scholarly journals Anal Necrosis - A Rare Entity Following Treatment with Herbal Supplements and Herbal Injections

2021 ◽  
pp. 1-3
Author(s):  
Mannjunath Haridas ◽  
◽  
Venkata Jaya Divya Tenneti ◽  
Divya Poduri ◽  
◽  
...  
Keyword(s):  
Anal Canal ◽  
Subcutaneous Tissue ◽  
The Elderly ◽  
Prior History ◽  
Herbal Supplements ◽  
Predisposing Factor ◽  
Uncommon Disease ◽  
Common Etiology ◽  
History Of ◽  
Early Reconstruction

Anal necrosis is an extremely rare and uncommon disease. It has a rich collateral blood supply. The most common etiology of anal necrosis in the elderly is ischemic secondary to atherosclerosis but anal necrosis in young with no predisposing factor is infrequent thus impeling the authors to write a report. A young middle aged male presented to our emergency department with pain and foul smelling discharge from the anal canal. There was prior history of anal fistula and a recent treatment with herbal medication. The patient underwent computed tomography and magnetic resonance imaging confirming anal canal necrosis with infection. The patient was in septic shock. Antibiotics and supportive volume resuscitation was carried out for managing sepsis. He also underwent prompt debridement with defunctioning loop colostomy. Early reconstruction of the anal canal spinchters and flap construction of the skin and subcutaneous tissue was done to prevent loss of anal canal spinchters control and further morbidity.

Poststroke depression in elderly, a review

2011 ◽  
Vol 26 (S2) ◽  
pp. 826-826 ◽  
Author(s):  
M. Samakouri ◽  
S. Arseniou ◽  
F.-G. Keskeridou ◽  
M. Gymnopoulou ◽  
M. Livaditis
Keyword(s):  
Negative Impact ◽  
The Elderly ◽  
Prior History ◽  
First Year ◽  
Functional Impairments ◽  
Motor Abilities ◽  
Significant Burden ◽  
History Of ◽  
Death Wishes ◽  
Early Diagnose

IntroductionMood disturbances are often found in stroke patients and have a negative impact both on the recovery and the outcome of the stroke. Depression is the most common neuropsychiatric complication in the poststroke population, affecting nearly 30%–50% of patients within the first year. PSD implies a significant burden on both patients and their caregivers.Material and methodsUsing the search engines Pubmed and Scopus, 20 papers regarding the elderly dated from 2002–2010 were reviewed using the keywords depression, poststroke, recovery after stroke.ResultsThe core features of PSD include but are not limited to: persistent sadness, feelings of hopelessness, helplessness and worthlessness, guilt and sense of being a burden on the caregiver, lack of motivation, loss of interest, death wishes and suicidal ideation. Various cerebrovascular risk factors, including hypertension, atherosclerotic heart disease, hyperlipidemia and diabetes mellitus have been implicated as risks for depression in late life.Other predisposing factors are: prior history of depression or anxiety disorder, certain personality traits, baseline dementia but also, social isolation, living alone, physical functional impairments or a history of other psychiatric disorder.ConclusionDepression may impede recovery from stroke and impair outcome by affecting social functioning, motor abilities, cognitive functions and quality of life, thus it is important to early diagnose and prevent PSD.

scholarly journals A study into the clinicopathological profile of patients with voice change

2020 ◽  
Vol 6 (11) ◽  
pp. 1967
Author(s):  
Baneesh A. B. ◽  
Dhanya T. ◽  
Jinsha A.
Keyword(s):  
Treatment Modalities ◽  
Voice Change ◽  
Predisposing Factor ◽  
Clinicopathological Profile ◽  
Common Etiology ◽  
History Of ◽  
Chronic Laryngitis ◽  
Vocal Nodules ◽  
Microlaryngeal Surgery

<p class="abstract"><strong>Background:</strong> Hoarseness is a symptom used to describe change in normal quality of voice and is usually described as harsh, grating voice which can be lower in pitch and more or less discordant.</p><p class="abstract"><strong>Methods:</strong> The present study was carried out on 160 patients in the Department of ENT in PKDIMS over a period of 2 years from 2018 March to 2020 March. All patients with a history of voice change were evaluated.  </p><p class="abstract"><strong>Results:</strong> 160 patients between the age group of 21- 80 years were studied. The number of males and females were 97 (61%) and 63 (39%) respectively. Laborers (32%) and housewives (21%) are the major group affected. Smoking (25%) was the most common predisposing factor followed by alcohol consumption (21%). Voice change can be due to various pathologies. In the present study the most common etiology for voice change was vocal nodules (23%) followed by chronic laryngitis (13%), growth in the pharynx and larynx (11%).</p><p class="abstract"><strong>Conclusions:</strong> Voice is important for our communication. Any disturbance in voice affects the individual’s social and personal life. Treatment depends on the individuals needs and their diagnosis. Drug therapy, voice therapy, microlaryngeal surgery are the various treatment modalities done for our patients.</p>

scholarly journals Does Ménière's Disease in the Elderly Present Some Peculiar Features?

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
R. Teggi ◽  
A. Meli ◽  
M. Trimarchi ◽  
F. LiraLuce ◽  
M. Bussi
Keyword(s):  
The Elderly ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Predisposing Factor ◽  
Lifetime History ◽  
History Of ◽  
Ménière's Disease

Object. Aim of our study was to establish some peculiar features of Ménière's Disease (MD) in a group of elderly MD patients, in which the first vertigo spell happened when over 65 years old.Material and Methods. We analyzed a group of 73 younger than 65-years-old and a group of 30 elderly MD patients. All patients underwent a neurotological evaluation, an anamnestic evaluation including a lifetime history of migraine, and blood withdrawal for autoantibody screening.Results. Some differences were found between elderly and younger MD patients. Elderly MD patients presented a higher prevalence of Tumarkin attacks and a lower prevalence of lifetime history of migraine; moreover, they presented a faster develop of hearing loss and vertigo spells than a subgroup of 32 younger patients matched for the duration of illness.Conclusions. Some clinical features of MD in elderly have been pointed out. Particularly, the lower rate of migrainous history and positivity for autoantibodies often associated with MD, in our opinion, support the hypothesis of a vascular disorder acting as a predisposing factor for MD in elderly.

Mania in the elderly

1989 ◽  
Vol 155 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Kit Stone
Keyword(s):  
Retrospective Study ◽  
Family History ◽  
Affective Disorders ◽  
Age Of Onset ◽  
The Elderly ◽  
Prior History ◽  
Lithium Toxicity ◽  
Affective Illness ◽  
History Of

A retrospective study of 92 patients admitted with mania, aged over 65 years of age, found that 26% had no prior history of affective illness; 30% had previously only experienced depression, and half of these had at least three episodes of depression before the first manic illness. Patients with a family history of affective disorders had a significantly earlier age of onset of illness. There was evidence of cerebral organic impairment in 24% of the patients, and this group had a significantly later age of onset of illness. Prognosis was good, with only 8% still in hospital at six months. Half of the patients were started on lithium prophylaxis, but this did not significantly alter the number of readmissions. A quarter of those started on lithium developed evidence of lithium toxicity.

scholarly journals Clinical Use of Acid Suppressants and Risk of Dementia in the Elderly: A Pharmaco-Epidemiological Cohort Study

2020 ◽  
Vol 17 (21) ◽  
pp. 8271
Author(s):  
Liang-Yu Chen ◽  
Huey-Juan Lin ◽  
Wen-Tung Wu ◽  
Yong-Chen Chen ◽  
Cheng-Li Chen ◽  
...  
Keyword(s):  
Cox Regression ◽  
The Elderly ◽  
Cumulative Exposure ◽  
Prior History ◽  
Research Database ◽  
Dementia Patients ◽  
Hazard Ratios ◽  
Dementia Risk ◽  
Potential Link ◽  
History Of

Background: Results of studies regarding the potential link between acid suppressant use and dementia risk are inconsistent. This study aimed to evaluate the association of cumulative exposure to histamine 2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) with dementia risk in an Asian older cohort aged ≥65 years. Methods: Patients initiating H2RA (the H2RA user cohort, n = 21,449) or PPI (the PPI user cohort, n = 6584) and those without prescription for H2RA (the H2RA non-user cohort, n = 21,449) or PPI (the PPI non-user cohort, n = 6584) between 1 January 2000 and 31 December 2005 without a prior history of dementia were identified from Taiwan’s National Health Insurance Research Database (NHIRD). The outcome of interest was all-cause dementia. Patients’ exposure to H2RAs or PPIs was followed-up from dates of initial prescription to the earliest outcome of incident dementia, death, or the end of 2013. Potential associations between acid suppressant use and dementia risk were analyzed using time-dependent Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Results: After mutual adjustment for H2RA and PPI use and other potential confounders, patients with H2RA use had significantly higher risk of developing dementia as compared to those not treated with H2RAs (adjusted HR, 1.84; 95% CI, 1.49–2.20). Likewise, PPI users had significantly elevated risk of dementia compared to PPI non-users (adjusted HR, 1.42; 95% CI, 1.07–1.84). Conclusions: Our results indicate that exposures to H2RAs and PPIs are associated with increased dementia risk.

Bilateral pneumothorax after acupuncture treatment

2021 ◽  
Vol 14 (3) ◽  
pp. e241510
Author(s):  
Miyuki Nishie ◽  
Katsunori Masaki ◽  
Yohei Kayama ◽  
Tetsuhiro Yoshino
Keyword(s):  
Acupuncture Treatment ◽  
Subcutaneous Tissue ◽  
Female Physician ◽  
Prior History ◽  
Visceral Pleura ◽  
Chest Discomfort ◽  
Bilateral Pneumothorax ◽  
Levator Scapulae ◽  
History Of ◽  
Levator Scapulae Muscle

A 31-year-old female physician was diagnosed with bilateral pneumothorax a day after her acupuncture treatment. Her body mass index was 16.9 and she did not have a prior history of respiratory disease or smoking. Acupuncture needles may easily reach the pleura around the end of the suprascapular angle of the levator scapulae muscle where the subcutaneous tissue is anatomically thin. In our patient, the thickness between the epidermis and the visceral pleura in this area was only 22 mm as confirmed by an ultrasound scan. Although she felt chest discomfort 30 min after the procedure, she assumed the symptom to be a reaction to the acupuncture. In light of our case, we advise practitioners to select appropriate acupuncture needles for patients based on the site of insertion and counsel them regarding the appearance of symptoms such as chest pain and dyspnoea immediately after the procedure.

Evaluation of concomitant gynecological pathology in group of patients of reproductive age with tumors and tumor formations

2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin
Keyword(s):  
Diagnostic Errors ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Predisposing Factor ◽  
Ovarian Tumours ◽  
Preoperative Diagnostic ◽  
Neoplastic Process ◽  
History Of ◽  
The Moment

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

Dysbaric osteonecrosis associated with decompression sickness in a fishing diver

2019 ◽  
pp. 217-220
Author(s):  
Eduardo Briceño-Souza ◽  
◽  
Nina Méndez-Domínguez ◽  
Ricardo j Cárdenas-Dajda ◽  
Walter Chin ◽  
...  
Keyword(s):  
Femoral Head ◽  
Decompression Sickness ◽  
Small Scale ◽  
Prior History ◽  
Radiological Findings ◽  
Small Scale Fisheries ◽  
Left Limb ◽  
History Of ◽  
Decompression Stress ◽  
Probable Diagnosis

Diving as a method of fishing is used worldwide in small-scale fisheries. However, one of the main causes of morbidity and mortality among fishermen is decompression sickness (DCS). We report the case of a 46-year-old male fisherman diver who presented with chronic inguinal pain that radiated to the lower left limb. Living and working in a fishing port in Yucatan, he had a prior history of DCS. A diagnosis of avascular necrosis in the left femoral head secondary to DCS was made via analysis of clinical and radiological findings. The necrosis was surgically resolved by a total hip arthroplasty. Dysbaric osteonecrosis is a more probable diagnosis. In this region fishermen undergo significant decompression stress in their daily fishing efforts. Further studies regarding prevalence of dysbaric osteonecrosis among small-scale fisheries divers are needed. In a community where DCS is endemic and has become an epidemic, as of late, the perception of this health risk remains low. Furthermore, training and decompression technique are lacking among the fishing communities.

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