A Rare Case Report of a Preterm Occipital Meningoencephalocele
Dr. Deepu Abraham Cherian, Dr. Anilkumar Peethambaran, Dr. Prashanth Asher
Sch J Med Case Rep | 989-991
DOI : 10.36347/sjmcr.2020.v08i12.001
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Meningo encephalocele is one of the rare manifestation of congenital abnormality in which the brain and overlying meninx protrude out of a defect in the calvaria [1]. This is the case report of one of the monozygotic twin with occipital meningo encephalocele which was unruptured. The child was operated in view of the size and vital contents. The child survived the surgery and was discharged without any postoperative complications.
An Unusual Complication of Gall Stones-Mirizzi Syndrome – Primary Care Perspective
Ahmed Rashid Shaik, Nirupama Keshavrao Patil, Fathiya Muhammad Al-Meer
Sch J Med Case Rep | 992-993
DOI : 10.36347/sjmcr.2020.v08i12.002
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Mirizzi syndrome is a rare condition caused by the obstruction of the common bile duct or common hepatic duct and without preoperative diagnosis mortality could be as high as 17%. It has been reported that 6% to 28% of patients with preoperative diagnosis of Mirizzi syndrome actually had gallbladder cancer. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. In this current case A 22-year-old well gentleman presented with 4 days history of yellowish discoloration to eyes, skin, abdominal pain on eating food and weight loss of 10 kgs over past 6 months. Icterus was note on examination. He was referred to secondary care for further evaluation. Blood test confirmed deranged Liver function tests. MRCP showed – Stones of the Extrahepatic bile ducts causing intrahepatic bile duct obstruction, probably located within the lower end of the anomalously crossing cystic duct causing extrinsic compression of the common duct (Merizzi Syndrome). A Laparoscopic Cholecystectomy + Trans cystic CBD exploration with Choledochoscope and extraction of stones by Dormia basket + Intraoperative Cholangiogram (IOC) was carried out. Findings were in keeping with Mirizzi syndrome. Blood tests done post operatively showed improvement in bilirubin and LFTs in span of 20 days. He was discharged home on oral antibiotics and analgesia. Mirizzi’s syndrome is a rare complication caused by gallstone(s) located in the infundibulum of the gallbladder or cystic duct leading to adjacent biliary duct compression which results in partial or complete obstruction of the common hepatic duct and sometimes with the presence of cholecystocholedochal fistula. Incidence ranges from 1% per year in developed countries to upto 5.7% in developing countries. Surgical cholecystectomy is considered as the treatment of choice [3]. The surgeon is the main specialist for diagnosis and treatment but familiarity and a high degree of suspicion of this condition must be present by......
Management of Congenital Deafness of the Syndrome Branchio-Oto-Renal (BOR): A Case Report
Mohamed Ali Gliti, Khaoula Karim, Bencheikh Razika, Benbouzid Mohamed Anas, Leila Essakalli Houssyni
Sch J Med Case Rep | 994-999
DOI : 10.36347/sjmcr.2020.v08i12.003
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Objective: Describe the different therapeutic modalities of Branchio-oto-renal (BOR) Syndrome. Material and method: We report the case of a 7-year-old boy who presented with a Branchio-oto-renal syndrome (BOR). Clinical Case: T.S, a 7-year-old child presented from the age of 3 years, a progressive, bilateral deafness, with a preserved language. The otological examination found implanted low ears, bilateral prehelic fistulas, and left seromucosal otitis CT scan showed bilateral vestibulo-labyrinthine malformation confirmed by the MRI. Cochlear implant surgery on the right ear was performed. Conclusion: The therapeutic principle is based on the precociousness of the rehabilitation of a quality auditory canal, which remains a factor of good prognosis of bilateral deafness of the child reached of the syndrome of BOR. A quality ear canal is defined by an ability to perceive and understand speech by the ear canal alone. Severe or deep bilateral deafness is the subject of hearing rehabilitation by hearing aid or cochlear implant, speech therapy and educational support.
Wegener's Granulomatosis with Laryngeal Location: A Case Report
Mohamed Ali GLITI, Khaoula Karim, Bencheikh Razika, Benbouzid Mohamed Anas, Leila Essakalli Houssyni
Sch J Med Case Rep | 1000-1003
DOI : 10.36347/sjmcr.2020.v08i12.004
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Objective: Describe the different therapeutic modalities of glottic stenosis due to Wegener's granulomatosis. Material and method: We report the case of a 49-year-old man who presented with a glottic localization of Wegener's granulomatosis. Clinical case: Mr. AB presented a laryngeal dyspnea on a laryngeal stenosis due to a Wegener's disease with renal, cutaneous, naso-sinus, and glottic localization. A life-saving tracheostomy was performed first. The medical treatment allowed a regression of all the lesions. . Two months after starting treatment, the patient is stable and the laryngeal stenosis no longer affects the patient's daily activities. Conclusion: The appearance of upper respiratory symptoms in may be indicative of Wegener's disease and should alert and seek for laryngo-tracheal stenosis. Intralesional corticosteroid injection is a recent and less invasive method than dilation. It seems to give satisfactory results. Sometimes a tracheostomy is necessary.
A Rare Case Report of Trans Oral Removal of Air Gun Pellet
Dr. Deepu Abraham Cherian, Dr. Anilkumar Peethambaran, Dr. Sharmad M. S
Sch J Med Case Rep | 1004-1006
DOI : 10.36347/sjmcr.2020.v08i12.005
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This is the case report of trans oral trans pharyngeal removal of air gun pellet which was accidentally fired into the mouth of a young gentleman while attempting to clean the gun. The gun pellet pierced the soft palate and dodged into the Cranio Vertebral Junction (CVJ) in the anterior aspect. Removing a foreign body dodged close to such a deep and vital area of the brain and spinal cord was a very challenging task from the part of Surgeons. The most difficult part of the whole scenario was the dilemma of whether to operate upon a patient who was totally preserved and remove a foreign body or to just observe the patient. We proceeded with the first option of surgical removal. The patient survived the surgery and was discharged without any focal neurological deficit.
Tornwaldt Nasopharyngeal Cyst: Case Report and Review of Literature
Mohamed Amine Hanine, Mohammed ELAKHIRI, Abdelfattah ALJALIL, Youssef Darouassi, Haddou AMMAR
Sch J Med Case Rep | 1007-1008
DOI : 10.36347/sjmcr.2020.v08i12.006
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Tornwaldt's cyst (TC) is the presence of cystic swelling of the midline of the nasopharynx. It is a rare benign pathology which mainly interests adults. Clinically large cysts result in compressive rhinological syndrome which requires radiological exploration. We report the case of a patient with a Tornwaldt cyst to provide an update on this rare pathology.
Anterior Bilateral Dislocation of the Shoulder: Case Report
Hicham Douma, Faycal Rifki, Ouahb Azriouil, Mohamed Daoudi, Benabbouha Abdellatif, Khalid Koulali Idrissi
Sch J Med Case Rep | 1009-1011
DOI : 10.36347/sjmcr.2020.v08i12.007
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The anterior bilateral dislocation of the shoulder is a rare clinical entity. We report an observation of a young 22 years old soldier, right-handed person with a history of 2 episodes of antero-internal dislocation of the right shoulder, and who presented to the emergency room for functional impotence of the 2 upper limbs after falling from a ladder of 3 meters. The clinical examination suggesting a bilateral anterior dislocation of the 2 shoulders, confirmed on chest x-ray. An emergency reduction was performed by Kocher's maneuver with success during the first attempt. The patient was scheduled for delayed surgery on his unstable right shoulder.
Atrial Fibrillation: Diagnosis, Treatment and Outcomes- A Case Study
Md. Sohel Khan, Md. Shahabuddin Khan, Md. Hanif Hossain, A. K. Al Miraj, H. N. Ashikur Rahaman, Md. Magfur Rahman, Mahbubul Islam Khandoker, Md. Enamul Hoque, Muhammed Zafar Iqbal
Sch J Med Case Rep | 1012-1019
DOI : 10.36347/sjmcr.2020.v08i12.008
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Atrial fibrillation is the most common cardiac arrhythmia. It impairs cardiac function and increases the risk of stroke. The incidence of atrial fibrillation increases with age. Key treatment issues include deciding when to restore normal sinus rhythm, when to control rate only, and how to prevent thromboembolism. Rate control is the preferred management option in most patients. Rhythm control is an option for patients in whom rate control cannot be achieved or who have persistent symptoms despite rate control. The current recommendation for strict rate control is a resting heart rate of less than 80 beats per minute. However, one study has shown that more lenient rate control of less than 110 beats per minute while at rest was not inferior to strict rate control in preventing cardiac death, heart failure, stroke, and life-threatening arrhythmias. Anticoagulation therapy is needed with rate control and rhythm control to prevent stroke. Atrial fibrillation prevalence has been on the rise. The risk of stroke is 5-times higher in a patient with known atrial fibrillation compared to the general public. It is estimated that 19.6% of patients over the age of 65 will have apparent atrial fibrillation by 2030. The most feared side effect of atrial fibrillation is an acute stroke, which can lead to severe morbidity and mortality. It has been shown that 60% of strokes secondary to atrial fibrillation can be avoided with the use of anticoagulants. Using the CHADs-2-VASc score to evaluate patients with atrial fibrillation is a helpful guide for the management of these patients with the ultimate goal of preventing stroke. These AF classifications are not mutually exclusive and it is common for patients with one type of AF to exhibit overlapping features of another type. These classifications are relevant clinically with respect to outcomes and prognosis with rhythm-controlling treatment strategies. Atrial fibrillation is commonly associated with other supraventricular arrhythmia
Congenital Conjoined Double Medial Meniscus: A Case Report
Ahmed W, Ullah SMA, Sarwar Z, Rahman PK
Sch J Med Case Rep | 1020-1022
DOI : 10.36347/sjmcr.2020.v08i12.009
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Introduction: We report on a case of congenital conjoined double medial meniscus, which was incidentally found during arthroscopic anterior cruciate ligament reconstruction of a young patient. Both the meniscus were connected to each other throughout the whole length conjoined with having a junctional cleavage. And its periphery was connected to the joint capsule. This case demonstrates an interesting and very rare anatomical abnormality of the medial meniscus. We report on the case with a review of the literature.
Successful Pregnancy Outcome Following Cervico-Vaginal Dysgenesis –A Case Report
Banu PJ, Nasreen K, Ansary SA, Ishrat S, Deeba F, Begum N, Anwary S
Sch J Med Case Rep | 1023-1028
DOI : 10.36347/sjmcr.2020.v08i12.010
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Background: Congenital cervical dysgenesis with or without vaginal agenesis is a rare Müllerian developmental disorder that occurs in one in every 80,000 to 100,000 births. Cervical abnormalities two basic anatomical types. First, the cervix is absent with narrow lower uterine segment and absent vagina cervico vaginal agenesis. The second type is cervical dysgenesis. Management options for such conditions include total abdominal hysterectomy or conservative surgery with uterovaginal anastomosis, cervical canalization, or cervical reconstruction. In our case report, the patient had cervico vaginal dysgenesis. Objective: Aim is to successful reproductive out come after reconstructive surgery of cervicovaginal dysgenesis. Case report: Mrs. Rabeya came to BSMMU on 08/11/08 with primary amenorrhea with hematometra with vaginal agenesis at 15 yrs old. Reconstruction of cervix & vaginoplasty done & menstruation started. Upto 7 years after 1st operation her menstrual cycle was regular but scanty flows with severe dysmenorrhea. Above these complaint’s she again came to BSMMU at 2015 and reconstruction surgery was done due to narrowness of cervico vaginal space at that time. After 2nd operation her menstrual flow was average & dysmenorrhea decreased. She got married at 2017. Four months after her marriage she developed severe dyspareunia & came to BSMMU & admitted on 10/08/17. Re-anastomosis of cervico vaginal stenosis and resection of septum done for 3rd time and cervico vaginal canal restored. Her dyspareunia was improved. Now after her 3rd time operation she enjoying her new life & spontaneous pregnancy occur. Finally LUCS was done at her 36wks pregnancy on 6th May 2019. Discussion: A total of approximately 200 cases of congenital cervical atresia have been reported in the literature. The experience from reconstructive uterovaginal anastomosis was not satisfactory. Rock et al., recently reviewed 30 cases of cervical agenesis and dysgenesis that underwent reconstructive....
Aneurysm, Thrombosis and Muscle Atrophy Due to Unused Arterio-Venous Fistula in A Renal Transplant Recipient
Dr. Vipin Chandra, Dr. Rohit Upadhyay, Dr. Rajesh Tiwari
Sch J Med Case Rep | 1029-1031
DOI : 10.36347/sjmcr.2020.v08i12.011
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Arterio-venous fistula (AVF) is the best vascular access for hemodialysis in a patient with chronic kidney disease. Its complications during use for dialysis are well known but less has been reported about the complications of AVF that are left in situ (unused) after a successful renal transplantation. There are no specific recommendations regarding closure of AVF post renal transplantation. We are presenting a huge cephalic vein aneurysm in an unused radio-cephalic fistula along with atrophy of forearm muscles in an adult renal recipient about 15 years after the creation of AVF. He was evaluated and underwent excision with uneventful recovery.
Eosinophilic Esophagitis: A Rare Cause of Dysphagia: About A Case
Chait Yassine, Nacir Oussama, AitErrami Adil, Samlani Zouhour, Krati Khadija, Oubaha Sofia
Sch J Med Case Rep | 1032-1036
DOI : 10.36347/sjmcr.2020.v08i12.012
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Background: Eosinophilic esophagitis is a chronic, inflammatory disease characterized clinically by symptoms related to esophageal dysfunction and histologically by a marked eosinophilic infiltrate in the esophageal mucosa. It predominantly occurs in young men with a history of atopy. Dysphagia and food impaction are the most common presentations. Case presentation: A 35-year-old man with known history of recurrent allergic rhinitis, presented with recurrent dysphagia reveling food impaction. Esophageal biopsies showed eosinophilic polynuclear exocytosis. Avoiding the responsible allergens, as well as topical corticosteroid therapy improved the patient’s symptoms. Conclusion: Eosinophilic esophagitis is still poorly understood, It is more common in young men, and there is usually a marked atopic component. It is the leading cause of dysphagia and feeding impaction in young men. Depending on the case, patients may require multidisciplinary treatment by gastroenterologists, allergists, immunologists and nutritionists.
Study of Two Fractions versus Three Fractions of High Dose Rate Brachytherapy in Locally Advanced Carcinoma of Uterine Cervix after Pelvic Concurrent Chemoradiotherapy
Israt Jahan, Abdul Bari, Prof Sarwar Alam, Niaz Mostafa
Sch J Med Case Rep | 1037-1041
DOI : 10.36347/sjmcr.2020.v08i12.013
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Uterine cervical cancer is the commonest form of gynecologic malignancy in Bangladesh and South east Asia. The aim of this study was to compare the treatment outcome and complications following treatment with 9 Gy (gray) in two fractions of intracavitery radiotherapy (ICRT) following external beam radiotherapy (EBRT) with 7 Gy in three fractions of ICRT. A prospective randomized study carried out in different tertiary hospitals of Bangladesh during the period of 2015 to 2016 with a number of 61 patients evaluated, all patients received EBRT 50 Gy in 25 fraction of 2Gy per fraction over a period of 5 weeks and inj. Cisplatin 40 mg/m² weekly. Then ICRT weekly two fractions with 9 Gy per fraction in arm A and three fractions of 7 Gy to arm B was delivered. At 3 years follow up, complete remission was 77% and 73% respectively for arm A and arm B. The overall complete response was 75%. The common toxicities associated with treatment were bladder and rectal toxicities, skin reaction and hematologic complications which were managed well. During follow up after 3 years, there was no grade 3 or 4 toxicities and rectal and bladder toxicities were similar in both arms. This study showed that after standard EBRT total dose of 18 Gy ICRT in two fractions of 9 Gy over 2 weeks is equally effective in local control with acceptable toxicities in comparison with a total dose of 21 Gy in three fractions of 7 Gy ICRT.
Nutcracker Syndrome as Unusual Cause of Hematuria in a young woman: A Case Report
Prof. Dr. Kemal Niyazi Arda, Oğuz Han Karadenizli, Sinan Akay, Prof. Dr. Mesut Gürdal
Sch J Med Case Rep | 1042-1044
DOI : 10.36347/sjmcr.2020.v08i12.014
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Nutcracker syndrome is an uncommon vascular compression disorder that is characterized by the compression of left renal vein between the abdominal aorta and superior mesenteric artery. It tends to occur in female patients with a predilection of third and fourth decades. Symptoms are non-specific and diagnose is possible with exclusion of more common causes and, with imaging studies. The diagnosis can be made with Doppler ultrasound, computed tomography angiography, magnetic resonance angiography and retrograd venography. We present a case with this rare syndrome diagnosed with computed tomography angiography. This entity can be easily overlooked unless it comes to mind and dedicated imaging is performed.
Oral Manifestations Following GERD, Self-Injury Behavior and Wearing Dental Removable Prosthetics: An Overview and a Case Report
Pierluigi Guerrieri, Andrea Oliveira, Federico Arosio, Martino Meuli, Luca Viganò, Cinzia Casu
Sch J Med Case Rep | 1045-1053
DOI : 10.36347/sjmcr.2020.v08i12.015
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Introduction: Some physical and mental conditions can directly or indirectly influence the health of the oral cavity especially for traumatic injuries. In this review we decided to consider the presence of dental prostheses, mental illnesses and even gastroesophageal reflux in the development of traumatic lesions of the oral cavity. All these conditions are characterized by a greater risk of developing injuries. The aim is also to report a case of tongue erosion from gastro-esophageal reflux successfully treated with 808 nm diode laser. Materials and Methods: We investigated PubMed database using the keywords: “Oral manifestation of gastrointestinal disorders” “mental retardation and oral biting” and “denture wearers’ oral lesion”. Where possible, we included systematic review. Results: Several scientific papers, including systematic reviews, have highlighted the correlation between gastroesophageal reflux and oral lesions, such as dental erosion, erythema in various sites, glossitis and periodontitis. Mental retardation is involved in the development of self-injuries at the oral level, which may also evolve into serious lesions such as oral carcinoma. The most common denture-related oral lesions are fibrous hyperplasia, traumatic ulcers and denture stomatitis. Poor oral hygiene and inadequate fitting of the dentures appear to be risk factors for these injuries. Conclusion: It is important to evaluate the adequacy of dental prostheses in order to avoid traumatic mucosal injuries. It is also necessary to control gastric acidity to reduce the risk of developing lesions. For patients with mental disability, a close follow up and the use of intraoral devices is advisable. The use of diode laser could be a very safe and interesting tool for treatment of symptomatic oral mucosal lesions from GERD.
Upper Airway Management in a Patient with an Asymptomatic and Undiagnosed Vallecular Cyst: A Challenging Situation
Mohamed Moutaoukil, Said Khalikane, Abdelouahid Jaafaria, Habib Bellamlih, Mustapha Bensghir, Hicham Balkhi, Abdelouahid Baite
Sch J Med Case Rep | 1054-1059
DOI : 10.36347/sjmcr.2020.v08i12.016
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Vallecular cyst is a very rare lesion which can be potentially dangerous during anesthesia because they may completely obstruct the larynx or the anesthesiologist's view of the larynx causing difficult intubation and thus become life-threatening. This report describes airway management difficulties in a patient with an asymptomatic and undiagnosed vallecular cyst. Anaesthetic issues surrounding this pathology are discussed.
Splenic Hydatid Cyst: A Case Report
S. Tadsaoui, A. Chehboun, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi El Ganouni
Sch J Med Case Rep | 1060-1062
DOI : 10.36347/sjmcr.2020.v08i12.017
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Hydatidosis is an antropozoonosis caused by the larval form of the cestode of the genus echinococcus granulosus. Despite the endemic state of the disease in some countries of the Mediterranean basin, splenic hydatidosis is rare. It comes in 3rd position after the liver and the lung localization. The treatment is mainly surgical. We report the case of a 21-year-old patient living in a rural area around Marrakech, with no particular medical history, who presented with pain in the left hypochondrium that had developed for seven months revealing a splenic hydatid cyst on ultrasound with positive hydatid serology. The abdominal CT scan showed a hydatid splenic cyst with a membrane detachment occupying almost the entire splenic parenchyma. The patient underwent a resection of the protruding dome, the evolution of which was simple.
