scholarly journals An experience with Foot Macrodactyly: A case report and review of literature

2022 ◽  
Vol 7 (2) ◽  
pp. 87-89
Author(s):  
Anupam Kaur ◽  
Amandeep Kaur

Macrodactyly is a rare congenital malformation with clinical manifestations such as enlargement of soft tissue and osseous elements. It causes various health issues such as pain, difficulty in wearing shoes, impairment in ambulatory ability and gait development, aesthetic problem, and psychological issues. The aetiology of macrodactyly is ambiguous; however, its association with PIK3CA /AKT1 genes has been reported recently. In the present study, a rare congenital macrodactyly of second and third toe of right foot along with deformed leg in 16-year-old girl has been reported. A progressive increase in the size of the second and third toe of the right foot and deformed reddish swollen area on the same lower leg below knee was seen in the patient. The malformation was present at the time of birth and at the age of one year the patient was operated for macrodactyly, but again the toe progressively increased to the previous size. She was presented with multiple health problems. There was no positive family history and/or other congenital malformation. Thus, it was suggested that due to variable phenotypic manifestations, appropriate treatment should be chosen for the patient individually.

2021 ◽  
Vol 5 (3) ◽  
pp. 797-808
Author(s):  
Odelia Jovita Jusuf Fantoni ◽  
Inda Astri Aryani ◽  
Yuli Kurniawati ◽  
Raden Pamudji

Tuberculoid granulomas consist of epithelioid histiocytes, Langhans giant cells and rarely foreign bodies with lymphocytes, plasma cells and caseous necrosis. The granulomatous reaction pattern is defined as a typical inflammatory pattern that is characterized by granulomas. Various etiologies can lead to granulomatous reactions. The histopathological features of cutaneous disorders with tuberculoid granuloma include cutaneous tuberculosis, tuberculids, Morbus Hansen, syphilis and rosacea. There are various clinical manifestations of tuberculoid granuloma with similar appearances which makes it difficult to establish a definitive diagnosis. The histopathological features of cutaneous tuberculoid granuloma disorders can support the diagnosis. Therefore, the clinician can determine the appropriate treatment with the right diagnosis.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P182-P182
Author(s):  
Vardhan Vishnu ◽  
R. Martha

Problem Study of correlation of recurrence of NPF with its histopathologic appearance. Methods A retrospective and prospective study of 184 NPF cases identified, treated in Government Ear Nose Throat Hospital, and followed over a period of 26 years (1981–2006) and their histopathological slides are preserved, their recurrence rate is documented. The histopathology of NPF is varied - composed of vascular and fibrous components and their proportion varied. In our study we will undertake the review of histopathology slides that are already preserved and would also like to study the new recurrent cases in the coming 6 months. Results All recurrences were observed with in one year of of treatment and the recurrence rate was 19.66%. Recurrence had no correlation with age of patient, duration of symptoms, or surgical approach but correlated with stage of tumor at presentation (p less than 0.05). Preoperative embolisation was done in 16.85% cases and did not show any statistical difference in recurrence rate between the embolised and non embolised. Conclusion The correlation between the histopathological appearance and the recurrence rate will help in choosing the right approach for surgery and also postoperative follow-up to detect the recurrence at the earliest. Significance Histopathological detail can help in knowing the prognosis in terms of chances of recurrence and also guide for follow up at close intervals and advocate the appropriate treatment at the earliest.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Naoufal Elghoul ◽  
Omar Zaddoug ◽  
Mohammed Tbouda ◽  
Mohammed Benchakroun ◽  
Abdeloihab Jaafar

Schwannomas represent only 5% of all soft tissue tumors. As a variant of this tumor, the plexiform schwannoma is rare accounting for less than 5% of all schwannomas. Herein, we report a rare case of a 49-year-old athlete who suffered from a pain in the posterior aspect of the right leg one year before his presentation. Initially, a radiograph of his right leg showed no abnormality, and so, the emergency physician discharged him on analgesics and anti-inflammatory medications, and rest was advised. The persistent pain obliged the patient to consult our orthopedic department. On examination, we found a firm mass in the proximal medial aspect of his right leg. The neurovascular exam was normal. Sonography of the leg was not conclusive. Therefore, magnetic resonance imaging was performed, and a hemangioma or schwannoma was suspected. The patient underwent surgery in which the entire tumor mass was shelled out in one piece with no damage. The histopathological finding was concomitant with a plexiform schwannoma. Follow-up evaluation, sixteen months later, showed no evidence of recurrence, and the patient has regained his previous level of sportive activities. So, given the case described here, despite the rarity of the schwannoma, it should be taken into consideration as a possible diagnosis in such situation to promote early diagnosis and appropriate treatment.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Edva Noel ◽  
Naeem Abbas ◽  
Yevegeniy Skaradinskiy ◽  
Zwi Schreiber

Vascular thrombosis is a common clinical feature of both essential thrombocythemia (ET) and heparin-induced thrombocytopenia (HIT). The development of HIT in a patient with ET is rare and underrecognized. We report the case of a 77-year-old woman with preexisting ET, who was admitted with acute coronary syndrome, and IV heparin was started. She was exposed to unfractionated heparin (UFH) 5 days prior to this admission. Decrease in platelet count was noted, and HIT panel was sent. Heparin was discontinued. Patient developed atrial fibrillation, and Dabigatran was started. On day three, patient also developed multiple tiny cerebral infarctions and acute right popliteal DVT. On day ten of admission, HIT panel was positive, and Dabigatran was changed to Lepirudin. Two days later, Lepirudin was also discontinued because patient developed pseudoaneurysm on the right common femoral artery at the site of cardiac catheterization access. A progressive increase in the platelet count was noted after discontinuing heparin. Physicians should be aware of the coexistence of HIT and ET, accompanied challenges of the prompt diagnosis, and initiation of appropriate treatment.


2021 ◽  
Vol 5 (9) ◽  
pp. 825-836
Author(s):  
Odelia Jovita Jusuf Fantoni ◽  
Inda Astri Aryani ◽  
Yuli Kurniawati ◽  
Raden Pamudji

Tuberculoid granulomas consist of epithelioid histiocytes, Langhans giant cells and rarely foreign bodies with lymphocytes, plasma cells and caseous necrosis. The granulomatous reaction pattern is defined as a typical inflammatory pattern that is characterized by granulomas. Various etiologies can lead to granulomatous reactions. The histopathological features of cutaneous disorders with tuberculoid granuloma include cutaneous tuberculosis, tuberculids, Morbus Hansen, syphilis and rosacea. There are various clinical manifestations of tuberculoid granuloma with similar appearances which makes it difficult to establish a definitive diagnosis. The histopathological features of cutaneous tuberculoid granuloma disorders can support the diagnosis. Therefore, the clinician can determine the appropriate treatment with the right diagnosis.


Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 158
Author(s):  
Colin Eady

For 30 years, forage ryegrass breeding has known that the germplasm may contain a maternally inherited symbiotic Epichloë endophyte. These endophytes produce a suite of secondary alkaloid compounds, dependent upon strain. Many produce ergot and other alkaloids, which are associated with both insect deterrence and livestock health issues. The levels of alkaloids and other endophyte characteristics are influenced by strain, host germplasm, and environmental conditions. Some strains in the right host germplasm can confer an advantage over biotic and abiotic stressors, thus acting as a maternally inherited desirable ‘trait’. Through seed production, these mutualistic endophytes do not transmit into 100% of the crop seed and are less vigorous than the grass seed itself. This causes stability and longevity issues for seed production and storage should the ‘trait’ be desired in the germplasm. This makes understanding the precise nature of the relationship vitally important to the plant breeder. These Epichloë endophytes cannot be ‘bred’ in the conventional sense, as they are asexual. Instead, the breeder may modulate endophyte characteristics through selection of host germplasm, a sort of breeding by proxy. This article explores, from a forage seed company perspective, the issues that endophyte characteristics and breeding them by proxy have on ryegrass breeding, and outlines the methods used to assess the ‘trait’, and the application of these through the breeding, production, and deployment processes. Finally, this article investigates opportunities for enhancing the utilisation of alkaloid-producing endophytes within pastures, with a focus on balancing alkaloid levels to further enhance pest deterrence and improving livestock outcomes.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dallah Yoo ◽  
Sung-Hye Park ◽  
Sungwook Yu ◽  
Tae-Beom Ahn

Abstract Background Neurodegenerative disorders are characterized by insidious progression with poorly-delineated long latent period. Antecedent clinical insult could rarely unmask latent neurodegenerative disorders. Here, we report an autopsy-proven case of corticobasal degeneration which was preceded by a lacunar infarction. Case presentation A 58-year-old man presented with acute ataxia associated with a lacunar infarction in the right paramedian pons. His ataxia persisted with additional progressive gait difficulty and left arm clumsiness. Six months later, a follow-up neurological examination showed asymmetrical bradykinesia, apraxia, dystonic posturing, postural instability, and mild ataxia of the left limbs. Cognitive examination revealed frontal executive dysfunction and visuospatial difficulties. Dopamine transporter imaging scan demonstrated bilateral reduced uptakes in mid-to-posterior putamen, more prominent on the right side. Levodopa-unresponsive parkinsonism, asymmetric limb dystonia, and ideomotor apraxia became more conspicuous, while limb ataxia gradually vanished. The patient became unable to walk without assistance after 1 year, and died 4 years after the symptom onset. Autopsy findings showed frontoparietal cortical atrophy, ballooned neurons, and phosphorylated tau-positive astrocytic plaques and neuropil threads with gliosis and neuronal loss, confirming the corticobasal degeneration. Conclusions The case illustrates that precedent clinical events such as stroke might tip a patient with subclinical CBS into overt clinical manifestations.


2020 ◽  
Vol 12 (3) ◽  
pp. 433-439
Author(s):  
Riwaj Bhagat ◽  
Siddharth Narayanan ◽  
Marwa Elnazeir ◽  
Thong Diep Pham ◽  
Robert Paul Friedland ◽  
...  

Gasperini syndrome (GS), a rare brainstem syndrome, is featured by ipsilateral cranial nerves (CN) V–VIII dysfunction with contralateral hemibody hypoesthesia. While there have been 18 reported cases, the GS definition remains ambiguous. We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute brainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core features (ipsilateral CN V, VIII palsies and contralateral hemibody hemihypalgesia). Additionally, GS, similar to Wallenberg’s syndrome, represents a spectrum that can have other associated neurological features. The revised definition presented in this study may enlighten physicians with the immediate recognition of the syndrome and help improve clinical localization of the lesions and its management.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan Le Ho ◽  
Pui Fong Ng ◽  
Sotheenathan Krishinan ◽  
Basheer Ahamed Abdul Kareem

Abstract Background Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation. Case presentation We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination. Conclusion Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.


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