scholarly journals Ulcerated White Lesion of Tongue in a 7-Year-Old Child: A Diagnostic Dilemma

2021 ◽  
Vol 2 (1) ◽  
pp. 41-44
Author(s):  
Royasa Shakya ◽  
Bandana Koirala ◽  
Mamta Dali ◽  
Sneha Shrestha
Keyword(s):  
Symptomatic Treatment ◽  
Systemic Diseases ◽  
Drug Induced ◽  
Diagnostic Dilemma ◽  
White Coating ◽  
Appropriate Treatment ◽  
Long Time ◽  
Pediatric Dentists ◽  
Oral Soft Tissue ◽  
Complex Organ

Tongue is a complex organ associated with functions of taste, speech, mastication, deglutition, and development of jaws. It is considered the mirror of physical health as it can be the site of infections, immunological and drug-induced reactions, neoplasms and systemic diseases. This paper aims to present challenges in diagnosing a case of a 7-year-old male child who presented with ulceration and extensive white coating on the dorsum of tongue accompanied by fever, chills, tonsillitis, and submandibular lymphadenopathy. Despite symptomatic treatment done, the white coating with patches of depapillation lasted for a relatively long time. This may be the first reported case in the literature with such unusual tongue lesions in a child till date. Thus, pediatric dentists should have sound knowledge of the commonly encountered oral soft tissue lesions along with the rarer lesions and unusual presentation of common lesions for timely diagnosis, appropriate treatment, and referral if necessary.

Systemic Diseases Associated with Nasal Symptoms

1987 ◽  
Vol 1 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Guy A. Settipane
Keyword(s):  
Differential Diagnosis ◽  
Fungal Infections ◽  
Systemic Disease ◽  
Systemic Diseases ◽  
Proper Treatment ◽  
Csf Rhinorrhea ◽  
Nasal Symptoms ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Careful History

Many systemic diseases are associated with nasal symptoms, Rhinitis associated with asthma is probably the most common with leprosy and fungal infections being the rarest. A careful history and nasal examination in a patient with rhinitis may lead to the discovery of more significant systemic diseases. Proper treatment of systemic disease will often cure or improve the associated rhinitis. Similarly, appropriate treatment of the rhinitis/sinusitis may reduce systemic complaints such as asthma. At times, identification of the cause of rhinitis as in CSF rhinorrhea, Wegeners’ syndrome, etc., alerts one to a life-threatening entity. Thus, it is apparent that the nose is an excellent mirror of some systemic diseases and identifying and understanding the differential diagnosis of nasal symptoms may be a tremendous help in diagnosing the disease and treating the whole patient.

Case of cholestatic jaundice associated with papillary carcinoma of thyroid: a multidisciplinary challenge

2021 ◽  
Vol 14 (2) ◽  
pp. e236372 ◽  
Author(s):  
Sanchit Sharma ◽  
Anoop Saraya ◽  
Prasenjit Das ◽  
Deepak Gunjan
Keyword(s):  
Papillary Carcinoma ◽  
Primary Tumour ◽  
Symptomatic Treatment ◽  
Liver Function Tests ◽  
Needle Aspiration ◽  
Cholestatic Jaundice ◽  
Drug Induced ◽  
Post Surgery ◽  
Positron Emission ◽  
Needle Aspiration Cytology

The report describes a patient with cholestatic jaundice who had incidentally detected parathyroid hormone-independent hypercalcaemia. The differential diagnosis for this presentation includes systemic granulomatous and infiltrative disorders, drug-induced liver injury and malignancy. As the initial investigations were non-contributory towards the aetiology, she was given steroids and later plasma exchange for symptomatic treatment. The differentials were revised again in view of no clinical and biochemical response. A repeat fine-needle aspiration cytology of the thyroid nodule (seen on positron emission tomography/CT) revealed papillary carcinoma of the thyroid. The patient underwent total thyroidectomy. There was a complete normalisation of liver function tests and serum calcium, and resolution of pruritus 3 months post surgery. She was retrospectively diagnosed as a case of papillary carcinoma of the thyroid with paraneoplastic manifestations—hypercalcaemia and cholestatic jaundice—which got resolved with treatment of the primary tumour.

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

scholarly journals Genetic characterization of N-acetyltransferase 2 variants in acquired multidrug-resistant tuberculosis in Indonesia

2021 ◽  
Author(s):  
Rika Yuliwulandari ◽  
Kinasih Prayuni ◽  
Intan Razari ◽  
Retno W Susilowati ◽  
Yenni Zulhamidah ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Resistance Rate ◽  
Published Data ◽  
Drug Induced ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Appropriate Treatment ◽  
Acetylator Status ◽  
Mdr Tb

Background: Owing to the high resistance rate of tuberculosis (TB) to isoniazid, which is metabolized by N-acetyltransferase 2 (NAT2), we investigated the associations between NAT2 variants and multidrug-resistant (MDR)-TB. Materials & methods: The acetylator status based on NAT2 haplotypes of 128 patients with MDR-TB in Indonesia were compared with our published data from patients with anti-TB drug-induced liver injury (AT-DILI), TB and the general population. Results: NAT2*4 was more frequent in the MDR-TB group than in the AT-DILI group, TB controls and general controls. NAT2*4/*4 was significantly more frequent in patients with MDR-TB than in those with AT-DILI. NAT2*5B/7B, *6A/6A and *7B/*7B were detected at lower frequencies in patients with AT-DILI. Rapid acetylators were significantly more frequent in patients with MDR-TB than in those with AT-DILI. Conclusion: These results provide an initial data for optimizing TB treatment in the Indonesian population, and suggest that NAT2 genotyping may help to select appropriate treatment by predicting TB-treatment effect.

scholarly journals Kaleidoscope

2014 ◽  
Vol 205 (2) ◽  
pp. 166-167 ◽  
Author(s):  
Derek K. Tracy ◽  
Dan W. Joyce ◽  
Sukhwinder S. Shergill
Keyword(s):  
Violent Crime ◽  
Population Based ◽  
The Novel ◽  
Drug Induced ◽  
Persecutory Delusions ◽  
Appropriate Treatment ◽  
Cannabis Extract ◽  
Drug Induced Psychosis ◽  
The Uk

Drugs and violence are often observed as bedfellows; both have been associated with psychosis but the nature and timing of their relationships remains unclear. As part of the UK Prisoner Cohort Study, Keers et al prospectively followed up 967 prisoners convicted of sexual or violent offences (about a quarter of whom had a psychotic illness) in the community after release. Schizophrenia was associated with greater rates of violence, but the risk was mediated by untreated psychosis or when presenting with persecutory delusions – and no other definable psychopathology. Interestingly, drug-induced psychosis did not increase the risk of violence per se, once the substance misuse itself was accounted for. Does treatment have an impact on risk of violence in a population-based sample of patients with psychosis? Fazel et al demonstrated reductions in violent crime in patients during the time they were prescribed antipsychotics. Interestingly, the rates of violent crime were also reduced in patients with bipolar disorder who received mood stabilisers. Therefore, in addition to the effects of antipsychotics and mood stabilisers on relapse rates, their potential effects on violence and crime could be used to make decisions about management for these groups of patients. There is a clearer need for the appropriate treatment of prisoners with psychotic illnesses if their risk of violence is to be moderated. Cannabis is one of the most commonly used social drugs worldwide; it increases risk of psychosis, but there has been little to offer pharmacologically to those dependent upon this most prevalent illicit drug, and various trials of mood stabilisers, antidepressants and α2 adrenergic agonists have generally been disappointing. Allsop et al evaluated the novel cannabis extract nabiximols, containing cannabidiol – which has been shown to attenuate paranoia and euphoria – and tetrahydrocannabinol, delivered as a buccal spray. The active drug group showed statistically significant benefits in reduced withdrawal irritability, depression and cravings and remained longer in treatment. However, both placebo and drug groups showed reduced cannabis use at follow-up, with placebo being as effective as nabiximols in promoting longer-term cessation.

Non-Infectious Diseases of the Oral Soft Tissue: a New Approach

1993 ◽  
Vol 7 (2) ◽  
pp. 213-219 ◽  
Author(s):  
D.M. Williams
Keyword(s):  
Infectious Diseases ◽  
Oral Mucosa ◽  
Significant Proportion ◽  
Symptomatic Treatment ◽  
Mucous Membrane Pemphigoid ◽  
New Approach ◽  
Bullous Dermatosis ◽  
Clinical Presentations ◽  
Linear Iga Bullous Dermatosis ◽  
Oral Soft Tissue

A significant proportion of the non-infectious diseases of oral mucosa are either auto-immune in nature or have lesions which are the result of immunologically-mediated events. These include pemphigus, benign mucous membrane pemphigoid, linear IgA bullous dermatosis, dermatitis herpetiformis, epidermolysis bullosa acquisita, erythema multiforme, and lichen planus. Although each of these has certain specific characteristics, all may produce bullae, erosions, and ulcers on the oral mucosa, resulting in confusingly similar clinical presentations. With careful clinical, histological, and immunofluorescence examination, it is possible to establish a definitive diagnosis in a high proportion of cases. However, one of the most exciting developments which has emerged from recent research into these diseases is their precise molecular characterization. This raises the prospect of accurate, highly specific diagnostic tests which would provide the basis for sound clinical management, with original approaches replacing the somewhat unsatisfactory symptomatic treatment which is often all that is available.

scholarly journals Secondary Scoliosis as a Complication of Acute Transverse Myelitis in a Child

2020 ◽  
Vol 5 (2) ◽  
pp. 39
Author(s):  
Silvia D’Amico ◽  
Piero Pavone ◽  
Gianluca Testa ◽  
Filippo Greco ◽  
Lidia Marino ◽  
...  
Keyword(s):  
Transverse Myelitis ◽  
Complete Recovery ◽  
High Dose ◽  
Drug Induced ◽  
Rehabilitative Treatment ◽  
Immunomodulating Therapy ◽  
Acute Transverse Myelitis ◽  
Appropriate Treatment ◽  
Autoimmune Conditions ◽  
Thoracolumbar Curve

Acute transverse myelitis (ATM) is a rare neurological condition that affects the spinal cord. Several events, including infections, autoimmune conditions, inflammatory, and drug-induced factors, may cause this disorder. Correct and rapid etiological diagnosis is necessary in order to start appropriate treatment that mainly consists of immunomodulating therapy, high dose intravenous corticosteroids, and in plasma exchange in noninfectious cases. The outcome is varied and depends on several factors. In children, the prognosis is usually good. We report a case of an 11-year-old boy who presented with interscapular pain, right leg steppage, homolateral hyposthenia of the upper limb, and signs of autonomic dysfunction. After performing specific and instrumental exams, a diagnosis of transverse myelitis was reached, and appropriate therapy was performed. A few days post-treatment, the child developed a secondary scoliosis, involving a thoracolumbar curve with loss of cervical and lumbar lordosis. After rehabilitative treatment was undertaken for 12 months, a complete recovery and normal restoration of spinal physiological curves was obtained. The pediatric cases of ATM have a good response to steroid therapy combined with physiotherapy. Collaboration among the various specialists is worthwhile, in order to lead to a correct and rapid diagnosis.

Nasopalatine Cyst or Apical Pathology? A Diagnostic Dilemma and How to Manage It

Dental Update ◽  
2020 ◽  
Vol 47 (2) ◽  
pp. 165-169
Author(s):  
Marialena Cresta ◽  
Robert Philpott ◽  
Eleni Besi
Keyword(s):  
Clinical Examination ◽  
Clinical Relevance ◽  
Definitive Diagnosis ◽  
Histopathological Analysis ◽  
Apical Region ◽  
Diagnostic Dilemma ◽  
Anterior Teeth ◽  
Appropriate Treatment ◽  
Odontogenic Origin ◽  
Careful Assessment

Nasopalatine cysts (NPCs) present as maxillary midline radiolucencies and are the most common radiolucency of non-odontogenic origin. The proximity of these radiolucencies to the apical region of the maxillary anterior teeth may complicate diagnosis. We are presenting two cases of maxillary midline radiolucencies with a similar presentation but different diagnoses. Reaching a definitive diagnosis may be complicated, even when a detailed clinical examination has been carried out. The use of CBCT has been a valuable addition to the diagnostic armamentarium which can help clinicians reach more accurate diagnoses in such cases. A definitive diagnosis may be established following histopathological analysis, which is indicated in symptomatic cases. CPD/Clinical Relevance: This article highlights the importance of careful assessment of apical radiolucencies associated with the maxillary midline, leading to the correct diagnoses and appropriate treatment planning.

Malignant peripheral nerve sheath tumour of thyroid: a diagnostic dilemma

2020 ◽  
Vol 13 (4) ◽  
pp. e234374
Author(s):  
Muhammad Hassan Danish ◽  
Muhammad Wasif ◽  
Nasir Ud Din ◽  
Muhammad Sohail Awan
Keyword(s):  
Peripheral Nerve ◽  
Neck Mass ◽  
Diagnostic Dilemma ◽  
Airway Compression ◽  
Nerve Sheath Tumour ◽  
Neck Masses ◽  
Nerve Sheath ◽  
Appropriate Treatment ◽  
History Of ◽  
Peripheral Nerve Sheath Tumour

Malignant peripheral nerve sheath tumours of thyroid are rare entities that can present a diagnostic dilemma. We present the case of a patient who presented with neck mass with a history of multiple neck surgeries and airway compression. The patient’s previous histopathology was mistaken for Riedel’s thyroiditis in an outside hospital, which delayed appropriate treatment leading to suffering on part of the patient and frustration on part of the physician. We emphasise that rare malignancies should be considered in rapidly growing neck masses that are causing airway compression, and histopathology of such tumours should be reported by expert pathologists.

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