Rhabdomyolysis and hepatotoxicity following accidental monensin ingestion: A report of two cases

2020 ◽  
pp. 074823372097412 ◽  
Author(s):  
Zhiqiang Zhang ◽  
Shuqing Cui ◽  
Jinying Zhang
Keyword(s):  
Early Stage ◽  
Past History ◽  
Cardiopulmonary Arrest ◽  
Fluid Replacement ◽  
Comprehensive Treatment ◽  
Oral Ingestion ◽  
Life Threatening ◽  
History Of ◽  
Veterinary Antibiotic ◽  
Oral Hypoglycemic Drugs

Background: Monensin is a commonly used veterinary antibiotic with a narrow safety range. Overdose of monensin can cause animal poisoning or even death. Monensin poisoning is rare in humans, and there is no effective detoxification protocol in clinical treatment. Objective: We report here two cases of monensin-induced rhabdomyolysis and hepatotoxicity by oral ingestion. The two patients were a couple and both were admitted to the hospital due to oral ingestion of monensin 5 days prior. Patient 1, with a past history of chronic bronchitis and hypertension, presented with severe rhabdomyolysis, hepatotoxicity, and hypoxemia. After treatment with fluid replacement and alkalinization of urine, his condition deteriorated the next day and irreversible cardiopulmonary arrest occurred. Patient 2 was diabetic and using oral hypoglycemic drugs and had obvious rhabdomyolysis from the fifth day of admission. After treatment with fluid replacement, urine alkalization, and continuous renal replacement therapy (CRRT), the patient recovered and was discharged 1 month later. Discussion: The ingestion of monensin can lead to life-threatening toxicity, with rhabdomyolysis and hepatotoxicity as the main manifestations. Comprehensive treatment including CRRT in the early stage of rhabdomyolysis may improve the condition and prognosis.

scholarly journals A Case Report on Scleroderma: A Diagnostic Dilema

2021 ◽  
pp. 251-255
Author(s):  
Ch. K. V. L. S. N. Anjana Male ◽  
Hari Chandana Varikallu ◽  
Tirumalasetty Sai Swapna ◽  
N. Dileep ◽  
S. Hemanth Durga Prasad ◽  
...  
Keyword(s):  
Past History ◽  
Immunosuppressive Agents ◽  
Localized Scleroderma ◽  
Visceral Organ ◽  
Tight Skin ◽  
Heterogenous Group ◽  
Life Threatening ◽  
History Of ◽  
Organ Fibrosis

Scleroderma is a rare heterogenous group of autoimmune fibrosing disorder that mainly exists in two forms; localized scleroderma (LS) and systemic sclerosis (SSc). It involves thickening of the skin at fingers region extending from proximal to metacarpophalangeal joints. The diagnostic criteria of scleroderma include past history of patient, symptoms of patient, serology, and skin biopsy. The morbidity and mortality are much worse for SSc with the patients are at risk for life threatening lung, heart and other visceral organ fibrosis and vasculopathy. There is no drug that can cure or stop scleroderma over fibrosis, but certain drugs regulate the symptoms associated with it and boost the patient's quality of life, particularly steroidal creams that help alleviate swelling, joint pain, loosen tight skin; blood pressure drugs that dilate blood vessels; immunosuppressive agents. If the disease is severe amputation is necessary.

scholarly journals An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Zhao ◽  
Zhichao Lai ◽  
Xiaojun Song ◽  
Rong Zeng ◽  
Changwei Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Carotid Endarterectomy ◽  
Early Stage ◽  
Prostatic Hyperplasia ◽  
Surgical Patients ◽  
Blood Products ◽  
Case Presentation ◽  
Life Threatening ◽  
History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

scholarly journals Case of Mycotic Pseudoaneurysm of the Common Carotid Artery due to Salmonella typhi Bacteremia

2022 ◽  
pp. 263394472110610
Author(s):  
Sruti P. Nair ◽  
Aravind Reghukumar ◽  
Athul Gurudas ◽  
Kiran Kumar V. Sasidharan ◽  
Sreekumar Sivadasan
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Past History ◽  
Fatal Outcome ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
High Dose ◽  
Uncontrolled Diabetes ◽  
Life Threatening ◽  
History Of

Aneurysm of the extracranial carotid artery is a rare disease, mycotic pseudoaneurysms being even less common. They are a life-threatening complication of systemic infection and atherosclerosis. Immunocompromised people, including patients with HIV, uncontrolled diabetes melltus, those on immunosuppressants like high-dose steroids, and chemotherapy, are at a higher risk for development of mycotic pseudoaneurysms. Due to the high risk of potential complications like rupture and thromboembolic events, mycotic aneurysms always require surgical management. Early detection followed by restoration of blood flow is critical to minimize a fatal outcome. Here we report the case of a 52-year-old man with a past history of hypertension and dyslipidemia who presented with a pulsatile painful neck swelling. On evaluation, the patient was diagnosed to have Salmonella typhi bacteremia, HIV infection, and a mycotic aneurysm of the left common carotid artery.

scholarly journals Determination of Risk Factors for Pre–Eclampsia in aTertiary Hospital of Bangladesh

2017 ◽  
Vol 16 (1) ◽  
pp. 29-32
Author(s):  
Sabina Yeasmin ◽  
M Jalal Uddin
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Early Stage ◽  
Past History ◽  
Tertiary Care ◽  
Care Hospital ◽  
Socioeconomic Condition ◽  
Low Socioeconomic ◽  
History Of

Background: Pre-eclampsia is an idiopathic disorder of pregnancy characterized by proteinuric hypertention and still one of the important causes of maternal and fetal mortality.The identification of its predisposing factors before and during early stage of pregnancy will help in reducing the mortality.Objective:The objective of the present study is to determine the risk factors for pre-eclampsia among pregnant women in a tertiary level hospital.Methods: This study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care hospital in Chittagong, Bangladesh, from January to June 2015.A total number of 50 pregnant women with pre-eclampsia who admitted in this hospital were selected as study group.This was hospital based descriptive study.Results: Most of the partcipants were within 21-30 years of age group and mean age 24.06 ± 3.71.The factors that were found to be significant predictors of risk for development of PE were primigravida, low socioeconomic condition,family history of PE & hypertension, past history of PE and hypertention, past history of diabetes mellitus was also associated with development of PE.Chatt Maa Shi Hosp Med Coll J; Vol.16 (1); Jan 2017; Page 29-32

Gauzoma in A Scleroderma Patient Following Open Heart Surgery: A Case Report

2018 ◽  
Vol 15 (1) ◽  
pp. 79-81
Author(s):  
Mohammadali Nazarinia ◽  
Elmira Esmaeilzadeh
Keyword(s):  
Heart Surgery ◽  
Past History ◽  
Open Heart Surgery ◽  
Clinical History ◽  
Pathology Report ◽  
Open Heart ◽  
Posterior Aspect ◽  
Scleroderma Patient ◽  
Life Threatening ◽  
History Of

Introduction: Gauzoma is an iatrogenic complication which occurs rarely due to surgical team negligence. Depending on the sterility of the retained tissue, it can lead to life threatening surgical complications or may remain asymptomatic for many years and be detected incidentally in imaging studies. It may be mistaken as tumors or aneurysms. Thus, high clinical suspicion is needed to diagnose them in patients with past history of operation. </P><P> Reporting Case: A 35 years old woman, a known case of scleroderma underwent open-heart surgery 20 years before being diagnosed as scleroderma, presented by dyspnea especially on activity. The High Resolution CT (HRCT) for evaluating the interestial lung disease was done which detected a 7 cm (in greatest diameter) inflammatory mass in posterior aspect of left hemi thorax with a radiopaque thread in its center. True cut biopsy was done and sent for pathology, which revealed fragments of foreign body materials probably gauze pad fibers with cell debris and blood. Conclusion: Here, we highlighted the details in clinical history, CT findings, and pathology report of gauzoma in thorax of a scleroderma patient following previous open-heart surgery. It can be guidance for clinician to consider this diagnosis in patients with past history of operation.

scholarly journals Pulmonary Mucormycosis: A Case Report of a Rare Infection with Potential Diagnostic Problems

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Salwa O. Mekki ◽  
Amal A. Hassan ◽  
Afnan Falemban ◽  
Nashwa Alkotani ◽  
Salem M. Alsharif ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Hematological Malignancies ◽  
Histopathological Examination ◽  
Past History ◽  
Early Management ◽  
Pulmonary Mucormycosis ◽  
Life Threatening ◽  
History Of

Pulmonary mucormycosis is a relatively rare pulmonary fungal disease, which is difficult to diagnose early and lacks effective treatment. It is seen in patients with hematological malignancies, diabetes mellitus, and immunocompromised states. The diagnosis depends primarily on the detection of fungi in lung tissue. Here, we present a case of a 52-year-old male who has type 2 diabetes mellitus and a past history of treated pulmonary tuberculosis. Clinical diagnosis is difficult in pulmonary mucormycosis, and early diagnosis is needed for this life-threatening infection. Histopathological examination of a resected cavity confirmed the diagnosis of pulmonary mucormycosis. This report highlights the difficulty of diagnosis and the importance of histological examination in detecting mucormycosis which will help for early management.

scholarly journals Pulmonary Aspergilloma

1970 ◽  
Vol 10 (2) ◽  
pp. 149-151 ◽  
Author(s):  
Ahmed Hossain ◽  
Quazi Tarikul Islam ◽  
Md Mahmudur Rahman Siddiqui ◽  
Nadira Tamanna ◽  
Hashmi Sina ◽  
...  
Keyword(s):  
Past History ◽  
Needle Aspiration ◽  
Low Grade ◽  
Presenting Symptoms ◽  
Secondary Invasion ◽  
Life Threatening ◽  
History Of ◽  
Oral Itraconazole ◽  
Pulmonary Aspergilloma ◽  
Needle Aspiration Cytology

Pulmonary aspergilloma is a rare disease, usually presenting as secondary invasion of preexisting lung cavity. When a pre-existing lung cavity is colonized by Aspergillus fumigatus it forms a fungal ball (Pulmonary aspergiloma). Presenting symptoms is usually cough, haemoptysis that may be life threatening. The radiological findings are that of a ball like structure within preexisting lung cavity on plain radiography and computerized tomography of the chest. We report a case of aspergilloma in a 70 year old man with past history of tuberculosis presented with the complaint of occasional cough, respiratory distress and occasional low grade fever for two years. It was diagnosed radiologically and confirmed by fine needle aspiration cytology and treated successfully with oral Itraconazole. Key words: Aspergilloma, Pulmonary tuberculosis, Itraconazole doi: 10.3329/jom.v10i2.2836  J MEDICINE 2009; 10 : 149-151

scholarly journals Toward developing a metastatic breast cancer treatment strategy that incorporates history of response to previous treatments

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aleksandra K. Olow ◽  
Laura van ’t Veer ◽  
Denise M. Wolf
Keyword(s):  
Breast Cancer ◽  
Checkpoint Inhibitors ◽  
Early Stage ◽  
Past History ◽  
Metastatic Breast ◽  
Cell Cycle Checkpoint ◽  
Aurora A Kinase ◽  
History Of ◽  
Intrinsic Prior

Abstract Background Information regarding response to past treatments may provide clues concerning the classes of drugs most or least likely to work for a particular metastatic or neoadjuvant early stage breast cancer patient. However, currently there is no systematized knowledge base that would support clinical treatment decision-making that takes response history into account. Methods To model history-dependent response data we leveraged a published in vitro breast cancer viability dataset (84 cell lines, 90 therapeutic compounds) to calculate the odds ratios (log (OR)) of responding to each drug given knowledge of (intrinsic/prior) response to all other agents. This OR matrix assumes (1) response is based on intrinsic rather than acquired characteristics, and (2) intrinsic sensitivity remains unchanged at the time of the next decision point. Fisher’s exact test is used to identify predictive pairs and groups of agents (BH p < 0.05). Recommendation systems are used to make further drug recommendations based on past ‘history’ of response. Results Of the 90 compounds, 57 have sensitivity profiles significantly associated with those of at least one other agent, mostly targeted drugs. Nearly all associations are positive, with (intrinsic/prior) sensitivity to one agent predicting sensitivity to others in the same or a related class (OR > 1). In vitro conditional response patterns clustered compounds into five predictive classes: (1) DNA damaging agents, (2) Aurora A kinase and cell cycle checkpoint inhibitors; (3) microtubule poisons; (4) HER2/EGFR inhibitors; and (5) PIK3C catalytic subunit inhibitors. The apriori algorithm implementation made further predictions including a directional association between resistance to HER2 inhibition and sensitivity to proteasome inhibitors. Conclusions Investigating drug sensitivity conditioned on observed sensitivity or resistance to prior drugs may be pivotal in informing clinicians deciding on the next line of breast cancer treatments for patients who have progressed on their current treatment. This study supports a strategy of treating patients with different agents in the same class where an associated sensitivity was observed, likely after one or more intervening treatments.

scholarly journals Clinicopathological Study and Management of Carcinoma of The Breast

2021 ◽  
Vol 12 (2) ◽  
pp. 1208-1212
Author(s):  
Ajay Raja A ◽  
Lakshmana R ◽  
Abhilash M ◽  
Govinda Raju Chintad ◽  
Jeyakumar S ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Primary Treatment ◽  
Breast Cancer Surgery ◽  
Histopathological Correlation ◽  
Cancer Breast ◽  
Triple Assessment ◽  
Life Threatening ◽  
History Of

Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women and the leading cause of cancer death in women. In India, breast cancer accounts for 19% of all cancers in women and is second only to lung cancer as a cause of cancer deaths. Many early breast carcinomas are asymptomatic; pain or discomfort is not usually a symptom of breast cancer. Breast cancer is often first detected as an abnormality on a mammogram before it is felt by the patient or healthcare provider. Surgery and radiation therapy, along with adjuvant hormone or chemotherapy when indicated, are now considered the primary treatment for breast cancer. For many patients with low-risk early-stage breast cancer, surgery with local radiation is curative. In India, Breast cancer is the second most common malignancy among women next to the Ca cervix. Since it presents as a painless lump, patients neglect and come to the hospital often late. This study is an attempt has been made to study the various risk factors, the natural history of the disease, clinical features, and mode of spread, pathological types, staging and management of breast cancer. Since most cases presented to us either in the Early or Locally Advanced stage, they were included in the study. For the diagnosis of breast lesions, Triple Assessment should be involved to characterize the lesions, which include clinical examination, imaging and FNAC/ Biopsy for histopathological correlation.

scholarly journals Contralateral tension pneumothorax during video-assisted thoracic surgery for lung cancer in a patient with obesity and rib fractures: a case report and review of the literature

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Sakiko Kumata ◽  
Katsunari Matsuoka ◽  
Shinjiro Nagai ◽  
Mitsuhiro Ueda ◽  
Yoshinori Okada ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Past History ◽  
Tension Pneumothorax ◽  
Lung Ventilation ◽  
Rib Fractures ◽  
Review Of The Literature ◽  
One Lung Ventilation ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Abstract Background Intraoperative contralateral pneumothorax during one-lung ventilation is a rare but life-threatening complication. Although the exact incidence is unknown, only 14 cases with this complication have been reported until now. Case presentation A 67-year-old Japanese man with a weight of 80 kg, height of 162.2 cm, and body mass index of 30.4 kg/m2 underwent three-port video-assisted thoracic surgery for lung cancer with one-lung ventilation. He had suffered from traumatic right rib fractures 6 weeks before the referral. Fifteen minutes before the end of the surgery, the systolic blood pressure suddenly dropped to about 50 mmHg, which was immediately recovered by intravenous injection of phenylephrine. This episode occurred during chest closure after the completion of the left upper lobectomy, and one-lung ventilation was soon switched to two-lung ventilation. Contralateral tension pneumothorax was noted by the postoperative chest x-ray. As the patient was complicated with obesity and a past history of rib fractures, increased airway pressure during one-lung ventilation related to obesity together with the persistent compression of the visceral pleura by the fractured ends of the ribs was considered to be the factors responsible for this critical complication. Conclusions Patient backgrounds such as obesity and past history of rib fractures should be noted carefully as risk factors for intraoperative contralateral pneumothorax during one-lung ventilation. We present the clinical course and discuss the mechanism of development of this potentially life-threatening complication in the present case with a review of the literature.

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