scholarly journals Unwarranted hysterectomy in a case of oro-vaginal-vulvar lichen planus in a young woman: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Lajya Devi Goyal ◽  
Priyanka Garg ◽  
Manmeet Kaur

Abstract Background Lichen planus is a rare autoimmune disease primarily affecting the skin and mucous membranes of the oral mucosa, vulva, and vagina. Diagnosis is difficult and often delayed as the clinicians do not associate the oral symptoms with the genital symptoms. This has a negative impact on the out-of-pocket expenditure and quality of life of the patients. We report this case, as only anecdotal cases have been reported so far from a developing country such as India. We highlight the unindicated hysterectomy that the patient had undergone because of lack of awareness regarding this condition. Our case report also highlights the importance of the multidisciplinary team approach to optimize outcomes and avoid unnecessary morbidity to such patients. Case presentation We report a North-Indian patient with oro-vaginal-vulvar lichen planus who presented to us with complaints of recurrent vulvovaginal symptoms for the last 5 years. She had been previously treated with multiple courses of antibiotics, antifungals, and topical steroids over the course of 3 years and finally offered laparoscopic-assisted vaginal hysterectomy (LAVH) by a private practitioner but got no relief. She also had complained of oral symptoms in the form of a burning sensation after eating spicy food, but did not seek any treatment for this. After multidisciplinary team discussion, a final diagnosis of oro-vaginal-vulvar lichen planus was made at our institute based on the clinical and histopathological findings. The patient was immediately started on oral prednisolone to which she responded with improvement in her symptoms. Conclusion Lichen planus is a chronic painful condition with significant impact on the quality of life. Women often suffer for several years before an accurate diagnosis is made. Treatment is challenging and needs to be individualized with a multidisciplinary approach to prevent progressive anatomical distortion and associated morbidity.

2017 ◽  
Vol 31 (1) ◽  
pp. 53-58
Author(s):  
Keara McNair ◽  
Madeline Lutjen ◽  
Kara Langhamer ◽  
Jeremiah Nieves ◽  
Kimberly Hreha

2019 ◽  
Vol 56 (10) ◽  
pp. 1353-1358
Author(s):  
Fatemeh Khanchezar ◽  
Negin Moradi ◽  
Neda Tahmasebi Fard ◽  
Seyyed Mahmoud Latifi ◽  
Soodabeh Bassak Nejad ◽  
...  

Objective: Maintaining and improving patients’ quality of life (QOL) are regarded as the most important aims in health-care systems. These are directly associated with intervention of health-care providers across the world. The aim of the present study was to evaluate the impact of teamwork on frequency of care provided to children with cleft lip and palate and their mothers’ QOL. Methods: This analytical epidemiology study was conducted on 101 children with cleft lip and palate and their mothers who were divided into 2 groups: a multidisciplinary team and a group of individual providers. Data were collected using convenience sampling. Quality of Life Questionnaire (Short Form-36) was assessed. The statistical analysis was performed using the χ2 test, independent t test, and Mann-Whitney U test in SPSS (20). Results: Both groups were matched. There was a significant statistical difference among the members of multidisciplinary team who received surgery, genetic counseling, and dental care ( P ≤ .043) and the individual providers groups. The 2 groups did not have significant difference in receiving the hearing test, speech therapy, and dental care 12 months before the interview. There were significant differences in QOL scores between the multidisciplinary team and the group of individual providers ( P = .013). Conclusions: The services provided as a multidisciplinary team leads to a better outcome and improves the QOL of our patients and their families. It is recommended that services should be provided in the team approach for patients with cleft lip and palate.


Author(s):  
Georg Authried ◽  
Mathias Svendsen

Chronic nail biting (onychophagia) is a common habit which negatively impacts on the quality of life of those affected, has a negative social impact, and is accompanied with disabling inflammatory processes like gingivitis and paronychia. Habit reversal is a behaviour treatment procedure used to help patients get rid of the habit. The presented case report describes how a six-month period of habit reversal prescribed by the dermatologist was used to treat a 42-year male suffering from life-long onychophagia. During the treatment period, the patient experienced both an improved growth of nails and an improvement in quality of life, but never got fully cured from the habit. Finally, suggestions for an improved treatment success by prescribing habit reversal in specialized onychophagia clinics run by a multidisciplinary team (consisting of e.g., dermatologists, psychiatrists, and psychologists) who ensure regular follow-ups and patient compliance is provided.


2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.


Author(s):  
Ganapathi Rao ◽  
Vijay Kumar ◽  
Ashok Naikar ◽  
Chandrakanth Halli

A standard Ksharasutra is practiced in treatment of Bhagandara (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaja Prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Palasha Ksharasutra prepared in Arkaksheera was prepared by Palasha Kshara (Ash of Butea monosperma), Arka Ksheera (Calotropis gigantic) and turmeric powder (Curcuma longa). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaja predominant Prakruti with fistula-in ano having two external opening at 6 and 7 O’ clock position of anus was treated with application of Ksharasutra. The Palasha Ksharasutra prepared in Arkaksheera was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Palasha Ksharasutra prepared in Arkaksheera in multiple fistula-in ano.


2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
Author(s):  
P. Lucas Ramirez ◽  
Kelly Barnhill ◽  
Alan Gutierrez ◽  
Claire Schutte ◽  
Laura Hewitson

This case report describes the benefits of antibiotic and antifungal therapy on behavior in a child with autism undergoing treatment for encopresis. Over the course of treatment, the child exhibited a reduction in aberrant behaviors, increased gastrointestinal function, and improved quality of life.


Author(s):  
Laura L. Cord ◽  
Veena Rajpal ◽  
Nancy Pearl Solomon

Purpose At Walter Reed National Military Medical Center, service members (SMs) with polytraumatic injuries, usually resulting from blast explosions, are routinely referred to the Speech Pathology Clinic for evaluation of swallowing function. The purpose of this clinical focus article is to advance the speech-language pathologist's (SLP) knowledge of polytrauma and to improve the care of individuals with traumatic injuries, especially related to nutrition and swallowing within a larger multidisciplinary team approach. Case Report Previous research within our center identified common demographic and injury characteristics of SMs with combat-related injuries that led to referrals for swallowing evaluation. An SM with polytraumatic injuries was selected for this case report to illustrate the relevance of the research findings and also the importance of multidisciplinary team support to appropriately manage such complex cases. Evaluations and relevant treatments are described across a 3-month acute care hospitalization, including swallowing and nutritional recommendations at the time of each swallowing evaluation. Discussion Comparisons of polytrauma cases at Walter Reed National Military Medical Center with literature from civilian trauma centers revealed somewhat longer hospitalizations and the particular influence of maxillofacial trauma on dysphagia outcomes. The complex case reported in this article illustrates the importance of multidisciplinary care and coordination, with particular emphasis on the intersecting roles of the SLP and registered dietitian. This report can serve as a guide for SLPs working in trauma settings for developing prognostic statements, treatment plans, and multidisciplinary interaction.


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