scholarly journals Futile Sexual Homicide in Nepal: A Case Report

2021 ◽  
Vol 59 (243) ◽  
pp. 1174-1176
Author(s):  
Alok Atreya ◽  
Shiva Pandit ◽  
Samata Nepal ◽  
Jun Bajracharya ◽  
Deepak Shrestha
Keyword(s):  
Emergency Department ◽  
Sexual Abuse ◽  
Case Report ◽  
Sexual Intercourse ◽  
Sexual Homicide ◽  
Sexual Offenses ◽  
History Of ◽  
Uncommon Case

Although cases of sexual offenses are not uncommon in children, they present to the Emergency Department seeking treatment for a medical cause. Sometimes the history of abuse is missed by the treating clinicians who are only focused upon the presenting complaint and not upon the underlying cause. Furthermore, the lack of reporting of sexual abuse in medical literatures makes them a rarity in the Nepalese scenario. We present an uncommon case of a child where the perpetrator who tried to silence her during the sexual intercourse made a futile attempt to kill her cutting her throat with a sickle.

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

scholarly journals Non-painful severe variant form of eruptive lingual papillitis: A case report and literature review

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Manal Ahmed Halwani
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Oral Hygiene ◽  
Rare Case ◽  
Dorsal Surface ◽  
Variant Form ◽  
Girl Child ◽  
Rare Case Report ◽  
History Of

Eruptive lingual papillitis is a common benign disorder manifested by inflammation of fungiform papillae on the dorsolateral surface of the tongue. Several variants of lingual papillitis have been reported since 1997, most or all of them with painful erythematous papules. Here we report a case of 6 years old girl child with non-painful severe variant form of eruptive lingual papillitis presented to the emergency department. The entire dorsal surface of the tongue was surfaced by 2-3mm by multiple erythematous papules and some with a white or yellowish colour. The papules were excessively inflamed, pigmented, aggregated, and crusted. The cause was idiopathic which resolved within ten days. The parent and patient were reassured with advice to practice oral hygiene. This is a rare case report describing non-painful lingual papillitis without a history of any prior episodes.

scholarly journals Case report: MRI findings of acute uremic encephalopathy in a 1-year-old boy

2021 ◽  
pp. 20210057
Author(s):  
Amar Ajay Chotai ◽  
Dipayan Mitra
Keyword(s):  
Emergency Department ◽  
Renal Function ◽  
Case Report ◽  
Extracellular Potassium ◽  
Neurological Abnormality ◽  
Normal Range ◽  
Mri Findings ◽  
Intracellular Space ◽  
History Of ◽  
Function Profile

We present a 1-year-old boy who presented to the emergency department with a 7-day history of diarrhoea and vomiting. The initial renal function profile demonstrated a urea of 55 mmol l−1 (normal range between 5 and 20 mmol l−1), creatinine 695 micromol/L (normal range between 62–106 micromol/L) and potassium 9.1 mmol l−1 (normal range between 3.5–5.0 mmol l−1), with a profound metabolic acidosis. Upon examination, there were no significant findings, specifically no neurological abnormality. He was prescribed back-to-back Salbutamol nebulisers, to increase the shift of extracellular potassium into the intracellular space, followed by i.v. calcium gluconate, with some improvement in potassium levels. A further 5 mmol of sodium bicarbonate was given, as well as a stat dose of 1 mg/kg furosemide, and per rectal calcium resonium. He was then commenced on an infusion with 10% dextrose with insulin. He was subsequently found to be in urinary retention and a catheter was inserted, which drained 1700 ml. A subsequent renal function profile, 24 hours after admission, demonstrated improvement with urea 39 mmol l−1, creatinine 300 micromol/L and potassium 3.0 mEq/L.

Wound Management of a Pediatric Spina Bifida Patient Secondary to a Canine-Inflicted Fifth-Digit Amputation: A Case Report

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Brittany A. Lovett ◽  
Cristóbal S. Berry-Cabán ◽  
Deanna E. Duran ◽  
Sharon P. McKiernan
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Spina Bifida ◽  
Human Infection ◽  
Further Education ◽  
Wound Management ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
The Family ◽  
History Of

We present a case of a pediatric patient with a history of spina bifida who presented to the emergency department of a large Army medical treatment facility with a partially amputated right fifth digit she sustained while sleeping with the family canine. There are several reports in the popular press that suggest that an animal, particularly a dog, can detect human infection, and it is hypothesized that the toe chewing was triggered by a wound infection. This case provides an opportunity to provide further education in caring for foot wounds in patients with spina bifida.

scholarly journals Case Report: Pediatric POCUS: 4 month old infant with a timely diagnosis

POCUS Journal ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 13-14
Author(s):  
Victor Istasy MD, FRCPC ◽  
Tim Lynch MD, FRCPC ◽  
Rodrick Lim, MD, FRCPC
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Female Infant ◽  
Telephone Consultation ◽  
Timely Diagnosis ◽  
Bilious Vomiting ◽  
History Of ◽  
Local Emergency Department

A healthy, four month-old female infant presented to a local emergency department with a 12-hour history of decreased activity, non-bilious vomiting and one episode of dark red blood in the stools. There was no history of fever. Telephone consultation was completed and the patient was transferred to a tertiary, pediatric centre for further evaluation. On arrival, the infant appeared pale and was lethargic during the exam.

scholarly journals Uterovaginal prolapse following suspected sexual abuse to a child: a case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Odion-Obomhense Kesiena Helen ◽  
Ntaji Maureen Iru ◽  
Ekpebe Patrick Akpofure ◽  
Afeyodion Akhator
Keyword(s):  
Sexual Abuse ◽  
Case Report ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Uterovaginal Prolapse ◽  
Traumatic Rupture ◽  
Connective Tissues ◽  
Case Presentation ◽  
History Of

Abstract Background Uterovaginal prolapse occurs when damaged connective tissues allow the uterus to drop into the vagina. Rare in children, uterovaginal prolapse can occur as a result of violent sexual assault. This case is being reported because there has been no previous report of acquired pelvic organ prolapse following trauma suspected to be sexual abuse in a child in our setting. Case presentation Two-year-old female presented to our hospital with a 3-day history of abnormal protrusion from the vagina and a 2-day history of bleeding per vagina. Traumatic rupture of the hymen was observed. The urethra was not edematous or hyperemic. The reduction was done successfully under sedation and maintained using a crepe bandage. There was no recurrence after 3-month follow-up. Conclusions Uterovaginal prolapse presenting among children below 5 years is rare. If bleeding per vagina is reported in a child, the clinician should be aware of the possibility of uterovaginal prolapse.

The Association of Consensual Sexual Intercourse During Childhood With Adolescent Health Risk and Behaviors

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 907-913
Author(s):  
Michael D. Resnick ◽  
Robert Wm. Blum
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Sexual Intercourse ◽  
Risk Behaviors ◽  
Adolescent Health ◽  
Mental Health Treatment ◽  
Health Treatment ◽  
Gang Involvement ◽  
History Of ◽  
Index Cases

Objective. The association of childhood sexual intercourse, excluding sexual abuse, with adolescent health and risk behaviors was examined using the urban component of a statewide study on adolescent health, risky behaviors, and resiliency factors. Methodology. A specialized cohort design was used to derive a two-group sample. Index cases consisted of all adolescents who indicated that they had first intercourse at or before age 10 years, and controls were adolescents who either had not yet had intercourse or had done so at age 16 years or older. To avoid confounding with issues of sexual abuse, all adolescents who also indicated a history of sexual abuse on the survey were removed from the analysis, so that the comparison could focus on health and behavioral correlates of respondents who did not define their childhood sexual intercourse as constituting abuse. Comparisons were conducted separately for girls and boys. Results. A significantly greater proportion of index cases than controls indicated problem substance use by parents, poor school performance, gang involvement, frequent and unprotected sexual intercourse, history of pregnancy involvement, desire to leave the home, history of mental health treatment, emotional distress, and suicidal involvement. Logistic regression revealed significant group differences including academic risk, gang involvement, frequency of sexual intercourse, and history of mental health treatment. Correct group classification with the logit model was approximately 90% for both girls and boys. Conclusions. The results underscore the importance of childhood sexual intercourse as an indicator of other health-compromising behaviors and risk factors. Clinicians should be alert to this clustering of risk behaviors in their psychosocial assessment of young people.

scholarly journals Gemcitabine-induced pseudocellulitis: a case report and review of the literature

2019 ◽  
Vol 26 (5) ◽  
Author(s):  
H. Bami ◽  
C. Goodman ◽  
G. Boldt ◽  
M. Vincent
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Side Effects ◽  
Chemotherapeutic Agent ◽  
Whipple Procedure ◽  
Venous Stasis ◽  
Past Medical History ◽  
Review Of The Literature ◽  
Peripheral Vascular ◽  
History Of

Gemcitabine is a chemotherapeutic agent used in a wide variety of solid tumours. Known side effects include a dose-limiting myelosuppressive toxicity, mild rash, and radiation-dependent dermatitis. Rarely, localized inflammation in the form of pseudocellulitis has also been observed. We present the case of a 77-year-old woman with a history of a Whipple procedure for pancreatic adenocarcinoma who presented to the emergency department after the start of gemcitabine therapy with increased erythema, swelling, and tenderness in her lower legs. Relevant past medical history included peripheral vascular disease, dyslipidemia, and hypertension. A diagnosis of gemcitabine-induced pseudocellulitis aggravated by venous stasis was confirmed after an extensive workup. This case report and the literature review describe this rare reaction, highlighting the need for increased recognition to avoid unnecessary therapeutic intervention.

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