Granulosa Cell Tumors of Ovary – A Systematic Review
Biju Azariah M, Manisha Verma, Anuja Kapoor, Jayaprakash PG
Sch J Med Case Rep | 690-695
DOI : 10.36347/sjmcr.2021.v09i07.001
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Granulosa cell tumors constitute less than 5 % of all ovarian tumors. Unlike epithelial ovarian tumors, they occur in a younger age group, are usually detected in an early stage and often have features of hyperestrogenism. They follow an indolent course and are characterized by a long natural history. Stage of the disease is the only factor which affects survival of these patients. Fertility preserving surgery is an acceptable option in young women with stage I A disease. For whom fertility is not an issue, total abdominal hysterectomy, bilateral salpingo-oophorectomy and removal of all gross disease is recommended. Nodal dissection is not recommended in surgical staging of GCT. Patients with early stage disease (stage I and II) have a very good prognosis with 5 year DFS and OS of 89% and 99% respectively and usually don’t require any postoperative treatment. Advanced stage disease (stage III and IV), the 5 year DFS and OS disease was 72% and 80 % respectively hence the option of postoperative treatment with BEP chemotherapy or taxane platinum based chemotherapy should be considered. Due to high chance of recurrence even years after apparent clinical cure of the primary tumor, lifelong follow up with clinical examination and tumor markers like inhibin B is recommended.
Ovarian Gynandroblastoma – A Systematic Review
Biju Azariah M, Manisha Verma, Aashita, Jayaprakash PG
Sch J Med Case Rep | 696-698
DOI : 10.36347/sjmcr.2021.v09i07.002
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Gyandroblastomas are rare ovarian tumors, presenting in young aged women. They are benign tumors with malignant potential hardly reported. They have components of both granulosa cell tumor and sertoli leydig tumor and hence they present with the hormonal manifestation of both. Fertility preserving surgery is the preferred treatment for these tumours. The diagnosis of these tumours is mainly pathological, where the present of the above mentioned dual components in mandatory. Though benign, late recurrences are rarely reported and hence long term follow up may be necessary.
Sinus Histocytosis with Massive Lymphadenopathy (Rosai-Drofman Disease) in Seven Years Old Child in Sudan with Hepatomegaly Case Report
Dr. Manahil Salman Ali Ghandour, Dr. Hana mamoun Osman Al-Awad, Dr. Mohammed Ahmed Abd Allah
Sch J Med Case Rep | 699-701
DOI : 10.36347/sjmcr.2021.v09i07.003
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Sinus Histiocytosis with massive lymphadenopathy (SHML) Rosai-Dorfman Disease is a rare, idiopathic, node-based histiocytic proliferative disorder affecting different age group, 10% of the incidence in children less than 10 years old and 80% in young age group less than 20 years old [1]. Higher incidence of the disease was reported in African and West Indian descent [1]. The disease usually presents with massive painless cervical lymphadenopathy as part of a generalized process involving lymph nodes and may involve extranodal sites independently of lymph node status. The head and neck region represents one of more common extranodal areas, particularly the Sinonasal tract [1]. Here we report the first presentation of 7 years old child with unusual presentation of sinus histiocytosis (Rosai –dorfman disease) and hepatospleenomegly in Sudan.
Original Research Article
July 9, 2021
Prevalence and Risk Factors of Work Related Musculo Skeletal Disorders (WRMSD’s) Among Doctors - A Cross Sectional Study
Biju Azariah M, Geethu Babu
Sch J Med Case Rep | 702-706
DOI : 10.36347/sjmcr.2021.v09i07.004
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Work related musculoskeletal disorders (WRMSDs) have not only shown to impact the physical and pschycological comfort of the employee but also deteriorate the prospects of any production or service sector. The prevalence of WRMSDs, though studied extensively in various sectors, has been understudied in health sector, especially among doctors. This study which evaluated the prevalence and risk factors of these disorders among fifty cancer treating Radiation Oncologist at a Tertiary Care Cancer Centre in India had exposed out an alarming 68% prevalence of these disorders in the study population, with neck pain being the commonest site of these Muscloskeletal Disorders (MSDs). Several factors which could impact the development of MSDs were analysed. This higher incidence of MSDs is presumed to be because of extreme physical and mental stress of working in a high volume cancer care centre, persistent unhealthy postures during work, inadequate micropauses between works and uncomfortable working atmosphere. Adequate physician patient ratio, restricting the patient load, providing good physician friendly working environment and adequate mandatory breaks might significantly reduce the incidence of these disorders and can prevent the sagging of health care delivery.
Speech Disorders Revealing Balo's Concentric Sclerosis: A Case Report
Mohammed Ajamat, Aziz Ahizoun, Ayoub.Elbakkal, Youssouf Benmoh, Amal Satte, Jamal Mounach, Ahmed Bourazza
Sch J Med Case Rep | 707-710
DOI : 10.36347/sjmcr.2021.v09i07.005
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Introduction: Balo's concentric sclerosis (BCS) is a particular and rare demyelinating disease of the white matter of the brain that was first described by J. Balo in 1928 and considered as a rare variant of multiple sclerosis. The clinical manifestations usually consist of aphasia, behavioral disturbances, and seizures. This term results from a pattern of concentric aspect of the lesions with alternating areas of demyelination and areas of normal myelin in various parts of the brain and spinal cord. BCS was described as monophasic, progressive, and treated as a disease with a fulminant course. Case report: We report a case of 38 years old woman who developed slurring of speech with mild swallowing disorders for solid foods accompanied by vertigo. Her MRI showed “onion peel-like” demyelinating lesions over the subcortical areas of the left parietal lobe. Treatment given to the Patient was IV methylprednisolone followed by oral corticosteroids, with a favorable outcome without clinical recurrence after two years of follow-up. Conclusion: BCS is a rare disease with an unpredictable course, the pathognomonic brain MRI features help to secure the diagnosis. The clinical case described is interesting because of the rarity of this entity.
Psychiatric Presentation Revealing Creutzfeldt-Jakob Disease: A Case Report
Mohammed Ajamat, Youssouf Benmoh, Ayoub Elbakal, Houda Alloussi, Cedrik Moussavou, Hamid Mohamed, Amine Mnaili, Amal Satté, Jamal Mounach, Ahmed Bourazza
Sch J Med Case Rep | 711-714
DOI : 10.36347/sjmcr.2021.v09i07.006
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Creutzfeldt-Jakob disease or subacute spongiform encephalopathy is a rare prion encephalopathy with a long incubation period and fatal outcome without remission. In this summary, we report a case of sporadic Creutzfeldt-Jakob disease consolidates by positive income CSF analysis of the 14.3.3 protein. This patient study report presents a 54 years old Moroccan male patient with no underlying disease. Whose history of the disease goes back to 04 months, by the admission at the department of psychiatry for the quickly progressive installation of a depressive syndrome, with behavioral disorders made up of anxiety and aggression towards, associated with a decline in visual acuity that the patient reported as very annoying and disabling, while the ophthalmologic examination without abnormalities, and the patient was able to walk alone and avoids obstacles while walking. With a strictly normal brain MRI, treatment by antidepressants and neuroleptics has been prescribed. The evolution was marked 3 months later by the appearance of significant memory disorders associated with hallucinations, impaired walking, and myoclonus in the upper limbs which are exerted by sounds in the arms and legs. A new brain MRI performed showed bilateral frontal and occipital cortical high signal, a visual evoked potential demonstrated a decrease in the activity of the visual pathways with alteration of the central macular vision, the electroencephalogram (EEG) revealed a slowing of the background activity with periodic activity and rapid rhythmicity, the study of Cerebrospinal fluid (CSF) was without abnormalities regarding CSF value of proteins and glucose but the dosage of the protein 14.3.3 came back positive. Following these clinical, biological, radiological, and electrophysiological elements, the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) was retained.
Cervical Neuroplasty in a Patient with Postlaminectomy Syndrome after Epidural Infection - A Case Report
In-Jung Jun, Hyunho Kim, Joonho Cho, Woo Yong Lee, Yun-Hee Lim
Sch J Med Case Rep | 715-719
DOI : 10.36347/sjmcr.2021.v09i07.007
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Epidural neuroplasty is an available procedure for various causes of pain. Cervical epidural neuroplasty has a higher risk of side effects than that of lumbar, which can be a challenge for the operator. A 56-year-old female came to the pain clinic with severe neck pain caused by postlaminectomy syndrome. We inserted an epidural catheter from T3-4 level to C4-5 level. Confirming that contrast medium spreading epidural space at C7-T1, and then authors injected medication. The patient's pain was effectively reduced without side effects. In an area where it is not expected to secure an approach to the lesion, injection to the target point with steerable catheters is very helpful in relief of pain as a performing cervical epidural neuroplasty.
Arteria Lusoria Associated with a Bicarotid Trunk: Case Report and Review of the Litterature
N. Mennis, B. Zouita, D. Basraoui, H. Jalal
Sch J Med Case Rep | 720-722
DOI : 10.36347/sjmcr.2021.v09i07.008
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Arteria lusoria or retroesophageal right subclavian artery is the most common aortic arch malformation, accounting for 0.5-2.5% of cases. It is mostly aymptomatic, but can also be detected in patients with symptoms such as dyspnea, dysphagia or even recurrent respiratory infections. A combination of an aberrant right subclavian artery (ARSA) and a bicarotid trunk is extremely rare with a prevalence of <0,05% [1]. We present the case of a 3 months old girl who presented with a wheezing dyspnea. She underwent a computed tomography of the chest, and incidental anomalies of the aortic arch branches were found. A symptomatic aberrant right subclavian artery and bicarotid trunk, which was found, are rare and usually incidental findings.
Woodhouse-Sakati Syndrome with Unique Unreported Previous Findings
Amer O AlAli, Mohammed A Soeid, Ahmed E Shamakhi, Mosa Hakami, Mohammed Q Masmali, Omar E Masmali, Amro Alomar, Mohammed A fagehi, Mohammad A Razzaque, Badi Alenazi, Shemah M hakami, Nasir Al-Jurayyan
Sch J Med Case Rep | 723-726
DOI : 10.36347/sjmcr.2021.v09i07.009
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We present here at 16 years old a Saudi girl with alopecia which noted since birth and delayed puberty and short stature, dyslipidemia, diabetes and hypothyroidism. Family history was positive for similar complaints. Genetic study shows a mutation at DCAF17 which is known a common founder mutation confirming diagnosis of Woodhouse-Sakati Syndrome. This patient has many unreported findings of hepatic hemangioma, with Hepatomegaly, high indirect bilirubin, high uric acid, focal segmental Glomerulonephritis and low growth hormone level. Presentation of this syndrome may overlap with other important differential diagnosis like autoimmune polyendocrine syndrome, Alopecia-progressive neurological defect (ANE syndrome), and Turner and Mitochondrial disease. In such presentation, the presence of dysmorphic features and low intelligence quotient (IQ) scores, should alert the physician to look for WSS as a possible diagnosis.
Uraque Cyst Revealed Late by Infection About one Case and Review of the Literature
Messian GALLOUO, Yassine LARRACHE,Saleh NEDJIMA, Mahdi GRIOUID,Amine MOATAZ, Mohamed Dakir, Adil DEBBAGH et Rachid ABOUTAIEB
Sch J Med Case Rep | 727-728
DOI : 10.36347/sjmcr.2021.v09i07.010
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Uraque cysts are rare and discovered in adulthood. Ultrasound and computed tomography allow the diagnosis. Treatment is rarely conservative because of the risk of recurrence or malignant degeneration. We report a rare case of uracha cysts revealed by superinfection.
Contribution of Radiology in the Diagnosis of Gaucher Disease: A Case Report
R. Essofi, A. El Masloumi, B. Boutakioute, M. Ouali Idrissi. N Cherif Idrissi El Ganouni
Sch J Med Case Rep | 729-732
DOI : 10.36347/sjmcr.2021.v09i07.011
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Gaucher disease is a rare, autosomal recessive genetic disorder; caused by a deficiency in the activity of the lysosomal enzyme glucocerebrosidase which is responsable for the degradation of glucosylceramide. The enzyme substrate, accumulates in the body, predominantly in the liver, spleen, and bone marrow causing hematological abnormalities, splenohepatomegaly, and skeletal disorders. The Gaucher disease has been classified into 3 phenotypes, distinguished on the basis of the absence or presence and severity of central nervous system damage, type I with no neurological involvement is the most common. The diagnosis is suspected when there is a combination of clinical, biological and radiological evidence and is confirmed by an enzyme assay showing deficient glucocerebrosidase enzyme. MRI is the most appropriate examination to visualize the different aspects of gaucher diseas. Gaucher disease is the first lysosomal disease to benefit from enzyme replacement therapy; ERT was effective in reducing the liver and spleen size, the bone symptoms, and improving blood counts.
Acute Colonic Pseudo-Obstruction (Ogilvie Syndrome) Presenting with Septic Shock in Children with Cerebral Palsy
H. Loukili, R. Roukhssi, A. Mouhsine
Sch J Med Case Rep | 733-736
DOI : 10.36347/sjmcr.2021.v09i07.012
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Introduction: Acute colonic pseudo-obstruction, or Ogilvie syndrome, is a motility abnormality characterised by rapid and progressive dilation of the large intestine. It is seen in the adult population, but rarely in children. To achieves a diagnosis it is fundamental to exclude mechanical obstruction with imaging studies such as computer axial tomography. Clinical case: child of 08 years old with a history of cerebral palsy and anemia came to the pediatric emergencies for abdominal distension and vomiting evolving since a day before admission, all in a context of deterioration in general and feverish condition. The diagnosis of septic shock was made, and radiological examinations confirmed the diagnosis of Ogilvie syndrome. The treatment was conservative with slight clinical amalgamation at start but the symptoms worsened afterwards and the patient die 05 days later. Conclusions: Ogilvie’s syndrome is a rare condition in the pediatric population. Abdominal x-ray plays a crucial role in the diagnosis and management of ACPO, and CT scan help to look for complications. Conservative management in this disease is the initial approach. Interventions should be reserved for when conservative treatment fails.
Tension Pneumoventricle as an Unusual Complication of Head Trauma: A Case Report
Essofi R, Badraoui M, Boutakioute B, Ouali Idrissi M, Cherif Idrissi El Ganouni N
Sch J Med Case Rep | 737-738
DOI : 10.36347/sjmcr.2021.v09i07.013
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Pneumocephalus is a frequent complication of head trauma and cranial surgery unlike pneumoventriculus which is a rare entity. Imaging plays an important role in the positive diagnosis of pneumoventriculus and the CT scan is the key examination in the assessment of skull base fractures. We report the case of one patient presenting with a neglected open head injury following road traffic accident whose computed tomography (CT) brain images confirm skull base fractures with bilateral pneumoventriculus.
Subcutaneous Panniculitis-Like T-Cell LymphomaAssociated to Systemic Lupus Erythematosus
Majdouline Bouaouad, Soukaina Haidouri, Hajar Khibri, Kaoutar Znati, Zakiya Bernoussi, Wafa Ammouri, Mouna Maamare, Hicham Harmouche, Mohammed Adnaoui, Zoubida Tazi-Mezalek
Sch J Med Case Rep | 739-742
DOI : 10.36347/sjmcr.2021.v09i07.014
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Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) accounts for lessthan 1% of all Lymphomas that manifest themselves with sub cutaneous nodes, SPTCL may be associated to a systemic disease. We report in this paper the first case described in our department of a 57 years old female patient followed up for 5 years for a Subcutaneous panniculitis-like T-cell lymphoma, treated with dermocorticosteroids after 4 years of therapeutic abstention and who developed a Systemic lupus erythematosus for which she was put under treatment with a very good evolution.
Lung Cancer Revealed by Choroidal Metastasis: About Two Cases
K. Madbouhi, L. Kaissoumi, B. Mrini, A. Amazouzi, N. Boutimzine, O. Cherkaoui
Sch J Med Case Rep | 743-747
DOI : 10.36347/sjmcr.2021.v09i07.015
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The most common site of ocular metastasis is the choroid. We report two cases of choroidal metastases (CM) revealing lung cancer. The first case is a 66-year-old patient consulting for reduced visual acuity. The fundus reveals a posterior pole choroidal mass. Ultrasound shows a weakly hyperhecogenic choroidal mass. Chest CT revealed the primary lung tumor. The second case is a 62-year-old woman consulting for reduced visual acuity in whom the fundus found a choroidal mass with sero-retinal detachment opposite. Fluorescein angiography, OCT, and ultrasound were in favor of choroidal metastasis. The lung CT scan revealed a lung tumor. Although uncommon, CM can be the initial manifestation of lung cancer. Their diagnosis is based on a range of clinical and paraclinical arguments. The treatment of CM with chemotherapy combined or not with ocular radiotherapy is often effective in disabling eye disorders. The aim of this work is to summarize the current knowledge on choroidal metastases, with an emphasis on epidemiology, diagnosis and treatment.
Addiction to Nefopam: A Rare and Poorly Documented Clinical Entity in Sub-Saharan Africa
Nga Nomo Serge, Kuitchet Aristide, Iroume Cristella, Djomo Tamchom, Nkoumou S, Chobli Martin
Sch J Med Case Rep | 748-750
DOI : 10.36347/sjmcr.2021.v09i07.016
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Addictions represent a major public health problem in developing countries, with health, economic and socio-professional impacts. The consumption of psychoactive drugs is responsible in France for more than 100,000 preventable deaths per year [1]. Data from epidemiological surveys on the gravity of the situation in sub-Saharan Africa are essentially hospital-based and not very representative of reality, because there are few services specializing in addictions. Opioid analgesics are molecules whose addictogenic potential has been known and described for many years [2]. In Cameroon, non-morphine analgesics are widely prescribed for the treatment of pain. Addiction to long-term use of non-opioid analgesics remains anecdotal in the scientific literature. We report here a rare case of addiction to Nefopam, a non-opioid analgesic, in a 45-year-old black woman with fibromyalgia. The aim of this presentation is to draw the attention of clinicians to the risk of addiction linked to the misuse of nefopam.
