International Journal of Medical and Pharmaceutical Case Reports
ISSN / EISSN : 2394-109X / 2394-109X
Published by: Sciencedomain International (10.9734)
Total articles ≅ 300
Latest articles in this journal
Published: 11 May 2022
International Journal of Medical and Pharmaceutical Case Reports pp 19-23; https://doi.org/10.9734/ijmpcr/2022/v15i330159
A mucosal lesion that arises due to long standing chronic irritation is called Epulis fissuratum. It is a benign reactive hyperplastic lesion that commonly develops in the mucosa close to the overextending flanges of the ill-fitting dentures. This paper presents a case of atypical presentation of epulis fissaratum in a 74-year-old woman with history of ill-fitting denture for the past four months. Total excision of such lesions is recommended because they cause problems such as pain and discomfort during mastication and speech.
Published: 16 April 2022
International Journal of Medical and Pharmaceutical Case Reports pp 7-14; https://doi.org/10.9734/ijmpcr/2022/v15i330157
Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints. Extra-articular features are very common. We report a case of RA first diagnosed after an episode of congestive heart failure (CHF) and the evolution of left ventricular function after conventional treatment of CHF and immunosuppressive drugs. The patient, a 52-year-old man, with history of epilepsy and a stroke 6 years before, presented to the emergency department with increasing dyspnea. He had polyarthralgia 2 months before. The lower extremities had mild pitting edema. The musculoskeletal examination revealed synovial thickening of the metacarpophalangeal and proximal interphalangeal joints, but there was no joint tenderness. The patient’s alanine aminotransferase, troponin levels and CRP were slightly elevated. His renal function was preserved. The electrocardiogram (EKG) was normal. An echocardiogram performed in showed a global hypokinetic dilated cardiomyopathy with an ejection fraction of 15–20%, with apical thrombus. The patient was diagnosed with exacerbation of congestive heart failure (CHF) and was treated with intravenous diuretics. This led to symptomatic improvement. He got a conventional heart failure treatment with vit K antagonists. Coronarography was normal. Viral serologies were negative. The martial, phosphocalcic and thyroid markers were normal. However, the immunologic tests showed positive rheumatoid factor and anti-CCP. The diagnosis of dilated cardiomyopathy due to rheumatoid arthritis was retained. The patient was treated by corticosteroids and immunosuppressive agents. Patient was seen during routine follow-up after 6 months. Interestingly, echocardiographic findings were totally normal with left ventricular ejection fraction >50% and normal LV size.
Published: 16 April 2022
International Journal of Medical and Pharmaceutical Case Reports pp 15-18; https://doi.org/10.9734/ijmpcr/2022/v15i330158
Bullous lung disease is an illness characterized by nonfunctional air-filled spaces caused by deterioration of alveolar tissue. Lung diseases such as chronic bronchitis, emphysema, and bronchiolitis are associated with smoking. We aimed to present a case of giant bullous emphysema without any known comorbidity and who was admitted to the clinic with progressive dyspnea in a short time. A 52-years-old male patient was admitted to the clinic with the complaint of increasing dyspnea in the last 3 months. Smoking was 26 pack years, and no chronic disease. Giant bullae with a size of 13x15x20 cm, starting from the right apical and extending posteriorly to the lower lobe fissure, and diffuse emphysematous pathologies were seen in the thorax CT. The patient was operated on for a giant bullous lesion that subtotally contains the upper lobe of the right lung and causes respiratory dysfunction with the compression effect on the middle lobe and lower lobe (resection of the giant bulla was operated by the right thoracotomy). Except for the operation-related pain complaint, no respiratory symptoms were seen. The patient said with an effort, respiratory distress decreased significantly. No complications were observed, and the patient was discharged on the 6th day of the operation. Vanishing Lung Syndrome is a complication of Chronic Obstructive Pulmonary Disease, and it is defined as idiopathic giant bullous emphysema. This illness defined as giant bulla occupying one-third of the hemithorax, it compresses the mediastinum and lung parenchyma. Differentiating bullous lesions of the lung from pneumothorax is important in the treatment. Surgical treatment is a successful option in symptomatic giant bullae or with compression of lung parenchyma. Bullectomy improves the patient's symptoms, pulmonary function, quality of life, and expansion of the lung parenchyma.
Published: 11 April 2022
International Journal of Medical and Pharmaceutical Case Reports pp 16-19; https://doi.org/10.9734/ijmpcr/2022/v15i230154
Background: Spinal cord contrast enhancement is an unusual radiological finding in chronic degenerative disorders of the spine and often it is misdiagnosed with neoplastic or inflammatory disease. Case Description: Here we present the case of a 62-year-old male with cervical degenerative spondylosis at the C4–C5 and C6-C7 level. Preoperative magnetic resonance imaging showed severe spinal cord compression with intramedullary hyperintensity on T2-weighted sequences and spinal cord enhancement at the C4-5 level after administration of Gadolinium. The patient with several weeks’ history of worsening spastic tetraparesis, underwent two-level anterior discectomy with fusion and anterior stabilization at the myelopathy level. Conclusion: Intramedullary gadolinium enhancement due to cervical spondylotic myelopathy (CSM) is an important consideration in the differential of inflammatory disease or intramedullary tumors, especially since misdiagnosis may result in serious consequences, including neurological disability from delayed surgical interventions and unnecessary treatments. Persistent enhancement for months to years following decompressive surgery is usual. Recognition is important to prevent inappropriate interventions or delay in consideration of a potentially beneficial decompressive surgery.
Published: 25 March 2022
International Journal of Medical and Pharmaceutical Case Reports pp 12-15; https://doi.org/10.9734/ijmpcr/2022/v15i230153
Background: Child Sexual Abuse (CSA) is a crime against children. It is largely under-reported and commonly goes unpunished in our society. Case report: The patient is a 4-year-old girl who presented to our emergency paediatric unit with 14 hours duration of faecal incontinence following sexual assault by her landlord’s son. She also complains of pelvic pain and difficulty in walking. The landlords’s son forced his penis into her anus and inserted his fingers through her vagina. On examination of her anal region, there was anal sphincter tear at six 0’ clock, extending exteriorly to the right measuring 1 cm long and 0.5 cm deep with a rectovaginal fistula. Vaginal examination revealed minor laceration and excoriation on the right lateral wall and floor of the vagina, with mild bleeding. She had a left hymenal tear at the lower aspect and a vagina floor tear. Results of urine microscopy culture and sensitivity (MCS) revealed white blood counts (WBC) 2+, leucocytes 2+, epithelial cells+, Staphylococcus aureus was isolated which was sensityive to amoxiciilin. The child was resuscitated and given antibiotics and analgesics and prophylactic antiretroviral drugs. She had a perineal tear repair by the paediatric surgeon. She was placed on sitz bath and she responded well with good healing and recovery. She was discharged after 2 weeks on admission and came back for follow-up. This report highlights the management of a case of rectovaginal fistula in a child as a result of sexual assault.
Published: 20 February 2022
International Journal of Medical and Pharmaceutical Case Reports pp 9-11; https://doi.org/10.9734/ijmpcr/2022/v15i230152
Aims: A previous study reported hemolytic crisis in patients with erythro-enzymopathy. Here, we report two further cases of massive acute hemolysis with methemoglobinemia in two siblings with glucose dehydrogenase deficiency and parvovirus B19 (PAVB) infection. Presentations of Case: The first was his 8-year-old brother, who developed mild hemolysis with liver dysfunction and survived. The second patient was a 10-year-old boy, who developed liver and kidney failure and died. To elucidate the mechanisms through which PAVB can cause liver and kidney failure, we analyzed cytokines and virus burden. Conclusion: Physicians should be aware that severe hemolysis may occur in patients with hematological abnormalities and PAVB infection.
Published: 15 February 2022
International Journal of Medical and Pharmaceutical Case Reports pp 5-8; https://doi.org/10.9734/ijmpcr/2022/v15i230151
Vitamin B12 deficiency is a common nutritional deficiency in both developed and developing countries. This water-soluble vitamin is synthesized by bacteria and archaea and plays a major role in DNA synthesis and effective hematopoiesis. Most common etiologies of B12 deficiency include pernicious anemia and dietary deficiency. Hematological manifestations including anemia, leukopenia, thrombocytopenia, and macrocytosis can commonly be seen with vitamin B12 deficiency. Vitamin B12 deficiency is a rare cause of hemolytic anemia with approximately 1.5% of cases. Hemolysis with vitamin B12 deficiency remains a rare entity that has not been well described in the literature. Here we present a case of a 49-year-old male presenting with presyncope and fatigue who was found to have hemolytic anemia secondary to severe vitamin B12 deficiency with clinical improvement after vitamin supplementation therapy and provide a brief review of literature.
Published: 7 February 2022
International Journal of Medical and Pharmaceutical Case Reports pp 1-4; https://doi.org/10.9734/ijmpcr/2022/v15i230150
Aims: The world is in the grip of the COVID-19 pandemic. Here, we report two infant cases of vitamin D (VD) deficiency associated with a lack of sunlight. Presentations of case: Patients and their families stayed indoors according to orders issued by the public administration. Conclusion: Physicians should be aware that many health problems are associated with long stays at home, including VD deficiency, which may be associated with a lack of sunlight.
Published: 25 January 2022
International Journal of Medical and Pharmaceutical Case Reports pp 24-29; https://doi.org/10.9734/ijmpcr/2022/v15i130149
Background: With an angiographic prevalence approaching 1%, Anomalous connections of the Coronary arteries (ANOCOR) are rare. The term connection is preferred over origin since the coronary arteries do not grow out of the aorta but grow into the aorta from the peri truncal ring of coronary arterial vasculature. Very often these anatomical shapes are incidental findings without clinical impact; however, in some specific cases, clinical symptoms may occur arriving to sudden cardiac death (SCD), this is particularly true when there is a an interarterial course between the ascending aorta and the pulmonary. Case Presentation: This case is about patient that we receive in emergency department presenting with an inferior ST segment elevation myocardial infarction (STEMI) which was found to be caused by compression of the proximal right coronary artery (RCA) between the aorta and the pulmonary trunk. Surgery was indicated by the heart team for the treatment of this condition. Conclusions: This case presents a severe manifestation of proximal anomalous connection of the right coronary artery with a “malignant” course between the aorta and the pulmonary artery. This variant has been called malignant because of its association with sudden death especially in young asymptomatic athletes. In current guidelines for symptomatic ANOCOR with interarterial course the treatment recommended is surgery.
Published: 17 January 2022
International Journal of Medical and Pharmaceutical Case Reports pp 20-23; https://doi.org/10.9734/ijmpcr/2022/v15i130148
The inadvertent intravenous administration of oral suspension which is rarely reported has contributed to potential patient harm. We received an incident report in which a patient had received an oral liquid formulation intravenously. This has been happening when an oral liquid is prepared or dispensed in a parenteral syringe. Due to the break-in mental concentration, the medicine had been administered intravenously. Some health professionals did not accept the fact that the Luer connection on an intravenous syringe facilitates mis-administration. This is why we constantly repeat recommendations to dispense and administer unit doses of oral liquids in particular oral syringes. We strongly support that, the dispensing and administering of commercially available and compounded medicine in a particular cup and oral syringes or any other suitable containers. In order to avoid such medication administration error ensure the availability of oral syringes in the hospital and patient areas where liquid doses are administered orally. Oral syringes are not available in Pakistan and nurses routinely use injection syringes for oral liquid administration, as it helps in preventing spill of dose especially in young/non-cooperative children or patients. Availability of oral syringes in the hospital may reduce the inadvertent administration of medicine.