Open Access DOI:10.23937/2377-4630/1410061

Phenytoin in Topical Formulations Augments Pain Reduction of Other Analgesics in the Treatment of Neuropathic Pain

David J Kopsky and Jan M Keppel Hesselink

Article Type: Case Report | First Published: February 03, 2018

Topical analgesic formulations are gaining interest for the treatment of peripheral neuropathic pain since the beginning of 2000. Advantages of topical analgesics over oral medication are the absence of systemic side effects and drug-drug interactions, higher concentrations of active compound at the pain area, fast onset on action, improvement of compliance, and no risk of abuse. In many peripheral neuropathic pain states the pain area is small and thus topical analgesics are suitable. Most pati...

 Open Access DOI:10.23937/2377-9004/1410114

Laparoscopic Management of Interstitial Ectopic Pregnancy with Endo GIA™ without Rupture

Rawan Al Harmi, Rania Hassan, Basma Darwish and Nawal Dayoub

Article Type: Case Report | First Published: February 02, 2018

Interstitial pregnancy is uncommon, accounting for 2-4% of all ectopic pregnancies. It is potentially serious and mortality is most commonly due to rupture and subsequent hemorrhage. Both medical and surgical management options are available, depending on a given individual's case. Currently, the preferred surgical approach is laparoscopy. However, despite the presence of different laparoscopic techniques, there is no consensus on a single best technique. We report a case of a 27-year-old pregna...

 Open Access DOI:10.23937/iacvd-2017/1710004

Ventricular Electrical Standstill in a Patient with Left Ventricular Assist Device

Chee Kiang Teoh, Kah Leng Ho, Louis Teo, David Sim, Ka Lee Kerk, Jia Lin Soon, Teing Ee Tan, Sivathasan Cumaraswamy and Choon Pin Lim

Article Type: Case Report | First Published: February 02, 2018

Left ventricular assist device (LVAD) is designed primarily for circulatory support in left ventricular failure and its function relies heavily on intrinsic right ventricular function. We report, to our knowledge, the longest reported case of ventricular electrical standstill from progressive cardiomyopathy who was successfully managed on LVAD. A 51-year-old man, non-ischaemic cardiomyopathy who had been on HeartMate II LVAD support for three years, presented with frequent intermittent low pump ...

 Open Access DOI:10.23937/2469-5777/1510057

Overall Anatomic Severity and Prognosis in Patients Presenting with, or Requiring a Major Lower Limb Amputation from Civilian Trauma

Sanchez-Arteaga Alejandro, Lusilla-Lopez Alejandro, Zarain-Obrador Leire, Burneo-Esteves Mauricio, Rey-Valcarcel Cristina, Perez-Diaz MaDolores and Turegano-Fuentes Fernando

Article Type: Original Article | First Published: February 01, 2018

Trauma is one of the most frequent mechanisms causing limb amputation. However, major limb amputations are rare in the civilian population, the largest numbers being seen in the military, often caused by explosive devices, and are considered to have, in general, a poorer prognosis, needing more aggressive treatments....

 Open Access DOI:10.23937/2572-3286.1510034

Effective Role of CVVH in Fatal Phenobarbital Overdose Clearance: A Case Report

Chaudhry Adeel Ebad, Alan Gaffney and Peter J Conlon

Article Type: Case Report | First Published: January 31, 2018

We report affective utilization of continuous veno-venous hemofiltration for removal of phenobarbital in a patient who took twice amount of fatal dose and was hemodynamically stable. Historically treatment includes supportive care, activated charcoal and urinary alkalinisation along with the application of extracorporeal treatments such as charcoal haem perfusion or hemodialysis and continuous veno-venous hemodiafiltration are affective treatment for removal of drug. Early initiation of extracor...

 Open Access DOI:10.23937/2469-5769/1510029

Impact of Early Childhood Developmental Intervention Programs: Cost-Benefit Analysis Using a Proposed Model

Aravindhan Veerapandiyan, Lama Charafeddine, Durriyah Sinno and Mohamad A Mikati

Article Type: Research Article | First Published: January 31, 2018

Early Childhood Developmental Interventions (ECDIs) were developed with the aim of improving overall functional outcome of children over and above what the home environment provides. Cost-Benefit Analysis (CBA) of ECDIs using a flexible and easy to apply model that can complement the more granular and highly desirable CBA studies that often may be too difficult or too expensive to perform....

 Open Access DOI:10.23937/2474-3674/1510031

Bilateral Diaphragmatic Paresis after Cardiac Surgery: The Key is the Clinical Point-of-Care Ultrasound

Jose Luis Vazquez Martinez, Aida Lopez de Pedro, Ana Coca Perez, Raul Montero Yeboles and Cesar Perez-Caballero Macarron

Article Type: Case Report | First Published: January 31, 2018

Bilateral diaphragmatic paresis following cardiac surgery is rare. We present a case in which several extubation attempts failed in an infant after cardiac surgery. Point-of-care ultrasonography (POCUS) showed a slight but symmetric decrease of diaphragmatic motion, confirmed by fluoroscopy. Phrenic electromyography (EMG) was informed inconsistently as normal. After eight weeks of non-invasive ventilation the patient was weaned to room air, revealing the POCUS a recovery on the left side but per...

 Open Access DOI:10.23937/2378-3656/1410199

Disseminated Intravascular Coagulation due to Amniotic Fluid Embolism in an Early Molar Pregnancy

Veronika A Levin, John Villeneuve and Xuezhi Jiang

Article Type: Case Report | First Published: January 17, 2018

Disseminated intravascular coagulation (DIC) is a disruption of hemostasis and imbalance between thrombosis and thrombolysis. DIC can result in life-threatening bleeding, clot formation, and multi-system end organ damage. Although the prevalence of DIC in pregnancy is low, ranging from 0.03-0.35%, the prevalence increases in pregnancies complicated by comorbidities such as placental abruption, postpartum hemorrhage, pre-eclampsia, hemolysis elevated liver enzymes and low platelets (HELLP syndrom...

 Open Access DOI:10.23937/2469-5858/1510037

Comparative Study on Change in Degree of Independent Living between Continuation and Discontinuation of Home Medical Care among the Elderly in Japan

Takao Suzuki, Seungwon Jeong, Yasuyuki Arai, Yusuke Inoue, Masahiko Fukuchi, Yoshimichi Kosaka and Hideki Ohta

Article Type: Original Article | First Published: January 26, 2018

The present study focused on "fever" as an indicator or surrogate of aspiration pneumonia, which is the most commonly encountered event in home medical care and frequently requires a decision of whether to continue or discontinue (admission to hospital) home medical care. We compared the outcome of a group that continued to receive home medical care during and after a fever-related event and a group that discontinued home medical care and was hospitalized. Our analysis showed that loss of the ab...

 Open Access DOI:10.23937/2572-3235.1510031

Primary Intra-Articular Synovial Sarcoma of the Knee: A Report of Two Cases and Review of the Literature

Justin E Hellwinkel, Ryan P Farmer, Austin Heare, Joshua Smith, Nathan Donaldson, Michael Faddell and Travis Heare

Article Type: Case Report | First Published: January 24, 2018

Synovial sarcoma is a misleading term initially coined in reference to its pathological appearance that mimics synovium in its early stage of development. In reality, Synovial Sarcoma (SS) is a rare malignant neoplasm, which accounts for only 2.5 - 10% of all soft-tissue sarcomas. Peak incidence of SS occurs in the third decade of life, and 30% of cases occur in children and adolescents younger than 20 years of age. Although synovial sarcoma is more common in adults, it remains the second most c...