scholarly journals Osteoporosis-Related Simultaneous Four Joints Fractures and Dislocation after a Seizure: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4
Author(s):  
Abdullah S. AlOmran
Keyword(s):  
Vitamin D ◽  
Case Report ◽  
Clinical Examination ◽  
Epileptic Seizures ◽  
Antiresorptive Therapy ◽  
Multiple Fractures ◽  
Steroid Use ◽  
Skeletal Injury ◽  
History Of ◽  
Rule Out

A case of steroid-induced osteoporosis-related multiple fractures and dislocations are described after a seizure is reported. Patient had two years history of steroid use with no supplement or antiresorptive therapy. There was a delay in the diagnosis which affected an otherwise good outcome in such situations. It is recommended that patients on steroid should be given calcium, vitamin D, and an antiresorptive. Furthermore, a meticulous clinical examination is required in patients who are on steroids and suffer epileptic seizures to rule out skeletal injury.

scholarly journals External fixator for the treatment of narrowed pelvic canal in a cat

2021 ◽  
Author(s):  
S Pinna ◽  
C Tassani ◽  
M Rossini ◽  
F Lanzi
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Clinical Examination ◽  
External Fixator ◽  
Invasive Procedure ◽  
Sacral Fracture ◽  
Minimally Invasive Procedure ◽  
Canal Stenosis ◽  
Applied Tension ◽  
History Of

The aim of this study was to report the outcome of the use of an external fixator to treat a pelvic canal stenosis in a 5-month-old female cat. The cat was referred with a history of 3 weeks of intermittent signs of constipation refractory to the medical management, occurring after surgical treatment for a bilateral sacroiliac luxation and sacral fracture. The clinical examination revealed instability of the pelvis and a radiograph showed a pelvic canal stenosis and megacolon. External fixator was the method of choice to be used in this case. The manually applied tension on an external fixator resulted in a widening of the pelvic canal. At 45 days after surgery, there were no signs of constipation, and the radiological examination showed progressive bone healing. At 18 months post-op, the cat had no abnormalities both on the clinical examination and on the radiography. In conclusion, the use of an external fixator led to the widening of the pelvic canal using a minimally invasive procedure. To the authors’ knowledge, this case report represents the first surgical description and clinical outcome of the widening of the pelvic canal in cats using an external skeletal fixator.

scholarly journals Asystole in an older patient with recurrent falls. Case report

Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 77-83
Author(s):  
William Fernando Bautista-Vargas
Keyword(s):  
Case Report ◽  
Older Patients ◽  
Implantable Devices ◽  
Loop Recorder ◽  
General Terms ◽  
Recurrent Falls ◽  
History Of ◽  
Rule Out

Introduction: Recurrent falls are a usual problema in older patients. It is therefore important to learn how to differentiate a pathological or syncopal episode from a simple stumbling fall, especially in patients who have limitations for communicating clearly and are poorly understood, in general terms, during the medical consultation. Implantable loop recorders (ILR) have been used as an investigation tool in selected cases of recurrent falls in older patients. Consequently, this case report aims to describe its usefulness in this type of patients.Case presentation: An 87-year-old female patient, hypertensive, with a history of recent stroke and frequent falls —referred to as stumbling—, received an implantable loop recorder due to atrial fibrillation. During one follow-up appointment, a 36-second pause related to a fall was documented, so a bicameral pacemaker was implanted.Conclusions: Evaluating repeated falls in older patients is complex; it must be done in detail to rule out syncopal episodes. Implantable devices to diagnose arrhythmic causes are useful and allow achieving accurate diagnoses and establish specific behaviors aimed at improving the quality of life of patients.

scholarly journals Reversible splenial lesion syndrome due to oxcarbazepine withdrawal: case report and literature review

2018 ◽  
Vol 46 (3) ◽  
pp. 1277-1281 ◽  
Author(s):  
Chaoyang Jing ◽  
Lichao Sun ◽  
Zhuo Wang ◽  
Chaojia Chu ◽  
Weihong Lin
Keyword(s):  
Case Report ◽  
Corpus Callosum ◽  
Epileptic Seizures ◽  
Resonance Imaging ◽  
Splenial Lesion ◽  
History Of ◽  
Reversible Lesion ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Splenial Lesion Syndrome

Background Reversible splenial lesion syndrome is a distinct entity radiologically characterized by a reversible lesion in the splenium of the corpus callosum. According to previous reports, this condition may be associated with antiepileptic drug use or withdrawal. We herein report a case of reversible splenial lesion syndrome associated with oxcarbazepine withdrawal. Case Report A 39-year-old man presented with an 8-year history of epileptic seizures. During the previous 3 years, he had taken oxcarbazepine irregularly. One week prior to admission, he withdrew the oxcarbazepine on his own, and the epilepsy became aggravated. Magnetic resonance imaging (MRI) revealed an isolated lesion in the splenium of the corpus callosum with slight hypointensity on T1-weighted imaging and slight hyperintensity on T2-weighted imaging. Regular oxcarbazepine was prescribed. Over a 5-month follow-up period, repeat MRI showed that the abnormal signals in the splenium of the corpus callosum had completely disappeared. Conclusion Reversible splenial lesion syndrome is a rare clinicoradiological disorder that can resolve spontaneously with a favorable outcome. Clinicians should be aware of this condition and that oxcarbazepine withdrawal is a possible etiological factor.

scholarly journals Concurrent lymphosarcoma and Salmonella enteritidis infection in a cat: a case report

2009 ◽  
Vol 54 (No. 9) ◽  
pp. 451-454 ◽  
Author(s):  
M.I. Bhaiyat ◽  
H. Hariharan ◽  
A. Chikweto ◽  
E. Brathwaite-Sylvester ◽  
P.J.A. Burnett ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Examination ◽  
Salmonella Enteritidis ◽  
Thoracic Cavity ◽  
Palpable Mass ◽  
Mesenteric Mass ◽  
History Of ◽  
Gross Lesions ◽  
The Masses ◽  
Susceptibility Patterns

Concurrent lymphosarcoma and salmonellosis in a 12-year-old female neutered domestic shorthair cat in Grenada is described. Clinically, the cat was emaciated, and had a history of vomiting and diarrhea of two months duration. Clinical examination revealed a large palpable mass in the craniodorsal abdomen and fluid in the thoracic cavity. Gross lesions consisted of moderate pyothorax and pyoabdomen with variably-sized, single to multiple, soft, white masses in the mesentery adjacent to the pancreas, on the serosal surface of the stomach, and on the quadrate lobe of the liver. Histopathological findings associated with these masses were compatible with lymphosarcoma. Sheets of neoplastic round cells, some with intracytoplasmic eosinophilic granules, were found in the masses associated with the omentum, stomach, and liver. <i>Salmonella enteritidis</i> was isolated in pure culture from the thoracic fluid, collected during clinical examination, and mesenteric mass, collected during necropsy, and both isolates showed similar antimicrobial susceptibility patterns.

scholarly journals Familial Bell’s Palsy: A Case Report and Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Mark Kubik ◽  
Liliana Robles ◽  
Doris Kung
Keyword(s):  
Case Report ◽  
Bell’S Palsy ◽  
Facial Nerve Paralysis ◽  
Bell's Palsy ◽  
Unique Case ◽  
Nerve Paralysis ◽  
Csf Analysis ◽  
History Of ◽  
Sheer Number ◽  
Rule Out

Objective. To describe a unique case of familial Bell’s palsy and summarize the current literature regarding possible hereditary influences.Design. Case report.Main Outcome Measures. Clinical exam, CSF analysis, and family history provided per the patient.Results. We report the case of a 58-year-old female who presented with recurrent and bilateral episodes of facial palsy. The patient underwent multiple CSF investigations to rule out a possible infectious and rheumatologic etiology that were all negative. Further questioning revealed she was one of seven family members with a history of unilateral facial nerve paralysis.Conclusion. The sheer number of similar case studies to date suggests that familial clustering of Bell’s palsy is a real, noncoincidental phenomenon. Our case represents a unique and perplexing example of one such family. Familial Bell’s palsy may represent an autoimmune disease secondary to inherited HLA alloantigens or a structural predisposition to disease based on the dimensions of the facial canal.

scholarly journals Gastric dilatation and volvulus (bloat) - A case report and mini review of literature

2021 ◽  
Vol 6 (1) ◽  
pp. 13-18
Author(s):  
Kalaiselvan Elangovan ◽  
Shivaraju Shivaramu ◽  
Swapan K. Maiti ◽  
Sunil K.S. Padmanabha ◽  
Divya Mohan
Keyword(s):  
Heart Rate ◽  
Case Report ◽  
Ventricular Arrhythmia ◽  
Respiratory Rate ◽  
Clinical Examination ◽  
Gastric Tube ◽  
Gastric Dilatation ◽  
Review Of Literature ◽  
History Of ◽  
Electrocardiogram Monitoring

Gastric dilatation and volvulus (GDV) is a progressing bloat condition in dogs characterized as dilatation followed by rotation of stomach. A sevenyear old 18 kg black colour female non-descriptive dog presented, with history of difficulty in respiration within half an hour after feeding of curd meals. With the history and general clinical examination the case tentatively diagnosed as gastric dilatation. After unsuccessful advancement of oro-gastric tube, needle gastric paracentesis was performed on left side of the abdomen caudal to the last rib for decompression. Mid-ventral celiotomy and gastrotomy were performed after stabilization of heart rate and respiratory rate. After evacuating the whitish frothy content from the stomach, derotation and incisional gastropexy was performed. On 14thpostoperative day telecommunication confirmed the milk based meal induced GDV canine patient recovered uneventfully. Electrocardiogram monitoring done for first 24 hours period and ventricular arrhythmia was managed by using lidocaine (loading@2mg/ kg bw followed by 25mcg/kg/min for 30 min). It is concluded that on 14th postoperative day telecommunication confirmed the milk based meal induced GDV canine patient recovered uneventfully.

scholarly journals ENDOMETRIOSIS

2018 ◽  
Vol 25 (01) ◽  
pp. 165-167
Author(s):  
Mussarat Sultana ◽  
Huma Karamat ◽  
Asma Batool
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
Clinical Examination ◽  
Diagnosis And Treatment ◽  
Scar Endometriosis ◽  
History Of

A 32 years multiparous lady with history of previous three caesarean sections,presented with pain in the scar for the last three years. Clinical examination revealed a firm andtender nodule under the scar which used to become prominent on menstruation. Ultrasoundshowed hypoechoic areas with echogenic shadowing. MRI was unremarkable. Clinical diagnosisof scar endometriosis was made. Local incision done with enblock dissection. Histopathologyconfirmed the presence of endometrial glands. This is a case report of cesarean section scarendometriosis. The pathogenesis, diagnosis and treatment of this presentation are discussed.

scholarly journals P11 Multiple insufficiency fractures in rheumatoid arthritis

2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Qurat Ul Ain Amjad ◽  
Spencer Ellis
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Case Report ◽  
Treatment Failure ◽  
Fracture Risk ◽  
Inflammatory Markers ◽  
Disease Duration ◽  
Stress Fractures ◽  
Insufficiency Fractures ◽  
History Of

Abstract Case report - Introduction Rheumatoid arthritis (RA) is an autoimmune inflammatory arthropathy with systemic manifestations. It is 4-times more common in females. RA is recognised to induce bone loss and decrease in bone mineral density (BMD). Management may include corticosteroids (CS) for new presentations, acute flares, and more rarely longer-term management, which increases bone fragility. Patients are at 30—50% increased risk of developing osteoporosis with a 30% increase in fracture risk. This risk rises with the level of persistent disease inflammation. We present a case of a lady with longstanding RA, who sustained multiple bone fractures without significant osteoporosis on bone density scanning. Case report - Case description Our patient is a 64-year-old headteacher who took early retirement due to reduced mobility after 20 years of seropositive RA. She had received multiple disease modifying drugs (DMARDs) and biologics therapies, requiring repeated alterations primarily due to treatment failure. She was commenced on alendronic acid due to osteopaenia of the hip but 2 years later sustained a fractured neck of femur and was switched to risedronate. A year later she presented with acutely painful and swollen right foot and ankle without history of trauma. X-rays showed progressive degenerative change whilst inflammatory markers were normal. Ultrasound demonstrated sub-clinical synovitis. Her medication was optimised but the ankle swelling persisted, rendering her wheelchair-reliant. MRI revealed multiple stress fractures involving calcaneum, talus and 5th proximal phalanx. She was treated with 16 weeks of an Aircast boot. An old right upper medial tibial fracture was also identified. Repeat dual energy X-ray absorptiometry (DEXA) scan showed osteopaenia but with improvement from the previous scan (T score of -2.1 total hip and -1.6 lumbar vertebra). She smoked 1 cigarette a day, did not drink alcohol and there was no parental history of fractures. No evidence of malabsorption or endocrine disorder was identified. Unusually, she had received tamoxifen in her late 20s for cancer prevention based on breast fibroadenosis and she experienced early menopause aged 36 years. Inflammatory markers, calcium, parathyroid hormone, and immunoglobulins were normal. Vitamin D3 levels were insufficient at 40.3 nmol/l and replacement was initiated, following which she was switched to intravenous zoledronic acid. After one infusion of zolendronate, she twisted her right ankle and sustained a new malleolar fracture. She was converted to 6-monthly denosumab injections along with calcium and vitamin D, which has been continued. Her RA remains active, and she has recently commenced JAK2 inhibitors. Case report - Discussion Inflammatory arthropathies such as RA predispose to significant morbidity and disability. An earlier age of diagnosis poses a longer inflammatory response in body, with a higher incidence of bone health complications. A treat-to-target strategy in RA aids optimal disease management and reduces fracture risk. Studies have shown the risk of osteoporosis in RA is not just disease dependent but also affected by certain medications. Treatment challenges arise when a patient sustains fracture despite a BMD above osteoporosis risk criteria, leading us to consider other variables. She was further investigated for secondary causes of osteoporosis, including endocrine causes, and was found to be vitamin D insufficient, which was replaced prior to further antiresorptive treatment. Our case also highlights a diagnostic dilemma given that our patient presented with a single swollen joint assumed to be due to active RA. Multiple insufficiency fractures were only identified after MRI was performed. As per EULAR criteria, our patient had difficult to treat RA with a long disease duration. She showed intolerance to a several DMARDs and treatment failure with multiple biologic therapies. She had required local joint injections and repeated short courses of oral steroids. These factors are likely to have played a considerable role in her fracture development. RA is an independent risk factor for fracture in both men and women with disease duration and CS use being important clinical variables. Bisphosphonates are considered vital in fracture risk reduction. The compliance is an important factor for both primary and secondary prevention of fracture. They are associated with decreased bone remodelling and have been well studied for atypical femoral fractures; however, whether there is any link with stress fractures in the feet requires further studies. Long-term use (&gt;5years) hasn’t shown to be beneficial in preventing hip fractures. Case report - Key learning points

scholarly journals COMMA OF UNCLEARED CAUSE AS A DIAGNOSTIC PROBLEM. CASE REPORT OF ACCIDENTAL PESTICIDE POISONING

2008 ◽  
Vol 37 (2) ◽  
pp. 171-173
Author(s):  
Vasvija Uljic ◽  
Dragana Markovic ◽  
Mirsada Praso ◽  
Samir Delibegovic
Keyword(s):  
Adverse Effect ◽  
Case Report ◽  
Clinical Examination ◽  
Clinical Image ◽  
Pesticide Poisoning ◽  
Diagnostic Problem ◽  
Laboratory Methods ◽  
History Of Disease ◽  
History Of ◽  
Headache Pain

Pesticide is used in agriculture, but their non-competent usage can cause adverse effect on people and animals. There are numerous clinical states and symptoms which can give clinical image similiar to pesticide poisoning, with vagal symptoms as a vertigo, weariness, nausea, vomiting, headache, pain in abdomen and musles. That is why diagnosis of accidental pesticide poisoning is difficult. The base for establishing of diagnosis is information that the person was in contact with pesticide, confirmed by laboratory and toxicological analysis. In some cases pesticide poisoning can not be proved by laboratory methods. In these cases history of disease and clinical examination can help in establishing of diagnosis.

scholarly journals Vitamin D-Resistant Rickets Diagnostics and Treatment Challenges at Muhimbili National Hospital, Tanzania

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Evance K. Godfrey ◽  
Fatima Mussa ◽  
Parvina Kazahura ◽  
Aika Shoo ◽  
Helga Naburi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Laboratory Investigation ◽  
Clinical Judgment ◽  
Epiphyseal Growth Plate ◽  
Multiple Fractures ◽  
Resource Limited ◽  
History Of ◽  
Vitamin D Resistant Rickets ◽  
Case Presentations ◽  
Poor Weight Gain

Introduction. Rickets is softening of bones caused by defective mineralization of the cartilage in the epiphyseal growth plate, causing widening of the ends of long bones, growth retardation, and skeletal deformities in children. It can be classified into calciopenic and phosphopenic, each type with various subclasses. Case Presentations. We presented 2 cases, first of a 1 year and 4-month-old male, with a history of recurrent episodes of cough for 8 months and bowing of the legs 6 months prior to admission. Clinical and laboratory investigation was suggestive of vitamin D-dependent rickets, and he started vitamin D treatment with minimal response. The second case is of a 4 years and 7-month-old male who presented with developmental delay, poor weight gain, and recurrent chest infection and worsening of bone pain since 9 months of age. Laboratory investigation was suggestive of phosphopenic rickets, and he was started on treatment at 9 months of age with little improvement and at 4 years, he sustained multiple fractures and succumbed to severe respiratory tract infection and died at 4 years and 7 months of age. Conclusion. Rickets pose a diagnostic and treatment challenge in resource-limited countries, and clinical judgment and early initiation of treatment are important.

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