Unusual Localization of Darier-Ferrand Dermatofibrosarcoma: A Case Report
Abdelkoddous Bhihi, Imane Yafi, Mehdi Sahibi, Oumkeltoum Elatiqui, Moulay Driss Elamrani, Yassine Benchamkha
Sch J Med Case Rep | 113-114
DOI : 10.36347/sjmcr.2020.v08i02.003
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Darier-Ferrand dermatofibrosarcoma is a fibrous tumour of the skin with high local malignancy, with progressive progression and high potential for recurrence. We report an unusual case of a 46-year-old patient with a distal extremity of the inner leg in which biopsy-exeresis histologically confirmed the nature of the tumour. We report this observation to illustrate the difficulty of surgical excision of this carcinoma in this particular anatomical region.
Congenital Chylothorax and Hydrops Fetalis in Newborn: A Case Report
Dr. Mahmoud M. Osman, Dr. Mohamed Ali Tagin, Dr. Mohammed Saleh Alissa, Dr. Suzan Abdel-Hamid, Dr. Mohamed Salah Shoeib
Sch J Med Case Rep | 176-178
DOI : 10.36347/sjmcr.2020.v08i02.019
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Congenital chylothorax is the accumulation of chyle (lymphatic fluid) within the pleural space in fetus. Chyle is a sterile fluid that appears straw or milky colored depending on the infant’s feeding status. Herein we present a 35 weeks gestational age female infant antenatally diagnosed to have hydrops fetalis with bilateral chylothorax. Fetal interventions were applied. Her management was conservative approach and her outcome was favorable.
Carcinoma Cuniculatum of the Foot: A Case Report
M. Aboudourib, A. Aarab, M. Gouatri, N. Mansouri, Md El Amrani, O. Hocar, Y. Benchemkha, H. Rais, S. Amal
Sch J Med Case Rep | 179-180
DOI : 10.36347/sjmcr.2020.v08i02.020
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Verrucous carcinoma is a rare variant of squamous cell carcinoma. It is well differentiated and rarely metastases but can sometimes be very aggressive locally in depth. The paper presents a case report of a 40-year-old man with an enlarging lesion on the heel of his right foot. The patient underwent tumor excision and the histopathological diagnosis was verrucous carcinoma.
Original Research Article
Feb. 8, 2020
Negative Impact of Electronics Use on Lebanese Pediatric Population Aged between 2 and 6 Years
Sawsan Yaacoub, Amal Naous, Mariam Rajab, Bassem Abou Merhi
Sch J Med Case Rep | 102-105
DOI : 10.36347/sjmcr.2020.v08i02.001
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Background: Children tend to be active consumers of electronics and many electronic products are targeted to the youth market. Excessive use of such electronics prone children to aggressive behaviors, sleep disorders, impaired socialization, as well as decrease in academic skills. Objectives: The aim of this study was determine the negative impact of electronics use on Lebanese pediatric population aged between 2 and 6 years mainly involving sleep disturbances, change in general health status, increase aggressiveness and worsening of general manners. Methods: A descriptive cross sectional questionnaire was distributed over 966 families of Lebanese children aged between 2 and 6 years, in different Lebanese countries including some Lebanese schools, and collected. Demographic data included: age of child, type of electronic device used, whether parents depend on electronics to distract their children and calm them down, and to assess if parents know the amount of hours allowed for the child to spend on electronics. Data collected for the outcome included: number of hours spent on electronics, electronic use causing sleep disturbances in children, change in general health status, and increase aggressiveness and worsening in general manners. Results: During the study period, questionnaires were distributed over 966 families of Lebanese children aged between 2 and 6 years and collected. The mostly used electronic device in children was the IPAD (56.7%) followed by smart phone (50.1%). Our study showed that the more number of hours spent on electronics (> 4hrs) was associated with sleep disturbances (mean score of 54.6) (p value < 0.05). The more the number of hours spent on electronics by the child, the decline in the general health status was noticed with a mean score of 41.5 when child used 4 hours or more and was statistically significant (p value < 0.05). The more the number of hours spent on electronics, the more the child’s manners worsens and decline ..............
Original Research Article
Feb. 8, 2020
The Relationship between Cord Blood and Heel Prick Filter Paper Thyroid Stimulating Hormone Levels in the Light of Perinatal Factors
Faten Ghanem, Rayan Itani, Amal Naous, Bassem Abou Merhi, Mariam Rajab
Sch J Med Case Rep | 106-112
DOI : 10.36347/sjmcr.2020.v08i02.002
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Background: Congenital Hypothyroidism most common preventable cause of mental retardation with incidence of 1:2500 to 1:2800 live births. Early diagnoses is crucial, thus various screening programs were initiated. Neonatal screening programs include either cord blood TSH at birth or heel prick TSH at 24-48 hours of life. However these studies are influenced by multiple maternal and perinatal factors thus yielding false high positive results. Objectives: Our study objectives were to study the relationship between cord blood TSH taken at birth and heel prick filter paper TSH that is taken at 24-48 hours of life routinely for neonatal screening, and to compare the influence of perinatal factors on both levels. Methods: We carried out a cross-sectional study in the regular nursery at Makassed General Hospital (MGH). We included 252 live newborns delivered between November 2016 and February 2017 and between November 2018 and February 2019. Blood was drawn directly at birth from the maternal side of the umbilical cord for cord TSH and another sample was drawn at 24-48 hours of life from heel prick for neonatal screening TSH. The two samples were then compared in light of perinatal factors. Results: Cord blood TSH values were found to be normal limits in neonates, not affected significantly with any of the prenatal factors studied as for maternal age, mode of delivery, gender, birth weight, gestational age, birth order, pregnancy course, and maternal illness. None of the studied parameters had a significant effect on heel prick TSH. Cord blood TSH was of average=6.8 in comparison to heel prick TSH average=5 (P-value <0.0001) but still within normal levels. Comparison between the Cord-Heel TSH differences was not significantly affected by any of the above parameters. Conclusion: Cord blood TSH has the advantage of being easy to collect, non-invasive, and has better compliance from the parents. This study showed that there is no influence of any prenatal stressful...........
A Case of Ruptured Pseudomyxoma Revealed by an Occlusive Syndrome
Karam Aziz, Abdelouhab El Marouni, Houssam Belghali, Ahmed Zerhouni, Tarik Souiki, Karim Ibn Majdoub Hassani, Imane Toughrai, Khalid Mazaz
Sch J Med Case Rep | 115-116
DOI : 10.36347/sjmcr.2020.v08i02.004
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Peritoneal pseudomyxomas or “gelatinous diseases “of the peritoneum are rare diseases, defined by the abundant gelatinous substance in the abdomen secondary to ruptured appendicular mucinous lesion whose macroscopic cystic aspect is the mucocele. Histological analysis makes it possible to distinguish adenucinosis diffuse peritoneal, a relatively progressive benign form, malignant forms or peritoneal carcinomatosis Mucinous of very serious evolution. When diagnosed, the peritoneal pseudomyxoma is usually diffuse, scattered throughout the peritoneal cavity. Our observation presents a case of peritoneal pseudomyxoma, detected early with an appendicular mucocele ruptured and located at the dead end of Douglas.
Small Bowel Obstruction Due to Uterine Adhesions Following Caesarean: A Case Report
Karam Aziz, Abdelouhab El Marouni, Houssam Belghali, Ahmed Zerhouni, Tarik Souiki, Karim Ibn Majdoub Hassani, Imane Toughrai, Khalid Mazaz
Sch J Med Case Rep | 117-118
DOI : 10.36347/sjmcr.2020.v08i02.005
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A female patient was admitted urgently; for abdominal pain, vomiting and stopping of materials and gases. This symptomatology had been evolving for 36 hours. The interrogation notes a history of a caesarean. The physical examination confirmed the presence of an occlusive syndrome with abdominal distension and meteorism. Hernias parietal were free. The rest of the physical examination was normal. X-ray of the abdomen without preparation noted hydro-aerial levels of the hailic type. The Computed tomography showed an intestinal obstruction in a bird's beak.
Original Research Article
Feb. 8, 2020
Diffusion Factors of Coronary Artery Disease: A Comparative Study of 130 Patients
Asmaa Goulahsen, Joumana El Masrioui, Abdelkarim Ait Yahya, Hasna Ait ELHadj, Dounia Benzarouel, Mustapha El Hattaoui
Sch J Med Case Rep | 119-122
DOI : 10.36347/sjmcr.2020.v08i02.006
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Multivessel coronary artery disease is usually defined by the presence of angiographic stenosis over 50% in at least two of the three epicardic coronary truncs. This multivessel lesion is associated with pejorative prognosis, particularly in case of proximal anterior interventricular artery (proximal LAD) stenosis and/or left ventricular dysfunction [1]. The aim of our study is to compare the epidemiological, clinical and angiographic particularities of multivessel coronary patients with single vessel patients in order to suggest the different predictive factors of coronary lesion diffusion and to identify high risk patients in need of special attention and new therapeutic strategies. We conducted a transversal and descriptive study on over 130 patients, between January 2016 to January 2017, at the catheterization laboratory in the cardiology and vascular diseases department of university hospital Mohamed 6 in Marrakech. The prevalence of multivessel coronary artery disease was 40%+/_4%. In a bivariate analysis only age, diabetes and smoking were predictive of multivessel lesions. A multidisciplinary approach resting on clinical and angiographic scores is actually the cornerstone in the decision-making process to provide medical management of multivessel coronary lesions.
Persistent Mullerian Duct Syndrome -A Rare Case Report
Dr. Padmapriya B, Dr. K. Santhosh Rupa, Dr. Uma prasad, Dr. A.Bhagyalakshmi
Sch J Med Case Rep | 219-221
DOI : 10.36347/sjmcr.2020.v08i02.031
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Persistent mullerian duct syndrome is a disorder of sexual development that commonly affects male, also known as Hernia uteri inguinale. They have male external genitalia with admixture of male and female reproductive organs. Common clinical presentation is with infertility or inguinal hernia. The main modality of therapy is surgery. Early diagnosis and therapy maintains fertility and prevents malignant change. We are reporting a case of persistent mullerian duct syndrome in a 40 year old male who presented with inguinal hernia with preserved fertility.
Acute Hyperkalemia Paralysis in a Uremic Patient Taking Trimethropim-Sulfamethoxazole
Hajar Elassas, Mariam Chettati, Wafaa Fadili, Inass Laouad
Sch J Med Case Rep | 123-125
DOI : 10.36347/sjmcr.2020.v08i02.007
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Hyperkalemia is a life-threatening electrolyte disturbance that can present with a spectrum of clinical manifestations ranging from asymptomatic to life-threatening arrhythmias and secondary hyperkalemic paralysis [1] depending on the serum concentration and the underlying comorbidities, such as concomitant renal failure. Acute flaccid quadriplegia secondary to hyperkaliemia is a very rare and life threatening medical emergency. We report the case of a 24 year old female with ESRD secondary to glomerulonephritis on chronic hemodialysis presenting with rapidly progressive ascending paraplegia progressing to flaccid quadriplegia in about 23 hours due to life threatening hyperkaliemia (9.8mEq/L). Drug history revealed that the patient was on Trimethoprim-sulfamethoxazole 160mg/800mg per day (for the past 15 days), prednisone 20 mg per day, amlodipine 5 mg per day (for past 5 months). Patient was treated with antihyperkaliemic measures and hemodialysis .She regained dramatically her power after potassium levels normalized. The aim of this case report is to highlight and raise awareness for uncommon non cardiac presentation of hyperkalemia.
Experience and Feelings of Non-Fasting Diabetic Patients during the Month of Ramadan
Loubna Oukit, Sana Rafi, Ghizlane El Mghari, Nawal El Ansari
Sch J Med Case Rep | 128-131
DOI : 10.36347/sjmcr.2020.v08i02.009
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Background: During Ramadan, many changes occur in the daily life over the fasting. However, sick people are exempted; they live in the spirit of the holy month. Fasting is often perceived beyond the religious aspect, it is consider as a social event. Thus, how does the non-fasting diabetic patient adapt and perceive this period? Methods: Patients with type 2 diabetes, who do not fast were collected during the action of the endocrinology department before Ramadan, and interviewed by phone afterwards. Individual interviews open ended, were conducted by an investigator. Results: Patients involved were 176, including 95 non-fasting, 59 of them answered our interview, 61% of him was women, and the average age was 57.4 years. Also, the reaction to the prohibition of fasting was overall "surprise" and "guilt", with strong support from the relatives. But above all, the patients desired to fast to align with the usual habits and win against the disease. Conclusion: Very few studies are interested in the non-fasting diabetic living in a Ramadan context. Their perception of this situation remains unknown. We shed light on the complexity of accepting the fasting prohibition, the shock of it announcement and the direct impact on the patient's morale. Signifying the seriousness of his pathology and a feeling of a religious and social quarantine. Acceptance is often difficult and can go through several steps. The support and approval of the entourage is very important.
Tuberculous Pleurisy in Children: Report of Two Cases in the Pediatric Department of the Mali Hospital
Kane Bourama, Camara MA, Dembele G, Traore MM, Diallo KW, SIMAGA T, Konate D, Coulibaly O, Kone A, Drame ASI, Diallo Y, Kone O, Maiga M, Toure BM, Diakite AA, Kane AST, Dicko FT
Sch J Med Case Rep | 132-135
DOI : 10.36347/sjmcr.2020.v08i02.010
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In 2015, according to the WHO, there were 1.8 million deaths from tuberculosis worldwide. Tuberculous pleurisy is common but underdiagnosed in endemic countries. These were two boys, 5 and 10 years old, hospitalized for dyspnea in pediatrics at the Mali Hospital. They received BCG and There was no notion of TB infection. The diagnosis of tuberculous pleurisy was confirmed by histological examination of the pleura in one and by microbiology in the other. The pleural drainage associated with anti-tuberculosis treatment allowed healing without sequelae in the 2 children. Tuberculous pleurisy is common in endemic countries. Its diagnosis must be evoked before all the pleurisy in these countries.
Original Research Article
Feb. 12, 2020
Psychiatric Disorders among Hospitalized Women at the Psychiatry Hospital « Ibn Nafis Hospital » of Mohammed VI University Hospital Center
M. Rabitateddine, S. Elfellah, S. Ennazk, I. Adali, F. Manoudi, F. Asri
Sch J Med Case Rep | 136-146
DOI : 10.36347/sjmcr.2020.v08i02.011
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Women get hospitalized for various serious mental disorders that are gender specific, half of them married with children, the other half single\divorced women stigmatized and marginalized in our society. The aim of this study is to describe mentally ill women admitted into the psychiatric hospital, socio demographically and clinically, highlighting differences, specificities and multiple roles distress deviate with the course of disorder. It’s a cross-sectional prospective study about 70 patients admitted at the psychiatry hospital Ibn Nafis on Mohammed VI university hospital Center in Marrakesh-Morocco, and reports the following results: The average age is 37,4 years, 44% of them are single, with a low educational level (primary school) 32,8%. 64% of our women are from the urban region, 51,4% are jobless and 59% brought to the hospital by their families. 11,6% of patients in our study have positive family history, 70% of them suffered from paranoid schizophrenia. 55% of patients are admitted for schizophrenia, followed by bipolar I disorder 18%, Major depressive disorder affected 8% of our patients. 20% deal with a toxic habits, 14,5% abuse nicotine (74% low dependence FTND) and one woman have tried quitting. The criminal was 5,7% including different psychiatric disorders involved, assault is the most common charge. Suicide attempts are closely linked to major depressive episodes of MDD and BID, in patients were already under a combination of antidepressants and anxiolytics for at least 3 months. Psychotic features are observed in most of admitted disorders, 83% in BIP and 67% in MDD. According to HAMILTON-DEPRESSION 66.3% of women are admitted for a severe depressive episode, 50% present anxiety comorbidity and a history of CBT sessions months prior hospitalization. Shading the light into admitted women in psychiatry and deciphering specific demographic, clinical and therapeutic features may improve the global care system and women's adherence to treatment and fol
Exophytic Duodenal Stromal Tumor: A Rare Localization
Badr Boutakioute, Meriem Ouali Irissi, Najat Cherif Idrissi El Ganouni
Sch J Med Case Rep | 213-218
DOI : 10.36347/sjmcr.2020.v08i02.030
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Gastrointestinal stromal tumors (GIST) have become a well-defined entity and its classification is no more equivocal, but GIST of duodenum is rarely diagnosed. We report a case of a patient presented with only mild epigastric discomfort. The upper gastrointestinal (GI) endoscopy demonstrated an extrinsic compression of second part of duodenum. Thereafter, CT and MRI of abdomen revealed an exophytic mass emerging from the second part and third of duodenum. The patient underwent a wedge resection of tumor, and the histopathology of the mass confirmed the diagnosis of duodenal stromal tumor. The patient was treated with adjuvant imatinib chemotherapy with no sign of local recurrence after six months of follow up.
Pulmonary Sequestration with Aberrant Arterial Supply from Celiac Trunk
Sara Dehbi, Yazen EL Badri, Youssef Bouktib, Ibtissam Zouita, Dounia Basraoui, Hicham Jalal
Sch J Med Case Rep | 230-232
DOI : 10.36347/sjmcr.2020.v08i02.035
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Pulmonary sequestration is a rare anomaly, which does not have a connection with the bronchial system and gets its blood supply, generally, from the aorta or its branches. Anatomically, two forms were described: extralobar and intralobar which is the commoner type of pulmonary sequestration accounting for 75% of all sequestrations. Although 74% of intralobar pulmonary sequestrations get their blood supply from the descending thoracic aorta, they may get their blood supply from different arteries. Furthermore, there is more than one arterial anomaly in 14.8% of cases. We report an intralobar pulmonary sequestration, in, which arterial blood supply is from celiac trunk, with a cardiomegaly at the expense of the right atrium.
Successful Treatment of Recalcitrant Psoriasis by Scopolamine and Propofol: A Report of Two Cases
Qifang LI, Yumei WU, Buwei YU
Sch J Med Case Rep | 147-149
DOI : 10.36347/sjmcr.2020.v08i02.012
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Antagonism of cholinergic neurotransmission for treating inflammatory skin disease is an underexplored area in medical dermatology. Case reports and anecdotal evidence suggests that botulinum neurotoxins (BoNTs), which inhibit acetylcholine release, may be useful for treating plaque psoriasis. The therapeutic effects of scopolamine occur through antagonism of central muscarinic acetylcholine receptors, the predominate type of cholinergic receptor in the brain. Here we present two patients had been affected by plaque psoriasis for longer than 8 years and had got no benefits from the use of conventional therapies. We describe sustained clearance of plaque psoriasis in the two patients following off-label injections of scopolamine and propofol. Scopolamine and propofol may offer a novel therapeutic approach for treating recalcitrant plaque psoriasis. In this report, we discuss about the application of this method in the treatment of psoriasis.
Congenital Lobar Emphysema in Saudi Newborn
Abdulrahman Almesfer, Abdullah Al Mutairi, Mohammed Saleh Alfaleh, Badi Al Enazi
Sch J Med Case Rep | 173-175
DOI : 10.36347/sjmcr.2020.v08i02.018
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Congenital lobar emphysema is a rare developmental anomaly of the lower respiratory tract that is characterized by hyperinflation of one or more of the pulmonary lobes. The diagnosis of Congenital Lobar Emphysema often can be diagnosed by chest radiograph and CT. Treatment of CLE with respiratory distress is the surgical resection of the affected lobe (Lobectomy). The prognosis is typically good to excellent. Here we present a case report for a newborn with cyanosis that starts immediately after birth.
Original Research Article
Feb. 21, 2020
Evaluation of Left Ventricular Function after Complete Revascularization by Percutaneous Angioplasty in Multitrunk Coronary Patients
Goulahsen A, Benlafkih O, Benzeroual D, El Hattaoui M
Sch J Med Case Rep | 181-185
DOI : 10.36347/sjmcr.2020.v08i02.021
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Multitrunk coronary disease is usually defined by the presence of angiographic stenosis of more than 50% in at least two of the three epicardial coronary vessels. This multitrunk disease is associated with a pejorative prognosis, especially in cases of proximal VIA stenosis and/or left ventricular dysfunction. The aim of this Study is: To analyze the left ventricular function before and after complete revascularization by angioplasty of multitrunk coronary patients and to determine the place of angioplasty in the complete revascularization of the multitrunk coronary patients. Through a series of 19 multitrunk coronary patients who underwent complete revascularization by angioplasty during the period from January 2018 to July 2019.
Managing Auto Immune Hemolytic Anemia in Pregnancy with Thalassemia Trait
Keerti Angampally, Dr. S Pandu Ranga Rao, Pooja Veturi, Venkat S
Sch J Med Case Rep | 186-187
DOI : 10.36347/sjmcr.2020.v08i02.022
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Nutritional anemia most common type of anemia presenting in women. Auto Immune Hemolytic Anemia (AIHA) is a relatively uncommon cause of anemia in pregnancy with a little literature available. Thalassemia trait do not experience any health problem except for mild anemia. At present we report a case of pregnant women with history of chronic anemia found to be Warm Auto Immune Hemolytic anemia with beta thalassemia trait.
Breast Tuberculosis in Man a Very Rare Entity
Hamid Asmouki, Dr. Oussama Rachid, Dr. Khadija Najmeddine, Abderraouf Soummani
Sch J Med Case Rep | 188-190
DOI : 10.36347/sjmcr.2020.v08i02.023
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Breast tuberculosis in man is exceptional, even in endemic countries. It is an unusual presentation both clinically and radiologically leading into numerous differential diagnostic, including pyogenic abscess and cancer. The treatment of choice is chemotherapy. We are describing a rare case of a young healthy male with no other supposed localizations of tuberculosis or any immunodeficiency.
Ayurvedic Management of Dystonia Parkinsonism - A Case Report
Vidhya M Sanker, Jithesh M
Sch J Med Case Rep | 194-197
DOI : 10.36347/sjmcr.2020.v08i02.025
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Dystonias are the third common group of movement disorder after Parkinson’s disease and essential tremors. It is characterised by involuntary muscle contractions that causes repetitive movements. Because of the structural lesions in basal ganglia, many a times Parkinsonism and dystonia may co-exist in presentation. In some hereditary forms, it manifested as rapid onset of dystonia Parkinsonism. In X-linked Dystonia Parkinsonism, dystonia usually starts focally, later Parkinsonism sets into it. The reported case was presented with symptoms such as tremors, retrocollis etc. more or less compared to the symptoms of kampavata, akshepaka, manyasthamba which are discussed under the spectrum of vatavyadhi in Ayurvedic parlance. So for the management, vatavyadhi chikitsa was adopted with consideration for ama, involvement of other doshas and also the role of avarana. Rookshana, snehapana, sweda, sodhana, nasya and rasayanas along with suitable samana therapies were selected. Patient was having considerable symptomatic relief within short time span which was promising and worth reporting.
Nephrogenic Ascites Uncommon Cause of Exsudative Ascites
Dr. Lairani, Dr. Jiddi, Dr. Aboutarik, Pr Ait Errami, Pr Samlani, Pr Oubaha, Pr Krati
Sch J Med Case Rep | 198-200
DOI : 10.36347/sjmcr.2020.v08i02.026
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Nephnogenlc ascites is a rare condition characterized by the presence of massive ascites in patients with end stage renal disease (ESRD). Although the pathogenesis remains poorly understood, several factors have been considered. Nephrogenic ascites is associated with a grave prognosis, especially if treatment is not institued. Treatment options are limited, of those kidney transplant seems to be the most effective, however, special attention should be paid to intensive hemodialysis. Through this observation, we study clinicopathological and therapeutic features of this pathology. We report one case of a 64 years old patient with a past medical history of arterial hypertension, followed for a chronic renal failure undergoing hemodialysis for two years. Diagnostic paracentesis was done and found to be exudative. After detailed workup, hepatic, cardiac, infectious and malignant causes for ascites were ruled out. The diagnosis of ascites of nephrogenic origin was made. The patient has been treated conservatively with salt/fluid restriction and intensive hemodialysis with ultrafiltration which was very successful in our case.
Ileosigmoid Knotting – A Rare Case Report
M. Sabari Girieasen, Naveenkumar Viswanathan, S. Nedunchezhian, Kannan Ross
Sch J Med Case Rep | 201-203
DOI : 10.36347/sjmcr.2020.v08i02.027
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Ileosigmoid knotting is a rare cause of acute intestinal obstruction where the ileum wraps around the base of sigmoid colon and threatens the viability of both ileum and sigmoid colon. We had a case of 65 year old male who presented with symptoms of intestinal obstruction. His vitals were stable with no signs of peritonitis. Imaging showed intestinal obstruction with possibility of volvulus. Emergency laparotomy was done and there was gangrenous ileum wrapped around the gangrenous sigmoid colon. Gangrenous segments were resection and colorectal anastomosis and double barrel ileostomy were done. Our case is categorized as type I ileosigmoid knotting with no evidence of shock. Patient improved gradually and he was discharged on POD 10. As the condition was suspected early, active intervention was made which lead to better outcome in this patient. Ileosigmoid knotting should always be considered as differential diagnosis for acute intestinal obstruction in males.
Case Report of Epidermoid Cyst of the Testis and Review of Its Typical Imaging Features
Boutakioute B, Sarf I, Rais H, Ouali M, Cherif Idrissi El Ganouni N
Sch J Med Case Rep | 209-212
DOI : 10.36347/sjmcr.2020.v08i02.029
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Testicular epidermoid cysts are rare, benign intratesticular neoplasms. Preoperative diagnosis can be evoked by ultrasound and MRI, which are important criteria for the selection of testicular-preserving operations. In this paper, we report a case of a 21-year-old man who complained of a painful left testicular mass, which was found firm, regular, with a regular surface in examination. All laboratory investigations, including tumor markers, were normal. On ultrasonography, this mass appeared as a well-defined hypoechoic heterogeneous and avascular intratesticular lesion. On MRI, it was described as low signal T1 and heterogeneous hyper signal T2 lesion, surrounded by a capsule in hypo signal T1 and T2, enhanced after injection of Gadolinium, without perilesional oedema. Cyst enucleation cure was performed without postoperative complications. Histological diagnosis was an epidermoid cyst of the testis. A review of the literature has allowed us to highlight the different sonographic and MR imaging findings of testicular epidermoid cysts.
An Iatrogenic Iliocaval Fistula after a Lumbar Disc Herniation Surgery: Case Study
Elfatemi B, Bakkali T, Tijani Y, Khloufi S, Sefiani Y, Lekehel B, Mesnaoui A
Sch J Med Case Rep | 204-208
DOI : 10.36347/sjmcr.2020.v08i02.028
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An observation of an iliocaval fistula with right cardiac insufficiency was reported 8 years after surgery for a lumbar posterior disc herniation treated by endovascular stent grafting by femoral placement. The postoperative outcomes were favorable. The vascular complications of lumbar disc surgery are uncommon (about 0.04% of discectomies) but are very severe. The most frequent complications are arteriovenous ilio-venous fistulas between the primary right iliac artery and the inferior vena cava. They are enhanced by the close anatomical relationship between the last lumbar vertebrae and the retroperitoneal vessels and the degenerative lesions of the anterior vertebral ligament making its perforation easier during discectomy. Their treatment has become increasingly simple with the progress and innovation of endovascular techniques.
Primary Synovial Sarcoma of the Parotid Gland
Touiheme N, Hmidi M, Nakkabi I, Belatik H, Attifi H, Nadour K, Boukhari A
Sch J Med Case Rep | 222-224
DOI : 10.36347/sjmcr.2020.v08i02.032
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Synovial sarcoma is a rare malignant mesenchymal tumor of soft tissue. Its location in the parotid gland is exceptional. 55-year-old patient, with no specific history, with a history of slow evolution over one year of a mass in the right parotid region. The computed tomography objectified a tumor at the expense of the lobulated right parotid with serpiginous calcifications taking contrast on the periphery measuring 4 / 2.5 cm. The patient was initially treated by surgery and radiotherapy.The evolution was marked by good locoregional control without metastasis with a decline of four years. The diagnosis of parotid gland synovial sarcoma is confirmed by immunehistochemistry. Surgery combined to radiotherapy seems to be the best treatment.
Facial Paralysis Revealing Post-Traumatic Cholesteatoma: Case Report
N. Touiheme, H. Attifi, M. Hmidi, I. Nakkabi, H. Belatik, K. Nadour, A. Boukhari
Sch J Med Case Rep | 225-227
DOI : 10.36347/sjmcr.2020.v08i02.033
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Post-Traumatic cholesteatoma is a very rare entity. It occurs several years after the trauma to the temporal bone hence the difficulty of the diagnosis. We reported A case of posttraumatic cholesteatoma is presented that was revealed by a right facial nerve paralysis 10 years after the head trauma. Post-Traumatic cholesteatoma is revealed by repetitive otorrhea, or directly at the complication stage such as facial paralysis. Diagnosis is facilitated by imaging, especially the scanner. Treatment is based on surgery especially the wall up tympanoplaty. This case reveals the importance of prolonged monitoring of temporal bone trauma.
A Jehovah’s Bloodless Tale
Arvin Thiruchelvam, Kian Boon Wong, Kiew Kong Pau, Jeswant Dillon
Sch J Med Case Rep | 126-127
DOI : 10.36347/sjmcr.2020.v08i02.008
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Background: Jehovah’s Witnesses are a subgroup of Christianity who refrained from blood transfusions. As of 2017, there were reported 5069 Jehovah’s Witnesses in Malaysia. However, this is concerning as cardiac surgery is known to be associated with a high risk of perioperative blood loss and allogeneic blood transfusions. Recent studies always compared restrictive (Hb 7.0–8.0 g/dl) and liberal (Hb 9.0–10.0 g/dl) transfusion strategies. No study took into consideration the outcomes of patients with Hb less than 7.0g/dl. We are reporting a case and outcome of a patient who required a Redo Triple Valve surgery with no blood transfusion. Methods: 40 year old Jehovah’s female, with underlying CRHD who underwent a DVR (Aortic & Mitral) (Tissue) in 2004 currently presented with degenerative prosthetic valve. Upon sternotomy dense adhesions were noted. Meticulous resections and hemostasis was achieved as surgery progressed with the adjunct of Cell saver. Bicaval canulation and selective cardioplegia administration via coronary ostium was performed. Mitral valve was accessed via a transeptal approach and replaced with a size 27/29 mm On-X valve. As the STJ was only 19mm, root enlargement with autologous pericardium was performed and a size 19mm SJM valve was implanted. Cross clamp was released and Devega TAP was performed on a beating heart. Patient came off bypass with minimal support. Bypass time was 276minutes with Cross clamp time of 235 minutes and blood loss of 300mls.Chest was packed overnight and left opened to conserve blood and optimize clotting. Delayed chest closure was performed on POD 1 and patient was extubated POD 3.POD 4 patients documented Hb was 5.0g/dl, however patient compensated well and did not require any blood transfusion or inotropic support. Patient was discharged well on POD 9 with a Hemoglobin level of 6.7g/dl. Discussion: Preoperatively, patient was given IV iron and Hb level was boosted. During surgery the use of Cell Saver and meticulous....
Behavioral Characteristics and Psychological Profil of PRADER WILLI Syndrome: A Case Report
Rabitateddine M, Amraouza K, Ennazk S, Sak H, Adali I, Manoudi F, Asri F
Sch J Med Case Rep | 233-236
DOI : 10.36347/sjmcr.2020.v08i02.036
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Prader-Willi syndrome (PWS) is a neurodevelopmental disability characterized by hypotonia and failure to thrive during infancy, then the development of hyperphagia, hypogonadism, cognitive impairments and distinct physical and behavioral characteristics. Through our patient’s case and literature review, we’re willing to showcase the different psychiatric disorders that can occur in patients with PWS, and show treatments that are specific and/or effective. Our patient is a 19 year old Caucasian male, diagnosed with Prader-Willi syndrome through its clinical elements, has also type 1 diabetes and sent by the endocrinology unit to the psychiatry department to take charge its behavioral disorders. Several studies investigating social and communication skills have shown people with PWS to have difficulties with care, receptive and expressive language skills, interpreting emotional valence in faces, understanding personal space and a developmental delay in theory of mind. Temper outbursts, temper tantrums and skin picking are often seen in PWS. Different drugs can be used such as second generation of anti-pyschotics, antidepressants and oxytocin and others.
True Aneurysm of the Superficial Temporal Artery: Case Report and Review of Literature
Elfatemi B, Baikal T, Tijani Y, Khloufi S, Sefiani Y, Lekehel B, Mesnaoui A
Sch J Med Case Rep | 237-240
DOI : 10.36347/sjmcr.2020.v08i02.037
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Aneurysms of the superficial temporal artery are rare. It can be assumed that their impact is estimated as a result of cases operated but not published. They are mostly atherosclerotic or congenital. Their diagnosis is mainly based on clinical examination and the use of complementary examinations is only indicated for the differential diagnosis or looking aneurysmal other locations. It is necessary to distinguish between true and false aneurysms based on several clinical and pathological features. Few studies have been published in terms of the temporal artery aneurysms in children. Their treatment is surgical and involves the flattening with ligation of the vessel. A case has been reported of a true aneurysm of the superficial temporal artery in a child of 13 years old while recalling the clinical and therapeutic epidemiological characteristics of the disease.
Diagnostic Imaging of Schizencephaly: About 16 Cases
M. Badraoui, D. Basraoui, H. Jalal
Sch J Med Case Rep | 241-242
DOI : 10.36347/sjmcr.2020.v08i02.038
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Schizencephaly is a malformation of the central nervous system related to the presence of an extended unilateral or bilateral cleft of the lateral ventricle on the surface of the cerebral cortex. This is a retrospective and descriptive study of 16 cases of schizencephaly collected over a period of 8 years (January 2011 to December 2019). A radiological assessment made of a brain scan performed in 11 patients and a cerebral MRI performed in 5 patients. The reported cases ranged in age from 2 months to 45 years with a male predominance and a sex ratio of 1.66. The clinical symptomatology was dominated by epileptic seizures, psychomotor retardation and motor deficit. The malformations were divided as follows: unilateral schizencephaly (15 cases: 6 type I and 9 type II) and bilateral schizencephaly (1 case: type II). Schizencephaly is an uncommon cerebral malformation that is most often revealed by epilepsy. It is characterized by a cleft with open or closed lips sitting most often in the Rolandic regions. Imaging, especially MRI, is essential in the positive diagnosis and the assessment of lesions.
Hirschsprung’s Disease in Adulthood: Case Report and Review of the Literature
F. Haddar, F. Bellouhou, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati
Sch J Med Case Rep | 150-153
DOI : 10.36347/sjmcr.2020.v08i02.013
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Hirschsprung’s disease (HD) in adults is rare and often undiagnosed or misdiagnosed. We report a case of HD in a 35-year-old woman who had a history of chronic constipation that required laxatives and enemas since early childhood. Symptoms had worsened in recent months, prompting her to seek the evaluation of a proctologist. A computed tomographic scan confirmed significant fecal loading of the colon and rectum. An anal manometry revealed lack of normal rectoanal inhibitory reflex. A rectal biopsy showed aganglionic anorectum. A diagnosis of adult HD was made and treated. Hirschsprung’s disease should be considered in adults who have long-standing and refractory constipation.
Malignant Transformation of Ménétrier Disease: Case Report and Review of the Literature
F. Haddar, J. Elatmani, F. Bellouhou, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati
Sch J Med Case Rep | 161-164
DOI : 10.36347/sjmcr.2020.v08i02.015
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Ménétrier’s disease is an infrequent hypertrophic disease of the stomach associated with hypoproteinemia of unknown etiology. This disease is considered to be premalignant since 10-15% of affected individuals develop gastric cancer. We report the case of a malignant degeneration of Ménétrier disease associated with gastric polyposis in a 60-years-old man who had received a diagnosis of Ménétrier’s disease 6 years previously and who was found to have advanced antral gastric cancer during the follow-up. We provide an update on the optimal therapeutic approach, which has not been clearly defined to date.
A Malignant Omental Extra-Gastrointestinal Stromal Tumor: Case Report and Review of the Literature
F. Haddar, F. Bellouhou, A. Ait Errami, S. Oubaha, K. Krati, Z. Samlani
Sch J Med Case Rep | 165-169
DOI : 10.36347/sjmcr.2020.v08i02.016
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Extra gastrointestinal stromal tumours (EGIST) are rare neoplasms of the abdomen which have similar morphological and immunohistological features of gastrointestinal stromal tumours. These tumours are not connected to either stomach or intestine and most commonly arise from mesentery, retroperitoneum, omentum etc. We describe a case of EGIST arising from omentum in a 65 year old female patient who presented with abdominal pain.
Caroli’s Disease Associated to Renal Cysts: Case Report and Review of the Literature
F. Haddar, F. Bellouhou, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati
Sch J Med Case Rep | 170-172
DOI : 10.36347/sjmcr.2020.v08i02.017
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Caroli’s disease is characterized by multifocal segmental dilatation of the intrahepatic bile ducts. It is rare congenital condiction, which appears to autosomal recessively inherited in most cases. There are two forms of disease, one associated with congenital hepatic fibrosis and simple form occurring alone. Recent reports suggest that simple form may be as common as thar with congenital hepatic fibrosis. Other conditions, including choledochal cyst and renal cystic disease, are frequently associated. The major clinical feature is reccurent cholangitis, which may be complicated by intrahepatic calculi and hepatic abscess formation. There is good evidence that malignancy complicates Caroli’s disease in approximately 7 % of cases. The diagnosis rests on demonstrating that the cystic liver lesions are in continuity with the biliary tree. Modern imaging techniques allow the diagnosis to be made more easily and without invasive imaging of the biliary tree. The treatment depends on the clinical features and the location of the biliary abnormality. When the disease is localized to one hepatic lobe, hepatectomy relieves symptoms and appears to remove the risk malignancy. The patients with bilobar disease not amenable for liver transplantation but operated with Fag Kan intervention can be managed not only with removal of bile ducts stones when symptomatic, but with insertion of multiple plastic stents, that must be changed periodically, for example every three months during a daily hospital access.
The Risk of Acute Respiratory Distress Syndrome in Patients with Subarachnoid Hemorrhage, About A Case
Dr. Mohamed Mattous, Dr. Nabil Jbili, Dr. Jaouad Laoutid
Sch J Med Case Rep | 245-247
DOI : 10.36347/sjmcr.2020.v08i02.040
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Aneurysmal arachnoid hemorrhage (AAH) is a rare disease common in the young female population and can cause many neurological complications, namely hydrocephalus, vasospasm and rebleeding. However, it can also lead to extra neurological complications, including cardiovascular failure, renal failure, metabolic disorders (hypokalaemia, hyperglycemia, dysnatremia) and acute respiratory distress syndrome (ARDS). We report a case of a 50-year-old patient who developed ARDS during her hospitalization in the resuscitation department for an AAH. The occurrence of this complication in these patients could be explained on one hand by an activation of the sympathetic nervous system hence the appointment of neurogenic pulmonary edema and on the other hand by the presence of a systemic inflammatory response syndrome ( SIRS), but future studies will be needed to elucidate these pathophysiological mechanisms. According to recent studies, the treatment of ARDS is based on a mechanical ventilation strategy that uses low volumes with high PEEP, while prone position is a therapeutic alternative but with the risk of increased intracranial pressure. The management of aneurysmal arachnoid haemorrhage relies on the control of as well as other factors responsible for delayed ischemia and aneurysm treatment.
Original Research Article
Feb. 28, 2020
Spinal Cord Compression in Breast Cancer
Kriouile K, Afalah , Jayi.S, Fdili Alaoui. FZ, Chaara.H, Melhouf My A, H. Ouahbi, N. Mellas
Sch J Med Case Rep | 248-250
DOI : 10.36347/sjmcr.2020.v08i02.041
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Breast cancer is the most common malignancy and the first leading cause of death from cancer in Moroccan women. Breast cancer most commonly metastasizes to the bone and has a particular affinity with the spine, accounting for 2/3 of osseous metastases discovered. With significant improvements in cancer therapies, the number of patients at risk for symptomatic spinal metastases is likely to increase. Patients may suffer from intractable pain and neurological dysfunction, negatively influencing their quality of life. Timely diagnosis of patients is crucial and has been aided by several breakthrough advances in imaging techniques which aid in detection, staging, and follow-up of bone metastases. Breast metastases are usually responsive to hormonal therapy and pharmacologic interventions, but skeletal metastases often require surgical intervention. The treatments are palliative but goals include the preserving or restoring neurologic function, ensuring spinal stability, and relieving pain. In this case report, the clinical presentation, diagnosis, patient selection, and management of breast cancer metastatic to the spine are discussed.
Role of MRI in Childhood Multiple Sclerosis
Hicham Jalal, Amine El Masloumi, Anass Chehboun, Meryem Ouali Idrissi, Najat Cherif Idrissi El Ganouni
Sch J Med Case Rep | 251-253
DOI : 10.36347/sjmcr.2020.v08i02.042
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Multiple sclerosis (MS) is characterized by inflammatory lesions of the white matter of the central nervous system, disseminated in time and space. The average onset age is 30 years. The infantile form is rare, The aim of this work is to report the clinical and radiological features of the childhood multiple sclerosis through a case report of a 13-year-old girl.
Retinopathy of Valsalva Post Oesophageal-Gastroduodenal Fibroscopy: Case Report and Review of the Literature
El marzouqi B, Karmoun S, Amhoud K, Bouzoubaa T, Pr Abdelah E, Pr Boulanouar A, Pr Berraho A.
Sch J Med Case Rep | 254-257
DOI : 10.36347/sjmcr.2020.v08i02.043
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Introduction: Valsalva retinopathy is a rupture of vessels retinas during a physical exertion performed at closed glottis. It is linked to a sudden increase in intra-thoracic or intra-abdominal pressure. Materials and Methods: This is an elderly patient 27 years old, with no pathological history, who consult for a sudden visual acuity decrease in both eyes post oesogastroduodenal fibroscopy. The fundus revealed hemorrhages retinniene and pre - macular of both eyes. Fluorescein angiography showed no abnormality of retinal vessels. Macular OCT is normal. Discussion: Valsalva retinopathy usually occurs in healthy adults it has been reported after aerobic exercise, vigorous sexual activity, swelling balloons, prostate, dental surgery, episodes of constipation, vomiting and uprisings in pregnant women. After weightlifting, endotracheal intubation, vomiting, coughing with force, colonoscopy procedure, and in rare cases after upper gastrointestinal endoscopy. Valsalva-induced preretinal hemorrhage generally present in the macula. In case of macular damage, Valsalva retinopathy may cause a sudden decrease in vision. As a general rule, the visual prognosis is favorable usually, it is impossible to clinically distinguish the plan from premacular hemorrhage, sub-hyaloid ... From where the interest of fluoride angiography and macular OCT. In case of sudden loss of vision during a diagnostic procedure, the doctor may time and effort to try to determine the cause. If Valsalva maneuver is noted in the story, however, valsalva retinopathy should be considered as a possible explanation for vision loss. The evolution of retinopathy of Valsalva is most often spontaneously favorable. Nd - yag laser or vitrectomy are only performed in case of persistence of the hematoma because of risk of retinal toxicity. Conclusion: Retinopathy of valsalva is a rare condition with a good prognosis; its diagnosis is based on the clinical history. It does not require recourse physical or surgical treat
Torsade De Pointe Secondary to Proton Pump Inhibitor–Induced Hypomagnesemia
Dinia Mohamed, Elouardighi Kaoutar, Saeed Hatem
Sch J Med Case Rep | 258-260
DOI : 10.36347/sjmcr.2020.v08i02.044
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Magnesium is the third most common intracellular ion after potassium and calcium and plays an important role in several biochemical and physiological processes. Gastrointestinal disorders and kidney diseases are the main causes of hypomagnesemia, but it can also be an adverse effect of numerous drugs. Clinical manifestations of hypomagnesemia are nonspecific, the most severe of which are heart rhythm disturbances and mainly torsade de pointes. We present the case of an 82-year-old female patient presenting with torsade de pointes ventricular tachycardia secondary to proton pump inhibitor–induced hypomagnesemia.
A Rare Presentation of Pulsating Thoracoabdominal Mass
Dr. Malay Jhancy, Ammar Al Homsi, Mohammad Al Homsi
Sch J Med Case Rep | 261-263
DOI : 10.36347/sjmcr.2020.v08i02.045
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Ectopia Cordis is a partial or total protrusion of the heart outside the thoracic cavity. It accounts for 0.1% of congenital heart diseases [1]. This rare malformation can be a part of a syndrome called the Pentalogy of Cantrell, which is a constellation of five congenital defects. In its complete form, it presents with a defect of the heart, pericardium, diaphragm, sternum and abdominal wall [2]. These defects pose a challenge for surgeons, and early identification with strategic planning for management is essential for the survival of the patient. The author reports a case of ectopia cordis associated with a probable diagnosis of Pentalogy of Cantrell, in a neonate presenting with pulsating thoracoabdominal mass, sternal, and abdominal wall defect.
Profound Hypoglycemia and Convulsion, Think About Ecstasy Poisoning
Dr. Mohamed Mattous, Dr. Nabil Jbili, Dr. Lotfi Bibiche, Dr. Jaouad Laoutid
Sch J Med Case Rep | 264-265
DOI : 10.36347/sjmcr.2020.v08i02.046
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Ecstasy or MDMA (Methylene Dioxy Met Amphetamin) is a synthetic drug commonly used by young people for its stimulating and euphoric effect, it can however be responsible for side effects including hyperthermia, psychomotor agitation, cardiotoxicity, hepatotoxicity, hypoglycemia, renal failure, hyponatremia and seizures. We report a clinical observation of a 34-year-old patient who experienced profound hypoglycemia and convulsive hyponatremia following ingestion of an ecstasy tablet. The deep hypoglycemia is thought to be due to endogenous hyperinsulinémie requiring close monitoring of blood sugar in any patient admitted for ecstasy poisoning and a dosage of serum insulin and C-peptide in patients with hypoglycemia. Hyponatremia can be explained either by a direct action of ecstasy or by excessive consumption of water(dilution hyponatremia ),it can cause ,when it is deep, a cerebral edema which would explain the seizures, of or the advantage of ingesting water simultaneously to prevent dehydration or ingesting salt at the same time as reduced volumes of water.
Fibrous Dysplasia of the Middle Turbinate: About A Case Report
H. EL HAMMAOUI, M. EL GHAIDI, H EL MORTAJI, D BASRAOUI, H. Jalal
Sch J Med Case Rep | 191-193
DOI : 10.36347/sjmcr.2020.v08i02.024
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Fibrous dysplasia is a common benign fibro-osseous disease involving the flat bones, often affecting the bony structures of the skull and facial skeleton. Primary occurrence or secondary involvement of the nasal turbinate is not a common manifestation of the disease. Involvement of the inferior turbinate generally does not have specific management-related issues; however, involvement of the middle turbinate, especially the lateral lamella, can predispose to surgical morbidity during endoscopic surgical management. Clinical presentation, management and features of the disease on CT imaging are presented.
