Rytterblanchard1457

This case shows diagnostic difficulties and management of this rare disease.

Here, we report a rare case of a 48 year-old patient, in acutely decompensated heart failure, presenting an accelerated junctional rhythm (AJR) as initial presentation of light-chain cardiac amyloidosis. The diagnosis was made based on clinical, biological, radiological and histological findings. This case shows diagnostic difficulties and management of this rare disease.

Cameron Lesions are linear breaks in the proximal gastric mucosa, mostly in association with hiatal hernia. The condition presents with chronic iron deficiency anemia and occasionally with obscure bleeding. Overt bleeding is very rare and has not been reported in sub- Saharan Africa context.

A 78 year old male patient, with an already diagnosed hiatal hernia and gouty arthritis, presented with massive upper GI bleeding requiring resuscitation and blood transfusion. The patient was taking indomethacin for a gout flare prior to the episode and clinical suspicion was a peptic ulcer disease as the culprit for the bleeding. Endoscopy was done and it showed two linear erosions with recent bleeding in the hernia sac. No other bleeding source was identified. The patient was treated with a Proton Pump Inhibitor (PPI).

Cameron lesions could present with massive bleeding and should be actively looked for in patients with hiatal hernia as they could be easily missed. Even with concurrent NSAID use, the condition could be a cause of major bleeding and careful evaluation is important. Management entails PPI therapy with occasional endoscopic intervention.

In the setting of hiatal hernia, Cameron lesions should be actively looked for in patients presenting with overt GI bleeding.

In the setting of hiatal hernia, Cameron lesions should be actively looked for in patients presenting with overt GI bleeding.

Acute pancreatitis (AP) is a serious inflammatory condition of the pancreas. Hypertriglyceridemia (HTG) is considered an uncommon cause of AP. The current study aims to present a unique case of recurrent seasonal severe HTG-induced AP (HTG-AP); treated with insulin and heparin.

A 36-year-old male presented with recurrent attacks of severe upper abdominal pain that was radiating to the back and associated with repeated vomiting. The condition has being occurring every autumn-winter for the last three years. He had thalassemia minor and had a history of HTG-AP. His TG levels were relatively normal from February to August; however, from September to February, his TG levels highly elevated which has resulted in HTG-AP every year for the past three years. The condition was confirmed via a contrast-enhanced computerized tomography scan of the abdomen. To prevent the next HTG-AP, his TG level was monitored monthly. When TG levels spiked again, the patient was put on an insulin infusion with heparin, glucose, and potassium to rapidly reduce TG level. After two days, serum TG was dramatically reduced (<500 mg/dL).

Despite multiple theories being proposed, the pathogenesis of HTG-AP is yet to be understood. Usually, HTG-AP is a single episodic, and recurrent HTG-AP is considered uncommon finding. Previous reports are contradictory regarding TG level and seasonal variation. There is currently no standard management approach to treat HTG-AP cases.

HTG-AP rarely reoccurs on an annual basis, and seasonal variation seems to play a major role in its onset. The condition can be managed with insulin, heparin, and glucose infusions.

HTG-AP rarely reoccurs on an annual basis, and seasonal variation seems to play a major role in its onset. The condition can be managed with insulin, heparin, and glucose infusions.Bladder obstruction, including due to benign prostate enlargement (BPH), will trigger its anatomy and physiological function changes. Men with BPH have a 6 times higher risk of erectile dysfunction than those without BPH. Morphological and functional changes in subjects with partial bladder outlet obstruction (pBOO) occur differently depending on the duration of pBOO that has been experienced. The underlying pathophysiology of BPH is closely related to erectile dysfunction. Anatomically, functionally, and psychologically changes due to BPH will also have an impact on sexual function. Chronic pBOO causes lower urinary tract symptoms (LUTS) through a complex pathophysiological pathway. LUTS and bladder obstruction can lead to erectile dysfunction. The severity of LUTS and sexual dysfunction is inversely related to the quality of life. The treatment of LUTS symptoms will also enhance sexual function.A 25-year-old male vehicle driver had a road traffic accident and sustained a blunt chest injury. His chest x-ray in the emergency department showed left hemithorax opacification. A chest drain Fr32 was inserted, and 1300ml of Blood drained out. While having a computed tomographic scan of the thorax scan, he had a cardiac arrest and after Cardiopulmonary Resuscitation (CPR) he was transferred to our tertiary care hospital on a mechanical ventilator and massive ionotropic support (adrenaline and noradrenaline) with a blood pressure of 50/24 mmHg. We performed a lifesaving emergency thoracotomy in a supine position with all COVID precautions, as COVID status was not available before hospitalization. After the repair of the Subclavian artery patient recovered completely and was discharged for follow-up in outpatient.Otogenic frontal abscess is an uncommon location of otogenic abscess of the brain and constitutes less than 5%. And the orbital extension is even more exceptional. LF3 datasheet An 11-year-old child, presenting with a two-week-long history of an acute otitis badly treated. Admitted for headaches, fever, vomiting and left eyelid swelling. The preoperative CT scan revealed a left frontal epidural abscess associated to a sub-periosteal Abscess. The patient was operated on. A supraorbital incision through the eyebrows allowed the evacuation of the periorbital abscess and the cerebral empyema through a trephine hole. The patient received probabilistic intravenous antibiotic therapy with ceftriaxon, aminoglycoside and metronidazole. Then relay per os. Postoperative recovery was marked by disappearance of headaches at postoperative Day two and the periorbital edema at day six. The patient was discharged home at postoperative week four with oral antibiotic therapy. Three months postoperative months follow-up CT scan revealed a total radiological cleaning. Otogenic frontal abscess associated to orbital Abscess is extremely rare and should be considered in front of ophthalmological signs. The management is multidisciplinary, and the entry point treatment mustn't be forgotten.•This case presented with very rare feature of active Pulmonary TB.•It denotes that Empyema Necessitans can mimick mesothelioma.•Unusual CT findings of Empyema Necessitans.•It states importance of induced sputum for TB diagnosis.•We recommend to test induced sputum for extrapulmonary tuberculosis to halt the spread of TB in the communities.

Post-operative nausea and vomiting (PONV) are a common post-operative problem in anesthesia. The incidence of PONV in patients undergoing cesarean sections is very high. Post-operative nausea and vomiting have many negative impacts on the patient, baby, family, and health care system. Therefore, appropriate evidence-based knowledge regarding the prevention and management of PONV for those high-risk patients is a timely and very important issue to address to decrease the associated complications.

A comprehensive literature search was conducted in Pubmed/Medline, Cochrane reviews, and google scholar including those studies published in the English language from 2010 up to 2021. The methodological quality of the included studies was appraised by the Cochrane risk of a biased assessment tool for intervention and non-interventional studies.

The search strategy identified a total of 10,540 articles from different electronic databases. 33 articles were selected for screening after duplicates were removed; finahysiology of nausea and vomiting.

Rhabdomyosarcoma (RMS) is a primitive malignant soft tissue tumor arising from premature mesenchymal cells. The current study presents a rare case of embryonal rhabdomyosarcoma in the nasal cavity of an adult patient.

An 18-year-old female presented with right nasal obstruction for five months. Examination showed a pale soft, painless mass in the right nasal cavity with attachment to the nasal septum at the osteocartilaginous junction. The patient was falsely suspected for bacterial infection, but later histological examination showed undifferentiated small round blue cell tumor with extensive necrosis. Immunohistochemistry confirmed the diagnosis of embryonal RMS. The patient was operated on for endoscopic sinus surgery to remove the mass with additional cleaning of surrounding sinuses.

Embryonal RMS is a rare type of malignant tumor that mostly affects the head and neck area in children while usually occur in the extremities of adults. Encountering an adult ERMS of the nasal chambers represents a small portion of head and neck cases that lack specific presentations.

Adult embryonal RMS of the nasal cavity is exceedingly rare and presents a diagnostic and management challenge, with immunohistochemistry being the only definitive diagnostic method.

Adult embryonal RMS of the nasal cavity is exceedingly rare and presents a diagnostic and management challenge, with immunohistochemistry being the only definitive diagnostic method.

Post-operative nausea and vomiting (PONV) are common and distressing to patients. This common anesthetic and surgical side effect has been reported to increase patient dissatisfaction and can be more distressing to patients than post-operative pain. It has multi-factorial causes patient, anesthesia and surgery related risk factors have been identified. Prevention of PONV is important since it has psychological and physical effects, and it can also cause severe complications.

To determine the level of practice of PONV prophylaxis usage for caesarean section.

This clinical perspective study was conducted at all pregnant mothers scheduled for caesarean section under anesthesia from March 1 to March 30, 2021 consecutively. The standards were directly changed into question forms with two integral checking components, "Yes", and "No". Data were entered and analyzed by statistical package of social sciences (SPSS) version 20.

A total of 100 parturients scheduled for caesarean section were included with a resnd the adoption of a multimodal approach will highly likely ensure success in the management of PONV. The usage of appropriate anti-emetic prophylaxis to the right patient is necessary to have a good outcome after surgery and anesthesia.

Hernias containing appendix, caecum and transverse colon are uncommon in contrast with usual inguinal hernias containing small intestine. The patient usually presents with inguinoscrotal swelling.

We present a case of a 2 months old male child presented with inguinoscrotal swelling, vomiting with abdominal distention. On Ultrasonography (USG) of the scrotum, protrusion of the abdominal cavity contents through the right inguinal canal into the scrotum of approximately 3.4 cm×0.7 cm was found which indicates right inguinal hernia. On the opening of the hernia sac during surgical management, the appendix, caecum and transverse colon were lying inside the hernia sac. Open Herniotomy was performed and the abdomen was closed in layers. Postoperative period of the patient was uneventful.

Congenital inguinal hernia in the child occurs mostly due to persistent processus vaginalis. History and clinical examination reveals the appearance of lump in the inguinal region or scrotum. Preoperative Ultrasonography can be used to supplement the physical examination and increase the accuracy of its diagnosis.