scholarly journals Surgical Treatment of Patient with Ruptured Dissection of the Thoracic Aorta – Stanford A, De Bakey I – Case Report of the Patient Surgically Treated at UC of State Cardiosurgery – Skopje

2016 ◽  
Vol 70 (3) ◽  
pp. 163-167
Author(s):  
Sashko Jovev ◽  
Aleksandar Kolev ◽  
Suzana Dameska ◽  
Nadica Mehmedovikj ◽  
Omer Dzemali ◽  
...  

Abstract Introduction. A 59-year-old male patient with dissection of the thoracic aorta, DeBakey I, Stanford A is presented in this case study. We present his symptoms, his preoperative condition, diagnostic procedures, the surgical procedure and his postoperative treatment at the UC of State Cardiosurgery-Skopje. Case report. The surgery was performed two days after establishment of the diagnosis and more than 3 days (72 hours) after the symptoms occured, due to absence of patient’s consent for the surgery. This resulted in more difficult preoperative condition of the patient, surgical procedure harder to perform, and reduced survival expectations. Preoperative risk of predicted mortality from the cardiovascular surgery calculated according to EUROSCORE was 28.6%. Results. In this case study we also present classification, etiology, pathophysiology, and some statistics about the incidence of thoracic aorta dissection and survival rates emphasizing the increased mortality rate in delayed surgical interventions.

2021 ◽  
Vol 30 (6) ◽  
pp. 465-468
Author(s):  
Reza Kachuei ◽  
Hamid Badali ◽  
Afsane Vaezi ◽  
Nematollah Jonaidi Jafari ◽  
Kazem Ahmadikia ◽  
...  

This case report describes the progressive wound infection in the left thigh of a 34-year-old man due to an old landmine explosion. The infection developed into rapidly spreading skin and soft tissue necrotising Saksenaea infection, despite antifungal therapy and surgical debridement. The report provides evidence that Saksenaea spp. should be added to the list of mucoralean fungi that can cause severe necrotising infection. It also highlights the need for improved early diagnostic procedures and enhanced understanding of Saksenaea virulence factors that contribute to necrotising infection.


2021 ◽  
Vol 11 (1) ◽  
pp. 23-25
Author(s):  
Fathimath Fairooz ◽  
Yaafiya Saleem ◽  
Md Ashif Iqbal

Introduction: Gingival cyst also known as Dental Lamina cyst. They form small nodules or cysts on the alveolar ridge, each up to 2 mm in diameter. They are considered to be due to proliferation of the epithelial rests of Serres but can arise on the lateral aspects of the ridge and the crest. They are considered to be benign lesions which usually are present on the alveolar ridge and are often mistaken as neonatal tooth. Objective: The aim of this case report is to enlist and describe the diagnostic features and management of the gingival cyst of newborn, as these kind of lesions can cause anxiety and fear among the parents. It is important to diagnose these conditions in order to prevent unnecessary surgical interventions and provide adequate care and proper knowledge to the parents. Method: This is a case study of asymptomatic gingival cyst which was present in a newborn at the time of birth on the lower alveolar ridge. Diagnosis of this keratin filled small cystic lesion was made on the basis of clinical history and oral findings. Conclusion: Gingival cyst of infants are transient lesions. No definitive treatment was given but the patient was kept on follow-up for 3 months during which the lesion regressed by itself. Update Dent. Coll. j: 2021; 11 (1): 23-25


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.


2011 ◽  
Vol 21 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Farzan Irani ◽  
Rodney Gabel

This case report describes the positive outcome of a therapeutic intervention that integrated an intensive, residential component with follow-up telepractice for a 21 year old male who stutters. This therapy utilized an eclectic approach to intensive therapy in conjunction with a 12-month follow-up via video telepractice. The results indicated that the client benefited from the program as demonstrated by a reduction in percent stuttered syllables, a reduction in stuttering severity, and a change in attitudes and feelings related to stuttering and speaking.


2019 ◽  
Vol 98 (6) ◽  
pp. 256-259

Introduction: This case report describes bleeding from an iatrogenic thoracic aortic injury in minimally invasive thoracoscopic esophagectomy. Case report: A 53-year-old man underwent neoadjuvant radiochemotherapy for adenocarcinoma of the esophagus with positive lymph nodes. PET/CT showed only a partial response after neoadjuvant therapy. Minimally invasive thoracoscopic esophagectomy in the semi-prone position with selective intuba- tion of the left lung was performed. However, massive bleeding from the thoracic aorta during separation of the tumor resulted in conversion from minimally invasive to conventional right thoracotomy. The bleeding was caused by a five millimeter rupture of the thoracic aorta. The thoracic aortic rupture was treated by suture with a gore prosthesis in collaboration with a vascular surgeon. Esophagestomy was not completed due to hypovolemic shock. Hybrid transhiatal esophagectomy was performed on the seventh day after the primary operation. Definitive histological examination showed T3N3M0 adenocarcinoma. Conclusion: Esophagectomy for cancer of the esophagus is one of the most difficult operations in general surgery in which surgical bleeding from the surrounding structures cannot be excluded. Aortic hemorrhage is hemodynamically significant in all cases and requires urgent surgical treatment.


2014 ◽  
Vol 68 (2) ◽  
pp. 104-106
Author(s):  
Aleksandra Pivkova Veljanovska ◽  
Sonja Genadieva Stavrik ◽  
Zlate Stojanoski ◽  
Lazar Cadievski ◽  
Adela Stefanija ◽  
...  

Abstract The article presents a case with diagnosed Hodgkin disease (HD) during pregnancy. The aim of this case study was to present diagnostic possibilities in determining HD stage during pregnancy and therapeutic dilemmas. The incidence of HD during pregnancy is 3.2% of all cases with this malignant hematological disorder. The treatment of this disease during pregnancy depends on disease-related factors, pregnancy-related factors, as well as possible implications for fetal morbidity and mortality. The need of analysis of the nature of the disease during pregnancy indicates examination of a larger series of pregnant women with HD and the drawn conclusions affect the decision whether chemotherapy treatment should start immediately or it should be postponed for after delivery.


2018 ◽  
Vol 69 (7) ◽  
pp. 1830-1837
Author(s):  
Cristian Nicolescu ◽  
Alaxendru Pop ◽  
Alin Mihu ◽  
Luminita Pilat ◽  
Ovidiu Bedreag ◽  
...  

This article presents an observational randomized prospective study done on 65 patients, who underwent major surgical interventions in the field of orthopedic surgery-total hip replacement or general surgery � total colectomy. The level of albuminemia in these cases were determined before the surgical intervention, after 6 hours of the intervention and after 24 h of the intervention. The measurements of the plasmatic concentration of the pro-inflammatory cytokines Tumor Necrosis factor -alpha (TNF-alpha) and interleukin 6 (IL6) were simultaneously done with the determination of the plasmatic levels of albumin. Values of hemoglobin and hematocrit were determined 24 h after the surgical procedure in order to exclude hemodilution, which could lead to a possible drop in the levels of plasmatic albumin. After the collection of the data, the statistical work was done and it consisted of descriptive statistics, correlation and comparison tests as well as statistical validation tests. Obtained results indicate that IL-6 plays a major role comparatively with that of TNF-alfa, regarding the decrease of the plasmatic level of albumin, and due to this, the primordial cause for hypoalbuminemia is an acute hepatic phase reaction. Supplemental permeability of the capillary wall under the action of TNF alpha has a secondary role, but could lead to a faster decrease in plasmatic albumin in the first hours after the surgical procedure.


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.


2021 ◽  
Vol 10 (3) ◽  
pp. 395
Author(s):  
Justyna Rymarowicz ◽  
Michał Pędziwiatr ◽  
Piotr Major ◽  
Bryan Donohue ◽  
Karol Ciszek ◽  
...  

The Coronavirus Disease 2019 (COVID-19) pandemic has made changes to the traditional way of performing surgical consultations. The aim of the present study was to assess the need for surgical care performed by various surgical specialties among patients infected with COVID-19 hospitalized in a COVID-19 dedicated hospital. All surgical consultations performed for patients infected with COVID-19 in a COVID dedicated hospital in a seven month period were evaluated. Data on demographics, surgical specialty, consult reason, procedure performed, and whether it was a standard face to face or teleconsultation were gathered. Out of 2359 COVID-19 patients admitted to the hospital in the seven month period, 229 (9.7%) required surgical care. Out of those 108 consultations that did not lead to surgery, 71% were managed by telemedicine. A total of 36 patients were operated on while suffering from COVID-19. Out of them, only three patients admitted primarily for COVID-19 pneumonia underwent emergency surgery. The overall mortality among those operated on was 16.7%. Conclusions: Patients hospitalised with COVID-19 may require surgical care from various surgical specialties, especially during peaks of the pandemic. However, they rarely require a surgical procedure and only occasionally require major surgery. A significant portion of potentially surgical problems could be managed by teleconsultations.


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