Thoracopagus Conjoined Twins: Early Diagnosis by Ultrasound, A Case Report
Giovanna Rosica, Daniela Bucari, Giovanni Pastore and Angela Musella
Article Type: Case Report | First Published: April 23, 2020
A tempestive diagnosis of conjoined twins pregnancy is highly important to lead to the best the rapeutic option. Thoracopagus conjoined twins account for more than 40% of conjoined twins pregnancies, and the prognosis is very poor because in most of cases a single heart and/ or liver is present. In our case, the premature diagnosis has given the family a chance to choose for pregnancy termination reducing as far as possible the already heavy emotional impact of that condition....
The Management of an Early COVID-19 Case with Severe Acute Respiratory Distress Syndrome in a Community Hospital in Ontario, Canada
Maham Khalid, BMSc, Han-Oh Chung, MD, MSc HS Ed, Dimitra Fleming, BSc Phm, George Farjou, MD and Jennifer LY Tsang, MD, PhD
Article Type: Case Report | First Published: April 23, 2020
We reported an early COVID-19 case in a young patient in a Canadian community intensive care unit (ICU) with severe acute respiratory syndrome (ARDS). We discussed the management according to the recently published Surviving Sepsis Guidelines on COVID-19. This will provide critical care physicians important and timely information on the management of severe COVID-19 using a real case when critical care physicians are facing a surge in COVID-19 cases. Many of the recommendations regarding ARDS ar...
Remifentanil: Pharmacokinetics, Pharmacodynamics, and Current Clinical Applications
Marco A Maurtua, MD, Amanda Pursell, MD, Kyle Damron, MD and Patel Sonal, MD
Article Type: Review Article | First Published: April 15, 2020
Remifentanil is a mu-receptor agonist chemically related to fentanyl, alfentanil, and sufentanil that was approved for use in general anesthesia in 1996 by the US Food and Drug Administration. It is a piperidine derivative, a 3-(4-methoxycarbonyl-4-[(L-oxopropyl)- phenylamino]-L-piperidine) propanoic acid, methyl ester. The introduction of the methyl ester group onto the N-acyl side chain of the piperidine ring is what makes remifentanil structurally unique among the currently available opioids....
Subnormal Thyroid Makes the Heart Skip a Beat
Supraja Thunuguntla, MD, Rizwan Mohammed, MBBS, Lauren Muenchow, MS and Jose Campo Maldonado, MD, FACP
Article Type: Case Report | First Published: April 11, 2020
A 72-year-old Hispanic male with an unconfirmed history of alcohol-related cirrhosis presented to the hospital for rectal bleeding and dark stool for two days. Vitals included a heart rate of 90-120 bpm, blood pressure 90-140 over 50-60 mmHg. A left thyroid nodule was appreciated on physical exam. His pertinent labs included TSH, free T3 and T4 levels that were 0.033 mU/L (low), 3.33 mU/L and 1.33 mU/L (both within normal limits) respectively. A TSH done 3 days later was low (0.024). Thyroid per...
Trench Fever in Texas
E Jane Gibson, MD, Tuyet T Pham, MD, Tove M Goldson, MD, PhD and Samuel N Forjuoh, MD, MPH, DrPH
Article Type: Case Report | First Published: March 30, 2020
Trench Fever is caused by Bartonella quintana, a small fastidious gram-negative rod organism carried by the body louse. We report a case of a 62-year-old woman who was admitted to a hospital in central Texas for a two-week history of fever and malaise. She was initially treated for Q fever which is usually caused by inhaling dust particles contaminated by infected animals, given that she was regularly around farm animals, but when her extensive infectious disease panel came back negative, the se...
Cannabinoid Use and Depression: Comparison of Natural and Synthetic Cannabinoids
Serap Akdeniz Gorgulu, MD and Can Sait Sevindik, MD
Article Type: Original Article | First Published: February 29, 2020
Patients who predominantly used marijuana (natural cannabis) and patients who predominantly used synthetic cannabinoids in their history were evaluated as two separate groups in our study which aimed to compare the sociodemographic characteristics and depressive symptoms of these two groups. The sample of our study consisted of those patients who referred to the Polyclinic of Psychiatry at Ardahan State Hospital and were diagnosed with substance addiction. 30 polyclinic patients who defined pred...
Disseminated Nocardiosis in an Immunosuppressed Patient with Sarcoidosis
Zachary Koehler, OMS IV, MPH, Jun Park, MD and Nicholas Jenkins, MD
Article Type: Case Report | First Published: October 07, 2019
Nocardiosis is a relatively rare disease with an incidence of 3 cases per 1,000,000 each year in the United States. The infection is caused by the Nocardia spp., which are aerobic, gram-positive, branching, weakly acid-fast bacilli found primarily in soil, water and decaying vegetation. Nocardiosis can be localized to a single organ, such as the skin or lung, or disseminated. Immunocompetent patients who are affected typically experience a chronic course involving one organ, most commonly the lu...
An Unusual Case of Palpitations: Pectus Excavatum
Zulfiqar Ali Sandhu, Sharjeel Shaikh and Aidan Buckley
Article Type: Case Report | First Published: October 04, 2019
Pectus excavatum is a congenital deformation of the chest, presenting as a funnel-shaped impression in the median frontal chest between the fourth and the seventh rib. Asymmetric presentation occurs, and the extent of deformation may vary from slight to serious. Exact numbers about prevalence are difficult to obtain, as the deformation is often not noted or-when noted-is not mentioned in the medical reports. Pectus excavatum is found in Europe in at least one in every 1000 births, mainly in men ...
No doubts left in Gastric Tumors. Gastric Adenomyoma Detected by EUS
Ulises Leal Quiroga, Erik Antonio Mier Escurra and Eduardo Mendoza Fuerte
Article Type: Case Report | First Published: October 03, 2019
Endoscopic ultrasound is important to assess gastric tumors in pediatric age. However, at present there is little information about its indications, applications and risks, as well as difficulty in obtaining adequate training. A 5-year-old male patient with a gastric tumor under study, in the endoscopy, an umbilicated tumor suggestive of ectopic pancreas is observed, the endoscopic ultrasound reveals that it is dependent on the muscular layer, pathology diagnosed Gastric adenomyoma....
What are the Factors and the Method Used for the Formation of Nasal Septal Perforations due to Septoplasty?
Article Type: Original Article | First Published: September 14, 2019
There were 280 male and 120 female patients. 378 patients had no postoperative septal perforation. 22 had perforation after surgery. Of the patients in the perforated group, 19 male and 3 female were female. 21 of these patients smoked, 1 patient did not drink. 11 of these patients were drinking alcohol and 10 of them did not drink alcohol. Transseptal suturation + nasal saturation splint was used in 14 patients to stabilize the septum while perforation rate was 22/400 (1.3%). Male sex ratio was...
Effect of Chemical Irrigants on the Bond Strength of a Universal Adhesive System to Dentin-Enamel Junction and Different Dentin Regions
Alper KAPTAN, DDS, PhD., Vahti Kilic, DDS, PhD., Feridun HURMUZLU, DDS, PhD., Ahmet Serper, DDS, PhD. and Arife KAPTAN, DDS, PhD.
Article Type: Research Article | First Published: September 11, 2019
The purpose of this in vitro study was to evaluate the influence of different irrigation solutions on the microshear bond strength of a universal adhesive system applied in etch & rinse mode and self-etch mode to dentin- enamel junction (DEJ), coronal dentin, pulp chamber dentin, and floor of the pulp. As well as a highly adequate apical seal, an effective coronal seal, is one of the primary goals of a successful endodontic dental treatment. Recently, a large number of adhesive systems have been...
Atypical Presentation of Viral Myocarditis in a Young Adult
Mandeep Kaur, Prema Bezwada and Ayala Rodriguez Cesar
Article Type: Case Report | First Published: September 09, 2019
Convulsive Syncope can be difficult to distinguish from seizures at times. We present a young adult with cardiogenic convulsive syncope that mimic seizures. Continuous cardiac monitoring revealed various arrythmias during seizure like activity. She had a viral prodrome. Cardiac MRI was diagnostic for myocarditis. More detailed studies for the role of a noninvasive cardiac testing such as Cardiac MRI (CMR) and newer treatment modalities such as anti-thymocyte immunoglobulin are required for the m...
Chronic Wound Formation on an Old Burn Scar after Surgical Incision and Hyperbaric Oxygen Therapy: Case Report
Kubra Ozgok-Kangal, Iclal Karatop-Cesur, Cesur Ustunel and Kemal Simsek
Article Type: Case Report | First Published: September 04, 2019
Chronic wounds fail to progress through the phases of wound healing; inflammation-proliferation-remodelling which are usually the result of persistent infection, malperfusion due to periwound hypoxia, cellular failure, and unrelieved pressure or repetitive trauma. In this report, we present a different rare cause of a chronic wound; a surgical incision on a post-burn scar during the surgery of transurethral resection of the prostate (TUR-P) because of urethral stricture. After six weeks, the sur...
A Novel Use of Liraglutide: Induction of Partial Remission in Ulcerative Colitis and Ankylosing Spondylitis
Article Type: Case Report | First Published: August 29, 2019
Ulcerative colitis and ankylosing spondylitis treatment options are limited to a few classes of medications at this time. Those options provide improvement for some patients, but leaves many with ongoing, unremitting symptoms. We report a case of ulcerative colitis (UC) with comorbid ankylosing spondylitis (AS), in which administration of a daily subcutaneous liraglutide, an exogenous Glucagon-like Peptide-1 receptor agonist (GLP-1RA), led to symptomatic remission of UC and significant improveme...
The Impulsivity of the Elderly - Genital Self-mutilation Case Caused from an Argument with his Wife
Michiho Sodenaga, M.D., Ph.D., Koji Hori, M.D., Ph.D., Chiaki Hashimoto, M.D., Kyoko Katsumura, M.D., Ikuko Katsumura, M.D., Masananori Tadokoro, Ph.D. and Sachiko Tsukahara, PhD
Article Type: Case Report | First Published: August 26, 2019
Suicide rate in Japan is also high. The suicide cases were above 30,000 in 1998, which increased to 34,427 in 2003. Then it gradually decreased to 21,897 in 2016 but the suicide rate at the age of more than 60 years is the highest, accounting for about 40%. Morbidity of depression is said as a risk factor of suicide by elderly people. In this case, we have discussed about a 77 year old man, who was in depressed mood. His wife was also unaware with his depression; he often had quarrels and at las...
Surviving a Single Ventricle and a Single Atrium with a Situs Inversus Viscerum
Randa Tabbah, MD, Rachoin Rachoin, MD, Bassam Harb, MD and Kabalan Saroufim, MD
Article Type: Case Report | First Published: August 24, 2019
We report a rare case of an 18-years-old female surviving a single ventricle malformation associated with a single atrium and a situs inversus viscerum. She was misdiagnosed in utero and at birth and lost to follow up since her early age when diagnosed at 4-years-old and didn't undergo any palliative surgeries after then due to financial issues. Patient was admitted for heart failure decompensation with hepatic congestion, supraventricular arrhythmias and bilateral pleural effusion and was treat...
Tracheal Bronchus: Rare Cause of Recurrent Pneumonia and Worsening Bronchiectasis in Adults
Asma Jamil MD, Ayesha Jamil MD, Rajesh Gulati MD, Alina Popa MD and Hiba Ismail
Article Type: Case Report | First Published: August 14, 2019
True tracheal bronchus is an aberrant bronchus arising above 2-6 cm from carina, from the lateral wall of trachea and directed towards the upper lung lobe. Frequently located on the right side, it can be further described as supernumerary if there is an anatomic right bronchus with normal segmental apical, anterior and posterior bronchi. It is considered displaced if it's accompanied by an absence of anatomic segmental bronchi. Tracheal bronchus can supply the entirety or part of the upper lung ...
Assessment of Knowledge, Attitude and Practice (KAP) on Prevention of Malaria at Gode Lalo Kebele (010), Anchar Woreda, West Haraarge Zone, Oromia, Ethiopia: A Community Based Descriptive Cross-Sectional Study Methods
Rahel Miliyon Mokonen, BSc, Maleda Tefera Iffa, BSc, MSc and Masresha Leta Serbesa, BSc, MSc
Article Type: Case Report | First Published: July 31, 2019
Malaria is a major public health problem in worldwide and causes high morbidity and mortality, despite global efforts to eradicate the disease. While the disease is easily preventable, curable and treatable, it remains a big health threat to many communities all over the world; most especially in Sub-Saharan Africa. Malaria affects about 5% the world’s population. It is the leading cause of death in children under 5 years in sub Saharan Africa still among the ten top leading causes of morbidit...
The Performance of Novel Wavelet for Lung Image Analysis
Donia Ben Hassen and Sihem Ben Zakour
Article Type: Research Article | First Published: July 03, 2019
Even the advancement in the medical image, chest radiography still the most common used and cheapest method in detecting lung diseases. The generated image allows physicians to screen the normal, benign and malignant tissues in the lung. In order to better classify and reduce noise in the image's information, the employ of preprocessing methods is unavoidable. A novel scheme for lesions classification in chest radiographs is presented in this paper by combining discrete wavelet analysis (WA), FC...
Preterm Vaginal Delivery of Breech Presentation
Article Type: Short Note | First Published: June 22, 2019
Very early preterm delivery is defined as delivery in week 23-28 GA. The incidence of preterm delivery in Denmark is about 5.6%. The incidence of breech presentation at date of delivery is 3-4% and there is an increase of breech presentation in lower gestational age. The few cases of extreme premature delivery have not been subjects to randomized controlled studies. In recent years retrospective multicentre studies comparing vaginal delivery versus cesarean section in breech presentation have no...
Basal-Like Breast Cancer: Main Features of a Very Particular Entity of Breast Cancer
Haddad S, Zemni I, Bettaieb I, Adouni O, Saadallah F, Slimane M, Chargui R and Rahal K
Article Type: Case Series | First Published: June 14, 2019
Molecular classification of breast cancer identified the basal like subtype, characterized by high heterogeneity and a very poor prognosis. These tumors are mainly triple negative, characterized by the expression of basal markers: CK5/6 and EGFR. In this study, we sought to investigate the features, outcome and therapeutic modalities of basal-like breast cancers (BLBC)....
Case Report: Necrotizing Fasciitis due to Cryptococcus Infection in Non-HIV Non-Organ Transplant
Rbab Taha, Mohamed Alama, Hessa Aljhdali, Ayaz khan and Reham Kaki
Article Type: Case Report | First Published: June 12, 2019
We are presenting 67-year-old female, known to have diabetes for 10 years, not compliance to medication. Presented with 3 weeks history of isolated right lower limb and left thigh pain. Then she started to develop redness and swelling in same areas. She had also History of dry cough for one week. Admitted as a case of necrotizing fasciitis based on clinical laboratory and radiological features. She was treated empirically with vancomycin and meropenem and went for debridement twice. Histopatholo...