scholarly journals Nonketotic Hyperglycemic Chorea-Ballism (NKHCB): An Atypical Case and a Review of Literature

2017 ◽  
Vol 31 (1&2) ◽  
pp. 25
Author(s):  
Syed H. Shabbir ◽  
Neville M. Jadeja
Keyword(s):  
Computed Tomography ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Ct Scan ◽  
Case Reports ◽  
Review Of Literature ◽  
Atypical Case ◽  
Atypical Presentations ◽  
The Right

Nonketotic hyperglycemic chorea-ballism (NKHCB) is a rare movement disorder characterized by hemichoreahemiballism, contralateral striatal abnormality, and rapid resolution following glycemic control. We describe an atypical case of NKHCB in a 71-year-old female with uncontrolled type 2 diabetes exhibiting hemichorea and hemiballism limited to the right upper extremity. While NKHCB patients typically show abnormalities on computed tomography (CT) imaging of the head, a CT scan of our patient during the acute phase was unremarkable. The movements subsided following glycemic control and fluid administration. The current literature on NKHCB is sparse and largely limited to case reports and series. We discuss several typical and atypical presentations and findings on imaging. 

scholarly journals Delayed Extradural Hematoma after Evacuation of Contralateral Acute Extradural Hematoma

2020 ◽  
Author(s):  
Majid Anwer ◽  
Atique Ur Rehman ◽  
Farheen Ahmed ◽  
Satyendra Kumar ◽  
Md Masleh Uddin
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Postoperative Period ◽  
Road Traffic ◽  
Case Reports ◽  
Mass Effect ◽  
Extradural Hematoma ◽  
Traumatic Head Injury ◽  
Neurologic Deterioration ◽  
The Right

Abstract Introduction Traumatic head injury with extradural hematoma (EDH) is seen in 2% of patients. Development of EDH on the contralateral side is an uncommon complication that has been reported in various case reports. Case Report We report here a case of an 18-year-old male who had a road traffic injury. He was diagnosed as a case of left-sided large frontotemporoparietal acute extradural bleed with a mass effect toward the right side. He was managed with urgent craniotomy and evacuation of hematoma. A noncontrast computed tomography (NCCT) scan performed 8 hours after postoperative period showed a large frontotemporoparietal bleed on the right side with a mass effect toward the left side. He was again taken to the operating room and right-sided craniotomy and evacuation of hematoma were performed. A postoperative NCCT scan revealed a resolved hematoma. The patient made a complete recovery in the postoperative period and is doing well. Conclusion Delayed onset epidural hematoma is diagnosed when the initial computed tomography (CT) scan is negative or is performed early and when late CT scan performed to assess clinical or ICP deterioration shows an EDH. The diagnosis of such a condition requires a high index of suspicion based on the mechanism of injury along with fracture patterns. Additionally, change in pupillary size, raised intracranial pressure, and bulging of the brain intraoperatively are additional clues for contralateral bleeding. Neurologic deterioration may or may not be associated with delayed EDH presentation. An early postoperative NCCT scan within 24 hours is recommended to detect this complication with or without any neurologic deterioration.

scholarly journals Multislice Computed Tomography Imaging of Total Anomalous Pulmonary Venous Circulation: Three Rare Case Reports

2018 ◽  
Vol 6 (1-2) ◽  
pp. 73-77
Author(s):  
Nusrat Ghafoor ◽  
Md Rokonujjaman Selim ◽  
Nawshin Siraj
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Left Atrium ◽  
Case Reports ◽  
Pulmonary Veins ◽  
Cardiac Anomaly ◽  
Congenital Cardiac Anomaly ◽  
Venous Circulation ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Total anomalous pulmonary venous connection is a rare congenital cardiac anomaly in which the pulmonary veins have no connection with the left atrium and connect directly to the right atrium or to one of the systemic veins. In the diagnosis of total anomalous pulmonary venous connection, the presence and severity of the venous obstruction is important. Computed Tomography (CT) imaging is known to be a useful method for the evaluation of total anomalous pulmonary venous connection. Here we report 3 cases of total anomalous pulmonary venous circulation (TAPVC) where 32 slice CT scan played an important role in pre-operative diagnosis and management. Age of the patients ranged from seven months to sixteen years. Symptoms of the patients’ varied from fatigue, shortness of breath, mild cyanosis and reduced growth for their age. Echocardiography done revealed dilated right cardiac chambers and atrial septal defect (ASD) with suspicion of TAPVC. CT scan was performed and it provided detailed information about intra-cardiac anatomy, pulmonary veins and their confluence, route, drainage and most importantly their distance and relation with the left atrium. It also provided information about coronary sinus and its drainage. This information is very important for surgical mapping and planning. Ibrahim Card Med J 2016; 6 (1&2): 73-77

scholarly journals Periodontal Diseases in Diabetes Melitus - A Two Way Link? A Review of Literature

2020 ◽  
Vol 25 (4) ◽  
pp. 77-79
Author(s):  
Ovidiu Boitor ◽  
Carmen Natea Sitterli ◽  
Mihăilă Romeo
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Periodontal Disease ◽  
Metabolic Disorders ◽  
Periodontal Diseases ◽  
Review Of Literature ◽  
Diabetes Melitus

Abstract Numerous studies in the last decades report a frequent association of marginal periodontal disease with some systemic metabolic disorders, such as diabetes or obesity. The prevalence of these diseases is growing alarmingly both globally and in our country. Recent data from the literature confirm that advanced forms of periodontal disease can influence the evolution of type 2 diabetes. This may provide a premise for better glycemic control.

scholarly journals Primary Pleural Angiosarcoma in a 63-Year-Old Gentleman

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmed Abu-Zaid ◽  
Shamayel Mohammed
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Histopathological Examination ◽  
Case Reports ◽  
Immunohistochemical Analysis ◽  
Whole Body ◽  
Cytologic Examination ◽  
Ct Guided ◽  
Positron Emission ◽  
The Right

Primary pleural angiosarcomas are extremely rare. As of 2010, only around 50 case reports have been documented in the literature. Herein, we report the case of a 63-year-old gentleman who presented with a 3-month history of right-sided chest pain, dyspnea, and hemoptysis. Chest X-ray showed bilateral pleural effusion with partial bibasilar atelectasis. Ultrasound-guided thoracocentesis showed bloody and exudative pleural fluid. Cytologic examination was negative for malignant cells. An abdominal contrast-enhanced computed tomography (CT) scan showed two right diaphragmatic pleural masses. Whole-body positron emission tomography/computed tomography (PET/CT) scan showed two hypermetabolic fluorodeoxyglucose- (FDG-) avid lesions involving the right diaphragmatic pleura. CT-guided needle-core biopsy was performed and histopathological examination showed neoplastic cells growing mainly in sheets with focal areas suggestive of vascular spaces lined by cytologically malignant epithelioid cells. Immunohistochemical analysis showed strong positivity for vimentin, CD31, CD68, and Fli-1 markers. The overall pathological and immunohistochemical features supported the diagnosis of epithelioid angiosarcoma. The patient was scheduled for surgery in three weeks. Unfortunately, the patient died after one week after discharge secondary to pulseless ventricular tachycardia arrest followed by asystole. Moreover, we also present a brief literature review on pleural angiosarcoma.

scholarly journals Dapagliflozin-Induced Acute Pancreatitis: A Case Report and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Sunam M. Sujanani ◽  
Mohanad M. Elfishawi ◽  
Paria Zarghamravanbaksh ◽  
Francisco J. Cuevas Castillo ◽  
David M. Reich
Keyword(s):  
Type 2 Diabetes ◽  
Acute Pancreatitis ◽  
Alcohol Intake ◽  
Case Reports ◽  
Review Of Literature ◽  
Case Presentation ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
Hba1c Levels

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are increasingly used as add-on therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM). Although pancreatitis is not a known side effect of SGLT-2 inhibitors, there have been case reports of SGLT-2 inhibitor use being associated with pancreatitis. Case Presentation. A 51-year-old male with a history of type 2 diabetes, dyslipidemia, and status-post cholecystectomy presented to the emergency room with a four-day history of periumbilical pain radiating to the back. He denied any history of recent alcohol intake or prior episodes of pancreatitis. On physical examination, his abdomen was diffusely tender to palpation without guarding or rebound. Initial labs were notable for a leukocyte count of 9.3 × 109/L, creatinine level of 0.72 mg/dL, calcium level of 9.5 mg/dL, lipase level of 262 U/L, and triglyceride level of 203 mg/dL. His last HbA1c was 8.5%. CT scan of his abdomen and pelvis showed findings consistent with acute pancreatitis with no biliary ductal dilatation. Careful review of his medications revealed the patient was recently started on dapagliflozin five days prior to admission in addition to his longstanding regimen of insulin detemir, sitagliptin, metformin, and rosuvastatin. His symptoms resolved after discontinuation of sitagliptin and dapagliflozin. A year later, due to increasing HbA1c levels, a decision was made to rechallenge the patient with dapagliflozin, after which he developed another episode of acute pancreatitis. His symptoms resolved upon cessation of dapagliflozin. Conclusion. This case highlights the possible association of SGLT-2 inhibitors and pancreatitis. Patients should be informed about the symptoms of acute pancreatitis and advised to discontinue SGLT-2 inhibitors in case such symptoms occur.

scholarly journals Idiopathic Bilateral Extraocular Myositis in a Subject With Poorly Controlled Type 2 Diabetes Mellitus: Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Fuminori Tatsumi ◽  
Yoshiro Fushimi ◽  
Junpei Sanada ◽  
Masashi Shimoda ◽  
Kenji Kohara ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Extraocular Muscle ◽  
Brain Magnetic Resonance Imaging ◽  
Normal Range ◽  
Nerve Paralysis ◽  
The Right

Background: Extraocular myositis is characterized by acute onset of orbital pain, extraocular muscle swelling, absence of thyroid disease, and effectiveness of steroid therapy. While oculomotor nerve paralysis is often observed in subjects with diabetes mellitus, extraocular muscle paralysis is very rare among various diabetic mononeuropathies. In addition, while most diabetic mononeuropathies are observed as sporadic and/or unilateral neuropathy, bilateral mononeuropathy is also very rare.Case presentation: A 58-year-old male visited our institution due to diplopia. He was diagnosed as type 2 diabetes mellitus about 10 years before and treated with oral diabetes agents. To examine the cause of his symptom, he was hospitalized in our institution. Slight ptosis was observed, and failure of adduction was observed in the right eye. Glycemic control was poor; HbA1c was 9.3%. Liver, renal, and thyroid function were within normal range. Immunoglobulin (Ig) G was slightly high, but IgA, IgM, and IgG4 were within normal range. Various antibodies were all negative. Angiotensin-converting enzyme level was within normal range. There were no abnormalities in brain magnetic resonance imaging (MRI). After admission, to alleviate glucose toxicity, we started insulin therapy. On day 17, adduction failure of the left eye was observed in addition to the right eye. Vertical movement was also impaired in both eyes. Slight ptosis was observed in both eyes, and the right eye was completely close. In orbital MRI, some high signal was detected in both extraocular muscles. We performed steroid pulse therapy twice. About 4 months later, ptosis and vertical and horizontal movements in both eyes were almost completely recovered. Finally, we diagnosed him as idiopathic bilateral extraocular myositis.Conclusions: We should bear in mind the possibility of idiopathic bilateral extraocular myositis especially in subjects with poor glycemic control, although its incident rate is extremely rare.

scholarly journals Type 2 Diabetes Mellitus with Plantar Malignant Melanoma: Report of Two Cases and Literature Review

2021 ◽  
Author(s):  
Bi-ling Huang ◽  
Min Tan ◽  
Jie-Yu Liang ◽  
Ming-Liu Li ◽  
Lan Liao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Malignant Melanoma ◽  
Diabetic Foot ◽  
Malignant Tumour ◽  
Diabetic Foot Ulcers ◽  
Review Of Literature ◽  
History Of ◽  
Missed Diagnosis ◽  
The Right

Abstract Background: Malignant melanoma is a highly malignant tumour that originates from melanocytes. Its prognosis is poor and motality rate is high. Malignant melanoma usually occurs in the skin, also known as cutaneous melanoma,but rarely in the foot. Case report: Here we report two cases of type 2 diabetes diagnosed as malignant melanoma of the foot and provides a review of literature. The first patient was a 70-year-old woman with a 7 year history of diabetes, who had a ulcer in the right heel for half a year. The second case, which occurred in a 66-year-old woman whose third toe of the right foot had been red, swollen and blackened for 2 months. Both of them had been treated as diabetic foot at first , and then been diagnosed of malignant melanoma by a pathological biopsy of the lesions. Conclusion: From two rare cases of plantar malignant melanoma,we suggest that clinicians should be alert to the occurrence of acral malignant melanoma in diabetic foot patients. When diabetic foot ulcers occur repeatedly and continue not to heal, and the pathological features of the lesions are similar to malignant melanoma, a pathological biopsy of the lesions should be performed promptly to obtain a clear diagnosis, avoid a missed diagnosis and improve the survival rate.

scholarly journals An atypical presentation of type 1 diabetes

2021 ◽  
Vol 8 (3) ◽  
pp. 46-49
Author(s):  
Brandon Knopp ◽  
◽  
Parvathi Perumareddi ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Mellitus Type 2 ◽  
Clinical Presentation ◽  
Diabetes Patient ◽  
Gradual Onset ◽  
Atypical Presentations

Type 1 and type 2 diabetes have been described historically as occurring in distinct patient populations; however, atypical demographics are becoming more frequent as the prevalence of diabetes increases, crossing boundaries of ages. Some of these cases can be challenging to diagnose clinically as the patient symptomatology and progression can differ from the standard features of type 1 and 2 diabetes. Our case is an example of a patient whose type 1 diabetes presented atypically with characteristics often associated with type 2 diabetes. Patient presentations such as this are uncommon, with our patient having presented with the “textbook” characteristics of type 2 diabetes. When first diagnosed with diabetes mellitus type 2, the patient was 60 years old, had a BMI around 30 and experienced a gradual onset of symptoms over the course of several months. At the age of 64, the patient tested positive for GAD65 autoantibodies following a year of declining glycemic control and was re-evaluated and classified as a type 1 diabetes patient. Subsequent insulin injections resolved his diabetes-related complications which included polyuria, weakness and weight loss and improved his glycemic control. This case provides an example of an unusual clinical presentation of type 1 diabetes and serves to raise awareness for atypical presentations of diabetes to improve accurate classifications at earlier stages.

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