scholarly journals Uncommon primary Group A streptococcal erector spinae pyomyositis diagnosed as muscle strain in a fit young male

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984024
Author(s):  
Zhongxi Zheng ◽  
Chee Seng Yoong
Keyword(s):  
Young Male ◽  
Erector Spinae ◽  
Primary Group ◽  
Close Monitoring ◽  
Muscle Strain ◽  
Neurological Sequelae ◽  
Intravenous Antibiotics ◽  
Group A ◽  
Strenuous Physical Activity ◽  
Acute Lower Back Pain

Acute lower back pain in a fit healthy male with recent strenuous physical activity is often attributed to muscle strain. We report a rare case of erector spinae pyomyositis developing in a young and otherwise healthy young adult male that was almost misdiagnosed as muscle strain. Despite admission and close monitoring, diagnosis was only confirmed on a magnetic resonance imaging of the spine later during the hospital stay. Early diagnosis in this case allowed successful treatment with intravenous antibiotics alone, without requiring further surgical drainage or development of further neurological sequelae, common in later stages of erector spinae pyomyositis.

scholarly journals Fetal and maternal outcome following expectant management of severe pre-eclampsia remote from term

2017 ◽  
Vol 6 (12) ◽  
pp. 5420
Author(s):  
Deepak A. V. ◽  
Reena R. P. ◽  
Deepa Anirudhan
Keyword(s):  
Expectant Management ◽  
Severe Preeclampsia ◽  
Close Monitoring ◽  
Antenatal Corticosteroids ◽  
Maternal Complications ◽  
Medical College ◽  
Difficult Decision ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Expectant management of severe preeclampsia, remote from term is often a difficult decision. Maternal and foetal complications may occur while trying to achieve a more favourable perinatal outcome. We wanted to find out the foetal and maternal outcomes of expectant management in these women.Methods: A prospective cohort study was conducted at Government Medical College, Thrissur, India between May 2013 and April 2015. Women with severe preeclampsia remote from term, who were admitted, managed expectantly and delivered in our hospital during the study period, were recruited. The study subjects were grouped into: Group A (between 28 weeks and 31 weeks 6 days) and Group B (between 32 weeks and 33 weeks 6 days). A structured proforma was used to collect demographic and clinical details. The maternal and foetal outcomes were noted.Results: There were 4786 deliveries during the study period. Among them 76 (1.58% of total deliveries) women with severe preeclampsia between 28 weeks and 33-week 6 days gestation on expectant management were included in the study. The mean duration of expectant management was 7.92 days in group A (27 women) and 6.67 days in group B (49 women). Most women required termination of pregnancy for foetal distress (36.8%). HELLP syndrome and imminent eclampsia were the maternal complications that occurred. Perinatal loss was significantly more in Group A when compared to Group B.Conclusions: Expectant management of women with severe preeclampsia remote from term, especially between 32weeks and 33weeks 6 days, with antenatal corticosteroids and close monitoring, seems a reasonable option in developing countries.

scholarly journals Keratoconus: early onset, the worst prognosis, eye rubbing and hand-dominance

2020 ◽  
Vol 10 (4) ◽  
pp. 79-84
Author(s):  
Anisur Rahman ◽  
Sharah Rahman ◽  
Jamsed Faridi ◽  
Abdus Salam ◽  
Tarzia Asma Zafrullah ◽  
...  
Keyword(s):  
Observational Study ◽  
Central Corneal Thickness ◽  
Age Of Onset ◽  
Corneal Thickness ◽  
Young Patients ◽  
Close Monitoring ◽  
Dominant Hand ◽  
K Value ◽  
Group A ◽  
Group B

Purpose: Keratoconus is an ectatic disorder of cornea and mostly involve teen aged group, still the pathogenesis and aetiology is not clearly defined. We try to establish the progression of the diseases is inversely proportional to the age of onset of the patient. Design: It was an observational study, carried out at a private eye hospital where patient was referred for RGP contact lenses. Methods: This observational study was carried out from Jan’ 2017 to Dec’ 2019 total three year period and 304 patients with Keratoconus were in the initial study and we divided them into two groups. Group: A, ≤25 years old and Group: B, >25 years old but among these 304 patient we included 200 patients in our study those who completed minimum 3 years follow-up and meet the inclusion criteria. Results: After three years ‘K’ value in group: A, <0.0001 in group: B, <0.3655. Sim K’s Astigmatism <0.0001 in group: A. <0.0223 in group: B. Central corneal thickness <0.0001 in group: A and 0.1957 in group: B. ‘K’ value and central corneal thickness (CCT) deteriorate more in group: A, than group: B. It is also found that KC progress more in case of VKC and it is more prominent in dominant hand side. Conclusion: At diagnosis, keratoconus is often more advanced in children than in adults, with faster disease progression. Early detection and close monitoring are therefore crucial in young patients.

scholarly journals Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yuichiro Yoneoka ◽  
Yasuhiro Seki ◽  
Katsuhiko Akiyama ◽  
Yuki Sakurai ◽  
Nobumasa Ohara ◽  
...  
Keyword(s):  
Epidermoid Cyst ◽  
Hormone Replacement ◽  
Posterior Lobe ◽  
Endoscopic Transsphenoidal Surgery ◽  
Neurological Sequelae ◽  
Intravenous Antibiotics ◽  
Suprasellar Tumor ◽  
Mollaret's Meningitis ◽  
Intracranial Epidermoid ◽  
Transsphenoidal Resection

Prolonged postoperative pyrexia (PPP) due to Mollaret’s meningitis following endoscopic transsphenoidal surgery (eTSS) for an intracranial epidermoid cyst can be confused with postoperative meningeal infection after transsphenoidal resection, especially in the middle of the COVID-19 pandemic. Anosmia, as well as dysgeusia, cannot be evaluated in patients of eTSS for a while after surgery. We report a case of an infundibular epidermoid cyst with post-eTSS Mollaret’s meningitis (MM). The post-eTSS MM caused vasopressin-analogue-resistant polyuria (VARP) in synchronization with PPP. A 59-year-old man experiencing recurrent headaches and irregular bitemporal hemianopsia over three months was diagnosed with a suprasellar tumor. The suprasellar tumor was an infundibular cyst from the infundibular recess to the posterior lobe of the pituitary, which was gross-totally resected including the neurohypophysis via an extended eTSS. Since awakening from general anesthesia after the gross total resection (GTR) of the tumor, the patient continuously had suffered from headache until the 13th postoperative day (POD13). The patient took analgesics once a day before the surgery and three times a day after the surgery until POD11. Pyrexia (37.5–39.5 degree Celsius) in synchronization with nonnephrogenic VARP remitted on POD18. Intravenous antibiotics had little effect on changes of pyrexia. Serum procalcitonin values (reference range <0.5 ng/mL) are 0.07 ng/mL on POD12 and 0.06 ng/mL on POD18. His polyuria came to react with sublingual desmopressin after alleviation of pyrexia. He left the hospital under hormone replacement therapy without newly added neurological sequelae other than hypopituitarism. After GTR of an infundibular epidermoid cyst, based on values of serum procalcitonin, post-eTSS MM can be distinguished from infection and can be treated with symptomatic treatments. The postoperative transient nonnephrogenic VARP that differs from usual central diabetes insipidus can react with sublingual desmopressin after alleviation of PPP in the clinical course of post-eTSS MM. An infundibular epidermoid cyst should be sufficiently resected in one sitting to minimize comorbidities, its recurrence, or postoperative MM to the utmost.

Group A Streptococcal Necrotizing Fasciitis Subsequent to Pectoralis Muscle Strain

2000 ◽  
Vol 48 (3) ◽  
pp. 538 ◽  
Author(s):  
James W. Gaffield ◽  
David J. Finlay ◽  
Todd I. Braun ◽  
Robert K. Josloff
Keyword(s):  
Necrotizing Fasciitis ◽  
Pectoralis Muscle ◽  
Muscle Strain ◽  
Group A

scholarly journals One-Day Antibiotic Infusion for the Prevention of Postoperative Infection Following Arthroplasty: A Case Control Study

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Rui Niimi ◽  
Masahiro Hasegawa ◽  
Goshin Kawamura ◽  
Akihiro Sudo
Keyword(s):  
Postoperative Infection ◽  
Wound Infection Rate ◽  
Antibiotic Administration ◽  
Intravenous Antibiotic ◽  
Intravenous Antibiotics ◽  
Group A ◽  
Group B ◽  
To Receive ◽  
Antibiotic Infusion

Intravenous antibiotics effectively reduce the prevalence of postoperative infection. However, Japanese orthopaedic surgeons have no consensus with regard to the optimal duration of prophylaxis. The aim of this study is to compare the outcome of one-day intravenous antibiotic administration with that of long-term intravenous antibiotic administration. Patients who underwent total hip or knee arthroplasty were divided into 2 groups to receive one of 2 prophylactic protocols retrospectively. Group A (223 patients) received intravenous antibiotics twice only on the day of surgery, whereas Group B (104 patients) received intravenous antibiotics for at least 3 days after surgery. We analyzed the wound infection rate and monitored liver and renal functions. None of these patients had a postoperative infection. No liver dysfunction and renal dysfunction were observed. One-day antibiotic infusion was as effective as long-term antibiotics in preventing infection after arthroplasty and achieved greater cost effectiveness.

scholarly journals Uncommon cause of pelvic inflammatory disease leading to toxic shock syndrome

2018 ◽  
pp. bcr-2018-224955 ◽  
Author(s):  
Heather Lusby ◽  
Aaron Brooks ◽  
Eden Hamayoun ◽  
Amanda Finley
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Lower Quadrant ◽  
Reactive Protein ◽  
Source Of Infection ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Group A

A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients’ positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus. On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines. The patient was promptly treated with intravenous antibiotics and supportive care, and she acutely recovered. This case demonstrates a rare cause of PID and an atypical aetiology of severe sepsis. It illuminates the importance of considering PID as a source of infection for undifferentiated bacteraemia.

Walk to Health

2020 ◽  
Vol 4 (2) ◽  
pp. 1-11
Author(s):  
Paula Miller ◽  
James O. Connelly
Keyword(s):  
Physical Activity ◽  
Undergraduate Students ◽  
Stages Of Change ◽  
Leisure Time Physical Activity ◽  
Convenience Sample ◽  
Walking Program ◽  
Group A ◽  
Strenuous Physical Activity ◽  
Group B ◽  
Activity Questionnaire

This study examined the differences between the levels of exercise among university graduate and undergraduate students. A convenience sample of 137 students were assigned to two groups. Group A received instructions about the program with a pedometer and log sheet and told to focus on an exercise goal. Group B received the same material but without a goal. The two groups were compared on the transtheoretical model's five stages of change. Exercises for strenuous, moderate, and mild activity were compared with the pretest and posttest from the Godden-Shephard Leisure-Time Physical Activity Questionnaire. Analyses indicated that a walking program inspired graduate and undergraduate students to self-monitor their progress. At pretest, there was no distribution of performance toward increasing exercise across the five stages of change for students. However, at posttest, students in Group A with a goal were more likely to engage in mild (p<0.05) and moderate (p<0.05) exercise. Differences in strenuous physical activity were unsupported.

scholarly journals Significance of Hepatitis B Recurrence in Liver Transplantation Recipients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Hong-Shiue Chou ◽  
Chih-Hsien Cheng ◽  
Hao-Chien Hung ◽  
Jin-Chiao Lee ◽  
Yu-Chao Wang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
Liver Function ◽  
Survival Rates ◽  
Clinical Manifestations ◽  
Antiviral Agent ◽  
Close Monitoring ◽  
Group A ◽  
Group B ◽  
Hcc Recurrence

Background. A combination of antihepatitis B immunoglobulin and antiviral agents is the most common regimen for prophylaxis of hepatitis B recurrence after liver transplantation. However, hepatitis B recurrence still happens. The significance of hepatitis B recurrence is less mentioned. Materials. Forty-eight of the 313 hepatitis B liver transplant recipients having hepatitis B recurrence were included in this study. The patients were divided into group A, the patients transplanted for hepatitis B-related liver failure, and group B, the patients transplanted for hepatitis B-related cirrhosis and HCC. The clinical manifestations after hepatitis B recurrence were recorded. Results. Among the 48 patients with hepatitis B recurrence, 23 patients were in group A and 25 patients in group B. The age was 51.6±9.4 years in group A and 52.8±6.4 in group B (p=0.869). The MELD score prior to transplantation was 23.1±9.9 in group A patients and 12.9±5.6 in group B patients (p<0.001). The median (interquartile) interval from transplantation to hepatitis B recurrence was 10 (2-19) months for group A patients and 13 (8.5-35) months for group B patients (p=0.051). After hepatitis B recurrence, the liver function was almost normal in both groups. In group B patients, 10 patients had HCC recurrence with 7 of 10 patients having hepatitis B recurrence earlier than HCC recurrence. The interval between hepatitis B and HCC recurrence was 1 to 15 months. The 1-, 3-, and 5-year survival rates were 82.6%, 73.9%, and 69.0%, respectively, for group A patients and 96%, 76%, and 68%, respectively, for group B patients (p=0.713). Conclusion. The patients have uneventful liver function under antiviral agent while hepatitis B recurred. For the patients having HCC prior to transplantation, close monitoring of HCC recurrence is necessary if hepatitis B recurs.

scholarly journals SIAT-WEXv2: A Wearable Exoskeleton for Reducing Lumbar Load during Lifting Tasks

Complexity ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Xinyu Ji ◽  
Dashuai Wang ◽  
Pengfei Li ◽  
Liangsheng Zheng ◽  
Jianquan Sun ◽  
...  
Keyword(s):  
Adaptive Algorithm ◽  
Erector Spinae ◽  
Biomechanical Analysis ◽  
Muscle Strain ◽  
Effective Protection ◽  
Lumbar Muscle ◽  
Wearable Exoskeleton ◽  
Lumbar Load ◽  
Fuzzy Adaptive

Lumbar Exoskeleton, as an important instance of wearable exoskeleton, has broad application prospects in logistics, construction, and other industries. Specifically, in the working scenarios that require long-term and repeated bending and rising movements, active lumbar exoskeleton (ALE) can provide effective protection and flexible assistance to wear’s waist muscles and bones, which will significantly reduce the risk of lumbar muscle strain. How to improve the human-machine coupling and enhance the assistance performance are the main challenges for ALE’s development. Based on the biomechanical analysis of the movement of lifting heavy objects from bottom up, this paper proposes a lightweight but powerful ALE, named as SIAT-WEXv2, which can output maximum assistive force of 28 N. Additionally, we use robust fuzzy adaptive algorithm to improve SIAT-WEXv2’s antidisturbance ability, so that it can provide continuous and supple assistance for wearer. Electromyography (EMG) signals of the lumbar erector spinae (LES) from ten subjects in two experimental cases (with or without SIAT-WEXv2) were collected to evaluate the effectiveness of our new ALE. The experimental results indicate that the reduction of iEMG signal at LES decreased monotonically from 60% ± 5.5% to 40.5% ± 6.5% as the weight of lifting load increased from 0 to 25 kg.

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