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Radiosugery with CyberKnife in Primary Orbital MALT Lymphoma: A Case Report 射波刀放射治疗原发性眼眶MALT淋巴瘤1例报告
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1448
Vasko Graklanov, Popov Veselin, Grudeva-Popova Janet
MALT lymphoma constitutes one half of all orbital malignancies. Ocular adnexal lymphoma of MALT-type (OAML) may affect critical structures in the orbit and can become therapeutic challenge. Surgery, radiotherapy or chemotherapy, alone or in combined modalities can be used as treatment options based on the individual patient variables as well as the site, stage and surgical accessibility of the OAML. This case confirms that radiosurgery with CyberKnife is an effective and safe therapeutic option in patients with OALM reducing the collateral damage to a minimal rate.
MALT淋巴瘤占所有眼眶恶性肿瘤的一半。malt型眼附件淋巴瘤(OAML)可能影响眶内的关键结构,成为治疗的挑战。手术、放疗或化疗,单独或联合治疗均可作为治疗选择,这取决于患者的个体变量以及OAML的部位、分期和手术可及性。该病例证实了射波刀放射手术是OALM患者有效且安全的治疗选择,可将附带损伤降至最低。
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引用次数: 0
A Case of Primary Nasal Tuberculosis in 40-Year-Old Man 40岁男性原发性鼻结核1例
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1460
B. Thaker, S. Bhardwaj, Kailash Singh Thaker
Nasal tuberculosis is a rare clinical entity even in areas with high incidence of tuberculosis. Due to its rarity and no specific clinical presentation its timely diagnosis as well as proper management often gets delayed. Therefore here we report a case of primary nasal tuberculosis in a 40-year-old male presented with nasal obstruction, epistaxis and recurrent cold since past 2 years. This case report would further emphasize that Nasal tuberculosis should always be kept as one of the differential diagnosis in chronic nasal symptoms and in granulomatous lesions of the nose; so that patient may be given appropriate and timely treatment.
鼻结核是一种罕见的临床疾病,即使在结核病高发地区也是如此。由于它的罕见性和无特异性临床表现,它的及时诊断和适当的治疗往往被延误。因此,我们在此报告一位40岁男性原发性鼻结核病例,其表现为鼻塞、鼻出血和复发性感冒。本病例报告将进一步强调鼻结核应始终作为慢性鼻症状和鼻肉芽肿病变的鉴别诊断之一;使病人得到适当和及时的治疗。
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引用次数: 0
Transverse Myelitis in HIV Patient: A Case Report HIV患者横贯脊髓炎1例报告
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1464
Sayooj Sebastian, J. Jose, Leya P. Babu
Transverse myelitis is an uncommon neurological condition characterized by the inflammation of the spinal cord causing destruction to the myelin sheath. Acquired immunodeficiency syndrome can be a risk factor for this unusual disease. In later stages of AIDS, HIV myelopathy can be presented with diminished CD4 counts. We report the case of a 47-year-old male patient with H/O HIV and Hypertension presented with the complaints of asymmetrical limb weakness, followed by involuntary bowel and bladder habits, decreased bladder sensation, and intermittent fever. At the time of admission, the patient was found to have features of myelopathy and after various modalities of evaluation the patient was initiated on the treatment for the same. Being a rare case, this case report has great importance. Also, treatment of multiple diseases with multiple drug therapy remains a major challenge for physicians.
横贯脊髓炎是一种罕见的神经系统疾病,其特征是脊髓的炎症导致髓鞘的破坏。获得性免疫缺陷综合征可能是这种不寻常疾病的危险因素。在艾滋病晚期,HIV脊髓病可表现为CD4计数减少。我们报告一例47岁男性HIV /O伴高血压患者,其主诉为不对称肢体无力,随后出现非自主排便和膀胱习惯,膀胱感觉下降和间歇性发热。入院时,患者被发现有脊髓病的特征,经过各种形式的评估后,患者开始接受治疗。由于病例罕见,本病例报告具有重要意义。此外,用多种药物治疗多种疾病仍然是医生面临的主要挑战。
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引用次数: 0
Miller Fisher Syndrome Variant: The Incomplete Triad 米勒费雪综合症变体:不完全三联征
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1454
Noorhayati Binti Mohamad Nadzir, P. Raman, S. PremalaDevi, Khairul Husnaini Mohd Khalid
Miller Fisher Syndrome (MFS) is a rare inflammatory peripheral neuropathy where the diagnosis is made based on the clinical triad of ophthalmoplegia, ataxia, and areflexia. It is considered a variant of Guillain-Barre Syndrome (GBS) and associated with antiGQ1b IgG positive serology. Reports on cerebellar ataxia and supranuclear gaze palsy in MFS suggested an additional involvement of the central nervous system, encompassing Bickerstaff's Brainstem Encephalitis (BBE) spectrum.
Miller Fisher综合征(MFS)是一种罕见的炎性周围神经病变,其诊断基于眼麻痹、共济失调和反射性松弛的临床三联征。它被认为是格林-巴利综合征(GBS)的一种变体,与抗gq1b IgG血清学阳性相关。关于MFS患者小脑共济失调和核上凝视性麻痹的报道表明,中枢神经系统还受影响,包括比克斯塔夫脑干脑炎(BBE)谱。
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引用次数: 0
A Novel Tourniquet Technique to Reduce Hemorrhage in Placenta Accreta and Allow Transportation of Patient to Tertiary Care Hospital 一种新的止血带技术减少胎盘增生出血,并允许将患者运送到三级保健医院
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1468
Sidra Ahmed
Placenta accreta is an obstetrical complication that can result in life threatening hemorrhage if not managed with adequate care and cause high maternal morbidity. Caesarean hysterectomy is an effective method to control intra-operative bleeding; however, we present a case of placenta accreta that was diagnosed intra-operatively in our secondary set-up hospital. Owing to the lack of multidisciplinary team, bleeding was temporarily controlled by tying a tourniquet using a Foley’s catheter around the lower uterine segment with the tourniquet left in-situ and patient was shifted to a tertiary care hospital. This novel tourniquet technique bought time to transport the patient, arrange for a multidisciplinary team needed for this patient’s management, and reduce hemorrhage which directly determined maternal outcome.
胎盘增生是一种产科并发症,如果护理不当,可导致危及生命的出血,并导致产妇高发病率。剖宫产术是控制术中出血的有效方法;然而,我们提出一个病例的胎盘增生,是在手术中诊断在我们的二级设置医院。由于缺乏多学科团队,在子宫下段使用Foley 's导管系止血带暂时止血,并将止血带留在原位,将患者转至三级护理医院。这种新颖的止血带技术为运送患者争取了时间,安排了一个多学科团队来管理该患者,并减少了直接决定产妇结局的出血。
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引用次数: 0
Primary Prevention of Cardiovascular Disease 心血管疾病的初级预防
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1471
I. Hussain
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引用次数: 0
Immunological Components of Vaccination 疫苗接种的免疫学成分
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1473
Angela Behera
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引用次数: 0
Ovarian Vein Thrombosis Complicating Puerperal Group andlsquo;Aandrsquo; Streptococcal Sepsis 卵巢静脉血栓形成合并产褥期组;链球菌脓毒症
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1453
A. Gaboura, Z. Safty, A. Das, T. Gleeson, B. Carey, D. Honan, S. Babu
Group A Streptococcus (GAS) puerperal sepsis is still one of the significant causes of morbidity and mortality, despite the dramatic advancements in knowledge, prevention, and sepsis treatment since the days of Zimmerman. The incidence of GAS infections is variable. However, it is around 3-4 cases per 100,000 population every year in developed countries. It would be higher in developing countries. GAS Puerperal sepsis is the infection of the genital tract between membranes' rupture and the 42nd day postpartum, according to the WHO. We present the case of a 36-yearold Para 2, who came with fever and severe abdominal pain three days after vaginal delivery and progressed to septic shock. Differential diagnosis of complex appendicitis or Right Ovarian vessel thrombosis made. A Laparotomy confirmed Right Ovarian Vein Thrombosis, for which a Right Salpingo-Oophorectomy performed. Blood cultures established GAS infection. The woman made an uneventful recovery following aggressive antibiotic therapy and care in the Intensive Care Unit. The baby received antibiotics. She was discharged home on day 11, in good condition. One of the rarest complications of GAS Puerperal Sepsis is Ovarian Vein Thrombosis. Aggressive IV fluids and antibiotics therapy, as well as surgical intervention, is the mainstay of treatment. Multidisciplinary input is important.
A群链球菌(GAS)产褥期脓毒症仍然是发病率和死亡率的重要原因之一,尽管自齐默尔曼时代以来,在知识、预防和脓毒症治疗方面取得了巨大进步。GAS感染的发生率是可变的。然而,在发达国家,每年每10万人中约有3-4例病例。在发展中国家会更高。根据世界卫生组织的说法,产后败血症是指在胎膜破裂至产后42天之间发生的生殖道感染。我们提出的情况下,36岁Para 2,谁来发烧和严重腹痛阴道分娩后三天,并进展为感染性休克。复杂阑尾炎或右卵巢血管血栓的鉴别诊断。剖腹手术证实右卵巢静脉血栓形成,因此行右输卵管-卵巢切除术。血培养证实GAS感染。在重症监护室接受积极的抗生素治疗和护理后,该妇女顺利康复。婴儿接受了抗生素治疗。第11天,她出院回家,身体状况良好。产后脓毒症最罕见的并发症之一是卵巢静脉血栓形成。积极的静脉输液和抗生素治疗以及手术干预是治疗的主要手段。多学科的投入是重要的。
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引用次数: 0
A Case Report on Appendicular Endometriosis 阑尾子宫内膜异位症1例报告
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1455
Taghreed Albalawi, P. Gergi, A. Alotaibi
Background: Appendicular Endometriosis represents less than 1% of all pelvic endometriosis cases. It manifests with pain in right iliac fossa and bear resemblance to acute appendicitis. Definitive diagnosis is possible only after histopathological examination of excised appendix. Case presentation: We report a rare case of Appendicular Endometriosis (AE) in a 38 years old non-married female, otherwise healthy, came to emergency room with less than 24 hours lower abdominal pain associated with nausea but no vomiting. All other systemic review was unremarkable. Patient has no positive medical or surgical history. Blood investigations were normal and abdominal ultrasound US showed edematous wall thickening of the appendix with 12 mm distended lumen. Laparoscopic appendicectomy was performed with incidental finding of blood-tinged fluid in the pelvis and multiple prominent fibroids of the uterus, the appendix was inflamed, and appendectomy done. Postoperative recovery course was uneventful. The final histopathological examination confirmed endometriosis of appendix. Conclusion: AE is a rare entity and almost always diagnosed after histopathological examination. it should be included in the differential diagnosis of acute abdominal pain, especially when women of childbearing age present with clinical symptoms of acute appendicitis.
背景:阑尾子宫内膜异位症占所有盆腔子宫内膜异位症病例的不到1%。表现为右髂窝疼痛,与急性阑尾炎相似。只有在切除阑尾的组织病理学检查后才有可能确诊。病例介绍:我们报告一例罕见的阑尾子宫内膜异位症(AE)病例,患者为38岁未婚女性,其他方面健康,以不到24小时的下腹疼痛伴恶心但无呕吐来到急诊室。所有其他的系统评价都不显著。患者无阳性病史或手术史。血液检查正常,腹部超声显示阑尾水肿壁增厚,管腔膨胀12毫米。腹腔镜阑尾切除术时,意外发现盆腔内有血色液体,子宫内有多个突出的肌瘤,阑尾发炎,行阑尾切除术。术后恢复过程顺利。最终的组织病理学检查证实阑尾子宫内膜异位症。结论:AE是一种罕见的实体,几乎都是通过组织病理学检查诊断出来的。急性腹痛,尤其是育龄妇女出现急性阑尾炎临床症状时,应纳入鉴别诊断。
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引用次数: 0
Pharmacist-Led Medication Review Identifies and Mitigates Fall-Risk-Increasing Drugs and Multi-Drug Interactions 药剂师主导的药物审查识别和减轻下降风险增加药物和多药物相互作用
Pub Date : 2021-01-01 DOI: 10.37421/2165-7920.2021.11.1451
Katie Pizzolato, A. Matos, J. Turgeon, ni Bardolia
Purpose: Falls, a common cause of injuries and hospitalizations, are observed more commonly as age increases. Several factors may potentiate a fall including vision impairment, muscle weakness, and medications. Among those, medication use is a modifiable risk factor that pharmacists can address to lower the risk for falls and falls-related injuries. Fall-risk-increasing drugs are associated with adverse drug events such as sedation, dizziness, impaired coordination, and orthostatic hypotension. The purpose of this case report is to present mitigation strategies a clinical pharmacist provided after a medication review that identified a fall-risk-increasing drug and multi-drug interactions, to which its resultant intervention reduced the risk for falls and improved patient safety. Case: A 63-year-old male who suffered a recent fall in his home received a targeted fall assessment medication review by a clinical pharmacist. Upon review, the clinical pharmacist identified hydroxyzine as a fall-risk-increasing drug and identified drug-drug interactions with simvastatin and fluoxetine that could increase the risk for hydroxyzine-related adverse drug events. Additionally, other fall-risk-increasing drugs (e.g., clonazepam, meclizine, fluoxetine) were present, each involved in one or more drug-drug interactions. As a first step, the clinical pharmacist recommended to discontinue the hydroxyzine to lower his risk for a future fall and fall-related injury. Conclusion: This case demonstrates an example of a clinical pharmacist’s interventions that resulted in a reduction of falls risk, along with the improvement of patient safety.
目的:跌倒是造成伤害和住院的常见原因,随着年龄的增长,这种情况更为常见。有几个因素可能导致跌倒,包括视力受损、肌肉无力和药物。其中,药物使用是一个可改变的风险因素,药剂师可以解决,以降低跌倒和跌倒相关伤害的风险。增加跌倒风险的药物与药物不良事件有关,如镇静、头晕、协调性受损和体位性低血压。本病例报告的目的是介绍临床药剂师在进行药物审查后提供的缓解策略,该审查确定了增加跌倒风险的药物和多药物相互作用,由此产生的干预降低了跌倒风险并提高了患者安全。病例:一名63岁男性最近在家中跌倒,临床药剂师对其进行了有针对性的跌倒评估药物审查。经过审查,临床药师确定羟嗪是一种降低风险的药物,并确定与辛伐他汀和氟西汀的药物相互作用可能增加羟嗪相关药物不良事件的风险。此外,还存在其他降低风险的药物(如氯硝西泮、美氯嗪、氟西汀),每种药物都有一种或多种药物相互作用。作为第一步,临床药剂师建议停止羟嗪,以降低他未来跌倒和跌倒相关损伤的风险。结论:这个案例展示了临床药剂师干预的一个例子,减少了跌倒的风险,同时提高了患者的安全。
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引用次数: 0
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Journal of clinical case reports
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