scholarly journals A rare case of bilateral adrenal pheochromocytoma with unusual presentation: the case report

2020 ◽  
Vol 7 (6) ◽  
pp. 2039
Author(s):  
Nirmal Kumar Madesan ◽  
Vinay Kumar J. Rajendra

Here we report a 25 years old male patient came to our emergency department with chief complaints of headache from 3 months, blurring of vision 7 days, abdominal pain 7 days, and vomiting from 2 days. Young male, with no known comorbidities, presented to our casualty with headache since, 3 months, episodic in nature, increased over the last 1 week, holocranial, gradually progressive in severity. last recorded Blood pressure outside was 220/120 mmHg and papilledema were noted on fundoscopy. USG abdomen and pelvis, CECT abdomen done and diagnosed to have bilateral adrenal pheochromocytoma. Patient underwent bilateral adrenalectomy was performed with good intra op BP control. Right adrenals were enlarged and shows multiple nodular lesions, left adrenal noted shows nodular lesions. Surgery remains the first line of management in malignant pheochromocytoma. Norepinephrine, epinephrine, and dopamine all act on their target receptors, which causes a physiological change in the body. Increase in catecholamines cause severe hypertension and multiple systemic complications like (cardiovascular, cerebrovascular events) and can lead to death if untreated.

Author(s):  
Varsha Gupta ◽  
Lipika Singhal ◽  
Kritika Pal ◽  
Mani Bhushan ◽  
Rajeev Sharma ◽  
...  

Introduction: Human Salmonella infections have been classically distinguised into diseases caused by typhoidal and non-typhoidal salmonella (NTS). Typhiodal salmonella includes S. enterica serovars Typhi and Paratyphi that cause the systemic disease but are restricted to human infections, while NTS consists mainly of other serovars that predominantly cause self-limiting gastroenteritis in humans. Localisation of foci with persisting infection occurs due to dissemination of the bacteria throughout the body and can cause a variety of rare clinical syndromes at aberrant sites. Fournier’s gangrene, a rapidly progressive, often fatal, necrotizing fasciitis of the external genitalia and perineum due to Salmonella Typhimurium, is a rare manifestation and has never been reported. Case: A 22-year-old male, apparently healthy patient with no relevant past medical history presented to surgical emergency with chief complaints of swelling of bilateral scrotal area. Infective etiology was considered and a diagnosis of fournier’s gangrene was made. Pure growth of Salmonella Typhimurium was obtained after repeated subculture and was identified biochemically and on serotyping, as Salmonella enterica serotype Typhimurium using specific antisera. Conclusion: In our case report, we describe a case of fournier’s gangrene due to Salmonella Typhimurium in an otherwise healthy male to highlight the unusual presentation of Non typhoidal salmonellae at an aberrant site. We also emphasize the importance of using selective media like Selenite F broth for isolation of Salmonella Typhimurium from a pus sample.


2021 ◽  
pp. 251660852098428
Author(s):  
Vikas Bhatia ◽  
Chirag Jain ◽  
Sucharita Ray ◽  
jay Kumar

Objective: To report a case of young male with stroke and bilateral internal carotid artery (ICA) dissection. Background: Cervical Artery Dissection in Stroke Study trial has provided some insight on management of patients with ICA dissection. However, there is a need to modify the management strategies as per specific clinical scenario. Design/Methods: Case report and literature review. Results: A 45-year-old male presented with 1 month old history of acute onset numbness of right half of the body with slurring of speech. Computed tomography angiography showed complete occlusion of left cervical ICA just beyond origin with presence of fusiform dilatation and spiral flap in right extracranial cervical ICA. The patient was started on antiplatelets and taken for endovascular procedure using 2-mesh-based carotid stents. Patient was discharged after 3 days on antiplatelet therapy. At 1-year follow-up, there were no fresh symptoms. Conclusion: This case emphasizes the role of successful endovascular management of carotid dissection in a young male. These clinical situations may not be fully represented in trials, and a case-based approach is required.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takeshi Yamaguchi ◽  
Kei Shibata ◽  
Hiromi Wada ◽  
Hiroshi Kakehi ◽  
Kazuo Hokkirigawa

AbstractHerein, we investigated the effect of friction between foot sole and floor on the external forward moment about the body center of mass (COM) in normal and shuffling gaits. Five young male adults walked with normal and shuffling gaits, under low- and high-friction surface conditions. The maximum external forward moment about the COM (MEFM-COM) in a normal gait appeared approximately at initial foot contact and was unaffected by floor condition. However, MEFM-COM in a shuffling gait under high-friction conditions exceeded that under low-friction conditions (p < 0.001). Therein, MEFM-COM increased with an increasing utilized coefficient of friction at initial foot contact; this effect was weaker during a normal gait. These findings indicate that increased friction between foot sole and floor might increase tripping risk during a shuffling gait, even in the absence of discrete physical obstacles.


Development ◽  
1962 ◽  
Vol 10 (4) ◽  
pp. 530-562
Author(s):  
M. Enesco ◽  
C. P. Leblond

While the organs and tissues of the young rat are known to increase in size with age (Donaldson, 1924), little is known of the role played by the component cells in this increase. There is evidence that cells enlarge (Levi, 1906; Plenk, 1911) and new cells are added (Strasburger, 1893), but we do not know to what extent the enlargement and proliferation of the cells cause the growth of organs and tissues. The present work is an attempt to clarify this problem. In the past, the growth of organs and tissues has often been measured by weight gain (Donaldson, 1924). However, this approach might be misleading, since the body-weight may increase in the absence of growth, for instance as a result of fat-storage in old rats, of pregnancy in females, and even of changes in room temperature.


Author(s):  
Singh Binod Kumar ◽  
Bharkher D.L

The problem of ageing is experienced by all the countries. According to World Health statistics the life expectancy of Nepalese people has risen from 58.91 years to 67.86 years (1996 to 2015). Ageing is emerging issue in Nepal as well as global. Its tempo is expected to be unexpectedly fast as mortality continues to decline and life expectancy continues to increase. Ayurveda the science of life has observed ageing as a Jara avastha, which is a later phase of life, it is natural, inevitable phenomenon, in which maximum decline of bodily elements that may become as major cause of disability and functional dependency requiring services that affect many sectors of economy, health, security, income, housing, transportation etc. Jara chikitsa has been mentioned as one independent Anga in Ashtanga Ayurveda where Rasayana therapy is capable to impede the ageing process and to delay the degenerative process in the body. In this study we measured the effectiveness of Ashwagandha rasayana and Matra basti and compared with the Ashwagandha Rasayan only in Jara avastha. A total of thirty elderly patients were selected and divided in two groups A and B, given them either Ashwagandha Rasayana with Matra basti or Ashwagandha rasayana in prescribed doses for 45 days. Changes in the subjective complaints, objective parameters of the patients and appearance of adverse events were also evaluated. Both the groups provided better results on the chief complaints But, comparison in between both the groups is insignificant, that may be due to small sample size.


2020 ◽  
Author(s):  
Xiao-Ting Zhang ◽  
Yong-Yao Yu ◽  
Hao-Yue Xu ◽  
Zhen-Yu Huang ◽  
Xia Liu ◽  
...  

AbstractThe skin of vertebrates is the outermost organ of the body and serves as the first line of defense against external aggressions. In contrast to mammalian skin, that of teleost fish lacks keratinization and has evolved to operate as a mucosal surface containing a skin-associated lymphoid tissue (SALT). Thus far, IgT representing the prevalent immunoglobulin (Ig) in SALT have only been reported upon infection with a parasite. However, very little is known about the types of B cells and Igs responding to bacterial infection in the teleost skin mucosa, as well as the inductive or effector role of the SALT in such responses. To address these questions, here we analyzed the immune response of trout skin upon infection with one of the most widespread fish skin bacterial pathogens, Flavobacterium columnare. This pathogen induced strong skin innate immune and inflammatory responses at the initial phases of infection. More critically, we found that the skin mucus of fish having survived the infection contained significant IgT-but not IgM- or IgD-specific titers against the bacteria. Moreover, we demonstrate the local proliferation and production of IgT+ B-cells and specific IgT titers respectively within the SALT upon bacterial infection. Thus, our findings represent the first demonstration that IgT is the main Ig isotype induced by the skin mucosa upon bacterial infection, and that because of the large surface of the skin, its SALT probably represents a prominent IgT inductive site in fish.


2021 ◽  
Vol 9 (11) ◽  
pp. 2870-2876
Author(s):  
Samata Samata ◽  
Shaila Borannavar ◽  
Ananta S Desai

Alcoholic liver disease is a pathological condition of the liver parenchymal tissue due to excessive consumption of alcohol over a long period of 6-10 years or even earlier. Here in we present a case of a married male of 35 yr. old reported in the Panchakarma OPD of SJIIM Government Ayurveda Medical College Bengaluru on 30th -Jan- 2021, with chief complaints of swelling in the bilateral lower limbs, deep yellowish and burning micturition, yel- lowish discoloration of sclera, reduced appetite, nausea and generalized weakness in the body since 3 months, with the increased level of LFT and USG-abdomen report suggesting hepatomegaly with fatty changes, was ex- amined and diagnosed as alcoholic liver disease and treated with Amapachana with Trikatu Churna, Nitya Virechana with Chitraka Haritaki Leha fallowed by Mustadi Yapana Basti had shown a very good improvement in normalizing appetite, bilateral lower limb swelling and deep yellow micturition. Total bilirubin, SGOT and ALP values were reduced. Keywords: Alcoholic Liver disease, Shakhashrita Kamala, Nitya Virechana


2020 ◽  
Vol 19 (1-2) ◽  
pp. 55-61
Author(s):  
Andrej Nikolovski ◽  
Dragoslav Mladenovikj ◽  
Aleksandra Veljanovska ◽  
Gordana Petrusevka

Myeloid sarcoma (extramedullary myeloblastoma, granulocytic sarcoma, chloroma) is an extramedullary isolated malignant tumor of myeloblasts and immature myelocytes. It can occur anywhere in the body as a solitary tumor or can be accompanied with acute myeloid leukemia. We are presenting a case of a young male patient that presented with sings of a small bowel obstruction and a palpable tumor mass in the abdomen. After uneventful postoperative period, the immunohistochemistry analysis reported an extramedullary myeloid sarcoma since a normal bone marrow biopsy was revealed.


2021 ◽  
Author(s):  
Olivia Le Saux ◽  
Hélène Vanacker ◽  
Fatma Guermazi ◽  
Mélodie Carbonnaux ◽  
Clémence Roméo ◽  
...  

Homologous recombination deficiency and VEGF expression are key pathways in high-grade ovarian cancer. Recently, three randomized practice changing trials were published: the PAOLA-1, PRIMA and VELIA trials. The use of PARP inhibitors (PARPi) following chemotherapy has become standard of care in first line. Combination of PARPi with anti-angiogenic agents has demonstrated synergistic activity in preclinical study. This review summarizes the body of evidence supporting the efficacy and safety of the combination of PARPi and anti-angiogenic drugs in first-line homologous recombination deficiency high-grade ovarian cancer leading to US FDA and EMA approvals. This double maintenance is supported by: a large benefit with bevacizumab + olaparib compared with olaparib alone, a rationale for additive effect, and a good safety and cost-effective profile.


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