Myelodysplastic Syndromes with Ring Sideroblasts Well Managed with Homeopathic Treatment
Dr. Ghulam Yaseen
Sch J App Med Sci | 634-635
DOI : 10.36347/sjams.2021.v09i05.001
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Myelodysplastic syndromes (MDS) are the number of hematological conditions that affect the stem cells in the bone marrow. In these conditions stem cells in bone marrow fail to mature for proper functioning then lead to cytopenias, which cause anemia, increased risk of infections, and easy bruising and bleeding. The majority of the patients are aged >60 at presentation.Diagnosis is made upon bone marrow biopsy. MDS can develop into acute myeloid leukemia which is an aggressive cancer of bone marrow. A 68-years old male patient presented to our Homeopathic OPD with clear signs and symptoms of anemia. He had a pallor complexion, shortness of breath that aggravated on walking, progressive weight loss, vertigo, and loss of concentration. He was diagnosed with Myelodysplastic syndrome with multilineage dysplasia and ring sideroblasts 8 months ago. His Hb level was 7.7g/dl and WBCs 3.2 x10^9/l and Platelets 179 x10^9/l. His Hb was decreasing gradually. After complete examination and evaluation, he was prescribed Homeopathic medicines and asked for follow-up after one week. In one week his health improved markedly on all levels. Medicines prescribed for 2 weeks again. After 3 weeks his Hb level increased 8.3g/dl. He began walking on his own before that he must required support in climbing stairs. His shortness of breath on exertion also improved. His concentration level also increased, he started writing his research work without difficulty. After one more month his Hb level raised up to 8.4g/dl and he was almost symptoms free within first 2 months of treatment. Same Homeopathic prescription continued for 2 more months. His serological report showed Hb level of 9.2g/dl after 4 months of the treatment. He was absolutely doing well with excellent health condition. He was prescribed Calcarea Phos 3x and Lacithenium 3x for the regeneration of bone marrow-as these Homeopathic medicines work to cure cytopenias. Avena Stiva Q was given as energy booster. This case ................
Unilateral Absence of the Pulmonary Artery: A Case Report and Literature Review
S. Ouassil, F. Jaafari, B. Boutakioute, M. Ouali Idrissi, N, Cherif Idrissi Elganouni
Sch J App Med Sci | 636-639
DOI : 10.36347/sjams.2021.v09i05.002
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Unilateral agenesis of the pulmonary artery is a rare congenital cardiovascular malformation (1% of congenital heart diseases), it can be isolated or associated with different congenital heart diseases. We report the case of a young patient aged 18, operated on in childhood for congenital heart disease without document, admitted to resuscitation unit for heart failure. After stabilization of the patient's hemodynamic status, a thoracic CT angiography (done as part of the etiological assessment) was performed showing agenesis of the left pulmonary artery, left brachiocephalic artery and a permeable blalock-tausing shunt between the brachiocephalic artery and the trunk of the pulmonary artery which is reduced in size with direct emergence of the arch of the aorta the right subclavian artery and the right common carotid. The patient remained hemodynamically stable with 60% ambient air saturation.
Original Research Article
May 8, 2021
Lower Limb Salvage Surgery: King Hussein Medical Center Experience
Dr. Ghaith Abounou-Nouar, Dr. Yousef Khair, Dr. Mohammad Alwan, Dr. Mahmoud Etaiwi, Dr. Omar Bashnaf, Dr. Sura Al Rawabdeh
Sch J App Med Sci | 640-642
DOI : 10.36347/sjams.2021.v09i05.003
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Background: Lower Limb salvage represents a challenge for orthopedic surgeons through a procedure designed to remove bony and soft tissue Tumors without amputation. The primary goal is to restore and maintain stability and functional capability as much as possible. Purpose: Examining the results of lower limb salvage procedures using Endoprosthesis and biological reconstruction. Methodology: we retrospectively analyzed 30 patients that had underwent lower limb salvage procedures by using Endoprosthesis and biological reconstruction procedures between 2011 – 2021 to study the post-operative follow up (ranged from 3 Months – 10 years). The patients were examined for complications, oncological and functional outcomes. The Tumors included 12 patients with distal Femur osteosarcoma, 6 patients with Proximal Tibia osteosarcoma, 6 patients with distal Femur Ewing sarcoma, 2 patients with Distal Femur chondrosarcoma, 1 patient with proximal Femur chondrosarcoma, 2 patients with distal Femur Giant Cell Tumor, 1 patient with Proximal Femur Metastasis. Results: Local recurrences occurred in two cases and systemic metastasis in seven patients. 12 patients died and 18 remained disease free.
Diagnosis Numbers
distal Femur osteosarcoma 12 patients
Proximal Tibia osteosarcoma 6 patients
distal Femur Ewing sarcoma 6 patients
Distal Femur chondrosarcoma 2 patients
proximal Femur chondrosarcoma 1 patient
Distal Femur Giant Cell Tumor 2patients
Proximal Femur Metastasis. 1 patient
The 5 year Kaplan-Meier survival rate was 44.6%. The Average Musculoskeletal Tumor society (MSTS) Functional score was 60% in all patients. Conclusion: Lower Limb Salvage Procedures using Endoprosthesis and biological reconstruction techniques improved the oncological and functional outcomes.
Original Research Article
May 8, 2021
Clinical Outcome of Children Admitted with Acute Encephalitis Syndrome in a Tertiary Care Hospital, Dhaka, Bangladesh
Dr. Mustafa Mahbub, Dr. Suraj C Majumder, Dr. AZM Mosiul Azam
Sch J App Med Sci | 643-648
DOI : 10.36347/sjams.2021.v09i05.004
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Background: Acute encephalitides are the most common cause of acute neurological disease in children. This is a potentially devastating neurological syndrome with different etiologies including direct central nervous system infection with different agents most commonly viral and those mediated by immune system. The management has changed dramatically in recent years for several reasons including improved diagnostic and brain imaging techniques, better antiviral and more advanced neurointensive care and rehabilitation. Objective: To observe the presentation, diagnostic approach and management of the children admitted in neuroscience department of Dhaka Shishu Hospital. Method: A retrospective analysis of suspected encephalitis was done from records of discharged patients of the Neurosciences Department at Dhaka Shishu Hospital from January 2011-February 2013. SPSS is used for statistical analysis. Result: This study examined 31 patients (17 boys; 56.5 %, 14 Girls;45.16) with a mean onset age of 5.32 years (range 0.5-12 years).Out of 31 cases of AES, 8 patients (25.81%) were JE and 24 patients (77.42%) were non-JE. Among 31cases AES patients, 8(25.81%) were recovered completely (GOSV) , while 14 (45.16%) cases had neurological sequelae (GOS II –IV) with a wide range of severity varying from mild to severe at the time of discharge, 9(29.03%) patient died in the hospital (GOS I). Conclusion: The majority of cases of encephalitis have no known etiology with HSV being the most commonly identified pathogen in developed countries. Despite treatment with acyclovir, morbidity remains high. Diagnostic criteria, laboratory facility, treatment guideline and long term follow up is essential.
Original Research Article
May 8, 2021
Evaluation of the Incidence of Benign Prostatic Hyperplasia in Obese Patients Using Transabdominal Ultrasound
Nimra Tabassum, Akash John, Muhammad Ahmad Naeem, Abid Ali, Iqra Ghaffar, Syed Muhammad Yousaf Farooq
Sch J App Med Sci | 649-653
DOI : 10.36347/sjams.2021.v09i05.005
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Objective: To evaluate the incidence of benign prostatic hyperplasia in obese patients. Method: A cross-sectional study with 113 men aged 40 years and above without any prostatic pathology were recruited. The study population was categorized into 3 BMI groups (healthy, overweight and obese) and 2 WC groups (<90 cm and >90 cm). A <0.05 p-value was considered significant. Result: The mean prostate volume was 45.86±13.01ml, mean BMI was 28.97±3.63kg/m2 and mean waist circumference was 93.73±7.04cm. The incidence of BPH was found to be highest in men with BMI > 30 kg/m2 and WC > 90 cm. Positive significant relationship between BMI and WC was found with PV. Conclusion: Central obesity is an important and independent risk factor of BPH and thus it increases the risk of developing BPH significantly. The greater a man's obesity, the greater his chance of developing BPH.
Severe Bilateral Nasal Obstruction Revealing a Rhinoscleroma
Niema Benkhraba, Razika Bencheikh, Hanaa Rahim, Ahmed Ould Mohamed, Mohamed Anas Benbouzid, Leila Essakalli Houssyni
Sch J App Med Sci | 654-657
DOI : 10.36347/sjams.2021.v09i05.006
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Rhinoscleroma is a chronic granulomatous disease of the upper airways. Several predisposing factors such as living under conditions of poor hygiene and nutritional deficiencies have been described and are apparently necessary for transmission of the disease. The diagnosis is histological and the treatment is based on surgical debridement and long-term antibiotic therapy. We report the case of a 33-year-old female patient who presented a unilateral nasal obstruction, with chronic rhinorrhea, intermittent epistaxis, and anosmia. The clinical exam found a deformation of the nasal pyramid, a septal deviation, and an anterior nasal mass. The CT-scan of the paranasal sinuses shows a lesional process centered on the left nasal cavity with lysis of the nasal septum and turbinates. An endonasal endoscopic complete exeresis was realized. The histological study returned in favor of a granulomatous inflammatory process of the nasal cavity responding to a rhinoscleroma.
Sudden Death in a Young Woman from Cerebral Venous Sinus Thrombosis: An Autopsy Case Report and Review
Pawan Mittal, Shalley Dahiya, Anil Garg, Yogesh Kumar Vashist, Gaurav Sharma
Sch J App Med Sci | 658-662
DOI : 10.36347/sjams.2021.v09i05.007
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Cerebral venous sinus thrombosis (CVST) is a rare form of stroke and carries a high rate of mortality in the acute phase. A higher incidence is found in women in comparison to men. Several risk factors have been recognized in females including pregnancy, puerperium, oral contraceptive (OC) pill usage, infections, inflammatory diseases, and thrombophilia. Headache due to raised intracranial tension has been described as the most common presenting symptom. The symptoms may be highly non-specific and misleading, carrying every possibility of a missed/delayed diagnosis which, if prove fatal, may possibly raise the question of medical malpractice. Although many case studies are available in the clinical literature, autopsy reports over CVST-related deaths may be found on a fringe only. A medicolegal case highlighting the sudden death of 24 years old young female is hereby reported in which an autopsy revealed multiple fresh antemortem thrombi in majority of the intracranial venous sinuses. Bilateral cerebral infarctions were found upon sectioning of the brain. The recent usage of the OC pills seemed to be the most likely culprit.
Original Research Article
May 11, 2021
Laser Surgery for Treatment of Haemorrhoid and Anal Fissure and its Outcome
A. N. M. Jane Alam, Maksuda Akter, Nafiz Imtiaz Uddin Ahmed, Khondaker Sajia Afrin, Auditi Barman, S. M. Mustafizur Rahman
Sch J App Med Sci | 663-669
DOI : 10.36347/sjams.2021.v09i05.008
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Background: Haemorrhoids and anal fissure are a common source of pain, and no surgical technique achieves a painless outcome. Endovascular laser surgery for varicose veins as described in an experimental study is a method that could be used in the treatment of haemorrhoids and anal fissure, but there are few clinical trials described in the literature. In the past decade, several studies have investigated the effect of laser therapy on haemorrhoids and anal fissure but few have explored its use in anal fissure. Objectives: The present study aimed to evaluate the outcome and efficiency of laser surgery for treating haemorrhoids and anal fissure. Materials & Methods: This was a cross-sectional study carried out in the tertiary care and mid-level private hospital in the Cumilla region. This clinical trial was conducted on all the patients referred to same surgeon in 05 different tertiary care and midlevel private hospital in Cumilla city. Patients were from Cumilla, Chandpur, B-Baria, Noakhali and Feni districts of Bangladesh. The study was conducted on short term (12 months) effects of laser surgery on haemorrhoids and anal fissure. Results: Laser surgery for haemorrhoids and anal fissure is a simple, minimum-invasive and nearly painless surgical procedure with a low rate of complications. No significant intraoperative complications occurred. The follow-up was 12 months. Postoperative pain was null in most patients. Symptoms and HD downgrading reached a ‘‘plateau’’ at 3 to 6 weeks after the laser treatment. At this evaluation, frequency of bleeding, pain, itching, and haemorrhoidal syndrome decreased by 80% to 92%. HD grade showed a significant reduction. Conclusion: The diode laser surgery can be viewed as an effective treatment for patients with haemorrhoids and anal fissure. Haemorrhoidal laser surgery is newly potential approach and patents are getting benefitted from this treatment and this can be adopted as a modality of treatment for Hemorrhoids and anal ......
Soft Tissue Pseudotumors: A Pictoral Review
Rim Mahad, Nizar Mennis, Badre Boutakioute, Meriem Ouali Idrissi, Najat Cherif Idrissi El Ganouni
Sch J App Med Sci | 670-679
DOI : 10.36347/sjams.2021.v09i05.009
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Several pathological entities can present clinically as a soft tissue mass. These tumor- mimicking lesions, also known as pseudo-tumors, can be defined as clinically palpable masses or lesions that have tumor-like appearances on imaging. The advances in cross sectional imaging (ultra-sound, CT and MRI) play an important role in the correct evaluation of soft tissue pseudotumors. That means that in a growing number of situations, we can accurately determine not only the usual information of tumor size and topography, but often the exact nature of the tissue, almost always identifying whether a lesion is aggressive or not. Recognizing soft tissue pseudotumors on imaging may prevent more invasive actions and additional anxiety to the patients. In this pictorial essay we aim to provide a review of common soft tissue conditions which may mimic malignant tumors by classifying them into categories using an anatomical sieve.
Synovial Sarcoma of Parotid Gland: Very Rare Cause of Malignant Tumors of the Neck in Children
S. Ouassil, B. Bannar, B. Zouita, D. Basraoui, H. Jalal
Sch J App Med Sci | 680-683
DOI : 10.36347/sjams.2021.v09i05.010
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Synovial sarcoma is an unusual malignant tumour, derived from soft tissue mesenchymal cells,It arises most commonly in the deep soft tissues of lower extremities, especially in the region of the lower thigh, with a predilection for sites in proximity to large joints, such as the knee and ankle. Only 3% to 10% of all synovial sarcomas occur in the head and neck region. Primary synovial sarcoma of the parotid gland is exceptionally uncommon, with few cases reported in the literature. We report the case of a 10-month-old infant, who consulted for right parotid swelling evolving for 1 month, rapidly increasing in size without inflammatory signs or deterioration of the general condition. Ultrasound, CT and MRI were done showing a locally infiltrating lesion process. The infant underwent a biopsy with immunohistochemical study confirming the diagnosis of synovial sarcoma of the right parotid gland.
Sever’s Disease
M. Ouali Idrissi, S.Ouassil, B.Boutakioute, N. Cherif Idrissi El Ganouni
Sch J App Med Sci | 684-685
DOI : 10.36347/sjams.2021.v09i05.011
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Sever’s disease, also known as calcaneal apophysitis or calcaneoapophysitis, was first described by Haglund1 in 1907, it has been described in various ways and attributed to a variety of causative factors. We report a case of a 15-year-old adolescent who presented with bilateral mechanical talalgia and whose diagnosis was made by standard radiography.
Intestinal Occlusion on Fistulized Meckel's Diverticulum with Bridle
Abdelaziz Hebbezni, Soumia Arharas, Badr Boutakioute, Meriem Ouali Idrissi, Najat Cherif Idrissi Ganouni, Adil Habbab, Chanfir Abderrahim, Nabil Tirizit, Asmaa Hamri, Youssef Narjis, Redouane Benomar
Sch J App Med Sci | 686-688
DOI : 10.36347/sjams.2021.v09i05.012
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Meckel's diverticulum is the partial persistence of the omphalomenteric duct. It can be complicated by infection, perforation or fistulization thus creating an occlusion. We report the case of a 32-year-old patient presenting with intestinal obstruction and whose intraoperative finding was an occlusion on fistulized Meckel's diverticulum with bridle. The post-operative consequences are simple.
Music Therapy, As an Adjunct Therapy to Conventional Treatment Modalities in the Management of Fear Factor and Anxiety in COVID-19
Dr. Sangeeth Somanadhapai
Sch J App Med Sci | 689-694
DOI : 10.36347/sjams.2021.v09i05.013
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The emotion of fear and anxiety is the body’s basic mechanism to deal with the feeling of threat, danger or motivational conflict. In COVID-19, the main risk factors for fear and anxiety are uncertainties, updates from world bodies on health, the unknown reality, new practices, social isolation, lack of healthcare facilities and the hype around the pandemic created by the media. Drug therapy, Cognitive behavioural therapy and some non-pharmacological approaches help to treat the anxiety created by the pandemic. However, most of them are expensive and have side effects. In comparison, use of an intervention in the form of music could have advantages. Music could be administered as a ‘music medicine’ without a trained therapist or as a therapy with a therapist. Music therapy helps to improve the coping abilities, reduces the feeling of psychological distress and imbibes positive thoughts. In COVID-19, patients spend a long time in self-isolation and these periods of social isolation could trigger anxiety or fear. Music therapy could be a useful approach here. However, there is still a paucity of data on the possible role of music as an adjunct therapy for reducing fear and anxiety in COVID-19. The present article discusses some key aspects of the role of music in reducing COVID-19 related fear and anxiety.
Original Research Article
May 18, 2021
Laparoscopic Management of Impalpable Testis: A Single Center Experience
Amer alibrahim, Ahmad Abo Gora, Salim masadeh, Hiba Alabadi, Bahaa Abdulla
Sch J App Med Sci | 695-698
DOI : 10.36347/sjams.2021.v09i05.014
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Background: Undescended testis is a common abnormality, affecting 3–5 % of male infants at birth. Elongation of the testicular vessels is an important point in considering the procedure of choice. Fowler and Stephen showed that the division of testicular vessels, as high as possible to maintain collateral blood supply as the best way to manage high intra-abdominal testis. Moreover, single stage orchidopexy either laparoscopic assisted or open is another choice. In addition to orchidectomy. all of them made the study worthy for a definite diagnostic step to have a definite plan of your patient. Objective: To illustrate our experience on Queen Rania Al Abdulla hospital for children in the management of impalpable undescended testis according to the diagnostic laparoscopic findings. Method: We performed a retrospective data analysis of the medical records of 108 patients who underwent diagnostic laparoscopic for intraabdominal high testis in our department from august 2015 to February 2019 according to the findings we decide how to go for the definite procedure with the best outcomes. Result: The total number of children who underwent laparoscopy is 108 patients, however 18 have bilateral impalpable testes. One third of them was right sided and two third was left side impalpable testis. Then we classify the patients according to the presence of testis intraoperative, 55 testis have vas and vessels passed through the ring for which we explore the inguinal area. Furthermore, 51 has orchidopexy with good size testis and 4 testis underwent orchiectomy as the testis was atrophied. On the other hand, we found 16 atrophied testis intraabdominal for this we did laparoscopic removal. For the 55 viable testis 50 of them underwent first stage Fowler stephens procedure and the remaining 5 testis underwent primary laparoscopic orchidopexy. Conclusion: Laparoscopic exploration of the impalpable testis is the cornerstone in the management and treatment of impalpable testis ...
Adenoid Cystic Carcinoma of the Submandibular Gland: A Case Report
Niema Benkhraba, Najwa Belhaj, Mohamed Ali Gliti, Sophia Nitassi, Bencheikh Razika, Benbouzid Mohamed Anas, Abdelilah Oujilal, Leila Essakalli Houssyni
Sch J App Med Sci | 714-718
DOI : 10.36347/sjams.2021.v09i05.017
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Tumors of the salivary gland are comparatively rare, comprising less than 3% of all tumors. The distribution of tumors in the major salivary glands varies by site, with 85% to 90% occurring in the parotid gland, 10% to 15% occurring in the submandibular gland, and only 1% occurring in the sublingual gland. There is a higher incidence of malignancy in submandibular and sublingual tumors as compared with parotid tumors. Adenoid cystic carcinoma (ACC) is a malignancy of the seromucinous glands of the head and neck, accounting for 35% to 43% of malignant submandibular gland neoplasms. The majority of patients with ACC present with an asymptomatic mass that may have been present for months or even years prior to diagnosis. Adenoid cystic carcinoma is well known for its indolent pattern of recurrence and propensity for pulmonary metastases. Furthermore, it has a prolonged natural history and is slow growing even when there has been local recurrence and distant metastases. We report the case of a 46-year-old patient diagnosed with adenoid cystic carcinoma of the submaxillary gland, evolving for 5 years.
Original Research Article
May 23, 2021
The Negative Impact of COVID-19 on Adenoids and Tonsil Samples Received At a Pathology Deparment in a Tertiary Health Institution, South-South, Nigeria
Adekanye Abiola Grace, Omotoso Ayodele Joshua, Ugbem Theophilus Ipeh, Odusolu Patience, Ekpe Lawson Ekpe, Akaba Kingsley, Kooffreh-Ada Mbang, Oshatuyi Olukayode, Ogunlola Oluwadamilola D, Akpan Margar
Sch J App Med Sci | 719-722
DOI : 10.36347/sjams.2021.v09i05.018
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Background: The burden caused by the world most recent novel virus, COVID-19 has been a major concern in the health sector, paralyzing the arms of functioning health facilities, public, private and federal. This single stranded RNA virus originated from Middle East, causes severe acute respiratory syndrome. It is reported to be the fastest spreading virus ever recorded worldwide because of its mode of transmission. Nose, nasopharynx and oropharynx are the common port of entry for COVID-19 into human body. Operation at these anatomical sites exposes health personnel to COVID-19 infection especially in facilities where protective equipment is very scarce. Adenotonsillectomy is one of the commonest surgeries performed in children for inflammatory pathologies or neoplasms affecting adenoids and tonsillar. Objectives: This study is to determine the prevalence of adenoid and tonsil cases seen Pre and Post-COVID-19 era, and to compare the number of Pre and Post-COVID-19 adenoid and tonsil specimen received from the Otorhinolaryngology department of our health institution. Methodology: Data on adenoids and tonsillar tissues submitted for histological evaluations were retrieved from the Department of Pathology histology Registers, University of Calabar Teaching Hospital. Pre-COVID-19 era data collected was from January 2009- December 2019 (eleven years), and Post-COVID-19 was from January 2020- January 2021(one year). Data analysed using IBM Statistical Product and Service Solution version 26.0, and results were represented in both descriptive and tabular forms. Result: Our results show that less than half of average samples received in pre-SAR CoV2 era compared to what was received during the era. Conclusion: There is significant reduction in the number of adenoids and tonsillar operations and hence decreased number of tissues submitted for histological evaluation. However, it is highly commendable that the reduction is barely half despite paucity of personal protective...
Original Research Article
May 23, 2021
Effect of Mildronate on the Existence and Severity of Fatigue in Patients with Heart Failure
Ann Rekhviashvili, Tamar Kandashvil, Tamar Giorgobiani
Sch J App Med Sci | 723-730
DOI : 10.36347/sjams.2021.v09i05.019
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Heart failure (HF) is one of the major causes of morbidity and mortality in the world. Fatigue is frequently associated with the HF and causes disability, decreased motivation and life quality etc. Aim of the study was to evaluate effect of combination therapy with recommended HF therapy and Mildronate 1000mg/day for 3 months on systolic function of the heart and fatigue level. A non-probabilistic sample of 100 adult patients with HF with reduced ejection fraction (HFrEF) being on the recommended HF treatment according to the current HF management guidelines were involved in a cross-sectional observational study. All the patients underwent to the add on therapy with Mildronate 1000mg/day for 3 months. For assessment of fatigue existence and its severity has been used the 30-item Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Heart ultrasound and MSFI-SF was performed twice – in the beginning and after 3 months from onset of combination treatment. Combination treatment including Mildronate significantly improved EF and decreased MFSI-SF score (P<0.0001). There was observed significant improvement of fatigue, remembering things and muscle ache (P<0.0001). There was significant improvement in patients’ feelings of being upset, nervous, pooped, confused, sad, depressed, tensed and/or distressed (P<0.0001). EF level was positively correlated with the severity of cheerful, relaxed, refreshed and energetic feelings assessed from 0 to 4 points. Hence, EF was negatively correlated with the severity of trouble remembering things, concentrating and paying attention, muscles ache, feel upset, nervous, pooped, confused, sad, fatigued, depressed, tensed and tired, forgetfulness, weakness in legs and hands. We recommend to use MSFI-SF scale for assessment of existence and severity of fatigue in patients with HFrEF before and after treatment to evaluate the benefit of the treatment. Mildronate as an add-on agent on the standard HF treatment showed strong ability..
Original Research Article
May 23, 2021
Assessment of Anatomical Variation of Renal Vessels Using Multidetector Computed Tomography
Taef Alahmadi, Suhaila Alrddadi, Najd Alotebi, Samara Najdi, Safaa Mohammed
Sch J App Med Sci | 731-735
DOI : 10.36347/sjams.2021.v09i05.020
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Study of renal artery variations and determine the pattern and incidence of renal vessels variation in Saudi Arabia in the period from February 2021 to April 2021. The sample size of this study was 50 individuals (100 kidneys). The mean ± STD for age was 44.84± 18.38, for right kidney length and width was 8.63±1.84 and 4.62±0.71, for left kidney length and width was 8.84±2.02 and 4.89±1.53. for right renal artery length and width was 5.41±1.42 and 1.57±2.21, for right renal vein length and width was 3.92±1.47 and 1.52±1.26. for left renal artery length and width was 4.66±1.68 and 1.31±1.23, for left renal vein length and width was 7.19±1.54 and 1.51±0.69. Analysis of variance for patients age with measurements information's, were the p.value showed no significant difference between the patients age with right kidney length (p.value = 0.547), and left renal length and width (0.999) and (0.897), the right renal length for artery and vein showed no significant difference with age (0.370 and 0.405). for left renal artery length and vein length and width showed no significant difference with age where the p.value was (0.82, 0.117). while p.value show significant difference between the patients age with right kidney width, right kidney artery width, right renal vein width, left renal artery width and left renal vein width were the p.value was 0.035, 0.003, 0.000, 0.021 and 0.019. The study concluded that the renal arteries present a broad spectrum of variability in Saudi Arabia in their morphological expression regarding their length, level of ramification, diameter and entrance to the kidney parenchyma.
Original Research Article
May 24, 2021
Biochemical Parameters in Detecting Malnutrition and Inflammatory Markers in CAPD Patients
Mekhola MH, Chowdhury MAA, Alam KS, Alam MB, Akbar AAG, Saha S, Hossain MS, Rahman MH, Sultana M, Rahman MR, Tahsin S, Shahriar S, Sukur MA
Sch J App Med Sci | 736-740
DOI : 10.36347/sjams.2021.v09i05.021
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Background: The nutritional status of dialysis patients can be determined by biochemical Parameters, anthropometry, protein catabolic rate, and body composition methods. Over the past decade, various nutritional parameters have emerged. Objective: The aim of the study was evaluation of biochemical parameters in detecting Malnutrition and Inflammatory Markers in CAPD Patients. Methods: The cross-sectional study was conducted in the Department of Nephrology of National Institute of Kidney Diseases and Urology, Dhaka, Bangladesh to Detect Malnutrition and Inflammatory Markers in CAPD Patients. They were identified based on hospital registry and Peritoneal Dialysis service provider. 69 cases were randomly selected for the study. Clinical examination and evaluation were done from July 2018 to June 2019. Other necessary investigations were done if clinically indicated. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Out of 69 patients 39 were male (56.5%) and 30 were female (43.5%). 49.3% were diabetic, 30.4% had GN, 15.2% had HTN & 2.9% had OU & 1.4% had PKD. Mean Hb of Patients were 9.48 ± 1.77 (g/dl). Mean S Creatinine was 9.32 ± 3.94 (mg/dl). Mean CRP was 23.73 ± 26.67. Mean Albumin was 3.11 ± 0.60 (mg/dl). Mean Prealbumin was 0.30 ± 0.11 (ng/ml). Mean TIBC was 165.8 ± 59.5. S-albumin & S-prealbumin was significantly lower in patients with higher MIS-score (>5). Conclusion: Biochemical parameters and inflammatory markers significantly correlate with malnutrition among patients on CAPD.
Erecta Dislocation Following an Epileptic Seizure: A Case Report
Mohamed Badr Errachid, Youness Dahmani, Reda Lah Bassir, Moncef Boufettal, M. O. Lamrani, M. Kharmaz, M. S. Berrada
Sch J App Med Sci | 741-742
DOI : 10.36347/sjams.2021.v09i05.022
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Erectal dislocation is a rare dislocation of the shoulder, even rarer by the mechanism of seizure. We report the case of an erect dislocation after epileptic seizure in a young man complicated by axillary nerve palsy with partial recovery in the medium term after reduction. The aim of our work is to highlight the diagnostic and prognostic features of this dislocation.
Pseudotumoral Neurosarcoidosis
M.Badaoui, A.Aljalil, Z.Chahbi, S. Kaddouri, H. Qacif, M. Zyani
Sch J App Med Sci | 743-745
DOI : 10.36347/sjams.2021.v09i05.023
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Sarcoidosis is a systemic granulomatosis characterized by predominantly mediastinopulmonary involvement. Neurological involvement is reported in 5-16% of cases with predominant involvement of the central nervous system. The pseudotumoral form is only reported in 10% of neurological forms, and poses a real diagnostic problem, as is the case with our present observation. Observation: 77-year-old patient hospitalized for treatment of right hemiparesis with aphasia. In his ATCDs, we retain a follow-up for an undetermined psychiatric condition. The onset of the disease dates back 5 months after his hospitalization with the sudden onset of right hemiplegia accompanied by generalized tonicoclonic convulsive seizures, with secondary recovery of the motor deficit and the onset of extra-pyramidal syndrome. Imaging finds the presence of several cerebral lesional processes and at the thoracic level, nodular lesions especially of the 2 upper lobes without mediastinal lymphadenopathy. The laboratory results were normal apart from an inflammatory syndrome and lymphopenia. Stereotaxic biopsy showed chronic inflammatory changes with ischemic necrosis without tumor lesions. Discussion: Pseudotumoral neurosarcoidosis is rare and difficult to diagnose, especially in the absence of characteristic extra neurological involvement. The histological study can find 2 aspects: classic granuloma or rarely lesions of ischemic necrosis. Treatment is based on glucorticoids and in case of resistance, intolerance or dependence, immunosuppressants (methotrexate, cyclophosphamide).
Original Research Article
May 30, 2021
Evaluation of CT Perfusion for the Diagnosis of Hepatocellular Carcinoma in a Teaching Hospital
Dr. Anu Sarah Easo, Dr. Rajeev Anand, Dr. Jerrin Thomas
Sch J App Med Sci | 746-750
DOI : 10.36347/sjams.2021.v09i05.024
Abstract
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CT perfusion, the measurement of blood flow characteristics through dynamic CT acquisitions following intravenous administration of contrast agents, can easily be integrated into routine CT imaging protocols within the same imaging session. Clinical applications of CT perfusion imaging for earlier detection of hepatocellular carcinoma are being assessed in this study. The study was conducted in the department of Radiodiagnosis MOSC medical college, Kolencherry from January 2018 to March 2020. Total 56 patients were included in the study. Imaging done on 64 slice CT. For Analysis, data were processed at a workstation. Functional maps of HBF (hepatic blood flow), HBV (hepatic blood volume), MTT (mean transit time), TTP (time to peak), HPI (hepatic perfusion index) and PSAP (permeability surface area product) were generated. Statistical analysis has been carried out in the present study. Wilcoxon signed rank test was used to compare the perfusion parameters of HCC (hepatocellular carcinoma) and background liver parenchyma. All data were expressed as mean ± SD, and statistical analysis was performed with RStudio. Wilcoxon-signed ranks test (nonparametric test) of variance was used to compare the differences in CT perfusion parameters. P < 0.05 was considered statistically significant. Wilcoxon signed rank test was used to compare the perfusion parameters between the background liver and HCC. In our study there was significant increase in HBF, HBV, PSAP, and HPI whereas TTP and MTT was significantly reduced in HCC compared to background liver.Our results were comparable to the reference studies.