scholarly journals A case report on Sarcoidosis

2015 ◽  
Vol 22 (2) ◽  
pp. 225-228
Author(s):  
Sudip Ranjan Deb ◽  
Ratul Sarkar ◽  
Pratyay Hasan ◽  
Shegufta Mishket Mukerrama ◽  
Prianka Baral ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Organ System ◽  
Mediastinal Lymphadenopathy ◽  
Unknown Aetiology ◽  
Multisystem Disease ◽  
Medical College ◽  
Subcutaneous Nodules ◽  
The World ◽  
Diagnostic Work ◽  
Work Up

Sarcoidosis is a multisystem disease that may involve almost any organ system. Infiltration with non-caseating granulomas is the hallmark of the disease, and it may result in various clinical manifestations. Since the first description of the disease by British dermatologist Jonathan Hutchison in 1869, sarcoidosis has been seen in almost every part of the world and continues to engender considerable interest among clinicians because of its unknown aetiology, protean manifestations, and variable course and prognosis. Here we report a 65-year old woman who presented to us with a rather atypical presentation of sarcoidosis- subcutaneous nodules. Later, on subsequent diagnostic work-up, she was found to have bilateral hilar and mediastinal lymphadenopathy and pulmonary reticular lesions. It is a bit unusual to have only subcutaneous nodules as the presenting complaint of sarcoidosis without any prominent systemic and respiratory symptoms, which is what prompted this report. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21549 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 225-228

scholarly journals Aetiologies and temporal trends of atrioventricular block in young patients: a 20-year nationwide study

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1710-1716 ◽  
Author(s):  
Johnni Rudbeck-Resdal ◽  
Morten K Christiansen ◽  
Jens B Johansen ◽  
Jens C Nielsen ◽  
Henning Bundgaard ◽  
...  
Keyword(s):  
Heart Disease ◽  
Atrioventricular Block ◽  
Temporal Trends ◽  
Pacemaker Implantation ◽  
Young Patients ◽  
Unknown Aetiology ◽  
Number Of Patients ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Abstract Aims To describe aetiologies and temporal trends in young patients with atrioventricular block (AVB). Methods and results We identified all patients in Denmark, receiving their first pacemaker because of AVB before the age of 50 years between 1996 and 2015. Medical records were reviewed and clinical information and diagnostic work-up results were obtained to evaluate the aetiology. We used Poisson regression testing for temporal trends. One thousand and twenty-seven patients were identified, median age at time of implantation was 38 (interquartile range 25–45) years, 584 (56.9%) were male. The aetiologies were complications to cardiac surgery [n = 157 (15.3%)], congenital AVB [n = 93 (9.0%)], cardioinhibitory reflex [n = 52 (5.0%)], congenital heart disease [n = 43 (4.2%)], complication to radiofrequency ablation [n = 35 (3.4%)], cardiomyopathy [n = 31 (3.0%)], endocarditis [n = 18 (1.7%)], muscular dystrophy [n = 14 (1.4%)], ischaemic heart disease [n = 14 (1.4%)], sarcoidosis [n = 11 (1.1%)], borreliosis [n = 9 (0.9%)], hereditary [n = 6 (0.6%)], side-effect to antiarrhythmics [n = 6 (0.6%)], planned His-ablation [n = 5 (0.5%)], complication to alcohol septal ablation [n = 5 (0.5%)], and other known aetiologies [n = 11 (1.1%)]. The aetiology remained unknown in 517 (50.3%) cases. While the number of patients with unknown aetiology increased during the study period (P < 0.001), we observed no significant change in the number of patients with identified aetiology (P = 0.35). Conclusion In a nationwide cohort, the aetiology of AVB was identified in only half the patients younger than 50 years referred for first-time pacemaker implantation. The number of patients with unknown aetiology increased during the study period. These findings indicate need for better insight into aetiologies of AVB and improved diagnostic work-up guidelines.

Tripe palms and malignancy.

1989 ◽  
Vol 7 (5) ◽  
pp. 669-678 ◽  
Author(s):  
P R Cohen ◽  
M E Grossman ◽  
L Almeida ◽  
R Kurzrock
Keyword(s):  
Gastric Carcinoma ◽  
World Literature ◽  
Acanthosis Nigricans ◽  
Patients With Cancer ◽  
The World ◽  
Associated Malignancy ◽  
Diagnostic Work ◽  
Work Up ◽  
Pulmonary Tumors ◽  
Diagnostic Work Up

Tripe palms are characterized clinically by thickened velvety palms with pronounced dermatoglyphics. We describe two patients with triple palms and pulmonary tumors, and review the 77 patients with idiopathic- and malignancy-associated tripe palms reported in the world literature. The majority (94%) of published cases of tripe palms occurred in patients with cancer; only five patients showed no evidence of an associated malignancy. Tripe palms were frequently seen in conjunction with acanthosis nigricans (77% of cases), although they can occur alone (23% of cases). In cancer patients with tripe palms alone, the most common underlying neoplasm was pulmonary carcinoma (53% of cases), whereas patients with both tripe palms and acanthosis nigricans frequently had gastric (35% of cases) or pulmonary (11% of cases) carcinomas. A wide variety of other solid tumors have also been observed. Importantly, in over 40% of patients, tripe palms were the presenting feature of a previously undiagnosed malignancy. Therefore, all patients with tripe palms should be evaluated with a full diagnostic work-up for an associated malignancy, particularly lung or gastric carcinoma.

scholarly journals Bilateral Paget’s Disease of Nipple

2016 ◽  
Vol 34 (1) ◽  
pp. 33-36
Author(s):  
Mahbuba Begum ◽  
Ahsan Habib ◽  
Shahrier Faisal ◽  
MAM Chowdhury ◽  
KGM Iqbal
Keyword(s):  
Breast Carcinoma ◽  
Local Treatment ◽  
Malignant Lesion ◽  
Left Breast ◽  
Rare Entity ◽  
Medical College ◽  
Diagnostic Work ◽  
High Degree ◽  
Work Up ◽  
Diagnostic Work Up

Paget’s disease of nipple is a rare entity of malignant lesion of breast and bilateral Paget’s disease is very uncommon. It presents as eczema like condition of the nipple areola which persists despite local treatment. As it is a superficial manifestation of underlying breast carcinoma high degree of suspicion is essential for proper recognition of this condition, so that early diagnostic work up can be initiated for differentiating it from other benign inflammatory skindisorder and for detecting an underlying breast carcinoma, thereby delay in proper treatment can be avoided in order to avoiding dismal consequences. Here we report a case of bilateral Paget’s disease of nipple with invasive left breast carcinoma in a 40 year old lady diagnosed in Medical College for Women and Hospital, Uttara, Dhaka.J Bangladesh Coll Phys Surg 2016; 34(1): 33-36

scholarly journals Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine

2020 ◽  
Vol 9 (3) ◽  
pp. 864
Author(s):  
Louis Kreitmann ◽  
David Montaigne ◽  
David Launay ◽  
Sandrine Morell-Dubois ◽  
Hélène Maillard ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Infective Endocarditis ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
High Sensitivity ◽  
University Hospital ◽  
Delay In Diagnosis ◽  
Duke Classification ◽  
Diagnostic Work ◽  
Work Up

Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved adult patients admitted to the department of internal medicine at Lille University Hospital between 2004 and 2015 who fulfilled Duke Classification criteria for definite IE. Thirty-five patients were included. The most frequently involved bacteria were non-hemolytic streptococci. Most patients presented with various systemic, cardiac, embolic, rheumatic, and immunological findings, with no sign or symptom displaying high sensitivity. The first transthoracic echocardiogram was negative in 42% of patients. Furthermore, definite diagnosis required performing at least 2 transesophageal examinations in 24% of patients. We observed a trend towards decreased survival in the subgroup of patients in whom the delay between onset of symptoms and diagnosis was >30 days. In conclusion, patients who are initially referred to internal medicine for a diagnosis work-up and who are ultimately diagnosed with IE have non-specific symptoms and a high percentage of initial normal echocardiography. Those patients require prolonged echocardiographic monitoring as a prolonged delay in diagnosis is associated with poorer outcomes such as death.

scholarly journals Airway Malacia: Clinical Features and Surgical Related Issues, a Ten-Year Experience from a Tertiary Pediatric Hospital

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 613
Author(s):  
Michele Ghezzi ◽  
Enza D’Auria ◽  
Andrea Farolfi ◽  
Valeria Calcaterra ◽  
Alessandra Zenga ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Surgical Treatment ◽  
Acute Respiratory Failure ◽  
Chronic Cough ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Diagnostic Work ◽  
Work Up ◽  
Cardiovascular Anomalies

Background: Few studies have been carried out with the aim of describing the clinical course and follow-up of patients with tracheomalacia. We aim to describe the symptoms at diagnosis and the post-treatment clinical course of patients affected by airway malacia. Methods: We retrospectively analyzed characteristics of pediatric patients with a diagnosis of airway malacia. Patients were classified into three groups: bronchomalacia (BM), tracheomalacia (TM) and tracheo-bronchomalacia (TBM). Demographic and clinical data, diagnostic work-up and surgical treatment were recorded. Results: 13/42 patients were affected by congenital syndromes (30.9%). Esophageal atresia with or without tracheal-esophageal fistula (EA/TEF) was detected in 7/42 patients (16.7%). Cardiovascular anomalies were found in 9/42 (21.4%) and idiopathic forms in 13/42 (30.9%). BM occurred in 7/42 (16.6%), TM in 23/42 (54.7%) and TBM in 12/42 (28.6%). At the diagnosis stage, a chronic cough was reported in 50% of cases with a higher prevalence in EA/TEF (p = 0.005). Surgery was performed in 16/42 (40%) of children. A chronic cough and acute respiratory failure were correlated to the need for surgery. During follow-up, there was no difference in persistence of symptoms between conservative vs surgical treatment (p = 0.47). Conclusion: the management of tracheomalacia remains a challenge for pediatricians. Clinical manifestations, such as a barking cough and acute respiratory failure may suggest the need for surgery. Follow-up is crucial, especially in those patients affected by comorbidities, so as to be able to manage effectively the possible persistence of symptoms, including those that may continue after surgical treatment.

scholarly journals Meningitis

2022 ◽  
pp. 33-47
Author(s):  
Rupsi . ◽  
Rakesh Kumar
Keyword(s):  
Aseptic Meningitis ◽  
Clinical Manifestations ◽  
Accurate Method ◽  
Neurological Deficits ◽  
Polymerase Chain ◽  
Diagnostic Work ◽  
Microbial Dna ◽  
Work Up ◽  
The Brain ◽  
Csf Examination

The term aseptic meningitis encompasses all types of inflammations of the brain meninges other than that caused by pus producing organisms. It is usually a mild illness. Etiology of aseptic meningitis is very wide and includes many infections - both viral and non viral, drugs, malignancy and systemic illness. The most common cause is viral infection and enteroviruses - Coxsackie and ECHO viruses account for more than half of all cases. Clinical manifestations include headache, fever, malaise, photophobia and meningeal signs. Convulsions, neurological deficits and severe obtundation are rare except with certain non viral infectious meningitis. Diagnostic work up includes blood and cerebrospinal fluid (CSF) examination and serology for infectious meningitis. The polymerase chain reaction is a rapid and accurate method for detection of microbial DNA in CSF. Treatment is mainly supportive, except for the nonviral infectious etiology.

scholarly journals DIFFUSION-WEIGHTED IMAGING FOR DIFFERENTIATING MALIGNANT FROM BENIGN MEDIASTINAL LYMPHADENOPATHY

2020 ◽  
Vol 19 (4) ◽  
pp. 33-40
Author(s):  
A. V. Sudarkina ◽  
A. P. Dergilev ◽  
N. A. Gorbunov ◽  
V. V. Kozlov ◽  
Yu. A. Fokina ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Roc Curve ◽  
Diffusion Weighted Imaging ◽  
Mediastinal Lymphadenopathy ◽  
Histopathological Diagnosis ◽  
Diffusion Weighted ◽  
Wide Range ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Introduction. Mediastinal lymphadenopathy can be caused by a wide range of benign and malignant states. Determination of the genesis of lymphadenopathy is crucial for treatment planning and prognosis of the disease.The purpose of the study was to evaluate the diagnostic accuracy of diffusion weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurements in differentiating malignant versus benign mediastinal lymphadenopathy. Material and Methods. 48 consecutive patients with at least one enlarged mediastinal lymph node revealed on CT-scans were examined on 1,5 T MR-machine with conventional images and respiratory-triggered DWI. In all patients one of the biggest solid lymph nodes was selected for ADC measurements and mean ADCs of each node were recorded. ADCs were correlated with the results of complete diagnostic work-up (including histopathological diagnosis in 41 patients) and follow-up CT. Statistics included Student’s t-test, Mann-Whitney U-test and ROC-curve analysis. Results. 27 lymph nodes were classified as malignant (metastases, lymphoma) and 21 lymph nodes were classified as benign (sarcoidosis, reactive hyperplasia, tuberculosis). Mean ADC of malignant lymph nodes (1,02 ± 0,29×10−3 mm2/s) was significantly lower than that of benign lymph nodes (1,57 ± 0,32×10−3 mm2/s), p<0,0001. The cut-off value of ≤1,3×10−3mm2/s for ADC indicated the malignancy with a sensitivity of 81,5 % and a specificity of 85,7%. The area under the ROC-curve was 0,89 (95 % confidence interval: 0,77, 0,96), p<0,0001. Conclusion. DWI is a promising technique in chest pathology. DWI with ADC measurements could be used as a good complementary tool in the diagnostic work-up of patients with mediastinal lymphadenopathy.

scholarly journals Primary Pulmonary Hydatid Disease

2018 ◽  
Vol 6 (2) ◽  
pp. 105-107 ◽  
Author(s):  
Md Tarek Alam ◽  
Sadia Saber ◽  
Rafa Faaria Alam ◽  
Mohammad Monower Hossain
Keyword(s):  
Weight Loss ◽  
Mass Effect ◽  
Final Diagnosis ◽  
Organ System ◽  
Parasitic Disease ◽  
The World ◽  
Pulmonary Hydatid Disease ◽  
Work Up ◽  
Pulmonary Echinococcosis ◽  
Tomography Scan

Echinococcosis is a parasitic disease endemic in many parts of the world. Liver is the most common affected organ followed by lungs. However, the infestation of the latter is usually secondary to another infected organ system. Symptoms are not specific and can be produced by the mass effect or cyst complications. In the article we are reporting a case of pulmonary echinococcosis in a middle aged male, where the patient presented with symptoms of fever, cough with expectoration, weight loss and dysponea. An extensive work-up showed no other foci of infestation, hence final diagnosis was done based on chest radiography and tomography scan findings and was successfully treated with Albendazole.Bangladesh Crit Care J September 2018; 6(2): 105-107

scholarly journals Analysis of Neurological Clinical Manifestations and Diagnostic Workups in Pediatric COVID-19: A Systematic Review

2021 ◽  
Author(s):  
Gilbert Sterling Octavius ◽  
Shally Chandra ◽  
Jeremiah Hilkiah Wijaya ◽  
Andry Juliansen
Keyword(s):  
Systematic Review ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Time Correlation ◽  
Neurological Manifestations ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Diagnostic Work ◽  
Work Up

Abstract Background While numerous studies report neurological manifestations of COVID-19, there are fewer reviews in the pediatric population, focusing solely on the manifestations.Aim This systematic review aims to describe the clinical manifestations and laboratory findings of pediatric patients with neurological manifestations of COVID-19.Methods We searched Pubmed, Science Direct, Medline, Scielo, Medrxiv, Research Square, SSRN, and Biorxiv with the appropriate keywords. Inclusion criteria include new-onset neurological manifestations with a time correlation to the confirmed COVID-19 with a further diagnostic work-up. We use The Joanna Briggs Institute's (JBI) essential evaluation checklist and Newcastle Ottawa Quality Assessment Scale (NOS) to evaluate the quality of the studies. The protocol for this systematic review has been registered in The international Prospective Register of Systematic Review (PROSPERO) database (CRD42021228671).Results 31 articles were ultimately chosen with 42 patients (26 male) included in this systematic review. The neurological diagnosis was mostly of the CNS classification (38/42) with a predomination of brain disorders (22/38). Most patients had lymphopenia, elevated C-reactive protein, procalcitonin, ferritin, creatinine kinase, blood urea nitrogen, D-dimer, and erythrocyte sedimentation rate. In the CNS group, CSF monocytes (55%; 11–80%), CSF polymorphonuclear (PMN) cells (15%; 0–96%), CSF red blood cells (282 cells/mm3; 2-4000 cells/mm3), and opening pressure (34.5 cm/H2O; 25–100 cm/H2O) were elevated.Conclusions Our systematic review found that neurological manifestations in COVID-19 occurred more often in males, with a majority being CNS disorders. A majority had a favorable outcome. More studies are needed in order to elucidate the viral mechanisms of SARS-CoV-2 in CSF.

COVID 19: REALS AND CHALLENGES AGAINST DOCTORS

2020 ◽  
Vol 2 (1) ◽  
pp. 65-87
Author(s):  
Zen Ahmad
Keyword(s):  
Virus Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Unknown Etiology ◽  
Wuhan City ◽  
Traditional Markets ◽  
Pneumonia Case ◽  
The World ◽  
New Type ◽  
Health Organization

Corona Virus Disease (Covid-19) is a contagious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which was discovered in December 2019 in China. This disease can cause clinical manifestations in the airway, lung and systemic. The World Health Organization (WHO) representative of China reported a pneumonia case with unknown etiology in Wuhan City, Hubei Province, China on December 31, 2019. The cause was identified as a new type of coronavirus on January 7, 2020 with an estimated source of the virus from traditional markets (seafood market). ) Wuhan city

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