scholarly journals LUMBAR RADICULOPATHY MANAGED WITH SPINAL MOBILIZATION WITH LEG MOVEMENT: A CASE STUDY

2021 ◽  
Vol 20 (2) ◽  
pp. 246-249
Author(s):  
Varun Singh ◽  
◽  
Manoj Malik ◽  
Keyword(s):  
Surgical Intervention ◽  
Therapy Outcome ◽  
First Line ◽  
Lumbar Intervertebral Disc ◽  
Case Presentation ◽  
Interferential Therapy ◽  
Lumbar Traction ◽  
Leg Movement ◽  
Straight Leg Raise

Purpose. This report describes the case of prolapsed lumbar intervertebral disc with radiating pain to leg managed with spinal mobilization with leg movement (SMWLM) combined with intermittent lumbar traction (ILT) and interferential therapy. Case presentation. Twelve treatment sessions carried out over 4 consecutive weeks thrice weekly consisting of spinal mobilization with leg movement, intermittent lumbar traction and interferential therapy. Outcome measures were documented by using Visual analog score (VAS), Oswestry disability index (ODI) and range of straight leg raise (SLR) score. After 4 weeks, VAS improved by 7 points and ODI score improved by 19 points. Range of straight leg raise also increased significantly from 46.30 to 68.40. Conclusions. Spinal mobilization with leg movement combined with intermittent lumbar traction and interferential therapy resulted in decrease in disability and pain as well as improvement in range of straight leg raise. Therefore, it may be used as a first line of treatment with massive disc prolapse before surgical intervention.

scholarly journals Immediate hypersensitivity reaction followed by successful oral desensitization to ursodiol

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Erika Yue Lee ◽  
Christine Song
Keyword(s):  
Hypersensitivity Reaction ◽  
Primary Biliary Cholangitis ◽  
Line Treatment ◽  
Second Line ◽  
Immediate Hypersensitivity ◽  
First Line ◽  
Case Presentation ◽  
Desensitization Protocol ◽  
First Line Treatment ◽  
Oral Desensitization

Abstract Background Immediate hypersensitivity reaction to ursodiol is rare and there is no previously published protocol on ursodiol desensitization. Case presentation A 59-year-old woman with primary biliary cholangitis (PBC) developed an immediate hypersensitivity reaction to ursodiol—the first-line treatment for PBC. When she switched to a second-line treatment, her PBC continued to progress. As such, she completed a novel 12-step desensitization protocol to oral ursodiol. She experienced recurrent pruritus after each dose following desensitization, which subsided after a month of being on daily ursodiol. Conclusion Immediate hypersensitivity reaction to ursodiol is uncommon. Our case demonstrated that this novel desensitization protocol to ursodiol could be safely implemented when alternative options are not available or have proven inferior in efficacy.

scholarly journals State-of-the-art surgery for ulcerative colitis

2021 ◽  
Author(s):  
Shanglei Liu ◽  
Samuel Eisenstein
Keyword(s):  
Ulcerative Colitis ◽  
Surgical Intervention ◽  
State Of The Art ◽  
Total Proctocolectomy ◽  
First Line ◽  
Anastomotic Complications ◽  
Permanent Ileostomy ◽  
Elective Setting ◽  
Pouch Reconstruction ◽  
Degrees Of Severity

AbstractUlcerative colitis (UC) is an autoimmune-mediated colitis which can present in varying degrees of severity and increases the individual’s risk of developing colon cancer. While first-line treatment for UC is medical management, surgical treatment may be necessary in up to 25–30% of patients. With an increasing armamentarium of biologic therapies, patients are presenting for surgery much later in their course, and careful understanding of the complex interplay of the disease, its management, and the patient’s overall health is necessary when considering he appropriate way in which to address their disease surgically. Surgery is generally a total proctocolectomy either with pelvic pouch reconstruction or permanent ileostomy; however, this may need to be spread across multiple procedures given the complexity of the surgery weighed against the overall state of the patient’s health. Minimally invasive surgery, employing either laparoscopic, robotic, or transanal laparoscopic approaches, is currently the preferred approach in the elective setting. There is also some emerging evidence that appendectomy may delay the progression of UC in some individuals. Those who treat these patients surgically must also be familiar with the numerous potential pitfalls of surgical intervention and have plans in place for managing problems such as pouchitis, cuffitis, and anastomotic complications.

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

scholarly journals Early radical cystectomy with negative margins in a 57-year-old female with myxoid/round cell liposarcoma of the bladder suggests prolonged overall survival

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Johannes Eduard Delport ◽  
Khanyisa Makamba
Keyword(s):  
Overall Survival ◽  
Surgical Intervention ◽  
Radical Surgery ◽  
Bladder Tumour ◽  
Eastern Cape ◽  
Round Cell ◽  
Female Population ◽  
Case Presentation ◽  
Rural Town ◽  
Common Cancer

Abstract Background Bladder cancer is the 17th most common cancer in the female population. Most bladder cancers are of urothelial origin. Sarcomas of the bladder are very uncommon. Case presentation This case concerns a 57-year-old female from a rural town in the Eastern Cape who was diagnosed with myxoid/round cell liposarcoma of the bladder. After the initial transurethral resection of the bladder tumour, she underwent an anterior exenteration with Bricker’s diversion (ileal conduit) and negative margins were achieved. Conclusions Sarcomas of the bladder are known to have a poor prognosis. Our patient is alive with good stoma function more than 24 months since her radical surgery. We are of the opinion that her favourable overall survival is attributable to early radical surgical intervention with negative margins.

scholarly journals Allopurinol-Induced Oral Lichenoid Drug Reaction with Complete Regression after Drug Withdrawal

2020 ◽  
Vol 7 (2) ◽  
pp. 18-25
Author(s):  
Alexandre Perez ◽  
Benjamin Lazzarotto ◽  
Jean-Pierre Carrel ◽  
Tommaso Lombardi
Keyword(s):  
Drug Reaction ◽  
Lichen Planus ◽  
Drug Withdrawal ◽  
Acute Onset ◽  
Complete Regression ◽  
Oral Manifestations ◽  
First Line ◽  
Drug Induced ◽  
Case Presentation ◽  
Oral Lichenoid Lesions

Background: Lichen planus is a chronic mucocutaneous inflammatory disease. Oral manifestations are common, and may remain exclusive to the oral mucosa without involvement of the skin or other mucosae. A differential diagnosis includes oral lichenoid drug reactions. Allopurinol, which is the first line hypo-uricemic treatment, is often quoted as being a possible offending drug, though oral reactions have rarely been reported. Case presentation: We describe a 59-year-old male gout patient, successfully treated with allopurinol, who developed acute onset of oral lichenoid lesions, involving bilaterally the buccal mucosa, the tongue and the labial mucosa. Histopathology was consistent with a lichen planus or a drug-induced lichenoid reaction. Improvement of the patient’s condition after withdrawal of allopurinol confirmed the lichenoid nature of the lesion. Remission was complete after a few weeks. Discussion: Although unusual, allopurinol may induce a lichenoid drug reaction. These reactions may mimic clinically and histopathologically idiopathic lichen planus. Improvement or complete regression of the lesions may be attempted to confirm the diagnosis. According to the latest WHO recommendations, these lesions have a potential for malignant transformation.

FIRST CASE SERIES OF VENOUS SINUS STENTING IN IIH PATIENTS IN WALES

2015 ◽  
Vol 86 (11) ◽  
pp. e4.113-e4
Author(s):  
Gauhar Abbas Malik ◽  
Yogish Joshi
Keyword(s):  
Intracranial Hypertension ◽  
Case Series ◽  
Headache Disorder ◽  
Venous Sinus ◽  
First Line ◽  
Venous Stenting ◽  
First Case ◽  
Sinus Stenosis

BackgroundIdiopathic Intracranial Hypertension (IIH), is defined by increased cerebral spinal fluid (CSF) pressure in the absence of other causes of intracranial hypertension. There has been recent interest in the role of intracranial venous sinus stenosis in IIH. The raised pressures in IIH are argued to worsen by the secondary appearance of the venous sinus stenosis.Objective5 patients have undergone endovascular pressure measurement in Wales and their clinical details including history, examination, initial management, neuroimaging pre- and post venous stenting, and follow-up (6–24 months) to provide the first case study of patients undergoing Venous sinus stenting in Wales.Methods5 patients with IIH refractory to first line treatments underwent venography and manometry and 4 patients underwent stenting of the venous sinuses after this procedure had shown a pressure gradient proximal to stenosis in the lateral sinuses.ResultsThree patients were rendered asymptomatic, two were improved including one patient unmasking a different headache disorder following treatment.ConclusionsStenting in venous stenosis provides a further treatment option to patients refractory to first line treatments with IIH. This case series highlights in selected cases treatment is promising with good outcomes.

BRAF-MAD1L1 and BRAF-ZC3H7A: novel gene fusion in Rhabdomyosarcoma and Lung adenocarcinoma

2021 ◽  
Author(s):  
Jiang Da ◽  
Hui Jin ◽  
Xinliang Zhou ◽  
Shaoshuang Fan ◽  
Mian Xu ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Gene Fusion ◽  
Tumor Resection ◽  
Kinase Domain ◽  
Rapid Progression ◽  
First Line ◽  
Case Presentation ◽  
First Case ◽  
Exon 11 ◽  
Domain Exon

Abstract Background: Rhabdomyosarcoma (RMS) and lung adenocarcinoma (LADC) epitomizes the success of cancer prevention by the development of conventional therapy, but huge challenges remain in the therapy of advanced diseases.Case presentation: We reported two cases of novel BRAF gene fusion. The first case was a 34-year-old female with RMS harboring a BRAF-MAD1L1 fusion. She suffered tumor resection, recurrence and rapid progression. The second case was a 72-year-old female with LADC harboring a BRAF-ZC3H7A fusion, and she gained rapid progression after receiving a first-line course of chemotherapy.Conclusions: These two BRAF fusions retain the intact BRAF kinase domain (exon 11-18) and showed poor prognosis in RMS and LADC.

Sonographic Discovery of Segmental Testicular Infarction

2021 ◽  
pp. 875647932110649
Author(s):  
Kelly Pham
Keyword(s):  
Conservative Treatment ◽  
Testicular Torsion ◽  
Treatment Process ◽  
Surgical Intervention ◽  
Treatment Approach ◽  
Accurate Diagnosis ◽  
Sonographic Diagnosis ◽  
Testicular Infarction ◽  
Segmental Testicular Infarction

The prevalence of segmental testicular infarction is extremely uncommon and very few cases have been reported in literature. Clinical and sonographic presentation of this condition can mimic testicular neoplasms or testicular torsion. Therefore, accurate diagnosis of segmental testicular infarction is imperative in the treatment process. This case study presents the sonographic diagnosis of testicular infarction in a 49-year-old man who reported mild testicular tenderness. A conservative treatment approach was used, saving the patient unnecessary surgical intervention.

Use of an optical surface scanner in assessment of outcome following rhinoplasty surgery

2008 ◽  
Vol 122 (9) ◽  
pp. 972-977 ◽  
Author(s):  
H Chau ◽  
R Dasgupta ◽  
V Sauret ◽  
G Kenyon
Keyword(s):  
Surgical Intervention ◽  
University Hospital ◽  
Facial Features ◽  
Optical Surface ◽  
Case Study Analysis ◽  
The Future ◽  
University College London ◽  
One Year ◽  
The Right

AbstractObjective:To demonstrate the use of an optical surface scanner, with associated software, in the assessment of rhinoplasty patients, and to discuss the possible clinical applications of this technology in the future.Design:Case study analysis of pre- and post-operative scans of a patient undergoing septorhinoplasty at Whipps Cross University Hospital, London, UK.Subject:A 21-year-old man undergoing septorhinoplasty underwent pre-operative optical surface scanning of his face. The scans were repeated at one week and one year post-operatively. Software developed at University College London was then used to analyse the scans.Results:The scans clearly showed that the man's dorsal hump had been well reduced and the nose straightened, with a resulting 1600 mm3 gain on the right side and a 1000 mm3 loss on the left side of the nose. Tip projection had also been achieved.Conclusion:This technique allowed objective quantification of facial features and analysis of change. It may well prove useful in the future in predicting change following surgical intervention.

scholarly journals Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwag Yagoub Aloyouny
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Fungal Infections ◽  
The Body ◽  
Palatine Tonsil ◽  
Unusual Site ◽  
Case Presentation ◽  
Lymphoepithelial Cysts ◽  
Malignant Lesions

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

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