scholarly journals Car Accident Due to Horse Crossing the Motorway: Two Case Reports

2018 ◽  
Vol 23 (1) ◽  
pp. 73-76 ◽  
Author(s):  
Serbülent Kılıç ◽  
Gürol Cantürk

Basic Commercial Court in Ankara wanted a report from our department of forensic medicine about two injury cases due to animal vehicle collision. The reports should include the disability rate and the duration of unfunctionality. After the examination we prepared the reports. Both vehicle collisions happened due to free ranging horse crossing the motorway. Both cases had different types of injury due to trauma. Vehicle collision due to horse crossing the motorway is rarely met in Turkey. Our first case is a man that had upper extremity and facial injury. He uses prothesis due to ear amputation. He has a scar tissue on the right side of his face and left forearm. The other case is three-years-old boy that had cranial bone fracture and cranial hematoma. He has also hemiparesis of the right side of body. Both cases have neurologic sequels but they have no psychiatric sequels.  In literature, animal vehicle collisions involve lots of animal species such as kangaroo, deer, camel and moose. Animal vehicle collision involving the horses is rarely met. Forensic medicine specialists should state the causal link between traumatic events and disabilities in order to help justice. Our aim to present the current two cases is investigation of injuries of animal related collision and makes forensic medicine specialists pay attention to the subject of preparing reports about such cases. Key words: Animal vehicle collision; death; disability; horse; injury; motorway.  

2019 ◽  
Vol 11 (3) ◽  
pp. 89-93
Author(s):  
Yohanes Widjaja ◽  
Khairuddin Djawad ◽  
Saffruddin Amin ◽  
Widyawati Djamaluddin ◽  
Dirmawati Kadir ◽  
...  

Abstract Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.


2020 ◽  
Author(s):  
Hui Li ◽  
Yu Zhao ◽  
Yan-an Xu ◽  
Tao Li ◽  
Jun Yang ◽  
...  

Abstract Background Blunt celiac artery injury is extremely rare, but it is easy to ignore. The clinical manifestation of celiac artery injuries is usually atypical, so it is easy to fail to diagnose them. Case presentation: We report two cases of celiac artery occlusion after multiple trauma admitted, its mechanisms were motor vehicle collision and fall from height, respectively. The first patient was combined with severe liver injury, and the right hepatic arterial was embolized with coil assisted by the operation through the superior mesenteric artery. Both patients were managed with non-operation treatment, and no complications occurred during hospitalization. Conclusions For patients with celiac artery injury, conservative treatment is an important choice, but successful treatment still needs to be individualized based on the patient's condition.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Sandrine Malochet Guinamand

Atypical femoral fractures as defined by the American Society for Bone and Mineral Research (ASBMR) are linked with long-term bisphosphonate therapy. We report the cases of 3 patients treated with bisphosphonates, and presenting non femoral atypical fracture. Our first patient presented with a series of fractures after being treated with risedronate: the left tibia, bilateral tibial plateau successively, the left femoral and tibial metaphysis, the right tibia and calcaneus, the left talus, and the left talar dome. The second patient had been taking alendronate and presented with a spontaneous fracture of the spine of the left scapula. The third patient had been treated with alendronate and presented with a fracture of the upper right tibial diaphysis with an unusual oblique orientation. These fractures could be suggestive of bisphosphonate therapy failure or stress fractures. However, the number of fractures in our first case, the fracture site in the second and the fracture line orientation in the third brings to mind the hypothesis of atypical non femoral fractures associated with bisphosphonate therapy. We therefore suggest the possibility of a new type of atypical fracture in patients treated with bisphosphonates, and whose causal relationship with bisphosphonates is even more difficult to demonstrate.


2021 ◽  
Vol 32 (6) ◽  
pp. 115-123
Author(s):  
Wesley Fernandes Gonçalves ◽  
Lucas da Fonseca Roberti Garcia ◽  
Daniela Peressoni Vieira-Schuldt ◽  
Eduardo Antunes Bortoluzzi ◽  
Luiz Carlos de Lima Dias-Júnior ◽  
...  

Abstract This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.


Author(s):  
Ali Kerro ◽  
Reza Bavarsad Shahripour

Introduction : Double hearing or Diplacusis is a synchronous double perception of a sound and can have Binauralis or Monauralis pattern, with inner ear disorders being the main culprit [1] . Other forms of Auditory illusions have been reported as a co‐manifestation of stroke syndromes, but none as an isolated presentation [1][2] . This is a case of a 77‐year‐old male with acute onset isolated Diplacusis in a patient due to a right temporal lobe ischemic infarct. To our knowledge, this is the first case report of an isolated diplacusis due to cortical infarct. Methods : A case presentation with Pubmed search of review articles and case reports. Results : The patient had a past medical history of sensorineural deafness in his left ear. He described any sound heard as the same quality but occurring with an echo heard a fraction of a second later in his right ear. There was no decreased hearing quality or tinnitus reported in his right ear. His drug screen test was negative. His examination was only remarkable for a sensorineural hearing loss pattern on his left ear. His (NIHSS) was zero, and no other cranial nerve abnormalities were detected. His MRI was significant for a punctate restricted diffusion on the right temporal lobe, resembling an ischemic infarct (Figure). Conclusions : Isolated diplacusis can present as acute ischemic stroke in the temporal lobe. Further studies are needed to understand its pathophysiology.


2020 ◽  
Vol 10 ◽  
Author(s):  
Matthew D. Tucker ◽  
Kathryn E. Beckermann ◽  
Jennifer B. Gordetsky ◽  
Giovanna A. Giannico ◽  
Nancy B. Davis ◽  
...  

Immunotherapy-based combinations have become standard of care in advanced renal cell carcinoma (RCC). Despite the potential for complete radiographic response, complete pathologic responses have been rarely reported. We present two cases of confirmed complete pathologic response to immunotherapy despite residual radiographic abnormalities. The first case describes a 68-year-old female with metastatic RCC who was treated with upfront pembrolizumab plus axitinib. She underwent nephrectomy after 15 doses of pembrolizumab with pathology revealing no evidence of viable tumor. To our knowledge, this is the first reported case of a complete pathologic response with pembrolizumab in metastatic RCC. The second case describes a 64-year-old female with metastatic RCC who was treated with second-line nivolumab after progression on cabozantinib. After 13 doses of nivolumab, she underwent nephrectomy with pathology revealing no evidence of viable tumor. These cases highlight the potential for scar tissue, fibrosis, and necrosis to persist radiographically after treatment with immunotherapy despite the absence of viable tumor cells.


2016 ◽  
Vol 9 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Nataliya Guramovna Zumbulidze ◽  
Dmitry A Yarovoy ◽  
Elena P Gavrilova ◽  
Farhod O Kasymov

Since 1990s, the prevalence increase of dirofilariasis with local transmission of infection in a zone of a temperate climate is observed. Сases of Dirofilaria repens infection in humans were registered in 42 territorial entities of the Russian Federation. Two male patients: P., 66 years old, and F., 64 years old, both Leningrad region residents, requested medical assistance at the St. Petersburg Municipal Clinical Hospital No 2 for a feeling of moving foreign body under the conjunctiva of the right eye, local hyperemia and edema of inferior and superior eyelids. Through a conjunctival incision, a threadlike white object was removed in each of the two cases (11.7 cm long, and 0.6 mm thick in the first case, and 13.5 cm long, 0.6 mm thick in the second case). The parasite was identified as impuberal female Dirofilaria repens in both cases.


2019 ◽  
Vol 32 (01) ◽  
pp. 036-042
Author(s):  
Amulya Ratna Sahoo ◽  
Akshaya Kumar Hati ◽  
Chintamani Nayak ◽  
Chaturbhuja Nayak

Introduction Urolithiasis is a very common disease. Stones in any part of the urinary tract can produce symptoms and complication, but because the lower part of the ureter is the narrowest part of the urinary tract, stones get lodged easily producing pain and haematuria commonly. If we keep in mind the limitation and complication of the surgical procedure, homoeopathy can provide a real solution for such conditions. There are several ways of homeopathic prescription, such as based on keynotes, general symptoms, constitution, miasm, etc. Two cases of ureteric calculi are presented here, who were prescribed on the basis of constitutional symptoms and got good results. Case Profile In the first case, the only symptom was pain in the right flank, and as per ultrasonography (USG) report, there was 7.4 mm calculus in the lower part of the right ureter. In the second case, there were symptoms like pain in the left flank, burning urination and haematuria. The USG report confirmed 6 mm stone in the left ureterovesical junction (UVJ). After detailed case taking, both the cases were prescribed on the basis of constitutional symptoms. Lycopodium in 50 millesimal potencies (0/1–0/4) in the first case and Phosphorus in centesimal potency (1M) in the second case provided prompt relief of the symptoms within a short period. USG reports of both the cases also confirmed no stones after approximately 2 months of treatment. Conclusion Homeopathy provided good relief in two cases of ureteric calculi; constitutional medicines were found useful in combating acute ureteric colic and facilitating expulsion of stones. Because the constitutional symptoms matched, the polychrest homoeopathic medicines like Lycopodium and Phosphorus produced their best effect. But the inferences drawn from the two case reports may not be sufficient to reach a definitive conclusion. So clinical trials to establish the efficacy of constitutional remedies in the treatment of ureteric calculi are suggested.


2012 ◽  
Vol 28 (5) ◽  
pp. 208-210 ◽  
Author(s):  
Thomas G Wadsworth ◽  
Jo Kiester ◽  
E Gregory Thompson

Objective: To report a case of metformin-associated exacerbation of chronic pancreatitis and examine this possible drug-disease interaction. Case Summary: A 59-year-old woman with chronic pancreatitis (CP) experienced a severe exacerbation of her characteristic chronic abdominal pain 3 weeks after initiation and titration of metformin therapy; the exacerbation resolved upon discontinuation of metformin. The patient presented to the emergency department experiencing nausea and severe right upper quadrant abdominal pain with radiation to the right flank. Persistent abdominal pain, which had been a primary feature of CP, was previously mild and easily controlled with oral analgesics. Laboratory studies ruled out acute pancreatitis and were significant only for elevated glucose (168 mg/dL). Subsequently, she was given intravenous pain and nausea medications and discharged to home. The pain and nausea shortly returned and continued for 3 more days, at which point she telephoned her gastroenterologist, who advised that she discontinue metformin because of possible adverse reaction. Within a few days of discontinuing metformin, the nausea resolved and abdominal pain gradually returned to baseline level. Discussion: Metformin is not generally known to cause or exacerbate pancreatitis, although cases of acute pancreatitis associated with metformin therapy have been reported in the literature. No cases involving chronic pancreatitis have been reported. Consequently, metformin's prescribing guidelines do not contain precautions or contraindications for patients with chronic pancreatitis. Use of the Naranjo probability scale for assessment of this case revealed that the adverse drug effect was possible, reflecting the symptomatic resolution upon discontinuation while accounting for the lack of causative certainty, previous conclusive case reports, as well as the presence of possible nondrug causes. Conclusions: To our knowledge, this is the first case describing metformin-associated exacerbation of chronic pancreatitis. Although this occurrence may be rare, cautionary consideration, education, and monitoring should accompany initiation of metformin therapy in select patients with chronic pancreatitis.


2009 ◽  
Vol 33 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Jan H. B. Geertzen ◽  
Paul Jutte ◽  
Christiaan Rompen ◽  
Merse Salvans

A limb amputation is a traumatic experience for the amputee but it is also a challenge for the recipient to get used to a new situation and reach her/his greatest level of independence. Two patients are presented who had undergone a total calcanectomy. In the first case, a woman with spina bifida aperta L4-L5, calcanectomy was performed to excise a non-healing ulcer and osteomyelitis of the right heel. In the second case, a woman of 72 years of age, calcanectomy was the treatment of the isolated central chondrosarcoma. Both patients were somewhat disabled prior to calcanectomy, one because of spina bifida aperta and the other because of her age. After calcanectomy both patients were able to remain independent for several years. Calcanectomy is an uncommon amputation that may provide better quality of life than other more proximal amputations such as Syme or transtibial amputation. Furthermore more proximal levels of amputation are associated with increased mortality and morbidity. When indicated, calcanectomy should be considered as an alternative type of amputation which provides an effective chance to maintain the patient's independency.


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