fractures. Orthopedic surgeons as well as primary care physicians must keep atypical fractures in their differential diagnosis in patients presenting with prodromal symptoms and who are on long-term bisphosphonate therapy
{"title":"Untreated Atypical Left Femoral Shaft Fracture: A Case Report of Its Complication","authors":"Dany k. Aouad, Nagham Azar, M. Daher, N. Dib, George S El Rassi","doi":"10.38179/ijcr.v3i1.159","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.159","url":null,"abstract":"Background: Bisphosphonate therapy is used to manage osteoporosis and decrease the risk of vertebral and hip fractures. These drugs act by suppressing osteoclast activity by inducing the inhibition of bone resorption and increasing bone mineral density. It has been shown that long-term use of bisphosphonate is correlated to a higher incidence of atypical femoral fractures.\u0000Case report: This is a case report of an 81-year-old female, on bisphosphonate therapy for 12 years and with chronic left thigh pain for two and a half years who developed an incomplete atypical left femur fracture. What’s special about this case is that the fracture was ignored and then progressed after three months into a complete displaced spiral fracture that required surgical fixation.\u0000Conclusion: The benefits of bisphosphonate treatment in preventing osteoporotic fractures outweigh the risk of the occurrence of these atypical fractures. Orthopedic surgeons as well as primary care physicians must keep atypical fractures in their differential diagnosis in patients presenting with prodromal symptoms and who are on long-term bisphosphonate therapy","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84722675","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}
{"title":"Therapeutic Approaches in Youth Psychiatry: The Art of Balancing Between ‘Do not Harm’ and ‘Best Possible Care’: An Editorial","authors":"Perla Ghalloub, Nancy Emmanuel","doi":"10.38179/ijcr.v3i1.252","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.252","url":null,"abstract":". \u0000 ","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86279992","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}
Maria Luiza Marinho Vidigal, Nathalia Godoi Ignáciz, Mahmoud Zafer Merhi, Pamela Carrijo Costa, Diego Barão da Silva, Matheus Bartolomei de Siqueira Corradi
Introduction: Skin cancer is among the most frequent neoplasms worldwide. It is divided into two major groups: non-melanoma skin cancer (NMSC) and melanoma skin cancer (MSC), with NMSC still classified into several subtypes, with the most prevalent being basal cell carcinoma subtype (BCC), followed by squamous cell carcinoma (SCC). Although NMSC does not present high mortality rates, it can involve high morbidity on the functional, aesthetic, and emotional levels. There is a divergence in the literature regarding decision-making in the cases of elderly (patients above 65 years of age) and super elderly patients (starting at 80 years of age). Objectives: This study aims to: 1. Identify the complications of surgical resection of the NMSC of the face and neck in the elderly population. 2. Demonstrate that surgical resection can be used as a therapeutic option in the elderly population without a significantly higher risk of morbidities. Method: This is a transversal, retrospective single-center study of quantitative nature. After the approval of the Research Ethics Committees, analysis was performed on the electronic records of 34 patients who underwent surgery at the Carapicuíba General Hospital between August 2017 and November 2019. The descriptive analysis of the results was performed employing absolute and relative frequency of the qualitative variables; mean and standard deviation were used for the quantitative variables. Analysis of group differences was done through the Fisher's Exact, Student's, or Mann-Whitney T-tests, to evaluate the factors associated with the complications of the procedure. Results: The results showed a mean age of 85.1 years; higher prevalence in females (61.8%); higher prevalence of BCC (76.5%); higher involvement in the nasal (23.5%), periauricular (23.5%), and malar regions (17.7%); hypertension (55.9%), and diabetes mellitus (35.3%) as the main comorbidities; 8 (23.5%) patients had post-surgical complications, and 0 patients had intraoperative complications. Conclusion: It was concluded that surgical resection was a good therapeutic method for the patients approached in the study. It is suggested that the therapeutic choice should be individualized, with the evaluation of the patient as a whole and taking into account aspects other than age group and comorbidities. Moreover, it is necessary to develop new studies and clinical trials with a more significant sample.
{"title":"Analysis of Surgical Resection of Non-Melanoma Skin Cancer in The Head and Neck of Elderly Population in a Public Hospital of São Paulo","authors":"Maria Luiza Marinho Vidigal, Nathalia Godoi Ignáciz, Mahmoud Zafer Merhi, Pamela Carrijo Costa, Diego Barão da Silva, Matheus Bartolomei de Siqueira Corradi","doi":"10.38179/ijcr.v3i1.188","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.188","url":null,"abstract":"Introduction: Skin cancer is among the most frequent neoplasms worldwide. It is divided into two major groups: non-melanoma skin cancer (NMSC) and melanoma skin cancer (MSC), with NMSC still classified into several subtypes, with the most prevalent being basal cell carcinoma subtype (BCC), followed by squamous cell carcinoma (SCC). Although NMSC does not present high mortality rates, it can involve high morbidity on the functional, aesthetic, and emotional levels. There is a divergence in the literature regarding decision-making in the cases of elderly (patients above 65 years of age) and super elderly patients (starting at 80 years of age).\u0000Objectives: This study aims to:\u00001. Identify the complications of surgical resection of the NMSC of the face and neck in the elderly population.\u00002. Demonstrate that surgical resection can be used as a therapeutic option in the elderly population without a significantly higher risk of morbidities.\u0000Method: This is a transversal, retrospective single-center study of quantitative nature. After the approval of the Research Ethics Committees, analysis was performed on the electronic records of 34 patients who underwent surgery at the Carapicuíba General Hospital between August 2017 and November 2019. The descriptive analysis of the results was performed employing absolute and relative frequency of the qualitative variables; mean and standard deviation were used for the quantitative variables. Analysis of group differences was done through the Fisher's Exact, Student's, or Mann-Whitney T-tests, to evaluate the factors associated with the complications of the procedure.\u0000Results: The results showed a mean age of 85.1 years; higher prevalence in females (61.8%); higher prevalence of BCC (76.5%); higher involvement in the nasal (23.5%), periauricular (23.5%), and malar regions (17.7%); hypertension (55.9%), and diabetes mellitus (35.3%) as the main comorbidities; 8 (23.5%) patients had post-surgical complications, and 0 patients had intraoperative complications.\u0000Conclusion: It was concluded that surgical resection was a good therapeutic method for the patients approached in the study. It is suggested that the therapeutic choice should be individualized, with the evaluation of the patient as a whole and taking into account aspects other than age group and comorbidities. Moreover, it is necessary to develop new studies and clinical trials with a more significant sample.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86758929","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}
Pamela Carrijo Costa, Mahmoud Zafer Merhi, Bruno Amantini Messias, Diego Barão da Silva
Background: Non-melanoma skin cancer is the most frequent tumor in Brazil and the world. One of its forms, squamous cell carcinoma (SCC) predominantly affects the old white population in areas of high exposure to the sun. Most SCCs are indolent, evolving with a cure rate higher than 90% within five years. Rarely, metastasis occurs mainly in regional lymph nodes, but it can also happen in the lungs, liver, brain, skin, and bones. There are currently many treatment options; based on the stratification of the neoplasm as high or low risk, an appropriate approach is defined. Case presentation: This report presents the case of a patient with high-risk squamous cell carcinoma affecting an area not exposed to solar radiation and without any other previous triggering factor, which is quite uncommon for this type of tumor. The rarity of the case stems from the lack of scientific reports on the occurrence of SCC in the axillary region, without a history of local chronic inflammatory lesions. The Portuguese, English, and Spanish languages were used to search the database of the main scientific platforms Pubmed, Cochrane Library, Scielo, and Lilacs, with no results similar to the case reported. Conclusion: Despite the fact that the axillary area is not sun-exposed, squamous cell skin cancer manifested as an extensive lesion that required a complex surgical resection with flap repair. Such findings highlight the importance of a thorough physical exam and work-up to diagnose lesions in their early forms which require simple resection procedures and avoid late diagnoses resulting in complex procedures. Such an approach reduces the risk of various complications like wound infection or dehiscence, flap ischemia, or necrosis, among others.
{"title":"A Rare Axillary Cutaneous Squamous Cell Carcinoma: A Case Report and Literature Review","authors":"Pamela Carrijo Costa, Mahmoud Zafer Merhi, Bruno Amantini Messias, Diego Barão da Silva","doi":"10.38179/ijcr.v2i1.187","DOIUrl":"https://doi.org/10.38179/ijcr.v2i1.187","url":null,"abstract":"Background: Non-melanoma skin cancer is the most frequent tumor in Brazil and the world. One of its forms, squamous cell carcinoma (SCC) predominantly affects the old white population in areas of high exposure to the sun. Most SCCs are indolent, evolving with a cure rate higher than 90% within five years. Rarely, metastasis occurs mainly in regional lymph nodes, but it can also happen in the lungs, liver, brain, skin, and bones.\u0000There are currently many treatment options; based on the stratification of the neoplasm as high or low risk, an appropriate approach is defined.\u0000Case presentation: This report presents the case of a patient with high-risk squamous cell carcinoma affecting an area not exposed to solar radiation and without any other previous triggering factor, which is quite uncommon for this type of tumor. The rarity of the case stems from the lack of scientific reports on the occurrence of SCC in the axillary region, without a history of local chronic inflammatory lesions. The Portuguese, English, and Spanish languages were used to search the database of the main scientific platforms Pubmed, Cochrane Library, Scielo, and Lilacs, with no results similar to the case reported.\u0000Conclusion: Despite the fact that the axillary area is not sun-exposed, squamous cell skin cancer manifested as an extensive lesion that required a complex surgical resection with flap repair. Such findings highlight the importance of a thorough physical exam and work-up to diagnose lesions in their early forms which require simple resection procedures and avoid late diagnoses resulting in complex procedures. Such an approach reduces the risk of various complications like wound infection or dehiscence, flap ischemia, or necrosis, among others.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81660086","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: Knowledge, clinical guidelines, and medicolegal frameworks regarding intersex individuals are inexistent in the Arab world. Some medical professionals view intersexuality as a disorder of sexual development that often needs sex-reassignment surgery to correct while others view intersexuality as a natural variation along the sex spectrum. No study to date addresses the vast gap in the literature. Methods: We contacted eleven non-governmental and civil society organizations involved in matters of sexuality and gender in the Arab world through email. Eight organizations answered but only one, Helem, had been directly involved in supporting intersex individuals and agreed to an interview. We conducted a semi-structured interview with Helem after consent was taken from intersex individuals or their legal guardians to share their experiences. Results: We studied three cases of intersex individuals, of which two underwent sex-reassignment surgery at a young age. The surgeries were experimental in nature and had negative health consequences. Decision-making is influenced by physician factors, notably lack of knowledge, and parental factors, like stigma. Sociocultural reasons factor in the decision more than scientific evidence. Physicians, in the cases presented, dealt with intersexuality as a rare pathology requiring urgent surgical intervention. Parents of intersex individuals suffer significant psychosocial stressors. Conclusion: Medical professionals are ill-equipped to deal with intersex individuals in the Arab world, often performing unethical and abusive practices for which they are not held accountable. Parent education and referral to intersex-knowledgeable physicians seem to deter parents from opting for SRS. Intersexuality is severely understudied and ignored in the medical field. Guidelines and medicolegal frameworks are required to address this issue.
{"title":"Decision-Making and Implications of Sex-Reassignment Surgery in Intersex Individuals in the Arab World: A Case Series","authors":"Alfred Chabbouh, Rim Chehab, Elie Charro","doi":"10.38179/ijcr.v3i1.207","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.207","url":null,"abstract":"Background: Knowledge, clinical guidelines, and medicolegal frameworks regarding intersex individuals are inexistent in the Arab world. Some medical professionals view intersexuality as a disorder of sexual development that often needs sex-reassignment surgery to correct while others view intersexuality as a natural variation along the sex spectrum. No study to date addresses the vast gap in the literature. \u0000Methods: We contacted eleven non-governmental and civil society organizations involved in matters of sexuality and gender in the Arab world through email. Eight organizations answered but only one, Helem, had been directly involved in supporting intersex individuals and agreed to an interview. We conducted a semi-structured interview with Helem after consent was taken from intersex individuals or their legal guardians to share their experiences.\u0000Results: We studied three cases of intersex individuals, of which two underwent sex-reassignment surgery at a young age. The surgeries were experimental in nature and had negative health consequences. Decision-making is influenced by physician factors, notably lack of knowledge, and parental factors, like stigma. Sociocultural reasons factor in the decision more than scientific evidence. Physicians, in the cases presented, dealt with intersexuality as a rare pathology requiring urgent surgical intervention. Parents of intersex individuals suffer significant psychosocial stressors.\u0000Conclusion: Medical professionals are ill-equipped to deal with intersex individuals in the Arab world, often performing unethical and abusive practices for which they are not held accountable. Parent education and referral to intersex-knowledgeable physicians seem to deter parents from opting for SRS. Intersexuality is severely understudied and ignored in the medical field. Guidelines and medicolegal frameworks are required to address this issue.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79830224","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}
Introduction: Ectopic or extrauterine pregnancy is a life-threatening medical condition in which a fertilized egg is implanted elsewhere than in the uterine cavity, commonly in the fallopian tubes. However, it can also occur in the peritoneal cavity, ovaries, and cervix. There are several etiological factors contributing to ectopic pregnancies, such as a history of pelvic inflammatory diseases, habitual abortions, and miscarriages, previous ectopic pregnancies, fertility procedures, as well as increased maternal age that has been correlated with a higher risk of carrying an ectopic pregnancy. Often, the first alerting sign in any ectopic pregnancy is a pain in the pelvic region, along with vaginal bleeding usually spotted between the 6th and 11th gestational week. Other symptoms include vomiting, nausea, tachycardia, and in severe cases hypovolemic shock due to internal bleeding induced by the rupture of the tubes. The key to diagnosing an ectopic pregnancy is transvaginal ultrasound, alongside the measurement of beta human chorionic gonadotropin hormone (beta-hCG) concentrations, which are usually found to be low in such cases. The management of ectopic pregnancy is either medical or surgical. Case report: We are reporting the case of a 32-year-old pregnant woman, who presented to the emergency department for diffuse abdominal pain and recurrent episodes of vomiting and diarrhea of one-week duration. The patient was stable on admission, but later on, she showed a rapid shift in her vital signs. Blood tests were obtained, and pelvic ultrasound was done, followed by a Computed Tomography (CT) scan that revealed the presence of a right cornual ectopic pregnancy. A rapid surgical intervention was carried out to save the patient’s life and alleviate the pain. Conclusion: Ectopic pregnancy is an urgent condition that needs to be treated immediately to avoid its fatal consequences. Several risk factors stand behind it, and a usual history and physical gynecological examinations are insufficient to detect it, hormone screening tests additionally to ultrasounds are highly recommended to decrease the incidence of mortality. A proper follow-up with a specialist could avoid the risk of an ectopic pregnancy as well as its undesirable outcomes.
{"title":"Diagnosis of Cornual Pregnancy in the Emergency Room: a Rare Case Report","authors":"Lili-Ji Helou, Hiba Hamdar, G. Raad","doi":"10.38179/ijcr.v3i1.201","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.201","url":null,"abstract":"Introduction: Ectopic or extrauterine pregnancy is a life-threatening medical condition in which a fertilized egg is implanted elsewhere than in the uterine cavity, commonly in the fallopian tubes. However, it can also occur in the peritoneal cavity, ovaries, and cervix. There are several etiological factors contributing to ectopic pregnancies, such as a history of pelvic inflammatory diseases, habitual abortions, and miscarriages, previous ectopic pregnancies, fertility procedures, as well as increased maternal age that has been correlated with a higher risk of carrying an ectopic pregnancy. Often, the first alerting sign in any ectopic pregnancy is a pain in the pelvic region, along with vaginal bleeding usually spotted between the 6th and 11th gestational week. Other symptoms include vomiting, nausea, tachycardia, and in severe cases hypovolemic shock due to internal bleeding induced by the rupture of the tubes. The key to diagnosing an ectopic pregnancy is transvaginal ultrasound, alongside the measurement of beta human chorionic gonadotropin hormone (beta-hCG) concentrations, which are usually found to be low in such cases. The management of ectopic pregnancy is either medical or surgical.\u0000Case report: We are reporting the case of a 32-year-old pregnant woman, who presented to the emergency department for diffuse abdominal pain and recurrent episodes of vomiting and diarrhea of one-week duration. The patient was stable on admission, but later on, she showed a rapid shift in her vital signs. Blood tests were obtained, and pelvic ultrasound was done, followed by a Computed Tomography (CT) scan that revealed the presence of a right cornual ectopic pregnancy. A rapid surgical intervention was carried out to save the patient’s life and alleviate the pain.\u0000Conclusion: Ectopic pregnancy is an urgent condition that needs to be treated immediately to avoid its fatal consequences. Several risk factors stand behind it, and a usual history and physical gynecological examinations are insufficient to detect it, hormone screening tests additionally to ultrasounds are highly recommended to decrease the incidence of mortality. A proper follow-up with a specialist could avoid the risk of an ectopic pregnancy as well as its undesirable outcomes.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89081151","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: Colon lipomas are rare benign lesions taking place mostly in the right colon with a female predomination. They are mainly submucosal and symptomatic when becoming > 2 cm in size. Case Report: This is the case of a 43 years old female patient presenting with bowel obstruction associated with colo-colic intussusception due to a giant colonic lipoma. A segmental partial colectomy has been performed followed by a favorable postoperative course. Conclusion: Giant colon lipomas presenting with intussusception is a rare finding. Surgery is the major treatment but, unfortunately, there is no clear consensus on the recommended procedure in the literature.
{"title":"Colo-colic Hepatic Angle Intussusception due to Ascending Colon Giant Lipoma: a Case Report and a Review of Literature","authors":"J. Terro, S. Zguem, E. El-helou, Thierry Asensio","doi":"10.38179/ijcr.v3i1.175","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.175","url":null,"abstract":"Background: Colon lipomas are rare benign lesions taking place mostly in the right colon with a female predomination. They are mainly submucosal and symptomatic when becoming > 2 cm in size.\u0000Case Report: This is the case of a 43 years old female patient presenting with bowel obstruction associated with colo-colic intussusception due to a giant colonic lipoma. A segmental partial colectomy has been performed followed by a favorable postoperative course.\u0000Conclusion: Giant colon lipomas presenting with intussusception is a rare finding. Surgery is the major treatment but, unfortunately, there is no clear consensus on the recommended procedure in the literature.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"447 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83061264","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: Invasive fungal infections are a major cause of death in pediatric oncology, especially among patients under chemotherapy. This study aims to identify risk factors for invasive fungal infections in pediatric oncology. Methods: We conducted a monocentric retrospective case-control multi-cohort study on a population of 30 patients with malignant hemopathies or solid cancers under chemotherapy, admitted in the Pediatric Oncology unit of Nafissa Hammoud Hospital in Algiers, amongst which 24 patients were controls, and 6 patients were cases. Results: In a total of 30 patients (53.3 % male), 13 patients developed a fever, from which 6 patients were identified as invasive fungal infection cases according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and Infectious Diseases Mycoses Study Group (EORTC/MSG) guidelines, with an incidence of 20 %. The mean age was 7.47 years old at the admission date. Four statistically significant risk factors were identified (p-value < 0.05, CI 95 %): mucositis with an odds ratio (OR) at 10 (1,34 – 74,51), the most aggressive chemotherapy protocol according to the ITR2 with an OR at 115 (6,10 – 2165,95), severe prolonged neutropenia with an OR at 7,6 (1,07 – 54,09) and severe prolonged lymphopenia with an OR at 25 (2,27 – 275,71). Conclusion: Many conditions were identified as risk factors for invasive fungal infections in pediatric oncology, especially severe lymphopenia and aggressive chemotherapy. These patients may have to receive close monitoring or even antifungal prophylaxis.
{"title":"Risk Factors for Invasive Fungal Disease in Pediatric Oncology","authors":"Adam Maamar Roumani, N. Benmouffok","doi":"10.38179/ijcr.v3i1.202","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.202","url":null,"abstract":"Background: Invasive fungal infections are a major cause of death in pediatric oncology, especially among patients under chemotherapy. This study aims to identify risk factors for invasive fungal infections in pediatric oncology.\u0000Methods: We conducted a monocentric retrospective case-control multi-cohort study on a population of 30 patients with malignant hemopathies or solid cancers under chemotherapy, admitted in the Pediatric Oncology unit of Nafissa Hammoud Hospital in Algiers, amongst which 24 patients were controls, and 6 patients were cases.\u0000Results: In a total of 30 patients (53.3 % male), 13 patients developed a fever, from which 6 patients were identified as invasive fungal infection cases according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and Infectious Diseases Mycoses Study Group (EORTC/MSG) guidelines, with an incidence of 20 %. The mean age was 7.47 years old at the admission date. Four statistically significant risk factors were identified (p-value < 0.05, CI 95 %): mucositis with an odds ratio (OR) at 10 (1,34 – 74,51), the most aggressive chemotherapy protocol according to the ITR2 with an OR at 115 (6,10 – 2165,95), severe prolonged neutropenia with an OR at 7,6 (1,07 – 54,09) and severe prolonged lymphopenia with an OR at 25 (2,27 – 275,71).\u0000Conclusion: Many conditions were identified as risk factors for invasive fungal infections in pediatric oncology, especially severe lymphopenia and aggressive chemotherapy. These patients may have to receive close monitoring or even antifungal prophylaxis.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":"11 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76266819","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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