scholarly journals Maternal Collapse during Caesarean Section: Two Case Reports

2016 ◽  
Vol 11 (1) ◽  
pp. 65-67
Author(s):  
Ritu Pradhan ◽  
Tara Gurung ◽  
Sangeeta Shrestha ◽  
Ujjwol Basnet ◽  
Kiran R Sharma ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Caesarean Section ◽  
Blood Transfusion ◽  
Case Reports ◽  
Rare Complication ◽  
Case Series ◽  
Massive Blood Transfusion ◽  
Obstetric Haemorrhage ◽  
The World

Obstetric haemorrhage is the leading cause of maternal collapse in our part of the world. That can result in cardiac arrest. Cardiac arrest during caesarean section is a rare complication which is challenging to both the anaesthesiologists and the obstetricians. Here we are reporting two case series of cardiac arrest during caesarean section following delivery of baby due to haemorrhage. Both the cases revived after prompt and active resuscitation followed by massive blood transfusion.

scholarly journals Massive blood transfusion for obstetric haemorrhage

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
S Simmons ◽  
WE Pollock ◽  
L Phillips ◽  
S McDonald
Keyword(s):  
Blood Transfusion ◽  
Massive Blood Transfusion ◽  
Obstetric Haemorrhage

scholarly journals Clinical Features and Outcome of SARS-CoV-2 Infection in Neonates: A Systematic Review

2020 ◽  
Author(s):  
Shashi Kant Dhir ◽  
Jogender Kumar ◽  
Jitendra Meena ◽  
Praveen Kumar
Keyword(s):  
Caesarean Section ◽  
Clinical Features ◽  
Search Strategy ◽  
Web Of Science ◽  
Case Reports ◽  
Mode Of Delivery ◽  
Case Series ◽  
Congenital Infection ◽  
Modes Of Transmission ◽  
Mesh Terms

Abstract Objective The objective of this study is to systematically synthesize the currently available literature on various modes of transmission (congenital, intrapartum, and postpartum), clinical features and outcomes of SARS-CoV-2 infection in neonates. Methods We conducted a comprehensive literature search using PubMed, EMBASE, and Web of Science until 9 June 2020. A combination of keywords and MeSH terms, such as COVID-19, coronavirus, SARS-CoV-2, 2019-nCoV, severe acute respiratory syndrome coronavirus 2, neonates, newborn, infant, pregnancy, obstetrics, vertical transmission, maternal–foetal transmission and intrauterine transmission, were used in the search strategy. We included studies reporting neonatal outcomes of SARS-CoV-2 proven pregnancies or neonatal cases diagnosed with SARS-CoV-2 infection. Results Eighty-six publications (45 case series and 41 case reports) were included in this review. Forty-five case series reported 1992 pregnant women, of which 1125 (56.5%) gave birth to 1141 neonates. A total of 281 (25%) neonates were preterm, and caesarean section (66%) was the preferred mode of delivery. Forty-one case reports describe 43 mother-baby dyads of which 16 were preterm, 9 were low birth weight and 27 were born by caesarean section. Overall, 58 neonates were reported with SARS-CoV-2 infection (4 had a congenital infection), of which 29 (50%) were symptomatic (23 required ICU) with respiratory symptoms being the predominant manifestation (70%). No mortality was reported in SARS-CoV-2-positive neonates. Conclusion The limited low-quality evidence suggests that the risk of SARS-CoV-2 infections in neonates is extremely low. Unlike children, most COVID-positive neonates were symptomatic and required intensive care. Postpartum acquisition was the commonest mode of infection in neonates, although a few cases of congenital infection have also been reported.

scholarly journals ECMO in Poisoning

2017 ◽  
Vol 01 (02) ◽  
pp. 82-88
Author(s):  
Vivek Gupta ◽  
Gurpreet S. Wander
Keyword(s):  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Reports ◽  
Case Series ◽  
Supportive Therapy ◽  
Tissue Perfusion ◽  
Western World ◽  
Hemodynamic Compromise ◽  
The World

AbstractSevere poisoning may lead to life-threatening situation or death due to cardiovascular dysfunction, arrhythmia, or cardiogenic shock. The poisoning substance varies in different parts of world; in the Western world, the drugs with cardiotoxic potential are more common, while pesticides and other household toxins are common in the rest of the world. However, most of these patients are relatively young and otherwise healthy irrespective of poisoning substances. Extracorporeal membrane oxygenation (ECMO) has regained interest in recent past and now its use is being explored for newer indications. The use of ECMO in poisoning has shown promising results as salvage therapy and can be used as bridge to recovery, antidote, and toxin removal with renal replacement therapy or transplant. The ECMO has been used in those poisoned patients who have persistent cardiogenic shock or refractory hypoxemia despite adequate supportive therapy. ECMO may be useful in providing adequate cardiac output and maintain tissue perfusion which helps in the redistribution of toxins from central circulation and facilitate the metabolism and excretion. However, the available literature is not sufficient and is based on case reports, case series, and retrospective cohort study. In spite of high mortality with severe poisoning and encouraging outcome with use of ECMO, it is an underutilized modality across the world. Though evidences suggest that early consideration of ECMO in severely poisoned patients with refractory cardiac arrest or hemodynamic compromise refractory to standard therapies may be beneficial, the right time to start ECMO in poisoned patients, criteria to start ECMO, and prognostication prior to initiation of ECMO is yet to be answered. Future studies and publications may address these issues, whereas the ELSO (Extracorporeal Life Support Organization) data registry may help in collecting global data on poisoning more effectively.

scholarly journals Unmasking of Neurosarcoidosis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A618-A618
Author(s):  
Sharini Venugopal ◽  
Binita Neupane ◽  
Mahesh Nepal ◽  
Luis F Chavez
Keyword(s):  
Diabetes Insipidus ◽  
Medical History ◽  
Case Reports ◽  
Rare Complication ◽  
Case Series ◽  
Primary Hypothyroidism ◽  
Past Medical History ◽  
Water Excretion ◽  
History Of ◽  
Glucocorticoid Deficiency

Abstract Introduction: Central diabetes insipidus is a rare complication of neurosarcoidosis. In patients with concomitant adrenal insufficiency (AI), the symptoms of Diabetes Insipidus (DI) can be masked. Case: A 55-year-old female with past medical history of sarcoidosis presented to the hospital with hematemesis, nausea and dizziness. She has a past medical history of cardiac sarcoidosis that was revealed on a PET scan done before 10 years for which she was being treated with methotrexate and prednisone. She was off prednisone for a year prior to hospitalization. She underwent an upper endoscopy that showed diffusely erythematous gastric mucosa in the antrum. She was also hypotensive on admission, and she received packed red blood transfusions after which her sodium increased from 145mmol/L to 165mmol/L (Normal: 135-145mmol/L) in 48 hours. Further workup revealed persistent hypernatremia and urine osmolality was 75mOsm/kg H2O. (Normal: 50-1200mOsm/kg H2O). She was also hypoglycemic and hypotensive requiring multiple fluid boluses throughout her hospitalization. This prompted us to perform a random cortisol that came back at 2.1ug/dl (Normal: 3-23ug/dl) and 1.8ug/dl on two occasions. Cortisol Stimulation test was subsequently ordered, but was done only at 30 minutes, and Cortisol increased from 1.8ug/dl to 6.3ug/dl. Free thyroxine was 0.5 ng/dl (Normal: 0.9-1.8 ng/dl) and her TSH was 7.58uIU/ml (Normal: 0.55-4.78uIU/ml). MRI of the brain revealed extensive areas of extra-axial supra-sellar/infundibular nodular homogeneous intense enhancement that is most consistent with neuro-sarcoid. She was started on prednisone 40 mg daily, Desmopressin 0.05 mg twice daily, and levothyroxine as well. Her sodium level normalized and was 137mmol/L at discharge. She followed up later with outpatient Endocrinology and reported around 90lbs weight gain and no more episodes of nausea or vomiting or epistaxis or lightheadedness. Conclusion: The involvement of the hypothalamic-pituitary axis in sarcoidosis is extremely rare and attributes to < 1% of patients with a sellar mass. Small case series have shown that hypogonadism is the most common endocrine abnormality followed by DI. Our patient had a long-standing history of sarcoidosis with her pituitary dysfunction unmasked only on admission for other causes. She did not manifest any symptoms of DI or AI. There have been case reports where the symptoms of DI are masked due to underlying glucocorticoid deficiency. There have been theories that glucocorticoid deficiency impairs renal water excretion by both ADH (Anti-diuretic hormone) dependent and ADH independent pathways. Another notable feature in our case is that our patient presented with primary hypothyroidism. In fact, sarcoidosis has been commonly implicated in auto-immune polyglandular syndromes type 3, which can present with auto-immune thyroiditis more so in females.

scholarly journals Massive Soft Tissue Haemophilic Pseudotumor in Limbs: Lessons Learnt from an Extremely Rare Problem

2021 ◽  
pp. 1-4
Author(s):  
C F Munson ◽  
C F Munson ◽  
A N Morritt
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Medical Management ◽  
Case Reports ◽  
Case Series ◽  
Lessons Learnt ◽  
The World ◽  
The Future ◽  
Extensive Surgery ◽  
Future Management

Haemophilic pseudotumors are very rare, encapsulated haematomas forms as a result of repetitive bleeding, forming a mass of clotted blood and necrosed tissue. Reported experience in the literature is limited to case reports and case series from around the world, reporting on smaller and medium sized pseudotumors. Conflicting opinion exists following failed medical management, which includes minimally invasive interventions through extensive surgery. We present our experience with the management of two of the largest soft tissue pseudotumors reported in the literature. We also provide some guidance, based on our experiences, for the future management of massive haemophilic pseudotumors.

scholarly journals Gastrointestinal perforation in COVID-19 patients – case series and review of the literature

2020 ◽  
Vol 4 (4) ◽  
pp. 18-21
Author(s):  
Deepak Verma ◽  
◽  
Sarthak Sharma ◽  
Lalit Kishore Garg ◽  
Aishwarya Tinaikar
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Gastric Perforation ◽  
Rare Complication ◽  
Case Series ◽  
Colonic Perforation ◽  
Gastrointestinal Perforation ◽  
Review Of The Literature ◽  
Abdominal Symptoms ◽  
The World ◽  
Almost All

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2) involving the respiratory tract started in 2019 in Wuhan, China but spread to almost all parts of the world to the extent that it was declared a pandemic by WHO. As more and more cases are detected, the involvement of systems other than respiratory was observed and nearly 5 to 50 % of patients have abdominal symptoms like pain and diarrhea. During the course of treatment, few patients developed a rare complication of gastrointestinal perforation. Three cases (two with colonic perforation and one with gastric perforation) of gastrointestinal perforation in COVID-19 positive patient are reported in the article with a review of the literature regarding the various hypothesis of intestinal perforation in these patients. Keywords: COVID-19; gastrointestinal perforation; severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2); Tocilizumab

Intravenous ranitidine injection and risk of cardiac arrest: Medication errors

2020 ◽  
pp. 1-7
Author(s):  
Mulugeta Russom ◽  
Dawit Tesfai ◽  
Amon Solomon Ghebernegus ◽  
Merhawi Debesai ◽  
Habtom Kifle ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medication Errors ◽  
Healthcare Professionals ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Causal Link ◽  
The Other ◽  
Pharmacovigilance Centre ◽  
Global Database

BACKGROUND: Ranitidine injection is not well-known to cause cardiac arrest except in few published case reports. The Eritrean Pharmacovigilance Centre received four cases of cardiac arrest associated with ranitidine injection. AIM: To assess the causal relationship between cardiac arrest and ranitidine, and to identify possible risk factors. METHODS: This is a descriptive case series assessment of cardiac arrest associated with ranitidine and data was mined to supplement the cases from the WHO global database of individual case safety reports. RESULTS: In all cases, ranitidine injection was administered fast IV bolus without proper dilution and the outcome was fatal in three. All patients encountered cardiac arrest within 20 minutes of intravenous use. Causality was found to be probable in two cases and possible in the other two. Cardiac arrest could have been prevented in all cases. On top of this, from the WHO global database, 185 cases of cardiac arrest and cardio-pulmonary arrest associated with ranitidine were retrieved and 49.7% were fatal. In 40% of the cases, ranitidine was reported as a single suspect. In 36 cases, cardiac arrest resolved following withdrawal of ranitidine and reaction recurred in one case after re-introduction of the product. CONCLUSION: There appears a causal link between ranitidine and cardiac arrest, possibly related to medication errors that warrants immediate attention from healthcare professionals.

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

2020 ◽  
Vol 04 (02) ◽  
pp. 110-121
Author(s):  
Zachary Henry
Keyword(s):  
Portal Hypertension ◽  
Case Reports ◽  
Rare Complication ◽  
Treatment Options ◽  
Specific Treatment ◽  
Case Series ◽  
Vascular Anatomy ◽  
Rectal Varices ◽  
Ectopic Varices ◽  
Definitive Therapy

AbstractGastric and Ectopic varices are a rare complication of portal hypertension and represent a complex, heterogeneous system of vascular shunts. Bleeding from these shunts can be severe and life-threatening, with poorly standardized treatment algorithms to follow in their management. When bleeding occurs, it is important to follow standard diagnostic procedures for portal hypertensive bleeding and always obtain imaging of the underlying vascular anatomy to help guide therapy. Potential treatment methods will depend on these imaging findings as well as the location of the varix within the gastrointestinal tract. While gastric varices have more data to support specific treatment options, duodenal and rectal varices have only case reports and case series to guide their care. In addition, stomal varices are a very rare complication of portal hypertension and have limited data to support any one treatment modality. Gastric and ectopic varices are best approached in a multidisciplinary fashion after discussion with hepatologists and interventional radiologists to overcome the uncertainty in choosing a definitive therapy.

scholarly journals Immunotherapy-related gastritis: Two case reports and literature review

2021 ◽  
Vol 15 ◽  
pp. 117955492110285
Author(s):  
Rachel Woodford ◽  
Karen Briscoe ◽  
Richard Tustin ◽  
Ankit Jain
Keyword(s):  
Adverse Event ◽  
Literature Review ◽  
Case Reports ◽  
Rare Complication ◽  
Case Series ◽  
Common Adverse Event ◽  
Comprehensive Review

Immunotherapy is increasingly defining a role in a wide variety of tumours such that as use becomes more ubiquitous, so too will the complications. A relatively rare complication of immunotherapy use is immune-related gastritis. In this case series, we present two cases of immunotherapy-related gastritis from our institution and undertake a comprehensive review and analysis of the literature around this less common adverse event.

Coblation for epistaxis management in patients with hereditary haemorrhagic telangiectasia: a multicentre case series

2011 ◽  
Vol 125 (11) ◽  
pp. 1176-1180 ◽  
Author(s):  
H Joshi ◽  
B A Woodworth ◽  
A S Carney
Keyword(s):  
Disease Severity ◽  
Treatment Modality ◽  
World Literature ◽  
Case Reports ◽  
Case Series ◽  
Treatment Modalities ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Potential Treatment ◽  
Novel Technique ◽  
The World

AbstractObjective:To propose radiofrequency coblation as a potential treatment modality for mild to moderate epistaxis in patients with hereditary haemorrhagic telangiectasia.Method:Case reports and review of the world literature concerning coblation and other treatment modalities for epistaxis in patients with hereditary haemorrhagic telangiectasia.Results:Effective epistaxis control was achieved in four out of five cases of hereditary haemorrhagic telangiectasia. In the fifth case, we struggled to achieve haemostasis due to disease severity.Conclusion:Radiofrequency coblation is a novel technique, which was found to be a safe, effective, quick and well tolerated treatment option for epistaxis management in patients with hereditary haemorrhagic telangiectasia.

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