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Isolated sublingual hematoma is a rare complication seen in trauma, severe uncontrolled hypertension, dental operations, bleeding diathesis, and the use of dual antiplatelet and anticoagulant agents. In advanced and neglected cases, a sublingual hematoma may interfere with the patient's airway, causing suffocation and fatal airway obstruction. Our objective was to present a case of iatrogenic isolated sublingual hematoma in a 70-year-old business man, heavy smoker with a history of hypertension. Furthermore, to report the literature review, and to organize treatment strategies to reduce the rate of progression of the hematoma. In addition to recommend or advice a strategic plan to prevent this complication during carotid stenting.
This case report has been reported in line with the SCARE Criteria. We represented a case report of an iatrogenic isolated mild/moderate sublingual hematoma in a 70-year-old business man. This hematoma developed as one of the rare complications of endovascular internal carotid ansensus about the management regarding the hematoma itself. Mostly, clinicians start with observation for spontaneous resolution. When conservative treatment is not appropriate, surgical intervention must be performed. However, electively secure the airway is the main objective for treatment.
The first step in management should be prompt airway management. Conservative treatment took place without any further intervention. To date, there is no consensus about the management regarding the hematoma itself. Mostly, clinicians start with observation for spontaneous resolution. When conservative treatment is not appropriate, surgical intervention must be performed. However, electively secure the airway is the main objective for treatment.
This case report describes the reconstruction of the traumatic distal fibular and lateral malleolus defects with a novel method of using individualized 3D printed titanium prosthesis for the first time.
A 63-year-old male farmer was hospitalized in emergency because of open injury and distal fibular and lateral malleolus defects in the left leg caused by a car accident. 3months after debridement and latissimus dorsi muscle flap transplantation and skin graft operation, the patient re-hospitalized because of distal fibular and lateral malleolus defect and local pain. We examined the bilateral ankle joint with three-dimensional CT, obtained data about the missing left distal fibular and lateral malleolus through the mirror principle. The corresponding titanium alloy prosthesis then was designed and printed using a 3D metal printer. The patient had no obvious contraindication for surgery, so the prosthesis was surgically implanted. The patient was followed up for 2years. There was no discomfort at the surgicthe repair and reconstruction of similar bone defects. The use of 3D printed prosthesis for surgical repair needs to be further examined in the future through long-term follow-up studies and in more cases.
The structure and function of the reconstructed distal fibular and the lateral malleous were close to normal. CDK inhibitor drugs Individualized 3D printed prosthesis might have considerable advantages over traditional treatment methods. The individualized 3D printed titanium alloy prosthesis provides a new method for the repair and reconstruction of similar bone defects. The use of 3D printed prosthesis for surgical repair needs to be further examined in the future through long-term follow-up studies and in more cases.
Solid pseudopapillary neoplasm (SPN) of pancreas is a rare neoplasm with very low malignant potential. It mainly affects females in third decade of life and has favourable prognosis.
We report a case where a 17-years old girl presented with history of blunt abdominal trauma with handlebar of bicycle 6months back, following which she developed abdominal pain and fullness in epigastrium. Keeping pancreatic pseudocyst as provisional diagnosis, she was investigated. The final diagnosis of SPN of pancreas came as a surprise. The mass, about 6x5cm, was excised and Roux-en-Y distal pancreatico-jejunostomy was done.
Patient showed no recurrence or metastasis till one year of follow-up. This is the first case report of SPN presenting after handlebar injury.
Timely and adequate resection provides good long-term survival.
Timely and adequate resection provides good long-term survival.
Port-a-caths are long-stay central catheters often used for chemotherapy or parenteral nutrition. The implantation of a port-a cath, despite being involved in routine procedures, is also associated with immediate and delayed complications. Complications are rare but must be known and managed by operators.
A delayed complication related to the presence of a port-a-cath, consisting in the fragmentation of the catheter, has been reported, in a 63-years-old female patient. The port was placed via subclavian venous access and affected by pinch-off syndrome, which resulted in catheter malfunction and then in fragmentation from compression by the subclavius-costoclavicular complex. The onset symptom was device malfunction.
The focus in the management of this rare but possible complication was the quick removal of the device and of the catheter fragment in the endovascular lumen with collaboration between different medical specialists.
The focus in the management of this rare but possible complication was the quick removal of the device and of the catheter fragment in the endovascular lumen with collaboration between different medical specialists.
Hydatidosis is an uncommon zoonotic infection in the Philippines with only a few reported cases. It frequently presents as benign liver cysts with variable symptoms often related to mass effect.
We present a 49-year-old male with a significant travel history from East and Central Asia, surgically treated twice as a benign liver cyst and now presenting with recurrent multiple intraabdominal cysts. He subsequently underwent surgical excision of multiple hydatid cysts with prolonged albendazole treatment. The patient presently remains disease-free as of most recent follow-up.
The disease is caused by the tapeworm Echinococcus granulosus and transmission happens when humans acting as intermediate host ingest food contaminated with the parasite eggs, resulting to the liver being the most common location. Frequently, it manifests and is treated as incidental hepatic cysts for the disease is characterized to have a long asymptomatic period. Symptoms are variable and may range from having abdominal pain, increasing abdominal girth, vomiting, fever or myalgia. Ultrasound or CT scan reveals single or multiple cysts however, biopsy of the cyst wall with demonstration of the larval form (protoscoleces) is diagnostic.
This case highlights the value of history-taking and having a high-index of suspicion particularly for rare cases.
This case highlights the value of history-taking and having a high-index of suspicion particularly for rare cases.
Kidneys are one of the most commonly affected retroperitoneal organ in trauma cases despite its relatively well-protected location. Renal trauma occurs in 80-95% of urogenital trauma cases and 8-10% of abdominal blunt trauma. Renal trauma in hydronephrotic kidney due to ureteropelvic junction obstruction (UPJO) is a rare entity, despite of high risk of trauma urogenital due to large size and thin parenchyma. In this case we reported blunt renal injury with a congenital abnormality of the kidney.
We present a case of abdominal blunt trauma due to motor-vehicle accident in a 23year old male patient. The patient complaint of visible hematuria since 1day after falling from motorcycle with right flank hit the road, accompanied with right flank pain. Vital signs were within normal limits. Physical examinations reveal distention of right flank with no sign of peritonitis. Supporting examination with FAST ultrasound revealed grade 4 hydronephrosis with internal echo, suspected blood accumulation inside the kidneyor renal trauma, and clinical judgement from the physician plays an important role to provide the best treatment for this patient.
Although nowadays rare, Potts Puffy Tumor (PPT) is a rare but serious diagnosis characterized by osteomyelitis of the frontal bone. The introduction of broad-spectrum antibiotics made PPT an uncommon diagnosis in modern medicine, and it is mostly seen as a complication of frontal sinusitis in children and adolescents.
We report a case of PPT in an elderly man with a sudden and increasing swelling of the forehead, which was initially diagnosed as an epidermoid cyst. Subsequent surgical exploration revealed osteomyelitis of the underlying frontal bone. Medical imaging by computed tomography (CT) and magnetic resonance imaging (MRI) was done, and treatment with Functional Endoscopic Sinus Surgery (FESS) and reconstructive surgery of the frontal bone was conducted.
PPT is a rare, yet serious condition which is usually seen as a complication of chronic sinusitis which causes osteomyelitis and a subperiosteal abscess. Despite the atypical presentation of symptoms, the reported case underlines the importance of rapid deployment of medical imaging, referral, and administration of broad-spectrum antibiotics. Furthermore, surgical intervention is indicated in most cases. When left untreated, PPT can result in severe intracranial complications.
The diagnosis PTT is still relevant and may have a nonspecific presentation. A persisting epidermoid cyst after drainage should lead to the suspicion of a PTT. Immediate imaging and adequate treatment are required to prevent serious, potentially lethal intracranial complications.
The diagnosis PTT is still relevant and may have a nonspecific presentation. A persisting epidermoid cyst after drainage should lead to the suspicion of a PTT. Immediate imaging and adequate treatment are required to prevent serious, potentially lethal intracranial complications.The basic helix-loop-helix (bHLH) transcription factors play vital regulatory roles in a series of metabolic, physiological, and developmental processes of plants. Here, SlPRE5, an atypical bHLH gene, was isolated from tomato. SlPRE5 was noticeably expressed in young leaves, sepals, and flowers. SlPRE5-overexpressing plants exhibited rolling leaves with reduced chlorophyll content, increased stem internode length, leaf angle, and compound leaf length. The water loss rate of mature leaves and the content of starch were significantly reduced, while the content of gibberellin was significantly increased in transgenic plants. Yeast two-hybrid and bimolecular fluorescence complementation (BiFC) showed that SlPRE5 could interact with SlAIF1, SlAIF2, and SlPAR1. qRT-PCR and RNA-seq results revealed that the expression levels of genes related to chloroplast development, chlorophyll metabolism, gibberellin metabolism and signal transduction, starch, photosynthesis, and cell expansion were significantly altered in SlPRE5-overexpression plants. Collectively, our results suggest that SlPRE5 is a crucial transcription factor involved in plant morphology and chlorophyll accumulation in tomato leaves.
Emerged coronavirus disease 2019 (COVID-19) is a pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Disease severity is associated with elevated levels of proinflammatory cytokines, such as interleukin-6 (IL-6). Genetic polymorphisms in the regulatory regions of cytokine genes may be associated with differential cytokine production in COVID-19 patients. This study aimed to investigate the association between three potentially functional single-nucleotide polymorphisms (SNPs) in the promoter region of IL-6 and the severity of susceptibility to COVID-19 in an Iranian population.
In total, 346 individuals (175 patients with severe COVID-19 and 171 patients with mild COVID-19) were recruited for this cohort study. Genomic DNA was extracted from peripheral blood leukocytes of patients to determine the genotypes of three selected SNPs (rs1800795 (-174 G>C), rs1800796 (-572 G>C), and rs1800797 (-597 G>A)) in the promoter region of the IL-6 gene using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
