A. Berjawi, H. Tamim, Mohamed Fouad Mohamed Fouad, N. Kanj
Background: Electronic cigarettes (E-cigarettes) are gaining momentum worldwide. They are looked at as an effective way to cease smoking with reduced harm. Since Lebanon is a country with a high smoking prevalence, it is of interest then to analyze the current and expanding role of E-cigarettes among the Lebanese population. Aim: The objective of our study was to evaluate the awareness, perception, and behaviors related to E-cigarettes in Lebanon. Methods: A cross-sectional survey of Lebanese pedestrians chosen from random sectors of Beirut was recruited in our sample study. A self-administered questionnaire was distributed to examine their awareness, perception, and behaviors related to E-cigarettes. SPSS was used for analysis. The main outcome was to assess the awareness of E-cigarettes in the Lebanese population and evaluate their perception as an effective smoking cessation tool. Results: Of the 364 respondents, 53% were males, 84% were aware of E-cigarettes, and 16% never-tried them. E-cigarettes helped 56% of users to cut down on tobacco smoking, and among all respondents, 60% believed that it is less harmful than tobacco cigarettes. Moreover, 30% perceived it as an effective way to quit smoking. The majority of participants (61%) who tried it were between 18 and 25 years of age, and 36% of them were nonsmokers. Conclusion: Our study is the first in Lebanon to assess the awareness, perception, and behaviors related to E-cigarettes. The majority of our population was aware of E-cigarettes, and some perceived them as a less harmful replacement compared to tobacco smoking. Additionally, non-smokers may be attracted to E-cigarette smoking which may lead to developing a new attraction and gateway for smoking. Therefore, awareness about E-cigarette's correct use, benefits, and harms need to be highlighted among the public, particularly the young generation in Lebanon.
{"title":"Awareness, Perception and Behaviors Related to Electronic Cigarettes in Lebanon: A Survey Study","authors":"A. Berjawi, H. Tamim, Mohamed Fouad Mohamed Fouad, N. Kanj","doi":"10.38179/ijcr.v3i1.93","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.93","url":null,"abstract":"Background: Electronic cigarettes (E-cigarettes) are gaining momentum worldwide. They are looked at as an effective way to cease smoking with reduced harm. Since Lebanon is a country with a high smoking prevalence, it is of interest then to analyze the current and expanding role of E-cigarettes among the Lebanese population.\u0000Aim: The objective of our study was to evaluate the awareness, perception, and behaviors related to E-cigarettes in Lebanon.\u0000Methods: A cross-sectional survey of Lebanese pedestrians chosen from random sectors of Beirut was recruited in our sample study. A self-administered questionnaire was distributed to examine their awareness, perception, and behaviors related to E-cigarettes. SPSS was used for analysis. The main outcome was to assess the awareness of E-cigarettes in the Lebanese population and evaluate their perception as an effective smoking cessation tool.\u0000Results: Of the 364 respondents, 53% were males, 84% were aware of E-cigarettes, and 16% never-tried them. E-cigarettes helped 56% of users to cut down on tobacco smoking, and among all respondents, 60% believed that it is less harmful than tobacco cigarettes. Moreover, 30% perceived it as an effective way to quit smoking. The majority of participants (61%) who tried it were between 18 and 25 years of age, and 36% of them were nonsmokers.\u0000Conclusion: Our study is the first in Lebanon to assess the awareness, perception, and behaviors related to E-cigarettes. The majority of our population was aware of E-cigarettes, and some perceived them as a less harmful replacement compared to tobacco smoking. Additionally, non-smokers may be attracted to E-cigarette smoking which may lead to developing a new attraction and gateway for smoking. Therefore, awareness about E-cigarette's correct use, benefits, and harms need to be highlighted among the public, particularly the young generation in Lebanon.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87548251","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}
R. Massaad, Said El Orra, Dounia Massaad, Monah Orra
Background: Traumatic hip dislocation (THD) is a rare pathology in the pediatric population. The severity of the trauma, mismanagement, or late treatment of such pathology can lead to complications, including avascular necrosis (AVN) of the femoral head. We hereby report a case of recurrent traumatic posterior hip dislocation that eventually lead to AVN of the femoral head in a 10-year-old girl. Case presentation: A 10-year-old girl presented to the Emergency Department complaining of left hip pain one day following a fall from a standing position. On physical examination, the left hip was held in the position of flexion, adduction, and internal rotation, with complete loss of range of motion of the left hip joint. Radiographic imaging was done and showed: a posterior dislocation of the left hip, enlargement of the growth cartilage of the left femoral epiphysis, and hypertransparency of the anterosuperior corner of the left femoral neck, and increased bone density of the upper left femoral epiphysis, suggesting previous hip dislocations. Open reduction with arthrotomy and posterior capsulorrhaphy was performed 36 hours post-injury, followed by hip immobilization by a spica cast. Two months after surgery, the cast was removed. On examination, the left hip was stable with good mobility, and weight-bearing was authorized. Follow-up was done three months post-injury. The patient had no complaints, but radiographic images showed signs of avascular necrosis (AVN) on the left femoral head. Conclusion: Our case emphasizes the importance of early diagnosis and management of a THD in pediatrics, to prevent serious complications such as AVN.
{"title":"Avascular Necrosis of the Femoral Head After Recurrent Traumatic Posterior Hip Dislocation in a 10-Year-Old Girl: A Case Report","authors":"R. Massaad, Said El Orra, Dounia Massaad, Monah Orra","doi":"10.38179/ijcr.v3i1.48","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.48","url":null,"abstract":"Background: Traumatic hip dislocation (THD) is a rare pathology in the pediatric population. The severity of the trauma, mismanagement, or late treatment of such pathology can lead to complications, including avascular necrosis (AVN) of the femoral head. We hereby report a case of recurrent traumatic posterior hip dislocation that eventually lead to AVN of the femoral head in a 10-year-old girl.\u0000Case presentation: A 10-year-old girl presented to the Emergency Department complaining of left hip pain one day following a fall from a standing position. On physical examination, the left hip was held in the position of flexion, adduction, and internal rotation, with complete loss of range of motion of the left hip joint. Radiographic imaging was done and showed: a posterior dislocation of the left hip, enlargement of the growth cartilage of the left femoral epiphysis, and hypertransparency of the anterosuperior corner of the left femoral neck, and increased bone density of the upper left femoral epiphysis, suggesting previous hip dislocations. Open reduction with arthrotomy and posterior capsulorrhaphy was performed 36 hours post-injury, followed by hip immobilization by a spica cast. Two months after surgery, the cast was removed. On examination, the left hip was stable with good mobility, and weight-bearing was authorized. Follow-up was done three months post-injury. The patient had no complaints, but radiographic images showed signs of avascular necrosis (AVN) on the left femoral head.\u0000 Conclusion: Our case emphasizes the importance of early diagnosis and management of a THD in pediatrics, to prevent serious complications such as AVN.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79275669","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: Vitamin D deficiency in children is common and usually characterized by hypocalcemia, hypophosphatemia, and elevated serum parathyroid hormone level. However, vitamin D deficiency can be associated with parathyroid hormone resistance in the kidneys which may cause hyperphosphatemia instead, mimicking thus pseudohypoparathyroidism type II. The exact pathogenesis for parathyroid hormone resistance remains unclear, and the distinction between the two conditions remains difficult. We describe the case of an adolescent who presented with seizures and was found to have biochemical features consistent with pseudohypoparathyroidism, likely related to vitamin D deficiency. Case Report: A 13-year-old previously healthy adolescent presented with seizures. He experienced back pain during the previous month prior to the presentation. He did not have features of Albright hereditary osteodystrophy. His laboratory studies were significant for hypocalcemia, hyperphosphatemia, elevated serum alkaline phosphatase level, elevated parathyroid hormone level, and a deficient vitamin D level. Magnetic resonance imaging of the spine revealed multiple compression fractures. The child was treated with intravenous calcium and vitamin D administration with rapid improvement and his seizures resolved. Conclusion: Hypocalcemia from vitamin D deficiency can mimic pseudohypoparathyroidism type II. The principles of treatment for hypocalcemia in both conditions are similar and patients require timely intervention with close follow-up to ensure the resolution of symptoms. Patients with resolution of symptoms after adequate treatment may not require further evaluation for other types of pseudohypoparathyroidism.
{"title":"Vitamin D Deficiency Mimicking Pseudohypoparathyroidism Type II in an Adolescent Boy: A Case Report","authors":"A. Shieh, Griselda Alvarez","doi":"10.38179/ijcr.v3i1.126","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.126","url":null,"abstract":"Background: Vitamin D deficiency in children is common and usually characterized by hypocalcemia, hypophosphatemia, and elevated serum parathyroid hormone level. However, vitamin D deficiency can be associated with parathyroid hormone resistance in the kidneys which may cause hyperphosphatemia instead, mimicking thus pseudohypoparathyroidism type II. The exact pathogenesis for parathyroid hormone resistance remains unclear, and the distinction between the two conditions remains difficult. We describe the case of an adolescent who presented with seizures and was found to have biochemical features consistent with pseudohypoparathyroidism, likely related to vitamin D deficiency. \u0000Case Report: A 13-year-old previously healthy adolescent presented with seizures. He experienced back pain during the previous month prior to the presentation. He did not have features of Albright hereditary osteodystrophy. His laboratory studies were significant for hypocalcemia, hyperphosphatemia, elevated serum alkaline phosphatase level, elevated parathyroid hormone level, and a deficient vitamin D level. Magnetic resonance imaging of the spine revealed multiple compression fractures. The child was treated with intravenous calcium and vitamin D administration with rapid improvement and his seizures resolved.\u0000Conclusion: Hypocalcemia from vitamin D deficiency can mimic pseudohypoparathyroidism type II. The principles of treatment for hypocalcemia in both conditions are similar and patients require timely intervention with close follow-up to ensure the resolution of symptoms. Patients with resolution of symptoms after adequate treatment may not require further evaluation for other types of pseudohypoparathyroidism.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78668776","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}
Lina Hammoud, Yara R. Neaimeh, Katia K. El Taoum, Ramia Zakhour
Background: We present a case of progressive back pain associated with weight loss and low-grade fever in a 17-year-old patient previously diagnosed with spinal tuberculosis (TB) also known as tuberculous spondylitis or Pott’s disease. Case presentation: Upon the patient's presentation to the clinic, a differential diagnosis including infectious and non-infectious causes such as extra-pulmonary tuberculosis, septic arthritis, malignancy, rheumatologic diseases, and physical abuse was made. Her preliminary workup was suggestive of granulomatous disease. A positive tuberculin skin test (TST), and a polymerase chain reaction (PCR) test of the tissue with mycobacterium tuberculosis deoxyribonucleic acid (MTB DNA), confirmed the diagnosis of musculoskeletal TB. Conclusion: The patient was treated with anti-TB regimen and Pyridoxine to avoid peripheral neuropathy associated with isoniazid use. Her clinical follow-up showed improvement with a proper response to treatment and no sequelae.
{"title":"Musculoskeletal Tuberculosis Involving Ribs, Spine, and Pelvis in a 17 year old Girl: A Case Report","authors":"Lina Hammoud, Yara R. Neaimeh, Katia K. El Taoum, Ramia Zakhour","doi":"10.38179/ijcr.v3i1.167","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.167","url":null,"abstract":"Background: We present a case of progressive back pain associated with weight loss and low-grade fever in a 17-year-old patient previously diagnosed with spinal tuberculosis (TB) also known as tuberculous spondylitis or Pott’s disease.\u0000Case presentation: Upon the patient's presentation to the clinic, a differential diagnosis including infectious and non-infectious causes such as extra-pulmonary tuberculosis, septic arthritis, malignancy, rheumatologic diseases, and physical abuse was made. Her preliminary workup was suggestive of granulomatous disease. A positive tuberculin skin test (TST), and a polymerase chain reaction (PCR) test of the tissue with mycobacterium tuberculosis deoxyribonucleic acid (MTB DNA), confirmed the diagnosis of musculoskeletal TB.\u0000Conclusion: The patient was treated with anti-TB regimen and Pyridoxine to avoid peripheral neuropathy associated with isoniazid use. Her clinical follow-up showed improvement with a proper response to treatment and no sequelae.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78272446","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}
E. Feghali, A. Daccache, Edwin Feghali, Z. Sleiman
Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. The patient was discharged uneventfully the second day after the surgery, and the pathology result confirmed the presence of diffuse adenomyosis. Conclusion: Non-communicating rudimentary horn is a rare finding manifesting as different symptoms in young women. The enlargement of the horn can have obstructive consequences on an active endometrium, and this would lead to the formation of a hematometra and the distension of the cavity, and sometimes adenomyosis.
{"title":"Rudimentary Horn Adenomyosis in A 20-Year-Old Patient With Unicornuate Uterus: A Case Report","authors":"E. Feghali, A. Daccache, Edwin Feghali, Z. Sleiman","doi":"10.38179/ijcr.v3i1.87","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.87","url":null,"abstract":"Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce.\u0000Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. The patient was discharged uneventfully the second day after the surgery, and the pathology result confirmed the presence of diffuse adenomyosis.\u0000Conclusion: Non-communicating rudimentary horn is a rare finding manifesting as different symptoms in young women. The enlargement of the horn can have obstructive consequences on an active endometrium, and this would lead to the formation of a hematometra and the distension of the cavity, and sometimes adenomyosis.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87165235","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}
S. Khoury, Tony Bechara, M. Dabbous, Micheal Saba, Said El Orra
Background: Cardiac sarcoidosis (CS) is a rare pathology that affects the middle-aged population. Its diagnosis, as well as its treatment, can be quite challenging, especially dealing with device management. We hereby discuss a case of CS, managed by a biventricular pacemaker in a 43-year-old man. Case Report: A 43-year-old male presented to the emergency department with a 15-day history of chronic cough and worsening dyspnea. On examination, he was found to be bradycardic in the context of a third-degree heart block on ECG as well as bilateral hilar lymphadenopathy on chest radiography. Based on these findings, cardiac sarcoidosis was suspected. A temporary right internal jugular transvenous pacemaker was implanted in the right ventricle and empiric corticosteroid management was commenced. Lung tissue biopsies were obtained via bronchoscopy and were positive for granulomas consistent with a diagnosis of sarcoidosis. Even though the patient showed a partial positive response to corticosteroid treatment, he required a permanent pacemaker. A dual-chamber implantable cardioverter-defibrillator (ICD) was implanted and the patient was discharged on prednisone. His follow-up plan consisted of serial echocardiography and consideration of a new coronary sinus lead in the event of left ventricular dysfunction in the future. Conclusion: Cardiac rhythm management in the context of CS is often difficult, with decisions that need to be made between a pacemaker, a defibrillator, or a cardiac resynchronization device. The idea that biventricular pacing has a preventative role against heart failure in patients with normal left ventricular ejection fraction and CS deserves more attention and discussion.
{"title":"Cardiac Sarcoidosis Managed by Biventricular Pacing: A Case Report","authors":"S. Khoury, Tony Bechara, M. Dabbous, Micheal Saba, Said El Orra","doi":"10.38179/ijcr.v3i1.147","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.147","url":null,"abstract":"Background: Cardiac sarcoidosis (CS) is a rare pathology that affects the middle-aged population. Its diagnosis, as well as its treatment, can be quite challenging, especially dealing with device management. We hereby discuss a case of CS, managed by a biventricular pacemaker in a 43-year-old man.\u0000Case Report: A 43-year-old male presented to the emergency department with a 15-day history of chronic cough and worsening dyspnea. On examination, he was found to be bradycardic in the context of a third-degree heart block on ECG as well as bilateral hilar lymphadenopathy on chest radiography. Based on these findings, cardiac sarcoidosis was suspected. A temporary right internal jugular transvenous pacemaker was implanted in the right ventricle and empiric corticosteroid management was commenced. Lung tissue biopsies were obtained via bronchoscopy and were positive for granulomas consistent with a diagnosis of sarcoidosis. Even though the patient showed a partial positive response to corticosteroid treatment, he required a permanent pacemaker. A dual-chamber implantable cardioverter-defibrillator (ICD) was implanted and the patient was discharged on prednisone. His follow-up plan consisted of serial echocardiography and consideration of a new coronary sinus lead in the event of left ventricular dysfunction in the future.\u0000Conclusion: Cardiac rhythm management in the context of CS is often difficult, with decisions that need to be made between a pacemaker, a defibrillator, or a cardiac resynchronization device. The idea that biventricular pacing has a preventative role against heart failure in patients with normal left ventricular ejection fraction and CS deserves more attention and discussion.\u0000 \u0000 \u0000 ","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81982850","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}
Jony Dib, Rim Boutari, Boshra Yaacoub, Nayef Al Khalil, Mohamad Al Ayoubi, Othman Itani
Background: Central venous catheterizations are used frequently in critical care unit. The procedure is associated with various complications ranging from mechanical ones during insertion and the possibility of vessel laceration and dissection to infections, not to forget haemothorax and pneumothorax that may require chest tube insertion. However, some complications may also origin from its removal. Case Report: This is a case of a 72-year-old patient with multiple comorbidities admitted to the Intensive Care Unit (ICU) for respiratory distress. A central line was inserted because a peripheral line was hard to establish, and as a consequence of catheter removal, he had a massive right-sided hemothorax. Conclusion: Central venous line removal could cause fatal complications such as massive hemothorax that should be looked for. We emphasize monitoring of patients after catheter removal because the uncommon nature of this complication can lead to diagnosis delay and even misdiagnosis.
{"title":"Hemothorax Occurring After Central Venous Catheter Removal: A Case Report","authors":"Jony Dib, Rim Boutari, Boshra Yaacoub, Nayef Al Khalil, Mohamad Al Ayoubi, Othman Itani","doi":"10.38179/ijcr.v3i1.123","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.123","url":null,"abstract":"Background: Central venous catheterizations are used frequently in critical care unit. The procedure is associated with various complications ranging from mechanical ones during insertion and the possibility of vessel laceration and dissection to infections, not to forget haemothorax and pneumothorax that may require chest tube insertion. However, some complications may also origin from its removal.\u0000Case Report: This is a case of a 72-year-old patient with multiple comorbidities admitted to the Intensive Care Unit (ICU) for respiratory distress. A central line was inserted because a peripheral line was hard to establish, and as a consequence of catheter removal, he had a massive right-sided hemothorax.\u0000Conclusion: Central venous line removal could cause fatal complications such as massive hemothorax that should be looked for. We emphasize monitoring of patients after catheter removal because the uncommon nature of this complication can lead to diagnosis delay and even misdiagnosis.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73586165","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}
R. Massaad, Said El Orra, Dounia Massaad, Antonella Massaad, Abdallah El-Azanki
Background: The complexity of implant removal is a well-known problem in the field of orthopedics. It is encountered mainly during the removal of plates and screws and understood by the phenomenon of seizing or cold-welding, formerly known in mechanics. In this case study, we describe a complex experience during a gamma nail removal in a 21-year-old male patient, explained by the same phenomenon of seizing or cold-welding. The case is rather unusual and rare, with no similar reports in the literature, and required a special technique of extraction. Case Report: A 21-year-old male presented to our clinic with a 5-months history of right groin pain radiating to the anterior thigh. The patient was a victim of a car accident three years ago that resulted in right femoral neck and shaft fractures, which were managed by open reduction and internal fixation by a long gamma nail with distal locking. After proper examination, the team decided to remove the implant. There was difficulty loosening the cephalic screw as it was welded to the nail. For this reason, we opted for a technique that involved making a transverse slit at the level of the anterior part of the nail which is in contact with the cephalic screw. It was followed by a hammer blow at the level of the cephalic screw, allowing it to loosen and thus allowing the screws along the femoral nail to be removed successfully. Conclusion: Our report describes a rare case of a cephalic screw cold-welded/seized into the intramedullary nail, which can be an unexpected and serious complication during intramedullary nail removal. However, our technique described in this case can be an effective way to treat such a complication.
{"title":"A Special Technique to Remove a Jammed Cephalic Screw from an Intramedullary Nail: A Case Report","authors":"R. Massaad, Said El Orra, Dounia Massaad, Antonella Massaad, Abdallah El-Azanki","doi":"10.38179/ijcr.v3i1.37","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.37","url":null,"abstract":"Background: The complexity of implant removal is a well-known problem in the field of orthopedics. It is encountered mainly during the removal of plates and screws and understood by the phenomenon of seizing or cold-welding, formerly known in mechanics. In this case study, we describe a complex experience during a gamma nail removal in a 21-year-old male patient, explained by the same phenomenon of seizing or cold-welding. The case is rather unusual and rare, with no similar reports in the literature, and required a special technique of extraction.\u0000Case Report: A 21-year-old male presented to our clinic with a 5-months history of right groin pain radiating to the anterior thigh. The patient was a victim of a car accident three years ago that resulted in right femoral neck and shaft fractures, which were managed by open reduction and internal fixation by a long gamma nail with distal locking. After proper examination, the team decided to remove the implant. There was difficulty loosening the cephalic screw as it was welded to the nail. For this reason, we opted for a technique that involved making a transverse slit at the level of the anterior part of the nail which is in contact with the cephalic screw. It was followed by a hammer blow at the level of the cephalic screw, allowing it to loosen and thus allowing the screws along the femoral nail to be removed successfully.\u0000Conclusion: Our report describes a rare case of a cephalic screw cold-welded/seized into the intramedullary nail, which can be an unexpected and serious complication during intramedullary nail removal. However, our technique described in this case can be an effective way to treat such a complication.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77543264","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}
Very few fields have evolved as Cardiology has. The last four centuries have brought extraordinary discoveries, achievements, inventions, and innovations, and we are now on the verge of witnessing the beginning of a new chapter of Cardiology that will unlock diagnostic and therapeutic interventions that are today considered impossible. Why? Artificial Intelligence (AI).
{"title":"Artificial Intelligence: A New Era in Cardiology","authors":"R. Abed","doi":"10.38179/ijcr.v3i1.203","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.203","url":null,"abstract":"Very few fields have evolved as Cardiology has. The last four centuries have brought extraordinary discoveries, achievements, inventions, and innovations, and we are now on the verge of witnessing the beginning of a new chapter of Cardiology that will unlock diagnostic and therapeutic interventions that are today considered impossible. Why? Artificial Intelligence (AI).\u0000 ","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87802453","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: Cytomegalovirus (CMV) infections are common, especially in immunocompromised patients. These infections are usually asymptomatic but can become symptomatic in immunocompromised individuals, with colitis being the second most common presentation of end-organ disease. CMV colitis can mimic Inflammatory Bowel Disease (IBD) or cause an IBD flare, thus making the diagnosis challenging. Case Report: We describe the case of a 69-year-old male known to have Chronic Lymphocytic Leukemia (CLL) maintained in remission on venetoclax, a BCL-2 inhibitor. The patient was recently started on mesalamine and steroids after a Crohn’s Disease (CD) diagnosis three weeks before presentation. The patient presented with bloody diarrhea and abdominal pain. His workup included a colonoscopy that showed skip lesions (diffuse ulcerated lesions separated by areas of normal mucosa), a characteristic of CD. Ileal and colonic biopsies were sent for Polymerase Chain Reaction (PCR) of CMV and turned out positive. Therefore, the patient was diagnosed with CD with superimposed CMV colitis. We started the patient on ganciclovir. Three months later, a repeat colonoscopy revealed complete resolution of mucosal ulcerations, practically changing the diagnosis to an isolated CMV colitis mimicking CD. Conclusion: An isolated CMV colitis can mimic CD, and physicians must consider this entity in their differential diagnosis. This case is additionally remarkable because CLL and the use of a BCL-2 inhibitor usually have a protective role against CMV disease, but this was not the case for our patient.
{"title":"CMV Colitis Mimicking Crohn’s Disease in a Patient with CLL: A Case Report","authors":"Eddy Fares, M. Hoteit, Saliba R. Wehbe, A. Bahr","doi":"10.38179/ijcr.v3i1.38","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.38","url":null,"abstract":"Background: Cytomegalovirus (CMV) infections are common, especially in immunocompromised patients. These infections are usually asymptomatic but can become symptomatic in immunocompromised individuals, with colitis being the second most common presentation of end-organ disease. CMV colitis can mimic Inflammatory Bowel Disease (IBD) or cause an IBD flare, thus making the diagnosis challenging.\u0000Case Report: We describe the case of a 69-year-old male known to have Chronic Lymphocytic Leukemia (CLL) maintained in remission on venetoclax, a BCL-2 inhibitor. The patient was recently started on mesalamine and steroids after a Crohn’s Disease (CD) diagnosis three weeks before presentation. The patient presented with bloody diarrhea and abdominal pain. His workup included a colonoscopy that showed skip lesions (diffuse ulcerated lesions separated by areas of normal mucosa), a characteristic of CD. Ileal and colonic biopsies were sent for Polymerase Chain Reaction (PCR) of CMV and turned out positive. Therefore, the patient was diagnosed with CD with superimposed CMV colitis. We started the patient on ganciclovir. Three months later, a repeat colonoscopy revealed complete resolution of mucosal ulcerations, practically changing the diagnosis to an isolated CMV colitis mimicking CD.\u0000Conclusion: An isolated CMV colitis can mimic CD, and physicians must consider this entity in their differential diagnosis. This case is additionally remarkable because CLL and the use of a BCL-2 inhibitor usually have a protective role against CMV disease, but this was not the case for our patient.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72649858","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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