scholarly journals Secondary Angle Closure due to Crystalline Lens Dislocation in a Patient with Atopic Dermatitis and Chronic Eye Rubbing

2018 ◽  
Vol 9 (1) ◽  
pp. 197-201 ◽  
Author(s):  
Justin Kuiper ◽  
Mark Slabaugh
Keyword(s):  
Atopic Dermatitis ◽  
Past History ◽  
Corneal Edema ◽  
Crystalline Lens ◽  
Atopic Disease ◽  
Angle Closure ◽  
Ectopia Lentis ◽  
Laser Iridotomy ◽  
History Of ◽  
The Right

Purpose: To report an unusual case of ectopia lentis and angle closure in a patient with chronic eye rubbing. Methods: A 57-year-old male with a history of poorly controlled atopic dermatitis presented with right eye pain, decreased vision, and an intraocular pressure (IOP) of 55 mm Hg. He had no past history of ocular disease and no reported history of trauma. He did report a history of chronic eye rubbing. Results: Best corrected visual acuity was hand motions. The examination revealed severe atopic keratoconjunctivitis in both eyes, microcystic corneal edema of the right eye, and 2+ nuclear sclerosis in both eyes. Gonioscopy showed no visible angle structures OD and an open angle OS. Topical and oral IOP-lowering medications and a laser iridotomy were unsuccessful at lowering IOP. He was taken to the operating room for a lensectomy and was found to have 9 clock hours of zonular dehiscence and a dislocated lens. After lensectomy, the IOP improved to 9 mm Hg on postoperative day 1. A follow-up examination at 2 weeks showed improved acuity to 20/150 with a pinhole and an IOP of 10 mm Hg. A dilated examination OS did not reveal significant phacodonesis, and the patient was referred for a possible sutured sulcus lens or anterior chamber intraocular lens. Conclusions: It is important for the provider to consider ectopia lentis in the differential for patients with pupillary block angle closure. For patients with atopic disease, one should be aware that eye rubbing may be a cause of zonular dehiscence, even in the absence of reported trauma or prior intraocular surgery.

scholarly journals Splenic undifferentiated high grade pleomorphic sarcoma of a small size with fatal tumor rupture

1970 ◽  
Vol 1 (2) ◽  
pp. 151-153 ◽  
Author(s):  
BM Amatya ◽  
M Sawabe ◽  
T Arai ◽  
T Kumakawa ◽  
K Takubo ◽  
...  
Keyword(s):  
Past History ◽  
Distant Metastases ◽  
Tumor Rupture ◽  
Retroperitoneal Hemorrhage ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Bone Marrow Histology ◽  
Pleomorphic Sarcoma ◽  
Fatal Bleeding ◽  
History Of ◽  
The Right

(The order of authors on this article was changed on 09/01/2012.)Primary undifferentiated pleomorphic sarcoma of the spleen is a rare and highly aggressive neoplasm that usually presents with splenomegaly, constitutional symptoms and frequent distant metastases. We report a case of 77-year old male patient with a past history of dissecting aortic aneurysm that developed acute hemorrhagic shock. Aneurysmal rupture was clinically suspected, but the postmortem examination revealed a 25 mm-sized tumor in an atrophic spleen weighing 65 gram with massive retroperitoneal bleeding. Metastases were found in the right renal hilus, the right adrenal gland and femoral bone marrow. Histology of the tumor showed undifferentiated pleomorphic sarcoma. Tumor rupture with fatal bleeding and systemic metastases had occurred despite the small size of the tumor. Tumor size is not a reliable predictor of systemic metastasis or tumor rupture for splenic undifferentiated pleomorphic sarcoma. Keywords: Undifferentiated pleomorphic sarcoma; Malignant fibrous histiocytoma; Splenic neoplasms; Retroperitoneal hemorrhage DOI: http://dx.doi.org/10.3126/jpn.v1i2.5411 JPN 2011; 1(2): 151-153

scholarly journals A case of Young Stroke due to Moyamoya Disease

2020 ◽  
Vol 15 (1) ◽  
pp. 110-113
Author(s):  
Md Abdur Razzak ◽  
Ghulam Kawnayn ◽  
Fateha Naznin ◽  
Quazi Audry Arafat Rahman
Keyword(s):  
Moyamoya Disease ◽  
Past History ◽  
Cerebral Arteries ◽  
Armed Forces ◽  
Cerebral Angiogram ◽  
Medical College ◽  
Middle Cerebral Arteries ◽  
History Of ◽  
Collateral Vessels ◽  
The Right

Moyamoya disease is a disease in which certain arteries in the brain are constricted. Blood flow is blocked by the constriction, and also by blood clots (thrombosis). A collateral circulation develops around the blocked vessels to compensate for the blockage, but the collateral vessels are small, weak, and prone to bleeding, aneurysm and thrombosis which may result in TIA, recurrent ischemic or hemorrhagic stroke or seizure. The disease may manifest in pediatric age or young adults. In May 2019 we have diagnosed a young lady with Moyamoya disease who presented with right sided hemiplegia, motor aphasia and dysphagia. She was labeled as hypertensive 6 months prior to this event and used to take anti-hypertensive irregularly and gave past history of occasional headache. Her CT scan and MRI of brain revealed left sided ischemic infarct involving frontotemporoparietal region and cerebral angiogram revealed narrowing of left MCA and non-visualization of distal part. There is extensive fine collaterals (Moyamoya vessels) giving the appearance of puffed smoke. The right ACA and MCA were also narrowed with appearance of early collateral vessels. She was treated with aspirin, PPI, NG feeding, antihypertensive medication, physiotherapy, rehabilitation therapy and other supportive care. His condition gradually improved and discharged on 2.7.19. He was referred to Department of Neurosurgery for cerebral revascularization by STA-MCA (superficial temporal and middle cerebral arteries) bypass surgery after stabilization and MR perfusion study. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 110-113

scholarly journals Prevalence of atopic dermatitis, asthma and rhinitis from infancy through adulthood in rural Bangladesh: a population-based, cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042380
Author(s):  
Courtney J Pedersen ◽  
Mohammad J Uddin ◽  
Samir K Saha ◽  
Gary L Darmstadt
Keyword(s):  
Atopic Dermatitis ◽  
Medical Diagnosis ◽  
Severe Disease ◽  
Age Groups ◽  
Working Party ◽  
Atopic Disease ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
History Of

ObjectiveDescribe the pattern of atopic disease prevalence from infancy to adulthood.DesignCross-sectional household survey.SettingCommunity-based demographic surveillance site, Mirzapur, Bangladesh.Participants7275 individuals in randomly selected clusters within 156 villages.Primary and secondary outcome measuresThe 12-month prevalence of atopic dermatitis (by UK Working Party Criteria (UK criteria) and International Study of Asthma and Allergies in Childhood (ISAAC)), asthma and rhinitis (by ISAAC); disease severity (by ISAAC); history of ever receiving a medical diagnosis.ResultsChildren aged 2 years had the highest prevalence of atopic dermatitis—18.8% (95% CI 15.2% to 22.4%) by UK criteria and 14.9% (95% CI 11.6% to 18.1%) by ISAAC— and asthma (20.1%, 95% CI 16.4% to 23.8%). Prevalence of rhinitis was highest among 25–29 year olds (6.0%, (95% CI% 4.5 to 7.4%). History of a medical diagnosis was lowest for atopic dermatitis (4.0%) and highest for rhinitis (27.3%) and was significantly associated with severe disease compared with those without severe disease for all three conditions (atopic dermatitis: 30.0% vs 11.7%, p=0.015; asthma; 85.0% vs 60.4%, p<0.001; rhinitis: 34.2% vs 7.3%, p<0.001) and having a higher asset-based wealth score for asthma (29.7% (highest quintile) vs 7.5% (lowest quintile), p<0.001) and rhinitis (39.8% vs 12.5%, p=0.003). Prevalence of having >1 condition was highest (36.2%) at 2 years and decreased with age. Having atopic dermatitis (ISAAC) was associated with significantly increased odds ratios (OR) for comorbid asthma (OR 5.56 (95% CI 4.26 to 7.26)] and rhinitis (3.68 (95% CI 2.73 to 4.96)). Asthma and rhinitis were also strongly associated with each other (OR 8.39 (95% CI 6.48 to 10.86)).ConclusionsAtopic disease burden was high in this rural Bangladeshi population. Having one atopic condition was significantly associated with the presence of another. Low incidence of ever obtaining a medical diagnosis highlights an important opportunity to increase availability of affordable diagnosis and treatment options for all age groups.

scholarly journals How does parental history of atopic disease predict the risk of atopic dermatitis in a child? A systematic review and meta-analysis

2020 ◽  
Vol 145 (4) ◽  
pp. 1182-1193 ◽  
Author(s):  
Nina H. Ravn ◽  
Anne-Sofie Halling ◽  
Aviva G. Berkowitz ◽  
Maria R. Rinnov ◽  
Jonathan I. Silverberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Atopic Dermatitis ◽  
Meta Analysis ◽  
Atopic Disease ◽  
Parental History ◽  
History Of

scholarly journals Tricuspid valve infective endocarditis in a non-IVDU patient with atopic dermatitis

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Heerani Woodun ◽  
Sarah Bouayyad ◽  
Sura Sahib ◽  
Nadir Elamin ◽  
Steven Hunter ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Intravenous Drug User ◽  
Blood Cultures ◽  
Topical Steroids ◽  
Foramen Ovale ◽  
History Of ◽  
The Right ◽  
Systemic Infections

Abstract A 29-year-old male, with chronic atopic dermatitis (AD), presented with a 2-week history of fatigue, pyrexia and weight loss. Examination showed eczematous patches with lichenified papules, erosions on the right shin and a new murmur. Blood cultures isolated methicillin-sensitive Staphylococcus aureus. Transthoracic echocardiography showed vegetation on the tricuspid valve (TV) that was adherent to the septal leaflet. He was treated for infective endocarditis, attributed to poorly controlled AD, with intravenous Flucloxacillin. Due to ongoing sepsis and pulmonary septic emboli, Clindamycin was added. He underwent TV repair; the septal leaflet was excised, and the remnant two leaflets were brought together with a ring. His patent foramen ovale was closed. His skin was treated with topical steroids and emollients. Right-sided endocarditis of an intact TV is uncommon in a non-intravenous drug user. Therefore, this novel case portrays the importance of aggressively managing AD as it is a risk factor for significant systemic infections.

scholarly journals Repeatability and reproducibility of axial length, anterior chamber depth and crystalline lens thickness measurements using the Nidek US-500 Echoscan

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Khathutshelo P. Mashige
Keyword(s):  
Anterior Chamber ◽  
Axial Length ◽  
Repeated Measures ◽  
Anterior Chamber Depth ◽  
Correlation Coefficients ◽  
Crystalline Lens ◽  
Angle Closure ◽  
Lens Thickness ◽  
Primary Angle Closure Glaucoma ◽  
The Right

Aim: The reliability of an instrument used to collect data for clinical and research purposes is greatly important, especially when it is used to determine changes in measured ocular parameters over time. The purpose of this study was to determine the intra-session repeatability and inter-session reproducibility of axial length (AL), anterior chamber depth (ACD) and crystalline lens thickness (LT) measurements using the Nidek US-500 Echoscan.Method: Fifty successive automatic measurements of the above parameters were taken on the right eyes only of 12 healthy subjects aged 23–44 years old, followed by similar repeated measures after 1 week. Sample standard deviations (s.d.), precision (P) and coefficient of repeatability (COR) were calculated to determine intra-session repeatability. Coefficient of reproducibility (CRP), Bland and Altman plots, concordance correlation coefficients (CCC) and paired t-tests that compared measurements obtained in the first and second sessions, were used to determine inter-session reproducibility.Results: Both the intra-session repeatability and inter-session reproducibility were within acceptable limits for the three variables assessed.Conclusion: The study showed that the Nidek US-500 Echoscan provides accurate, repeatable and reproducible measurements of AL, ACD and LT in healthy eyes. This finding will be of interest to optometrists and ophthalmologists who measure these parameters when diagnosing, managing and investigating conditions such as primary angle-closure glaucoma and keratoconus.

scholarly journals A Rare Case of Unilateral Progressive Cataract in a Young Patient Receiving Topiramate

2020 ◽  
Vol 11 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Tanuja Kate ◽  
Rajiv Choudhary ◽  
Jyoti Singhai ◽  
Navita Pathak
Keyword(s):  
Young Patient ◽  
Past History ◽  
Anterior Segment ◽  
Acute Angle ◽  
Angle Closure ◽  
Rapid Progression ◽  
Topical Steroids ◽  
Acute Angle Closure ◽  
The Right

This case report presents an instance of unilateral cataract formation and its rapid progression following topiramate-induced bilateral acute angle closure. An 18-year-old female diagnosed with acute angle closure in both eyes had started treatment on the previous day at another healthcare facility. The patient presented with complaints of pain, sudden diminution of vision, excessive watering, and photophobia (both eyes) and reported the use of topiramate for headache for 10 days. There was no past history of decreased vision, trauma, uveitis, or use of steroids. Topiramate-induced bilateral secondary angle closure attack was the presumptive diagnosis. Topiramate use was stopped, and antiglaucoma drugs, topical cycloplegic, and topical steroids were started. On 1-day follow-up, clearer cornea and peripheral anterior capsular lenticular opacity of the right eye were observed. Gonioscopy showed closed angles. Anterior segment optical coherence tomography showed forward movement of the iris-lens diaphragm and closed angles. B-scan showed ciliochoroidal effusion in the right eye and normal left eye. At 2-month follow-up, formed anterior chamber and posterior subcapsular cataract in the right eye were seen. There were no lenticular changes in the left eye. Definite progression of cataract from day-1 to 2-month follow-up was seen in the right eye. To our knowledge, this is the first report of the rapid progression of cataract following topiramate-induced secondary angle closure in a young patient warranting surgical intervention.

scholarly journals Anterior lens capsule rupture following minor blunt trauma with a past history of minimal change glomerulopathy

2014 ◽  
Vol 6 (2) ◽  
pp. 230-233
Author(s):  
Stephen V Lau V Lau ◽  
Prerana Kansakar ◽  
Ben Limbu
Keyword(s):  
Unusual Case ◽  
Past History ◽  
Lens Capsule ◽  
Minimal Change ◽  
Minor Trauma ◽  
Current Case ◽  
Anterior Lens Capsule ◽  
History Of ◽  
The Right ◽  
Anterior Subcapsular Cataract

Introduction: Few cases have been reported describing anterior lens capsule ruptures secondary to blunt trauma.Case: We present an unusual case of anterior lens capsule ruptures following minor trauma from a human elbow with a two-year history of minimal-change glomerulopathy in a 17-year-old male. In addition to having bilateral posterior subcapsular cataracts, he developed an anterior subcapsular cataract underlying the anterior lens rupture in the right eye. He was managed conservatively.  Observations: The current case differs from those of the existing literature in terms of the characteristics of the physical insult and the eye on presentation. We suggest there could be a predisposing anterior capsule weakness secondary to the minimal-change glomerulopathy or the associated drug therapy, but there needs to be more evidence to confirm or refute our claim.  Conclusions: Anterior lens capsule may rupture following minor trauma on a background of minimal-change glomerulopathy.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11714Nepal J Ophthalmol 2014; 6 (12): 230-233 

scholarly journals Primary renal leiomyosarcoma: A rare case report

2021 ◽  
pp. 503-505
Author(s):  
Sudeshna Nandi ◽  
Smritiparna Das ◽  
Chhanda Das ◽  
Madhumita Mukhopadhyay
Keyword(s):  
Abdominal Pain ◽  
Immunohistochemical Staining ◽  
Rare Case ◽  
Past History ◽  
Renal Calculi ◽  
Rare Type ◽  
The Past ◽  
Rare Case Report ◽  
History Of ◽  
The Right

Leiomyosarcoma of the kidney is a rare type of adult renal sarcoma. Here, we presented a case of a 68-year-old female who had a past history of bilateral renal calculi 3 years back with hydronephrotic changes, now presented to the OPD with complaints of abdominal pain for the past few months. On further evaluation, a heterogeneously enhancing necrotic mass was identified in the right kidney measuring 7.5 cm in the greatest dimension. A right radical nephrectomy with left Double J stenting was done. From histopathological and immunohistochemical staining, it was diagnosed as leiomyosarcoma.

Biodegradable Antibiotic Delivery Systems in the treatment chronic osteomyelitis

2014 ◽  
Vol 2 (2) ◽  
pp. 73-77
Keyword(s):  
Chronic Osteomyelitis ◽  
Past History ◽  
Delivery Systems ◽  
Subsequent Treatment ◽  
Passive Movement ◽  
Residential Home ◽  
Low Grade ◽  
History Of ◽  
The Right ◽  
Antibiotic Delivery

An 82-year-old woman was referred to the orthopedic department with a three-month history of low-grade fever. She had a known past history of type 2 diabetes. She had been unwell for last 5-days, complaining of feeling hot and 'shivery' with general aches, particularly in her right shoulder. The staff in the residential home where she lived had called the general practitioner who had prescribed a three-day course of trimethoprim for a suspected urinary tract infection. On examination, she was pyrexia with a temperature of 39.5°C. She was drowsy but reusable. Pulse was 125 beats per minute and regular. Blood pressure was 90/55 mmHg. Heart sounds were normal with no added sounds or murmurs. The chest was clear. Her abdomen was soft and non-tender with no palpable masses or organs. The skin overlying the right shoulder was warm to touch and erythematous. She was unable to tolerate any passive movement of the joint. A plain x ray of her shoulder shows lucent defects in the head of the humerus with loss of the normally well-corticated surface. This is consistent with osteomyelitis. Two of 2-blood cultures and numerous operative cultures grew MRSA. His subsequent treatment consisted of intravenous vancomycin, achieving plasma drug levels approximating 24 μg/mL. This treatment was extended for 8 weeks, given the clinical concern for possible osteomyelitis in an area. Treatment was complicated by significant a decline in hearing. Biodegradable drug delivery systems provide a method for local delivery of drugs in deeper tissues, obviating parenteral or enteral usage; in some situations, a significant advantage is that much higher doses and/or strengths of the drug can be delivered locally than can be tolerated if the drug is delivered systemically. In this case report, we discussed the use of Biodegradable Antibiotic Delivery Systems in treatment chronic osteomyelitis.

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