16026
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Abdellatif M, Alsinani S, Al-Balushi Z, Al-Dughaishi T, Abuanza M, Al-Riyami N. Spontaneous resolution of fetal and neonatal ascites after birth. Sultan Qaboos Univ Med J 2013; 13:175-8. [PMID: 23573403 DOI: 10.12816/0003216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 10/08/2012] [Accepted: 11/24/2012] [Indexed: 11/27/2022] Open
Abstract
Fetal ascites is an uncommon abnormality usually reported in relation to non- immunological causes. The prospect for fetal and neonatal mortality is high, particularly when the ascites develops before 24 weeks of gestation. The diminution of severe fetal ascites without intrauterine management, especially with an uncomplicated neonatal outcome, is unusual. We report a case of isolated fetal ascites detected at 20 weeks' gestation. All investigations carried out were normal. Consecutive ultrasound examination showed ascites at 20 weeks' gestation. A follow-up ultrasound examination at 6 months of age revealed complete recovery from the ascites. Spontaneous resolution of fetal ascites, with a good prognosis, can occur in cases with an idiopathic aetiology.
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16027
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Kuba PK, Sharma J, Sharma A. Successful Surgical Treatment of a Septuagenarian with Anomalous Right Coronary Artery from the Pulmonary Artery with an Eleven Year Follow-Up: Case report and review of literature. Sultan Qaboos Univ Med J 2013; 13:169-74. [PMID: 23573402 DOI: 10.12816/0003215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 06/24/2012] [Accepted: 10/18/2012] [Indexed: 11/27/2022] Open
Abstract
An anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare coronary artery anomaly with only 98 cases reported in literature till date. We report the oldest surgically treated patient and the fourth ever septuagenarian with this anomaly diagnosed ante-mortem with an eleven year follow-up. The literature on this anomaly was reviewed and discussed to highlight the clinical implications.
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16028
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Kariyattil R, Panikar D. Scissoring of a Cobalt Alloy Aneurysm Clip causing Slippage during Cerebral Aneurysm Surgery: Case report and review of literature. Sultan Qaboos Univ Med J 2013; 13:179-82. [PMID: 23573404 DOI: 10.12816/0003217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Revised: 09/01/2012] [Accepted: 10/06/2012] [Indexed: 11/27/2022] Open
Abstract
Clip slippage is a rare occurrence, and the scissoring or torsional failure of aneurysm clips is rarer still. Titanium clips have been implicated in a few such reported cases. The authors report its occurrence while using a fenestrated cobalt alloy clip for an internal carotid artery aneurysm which was identified by intraoperative angiography and rectified by re-applying a non-fenestrated cobalt alloy clip. The possible mechanism of this complication, and measures that may prevent its occurrence, including meticulous dissection, decompression when possible, proper clip selection, and intraoperative angiogram are described.
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16029
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Mathew M, Gonsalves H, Al-Azawi S, Saparamadu PAM. Asymptomatic Ovarian Mucinous Cystadenoma with a Solid Mural Leiomyoma: Case report and brief review. Sultan Qaboos Univ Med J 2013; 13:127-31. [PMID: 23573393 DOI: 10.12816/0003206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 08/18/2012] [Accepted: 09/02/2012] [Indexed: 11/27/2022] Open
Abstract
Mucinous neoplasms of the ovary may have associated benign or malignant mural nodules. A leiomyomatous mural nodule is a rare, benign lesion associated with mucinous tumors of the ovary. We report a case of a mural leiomyomatous nodule arising in a benign mucinous cystadenoma in a 29-year-old woman who presented with a large heterogenous abdominal mass. After pre-operative evaluation, exploratory laparotomy was performed upon suspicion of ovarian malignancy. A pathological examination confirmed the benign nature of the mural nodule.
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16030
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Robb AJ, Howitt S. Conservative management of a type III acromioclavicular separation: a case report and 10-year follow-up. J Chiropr Med 2013; 10:261-71. [PMID: 22654684 DOI: 10.1016/j.jcm.2011.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 01/10/2011] [Accepted: 01/18/2011] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The purpose of this study is to present a 10-year prospective case of a right incomplete type III acromioclavicular (AC) separation in a 26-year-old patient. CLINICAL FEATURES A 26-year-old male patient fell directly on his right shoulder with the arm in an outstretched and overhead position. Pain and swelling were immediate and were associated with a "step deformity." The patient had limited right shoulder range of motion (ROM), strength, and function. Radiographic findings confirmed a type III AC separation on the right. At 1-year follow-up, the patient did not report any deficits in ROM or function, but did note a prominent distal clavicle on the right. At 3-, 5-, 7-, and 10-year follow-up, the patient did not report changes from 1 year. The radiographic findings at the 10-year follow-up indicated mild degenerative joint disease in both AC joints and mild elevation of the distal clavicle on the right. INTERVENTION AND OUTCOME The patient received chiropractic care to control for pain, swelling, and loss of ROM. The patient received acupuncture, joint mobilizations, palliative adhesive taping of the AC joint, Active Release Technique, and progressive resisted exercises. Radiographic study was done at the time of the injury and at 10 years to observe for any osseous changes in the AC joint. CONCLUSION The patient yielded excellent results from conservative chiropractic management that was reflected in a prompt return to work 19 days after the injury. Follow-up at 1, 3, 5, 7, and 10 years exhibited absence of residual deficits in ROM and function. The "step deformity" was still present after the injury on the right.
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16031
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Jafferbhoy S, Symeonides P, Levy M, Shiwani MH. Chronic Umbilical Discharge: An unusual presentation of endometriosis. Sultan Qaboos Univ Med J 2013; 13:143-6. [PMID: 23573396 DOI: 10.12816/0003209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 09/08/2012] [Accepted: 10/06/2012] [Indexed: 11/27/2022] Open
Abstract
Umbilical endometriosis is an important differential diagnosis of any umbilical lesion. A 35-year-old type 2 diabetic woman presented with intermittent umbilical discharge which failed to respond to various antibiotics. An ultrasound scan and MRI scan failed to show any obvious abnormality. The umbilicus was excised and histology confirmed endometriosis. Surgical excision provides a definitive diagnosis and curative treatment for isolated endometriosis.
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16032
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Al-Jabri S, Al-Abri M, Al-Hinai A, Al-Azri F. Bilateral Ocular Ischaemic Syndrome-Rare Complication of Rhinocerebral Mucormycosis in an Omani Patient: Case report and literature review. Sultan Qaboos Univ Med J 2013; 13:137-42. [PMID: 23573395 DOI: 10.12816/0003208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 10/16/2012] [Accepted: 11/24/2012] [Indexed: 11/27/2022] Open
Abstract
Ocular ischaemic syndrome (OIS) is a relatively uncommon condition. Simultaneous bilateral involvement is even less common and has been reported in only 22% of all cases of OIS. It has variable clinical presentations, of which visual loss and ocular pain are the most common. It is believed to occur when there is a 90% or greater carotid artery obstruction. This syndrome is often associated with a number of systemic diseases including diabetes mellitus, hypertension, coronary artery disease, and cerebrovascular disease. Only occasionally has it been described as a complication of rhinocerebral mucormycosis. We report an unusual case of bilateral OIS secondary to bilateral internal carotid artery thrombosis as a complication of invasive rhinocerebral mucormycosis. In addition, a review of clinical presentation, diagnostic work-up and treatment options for OIS is provided.
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16033
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El-Naggari MA, Javad H, Chacko AP, Abdelmogheth AA. Intravenous immunoglobulin in the treatment of vancomycin-induced toxic epidermal necrolysis. Sultan Qaboos Univ Med J 2013; 13:132-6. [PMID: 23573394 DOI: 10.12816/0003207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 10/30/2012] [Accepted: 11/24/2012] [Indexed: 11/27/2022] Open
Abstract
Toxic epidermal necrolysis (TEN), an uncommon but potentially life-threatening skin reaction, is frequently induced by drugs. The mucocutaneous reaction is characterised by bullous detachment of the epidermis and mucous membranes. We present a 9-month-old male with methylmalonic acidaemia, generalised hypotonia, and global developmental delay. He presented with a 3-day history of fever, cough, shortness of breath, and vomiting. Eruption appeared after 5 days of vancomycin treatment. The eruption involved almost 60% of the total body surface area and both eyes. He was successfully treated with intravenous immunoglobulin (IVIG), antibiotics, and appropriate wound management and made a full recovery with negligible sequelae despite the severity of his disease. Important components of successful treatment include early recognition, intensive care, prompt withdrawal of the causative agent, early administration of IVIG, appropriate fluid resuscitation, and control of infection. IVIG might be beneficial in the treatment of TEN; however, controlled studies are needed to evaluate IVIG compared to other modalities.
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16034
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Panduranga P, Al-Mukhaini M, Rajarao MP. Multi-factorial causes of torsade de pointes in a hospitalised surgical patient. Sultan Qaboos Univ Med J 2013; 13:152-155. [PMID: 23573398 PMCID: PMC3616783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 05/28/2012] [Accepted: 07/30/2012] [Indexed: 06/02/2023] Open
Abstract
A 55-year-old chronic alcoholic male known to be positive for human immunodeficiency virus (HIV) was admitted to a surgical ward following perianal abscess drainage. He was noted to have sinus bradycardia, ventricular premature complexes, and mild hypotension. His laboratory investigations revealed mild hypokalaemia. He was intermittently agitated and alcohol withdrawal syndrome (AWS) was diagnosed. Postoperatively, he received intravenous piperacillin/tazobactam and metronidazole infusions along with a small dose of dopamine. Analysis of a 24-hour Holter monitor (ECG) showed a prolonged QT interval with two episodes of self-terminating torsade de pointes. His AWS was treated, hypokalaemia was corrected, and dopamine, along with antibiotics, was withdrawn. There was no recurrence of arrhythmias. This case highlights the importance of avoiding QT-prolonging drugs in hospitalised patients, since hospitalised patients often have multiple risk factors for a proarrhythmic response.
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16035
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Abdelmogheth AA, El-Baroudy I, Al-Yaaruby S. Plasmapheresis-induced hypercalcaemia. Sultan Qaboos Univ Med J 2013; 13:147-151. [PMID: 23573397 PMCID: PMC3616782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 09/04/2012] [Accepted: 10/06/2012] [Indexed: 06/02/2023] Open
Abstract
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that can cause total motor paralysis in severe cases. Reports of hypercalcaemia in patients with GBS are rare. Plasmapheresis, an extracorporeal blood purification procedure for the removal of large molecular weight substances, is a well-established therapy for ventilated GBS patients. Although it has been observed in a few reported cases, theoretically, hypercalcaemia is not described as a plasmapheresis-related problem unless there is an underlying cause. We present a rare case of an 8-year-old child presenting with headache, diplopia, and squint, followed by disturbed conscious levels and paralysis. He was treated with both intravenous immunoglobulin and plasmapheresis, with a favourable outcome. We made a laboratory observation of hypercalcaemia which was associated with the plasmapheresis therapy without any related underlying cause. This raises the need for similar observations and the gathering of other possible acceptable explanations.
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16036
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Gujjar AR, Jacob PC, Ramanchandiran N, Al-Asmi A. Eating Epilepsy in Oman: A case series and report on the efficacy of temporal lobectomy. Sultan Qaboos Univ Med J 2013; 13:156-61. [PMID: 23573399 PMCID: PMC3616784 DOI: 10.12816/0003212] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 09/04/2012] [Accepted: 09/22/2012] [Indexed: 11/27/2022] Open
Abstract
Eating epilepsy (EE), where seizures are triggered by eating, is rare and has not been reported in the Gulf region. In EE, the ictal semiology includes partial or generalised seizures. Focal brain changes on imaging, if present, are often confined to the temporal lobe or perisylvian region. Therapeutic options, especially in those patients who are refractory to pharmacotherapy, have not been well-established. We report a series of five patients with EE from Oman, a country located in the eastern part of the Arabian Gulf region, and highlight the usefulness of temporal lobectomy in one patient who had medically-intractable EE. Surgical intervention could be considered as a potential therapeutic option in carefully selected patients with medically-intractable seizures.
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16037
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Reyes ZS, Bashir W, Pathare A. Transient Myeloproliferative Disorder and Down Syndrome: Is there a link? Sultan Qaboos Univ Med J 2013; 12:498-502. [PMID: 23275848 DOI: 10.12816/0003177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 06/03/2012] [Accepted: 06/27/2012] [Indexed: 11/27/2022] Open
Abstract
An extremely premature male neonate presented with an unusual multisystem dysfunction within the first 24 to 48 hours of life. The unfolding of clinical events and investigations revealed a transient myeloproliferative disorder (TMD). TMD was the main indication for karyotyping of this premature infant without clinical symptoms of Down syndrome. The awareness of TMD in a newborn warrants karyotype analysis to look for trisomy 21 and a close surveillance because of its potential progression to true leukaemia.
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16038
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Lamki T, Ammirati M. Spinal Neurofibroma Masquerading as a Herniated Disc: A case report. Sultan Qaboos Univ Med J 2013; 12:522-5. [PMID: 23275853 DOI: 10.12816/0003182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 04/28/2012] [Accepted: 08/01/2012] [Indexed: 11/27/2022] Open
Abstract
We present the only case in English medical literature of a spinal neurofibroma misdiagnosed as a herniated disc using magnetic resonance imaging (MRI). This case presented with typical symptoms and radiological findings of a herniated disc. Intraoperatively, an abnormality was noted at the S1 nerve root sleeve. Further exploration revealed a spinal neurofibroma which was completely resected, resulting in an improvement in the patient's symptoms. Currently, there is heavy reliance on MRI as a highly sensitive and specific tool used in the diagnosis of herniated lumbar discs. Although there have been occasional reports of misdiagnoses using MRI, there are no reported cases of a spinal neurofibroma being misdiagnosed as a herniated lumbar disc. Despite great advances in radiological diagnostic imaging, surgical surprises do still occur. Ultimately, instinct is still essential in intraoperative surgical decisions.
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16039
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Moshiri M, Etemad L, Javidi S, Alizadeh A. Peganum harmala intoxication, a case report. AVICENNA JOURNAL OF PHYTOMEDICINE 2013; 3:288-92. [PMID: 25050285 PMCID: PMC4075715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 02/16/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Peganum harmala (P. harmala), "Espand" in Persian, has small seeds and has been used in traditional medicine as emmenagogue and an abortifacient. It has various pharmacological effects such as antifungal, antibacterial, hypothermic, anticancer, antinociceptive, and reversible monoamine oxidase inhibition. CASE DETAILS This case was a 45 years old woman who ingested about 50 grams seed of P. harmala for hypermenorrhae. She suffered nausea, vomiting, dizziness, tremor, ataxia, and confusion. On physical examination, she had hypotension (BP=90/60 mmHg) with normal heart rate (60 beat/min) and impaired knee to heel test. Her consciousness was reduced without any hallucination. Her laboratory test was normal. She was discharged at good condition 18 hours later. CONCLUSION In conclusion, physicians working in Iran and other regions that P. harmala is prescribed or used illegally, should know signs and symptoms of its toxicity in order to be able to deal with the emergencies, however, prognosis of these toxicity is not bad.
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16040
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Chauhan N, Gaur DS, Pathak VP. Round Cell Vaginal Malignant Melanoma: A rare entity. Sultan Qaboos Univ Med J 2013; 12:508-11. [PMID: 23275850 DOI: 10.12816/0003179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 06/15/2012] [Accepted: 06/27/2012] [Indexed: 11/27/2022] Open
Abstract
Malignant melanoma is predominantly a skin disease but in rare instances it may occur at other sites. A vaginal melanoma is a rare clinical entity and the round cell type is an uncommon variant. Although the present case was clinically diagnosed as a urethral caruncle, on histopathological examination and immunostaining it was diagnosed as a round cell pigmented malignant melanoma. The patient refused radical surgery and was given a full course radiotherapy treatment but died a year later. Malignant vaginal melanoma carries a very poor prognosis even when lesion is localised at the time of presentation. The five-year survival rate ranges from 10-20% with the prognosis being influenced by tumour size. A tumour size ≥3cm has a poor prognosis. Age, mitotic count, stage, and location of the lesion do not influence survival rates.
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16041
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Albarrag MK. Bilateral asymmetrical traumatic sternoclavicular joint dislocations. Sultan Qaboos Univ Med J 2013; 12:512-6. [PMID: 23275851 DOI: 10.12816/0003180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 05/28/2012] [Accepted: 07/09/2012] [Indexed: 11/27/2022] Open
Abstract
Unilateral and bilateral sternoclavicular joint (SCJ) dislocations are rare injuries. The difficulty in assessing this condition often leads to delay in diagnosis and treatment. We report a rare case of bilateral asymmetrical traumatic SCJ dislocations in a 45-year-old male. The right anterior SCJ dislocation was reduced in the emergency room (ER) and resulted in residual instability. The left posterior SCJ dislocation was asymptomatic and unnoticed for six months. It is important for ER physicians and orthopaedic surgeons to be able identify and treat this condition. All suspected SCJ dislocations should be evaluated by computed tomography (CT) scan for confirmation of the diagnosis and evaluation of both SCJs. Posterior SCJ dislocation is a potentially fatal injury and should not be overlooked due to the presence of other injuries. Surgical intervention is often necessary in acute and old cases.
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16042
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Pushpanshu K, Kaushik R, Sathawane RS, Athawale RP. Extensive Gingival Enlargement in Siblings: A case report. Sultan Qaboos Univ Med J 2013; 12:517-21. [PMID: 23275852 DOI: 10.12816/0003181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 05/14/2012] [Accepted: 06/16/2012] [Indexed: 11/27/2022] Open
Abstract
Gingival fibromatosis is characterised by varying degrees of fibrotic gingival overgrowth that can be caused by a variety of aetiological factors. Hereditary gingival fibromatosis (HGF) is a rare genetic disorder, characterised by a slowly progressive, benign enlargement of keratinised gingiva. The condition may be found in an autosomal dominant or autosomal recessive mode of inheritance, the former being more common. It usually develops as an isolated disorder but can be one feature of a multisystem syndrome. Accordingly, HGF has been divided into two forms: non-syndromic and syndromic. The gingival enlargement can be localised or generalised, but usually involves both arches. The authors describe a case of non-syndromic generalised severe HGF, involving the maxillary and mandibular arches in two brothers. This report focuses on the diagnosis, treatment, and control of the disease. The pattern of inheritance and histopathologic characteristics are also emphasised.
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16043
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Neishaboori H, Maleki I, Emadian O. Jejunal intussusception caused by a huge Vanek's tumor: a case report. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2013; 6:210-3. [PMID: 24834274 PMCID: PMC4017524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 08/18/2013] [Indexed: 11/25/2022]
Abstract
Inflammatory fibroid polyp (known also as Vanek's tumor) is a type of localized, non-neoplastic inflammatory pseudotumor or inflammatory myofibroblastic tumor that occurs most commonly in the stomach but also in the small and large bowel. It is a documented cause of intussusception in adults. We report a case of a 40-year-old woman who presented with severe, postprandial abdominal pain followed by projectile vomiting over a period of three days. Ultrasonography demonstrated a solid and echogenic mass surrounded by the typical mural layers of an invaginated jejunum. She underwent urgent laparotomy and resection of an 18 cm tumor from the distal jejunum. The immuno-histopathological diagnosis after segmental jejunal resection was a jejunal inflammatory fibroid polyp. Although inflammatory fibroid polyps are seen very rarely in adults, they are among the probable diagnoses that should be considered in obstructive tumors of the small bowel causing intussusceptions.
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16044
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Asare KA, Jahng M, Pincus JL, Massie L, Lee SA. Sternal osteomyelitis caused by Aspergillus fumigatus following cardiac surgery: Case and review. Med Mycol Case Rep 2012; 2:4-6. [PMID: 24432203 DOI: 10.1016/j.mmcr.2012.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022] Open
Abstract
Postsurgical sternal wound infection is a serious post-operative complication of cardiac surgery. Aspergillus infection of the sternum is extremely rare. We describe a case of sternal infection due to Aspergillus in an immunocompetent patient following aortic valve replacement.
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16045
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Nouri N, Nouri N, Abdali H, Shafie M, Karimi H. Stuttering: Genetic updates and a case report. Adv Biomed Res 2012; 1:14. [PMID: 23210073 PMCID: PMC3507011 DOI: 10.4103/2277-9175.96070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 02/18/2012] [Indexed: 11/30/2022] Open
Abstract
Developmental stuttering is a common disorder of speech dissiliency that is characterized by excessive repetitions of sounds, syllables, and monosyllabic words, as well as sound prolongations and complete blockages of the vocal tract. About 60 million people are affected and it is more common between the age of 3 and 6, when children begin forming sentences and connecting thoughts verbally. There are three types of stuttering known as developmental stuttering, neurogenic stuttering, and psychogenic stuttering. The exact pathophysiology of developmental stuttering is unknown; however, various family and twin studies have repeatedly implicated heredity as a major factor in the etiology of stuttering. It is clear that the genetic influence is not in the form of an exact single gene effect such as autosomal recessive, autosomal dominant, or x-linked in all families; however, in all of the inheritance forms it is influenced by sex with higher occurrence in males than females at a ratio of 4:1 in older children and adults. Recently special genetic locus has been determined on several autosomal chromosomes related to developmental stuttering. In this report, the proband is a 20-year-old boy was referred to our clinic for premarriage genetic counseling; he has been affected since 3 years and now is under cure. three generation study of his family show 13 individuals are affected by stuttering. For the first it occurred in the proband's grandfather and after this time about all of affected cases has been seen in consanguineous marriages. Therefore, the genetical inheritance of stuttering is crystal clear in this family and autosomal recessive inheritance pattern is proposed. Totally in such families with repeated occur of stuttering, we cannot account it as a multifactorial disorder.
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16046
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Closs LQ, Tovo M, Dias C, Corradi DP, Vargas IA. Aarskog-scott syndrome: a review and case report. Int J Clin Pediatr Dent 2012; 5:209-12. [PMID: 25206170 PMCID: PMC4155891 DOI: 10.5005/jp-journals-10005-1168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 06/28/2012] [Indexed: 11/30/2022] Open
Abstract
This paper reports the treatment and 12-year follow-up of a patient 7 years old who had been diagnosed with Aarskog-Scott syndrome. The patient had a history of premature multiple tooth loss, vertical dimension loss and severe dentoalveolar discrepancy. Orthopedic and orthodontic rehabilitation treatments were performed to improve the patient’s esthetic, functional and psychological condition. How to cite this article: Closs LQ, Tovo M, Dias C, Corradi DP, Vargas IA. Aarskog-Scott Syndrome: A Review and Case Report. Int J Clin Pediatr Dent 2012;5(3):209-212.
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16047
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A high bifurcation of the dorsal branch with dominant superficial palmar branch of the radial artery: a case report of an aberrant radial artery with traumatic aneurysm. J Hand Microsurg 2012. [PMID: 23204774 DOI: 10.1007/s12593-011-0038-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Anatomical abnormalities such as unusual bifurcations or aberrant arteries of the radial artery are extremely rare and due to malformation or disruption of the vascular net. We present a case of a 64 year old woman with a high bifurcated dorsal branch of the left radial artery, consulting us for a pulsatile mass in the anatomical snuffbox after a fall. The mass measured 3-4 mm in diameter and was located on the dorsal aspect of the wrist over the anatomical snuffbox. Primary imaging studies using Duplex Ultrasound suggested an aneurysm of the radial artery, further imaging with arteriogram revealed a high bifurcation of the dorsal branch of the radial artery, presenting with an aneurysm. The deep palmar branch of the ulnar artery was the dominating vessel, allowing ligation and excision of the aneurysm. Histological evaluation revealed intimal wall hyperplasia within the aneurysm, suggesting an injury as initiating factor. A review of the literature showed that this abnormality of high bifurcation of the dorsal palmar branch of the radial artery has not been previously reported. Management of aneurysms at the wrist is discussed.
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16048
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Abstract
OBJECTIVES To analyze the concept of "case series" in the medical literature compared with case reports. METHODS A PubMed search for articles published during 2009 which had "case series" in their title was performed. A total number of 621 articles were retrieved. 586 papers were included in the analysis and 35 were excluded (18 were commentary letters, 5 were not in English, and twelve could not be retrieved by our Library). The number of patients and category of these articles were analyzed. RESULTS The median (range) of the number of cases of articles having "case series" in their title was 7 (1-6432) cases. 186/ 586 articles had less than 5 cases (31.7%, 95% CI (28.3-35.1%)). The median (range) of the number of cases of articles having "case report" as their publication type was 4 (1-178) cases. Out of the 219 articles categorized as case reports 114 (52.1%, 95% CI (45.6-58.6%)) had less than five cases. CONCLUSIONS The concept of "case series" is not well defined in the literature and does not reflect a specific research design. We suggest that a case series should have more than four patients while four paitents or less should be reported individually as case reports.
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16049
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Elshafie O, Osman A, Aamer F, Al-Mamari A, Woodhouse N. Cushing's Disease: Sustained remission in five cases induced by medical therapy with the dopamine agonist cabergoline. Sultan Qaboos Univ Med J 2012; 12:493-7. [PMID: 23275847 DOI: 10.12816/0003176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 06/05/2012] [Accepted: 08/29/2012] [Indexed: 11/27/2022] Open
Abstract
We report five cases of Cushing's disease where the patients were given a therapeutic trial of cabergoline. Morning serum cortisol, adrenocorticotrophic hormone (ACTH), and sleeping cortisol concentrations were significantly raised. Magnetic resonance imaging (MRI) scans revealed pituitary microadenomas in 3 patients but were normal in the others. Ectopic ACTH production was excluded in the 2 patients with normal MRI scans. All were given a therapeutic trial of cabergoline (1 mg daily). Four patients responded with a prompt fall in serum cortisol levels and had a sustained clinical and biochemical remission for 378, 44, 28 and 14 days, respectively. One patient failed to respond. In conclusion, we suggest that all patients with Cushing's disease should undergo a therapeutic trial of cabergoline. Responders can then be prepared for surgery or, if needed, treated medically in the long term.
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16050
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Hong SC, Lim YK, Chew SH, Chia YN, Yam KL. Case report of granular cell tumor of the vulva and review of current literature. GYNECOLOGIC ONCOLOGY CASE REPORTS 2012; 3:20-2. [PMID: 24371657 DOI: 10.1016/j.gynor.2012.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 10/30/2012] [Indexed: 12/11/2022]
Abstract
► We present four cases of benign granular cell tumours of the vulva managed between 1998 and 2001. ► We discuss the clinical and histopathological features of this condition. ► Treatment of this condition is primarily surgical.
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