Extra-Skeletal Ewing Sarcoma: Report of Two Cases
Rim Mahad, Meriem Ouali Idrissi, Lkbir Abidine, Badre Boutakioute, Najat Cherif Idrissi El Ganouni
Sch J Med Case Rep | 474-475
DOI : 10.36347/sjmcr.2021.v09i05.001
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Background: Aluminum phosphide is a poison, use as a fumigant to protect stored grain from pests and rodents. It is marketed in Morocco as 3 g tablets under PHOSTOXIN® brand names. Once ingested, it is acutely toxic with a high mortality. When aluminium phosphide comes in contact with water, it releases large quantities of phosphine (PH3), a very toxic gas and a mitochondrial poison and cause cardiac damage hemodynamic disorders. We report a case of aluminum phosphide associated with reversible myocardial injury. Cases Reports: A 16-year-old woman admitted to hospital following ingestion of aluminum phosphide with the aim of a suicide. The clinical course was characterized by the development of a shock syndrome requiring the use of vasoactive amines drugs et liver dysfunction. The electrocardiogram showed a diffuse ST-depression and repolarization anomaly. The plasma concentrations of cardiac enzymes were elevated and Tran’s thoracic ultrasound showed a global hypokinesis and a severe left ventricular dysfunction. After 9 days of intensive care, the heart function was restored as well as its hemodynamic state and liver function. Conclusion: The severity of the poisoning is judged by the cardiac failure and the unavailability of an antidote. Myocardial injury following AlP is responsible for significant mortality. Reversible myocardial injury following aluminum phosphide poisoning can be seen in some rare cases.
Reversible Myocardial Injury Associated with Aluminum Phosphide Poisoning: Case Report
Kenza Zniber, Abdoulaye Diatta, Dania Srifi, Yasmina Benchekroun, Sofia Kaddaf, Khalid Abidi, Amine Ali Zeggwagh
Sch J Med Case Rep | 476-479
DOI : 10.36347/sjmcr.2021.v09i05.002
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An extra-skeletal Sarcoma (EES) is a rare and rapidly progressive mesenchymal cell tumor in young patients. Histological characteristics are similar to those of Ewing bone sarcoma. Imaging is essential for early diagnosis and evaluation of the preoperative response. Here, we report two cases of young patients in which imaging and histology determined that extra-skeletal sarcoma was involved.
Agressive Esthesioneuroblastoma about A Case
Ihssane Allouch, Hanaa Rahim, Najour Belhaj, Razika Bencheikh, Mohamed Anas Benbouzid, Leila Essakalli
Sch J Med Case Rep | 480-484
DOI : 10.36347/sjmcr.2021.v09i05.003
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Introduction: Esthesioneuroblastomas (ENB) or olfactory neuroblastomas are rare tumors derived from the olfactory epithelium. These tumors have a propensity for local invasion into surrounding structures and distant metastasis, most commonly to the neck, lungs, and bones. We present a case of a 12-year-old child with olfactory neuroblastoma with lymph node metastasis with early recurrence. Case Report: It is a 12 year old child, without pathological history who presented an evolving right nasal obstruction for 8 months, permanent, associated with a rhinorrhea and intermittent epistaxis, associated with a mass of the ipsilatéral parotid and the submandibular region. The patient underwent a nasosinnus and cervical scan, a biopsy under general anesthesia, an anatomopathological study with immunohistochemistry which were in favor of esthesioneuroblastoma. Conclusion: ENB is a rare malignant tumor of the nasal cavity. It is characterized by clinical polymorphism and difficulty in histological diagnosis. CT and MRI are one of the therapeutic strategy keys and then to post-treatment monitoring.
Pleomorphic Adenoma of the Inner Side of the Cheek
Ihssane Allouch, Hanaa Rahim, Ikrame Boumendil, Razika Bencheikh, Mohamed Anas Benbouzid, Leila Essakalli
Sch J Med Case Rep | 485-487
DOI : 10.36347/sjmcr.2021.v09i05.004
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The pleomorphic adenoma or mixed tumor is a heterogeneous benign tumor of salivary glands. The parotid gland is its principal localisation, it is rare in accessory salivary glands, with a preferential localisation on the oral mucosa (palate, cheeks and lips). We present a rare case of pleomorphic adenoma of the inner side of the left cheek. This is a 34-year-old patient who presents a mass on the inner left cheek that has been developing for 2 years, painless, without signs of inflammation or fistulization at the level of the oral mucosa and of the opposite skin, examination of the parotid region and peripheral lymph node areas was normal. The patient underwent an ultrasonography (USG) which revealed the presence of a left cheek submucosal mass with a polylobed tissue appearance. A surgical resection was performed and the pathological examination was in favor of pleomorphic adenoma.
Angioneurotic Edema: About A Case
Ihssane Allouch, Ikrame Boumendil, Hanaa Rahim, Sophia Nitassi, Razika Bencheikh, Mohamed Anas Benbouzid, Abdelilah Oujilal, Leila Essakalli
Sch J Med Case Rep | 488-489
DOI : 10.36347/sjmcr.2021.v09i05.005
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Angioneurotic edema is most often hereditary and due to a deficiency of C1 inhibitor (C1 INH). It manifests by recurrent episodes of subcutaneous and / or submucosal edema, non inflammatory and non pruritic, of the face and extremeties or by pseudo-occlusive, spontaneously reversible abdominal seizures. We report the case of a 19-year-old patient who presented a tongue edema which resolved spontaneously, he has in his history, several episodes of reversible face edema, the Exploration of the classical complement pathway during this episode shows a normal C3 and a lower C4.
COVID-19 Test in Bangladesh: Psychological Factors
M.M.A. Shalahuddin Qusar, Monirul Islam, Md. Momin Islam
Sch J Med Case Rep | 490-492
DOI : 10.36347/sjmcr.2021.v09i05.006
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Coronavirus (COVID-19) disease is a highly contagious disease and has a serious psychological impact and mental health problems throughout the entire world. The aim of this study is to find out the Psychological factors which are responsible for the decreasing rate of COVID-19 tests in Bangladesh. A nationwide online survey was conducted during April 2020 to June 2020 by a magazine related to mental health named “Moner Khbor”. Among 560 participants who gave their opinion about the reluctance of testing COVID-19, 65% were male and 35% female. 23.57% participants think that the rate of COVID-19 test is decreasing due to facing lots of troubles and harassments during test procedure. 22.32% participants believed that people lost their credibility per test and 16.07% believed that the risk of infection increases when they go to hospital for a test. Several psychological reasons were found from that survey which is responsible for the decreasing rate of COVID-19 tests in Bangladesh.
Submandibular Desmoid Tumor in Children: A Case Report
H.Kabbaj, Z.Aziz, F.Fettal, M. Elbouihi, N. Mansouri- Hattab
Sch J Med Case Rep | 493-496
DOI : 10.36347/sjmcr.2021.v09i05.007
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Desmoid tumors also called fibromatosis of the face are very rare especially in children. These tumors although benign are known to be reccurent and very aggressive locally so they can be confused with malignant tumors. Several treatments can be offered, but only surgery with a complete excision remains the guarantee of a complete remission. Case report: We present a case of mandibular desmoid tumor in a 2-year-old girl who presented with left mandibular mass rapidly increasing in volume. After the biopsy has confirmed the nature of the tumor, surgical treatment has been proposed thus proceeding with the complete excision of the tumor. The postoperative follow-up was simple. No recurrence was recorded 2 years after the operation. Conclusion: The treatment of a desmoid facial tumor in children is difficult, all the more so as the tumor is large or locally aggressive. Wide excision is the only guarantee of a good evolution even if it can compromise the growth potential.
Immediate Allergic Reaction to Hydrocortisone Hemisuccinate: About A Case and Literature Review
Nezha Reguig, Laila Herrak, Meryem Berkchi, Younes Amchich, Mustapha EL Ftouh, Leila Achachi
Sch J Med Case Rep | 497-499
DOI : 10.36347/sjmcr.2021.v09i05.008
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Corticosteroids are widely prescribed in the treatment of respiratory or allergic pathologies due to their anti-inflammatory and immunomodulating properties. Their side effects are well known, but allergic reactions are more rare and unexpected. These reactions can be severe up to anaphylactic shock, toxidermies or serious respiratory manifestations, regardless of their mode of administration. An allergological investigation with tests are necessary to specify the responsible treatment and propose an alternative therapeutic if necessary. We report in this article the case of an immediate allergy to hydrocortisone hemisuccinate in a patient with asthma.
Ulcerative Colitis Complicated By Budd- Chiari Syndrome: A Case Report
S. Bouchrit, K. Benjouad, Y. Lemfadli, A. Aiterrami, S. Oubaha, Z. Samlani, K. Krati
Sch J Med Case Rep | 500-502
DOI : 10.36347/sjmcr.2021.v09i05.009
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The association of inflammatory bowel disease and thromboembolic events is frequent and secondary to hypercoagulability. Budd–Chiari syndrome has been reported as a rare complication of UC. The incidence of venous thrombosis in UC was found to be 39% in one necropsy study several etiologies are involved, namely coagulopathies and inflammation, the diagnosis is based on imaging (Doppler and abdominal CT). The prognosis depends on the degree of hepatic fibrosis or the interest of an adequate and urgent treatment. We report a case of active ulcerative colitis complicated by hepatic vein thrombosis.
Intussusception in Adults with Small Intestine Leiomyoma: Case Report and Literature Review
Mouna Jaouaher, Soumia Arharas, Badr Boutakioute, Meriem Ouali Idrissi, Najat Cherif Idrissi El Ganouni
Sch J Med Case Rep | 503-505
DOI : 10.36347/sjmcr.2021.v09i05.010
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Leiomyomas are benign tumors that develop in the small bowel, either in the inside or outside of the lumen or the bowel wall. They tend to occur at an age range around fifty years old, although they could occur at all ages, independent of gender. The diagnosis is often late due to the vague clinical manifestations which include: digestive hemorrhage, intestinal occlusion or abdominal mass. The diagnosis is confirmed by an immunohistochemical analysis of the tissue and the positive CD117 markers. The treatment is the surgical excision of the tumor. This study evolves around the case of a 25-year-old patient presenting with an ileum leiomyoma, including the clinical description, diagnosis, treatment and anatomopathology description. What motivated this work is the rarity of leiomymas cases and the difficultly of diagnosis.
Primary Soft Palate Lymphoma: A Case Report of Unique Entity in A Tertiary Institution, South-South, Nigeria
Francis Paul Mambi, Adekanye Abiola Grace, Ugbem Theophilus Ipeh, Mgbe Robert Bassey
Sch J Med Case Rep | 506-509
DOI : 10.36347/sjmcr.2021.v09i05.011
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Lymphomas are malignant neoplasms of the lymphocytic cell lines, involving mainly lymph nodes and also extra nodal sites. They are generally classified as either Hodgkin’s lymphoma, or Non-Hodgkin’s lymphoma; which may be of either B – lymphocyte or T – lymphocyte in origin. Oropharyngeal lymphomas are relatively rare and diagnosis is a challenge. Most frequently arising from the Waldeyer’s ring after gastrointestinal tract is the second most common site for extra nodal lymphomas. We report a case of primary Non –Hodgkin’s lymphoma arising from the soft palate in a 71- year- old male who presented with progressive difficulty in swallowing, slurred speech and choking on lying supine. There was no other lymphomatous lesion detected elsewhere in the body. Postnasal X- ray revealed a pedunculated mass arising from the soft palate down the laryngeal inlet. Excisional biopsy of the lesion showed sections of lymphoid tissue with partial effacement of the architecture replaced by ill- defined follicles and diffused pattern in some areas. Follicles are of various sizes and shapes, containing varying proportions of centrocytes and centroblasts suggestive of follicular mixed type of primary extra nodal lymphoma. Immunohistochemistry confirmed the diagnosis. Our patient has been followed up for 15months and currently doing well.
Huge Thyroglossal Duct Cyst at the Supra-Sternal Notch in Adult Patient: Unusual Location, Unusual Size, and Unusual Age
Adoua Y, Gharnati K, Alaoui G, Zaki Z, EL Alami MN
Sch J Med Case Rep | 515-517
DOI : 10.36347/sjmcr.2021.v09i05.013
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Thyroglossal duct cysts (TGDC), a very common cause of neck mass in children, represent the embryologic remnants of the descending thyroglossal duct. The majority of these swellings are presented as a tumor in the midline, usually located in the infrahyoid region or in close proximity to the hyoid bone. Most appear in children between 2 and 10 years of age; boys and girls are equally affected. Seeing TGDCS in the late second decade of life or later, like in our patient, is a rarity. We present a 37 years old male patient who presented with supra-sternal notch cyst which was diagnosed as TGDC only after histopathology. The rarity of such TGDC in such uncommon site, made us report this case.
Extranodal NK/T-Cell Lymphoma, Nasal Type (Angiocentric T-Cell Lymphoma): A Case Report
Akhana.A, Adoua.Y, Gharnati.K, Kamal.D, Alami.MN
Sch J Med Case Rep | 518-519
DOI : 10.36347/sjmcr.2021.v09i05.014
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NK/T lymphoma is a rare type of non-Hodgkin's lymphoma. It corresponds to a clinical entity with necrosis that starts preferentially in the nasal cavities and the nasopharynx and extends to the centrofacial bone structures. Its anatomopathological diagnosis is not always obvious. Modern immunophenotyping and molecular biology tools have made it possible to isolate this type of lymphoma. Treatment is based on radiotherapy and chemotherapy. Nasosinus localization of T/NK lymphoma is rare. This is the case report of a 18-year-old female patient who presented with nasal obstruction and foul smelling, edema of the right hemiface and an ulcerative lesion over the palate of 4 months duration, which had been treated with antibiotics without success. After performing a number of diagnostic tests, it was found histologically and confirmed by immunohistochemical analysis that the patient had an ENKL, nasal type (also known as angiocentric T-cell lymphoma). Our Purpose of the presentation is To discuss the particularity of this localization, the diagnosis difficulties and therapeutic modalities.
Unusual Case of Inguinal Bladder Hernia: About A Case Report
M. Badraoui, S. Faiz, B. Boutakioute, M. Ouali Idrissi, N. Chefir El Ganouni Idrissi
Sch J Med Case Rep | 520-522
DOI : 10.36347/sjmcr.2021.v09i05.015
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The inguinal bladder hernia is a rare entity and constitutes 1 to 5% of inguinal hernias. Medical imaging is essential to confirm the diagnosis. Treatment consists of hernia surgery with reintegration of the bladder.
Optic Nerve Sheath Meningioma (ONSM): Case Report
M. Badraoui, K. Zitouni, B. Boutakioute, M. Ouali Idrissi, N. Cherif El Ganouni Idrissi
Sch J Med Case Rep | 523-526
DOI : 10.36347/sjmcr.2021.v09i05.016
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Optic nerve sheath meningiomas are rare benign tumors of the central nervous system. The diagnosis of ONSM is confirmed with magnetic resonance imaging (MRI), especially with gadolinium-enhanced fat-suppression sequences. The MRI has become the gold standard for the diagnosis and has obviated the need for tissue biopsy.
Acute Uterine Inversion Secondary to an Intracavitary Leiomyoma: A Rare Gynecologic Emergency
O. Baroud, S. Mahdaoui, K. Ikouch, H. Boufettal, N. Samouh
Sch J Med Case Rep | 534-536
DOI : 10.36347/sjmcr.2021.v09i05.019
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The uterine inversion of gynecological origin is a rare entity and the uterine leimyoma represents its main cause followed by the sarcomas of the uterus. The clinical diagnosis is not always easy and the imaging stays of a big contribution contrary to the puerperal uterine inversions. We report the case of a patient of 48 years which consulted for a pelvic pain and a vaginal bleeding having caused a hemorrhagic shock. The clinical examination had found an intravaginal mass reminding a uterine myoma in necrobiosis and the uterine bottom was not tangible. A laparotomy was done and showed a uterine inversion taking the Fallopian tube. In front of the failure of taxis, a hysterectomy was realized. The last diagnosis was a uterine inversion on intracavitary uterine leiomyoma.
Severe Carbon Dioxide Retention during Laparoscopic Surgery: A Case Report
Ilyass Masad, Atmani Walid, Anass Elbouti, Jaafari Abdelhamid, Mustapha Bensghir
Sch J Med Case Rep | 537-539
DOI : 10.36347/sjmcr.2021.v09i05.020
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Excessive CO2 absorption, severe hypercapnia and acidosis may been countered in patients undergoing laparoscopic surgery. We have witnessed a patient, free of cardiac or pulmonary disease, undergoing laparoscopic surgery, who sustained severe hypercapnia and respiratory acidosis during operation.
Isolated H Reflex Abnormality as the Sole Electrophysiological Marker of Demyelinating Neuropathy at Day -14- A Novel Observation
Sachin Sureshbabu, Nikitha K, Sudhir Peter, Sobhana Chindrippu, Merisin Joseph, Abdurehiman K P
Sch J Med Case Rep | 540-541
DOI : 10.36347/sjmcr.2021.v09i05.021
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Guillian Barre Syndrome (GBS) is a clinical diagnosis with typical electrophysiological features which evolve over 1-2 weeks. H reflex and F wave abnormalities are the earliest to appear. In this report, H reflex abnormality as an isolated feature even after two weeks of illness is an unusual feature which is highlighted by this case report. 38 year old male patient presented with history of antecedent febrile illness presented with progressive weakness of lower limbs of three days duration. He had areflexic proximal more than distal weakness of lower limbs more than upper limbs. Cerebrospinal fluid analysis showed albumin0- cytological dissociation. Nerve conduction study done on day 3 and day 13 showed an absent H reflex despite clinical progression. Patient responded well to immunotherapy. The importance of minor but definitive abnormalities on nerve conduction when collaborated with clinical findings is extremely useful in the clinical diagnosis of GBS.
Arteriovenous Malformation of the External Ear: Case Report
A Diani, B Boutakioute, M Aitchtouk, A El Hajjami, Z Belhaj, M Ouali Idrissi, N Cherif Idrissi Guenouni
Sch J Med Case Rep | 542-544
DOI : 10.36347/sjmcr.2021.v09i05.022
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Arteriovenous malformation (AVM) occurs due to the failure of complete involution of the fetal capillary bed resulting in the development of abnormal connections between arteries and veins (arteriovenous shunting). The most frequent location of arteriovenous malformations in the head and neck is intracranial, they can also occur in the cheek and parotid, ear, nose, forehead, and neck regions. The ear is the second most common location in the head and neck. We report a case of giant AVM of the left pinna in an adolescent, which are very rarely seen. We discussing the definition, clinical findings, diagnostic approaches and therapeutic management of arteriovenous malformations.
Huge Cervical Mass Hiding A UCNT from the Cavum: About A Case
Z.Benyahia, N.belhaj, H. Ait Taleb, R.Bencheikh, M.A.Benbouzid, L.Essakalli
Sch J Med Case Rep | 545-547
DOI : 10.36347/sjmcr.2021.v09i05.023
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An enormous cervical mass by adjacency in nasopharynx cancer is exceptional. This impairment poses difficulties at all stages of care from diagnosis to treatment. It is the consequence of significant tumor aggressiveness. We report the case of a 52-year-old patient presenting to the emergency room with a picture of a huge cervical mass that has been evolving for a week. Several biopsies were performed objectifying a UCNT of the cavum. The patient died before the start of treatment.
A Rare Case of Inverted Papilloma Arising From Middle Turbinate
Vinay S Bhat, Priyanka Singh, Shruti Nadagoud, Abhishek M P
Sch J Med Case Rep | 548-550
DOI : 10.36347/sjmcr.2021.v09i05.024
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Inverted papilloma is a rare benign tumour of nasal cavity and paranasal sinuses. Although it is included in class of benign tumour, it has strong potential for destruction and has a tendency to recur with incomplete resection. It has ability for malignant transformation to squamous cell carcinoma. Here we present a case of an inverted papilloma originating in a rare location i.e. middle turbinate. This report has the objective of emphasizing on the need for debulking of the tumour intraoperatively and then decide on appropriate approach.
Original Research Article
May 22, 2021
Surgical and Evaluationary Aspect of Cryptorchidy at the Service of “Chu of Luxembourg” in Mali
Sidibe S, Touré MK, Simaga A K, Koita S, Coulibaly M, Mariko M, Dramé A I, Doumbia M, Kané A.S.T., Coulibaly Y
Sch J Med Case Rep | 551-553
DOI : 10.36347/sjmcr.2021.v09i05.025
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During this study we have collaged 30 patients the goal of this job was to present therapeutic and evolutionary aspect and the taking in surgical charge of this affection. For that a prospective study has been done for a period of 12 months at the service of surgery “CHU” of Luxembourg Bamako-Mali. 22 Patients have been operated father the age of 2 years and the middle age was 5 years. The cryptorchidy was unnatural for 26 patients and bilateral for 4 patients conventional orchidopexy has been achieved for 29 of our patients and a orhcidectomy for evanxent textiles. The length of the cord was normal of all of our patients and all testes have the level of inguinal superficial orifice.
Pulmonary Arterial Hypertension in An Adult: What Would Be Your Diagnosis?
M. El Biadi, M. Ait Chtouk, M. Belmokadem, B. Slioui, N. Hammoune, E. Atmane, A. Mouhsine
Sch J Med Case Rep | 554-556
DOI : 10.36347/sjmcr.2021.v09i05.026
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Partial anomalous pulmonary venous return (PAPVR) accounts for approximately 3% of all congenital heart disease. Its diagnosis in adulthood is often tricky as long as clinical symptoms are misleading and sonographic signs are discrete and suggestive of pulmonary hypertension. We report the case of a 65-year-old female patient who was diagnosed with pulmonary arterial hypertension on partial abnormal pulmonary venous return on chest CT.
Reversal of Insulin-Requiring Diabetes after the Resection of a Large-Sized, Epinephrine-Dominant Pheochromocytoma, Following 9-Year Treatment of Diabetes without Hypertension
Yuji Aoki, Tomoko Kaneda, Mieko Kumagai, Atsuko Kaneko
Sch J Med Case Rep | 557-560
DOI : 10.36347/sjmcr.2021.v09i05.027
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Hypertension (sustained or paroxysmal) is a cardinal feature of pheochromocytomas, which are rare catecholamine-producing tumors derived from chromaffin cell of the adrenal medulla. We presented a 62-year-old man with diabetes mellitus who was discovered to have a large-sized, epinephrine-dominant pheochromocytoma. The patient had been treated for diabetes without hypertension for 9 years. He was referred to our hospital due to the difficulty in glycemic control, and his computed tomography of the abdomen revealed a 5–cm left adrenal tumor. Plasma and urine levels of catecholamines were elevated and, especially, the epinephrine levels exceeded more than 10 times the upper limit of the reference range. The patient was diagnosed of pheochromocytoma and underwent the left adrenalectomy. Stimulation of α2-adrenergic receptors decreases insulin secretion, which is the feature of epinephrine-associated hyperglycemia. The patient’s insulin-required diabetes was reversed after the tumor resection, and the insulin secretion assessed by serum C-peptide was clearly increased. As demonstrated in this case, epinephrine-dominant pheochromocytomas may have unusual modes of presentation leading to misdiagnosis. Disturbed glucose and insulin metabolism in pheochromocytomas seem not to be well-recognized in general.
Brachial Artery Thrombosis in a Patient with SARS-Cov-2 Infection: Case Report
Abidine L’kbir, Badr Boutakioute , Soumia Arharas, Meriem Ouali, Najat Cherif Idrissi eL Ganouni , Mohamed El-Alaoui , Rachid El Haouati , Drissi Boumzebra
Sch J Med Case Rep | 561-563
DOI : 10.36347/sjmcr.2021.v09i05.028
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COVID-19 is a viral infectious disease caused by SARS-CoV-2, it predominantly presents with respiratory symptoms, but in other cases ,its revealed by vascular presentation ,including deep venous thrombosis , pulmonary embolism, ischemic strokes, ,and arterial thrombosis .However, Limited literature is available regarding arterial thrombosis in COVID-19 disease. Here, we present a case of a 58-year old man who had COVID-19 infection with respiratory symptoms and developed upper limb ischemia. He was managed successfully by thrombolytic therapy.
COVID OR NOT COVID?
Jaber El Kaissi, Noureddine Jebbar, Ayoub Maaroufi, Jaouad Laoutid
Sch J Med Case Rep | 564-567
DOI : 10.36347/sjmcr.2021.v09i05.029
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Introduction: Covid 19 symptoms are not specifics. They may be encountered in other diseases and this may lead to diagnosis confusions. Observation: A 24 years old young male without medical background was admitted to emergency department for shortness of breath. Physical examination found a laborious rapid breathing to 30 breaths/ min and peripheral pulsed saturation was 85 % under room air, blood pressure was about 130 / 70 mmHg, heart rate about 112 beats per minute, and there was no fever. Chest computed tomography was realized and covid19 was suspected. Patient was admitted to isolation room and treated in this way without improvement. rt- PCR was negative to SARS-CoV2 and patient was transferred to non covid intensive care unit . Echocardiography has completely changed the outcome. Conclusion: Being a major public health emergency these days, respiratory symptoms make suspect covid19 first. Focusing on covid19 doesn’t exempt searching other diagnosis. Echocardiography has a beneficial impact on patient with suspected or confirmed covid19. It must figure in the initial assessment of patients.
Original Research Article
May 24, 2021
Allergic Conjunctivitis: Comparison of Four Protocols
Shamil Louaya, Mohammed Badaoui, Said Chatoui, Abdelbarre Oubaaz
Sch J Med Case Rep | 568-572
DOI : 10.36347/sjmcr.2021.v09i05.030
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Allergic conjunctivitis represents one of the most frequently encountered pathologies in daily ophthalmological practice, but despite the evolution of knowledge, its therapeutic management differs according to the practitioners, the aim of our work is to compare four therapeutic protocols in terms of efficiency. Thus, we carried out a prospective study concerning 120 patients followed up for minimal to moderate allergic conjunctivitis, during 08 months, the follow-up made thanks to the scores which we established. For the analysis we were based on adapted statistical tests (SPSS 17.0) the four protocols all by local route are: A (artificial tears), B (antihistamines), C (mast cell anti-granulants) and D (antihistamines associated with anti-granulants). At the end of the work, the four treatment protocols were compared, group D seems the most effective followed by group C then B and last A, 87.5% of patients adhered well to the instructions, in 6.66% a change in protocol was the rule. Minimal to moderate allergic conjunctivitis is a common pathology but too often ignored and untreated, if not on an ad hoc basis. Several studies have shown different results depending on the molecule chosen. Towards a single consensus for the management of allergic conjunctivitis, there is still a way to go. Conclusion to treat allergic conjunctivitis is to prevent chronicization and to confer better well-being on the patient. The antihistamine and anti-granulating combination seems to be one of the most encouraging protocols.
Original Research Article
May 24, 2021
The Non-Steroidal Anti-Inflammatory Drugs after Pterygium Surgery (In About 26 Cases)
Shamil Louaya, Mohammed Badaoui, Said Chatoui
Sch J Med Case Rep | 573-574
DOI : 10.36347/sjmcr.2021.v09i05.031
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The pterygium is a new conjunctival triangular formation, the etio-pathogenesis is multifactorial and whose treatment is surgical but maybe complicated by postoperative recurrence. We conducted a prospective study of 52 eyes of 52 patients undergoing single pterygium by excision with conjunctival -limbic autograft, these patients were divided into two groups, the first having used non-steroidal anti-inflammatory drugs (Gp-NSAIDs) postoperatively for 1 month and the second without NSAIDs (Gp-Without). Thus, we could not demonstrate a beneficial effect of the use of non-steroidal anti-inflammatory drugs after pterygium surgery since we objected to a recurrence rate of 19% overall (15% for Gp-NSAID vs 23% for Gp- Without) with no statistically significant difference (p = 0.496) and regardless of gender or age.
Legg-Perthes-Calvé Disease: A Case Report with Review of the Literature
ABBA Abbasse, NIASSE Moustapha, DIABY Ladji Mohamed, ALI Hassan
Sch J Med Case Rep | 575-580
DOI : 10.36347/sjmcr.2021.v09i05.032
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Legg-Perthes-Calvé disease (LPC) or primary hip osteochondritis (PHO) is an ischemic necrosis of the upper femoral epiphysis. It was described in 1910 simultaneously by Legg in the USA, Calvé in France, Perthes in Germany and Waldenstroem in Sweden. It is a serious and disabling disease. It attacks the upper extremity of the growing femur, and evolves in four phases: condensation, fragmentation, repair, and deformation. The frequency of this disease is not well known and varies according to the authors between 1 in 2000 in Europe and 1 in 5000 in black Africa. Legg-Perthes-Calvé disease is a hip disorder of children between three and ten years of age, with the majority of cases occurring in children under 14 years of age. The sex ratio is 4 boys to 1 girl and the mean age of diagnosis is 6.5 years. We report the observation of a 13 year old female patient who presented for 4 years after a road accident with mechanical pain involving the hips.
Primary Gougerot-Sjögren's Syndrome Revealed by an Ischemic Stroke in a Premenopausal Woman: A Case Report with Review of the Literature
ABBA Abbasse, NIASSE Moustapha, DIABY Ladji Mohamed, ALI Hassan
Sch J Med Case Rep | 581-586
DOI : 10.36347/sjmcr.2021.v09i05.033
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Gougerot-Sjögren's syndrome (GSS) is a systemic autoimmune disease whose target is the epithelium of the exocrine glands and in particular the salivary glands. As a result, the condition is referred to as autoimmune epithelitis [1]. GSS is manifested by a symptomatic triad of dryness, pain and fatigue and may be complicated by systemic complications in 30-50% of patients [2]. Neurological involvement is found in 10-60% of primary Gougerot-Sjögren's syndromes, with highly polymorphic presentations, which may involve both the peripheral and central nervous systems [3]. Involvement of the central nervous system is very rare, affecting less than 5% of patients, and may result in clinical pictures similar to multiple sclerosis [4]. The aim of our study is to illustrate, through a clinical case, the interest of evoking Primary Gougerot-Sjögren's Syndrome in the face of an attack on the central nervous system, in this case an ischemic stroke. The methodology was the study of the clinical file of a patient consulted in the rheumatology department of the CHU Aristide LeDantec in Dakar, Senegal in 2020.
Multifocal Nodular Fatty Infiltration of Liver: Approach to a Radiological Masquerader
Dr. Ravi Shanker Singh, Dr. Lokesh Meena, Dr. Jayendra K Arya, Dr. Anurag Modi, Dr. Swarnava Tarafdar
Sch J Med Case Rep | 587-590
DOI : 10.36347/sjmcr.2021.v09i05.034
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Fatty infiltration of liver is a common metabolic abnormality; which usually follows a diffuse pattern. However; in very rare cases; it may present as multiple focal hepatic lesions which may be mistaken for hepatic metastases on imaging. An accurate diagnosis is therefore vital for predicting prognosis and subsequently appropriate treatment. In this case report we are presenting a case of a young adult female patient who presented to our institution with the clinical complaint of pain in abdomen. She had past history of renal transplant for chronic kidney disease followed by intake of oral glucocorticoids for over 2 years. She was eventually investigated with various imaging modalities including ultrasound scan of abdomen as well as MRI scan of abdomen. Based on the imaging findings; a diagnosis of multifocal nodular hepatic steatosis was given.
Duplicated Appendix, a Challenge Diagnosis: About 2 Cases Report
Hanaa Khir Allah, Aiat Llah Skiredj, Fadoua Boughaleb, Assia mouad, Freddy niyongery, Fouad Ettaybi, Hicham Zerhouni
Sch J Med Case Rep | 591-593
DOI : 10.36347/sjmcr.2021.v09i05.035
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Introduction: Appendix duplication is an extremely rare congenital anomaly that is seen in 0.004% to 0.009% of appendectomy specimens. Even though the abnormality is rare, it is essential to make the diagnosis. Cases report: the first atient is a child of 07 years- old admitted for acute abdomen, The diagnosis of acute generalized peritonitis was retained with clinical and ultrasound arguments, a midline laparotomy showed 2 appendices in different position. The second was 14years old boy, presented to our department with appendicular syndrom, Mac Burney incision found duplicated appendix. Discussion: Preoperative diagnosis of a duplicated appendix is not easy at all for the surgeons and radiologists. Awareness of the Cave-Wallbridge classification system may assist surgeons in diagnosing appendiceal duplication, especially the type B duplication which presents the largest risk of misdiagnosis and may result in serious adverse patient outcomes and medicolegal consequences. Conclusion: Appendiceal duplication although rare and difficult to diagnose preoperatively, should be checked while operating for appendicular pathology in order to avoid serious clinical and medicolegal implication.
Primary Gougerot-Sjögren's Syndrome Revealed by an Ischemic Stroke in a Premenopausal Woman: A Case Report with Review of the Literature
ABBA Abbasse, NIASSE Moustapha, DIABY Ladji Mohamed, ALI Hassan
Sch J Med Case Rep | 594-599
DOI : 10.36347/sjmcr.2021.v09i05.036
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Gougerot-Sjögren's syndrome (GSS) is a systemic autoimmune disease whose target is the epithelium of the exocrine glands and in particular the salivary glands. As a result, the condition is referred to as autoimmune epithelitis. GSS is manifested by a symptomatic triad of dryness, pain and fatigue and may be complicated by systemic complications in 30-50% of patients. Neurological involvement is found in 10-60% of primary Gougerot-Sjögren's syndromes, with highly polymorphic presentations, which may involve both the peripheral and central nervous systems. Involvement of the central nervous system is very rare, affecting less than 5% of patients, and may result in clinical pictures similar to multiple sclerosis. The aim of our study is to illustrate, through a clinical case, the interest of evoking Primary Gougerot-Sjögren's Syndrome in the face of an attack on the central nervous system, in this case an ischemic stroke. The methodology was the study of the clinical file of a patient consulted in the rheumatology department of the CHU Aristide LeDantec in Dakar, Senegal in 2020.
Schwannoma of Median Nerve at Palmar Wrist: A Case ReportSchwannoma of Median Nerve at Palmar Wrist: A Case Report
Mohamed Badr Errachid, Ismail Kebbaj, Reda Lah Bassir, Moncef Boufettal, M. Kharmaz, M. O. Lamrani and M. S. Berrada
Sch J Med Case Rep | 600-602
DOI : 10.36347/sjmcr.2021.v09i05.037
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Schwannomas are rare benign tumors posing differential diagnosis problem with carpal tunnel syndrom if it presents complications such as numbness and tingling or neurofibromatosis especially when shwannomas are multiple. We present a case of woman presenting swelling of the palmar aspect of wrist with functional signs guiding the clinical diagnosis of carpal tunnel syndrom. On MRI the mass was well encapsulated to sharp limits without any peritumoral edema. The diagnosis was confirmed at histological exam after surgical intervention. However, It is essential to have a presumption diagnosis of schwannoma oriented by imaging such as ultrasound and especially MRI to have an idea on the dissection of the tumor, the schwannoma being easily resectable with easy dissection from the nerve fibers that surround it, while neurofibromatosis requires sacrifices of nerve fibers due to difficult dissection. Only surgical resection is considered a curative treatment. Generally, there are no sequelae of postoperative paresthesia, long-term recurrence or degeneration.
An Incidental finding of Intraosseous Lipoma of Ilium: A Rare Case Report and Literature Review
Meryem Ranib, Meriam Benzalim, Soumaya Alj
Sch J Med Case Rep | 603-606
DOI : 10.36347/sjmcr.2021.v09i05.038
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Intraosseous lipoma is a very rare benign bone lesion, which constitutes not more than 0.1% of all bone tumors. The majority of cases are located in the metaphyseal region of the long bones in the lower limbs and is usually identified as an incidental roentgenographic finding. We report a rare case of intraosseous lipoma of the ilium in a 33‑year‑old male, accidentally discovered during a lumbar MRI for hyperalgesic sciatica, the diagnosis was established due to the characteristic radiological features objectified by MRI and CT.
Holoprosencephaly Alobar: A Case Report
Meryem Ranib, Btissam Zouita, Anas Chehboun, Nidale Hazzab, Mounir Bourrous, Dounia Basraoui, Hicham Jalal
Sch J Med Case Rep | 607-609
DOI : 10.36347/sjmcr.2021.v09i05.039
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Holoprosencephaly is a rare congenital brain malformation resulting from failure of diverticulation and cleavage of primitive prosencephalon which occurs at 4 - 8th week of gestation and is usually associated with multiple midline facial anomalies. It is the most common forebrain developmental anomaly in humans and a worldwide distribution. The etiology of HPE is very heterogeneous. Clinical expression is variable, extending from a small brain with a single cerebral ventricle and cyclopia to clinically unaffected carriers in familial holoprosencephaly. Here, we report neonatal case of holoprosencephaly alobar of premature girl 34t week, with microcephaly, flat nose, a single nostril, midline cleft lip palate and choanal atresia.
Post-mortem Diagnosis of Pyruvate Carboxylase Deficiency by Exome Sequencing in a Family with three Deceased Children: A Case Report
Siham Chafai Elalaoui, Jaber Lyahyai, Abdelali Zrhidri, Ilham Ratbi, Abdelaziz Sefiani
Sch J Med Case Rep | 610-613
DOI : 10.36347/sjmcr.2021.v09i05.040
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Pyruvate carboxylase (PC) deficiency (OMIM, 266150) is a rare autosomal recessive disorder. It is characterized by developmental delay, failure to thrive, metabolic acidosis, and recurrent seizures. Hypoglycemia is an inconsistent finding. PC deficiency is divided in three clinical subtypes: an infantile form (Type A), a severe neonatal form (Type B), and a benign form (Type C). It is due to biallelic mutations in PC gene. In this study, we report the case of a Moroccan nonconsanguineous patient with hypotonia and metabolic acidosis. They had two deceased sibs with same phenotype and no accurate diagnosis. Clinical exome sequencing identified a compound heterozygous mutation c.2278C>T (p.Arg760Trp) and c.2602G>A (p.Gly868Arg) of PC gene leading to a post-mortem diagnosis of Pyruvate carboxylase deficiency. The identification of the genetic substrate in the deceased patient confirmed the clinical diagnosis of Pyruvate carboxylase deficiency and allowed appropriate genetic counseling to the family for future pregnancies. This case is the first observationof a post mortem case of familial PC deficiency, and it relates the importance of Next Generation Sequencing in post mortem diagnosis of patients with uncertain diagnosis.
Cerebellar Syndrome Revealing Carcinoma of The Cavum
M. Badaoui, A.Aljalil, Z. Chahbi, S. Kaddouri, H. Qacif, M. Zyani
Sch J Med Case Rep | 614-616
DOI : 10.36347/sjmcr.2021.v09i05.041
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Subacute cerebellar degeneration is one of the classic paraneoplastic neurological syndromes. It may be isolated or is only part of a larger nervous system involvement. We report the observation of a 45-year-old patient with no pathological history who presents an isolated cerebellar syndrome that has progressed for 3 months and has gradually worsened. Cerebral MRI found, in addition to cerebellar atrophy, thickening of the lining of the cavum which led to an ENT examination with biopsy of the cavum allowing confirmation of the undifferentiated corcinoma of the UCNT type. The patient was referred to the oncology department for management. Depending on the clinical and immunological criteria, different sub types of paraneoplastic cerebellar ataxias can be defined. These syndromes correspond to an autoimmune process originally directed against the tumor. They often have a devastating and irreversible course because they are accompanied very quickly by neuronal degeneration. Two therapeutic axes have been proposed: immunosuppressive therapy and tumor treatment. The prognosis of these syndromes can only be improved with the fastest possible diagnosis and treatment of cancer.
Autoimmune Hemolytic Anemia Complicating Castleman's Disease A Case Report
M.Badaoui, A.Aljalil, Z.Chahbi, S. Kaddouri, H. Qacif, M.Zyani
Sch J Med Case Rep | 617-618
DOI : 10.36347/sjmcr.2021.v09i05.042
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Anemia in Castelman's disease has multiple etiologies. The occurrence of autoimmune hemolytic anemia is rarely reported. We present the case of a 49-year-old patient known to have had Castelman's disease for 12 years, and who presented with acute hemolytic anemia. AHAI is believed to be secondary to a profound disorder of cellular immunity and to the production of autoantibodies by B cells under the effect of the overproduction of IL6. Treatment is usually with corticosteroid therapy.
