Journal of Case Reports and Scientific Images

Journal Information
ISSN / EISSN : 2708-0056 / 2708-0064
Published by: AkiNik Publications (10.22271)
Total articles ≅ 43
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Ali Gürel
Journal of Case Reports and Scientific Images, Volume 4, pp 01-02; https://doi.org/10.22271/27080056.2022.v4.i1a.41

Abstract:
Behçet’s disease (BD) is a type of systemic inflammatory vasculitis characterized by oral and genital ulcers, ocular lesions, skin lesions. Renal involvement is rare but may have serious cosequences. In this report we present a patient diagnosed as BD 5 years ago and nowadays presented with a catastrophic course necessitating renal replacement therapy (RRT). We successfully applied acute peritoneal dialysis as RRT and, he relatively ameliorated.
Vinod S, Sathish Babu, Vivek Kumar As, Kavitha N, Arif Khan S
Journal of Case Reports and Scientific Images, Volume 4, pp 03-08; https://doi.org/10.22271/27080056.2022.v4.i1a.42

Abstract:
Introduction: Doppler Sonography has become an accepted method for clinical detection and evaluation of cervical carotid occlusive disease. One of the most important parameters used in doppler assessment of carotid stenosis is the peak Doppler shift frequency occurring during systole. However, relatively little data is available to indicate how precisely peak systolic frequency correlates with luminal narrowing and how peak systolic frequency measurements made with frequency spectrum analysis should be used clinically in gauging stenotic lesions. Aim: To assess the ratio between peak systolic velocity of internal and common carotid arteries and its significance in prediction of carotid artery stenosis. Materials and Methods: This is a cross-sectional analytical study performed on patients who are referred to department of Radiodiagnosis, Sree Mookambika Institute of Medical Sciences (SMIMS), Kulasekharam for carotid artery ultrasonography colour doppler evaluation. Conclusion: Doppler Sonography plays an important role in the early detection and management of carotid artery stenosis disease. The increased ratio of peak systolic velocity of internal and external carotid arteries is correlating with the detection of carotid artery stenosis, thereby improving sensitivity and specificity
Chitranshu Saxena
Journal of Case Reports and Scientific Images, Volume 4, pp 15-17; https://doi.org/10.22271/27080056.2022.v4.i1a.45

Abstract:
Generalized Anxiety Disorder is a specifically an anxiety disorder characterized by excessive/uncontrollable and often irrational worry worrying, anxiety symptoms and tension about a variety of everyday problems, events or activities for a period of at least 6 months. Individuals with GAD often have other disorders including other psychiatric disorders (e.g., major depressive disorder), substance use disorder, obesity, and may have a history of trauma or family with GAD. As per Aacharya Charaka Generalized Anxiety Disorder can be correlated with the Chittodwega (Excited state of mind) which is type of Manovikara (disease of mind). The contemporary management of this disease employs anxiolytics to be used in long run which is not conducive to health. As per this view cannabis stands as ‘Holy Grail’ in the treatment of anxiety or mood disorders without eliciting any anxiogenic effects even in higher dose. This is a case of 57 year old women who presented with persistent anxiety and inability to relax. Based on signs and symptoms he was diagnosed as a case of GAD according to the ICD 10 F41.1 criteria. Treatment planned was low dose of oral medical cannabis tincture. Assessment of the condition of the patient before and after the treatment was done using Hamilton’s Anxiety Rating Scale to evaluate efficacy of treatment. After the completion of schedule of 3 month of treatment, a significant reduction in score from 20 to 12 on Hamilton’s Anxiety Rating Scale and improvement in symptoms was observed.
Shilpi Raj, Ritu Mehta, Rakesh Holla
Journal of Case Reports and Scientific Images, Volume 4, pp 09-10; https://doi.org/10.22271/27080056.2022.v4.i1a.43

Abstract:
The retroperitoneal tumors are commonly secondaries from ovaries, pancreas or colon. Among the primary retroperitoneal tumors, mucinous adenomas are more common than mucinous adenocarcinomas. Clinically, they may present as abdominal masses, weakness of limbs and weight loss. Radiologically, they present as cystic masses, the exact origin of which cannot be ascertained. Here, we present a case of 30 years male with symptoms of difficulty in passing urine, pain and weakness of left lower limb with thinning of the limb since 6 to 7 months and accompanied by history of erectile dysfunction. PET CT showed left mesorectal fascial thickening with loss of fat plane, indentation of left posterior bladder wall and no metabolically active Lymph node being detected.
Chitranshu Saxena, Satej Banne, Gundappa S Rao
Journal of Case Reports and Scientific Images, Volume 4, pp 11-14; https://doi.org/10.22271/27080056.2022.v4.i1a.44

Abstract:
CINV is the most serious side effect and the main concern for cancer patients. Its prevalence is reported between 54% and 96%. This side effect induces physiological and electrolytic dysfunctions, changes in immunity system, nutritional disruption, and even esophageal perforation. Consequently, it affects patients’ quality of life and the continuance of treatment. Most patients with cancer experience CINV. The increase of excessive vogues excitation due to sympathetic inhibition is among the most important factors in the manifestation of CINV. Many factors increase the chance of CINV. The most important of them include blood pressure drop, the addition of compounds like vascular contractors, neostigmine, and opioids to anesthetics. Here is a case about 55 years old female undergone FNAC with radical mastectomy and was treated with chemotherapy for carcinoma. Medical cannabis was administered to counteract the delirious effect of chemotherapy induced nausea and vomiting.
Moueden Mohamed Amine, Messaoudi Reda, Seghier Fatima, G Ramakrishna Reddy
Journal of Case Reports and Scientific Images, Volume 3, pp 12-13; https://doi.org/10.22271/27080056.2021.v3.i2a.31

Abstract:
Aim: To present a case report of CLL, with a false macrocytosis caused by an important lymphocytosis and to demonstrate how we were able to detect it and our action to correct it. Methodology: When we have double population RBC histogram we have to use another parameter is the red blood cells most frequent volume (R-MFV) that defines the peak of the curve and fits the MCV in normal distribution. Results: CBC revealed leucocytosis (60×109/L), moderate normochromic anaemia (haemoglobin of 11.9 g/dL, MCV of 125 fl, In our case R-MFV is of 107 fl. The macrocytosis is still present; but would not be expected to reach 125 fl. It is also necessary to recalculate the parameters which depend on the MCV. Liver laboratory tests are abnormal in relation to the liver failure. This explains the mild macrocytosis observed even after correction of MCV. Conclusion: Pronounced leukocytosis can lead to overestimation of the MCV, especially in chronic lymphoid leukemia, therefore we must be careful when we interpret the parameters of complete blood count.
Mounika Katyayani K, Vamsikrishna Reddy K, Vamsikrishna P, Kanta Kumari P, Vijaya Laxmi B
Journal of Case Reports and Scientific Images, Volume 3, pp 26-28; https://doi.org/10.22271/27080056.2021.v3.i2a.35

Abstract:
Alkaptonuria is a rare genetic disorder of tyrosine metabolism, due to deficiency of the enzyme homogentisate 1, 2 dioxygenase. This results in characteristic features like blackish urine discoloration, ochronosis, arthropathy, cardiac valve deterioration. In this paper, the authors presenta case report of a 4-month-old boy who was brought by his mother to the well-baby clinic, with a chief complaint of black staining of nappy, a few hours after voiding. A qualitative examination of urine after an hour of the collection showed dark black discoloration, Quantitative examination reveals the presence of homogentisic acid to the extent of200mg/dl. The Diagnosis of Alkaptonuria was confirmed and the infant was started on Vitamin C and put under regular follow-up.
Sathish Babu, Jagadeep, Arif Khan S, Vivek Kumar As, Suji M, Vinod S
Journal of Case Reports and Scientific Images, Volume 3, pp 17-20; https://doi.org/10.22271/27080056.2021.v3.i2a.33

Abstract:
Introduction: Knee joint injuries and disease conditions that cause disruption of ligament, menisci, articular cartilage and other structures causing painful knee result in significant morbidity and disability. Aim: To describe the MRI features of various types of traumatic and non-traumatic lesions associated with painful knee. Materials and Methods: This hospital based descriptive study was conducted in a tertiary care institute (n=50) using 1.5T MRI for patients being referred to Department of Radiodiagnosis for the evaluation of painful knee were included in the study and results analysed by a descriptive analysis. Results: Meniscal tears were the commonest soft tissue abnormality in our study. Posterior horn of the medial meniscus were commonly involved and mostly of Grade 3. Commonest type of meniscal tear was vertical tear and usually associated with history of trauma. The commonest manifestation affecting the ACL was tear, predominantly acute in nature. Complete PCL tear was the commonest manifestation among PCL abnormalities. One quarter of the patients had associated bone contusion, femur was predominantly involved followed by lateral tibial condyle. Acute ACL tears were particularly associated with bone contusions. Popliteal cyst was the commonest cystic lesion and usually associated with coexisting effusions and meniscal tears. Osteoarthritic process was most commonly involved in the Patello-femoral compartment. Conclusion: For evaluation of painful knee, MRI is an accurate, cost-effective and a non-invasive choice of investigation. MRI can demonstrate the exact nature and extent of bony as well as soft tissue abnormality and is helpful in clinical decision making. Multiplanar imaging capacity of MRI enables a satisfactory diagnosis in such patients in whom a complete clinical examination is almost impossible due to pain.
Anshul Agrawal, Rashpal Singh Gill, Abhimanyu Rana, Ashish Goyal
Journal of Case Reports and Scientific Images, Volume 3, pp 36-39; https://doi.org/10.22271/27080056.2021.v3.i2a.38

Abstract:
Meralgia paresthetica characterised by pain, tingling and numbness in lateral aspect of thigh. A 48 year-old male with 2 years history of left lateral thigh paresthesias and burning pain consistent with meralgia paresthetica was referred to our clinic after failing trials of physical therapy, nonsteroidal anti-inflammatories and neuropathic medications. We performed lateral femoral cutaneous nerve block with corticosteroid, after that patient had good relief for 2 months; however, block provided only temporary relief and patient again started feeling same pain. As this pain was limiting the patient's ability to perform his functions as truck driver, we planned to perform a pulsed radiofrequency treatment of the lateral femoral cutaneous nerve left side under ultrasound guidance. After locating the lateral femoral cutaneous nerve with ultrasound and reproducing the patient's dysesthesia with stimulation, pulsed radiofrequency treatment was performed at 42°C for 120 seconds. The needle was then rotated 180° and an additional cycle of pulsed radiofrequency treatment was performed followed by injection of 0.125 % bupivacaine with 20 mg triamcinolone. At 2 and 4 month follow-up visits, the patient reported excellent pain relief with activity and improved ability to perform his duties. We have also described various aetiologies for meralgia paresthetica and multiple modalities available for the treatment of meralgia paresthetica.
Das Uddalok, Selim Sahajada, Singh Ramudar, Pandit Narayan
Journal of Case Reports and Scientific Images, Volume 3, pp 29-31; https://doi.org/10.22271/27080056.2021.v3.i2a.36

Abstract:
Eventration of the diaphragm is a condition wherein the diaphragm is abnormally elevated while retaining its normal attachments to the sternum, ribs, and dorsolumbar spine. The continuity of the diaphragm remains intact. This is a rare anomaly and is often mistaken as a diaphragmatic hernia on chest radiographs by physicians. Magnetic Resonance Imaging (MRI) gives a definitive diagnosis. We present the case of a neonate who was admitted to the Neonatal Intensive Care Unit and after X-ray and ultrasonography (USG) was presumed to have a right-sided congenital diaphragmatic hernia. But then MRI was done and the diagnosis was changed to eventration of the diaphragm as the continuity of the diaphragm was maintained. The baby was treated with surgery.
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