Pub Date : 2019-04-30DOI: 10.46619/joccr.2019.2-1036
B. Stefan
Lewis Carroll wrote in 1864 the novel of Alice in Wonderland “Alice`s Adventures under Ground” [1]. The British psychiatrist John Todd (1914-1987) described the curious condition of micro-and macrosomatognosia, altered perceptions of body image, and described it as Alice in Wonderland Syndrome. John Todd described it 1955 and gave it the literary name in his publication
{"title":"The Real Origin of Alice in Wonderland Syndrome in Childhood is still Unknown: Does Physical Abuse Play a Major Role?","authors":"B. Stefan","doi":"10.46619/joccr.2019.2-1036","DOIUrl":"https://doi.org/10.46619/joccr.2019.2-1036","url":null,"abstract":"Lewis Carroll wrote in 1864 the novel of Alice in Wonderland “Alice`s Adventures under Ground” [1]. The British psychiatrist John Todd (1914-1987) described the curious condition of micro-and macrosomatognosia, altered perceptions of body image, and described it as Alice in Wonderland Syndrome. John Todd described it 1955 and gave it the literary name in his publication","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85082295","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}
Pub Date : 2019-01-01DOI: 10.46619/joccr.2019.2-1044
V. Volkov
Aim: A comparative morphometric study of heart condition on the organ level of its organization in each clinical stage of neuroleptic cardiomyopathy. Methods and Results: In compliance with the modern requirements of evidential medicine the morphometric method of a research differing in objectivity and high informational content is used. For analysis of data from organometry of heart an own original method was used. It was found that on the organ level the process of cardiac remodeling ends during the latent stage of the disease. Progression of myocardial dysfunction is connected with the changes. Conclusion: During the morphogenesis of an antipsychotic cardiomyopathy a certain definition of the stage of clinical manifestations of a disease corresponding to the remodeling of the heart at the organ level is observed.
{"title":"Morphogenesis of Neuroleptic Cardiomyopathy in Morphometric Light","authors":"V. Volkov","doi":"10.46619/joccr.2019.2-1044","DOIUrl":"https://doi.org/10.46619/joccr.2019.2-1044","url":null,"abstract":"Aim: A comparative morphometric study of heart condition on the organ level of its organization in each clinical stage of neuroleptic cardiomyopathy. Methods and Results: In compliance with the modern requirements of evidential medicine the morphometric method of a research differing in objectivity and high informational content is used. For analysis of data from organometry of heart an own original method was used. It was found that on the organ level the process of cardiac remodeling ends during the latent stage of the disease. Progression of myocardial dysfunction is connected with the changes. Conclusion: During the morphogenesis of an antipsychotic cardiomyopathy a certain definition of the stage of clinical manifestations of a disease corresponding to the remodeling of the heart at the organ level is observed.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75618585","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}
Pub Date : 2019-01-01DOI: 10.46619/joccr.2019.2-1032
P. Lago-López, María José Parrado-Alonso, B. Villar-Fernández, T. Calheiros-Cruz, J. Ruibal-Azevedo, Lago Xoán Antón Ricoy, J. Cameselle-Teijeiro
Herpes zoster is caused by a reactivation of residual varicella zoster virus (VZV) which remains latent in the nerve ganglia, after primary chicken pox. Zoster or girdle refers to occurrence of the disease in a segmental distribution.
{"title":"Sudden, Intense, Unexpected and Negative Emotions are a Reactivation Factor of Herpes Zoster","authors":"P. Lago-López, María José Parrado-Alonso, B. Villar-Fernández, T. Calheiros-Cruz, J. Ruibal-Azevedo, Lago Xoán Antón Ricoy, J. Cameselle-Teijeiro","doi":"10.46619/joccr.2019.2-1032","DOIUrl":"https://doi.org/10.46619/joccr.2019.2-1032","url":null,"abstract":"Herpes zoster is caused by a reactivation of residual varicella zoster virus (VZV) which remains latent in the nerve ganglia, after primary chicken pox. Zoster or girdle refers to occurrence of the disease in a segmental distribution.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80447613","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}
Pub Date : 2019-01-01DOI: 10.46619/joccr.2019.2-1035
Imran Muhammad
Acute confusional state is a challenging condition especially when present in young patients. I am presenting a challenging case of acute confusion in a young patient which was not diagnosed in a timely manner. A 33-year-old pleasant lady was initially admitted with fits and managed with sodium valproate. There were no past medical problems. No cause was found and she was discharged with outpatient neurologist follow up. One week later she re-admitted with confusion, bizarre behaviour and personality change. Her confusion got worse and her personality was changed to that extent that her family and other ward members including nursing staff felt about demonic possession. This presentation was considered secondary to sodium valproate which was changed to phenytoin. Afterward, she went through extensive investigations including CT head, MRI head and Spine, Lumbar puncture, Septic & autoimmune screen. Her pregnancy test was negative. LP results confirmed leucocytosis and EEG showed diffuse abnormality. MRI head showed encephalitis changes, MRV was normal. CSF culture did not grow any organism. She was treated with 14 days course of IV Aciclovir for? encephalitis which did not help and her condition deteriorated further and she was transferred to ITU. Neurologist subsequent review advised for VGKC, NMDA, GAD & Paraneoplastic antibodies. NMDA receptor antibodies result later came back positive. She had a CT TAP & TV ultrasound which ruled out any ovarian malignancy. She was treated with immunoglobins & IV steroids & her condition improved slightly however later she aspirated during fitting and was intubated and transferred to tertiary hospital where she received plasma exchange and got almost full recovery.
{"title":"Demonic Possession or Something else… Anti-NMDAR Encephalitis: A Case Report","authors":"Imran Muhammad","doi":"10.46619/joccr.2019.2-1035","DOIUrl":"https://doi.org/10.46619/joccr.2019.2-1035","url":null,"abstract":"Acute confusional state is a challenging condition especially when present in young patients. I am presenting a challenging case of acute confusion in a young patient which was not diagnosed in a timely manner. A 33-year-old pleasant lady was initially admitted with fits and managed with sodium valproate. There were no past medical problems. No cause was found and she was discharged with outpatient neurologist follow up. One week later she re-admitted with confusion, bizarre behaviour and personality change. Her confusion got worse and her personality was changed to that extent that her family and other ward members including nursing staff felt about demonic possession. This presentation was considered secondary to sodium valproate which was changed to phenytoin. Afterward, she went through extensive investigations including CT head, MRI head and Spine, Lumbar puncture, Septic & autoimmune screen. Her pregnancy test was negative. LP results confirmed leucocytosis and EEG showed diffuse abnormality. MRI head showed encephalitis changes, MRV was normal. CSF culture did not grow any organism. She was treated with 14 days course of IV Aciclovir for? encephalitis which did not help and her condition deteriorated further and she was transferred to ITU. Neurologist subsequent review advised for VGKC, NMDA, GAD & Paraneoplastic antibodies. NMDA receptor antibodies result later came back positive. She had a CT TAP & TV ultrasound which ruled out any ovarian malignancy. She was treated with immunoglobins & IV steroids & her condition improved slightly however later she aspirated during fitting and was intubated and transferred to tertiary hospital where she received plasma exchange and got almost full recovery.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90649554","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}
Pub Date : 2019-01-01DOI: 10.46619/joccr.2019.2-1029
A. Nasser, Muhammad Tareq Khan Yaseer, Ismail Mousa Tia Khalid
In miliary TB, the role of steroid remains to be unclear. Till date, extremely limited studies have been conducted to evaluate corticosteroids’ role in miliary TB. We report a patient with miliary TB and co-existing organizing pneumonia (OP), a condition that was managed successfully by anti-TB chemotherapy in adjunct with the corticosteroid. To the best of our knowledge, this association has not been reported or extremely infrequently reported in the existing literature. The adjunctive use of corticosteroids does not appear to diminish the efficacy of ‘adequate’ anti-tuberculosis therapy. The use of corticosteroids has significant short- and long-term benefits in most forms of tuberculosis.
{"title":"Use of Corticosteroid as an Adjunct with Antitubercular Therapy in the Management of Miliary Tuberculosis Associated with Organizing PneumoniaA Case Report","authors":"A. Nasser, Muhammad Tareq Khan Yaseer, Ismail Mousa Tia Khalid","doi":"10.46619/joccr.2019.2-1029","DOIUrl":"https://doi.org/10.46619/joccr.2019.2-1029","url":null,"abstract":"In miliary TB, the role of steroid remains to be unclear. Till date, extremely limited studies have been conducted to evaluate corticosteroids’ role in miliary TB. We report a patient with miliary TB and co-existing organizing pneumonia (OP), a condition that was managed successfully by anti-TB chemotherapy in adjunct with the corticosteroid. To the best of our knowledge, this association has not been reported or extremely infrequently reported in the existing literature. The adjunctive use of corticosteroids does not appear to diminish the efficacy of ‘adequate’ anti-tuberculosis therapy. The use of corticosteroids has significant short- and long-term benefits in most forms of tuberculosis.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90340755","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}
Pub Date : 2018-10-30DOI: 10.46619/joccr.2018.1-1024
Abuosa Ahmed, Alrahimi Jamilah, Almouaalamy Nabil
Exercise Treadmill Testing to identify CAD is now a widely available and relatively low-cost examination that has been used for more than 60 years. The use of the ETT has expanded to include testing for functional capacity, chronotropic incompetence, assess the effects of therapy and also useful for risk stratification of patients with known CAD. The test sensitivity ranges from 61% to 73%, as reported by various analysts, and Specificity ranges from 59% to 81%, depending on the study or article referenced. Due to the various criteria set for the exercise stress test interpretation and reporting, we have outlined the criteria needed to support high quality exercise stress testing practice throughout Health facilities.
{"title":"Does Cardiac Exercise Stress Testing Still Exist?","authors":"Abuosa Ahmed, Alrahimi Jamilah, Almouaalamy Nabil","doi":"10.46619/joccr.2018.1-1024","DOIUrl":"https://doi.org/10.46619/joccr.2018.1-1024","url":null,"abstract":"Exercise Treadmill Testing to identify CAD is now a widely available and relatively low-cost examination that has been used for more than 60 years. The use of the ETT has expanded to include testing for functional capacity, chronotropic incompetence, assess the effects of therapy and also useful for risk stratification of patients with known CAD. The test sensitivity ranges from 61% to 73%, as reported by various analysts, and Specificity ranges from 59% to 81%, depending on the study or article referenced. Due to the various criteria set for the exercise stress test interpretation and reporting, we have outlined the criteria needed to support high quality exercise stress testing practice throughout Health facilities.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80357582","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}
Pub Date : 2018-10-30DOI: 10.46619/joccr.2018.1-1019
S. G. Maheshgir
Gestation outside the uterine cavity in which the implantation occurs in any tissue other than the endometrium is referred as ectopic pregnancy. The most places for occurring ectopic pregnancy (97% of cases) are the fallopian tubes including ampulla (55%), isthmus (25%), and fimbria (17%), and in 3% of patient’s ectopic pregnancy occurs in the abdominal cavity, ovary, or cervix. The tubal twin ectopic pregnancy is a rare condition, and the first unilateral tubal twin was reported by De Ott in 1891, and the first live twin tubal ectopic pregnancy was reported in 1944. A live tubal twin ectopic pregnancy is a very rare condition and among >100 reports of tubal twin pregnancies, till now, only 8 cases were live. Early diagnosis and treatment of women with tubal twin ectopic pregnancy is very important and may decrease the risk of tubal rupture. I present three cases of tubal twin ectopic gestation. In the first case, spontaneous unilateral live tubal twin ectopic gestation. The second and third cases spontaneous ruptured twin ectopic gestation. All three cases were successfully managed and there was no history of assisted reproductive techninique fertilization or pelvic inflammatory disease.
{"title":"Unsual Tubal Twin Ectopic Gestation Report of Three Different Cases","authors":"S. G. Maheshgir","doi":"10.46619/joccr.2018.1-1019","DOIUrl":"https://doi.org/10.46619/joccr.2018.1-1019","url":null,"abstract":"Gestation outside the uterine cavity in which the implantation occurs in any tissue other than the endometrium is referred as ectopic pregnancy. The most places for occurring ectopic pregnancy (97% of cases) are the fallopian tubes including ampulla (55%), isthmus (25%), and fimbria (17%), and in 3% of patient’s ectopic pregnancy occurs in the abdominal cavity, ovary, or cervix. The tubal twin ectopic pregnancy is a rare condition, and the first unilateral tubal twin was reported by De Ott in 1891, and the first live twin tubal ectopic pregnancy was reported in 1944. A live tubal twin ectopic pregnancy is a very rare condition and among >100 reports of tubal twin pregnancies, till now, only 8 cases were live. Early diagnosis and treatment of women with tubal twin ectopic pregnancy is very important and may decrease the risk of tubal rupture. I present three cases of tubal twin ectopic gestation. In the first case, spontaneous unilateral live tubal twin ectopic gestation. The second and third cases spontaneous ruptured twin ectopic gestation. All three cases were successfully managed and there was no history of assisted reproductive techninique fertilization or pelvic inflammatory disease.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74888500","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}
Pub Date : 2018-10-30DOI: 10.46619/joccr.2018.1-1025
Travedi Premal, Kriss Michael, B. Scott, Johnson Thor
Encephalopathy in the setting of transjugular portosystemic shunts (TIPS) is a difficult clinical problem. Shunt reduction often improves encephalopathy but increases the risk of portal hypertension related complications. In this case we describe the use of partial splenic artery embolization in a 60-year-old female who presented with both TIPS dysfunction and refractory encephalopathy. Prior to treatment the patient had an elevated TIPS gradiant, visible varices by endoscopy, and encephalopathy that was severe and refractory enough to be considered for hospice. Following 60% splenic volume embolization, encephalopathy resolved, varices decompressed, and patient was able to be discharged home. This demonstrates that splenic embolization may be considered as a potential alternative to TIPS reduction in the setting of TIPS dysfunction and encephalopathy.
{"title":"Splenic Embolization for Recalcitrant Post-TIPS Encephalopathy","authors":"Travedi Premal, Kriss Michael, B. Scott, Johnson Thor","doi":"10.46619/joccr.2018.1-1025","DOIUrl":"https://doi.org/10.46619/joccr.2018.1-1025","url":null,"abstract":"Encephalopathy in the setting of transjugular portosystemic shunts (TIPS) is a difficult clinical problem. Shunt reduction often improves encephalopathy but increases the risk of portal hypertension related complications. In this case we describe the use of partial splenic artery embolization in a 60-year-old female who presented with both TIPS dysfunction and refractory encephalopathy. Prior to treatment the patient had an elevated TIPS gradiant, visible varices by endoscopy, and encephalopathy that was severe and refractory enough to be considered for hospice. Following 60% splenic volume embolization, encephalopathy resolved, varices decompressed, and patient was able to be discharged home. This demonstrates that splenic embolization may be considered as a potential alternative to TIPS reduction in the setting of TIPS dysfunction and encephalopathy.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80461151","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}
Pub Date : 2018-10-30DOI: 10.46619/joccr.2018.1-1021
M. Jan
Phenytoin cream has been evaluated in many patients suffering from peripheral neuropathic pain. Its onset of action has been documented to be within 30 minutes. Its mechanism of action is via the inhibition of sodium channels of the nociceptors in the skin, as well as the inhibition of a number of secondary targets in the skin, such as the keratinocytes and possibly immune-competent cells. Here we describe for the first time the successful treatment of lingering neuralgiformic pains after a wasp sting. Within 20 minutes after application of 10% phenytoin cream, the pain vanished completely. Phenytoin cream might therefore also be of use in the treatment of pain induced by stinging insects.
{"title":"A Case of Wasp-induced Pain Treated with Topical Phenytoin Cream","authors":"M. Jan","doi":"10.46619/joccr.2018.1-1021","DOIUrl":"https://doi.org/10.46619/joccr.2018.1-1021","url":null,"abstract":"Phenytoin cream has been evaluated in many patients suffering from peripheral neuropathic pain. Its onset of action has been documented to be within 30 minutes. Its mechanism of action is via the inhibition of sodium channels of the nociceptors in the skin, as well as the inhibition of a number of secondary targets in the skin, such as the keratinocytes and possibly immune-competent cells. Here we describe for the first time the successful treatment of lingering neuralgiformic pains after a wasp sting. Within 20 minutes after application of 10% phenytoin cream, the pain vanished completely. Phenytoin cream might therefore also be of use in the treatment of pain induced by stinging insects.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73192963","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}
Pub Date : 2018-10-30DOI: 10.46619/joccr.2018.1-1022
Azar Shadi, Barkmeier Daniel
Crepitus on digital rectal examination is a rare physical exam finding, but can be clinically concerning in a patient with infective symptoms and may prompt extensive workup for severe infection with a gas-forming organism. Historical urologic literature suggests that this finding typically relates to large prostatic calculi, however. Here we present a case of significant prostatic stone burden in a symptomatic patient causing crepitus in the prostate on physical exam.
{"title":"Prostate Calculi Causing Crepitus on Physical Exam","authors":"Azar Shadi, Barkmeier Daniel","doi":"10.46619/joccr.2018.1-1022","DOIUrl":"https://doi.org/10.46619/joccr.2018.1-1022","url":null,"abstract":"Crepitus on digital rectal examination is a rare physical exam finding, but can be clinically concerning in a patient with infective symptoms and may prompt extensive workup for severe infection with a gas-forming organism. Historical urologic literature suggests that this finding typically relates to large prostatic calculi, however. Here we present a case of significant prostatic stone burden in a symptomatic patient causing crepitus in the prostate on physical exam.","PeriodicalId":73665,"journal":{"name":"Journal of clinical cases & reports","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82913244","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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