Medical reports & case studies最新文献

{"title":"Reactivation of tuberculosis in Covid-19 infected patient: Case report","authors":"Megrelishvili Tamar, Ratiani Levan, Gaprindashvili Tinatin, Saralidze Nana, Nemsadze Grigol, Chikovani Irakli, Jashi Tornike, Nemsadze Vera, Silagava Mariam","doi":"10.5897/mcs2023.0139","DOIUrl":"https://doi.org/10.5897/mcs2023.0139","url":null,"abstract":"Tuberculous meningitis is a severe manifestation of extrapulmonary tuberculosis, often associated with substantial morbidity and mortality. This case report discusses a unique presentation of tuberculous meningitis in a 39-year-old male who was concurrently positive for COVID-19. The patient initially presented with symptoms of COVID-19, including fatigue, fever, and respiratory distress. However, subsequent neurological symptoms, including facial asymmetry, ptosis, and dysphagia, led to further evaluation. Imaging and cerebrospinal fluid analysis confirmed the diagnosis of tuberculous meningitis. Treatment involved a multidrug regimen and supportive care in an intensive care unit. The patient was eventually discharged with residual neurological deficits. This case emphasizes the importance of considering tuberculous meningitis in the context of COVID-19, particularly in regions with a high burden of tuberculosis. Timely diagnosis, through clinical evaluation and diagnostic tools such as cerebrospinal fluid analysis and radiographic imaging, is crucial for effective management. The potential risk of TB reactivation in COVID-19 patients underscores the need for continued vigilance and prompt intervention to prevent severe disease outcomes. Key words: Covid-19, tuberculous meningitis, reactivation","PeriodicalId":91033,"journal":{"name":"Medical reports & case studies","volume":"128 16","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135765516","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":"Electrophysiological Analysis of Traumatic Optic Neuropathy and Traumatic Brain Injury Among Active Military.","authors":"Charles S Zwerling, Lea Carter, Brandon Lucke-Wold","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Traumatic Optic Neuropathy (TON) can cause persistent visual deficits and is a known sequala of Traumatic Brain Injury (TBI). Little is known regarding appropriate diagnosis, management, and treatment.</p><p><strong>Methods: </strong>we performed a prospective cohort study with 356 active military personnel using electrophysiological Visual Evoked Potential (VEP) testing for TON in the context of known or suspected TBI. This was done with the intent to review and revise management protocol for patients who are susceptible to TON. This new VEP protocol was incorporated with kinetic and static visual field testing to uncover occult cases of TON previously missed in the current disability examination, as well as aid in evaluation of patients with borderline concussive cases that do not meet current diagnosis of mild, moderate, or severe TBI by the Veteran's Disability Exam.</p><p><strong>Results: </strong>80 patients were diagnosed with TON. Average age of TON patients was 37.4 years, with most patients being male. Of those patients with TON, 45% had reported TBI, whereas an additional 54% had suspected history of concussion. Patients presented with bilateral TON (65.8%, n=52), while unilateral TON cases occurred less frequently (35.4%, n=28). Visual field defects were apparent in both static and kinetic visual field testing in 54% of cases. VEP sensitivity in our study was 88%. Military parachute jumpers (paratroopers) represent the highest risk group for undiagnosed TBI and TON.</p><p><strong>Conclusions: </strong>we recommend periodic static and kinetic visual field testing in high-risk individuals working in fields with high concussion rates. Focused collaboration for safer helmet design is imminent. By improving helmet design, we can reduce mTBI and related TON, as well as reduce costly medical care and disability payments after military discharge.</p>","PeriodicalId":91033,"journal":{"name":"Medical reports & case studies","volume":"7 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33442051","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":"Interventions in women with one blocked oviduct, lessons learnt and recommendations: A case report","authors":"Cosmas Josiah Musewu","doi":"10.5897/MCS2019.0126","DOIUrl":"https://doi.org/10.5897/MCS2019.0126","url":null,"abstract":"Women can still conceive naturally or through in vitro fertilization (IVF) with the one oviduct that is properly functioning if only one oviduct is blocked, however, the chances are decreased particularly if the blockage is close to the ovary (hydrosalpinx) because of wash out phenomena and toxic fluid produced by the fallopian tube that is blocked. In situations where only a single tube has hydrosalpinx specialists should advise patients appropriately and must be given options, to choose between undergoing salpingostomy, a surgical process that involves tubal reconstruction to expand their odds of getting pregnant naturally by removing the blockage or IVF treatment. For women with one working oviduct specialists must be on the lookout for ectopic pregnancy. This will enable early diagnosis of ectopic pregnancy and a treatment technique that spares the tube can be utilized. The patient is a woman of African origin with blood group O staying at Manyame Park Harare. She has never married before and has been trying to get pregnant from 2005. She eventually got a successful pregnancy in 2014 and delivered first child in 2015 after several interventions. Her infertility was initially due to the presence of hydrosalpinx on the left fallopian tube, scarring in the fimbriae of left tube, high prolactin level and was subsequently due to loss of the only working tube after ectopic pregnancy. The patient got pregnant whilst she was on bromocriptine, unfortunately the pregnancy did not last to full term. Chlomiphene was later added to her drug regiment and after six cycles she had an ectopic pregnancy which destroyed her only working tube. The patient then tried IVF treatments to achieve pregnancy. She underwent two IVF treatment cycles which failed to achieve pregnancy. The patient finally underwent tubal reconstruction microsurgery which enabled her to have two successful natural pregnancies. Gynaecologists must be vigilant in diagnosis of infertility factors and should give enough appropriate information to female patients when making decisions concerning fertility interventions. \u0000 \u0000 Key words: Fertility, in vitro fertilization (IVF), salpingostomy, hydrosalpinx, prolactin, fimbriae.","PeriodicalId":91033,"journal":{"name":"Medical reports & case studies","volume":"215 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87491026","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":"Case report: Challenges in diagnosis and treatment of Small bowel diverticulitis presenting with acute abdomen","authors":"J. J. Yahng","doi":"10.5897/MCS2018.0121","DOIUrl":"https://doi.org/10.5897/MCS2018.0121","url":null,"abstract":"Small bowel diverticulitis is a rare condition that is often excluded in the differential diagnosis of acute abdomen. We herein present two cases of patients with small bowel diverticulitis who presented with acute abdomen. First case was a 72-year-old lady who presented to emergency with 2 days of sudden-onset worsening generalized abdominal pain. The computed tomography (CT) revealed a segment of abnormally thickened jejunum with marked adjacent inflammatory mesenteric fat stranding and adjacent extraluminal gas locules, in keeping with complicating perforation. The patient was subsequently taken to the operating theater for an emergency laparotomy which revealed a contained perforation of the proximal jejunum secondary to a ruptured diverticulum. 20 cm of proximal jejunum containing the perforation was resected. The patient recovered uneventfully and was discharged day 7 following the operation. Second case was a 78-year-old lady who presented with 12 h of sudden-onset right-sided abdominal pain. The CT revealed the presence of multiple diverticula in the jejunum associated with diffuse wall thickening and marked peridiverticular inflammatory changes. This was most in keeping with small bowel diverticulitis, however, there was no definite extraluminal gas to suggest any evidence of perforation. The patient was managed conservatively with intravenous antibiotics and bowel rest. The patient’s pain improved with improving inflammatory markers during the hospital stay. The patient was discharged day 4 following the admission. We believe that there is a need to devise a comprehensive treatment guidelines specific for small bowel diverticulitis. In the meantime, it is deemed safe to conservatively manage uncomplicated cases without perforation. \u0000 \u0000 Key words: Intestine, small, abnormalities, abdomen, acute, diverticulosis, colonic, diverticulitis, colonic, clinical protocols, tomography, computed.","PeriodicalId":91033,"journal":{"name":"Medical reports & case studies","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85793110","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}