scholarly journals Case series on uterine rupture depicting the atypical presentations in the labour room

2021 ◽  
Vol 10 (12) ◽  
pp. 4549
Author(s):  
Srishti Aggarwal ◽  
Monika Jindal ◽  
Santosh Minhas
Keyword(s):  
Uterine Rupture ◽  
Bladder Wall ◽  
Case Series ◽  
Breech Presentation ◽  
Signs And Symptoms ◽  
Lateral Wall ◽  
Maternal Outcome ◽  
Male Fetus ◽  
Labour Room ◽  
Labour Pains

Uterine rupture is the complete division of all the three layers of uterus. Most uterine ruptures occur during labor in pregnant women, most commonly seen in previously scarred myometrium. Consequences of uterine rupture depend on the time between diagnosis of uterine rupture and intervention, and can be as grave as fetal and maternal death. Vigilance and avid action by the obstetrician can lead to better outcomes. Case 1 represented a 28-year-old moderately anemic G4P2L2A1 having previous 2 LSCS at POG 39 weeks 1 day presented in COVID emergency in active labour and was found to have a uterine scar rupture (5 cm rent) extending towards bladder wall with shoulder presenting on rent. A live female baby with thick meconium staining was delivered and uterine repair along with bilateral tubectomy was performed. Case 2 represented a 21-year-old primigravida with breech presentation at a gestation of 34 weeks 6 days with preterm labour pains who had been referred to our centre. Decision for LSCS was taken and on entering the abdomen rupture uterus with an inverted T-shaped rent in the upper segment extending up to the fundus was seen. A stillborn male fetus was delivered through the rent, followed by successful uterine repair. In spite of massive blood loss, the mother had survived. Case 3 represented a 30-year-old grand multipara at a gestation of 38 weeks 3 days with ultrasound documented fetal demise with fetal hydrocephalus and holoprosencephaly with labour pains was taken up for laparotomy due to suspicion of uterine rupture based on examination findings. Intra-operatively, baby was found lying in the peritoneal cavity with an unsalvageable uterus with a rupture in lower uterine segment and left lateral wall extending upto round ligament above and cervix below. A stillborn male fetus was delivered and peripartum subtotal hysterectomy with left salpingoophorectomy and right salpingectomy was done with a good maternal outcome. The above series suggest that the signs and symptoms of uterine rupture are usually variable and nonspecific, hence posing a challenge for the diagnosis. Early diagnosis and timely intervention by the obstetrician, can help us to improve the fetal and maternal outcome drastically.

scholarly journals Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

Exercise-Induced Scalenus Syndrome

2008 ◽  
Vol 36 (2) ◽  
pp. 369-374 ◽  
Author(s):  
Panagiotis Baltopoulos ◽  
Charalampos Tsintzos ◽  
George Prionas ◽  
Maria Tsironi
Keyword(s):  
Quality Of Life ◽  
Thoracic Outlet Syndrome ◽  
Surgical Intervention ◽  
Case Series ◽  
Signs And Symptoms ◽  
Underlying Mechanism ◽  
Level Of Evidence ◽  
Full Activity ◽  
Exercise Induced

Background Thoracic outlet syndrome is described as a group of distinct disorders producing signs and symptoms attributed to compression of nerves and blood vessels in the thoracic outlet region. Purpose To describe the exercise-induced scalenus anticus syndrome attributed to the anterior scalenus hypertrophy as a thoracic outlet syndrome underlying mechanism and to give recommendations for a safe and effective surgical treatment. Study Design Case series; Level of evidence, 4. Methods Twelve young professional athletes admitted for thoracic outlet syndrome (8 cases of neurologic thoracic outlet syndrome, 4 cases of mixed neurologic and vascular thoracic outlet syndrome) who reported numbness, tingling, early fatigue, muscle weakness, and pain were enrolled in the study. Scalenus hypertrophy was suspected to be the causative factor. Scalenectomy was performed in all cases. Results All patients had moderate to severe hypertrophy of the anterior scalenus muscle. Scalenectomy was performed, and there were no intraoperative or postoperative complications. Full activity was quickly achieved, and no recurrence of symptoms was documented. Conclusion Surgical intervention for scalenus anticus syndrome can allow an athlete to return to full activity and improve quality of life. Surgical intervention seems to be the treatment of choice in terms of restoring quality of life and physical activity.

Maternal outcome in obstructed labour in patients presenting to Nishtar Hospital Multan.

2021 ◽  
Vol 28 (03) ◽  
pp. 377-381
Author(s):  
Sadia Zafar ◽  
Nadia Taj ◽  
Rida Iqbal ◽  
Muhammad Sajjad Masood
Keyword(s):  
Vesicovaginal Fistula ◽  
Postpartum Haemorrhage ◽  
Case Series ◽  
Maternal Outcome ◽  
Bladder Rupture ◽  
Age Group ◽  
Maternal Deaths ◽  
Obstructed Labour ◽  
Maternal Morbidity And Mortality ◽  
Labour Ward

Objective: The objective of the study was to determine the frequency of maternal outcome in obstructed labour. Study Design: Descriptive Case Series. Setting: Labour Ward of Nishtar Hospital Multan, Pakistan. Period: 01-11-2018 to 30-04-2019. Material & Methods: Two hundred and forty two clinically diagnosed cases of obstructed labour admitted in labour ward of Nishtar Hospital Multan were enrolled for the study. Patients were monitored till delivery (vaginal/caesarean section) and complication of pregnancy were assessed till six week postpartum. Outcome variables i.e. complications like sepsis, uterine rupture, bladder rupture, vesicovaginal fistula, postpartum haemorrhage, and mortality was noted. Data was analyzed by using SPSS version 10.0. Results: The majority of women was in age group 20-29 years i.e. 42.97% and were primigravida. Sepsis was the most frequent maternal complication observed i.e. in 22.31% of cases. Postpartum haemorrhage was next in line i.e. in 19.42% of cases. Uterine and bladder rupture was a finding in 16.94% and 7.02% of cases respectively. Vesicovaginal fistula was recorded in 12 (4.95%) patients and there were 1 (4.54%) maternal deaths during the study period. Conclusion: Obstructed labour is an important and preventable cause of both maternal morbidity and mortality and needs to be addressed adequately with provision of better antenatal, intrapartum, and postnatal care.

scholarly journals Impact of nerve stimulator-guided obturator nerve block on the short-term outcomes and complications of transurethral resection of bladder tumour: A prospective randomized controlled study

2015 ◽  
Vol 9 (11-12) ◽  
pp. 780 ◽  
Author(s):  
Deniz Bolat ◽  
Ozgu Aydogdu ◽  
Zeki Tuncel Tekgul ◽  
Salih Polat ◽  
Tarik Yonguc ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Bladder Wall ◽  
Lateral Wall ◽  
Adductor Muscle ◽  
Obturator Nerve ◽  
Controlled Study ◽  
Nerve Stimulator ◽  
Short Term ◽  
Randomized Controlled ◽  
Obturator Nerve Block

Introduction: In this prospective randomized controlled study, we investigated the efficacy of obturator nerve block (ONB) on adductor muscle spasm and related short-term outcomes and complications in patients who underwent transurethral resection of lateral wall-located bladder tumours (TURBT).Methods: Between July 2014 and February 2015, 70 patients scheduled to undergo TUR of lateral bladder wall tumours were enrolled in the study. All patients were preoperatively evaluated by cystoscopy and imaging tools and selected according to localized tumours on the lateral bladder wall. Patients were randomly allocated to Group SA (35 patients who underwent only spinal anesthesia) and Group ONB (35 patients who underwent spinal anesthesia combined with ONB by the nerve stimulator). An independent observer, blinded to the approach, evaluated the obturator signs, including adductor muscle contraction, bladder perforation, and completeness of the resection during the TURBT procedure.Results: The differences between groups regarding mean operation time, tumour size, and number were not statistically significant (p > 0.05). Adductor muscle contraction was detected in 40% of patients in Group SA and 11.4% in Group ONB. This difference was statistically significant (p = 0.021). Complete bladder perforation was detected in 2 patients in Group SA, whereas no perforation was observed in Group ONB. There was no case of severe bleeding in both groups. Conclusions: We found that ONB performed after spinal anesthesia was effective in preventing intraoperative complications due to adductor muscle spasm while performing TURBT. Our study limitations include its small sample size, since we only enrolled patients with primary lateral wall-localized bladder tumo

scholarly journals Extraoral Sinus Tracts of Odontogenic Origin: A Case Series

2020 ◽  
Author(s):  
Ellahe Azizlou ◽  
Mohsen AminSobhani ◽  
Sholeh Ghabraei ◽  
Mehrfam Khoshkhounejad ◽  
Abdollah Ghorbanzadeh ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Cutaneous Lesions ◽  
Odontogenic Origin ◽  
The Face ◽  
History Of ◽  
Relationship Of ◽  
Dental Infections

Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.

scholarly journals P154 DOES A PENO-SCROTAL APPROACH FOR PENILE PROSTHESIS IMPLANTATION INCREASE THE INCIDENCE OF INGUINAL HERNIAS POSTOPERATIVELY?

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Shadi Al-Bahri ◽  
Hazem Taifour
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Case Series ◽  
Penile Prosthesis ◽  
Signs And Symptoms ◽  
General Surgeon ◽  
Direct Inguinal Hernia ◽  
Prosthesis Implantation ◽  
Radiologic Imaging ◽  
History Of

Abstract Aim The incidence of direct inguinal hernia and reservoir migration post-penile prosthesis implantation is extremely rare. We present a case series of patients presenting with direct inguinal hernia following three-piece penile prosthesis implantation. Material and Methods Three patients presented with direct inguinal hernia shortly following penile prosthesis implantation for treatment of refractory erectile dysfunction due to venous leak that was confirmed on ultrasound imaging. All patients underwent standard open Lichtenstein tension free repair. Results All patients underwent penile prosthesis Implantation through a peno-scrotal approach in which the reservoir was placed in the space of Retzius. The first patient had reservoir displacement one day post-operatively presenting as an inguinal bulge and discomfort, and repaired the same day. The other two patients presented with symptoms of inguinal swelling and pain at 40 days and 8 months respectively. None of our patients had signs and symptoms of intestinal obstruction. Identifiable risk factors included high BMI and a history of smoking, however dissection and placement of the reservoir may play a role in weakening the floor of the inguinal canal. Conclusions Despite the rare incidence of inguinal hernia post-penile prosthesis implantation, identification of patients with risk factors for inguinal hernia development should be done preoperatively. This may be evaluated through preoperative radiologic imaging with an abdominal wall ultrasound or clinical examination by a general surgeon.

scholarly journals Traumatic bone cyst of mandible: a case series

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Farnoosh Razmara ◽  
Zahra Ghoncheh ◽  
Ghazal Shabankare
Keyword(s):  
Bone Cyst ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
History Of ◽  
Mandibular Region ◽  
Clinical Signs And Symptoms ◽  
Anterior Mandible

Abstract Background A traumatic bone cyst is an uncommon nonneoplastic lesion of the jaws that is considered as a “pseudocyst” because of the lack of an epithelial lining. This lesion is particularly asymptomatic and therefore is diagnosed by routine dental radiographic examination as a unilocular radiolucency with scalloped borders, mainly in the posterior mandibular region. The exact etiopathogenesis of the lesion remains uncertain, though it is often associated with trauma. Case presentation We report three Persian cases of traumatic bone cyst with different clinical and radiographic features, and we present a review of the literature to further discuss diagnostic and treatment challenges. Only one of the three patients reported a history of trauma, and despite the usual signs and symptoms of the lesion, extension of the defect to the ramus, swelling of the lingual cortex, and their unusual presence in the anterior mandible were noted in these patients. Conclusions Because features of this cyst can be varied, careful history taking and radiographic evaluation alongside the clinical signs and symptoms have a very significant role in definitive diagnosis, appropriate treatment, and accurate assessment of prognosis.

Mycobacterial Infections of the Hand

Hand ◽  
2020 ◽  
pp. 155894472094006
Author(s):  
Vivek K. Bilolikar ◽  
Asif M. Ilyas
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Signs And Symptoms ◽  
Joint Space ◽  
Cutaneous Infections ◽  
Mycobacterial Infections ◽  
Resistant Tuberculosis ◽  
Resistance Patterns ◽  
New Diagnosis ◽  
Resistance Rates

Background Hand infections caused by mycobacteria are relatively uncommon compared to infections caused by other pathogens; therefore, much of the available literature consists of case reports and limited case series. Broadly categorized into tuberculous and nontuberculous mycobacterial (NTM) infections, both tuberculous and NTM infections are typically insidious with long incubation periods and with the ability to remain dormant for prolonged periods. Methods We reviewed the most current literature on the epidemiology, presentations, treatment methods, and resistance patterns of mycobacterial infections of the hand focusing on the indications and outcomes of nonoperative as well as operative interventions. Results The worldwide burden of tuberculosis remains high and while the overall rate of new diagnosis drug resistant tuberculosis has been on the decline some regions of the world have demonstrated staggeringly high resistance rates to first-line tuberculosis therapies. Signs and symptoms of mycobacterial hand infection are typically inconsistent, and highly dependent on the specific structures of the hand that are affected; therefore, these infections may mimic other infections of the hand like tenosynovitis, joint space infections, and cutaneous infections. The main stay of treatment remains antimycobacterial therapies including but not limited to rifampin, isoniazid, pyrazinamide, and ethambutol. Conclusions The complications associated with mycobacterial hand infections can be significant. Prompt evaluation, including a thorough history to evaluate for potential exposures to infectious sources, followed by appropriate antibiotic choice and duration, with surgical management as needed, is key to reducing the chance that patients experience lasting effects of the infection.

scholarly journals Maternal outcome after complete uterine rupture

2019 ◽  
Vol 98 (8) ◽  
pp. 1024-1031 ◽  
Author(s):  
Iqbal Al‐Zirqi ◽  
Anne Kjersti Daltveit ◽  
Siri Vangen
Keyword(s):  
Uterine Rupture ◽  
Maternal Outcome

scholarly journals Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series

2020 ◽  
Vol 5 (4) ◽  
pp. 247301142095379
Author(s):  
Jay M. Levin ◽  
James K. DeOrio
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Lateral Wall ◽  
Patient Characteristics ◽  
Calcaneal Fracture ◽  
Lateral Approach ◽  
Emergency Department Visits ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Calcaneal Osteotomy

Background: Calcaneofibular impingement is characterized by lateral hindfoot pain and is commonly resulting from calcaneal fracture malunion or severe flatfoot deformity. Lateral calcaneal wall decompression has been used successfully to relieve pain in patients who have calcaneofibular impingement. However, in cases of severe impingement and hindfoot valgus, lateral wall excision may leave only a small remnant of calcaneal bone for weightbearing and can lead to chronic heel pain. We describe a surgical technique using a medial displacement calcaneal osteotomy (MDCO) combined with a lateral wall exostectomy and report on the outcomes from our series of patients. Methods: Retrospective study of a single surgeon’s patients was done from 2010 to 2020 who underwent medial slide calcaneal osteotomy and lateral wall exostectomy for calcaneofibular impingement. Descriptive statistics were used to summarize patient characteristics. Our study included 9 patients, 6 females and 3 males, with a mean age of 59 years (range: 19-77) and a mean follow-up of 62 weeks (range: 6-184). Results: Five had an Achilles split approach, 2 had an oblique lateral approach, and 1 had an extensile lateral approach. Patients achieved radiographic relief of impingement and improvement in pain. Minor skin and soft tissue complications occurred in 3 patients, all of which were associated with laterally based incisions, and all resolved after a 10-day course of oral antibiotics. No major complications, emergency department visits, or readmissions occurred. Conclusions: MDCO and lateral wall exostectomy was a safe and effective treatment for severe calcaneofibular impingement. Level of Evidence: Level IV, retrospective case series.

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