Journal of medical clinical case reports最新文献

{"title":"Short-Term Outcomes of Umbilical Hernia Repair with Cirrhosis and Ascites","authors":"","doi":"10.47485/2767-5416.1053","DOIUrl":"https://doi.org/10.47485/2767-5416.1053","url":null,"abstract":"Background: Umbilical hernia is a popular disease, especially in patients with cirrhosis and ascites. The high and prolonged intra-abdominal fluid leads to increased intra-abdominal pressure, which causes the hernia to grow rapidly and cause complications. The clinical manifestations are mainly two: signs of hernia and symptoms of cirrhosis and ascites. The diagnosis of this condition is relatively simple, based mainly on clinical findings, and sometimes supported by imaging techniques. Umbilical hernia management in patients with cirrhosis and ascites has shifted towards early surgical repair to avoid complications. Two techniques of hernia reconstruction are available: simple suture and mesh implantation. Mesh-based methods are regarded as superior, but surgery in this population has many potential hazards and is still a surgical dilemma. This study examines the short-term outcomes of umbilical hernia reconstruction in patients with cirrhosis and ascites.\u0000Subjects – Methods: We conducted a retrospective study on 43 patients with cirrhosis and ascites who had umbilical hernia repair surgery at Cho Ray Hospital from January 2018 to December 2022. The surgery was either elective or emergency. We recorded the patient characteristics, surgical approaches, morbidity, and mortality. We followed up the patients for 30 days after the surgery.\u0000Results: The male: female ratio was 4:1. The average of age was 56.8 ± 10.7 years old (range: 27 – 79 years old). BMI was categorized into four groups: underweight in 9/43 cases (9.3%), normal in 22/43 cases (51.2%), overweight in 8/43 cases (18.6%), and obese in 9/43 cases (20.9%). All patients had a protrusion in the umbilicus when they were admitted to the hospital. Hernia pain and tenderness were present in 51.2% and 55.8% of the cases, respectively. 8/43 cases (18.6%) had complications of hernia rupture. The mean size of the hernia was 6.4 ± 5.1 cm (range: 2 – 30 cm). The patients underwent emergency surgery in 37/43 cases (86%). All surgeries were open, and the methods of hernia repair were simple suture in 35/43 cases (81.4%), onlay mesh placement in 4/43 cases (9.3%), sublay mesh placement in 1/43 case (2.3%), and preperitoneal mesh placement in 3/43 cases (7%). The mean operative time was 93 ± 37.2 minutes (range: 50-200 minutes). The mean hospital stay was 7 ± 3.2 days (range: 2 – 17 days). There were 13 cases with postoperative complications, accounting for 30%. 2 deaths occurred due to intra-abdominal bleeding and severe peritonitis.\u0000Conclusion: Umbilical hernia is a frequent complication in patients with ascites and cirrhosis. The diagnosis is mainly based on clinical signs, and imaging techniques are used in complicated cases that require further evaluation of the content and condition of the hernia sac. The patients have a high rate of complications and mortality after surgery, which are related to late surgery, degree of cirrhosis, and MELD score ≥ 20. Therefore, the patients need early diagnosis an","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"13 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507309","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":"Nivolumab Toxicity Meets Leptomeningeal Carcinomatosis: A Case Report","authors":"M. P. Shari S. Barro-Tarazona, Oms Harshita Nadella, Oms Bindiya Desai, DO Pgy Aditya Sapasetty","doi":"10.47485/2767-5416.1052","DOIUrl":"https://doi.org/10.47485/2767-5416.1052","url":null,"abstract":"Nivolumab (Opdivo) is an immune checkpoint inhibitor used in the treatment of multiple cancers including gastric adenocarcinoma. The diagnosis of antineoplastic therapy toxicity, such as nivolumab toxicity, occurs commonly in those receiving treatment with symptoms ranging from a rash to potentially death, which is an uncommon side effect. Patients who have cancer can develop the diagnosis of leptomeningeal carcinomatosis (LMC), which is considered rare, occurring in 2-4% of all cancers. The initial presentation with primarily neurological symptoms can occur in both diseases, however the prognosis and treatment varies greatly. In this case report, we discuss a patient with metastatic gastric adenocarcinoma reportedly in remission, who was initially being treated as having nivolumab toxicity, however 72 hours later he was found to have leptomeningeal carcinomatosis.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"58 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140510211","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":"Delirium and Pseudoparkinsonism in a Bipolar Patient: Case Report","authors":"","doi":"10.47485/2767-5416.1049","DOIUrl":"https://doi.org/10.47485/2767-5416.1049","url":null,"abstract":"Background\u0000Bipolar patients are at higher risk of delirium, in comparison to other psychiatric patients, regardless of being under lithium treatment. Indeed, lithium and antipsychotics are the mainstay drugs in the management of bipolar disorder. In clinical practice, the combinations of these drugs are commonly used in the management of acute phase of mania. Despite rare previous cases of olanzapine-associated delirium and cases of delirium with extrapyramidal signs due to a lithium-olanzapine combination therapy, these are mainly reported in elderly or severely ill patients.\u0000Case Presentation\u0000This case report illustrates a complex neuropsychiatric syndrome characterized by olanzapine-associated delirium alongside parkinsonism induced by aripiprazole, during a severe manic episode, in an antipsychotic-naïve young adult bipolar patient, under lithium maintenance treatment. \u0000Conclusions\u0000This case highlights the need for caution regarding delirium and extrapyramidal symptoms when treating antipsychotic-naïve bipolar patients under lithium maintenance therapy. The risk factors and the underlying physiopathology of this iatrogenic neuropsychiatric syndrome are discussed. We hypothesise a central cholinergic antagonism in the pathophysiology for delirium, and both pharmacokinetic and pharmacodynamic mechanisms for Parkinsonism, namely a putative flaw functioning of CYP2D6 or CYP3A4 cytochromes, bringing about a failure in metabolising aripiprazole at a normal rate, and a synergistic effect of lithium and antipsychotics on dopaminergic blockade.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138592005","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":"Targeted Intervention Creation and Its Effects on Connecting Men to HIV Services, a Steppingstone to Ending the Epidemic","authors":"","doi":"10.47485/2767-5416.1047","DOIUrl":"https://doi.org/10.47485/2767-5416.1047","url":null,"abstract":"Gender disparities in healthcare utilisation in South-Africa persist, with men underutilizing health services compared to women. Enhancing men’s health-seeking behaviour affects their general wellbeing and plays a crucial role in contributing to public health efforts to reduce the transmission of HIV through early detection and treatment. This article identifies the barriers preventing men from accessing health services and explores the interventions of a South African based NGO (Non-Government Organisation) which successfully addressed these barriers to improve men’s utilisation. This case study emphasizes the impact of tailoring services to target groups to increase service uptake.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":" 14","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135292090","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":"Gradual Approach for The Management of Penile Strangulation by Metal Ring: A Case Report","authors":"","doi":"10.47485/2767-5416.1046","DOIUrl":"https://doi.org/10.47485/2767-5416.1046","url":null,"abstract":"Penile strangulation by metal ring is a rare urological entity; it could be a truly urological emergency and requires a prompt resolution to avoid irreversible consequences. We present the case of a young male who received a successful gradual approach for the extraction of penile ring. This article provides to the readers some practical tips for the management of this rare condition.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618333","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":"Cystic Fibrosis","authors":"","doi":"10.47485/2767-5416.1045","DOIUrl":"https://doi.org/10.47485/2767-5416.1045","url":null,"abstract":"Cystic fibrosis is the most common, life-threatening hereditary disease in children. It is transmitted by recessive somatic character affecting the exocrine glands. The disease causes abnormal ion transport in the epithelial tissues, causing dehydration, making mucus thick and sticky, causing mechanical obstruction in the pores and glands. The organs. The severity of the disease varies. Although an increased survival rate has been achieved in recent years, death is the final result as progressive pulmonary complications occur, which pose a serious threat to the child’s life. As the disease is chronic hospitalizations can be frequent.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135043584","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":"Rhinolith in a 19-Year-Old Girl: A Case Report of a Rare Condition","authors":"","doi":"10.47485/2767-5416.1044","DOIUrl":"https://doi.org/10.47485/2767-5416.1044","url":null,"abstract":"Rhinolith means formation of stone in the nasal cavity which is an uncommon cause of nasal obstruction. It occurs due to mineralization of an endogenous or exogenous nidus with deposition of mineral salts, calcium and magnesium phosphates. Patients usually present with foul smelling/ purulent nasal discharge, nasal bleeding, nasal obstruction, halitosis, tooth ache or palatal perforation. Endoscopic removal of rhinolith leads to less morbidity which the treatment of choice. We report a case of 19-year-old female with rhinolith on the right nasal cavity which was removed endoscopically.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134946021","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":"A Case of Wolf-Parkinson-White Syndrome with Atrial Fibrillation Successfully Ablated from the Middle Cardiac Vein","authors":"","doi":"10.47485/2767-5416.1043","DOIUrl":"https://doi.org/10.47485/2767-5416.1043","url":null,"abstract":"<strong><span class=\"correspondence-author\">Background</span></strong> Wolf-Parkinson-White (WPW) syndrome with atrial fibrillation (AF) may be life threatening and catheter ablation is the top priority choice. Accessory pathways (APs) in this patient may locate in the posterior septum. We present a successful case of WPW with AF, which we ablated inside the middle cardiac vein (MCV). <strong><span class=\"correspondence-author\">Case Summary</span></strong> The report describes a case of WPW syndrome that was ablated within the MCV. A 42 male was referred to our hospital for palpitation and hypotension. After electrical cardioversion, a 12-lead electrocardiogram (ECG) in sinus rhythm showed preexcitation indicating a posteroseptal AP. Ablation in the right posterior septum of the endocardium could not completely block the conduction of AP and the best target site was mapped within MCV. The successful ablation sites were confirmed in MCV by angiography and AF never appeared during follow-up. <strong><span class=\"correspondence-author\">Conclusion</span></strong> When ablation of the posterior septum for APs from an endocardial approach has failed, venography should be performed to assess CS anatomy and mapping should be performed within the CS and its major branches. In young patients with AF and preexcitation, ablation of APs can prevent AF.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"229 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135902035","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":"Evaluation of the Relationship between Diuresis and Kidney Function in Transplant Patients at Tabriz Imam Reza Hospital","authors":"","doi":"10.47485/2767-5416.1041","DOIUrl":"https://doi.org/10.47485/2767-5416.1041","url":null,"abstract":"Introduction Kidney transplantation is the method of choice and a cost-effective treatment for ESRD patients, which has significantly reduced mortality and complications of the disease. In this study, we aim to investigate the effects of diuresis on renal function in transplant patients. The aim of this cross-sectional analysis is to find out the effects of diuresis on renal function in patients undergoing renal transplantation. Methods This cross-sectional study was conducted on kidney transplant patients at Tabriz Imam Reza Medical Education Center. During the study, patients were examined based on specific inclusion and exclusion criteria. Demographic information, including age, sex, morning weight the day before surgery, underlying disease, and duration of dialysis in years, was recorded. The study also included calculating the patients’ GFR using the CKD-EPI equation and determining its relationship with both recovery urinary output and 24-hour urinary output. Results This study included 49 patients who underwent kidney transplantation. The right and the left kidney was transplanted in 42 and 7 patients respectively. Present study showed that there was no significant relationship between the laboratory parameters of patients, including preoperative sodium, preoperative potassium, preoperative urea, preoperative creatinine, postoperative sodium, postoperative potassium, postoperative urea, postoperative creatinine, preoperative GFR, postoperative GFR, and diuresis of patients in the recovery room and 24 hours after surgery. Additionally, there was no significant relationship between indicators such as age and weight and the amount of diuresis of patients in the recovery room and 24 hours after the operation. Furthermore, this study did not find a significant difference in preoperative GFR, postoperative GFR, recovery output, and 24-hour output between patients with hypertension and the non-hypertensive group. Conclusion There was no significant relationship between demographic indicators and laboratory parameters and the amount of diuresis in patients. Additionally, the study found no significant difference in GFR and output between patients with hypertension and those without hypertension.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135097581","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":"Investigating the Rate of Sexual Disorders in Men With a Recent COVID-19 Infection Referred to the Tadbir Clinic in Urmia","authors":"","doi":"10.47485/2767-5416.1040","DOIUrl":"https://doi.org/10.47485/2767-5416.1040","url":null,"abstract":"Introduction The Covid-19 pandemic has had destructive social, psychological, and economic effects worldwide. Various studies reported a decrease in male sexual potency during the covid-19 pandemic and an increase in patients with erectile dysfunction disorders. The present study seeks to determine the rate of sexual disorders in men with a recent history of COVID-19. Methods The present study adopted a prospective design. The study population included patients referred to the lung and urology clinic at Tadbir Clinic in Urmia City in the previous two months, from 2020 to 2021, with recent complaints of impotence or its exacerbation. The International Index of Erectile Function (IIEF) questionnaire was administered to the patients to collect data regarding their sexual activity. Based on the scores obtained from the questionnaire, the patients were divided into three groups: those without disorders, those with mild to moderate disorders, and those with moderate to severe disorders. Results The mean sexual score in patients was 15.68 ± 6.06. While 17.4% of the patients did not have erectile dysfunction, 82.6% had some degree of erectile dysfunction. The prevalence of erectile dysfunction among patients hospitalized in the ICU was significantly higher than among those hospitalized in the ward. Patients with a history of hospitalization had a lower average sex score than those without a history of hospitalization. Conclusion The rate of sexual dysfunction in patients with a history of hospitalization in the ward and ICU was higher. Moreover, patients who had been hospitalized in the ICU were more likely to develop sexual dysfunction than those who had been hospitalized in the ward. This study found that Covid-19 had a significant impact on male sexual health.","PeriodicalId":94090,"journal":{"name":"Journal of medical clinical case reports","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135097580","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}