scholarly journals Multi-disciplinary Medico-legal Approach and Challenges in Interpretation of Injury from an Amputated Hand: A Case Report

2019 ◽  
Vol 2 (1) ◽  
pp. 82-85
Author(s):  
Jenash Acharya ◽  
Sailesh Pradhan ◽  
Sandesh Maskey
Keyword(s):  
Case Report ◽  
Body Part ◽  
Plastic Surgeon ◽  
Upper Limbs ◽  
Pathology Department ◽  
Keywords Amputation ◽  
Electric Injuries ◽  
Electric Injury ◽  
Legal Expert

Among various duties of any medico-legal expert, responsibility of Injury Examination Report preparation is encountered routinely in his/her career. Among various challenges faced by the examiner, documenting the injuries becomes exigent when s/he is acquainted with artifact like therapeutic alteration of the injury produced in victim. We report a case of a victim of electric injuries sustained over both his upper limbs. The requisition to prepare an Injury Examination Report was received from investigating officer a month after the incident. On examination of the patient, the challenge faced was that the injured limbs were amputated a day before the examination, and his body showed no other injuries. An urgent consultation with plastic surgeon revealed that the amputated body part was sent for histopathology analysis. A report was prepared from a formalin soaked amputated bilateral hands in pathology department and handed over to the investigating officer. Keywords: amputation; electric injury; injury examination report; medico-legal.

scholarly journals A Simplified Approach for Ocular Rehabilitation - A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 120-124
Author(s):  
P Manandhar ◽  
S R.B. Mathema
Keyword(s):  
Case Report ◽  
Cost Effective ◽  
Well Being ◽  
Body Part ◽  
Ocular Prosthesis ◽  
Simplified Approach ◽  
Comprehensive Method ◽  
Satisfactory Outcome ◽  
Custom Made ◽  
Ocular Defect

Loss of an eye or any body part has an intimidating and crippling effect on the psychosocial well-being of the patient. Although the artificial prosthesis cannot restore the function, it can highly improve the patient’s esthetics and help them regain their psychological confidence. Literature has advocated various rehabilitation modalities including empirical use of stock shells, modifying stock eyes, custom-made ocular prostheses, ocular implants, etc. A custom-made ocular prosthesis, among all the techniques, shows improved adaptation to tissue bed, distributes uniform pressure, provides a more esthetic and precise result, and is relatively cost-effective. This case report explores a relatively comprehensive method of custom ocular prosthesis fabrication for an ocular defect with a satisfactory outcome. 

scholarly journals Lead Toxicity due to Ingestion of Lead-Contaminated Opium in a Patient Presenting with Motor Neuropathy and Upper Limb Paresis: A case report

2019 ◽  
Vol 18 (4) ◽  
pp. 529 ◽  
Author(s):  
Seyed M. M. Mirzaei ◽  
Ayob Akbari ◽  
Omid Mehrpour ◽  
Nasim Zamani
Keyword(s):  
Nervous System ◽  
Case Report ◽  
Lead Poisoning ◽  
Chelation Therapy ◽  
Lead Level ◽  
Lead Toxicity ◽  
Blood Lead ◽  
Motor Neuropathy ◽  
Upper Limbs ◽  
Gastrointestinal Complications

Opium users may present with central or peripheral nervous system-related symptoms, gastrointestinal complications and anaemia; in such cases, lead poisoning should be suspected and chelation therapy initiated as soon as possible. We report a 64-year-old male patient with a 20-year history of opium addiction who was referred to the Imam Reza Hospital, Birjand, Iran, in 2017 with severe motor neuropathy and paresis in both upper limbs. His primary symptoms were generalised weakness, abdominal and bone pain, constipation and lower limb paraesthesia that had started several months prior. In addition, he reported severe progressive bilateral paresis of the upper limbs of one month’s duration. A diagnosis of lead poisoning was confirmed by a blood lead level of 140 μg/dL. The patient underwent chelation therapy after which he improved significantly. At a one-year follow-up visit, he was neurologically intact and symptom-free.Keywords: Opium Dependence; Lead Poisoning; Lead-Induced Nervous System Diseases; Paresthesia; Case Report; Iran.

scholarly journals Diastrophic dysplasia: prenatal diagnosis and review of the literature

2013 ◽  
Vol 131 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Jonathan Celli Honório ◽  
Rafael Frederico Bruns ◽  
Luciana Fernandes Gründtner ◽  
Salmo Raskin ◽  
Lilian Pereira Ferrari ◽  
...  
Keyword(s):  
Case Report ◽  
Prenatal Diagnosis ◽  
Homozygous Mutation ◽  
Upper Limbs ◽  
Sulfate Transporter ◽  
Chain Reaction ◽  
Realistic Interpretation ◽  
Diastrophic Dysplasia ◽  
Ultrasound Findings ◽  
Polymerase Chain

CONTEXT Diastrophic dysplasia is a type of osteochondrodysplasia caused by homozygous mutation in the gene DTDST (diastrophic dysplasia sulfate transporter gene). Abnormalities occurring particularly in the skeletal and cartilaginous system are typical of the disease, which has an incidence of 1 in 100,000 live births. CASE REPORT The case of a pregnant woman, without any consanguineous relationship with her husband, whose fetus was diagnosed with skeletal dysplasia based on ultrasound findings and DNA tests, is described. An obstetric ultrasound scan produced in the 16th week of gestation revealed characteristics that guided the clinical diagnosis. Prominent among these characteristics were rhizomelia of the lower and upper limbs (shortening of the proximal portions) and mesomelia (shortening of the intermediate portions). Both upper limbs showed marked curvature, with the first finger of the upper limbs in abduction and clinodactyly of the fifth finger. Molecular analysis using the polymerase chain reaction (PCR) and gene sequencing detected mutations that had already been described in the literature for the gene DTDST, named c.862C > T and c.2147_2148insCT. Therefore, the fetus was a compound heterozygote, carrying two different mutations. CONCLUSIONS Prenatal diagnosis of this condition allowed a more realistic interpretation of the prognosis, and of the couple's reproductive future. This case report shows the contribution of molecular genetics towards the prenatal diagnosis, for which there are few descriptions in the literature.

Elephantiasis Nostras Verrucosa or “Mossy Foot Lesions” in Lymphedema Praecox

2008 ◽  
Vol 98 (1) ◽  
pp. 66-69 ◽  
Author(s):  
Amy L. Duckworth ◽  
Jugnoo Husain ◽  
Patrick DeHeer
Keyword(s):  
Case Report ◽  
Chronic Inflammation ◽  
Disease Process ◽  
Wuchereria Bancrofti ◽  
Body Part ◽  
Rare Disorder ◽  
Chronic Obstructive ◽  
Fibroblast Proliferation ◽  
Clinical Appearance ◽  
Foot Lesions

Elephantiasis nostras verrucosa is a rare disorder that results from chronic obstructive lymphedema. It is characterized clinically by deforming, nonpitting edema; malodorous hyperkeratosis with generalized lichenification; cobblestoned papules; and verrucous changes, that often result in extreme enlargement of the involved body part. Although elephantiasis nostras verrucosa is striking in clinical appearance, biopsy reveals only moderately abnormal findings: pseudoepitheliomatous hyperplasia with dilated lymphatic spaces in the dermis, accompanied by chronic inflammation and fibroblast proliferation. The term elephantiasis nostras (nostras means “from our region”) has traditionally been used to differentiate temperate zone disease from the classic disease process, elephantiasis tropica, which is defined by chronic filarial lymphatic obstruction caused by Wuchereria bancrofti, Wuchereria malayi, or Wuchereria pacifica. We present a case report of elephantiasis nostras verrucosa arising as a result of lymphedema praecox. (J Am Podiatr Med Assoc 98(1): 66–69, 2008)

scholarly journals Facilitating Upper Limb Function using Assistive Technology in a Neurological Patient with Bilateral Upper Limb Impairment: A Case Report

2020 ◽  
Author(s):  
Shelley Fulton ◽  
Laura Wilkinson ◽  
Kathy Stiller
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Assistive Technology ◽  
Upper Limb ◽  
Daily Living ◽  
Assistive Device ◽  
Outpatient Rehabilitation ◽  
Upper Limbs ◽  
Cord Injury

Purpose: A combination of a stroke and spinal cord injury adversely affecting both upper limbs is an unusual combination for a patient presenting for outpatient rehabilitation services. Although the management of these conditions in isolation is well documented, there is limited literature regarding rehabilitation for these conditions in combination, particularly the use of assistive technology in this setting. Methods: A case report is presented of a 53-year-old male referred for outpatient rehabilitation following a left-sided stroke, with resultant dense right sided hemiplegia. A pre-existing spinal cord injury had affected his left upper limb such that he had marked proximal weakness. This combination of impairments meant he was unable to perform even basic activities of daily living involving the upper limbs. A therapy program, led by an occupational therapist with support and input from the multi-disciplinary team, included the use of an assistive device (a mobile arm support) to facilitate functional upper limb activities. This greatly improved his ability to do upper limb functional activities. Conclusion: The use of an assistive device enabled the patient to engage in meaningful activities of daily living involving the upper limbs.

scholarly journals Hyperacute tetraparesis with fasciculations as an initial manifestation of secondary hyperkalemic paralysis: a case report

2021 ◽  
Author(s):  
Tulio Marcos Coimbra ◽  
Sara Terrim ◽  
Guilherme Diogo Silva
Keyword(s):  
Case Report ◽  
Lupus Erythematosus ◽  
Lower Limbs ◽  
Cervical Region ◽  
Upper Limbs ◽  
Limb Weakness ◽  
Initial Manifestation ◽  
Complete Reversal ◽  
Grade Ii

Context: Acute flaccid paralysis (AFP) is characterized by progressive weakness with signs of impairment of the lower motoneuron. Secondary hyperkalemic paralysis is a cause of AFP that must be quickly recognized to prevent cardiac and neurological deterioration. Case report: We present a 69-years-old man admitted to the emergency department due to hyperacute weakness. The patient walked normally to the hospital’s laboratory, where he sat down to wait for the collection of laboratory exams for the investigation of a thrombocytopenia. He was unable to get up from his chair when he was asked to collect the exams. The neurological examination showed symmetrical tetraparesis. Weakness was proximal grade II and distal grade III in the lower limbs. Upper limb weakness was grade IV. Reflexes were abolished in lower limbs and hypoactive in upper limbs. The sensitivity and cranial pairs were normal. Our patient denied bladder or bowel complaints. He also presented intense fasciculations in the cervical region and in the proximal muscles of the upper limbs. Initial laboratory showed potassium of 9.3 mEq/dL. The correction of hyperkalemia led to a complete reversal of weakness and fasciculations. During hospitalization, the patient was diagnosed with systemic lupus erythematosus. Renal impairment led to hyperkalemia. Conclusions: Characterization of the motor examination, sensitivity and of reflexes allow the topographic diagnosis in AFPs. Secondary hyperkalemic paralysis manifests as symmetrical tetraparesis with a proximal predominance with hypoactive and abolished reflexes. Sensory examination is normal. The hyperacute manifestation and the presence of fasciculations reinforce this diagnosis as the cause of AFP.

IMPALEMENT OF AN UNUSUAL FOREIGN BODY IN THE LEG – A CASE REPORT

2021 ◽  
pp. 77-79
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran ◽  
Suresh Rajendran
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Body Part ◽  
The Body ◽  
Parenteral Antibiotic ◽  
Unusual Foreign Body ◽  
Operative Complications ◽  
Thorough Debridement ◽  
Antibiotic Cover

Foreign body penetration is not uncommon and may be glass, shrapnel, needles, etc. and may occur in almost any part of the body. Impalement injury is when a blunt force causes a long object to penetrate a body part resulting in retention of the object in situ. The management following foreign body penetration includes tetanus prophylaxis, parenteral antibiotic cover and removal of the foreign body in the theatre with exploration for neurovascular injury, thorough debridement and repair of any damaged tissue. Here, we report a case of an industrial foreign body that impaled a middle aged male while at work in the left leg which was carefully removed under anaesthesia with no post-operative complications.

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