scholarly journals Neonatal Multi-System Inflammatory Syndrome Associated With Covid-19 Exposure in Two Cases From Iran

2021 ◽  
Author(s):  
Maryam Saeedi ◽  
Kayvan Mirnia ◽  
Razieh Sangsari ◽  
Zeinab Jannat Makan ◽  
Vahid Ziaee
Keyword(s):  
Case Series ◽  
Corticosteroid Treatment ◽  
The Body ◽  
Positive Serology ◽  
Mortality And Morbidity ◽  
Positive History ◽  
First Case ◽  
History Of ◽  
Cytokine Cascade ◽  
Inflammatory Syndrome

Abstract Introduction:Immune dysregulation following exposure to Covid-19 results in MIS-N (Multi-system Inflammatory Syndrome in Neonates). MIS-N affects various systems in the body and is diagnosed with a positive history of PCR test, positive serologic test, and a history of contact with those vectors of COVID-19 infection. This case series aimed to differentiate from possible misdiagnosis about MIS-N.Case Presentation:Both cases are term neonates with positive serology of COVID -19 and the 2nd case with a mother's positive history of Covid-19 PCR at 30 weeks of pregnancy. The first case was admitted with diarrhea, dehydration, fever for three days, and rash on the 3rd day of hospitalization. We admitted the 2nd case on the 22nd day of birth with a cough, rashes on the head, palms, and soles for two days. Both cases responded to corticosteroid treatment that confirmed MIS-N. Finally, we discharged them with a stable and normal condition in follow-ups.Conclusions:In inflammatory syndromes, especially in delayed phases of COVID cytokine storms, the mortality and morbidity caused by infections diminish with proper interventions and inhibited cytokine cascade inflammations.

scholarly journals Skin Darkening in COVID-19 Patients: Case Series of Eight Patients in a Hemodialysis Unit.

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Habib Ullah Rind ◽  
Nadia Iftikhar ◽  
Fazal ur Rehman ◽  
Abdul Kareem Zarkoon ◽  
Syed Mohkam ◽  
...  
Keyword(s):  
Dialysis Patient ◽  
Single Case ◽  
Case Series ◽  
The Body ◽  
Pressure Sores ◽  
Cutaneous Manifestations ◽  
Mortality And Morbidity ◽  
Skin Manifestations ◽  
Hemodialysis Unit ◽  
Type Pressure

The Pandemic of COVID-19 has grasped the whole world and changed dramatically, together with our social, occupational and personal life with high mortality and morbidity with other consequences since December 2019 started from Wuhan and then declared pandemic in March. It has been observed to involve every organ of the body including skin. Various skin manifestations, but most cases reported were like urticarial rash, xanthemas,  chickenpox-like vesicle, vasculitidic type, pressure sores, contact dermatitis and a single case was reported in china with skin darkening. The COVID-19 and cutaneous manifestations are recognized by physicians and dermatologist treating COVID-19. We have observed around eight cases of COVID -19 who had skin darkening in our center Baluchistan Institute of Nephrology and Urology Quetta, among these included were six dialysis technicians one chronic maintenance dialysis patient and a physician. We present the representative cases and discuss the skin manifestations of COVID-19.

017 Paradoxical reaction in tuberculous meningitis: a tertiary referral hospital retrospective experience of concomitant immunosuppression therapy

2018 ◽  
Vol 89 (6) ◽  
pp. A8.1-A8
Author(s):  
David Ledingham ◽  
Shadi El-Wahsh ◽  
Cecilia Cappelen-Smith ◽  
Suzanne Hodgkinson ◽  
Alan McDougall ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Case Series ◽  
Corticosteroid Treatment ◽  
Asia Pacific ◽  
High Dose ◽  
Neck Stiffness ◽  
Gradual Improvement ◽  
Mri Brain ◽  
Thalamic Infarction ◽  
History Of

IntroductionTuberculous meningitis (TBM) accounts for <1% of all tuberculosis (TB) presentations. Paradoxical reactions (PR) in non-HIV patients are a common manifestation of anti-tuberculosis therapy characterised by clinico-radiological deterioration. We report a case series of TBM admissions to our institution, including two cases with corticosteroid-refractory PR who responded to adjuvant cyclosporin.MethodsRetrospective review of 12 HIV-negative patients admitted to Liverpool Hospital, Sydney (2005–2017) with laboratory and/or radiologically confirmed TBM.ResultsMedian age 40 (range 22–81 years), 7 males. Eleven patients were of Asia-Pacific origin. All eleven presented with central nervous system manifestations and 1 had preceding miliary TB. Nine patients had extra-cranial TB involvement, including 8 with past or current pulmonary disease. Cerebrospinal fluid (CSF) TB PCR/culture was positive in 10 patients. One patient had multi-resistant TB. PR of TBM developed in 5 patients despite concomitant corticosteroids in 4. Two cases had refractory PR.Case 1. 22 year old Vietnamese male presented with 6 week history of progressive headache and neck stiffness. CSF demonstrated 61 WCC (75% neutrophils), protein 2.67 g/L (n<0.45), glucose 2.1 mmol/L. Despite concomitant anti-tuberculosis and high-dose corticosteroid treatment, he developed worsening headaches and altered mentation with interval MRI brain increase in size and number of tuberculomas, hydrocephalus, and left thalamic infarction. Cyclosporin was added with gradual improvement and ultimately good outcome.Case 2. 47 year old Filipino male presented with 3 week history of headache and neck stiffness and 3 day history of fever, dysarthria and diplopia. MRI brain showed basal meningitis, hydrocephalus and left putaminal infarction. CSF demonstrated 245 WCC (35% neutrophils), protein 0.68 g/L, glucose 1.8 mmol/L. Despite concomitant anti-tuberculosis and corticosteroid treatment, the patient developed PR-induced worsening hydrocephalus necessitating ventriculo-peritoneal shunting. Cyclosporin was added with gradual PR resolution.ConclusionOur case series highlights the importance of concomitant corticosteroids in TBM and the potential role of cyclosporin in refractory PR.

scholarly journals Hyperglycaemia Among Nigerian Infants Weighing Less Than 1,500 Grammes at Birth: A Retrospective Assessment of the Clinical Data

2014 ◽  
Vol 21 (2) ◽  
pp. 81-87
Author(s):  
Alphonsus N. Onyiriuka ◽  
Francisca N. Enyi
Keyword(s):  
Blood Glucose ◽  
Low Birthweight ◽  
Retrospective Chart Review ◽  
Mortality And Morbidity ◽  
Vlbw Infants ◽  
Positive History ◽  
Retrospective Assessment ◽  
Medical Disorders ◽  
Intravenous Fluid Administration ◽  
History Of

Abstract Background and Aims: In very low birthweight (VLBW) infants, birthweight < 1,500g, hyperglycaemia is associated with increased rates of mortality and morbidity. Our study aimed at determining the prevalence of hyperglycaemia among VLBW infants and describing their clinical characteristics. Methods: A retrospective chart review of all inborn VLBW infants was performed. Information obtained included birthweight, gestational age (best obstetric record), gender, and history of chorioamnionitis/maternal medical disorders, type and rates of intravenous fluid administration. Blood glucose level ≥ 7 mmol/L on at least two occasions defined hyperglycaemia. Results: Of the 279 blood glucose values, obtained from 93 infants, 91 (32.6%; 95% CI = 27.1% -38.1%) were in the hyperglycaemic range, with the majority (61.5%) occurring in the first 48 hours of life. The frequency of hyperglycaemia was significantly associated with a rate of infusion greater than 0.4g/kg/hour (Odds Ratio, OR = 3.76; 95% CI=1.58-8.94) and a positive history of maternal chorioamnionitis (OR = 3.04; 95%CI= 1.15-8.01). Conclusion: In the first 48 hours of life, hyperglycaemia co-existing with or complicating primary illnesses was common in VLBW infants who had dextrose infusion and a positive history of maternal chorioamnionitis

scholarly journals Optic Disc Neovascularization in Vogt-Koyanagi-Harada Disease- A Case Series and Literature Review

2021 ◽  
Author(s):  
Lagan Paul ◽  
Shalin Shah ◽  
Manisha Agarwal ◽  
Shalini Singh
Keyword(s):  
Optic Nerve ◽  
Literature Review ◽  
Case Series ◽  
Vascular Occlusion ◽  
Autoimmune Disorder ◽  
The Body ◽  
Low Grade ◽  
Retinal Vessels ◽  
History Of ◽  
Vkh Disease

Abstract BackgroundVogt–Koyanagi–Harada (VKH) disease is an autoimmune disorder which affects numerous organs of the body. We report two cases of Optic Nerve Head neovascularisation (NVD) in diagnosed cases of Vogt Koyanagi Harada(VKH) disease.FindingsCase 1: A 40 years female presented with acute loss of vision in both eyes for 10 days. She had multiple serous detachments in both eyes and diagnosed as acute VKH disease. After treatment, she was observed to have NVD later on OCT Angiography(OCTA). Case 2: A 52 years old man presented with history of sudden blackouts in front of left eye since 4 months. He was a case of chronic VKH and NVD was seen clinically and on OCTA. ConclusionThe exact etiopathogenesis of neovascularization in Harada’s disease is unclear. The low grade inflammations acts as a stimulus and can induce disc neovascularization even in the absence of vascular occlusion. ONH vessels appear to be more susceptible to developing NVD than retinal vessels in presence of chronic inflammation.

scholarly journals COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a case series from a tertiary care pediatric hospital in Qatar

2021 ◽  
Author(s):  
Mohammad Hasan ◽  
Khaled Al Zubaidi ◽  
Karim Diab ◽  
Yahia Hejazi ◽  
Sharon Bout-Tabaku ◽  
...  
Keyword(s):  
Clinical Features ◽  
Early Recognition ◽  
Tertiary Care ◽  
Case Series ◽  
Case Definition ◽  
Cardiac Biomarkers ◽  
Medical Attention ◽  
Laboratory Findings ◽  
First Case ◽  
Inflammatory Syndrome

Abstract Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. Here we report the first case series of 7 children diagnosed with MIS-C in Qatar. Methods: Clinical features and outcomes of COVID-19 positive patients admitted to Sidra Medicine, Qatar from June to October 2020, who met the WHO case definition for MIS-C were reviewed.Results: The mean age in our case series was 5.6 years, of which 71.4% were males. All patients were previously healthy but had a history of COVID-19 infection. Fever, rash, vomiting and abdominal pain were the most common symptoms (70%-100%). The average hospitalization was 12.9 days with no case fatalities. Laboratory findings included lymphopenia and thrombocytopenia in most patients, as well as evidence of coagulopathy and elevated inflammatory markers such as C-reactive protein, ferritin and procalcitonin. Many patients (71.4%) required inotropic support in intensive care, while only one required respiratory support. Although all patients had elevated cardiac biomarkers, cardiovascular involvement was observed in 42.9% of patients with one patient developing a giant coronary aneurysm. All patients received intravenous immunoglobulin (IVIG) and 86% of patients received corticosteroids, with two patients requiring treatment with IL-1 inhibitors.Conclusions: Our report is one of the first reports on MIS-C from Asia. Although clinical features and outcomes are not significantly different from those reported elsewhere, lack of case fatalities in our cohort may indicate that early recognition and prompt medical attention is necessary for a favorable outcome in MIS-C.

scholarly journals Gambaran Kondisi Ibu Hamil dengan Diabetes Mellitus di RSD dr. Soebandi Jember Tahun 2013-2017 (Description of Pregnant Women Condition with Diabetes Mellitus in RSD dr. Soebandi Jember on 2013-2017)

2018 ◽  
Vol 6 (1) ◽  
pp. 46
Author(s):  
Meggeria Dyah Matrika Tito Putri ◽  
Pudjo Wahjudi ◽  
Irma Prasetyowati
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Maternal Age ◽  
Maternal Education ◽  
Case Series ◽  
Sampling Technique ◽  
The Body ◽  
Family History Of Diabetes ◽  
Low Education ◽  
History Of

Abstract Diabetes Mellitus or diabetes is a chronic metabolic disease disorder caused by pancreas does not produce enough insulin or the body can’t effectively use produced insulin. In pregnant women with a family history of diabetes mellitus, the prevalence of pregnancy with diabetes mellitus is 5.1%. This research aim to determine description of pregnant women condition with diabetes mellitus in RSD dr. Soebandi Jember. This research used descriptive method with case series design. The sample size of 19 pregnant women with diabetes mellitus was selected by total sampling technique. The results showed that the high maternal age (52.6%), low education (89.5%), unemployment or housewife (89.2%), had a genetic 78.9%), BMI overweight (57.9%), glucosuria (89.5%), history of pre-eclampsia (57.9%), low parity (79%), never miscarried (84.2%). Based on the result of the research, it was concluded that maternal education, maternal job, genetic, overweight BMI, glucosuria, and history of pre-eclampsia had an effect towards the occurrence of pregnant women with diabetes mellitus, also maternal age, parity and history of miscarriage had no effect on the occurrence of pregnant women with diabetes mellitus. To raise awareness of the risks of pregnancy with diabetes mellitus can be done with screening for diabetes mellitus.  Keywords: diabetes mellitus, pregnant women, RSD dr. Soebandi.  

scholarly journals A multisystem inflammatory syndrome in children associated with COVID-19 in a 11-years-old girl

2021 ◽  
pp. 78-78
Author(s):  
Milena Bjelica ◽  
Gordana Vilotijevic-Dautovic ◽  
Andrea Djuretic ◽  
Slobodan Spasojevic
Keyword(s):  
Gastrointestinal Symptoms ◽  
World Health ◽  
Nasopharyngeal Swab ◽  
First Case ◽  
Control And Prevention ◽  
Inflammatory State ◽  
Life Threatening ◽  
History Of ◽  
Health Organization ◽  
Inflammatory Syndrome

Introduction. Multisystem inflammatory syndrome in children (MIS-C) is a post-viral, life-threatening, inflammatory state with multisystem involvement that typically manifests 3-4 weeks after SARS-CoV-2 infection. In this article, we present the first case of MIS-C in the Institute for Child and Youth Health Care of Vojvodina at the beginning of the COVID-19 pandemic. Case outline. A previously 11-years-old healthy girl got sick two days before admission to the hospital with a fever, headache, vomiting, abdominal pain, and fatigue. She was tested positive for COVID-19 by nasopharyngeal swab PCR with positive IgM and IgG antibodies. In the further course the illness presented with prolonged fever, laboratory evidence of inflammation, multiorgan involvement such as respiratory, gastrointestinal, cardiovascular, and dermatologic. Based on Centers for Disease Control and Prevention and World Health Organization criteria the diagnosis of MIS-C was made and IVIG and methylprednisolone were introduced with favorable clinical course. Conclusion. Every prolonged and unusual febrile state, especially if it is accompanied by gastrointestinal symptoms, in a school-age child, should be investigated in the direction of recent COVID-19 infection or exposure. In a case of a positive COVID-19 history or history of exposure, the MIS-C diagnosis should be considered.

scholarly journals Lymphangioma Circumscriptum of the Vulva- A Case Series

2021 ◽  
Author(s):  
Rashmi S Mahajan ◽  
Yogesh S Marfatia ◽  
Atmakalyani R Shah ◽  
Kishan R Ninama
Keyword(s):  
Late Onset ◽  
Case Series ◽  
Suspected Case ◽  
Age Group ◽  
The Third ◽  
First Case ◽  
History Of ◽  
Subcutaneous Tissues ◽  
Uncommon Condition ◽  
Lymphangioma Circumscriptum

Vulval dermatoses pose a diagnostic and therapeutic challenge for the dermatologists. Lymphangioma Circumscriptum (LC) is a form of lymphangioma affecting the skin and subcutaneous tissues that is characterised by benign dilation of lymphatic channels. This uncommon condition is known to occur over the chest, mouth, axilla, tongue, and rarely in the vulva. In this series, authors present three cases of LC of vulva in women between the age group of 45 to 60 years with late-onset fluid-filled lesions over the vulva. The first case had history of hysterectomy prior to onset of lesions, the second case had a spontaneous onset of lesions while the third was a suspected case of pelvic tuberculosis with secondary lymphangioma.

scholarly journals P.052 Late-onset adrenoleukodystrophy mimicking primary progressive multiple sclerosis

2016 ◽  
Vol 43 (S2) ◽  
pp. S33-S33
Author(s):  
AJ Schabas ◽  
A Sayao
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Phenotypic Variability ◽  
Progressive Multiple Sclerosis ◽  
The Body ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
Progressive Myelopathy ◽  
First Case ◽  
History Of

Background: Adrenoleukodystrophy (ALD) is a peroxisomal disorder that leads to the accumulation of very long chain fatty acids in the body. Younger males typically present with a catastrophic cerebral demyelinating disease, while adult males tend to develop a progressive myelopathy and neuropathy. Methods: Case presentations and literature review. Results:Case1: A 58-year-old male with a three-year history of unsteady gait. His MRI showed multiple T2-hyperintensities most prominently in the posterior corpus collosum (which progressed over time) as well as spinal cord atrophy. Primary progressive multiple sclerosis (PPMS) was suspected. Case 2: The patient’s bother, a 49-year-old, had a ten-year history of difficulty walking. MRI findings included a single large T2 hyper-intensity spanning the anterior aspect of the corpus collosum and an atrophic spinal cord. Given the family history, both brothers were investigated for and diagnosed with ALD. Conclusions: Both cases are of males presenting with a progressive myelopathy in middle age. In the first case, the history, physical exam, and imaging findings were most consistent with PPMS. However, the second case was less typical for MS prompting further investigations. These cases highlight the need to have a broad differential when confronted with atypical cases of MS and reminds the clinician of the phenotypic variability of ADL.

scholarly journals Orbital foreign body- Study of a case series

2015 ◽  
Vol 7 (1) ◽  
pp. 60-64
Author(s):  
S Dasgupta ◽  
V Vats ◽  
K S Mittal
Keyword(s):  
Traffic Accident ◽  
Road Traffic ◽  
Case Series ◽  
Lower Eyelid ◽  
Orbital Trauma ◽  
Orbital Cavity ◽  
Upper Eyelid ◽  
Surgical Exploration ◽  
First Case ◽  
History Of

Background: Orbital foreign bodies (OFBs) may remain in the orbital cavity for considerable time and manifest with secondary complications.Objective: To report five consecutive cases of orbital trauma with OFBs, who presented at our institute from Jan 2010 to Dec 2013. Cases: The first case of our series with a non-specific history of injury had a chronic granulomatous discharging sinus in the left upper eyelid and an intact globe. The second case, with an injury to the left lower eyelid following an assault, presented late and the manifestations were similar to that of the first case. The third case, of a road traffic accident, had sustained multiple facial and periocular injuries. The nature of all of three OFBs was uncertain by CT- scan, till surgical exploration. The fourth case had sustained injury to his left eye by a flying metal object. X-ray was sufficient to detect the OFB, but as scleral penetration was associated, management was complex. The fifth case had a nonspecific history of injury and the manifestation was similar to that of the first case. The surgical exploration revealed multiple OFB (wood). Conclusion: The OFBs pose difficult diagnostic and therapeutic challenges. Management of such cases, at times, calls for innovation in decision making and formulation of strategies.

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