scholarly journals ACUTE CORNEAL HYDROPS IN KERATOCONUS – A CASE REPORT

2019 ◽  
Vol 17 (1) ◽  
pp. 64-66
Author(s):  
V. Haykin ◽  
Y. Zdravkov ◽  
S. Kostova ◽  
A. Oscar ◽  
S. Dokov ◽  
...  
Keyword(s):  
Conservative Therapy ◽  
Rare Complication ◽  
Young Patients ◽  
Acute Onset ◽  
Definitive Treatment ◽  
Ophthalmological Examination ◽  
Descemet Membrane ◽  
Stromal Edema ◽  
Corneal Hydrops ◽  
The Right

Keratoconus is observed in cases of impaired corneal biochemical activity, leading to secondary thinning and ectasia. Usually the onset is in the second – third decade of life. The acute corneal hydrops occurs when intraocular aqueous passes through a rupture of Descemet membrane (DM) and is characterized with stromal edema. Estimated frequency is 2.5 – 3.0% among the keratoconus patient. Eye rubbing is the major risk factor. In most cases the hydrops persists for 2 -4 months. The resolution is cicatrix/scar formation, but there is a risk for complications such as vascularization, infection and corneal perforation. We present a case of a 23 year old male patient, presenting with complains of reduced and blurry vision in the right eye and photophobia. Visual acuity and full ophthalmological examination was done. UBM was performed of the right eye. The patient received conservative therapy. The acute corneal hydrops occurs when intraocular aqueous passes through a rupture of Descemet membrane (DM) and is characterized with stromal edema. The treatment could be conservative or surgical. The conservative therapy includes topical lubricants, antibiotics, cycloplegics, hyperosmotic solutions, antiglaucoma drugs, topical corticosteroids and non-steroid anti-inflammatory drugs. Surgical treatment includes intracameral injection of air or gas, but the definitive treatment is penetrating keratoplasty. We describe a newly diagnosed patient with keratoconus, who presents with rare complication - acute corneal hydrops. Differential diagnosis in cases of young patients with acute onset of keratitis, especially young males, should be made with acute corneal hydrops.

Noninvasive Localization of Language Cortex in an Awake 4-Year-Old Child with Rasmussen Encephalitis: A Case Report

2019 ◽  
Vol 18 (5) ◽  
pp. E175-E180
Author(s):  
Shalini Narayana ◽  
Luke M Embury ◽  
Namrata Shah ◽  
Sarah Weatherspoon ◽  
Asim F Choudhri ◽  
...  
Keyword(s):  
Young Children ◽  
Young Patients ◽  
Definitive Treatment ◽  
Rasmussen Encephalitis ◽  
Mri Findings ◽  
Left Frontal Lobe ◽  
Epilepsia Partialis Continua ◽  
Language Functions ◽  
Mapping Tool ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE Presurgical mapping of eloquent cortex in young patients undergoing neurosurgery is critical for timely intervention, surgical planning, and minimizing postoperative deficits. However, invasive direct cortical stimulation has limited success in young children and noninvasive modalities, such as magnetoencephalography and functional MRI, require sedation, often precluding localization of critical language cortices. Transcranial magnetic stimulation (TMS), a noninvasive brain stimulation technique, is well suited to evaluate language areas in young children because it does not require the patient to remain still during mapping. CLINICAL PRESENTATION A 4-yr and 11-mo-old female patient diagnosed with epilepsia partialis continua of the right arm and face and right-sided weakness was evaluated at our institution. MRI findings and clinical examination led to the diagnosis of Rasmussen encephalitis involving left frontal lobe and insula. Language cortices were successfully identified in both hemispheres using TMS. The TMS findings aided in discussing with the family the risks of postsurgical deficits of left functional hemispherectomy, the definitive treatment for Rasmussen encephalitis. Postoperatively, the patient had intact speech and was seizure free. CONCLUSION We illustrate the feasibility and utility of TMS as a noninvasive functional mapping tool in this young child. The preoperative demonstration of bilateral language organization indicated a greater likelihood of preserved language functions postsurgery. We demonstrate that TMS is a safe and noninvasive tool to map language cortices in young children with serious epilepsy syndromes.

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

scholarly journals Juvenile Osteochondritis Dissecans of the Knee. About A Case

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0002
Author(s):  
Ignacio Astore ◽  
Juan Ignacio Agotegaray ◽  
Ignacio Comba ◽  
Luciana Bisiach
Keyword(s):  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Young Patients ◽  
Body Burden ◽  
Acute Onset ◽  
Type Iv ◽  
Juvenile Osteochondritis Dissecans ◽  
Osteosynthesis Material ◽  
History Of ◽  
The Right

Introduction: Juvenile osteochondritis dissecans is a pathology that affects the superficial articular cartilage and subchondral bone in patients with open physes. Treatment of this disease is based on patient’s age and the stage of the disease. Methods: 16-year-old patient, athlete, with a history of knee pain on the right side of acute onset, without traumatic history. A physical examination shows pain in the external compartment of the knee. MRI shows a stable lesion that involves the external femoral condyle, over a posterior area of 16 mm by 20mm. Crutches are indicate for walking without body burden. Symptoms continue for six months and there are no changes in MRI. It is decided to do a stabilization with a Herbert type screw. After the surgery, pain persists and in x-ray controls, osteointegration is not observed. Osteosynthesis material is extracted and mosaicplasty is performed. We used Guhl’s intraoperative classification. Results: In this case, for a young patient with Guhl’s lesion type III, the reduction with a Herbert type screw was indicated, as the lesion was stable, of a significant size and congruent. Lesion progressed to type IV in 6 months. Thus, mosaicplasty was performed, obtaining a good functional result according to the physical exam, with a complete range of flexion and extension. A second-look arthroscopic assessment was carried out 2 months after surgery, showing osteointegration and stability of the allogenic graft. Conclusion: The variable of stability of the fragment is very important when determining the treatment. Most of the stable lesions can be successfully treated with a conservative treatment. Also, it has been demonstrated that young patients have a higher rate of healing. Instead, unstable lesions require surgical treatment.

Epiretinal membrane and cataract in a 5-year-old boy with the suspicion of neurofibromatosis type 2

Open Medicine ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Joanna Siwiec-Proscinska ◽  
Anna Gotz-Wieckowska ◽  
Marta Pawlak ◽  
Jaroslaw Kociecki
Keyword(s):  
Visual Acuity ◽  
Family History ◽  
Young Patients ◽  
Neurofibromatosis Type ◽  
Ophthalmological Examination ◽  
Neurofibromatosis 2 ◽  
Epiretinal Membranes ◽  
Negative Results ◽  
History Of ◽  
The Right

AbstractDifferent ocular findings have been described in association with neurofibromatosis 2 (NF2). Detailed ophthalmological examination of asymptomatic subjects with a family history of NF2 could help confirm the diagnosis in young patients. We present a case of unilateral cataract and bilateral epiretinal membranes in a 5-year-old boy with a family history of neurofibromatosis 2. The patient was referred to our department with diminished visual acuity bilaterally and an initial diagnosis of cataract in the right eye. Bestcorrected visual acuity was 3/19 in the right eye and 3/24 in the left eye (LH charts). On fundus examination, bilateral macular epiretinal membranes were found and confirmed by optical coherent tomography. In view of the ophthalmic signs mentioned above and the history of the patient’s father, who suffered from NF2 and died from meningioma and ependymoma, the patient was referred for genetic examination. Seventeen exons of the NF2 gene were tested with negative results. No pathology was found on clinical neurologic examination and magnetic resonance imaging of the brain. Although the patient has not met the criteria for NF2, he is now considered as an asymptomatic subject at risk and observed. Lens opacities with epiretinal membranes in children may be regarded as part of the clinical manifestation of NF2.

Paracentral acute middle maculopathy (PAMM) associated with ulcerative colitis and coexisting hyperhomocysteinemia: A case report

2020 ◽  
pp. 112067212096204
Author(s):  
Micol Alkabes ◽  
Stela Vujosevic ◽  
Andrea Muraca ◽  
Stefano De Cillà
Keyword(s):  
Ulcerative Colitis ◽  
Young Patients ◽  
Imaging Study ◽  
Acute Onset ◽  
Drop Out ◽  
Folate Supplementation ◽  
Definitive Evidence ◽  
Capillary Plexus ◽  
The Right ◽  
Retinal Thinning

Introduction: Paracentral acute middle maculopathy (PAMM) is a tomographic finding of a retinal occlusive vascular disorders with different aetiologies. Despite the well documented triple association among hyper-homocysteine, retinal vein occlusion and PAMM, up to date no reports exist on the development of PAMM in young patients affected by ulcerative colitis (UC). Case description: A multimodal imaging study, including fundus photographs, optical coherence tomography (OCT) B-scans, OCT angiography (OCT-A) and fluorescein and indocyanine green angiography, was performed in a 32-years-old male complaining of acute-onset paracentral scotoma in the right eye. Fundus images demonstrated the typical dark gray area of retinal capillary ischemia, corresponding on OCT B-scans to the hyper-reflective plaques in the INL, and consistent with PAMM lesions.The deep capillary plexus (DCP) was normal on OCT-A. Fluorescein angiography revealed a concurrent branch retinal vein preocclusion and showed capillary drop out parafoveally. Patient’s anamnesis was negative except for a 15-years history of UC and use of acetylsalicylic acid (ASS). At the time of presentation, UC was quiescent, but new blood tests revealed concomitant high values of homocysteinemia requiring oral vitamin B12 and folate supplementation. Two months later PAMM lesions had disappeared on OCT B-scans and a retinal thinning at the level of the inner nuclear layer (INL) was visible. The DCP on OCT-A remained unchanged without any sign of capillary ischemia. Conclusions: Although no definitive evidence directly links UC with PAMM, the latter should be suspected in young patients affected by IBD with coexisting hyper-homocysteinemia and unexplained visual symptoms.

scholarly journals Diabetic Myonecrosis: A Diagnostic and Treatment Challenge in Longstanding Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Lima Lawrence ◽  
Oscar Tovar-Camargo ◽  
M. Cecilia Lansang ◽  
Vinni Makin
Keyword(s):  
Diabetes Mellitus ◽  
Rare Complication ◽  
Acute Onset ◽  
Muscular Pain ◽  
Uncontrolled Diabetes ◽  
Long Term Prognosis ◽  
The Right ◽  
High Index Of Suspicion ◽  
Microvascular And Macrovascular Complications

Objective. Diabetes mellitus is associated with microvascular and macrovascular complications; the most commonly recognized ones include diabetic nephropathy, retinopathy, and neuropathy. Less well-known complications are equally important, as timely recognition and treatment are essential to decrease short- and long-term morbidity. Methods. Herein, we describe a case of a 41-year-old female with longstanding, uncontrolled type 2 diabetes, who presented with classical findings of diabetic myonecrosis. Results. Our patient underwent extensive laboratory and imaging studies prior to diagnosis due to its rarity and similarity in presentation with other commonly noted musculoskeletal conditions. We emphasize the clinical presentation, laboratory and imaging findings, treatment regimen, and prognosis associated with diabetic myonecrosis. Conclusion. Diabetic myonecrosis is a rare complication of longstanding, poorly controlled diabetes mellitus. The diagnosis requires a high index of suspicion in the right clinical setting: acute onset nontraumatic muscular pain with associated findings on clinical exam, laboratory studies, and imaging. While the short-term prognosis is good, the recurrence rate remains high and long-term prognosis is poor given underlying uncontrolled diabetes and associated sequelae.

Renal Infarction and Pulmonary Embolism in Patient with Myelodysplastic

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mounia Bendari ◽  
Nouama Bouanani ◽  
Mohamed Amine Khalfaoui ◽  
Maryam Ahnach ◽  
Aziza Laaraj ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Myeloproliferative Neoplasms ◽  
Bone Biopsy ◽  
Bone Marrow Aspiration ◽  
Myeloproliferative Disorders ◽  
Acute Onset ◽  
International Prognostic Scoring System ◽  
Renal Infarction ◽  
The Right ◽  
Enhanced Computed Tomography

The myelodysplastic syndrome-myeloproliferative neoplasms (MDS/MPNs) are defined by a group of heterogeneous hematological malignancies resulting from stem cell−driven clonal growth of pathological hematopoietic progenitors and ineffective hematopoiesis, they are characterized concomitant myelodysplastic and myeloproliferative signs. Myelodysplastic/myeloproliferative disorders have been considered to have a higher risk of thrombus formation.We report a rare case about a 64 years old Moroccan woman, experienced renal infarction (RI) associated with pulmonary embolism as a complication of a myelodysplastic/myeloproliferative disorder.The patient complained of acute-onset severe left flank pain, a contrast-enhanced computed tomography (CT) of the chest and abdomen revealed RI by a large wedge-shaped defect in the right kidney with pulmonary embolism.Biological exam showed deep anemia, the bone marrow aspiration found myelodysplasia.the bone biopsy showed signs of myeloproliferatif disease. The karyotype was normal, BCR-ABL, JAK2, CALR mutations were absents, and MPL mutation was positive. The International Prognostic Scoring System (IPSS-R) was 0, and the patient was included to the low risk group.Anticoagulation therapy was initiated with heparin to treat RI and pulmonary embolism. Three months later, pulmonary embolism had resolved without the appearance of additional peripheral infarction.This case emphasizes the need to consider myelodysplastic/myeloproliferative disorders as a cause of infraction renal and pulmonary embolism.

Management of Patient with Aggressive Periodontitis by Orthodontic and Prosthodontic Collaboration

DENTA ◽  
2017 ◽  
Vol 11 (1) ◽  
pp. 80
Author(s):  
Chaterina Diyah Nanik K ◽  
Anindita Apsari
Keyword(s):  
Orthodontic Treatment ◽  
Young Patients ◽  
Interdisciplinary Approach ◽  
Aggressive Periodontitis ◽  
Definitive Treatment ◽  
Dental Arch ◽  
Preliminary Treatment ◽  
Young Adult Patient ◽  
Anterior Teeth ◽  
Long Span Bridge

<p><strong><em>Background:</em></strong><em> One of the most common inflammation disease in the oral cavity for the past few years is the aggressive form of periodontitis. Common signs of aggressive periodontitis is the mobility of teeth especially in incisive and first molars, and occuring mostly in young patient. Young patients whose losing her anterior teeth, are a real challenge for dentist and prosthodontist. Prosthodontist need to consider both functional and esthetic aspects. <strong>Objective:</strong> Rehabilitation of young adult patient with aggressive periodontitis by an interdisciplinary approach of orthodontist and prosthodontist. <strong>Case Description:</strong> A young woman, suffered from aggressive periodontitis with major complain of her teeth mobility, especially incisive and first molar in mandible. She had undergone periodontal treatment, but the result was failed. The anterior teeth in mandible need to be extracted, therefore patient wished not to be in edentulous state. As preliminary treatment, we choose immediate denture to replace the anterior mandible teeth. We faced difficulties in mandible, because her right canine weren’t in the proper dental arch. So we asked orthodontist to place fixed orthodontics in mandible, to get the canine back in the proper arch. We’ve chosen orthodontic treatment,because we didn’t want to extract the canine teeth. We evaluated in six months and after the canine back in the proper arch, we proceed to long span bridge in mandible as our definitive treatment. <strong>Conclusion:</strong> By not extracting the canine teeth, we got some advantages, especially patient psychically was happier with her own teeth. The collaboration with another dentistry field, provides us better treatment for patient. After treatment, patient had no complaints and was happy with her new smile.</em></p><p><strong><em>Keywords:</em></strong><em>  Prosthodontic rehabilitation, aggressive periodontitis, orthodontic treatment, esthetic</em><em>.</em></p><strong><em>Correspondence:</em></strong><em> Chaterina Diyah Nanik. K; Department of Prostodontitics, Faculty of Dentistry, Hang Tuah University, Arif Rahman Hakim 150, Surabaya; Phone 031-5912191, Email: </em><a href="mailto:[email protected]"><em>[email protected]</em></a>

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

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