scholarly journals The Etiologies of Isolated Fourth Cranial Nerve Palsy: A 10-Year Review of 158 Cases

2021 ◽  
Author(s):  
Apatsa Lekskul ◽  
Wadakarn Wuthisiri ◽  
Phantaraporn Tangtammaruk
Keyword(s):  
Nerve Palsy ◽  
Demographic Data ◽  
Closed Head Injury ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Rapid Progression ◽  
Clinical Signs And Symptoms ◽  
Atypical Presentations ◽  
Fourth Nerve Palsy

Abstract MethodsPatients diagnosed with isolated fourth nerve palsy from January 1, 2009, through July 31, 2020 in Ramathibodi Hospital, were included in this retrospective, observational case series. The demographic data of patients, age at presentation, the etiologies of isolated fourth nerve palsy and neuroimaging results (if indicated) were recorded.ResultsWe identified 153 unilateral and 5 bilateral cases of isolated fourth nerve palsy. Mean age at presentation was 38.89 ± 25.71 years old. Most of the unilateral cases were congenital (58.17%), with vasculopathy (27.45%), intracranial neoplasm (8.5%) and other etiologies. Trauma with closed head injury was the most common etiology of bilateral cases (60%), followed by ruptured arterovenous malformation (20%) and vasculopathy (20%). Twenty-one of the 43 (48.84%) patients with vasculopathy-associated fourth nerve palsy underwent neuroimaging, with normal findings, and all patients’ symptoms resolved within 6 months of symptom onset.ConclusionsIn our series, most of the isolated fourth nerve palsy cases were congenital, followed in frequency by vasculopathy and intracranial tumor, as in many studies. In cases of vasculopathy, the clinical signs and symptoms resolved within 6 months in all cases: observation was sufficient, with no necessity for neuroimaging. However, neuroimaging should be considered in cases with atypical presentations, such as headache, periorbital pain, ataxia with positive cerebellar signs, or if there is rapid progression or no recovery.

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.

scholarly journals Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

2020 ◽  
Author(s):  
Abdolali MOSHFE ◽  
Arash ARIA ◽  
Najme ERFANI ◽  
Ali JAMSHIDI ◽  
Bahador SARKARI ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Serological Test ◽  
Demographic Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diagnosis And Management ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran.    Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

scholarly journals Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Health Workers ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Positive Indicators ◽  
Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

scholarly journals Aspergillus fumigatus spondylodiscitis with bilateral psoas abscess in a renal transplant patient with pulmonary tuberculosis : A rare case report

2015 ◽  
Vol 3 (2) ◽  
pp. 51
Author(s):  
Ravikumar Tv ◽  
Raghvendra Rao ◽  
Amit Grover ◽  
Daksh Gadi
Keyword(s):  
Case Report ◽  
Pulmonary Tuberculosis ◽  
Invasive Aspergillosis ◽  
Aspergillus Fumigatus ◽  
Psoas Abscess ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Rapid Progression ◽  
Mortality And Morbidity ◽  
Clinical Signs And Symptoms

<p><strong>Background:</strong> Aspergillus spondylodiscitis is increasingly described in immune-compromised patients. Its diagnosis is challenging and its delay results in high mortality and morbidity in view of its relative infrequency and the non- specific clinical signs and symptoms.</p><p><strong>Case report:</strong>We report a case of thoracic spondylodiscitis caused by Aspergillus fumigatus in a patient of renal transplantation and with proven pulmonary tuberculosis.</p><p><strong>Conclusion:</strong>We reiterate that transplantist and the treating physician should have high grade of suspicion for the invasive Aspergillosis even when the patient complains of vague non-specific back pain, and aggresively aim to rule out fungal infection. Early surgical debridement and antifungal therapy to be executedto prevent rapid progression of invasive aspergillosis and neurological damage.</p>

scholarly journals Scientific knowledge about infections by the new coronavirus in older adults: a scoping review

2021 ◽  
Vol 74 (suppl 1) ◽  
Author(s):  
Darlene Mara dos Santos Tavares ◽  
Nayara Gomes Nunes Oliveira ◽  
Marina Aleixo Diniz-Rezende ◽  
Graziele Ribeiro Bitencourt ◽  
Marcos Barragan da Silva ◽  
...  
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Scientific Knowledge ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Review Literature ◽  
Adverse Outcomes ◽  
Other Information ◽  
Clinical Signs And Symptoms

ABSTRACT Objective: to map the scientific knowledge about COVID-19 in older adults. Method: this is a scoping review literature review. A search was performed in the PubMed, CINAHL, Web of Science and LILACS databases. Original articles that answered the guiding question were included: what scientific knowledge is available in the world about COVID-19 in older adults? Results: thirty-one articles were included, most of them carried out in China (n=23) and with a retrospective design (n=13) and case studies/case series (n=13). Based on the findings, six thematic categories emerged: clinical signs and symptoms (n=12), other information (n=9), adverse outcomes/complications resulting from COVID-19 (n=8), age relationship and greater severity of COVID-19 (n=8), variables related to death by COVID-19 (n=8), and diagnostic findings (n=8). Conclusion: the findings reinforce older adults’ greater vulnerability to the worsening of COVID-19, as well as to complications resulting from the disease, including the greater occurrence of death.

scholarly journals A scoping review protocol to identify clinical signs, symptoms and biomarkers indicative of biofilm presence in chronic wounds

2021 ◽  
Vol 4 ◽  
pp. 71
Author(s):  
John D. Ivory ◽  
Akke Vellinga ◽  
James O'Gara ◽  
Georgina Gethin
Keyword(s):  
Chronic Wounds ◽  
Evidence Synthesis ◽  
Demographic Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Third Party ◽  
Scoping Reviews ◽  
Clinical Signs And Symptoms ◽  
High Level

Introduction: Wound healing is characterised by haemostatic, inflammatory, proliferative and remodelling phases. In the presence of comorbidities such as diabetes, healing can stall and chronic wounds may result. Infection is detrimental to these wounds and associated with poor outcomes. Wounds are contaminated with microbes and debris, and factors such as host resistance, bacterial virulence, species synergy and bioburden determine whether a wound will deteriorate to critically colonised/infected states. Biofilms are sessile microbial communities, exhibiting high-level antibiotic tolerance and resistance to host defences. Biofilm in critically colonised wounds can contribute to delayed healing. Little is known about clinical presentation and diagnosis of wound biofilms. Objective: To identify from the literature clinical signs, symptoms and biomarkers that may indicate biofilm in chronic wounds. Methods: This review will be guided by the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR), and the Joanna Briggs Institute Manual for Evidence Synthesis. Studies of any design in any language recruiting adult patients with  venous, diabetic, pressure or mixed arterial-venous ulcers and reporting data on clinical signs/symptoms of biofilm are eligible. Searches of Medline, Embase, CINAHL, Cochrane Central, Scopus, Web of Science, Google scholar and BASE will be conducted from inception to present. Reference scanning and contact with content experts will be employed. Title/abstract screening and full text selection will be executed by two reviewers independently. Discrepancies will be resolved by discussion between reviewers or through third party intervention. Data will be extracted by a single reviewer and verified by a second. Clinical signs and symptoms data will be presented in terms of study design, setting and participant demographic data. Discussion: Understanding biofilm impact on chronic wounds is inconsistent and based largely on in vitro research. This work will consolidate clinical signs, symptoms and biomarkers of biofilm in chronic wounds reported in the literature.

scholarly journals A scoping review protocol to identify clinical signs, symptoms and biomarkers indicative of biofilm presence in chronic wounds

2021 ◽  
Vol 4 ◽  
pp. 71
Author(s):  
John D. Ivory ◽  
Akke Vellinga ◽  
James O'Gara ◽  
Georgina Gethin
Keyword(s):  
Chronic Wounds ◽  
Evidence Synthesis ◽  
Demographic Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Third Party ◽  
Scoping Reviews ◽  
Clinical Signs And Symptoms ◽  
High Level

Introduction: Wound healing is characterised by haemostatic, inflammatory, proliferative and remodelling phases. In the presence of comorbidities such as diabetes, healing can stall and chronic wounds may result. Infection is detrimental to these wounds and associated with poor outcomes. Wounds are contaminated with microbes and debris, and factors such as host resistance, bacterial virulence, species synergy and bioburden determine whether a wound will deteriorate to critically colonised/infected states. Biofilms are sessile microbial communities, exhibiting high-level antibiotic tolerance and resistance to host defences. Biofilm in critically colonised wounds can contribute to delayed healing. Little is known about clinical presentation and diagnosis of wound biofilms. Objective: To identify from the literature clinical signs, symptoms and biomarkers that may indicate biofilm presence in chronic wounds. Methods: This review will be guided by the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR), and the Joanna Briggs Institute Manual for Evidence Synthesis. Studies of any design in any language recruiting adult patients with  venous, diabetic, pressure or mixed arterial-venous ulcers and reporting data on clinical signs/symptoms of biofilm are eligible. Searches of Medline, Embase, CINAHL, Cochrane Central and BASE will be conducted from inception to present. Reference scanning and contact with content experts will be employed. Title/abstract screening and full text selection will be executed by two reviewers independently. Discrepancies will be resolved by discussion between reviewers or through third party intervention. Data will be extracted by a single reviewer and verified by a second. Clinical signs and symptoms data will be presented in terms of study design, setting and participant demographic data. Discussion: Understanding biofilm impact on chronic wounds is inconsistent and based largely on in vitro research. This work will consolidate clinical signs, symptoms and biomarkers of biofilm in chronic wounds reported in the literature.

scholarly journals Endodontic management of dens invaginatus Type IIIb: Case series

2016 ◽  
Vol 10 (04) ◽  
pp. 561-565 ◽  
Author(s):  
Jorge N. R. Martins ◽  
Rui Pereira da Costa ◽  
Craig Anderson ◽  
Sérgio André Quaresma ◽  
Luís S. M. Corte-Real ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Aggressive Approach ◽  
Invasive Approach ◽  
Technical Requirements ◽  
Type Iiib ◽  
Complex Anatomy ◽  
Clinical Signs And Symptoms ◽  
Dens Invaginatus

ABSTRACTDens invaginatus may be seen as a developmental malformation. It is characterized by an invagination of the enamel and dentin, creating a lumen inside the affected tooth, which may extend as deep as the apical foramen. Oehlers Type IIIb is considered the most challenging clinical conditions. The purpose of this study is to discuss the nonsurgical endodontic management of vital and necrotic dens invaginatus Type IIIb cases. Due to the complex anatomical consideration of dens invaginatus Type IIIb, endodontic treatment is extremely technique sensitive. A conservative approach was used in a vital case to treat the invaginated lumen only, to preserve the vitality of the pulp, and a more invasive approach was used in a necrotic case to debride the lumen and necrotic pulp for proper disinfection of the root canal system. Although different, all the approaches were successful. The clinical signs and symptoms were resolved. The vital case remains vital after 19 months, and the recall radiographs were able to show satisfactory periapical healing both in vital and necrotic cases. Due to the highly complex anatomy of dens invaginatus Type IIIb, the decision of preserving the pulp vitality may not be related only to pulpal diagnosis but also to the technical requirements of the treatment. Although very technically sensitive, it may be possible to treat the invaginated lumen exclusively, while preserving the vitality of the pulp. Necrotic cases may require a more aggressive approach to achieve a favorable prognosis.

scholarly journals Presentation and management of N-acetylglutamate synthase deficiency: a review of the literature

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Aileen Kenneson ◽  
Rani H. Singh
Keyword(s):  
Current Knowledge ◽  
Case Reports ◽  
Management Strategies ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Protein Restriction ◽  
Therapeutic Trials ◽  
Acetylglutamate Synthase ◽  
Clinical Signs And Symptoms

Abstract Background N-Acetylglutamate synthase (NAGS) deficiency is an extremely rare autosomal recessive metabolic disorder affecting the urea cycle, leading to episodes of hyperammonemia which can cause significant morbidity and mortality. Since its recognition in 1981, NAGS deficiency has been treated with carbamylglutamate with or without other measures (nutritional, ammonia scavengers, dialytic, etc.). We conducted a systematic literature review of NAGS deficiency to summarize current knowledge around presentation and management. Methods Case reports and case series were identified using the Medline database, as well as references from other articles and a general internet search. Clinical data related to presentation and management were abstracted by two reviewers. Results In total, 98 cases of NAGS deficiency from 79 families, in 48 articles or abstracts were identified. Of these, 1 was diagnosed prenatally, 57 were neonatal cases, 34 were post-neonatal, and 6 did not specify age at presentation or were asymptomatic at diagnosis. Twenty-one cases had relevant family history. We summarize triggers of hyperammonemic episodes, diagnosis, clinical signs and symptoms, and management strategies. DNA testing is the preferred method of diagnosis, although therapeutic trials to assess response of ammonia levels to carbamylglutamate may also be helpful. Management usually consists of treatment with carbamylglutamate, although the reported maintenance dose varied across case reports. Protein restriction was sometimes used in conjunction with carbamylglutamate. Supplementation with citrulline, arginine, and sodium benzoate also were reported. Conclusions Presentation of NAGS deficiency varies by age and symptoms. In addition, both diagnosis and management have evolved over time and vary across clinics. Prompt recognition and appropriate treatment of NAGS deficiency with carbamylglutamate may improve outcomes of affected individuals. Further research is needed to assess the roles of protein restriction and supplements in the treatment of NAGS deficiency, especially during times of illness or lack of access to carbamylglutamate.

Prevalence of Temporomandibular Disorders among Nepalese Population

2019 ◽  
Vol 9 (3) ◽  
pp. 34-42
Author(s):  
Peeyush Shivhare ◽  
Vivek Singh ◽  
Ritesh Giri ◽  
Ankur Singh ◽  
Mohan Raju Penumatcha ◽  
...  
Keyword(s):  
Temporomandibular Disorders ◽  
Myofascial Pain ◽  
Demographic Data ◽  
Clinical Signs ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Medical College ◽  
Gum Chewing ◽  
Clinical Signs And Symptoms ◽  
Dental Appointment

 Background: Temporomandibular disorders (TMDs) comprise of a variety of clinical signs and symptoms such as joint sounds, muscle tenderness, joint tenderness, deviation, deflection, pain on mouth opening, protru­sive, lateral movement and limited mouth opening which can be the re­sult of trauma, stress, gum chewing, hard food biting habits, bruxism, long dental appointment. This study was aimed to determine the prevalence of temporomandibular disorders in Nepalese population in Eastern Nepal. Methods: The study was performed from May 2018 to Oct 2018. All the patients who came to the Department of Oral Medicine and Radiology, Nobel Medical College and Teaching Hospital (NMCTH) and health camps in Eastern part of Nepal were included. The self-administered questions were asked to the subjects about demographic data, different signs and symptoms of TMDs and etiological factors responsible for it. Results: More than two thirds of the study sample (83.96%) in the present study had one or more clinical signs and symptoms of TMDs. Deviation of mandible on mouth opening and clicking sound made up the highest per­centage. Females were reported to have significantly higher prevalence of TMDs signs and symptoms than male. Disc displacement was the most prevalent disorder followed by myofascial pain and degenerative joint dis­order. Conclusions: The results of this study show that a significant percentage of the population has signs and symptoms of TMDs. Measures should be taken to prevent and treat TMDs in this part of the world.

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