scholarly journals Management of Ardit w.s.r to Bell ’s palsy with Nasya and Ayurveda treatment protocol- A Single Case Report

2018 ◽  
Vol 2 (2) ◽  
pp. 35-38
Author(s):  
Neha Sharma
Keyword(s):  
Facial Paralysis ◽  
Single Case ◽  
Previous History ◽  
Treatment Protocol ◽  
Facial Movement ◽  
Recent Infection ◽  
Single Case Report ◽  
Patient Reported ◽  
Oral Steroids ◽  
History Of

A 36 year old female patient with two weeks history of right sided facial paralysis, presenting with inability to close right eye, which also had tearing and a burning sensation.In present time, due to fast life style, anxiety, stress etc., incidence of Vatavyadhi like Pakshaghata, Ardita etc is increasing. Aggravation of Vata is responsible to cause Ardita. On the basis of its origin and symptoms mentioned in Sushruta Samhita, Ardita can be correlated with facial paralysis or Bell’s palsy caused by involvement of VII cranial nerve.  The great Indian sage Caraka, in his medical tome scripted in the second century BC describes the aetiology and management of Ardita. Bearing this idea in mind Nasya karma with panaspatra sveda was selected in present case.  There was no previous history of similar symptoms or a recent infection. Prior treatment had included oral steroids. The patient perceived a 70% to 80% improvement of facial movement after the first treatment. After the second treatment, the patient reported full control of his facial movement.

Amavat in pediatric age group (multidisciplinary Ayurvedic approach): a single case study

2020 ◽  
Vol 8 (03) ◽  
Author(s):  
Mayuri Pawar
Keyword(s):  
Clinical Symptoms ◽  
Single Case ◽  
Treatment Protocol ◽  
Oral Intake ◽  
External Application ◽  
Pediatric Age Group ◽  
Patient Reported ◽  
Ayurvedic Treatment

Amavata is a chronic, progressive and crippling disorder caused due to generation of ama and its association with vitiated vata dosha and deposition in shleshma sthana (joints). Clinically resembling with Rheumatoid Arthirtis, it poses a challenge for the physician owing to its chronicity, morbidity and complications. The treasure of Ayurveda therapeutics has laid out detailed treatment line for amavata. A 13years old male patient reported to this hospital with pain and stiffness of metacarpophalangeal joints of right hand followed by pain in corresponding joints of other hand 1 year back. This was succeeded by pain and mild swelling on bilateral wrist, ankle and elbow joints. Based on clinical examination and blood investigations, diagnosis of amavata was made and Ayurvedic treatment protocol was advised with baluka sweda (sudation) as external application, rasnasaptak kashayam and dashmoolharitaki avaleha for oral intake for 30 days. The patient was asked for follow up every 15 days up to total of 45 days. Assessment was done subjectively based on clinical symptoms and blood investigations as objective parameters. There was substantially significant improvement and the patient felt relieved of the pain and inflammation of the joints after the treatment. This case study reveals the potential of Ayurvedic treatment protocol in management of amavata and may form a basis for further detailed study of the subject.

scholarly journals Computed Tomography Findings of Pulmonary Mycobacterium simiae Infection

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Ayeh Baghizadeh ◽  
Payam Mehrian ◽  
Poopak Farnia
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Pulmonary Infection ◽  
Previous History ◽  
Treatment Protocol ◽  
Zonal Distribution ◽  
Sputum Production ◽  
History Of ◽  
Nodular Lesions ◽  
Mycobacterium Simiae

Nontuberculous mycobacterial (NTM) pulmonary infections can be quite similar to tuberculosis, both clinically and radiologically. However, the treatment protocol is not similar. Mycobacterium simiae is a rare cause of NTM pulmonary infection. Herein, we aimed to evaluate and compare the computed tomography (CT) scan findings of M. simiae infection in lungs. For this reason, thirty-four patients (n=34) with M. simiae lung infection were retrospectively evaluated. Diagnosis was confirmed by American Thoracic Society (ATS) guidelines and CT scans were reviewed in both lung and mediastinal windows. The average age of patients was 63±14.54 years and 52.9% were male. The majority of patients had cough (91.2%) and sputum production (76.5%). Clinically, 41.2% of patients had previous history of TB (14/34), 38.2% had cardiac diseases (13/34), and 35.3% had diabetes mellitus (12/34). The most common CT findings in our study were nodular lesions (100%) and bronchiectasis (85.29%). Regarding the severity, grade I bronchiectasis was the most prevalent. Other prominent findings were tree-in-bud sign (88.2%), consolidation (52.94%), and lobar fibrosis and volume loss (67.6%). There was no significant zonal distribution of findings. In conclusion, nodular lesions and bronchiectasis are the most frequent features in CT scan of M. simiae pulmonary infection.

scholarly journals Rifampicin-resistance Pattern of Mycobacterium Tuberculosis and Associated Risk Factors Among Presumptive Pulmonary and Extra Pulmonary Tuberculosis Patients at Madda Walabu University Goba Referral Hospital, Southeast Ethiopia

2021 ◽  
Author(s):  
Wakuman Taye Kelecha ◽  
Solomon Gebra-Sellasie Teklegiorgis ◽  
Mesay Mitiku Gemechu
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Close Contact ◽  
Previous History ◽  
Treatment Protocol ◽  
Resistance Pattern ◽  
P Value ◽  
Drug Resistant ◽  
Tuberculosis Patients ◽  
History Of ◽  
Extra Pulmonary

Abstract Background: Drug resistant M.tuberculosis is one of the serious public health trouble that intimidating progress made in tuberculosis cases and control in several countries. Early detection of drug-resistant tuberculosis is crucial for patient management and infection control. Methods: Hospital based cross-sectional study design was conducted from October 2020 to February 2021. Detection of Mycobacterium tuberculosis and resistance to Rifampicin pattern was determined by using GeneXpert MTB/RIF assay. Data were entered and analyzed by SPSS version 23.0. Bivariate and multivariate analyses were used to examine the relationship between dependent and independent variables. Less than 0.05 P-value was used to show significance.Results: A total of 301 presumptive tuberculosis patients were included in the study; of these, 46 (15.3%) of them were identified as having Mycobacterium tuberculosis, 2/46 (4.35%) were resistant to Rifampicin and 4/46 (14.8%) patients were TB/HIV co-infected. From the total of M. tuberculosis detected 40 (16.7%) were identified in pulmonary and 6 (9.8%) were in extra-pulmonary presumptive patients. Rifampicin-resistant M. tuberculosis was detected in 2 patients who had a history of taking Anti-tuberculosis drugs. Conclusion: Previous history of tuberculosis treatment and having close contact history with tuberculosis patients were found as important associated factors that enhance the prevalence of tuberculosis among presumptive tuberculosis patients. This indicates the mandate to make better and oversee the treatment protocol to control the burden of drug resistant M.tuberculosis.

scholarly journals PERIDURAL CATETER RUPTURE DURING ANESTHETIC ACT

2020 ◽  
Vol 7 (3) ◽  
pp. 56-58
Author(s):  
Ana Flávia de Oliveira Castro ◽  
Clara Rebeca Meneses Moura ◽  
Pedro Durán Marques de Souza ◽  
Rafaela Soares Azevedo Mundim Rios ◽  
Vantuir José Domingos da Mota ◽  
...  
Keyword(s):  
Epidural Catheter ◽  
Previous History ◽  
Infectious Complications ◽  
Diagnostic Methods ◽  
Axial Tomography ◽  
Thoracic Epidural ◽  
Patient Reported ◽  
History Of ◽  
The Subject ◽  
The Right

ABSTRACT: Epidural catheter rupture is a condition rarely described in the literature, being considered rare. The reports on the subject present discussions about the possible causes and consequences in the anesthetic act. Discussions about complications are even rarer, of which neurological symptoms, pain, inflammation, root avulsion or infectious complications. Thus, this clinical case describes an event of epidural catheter rupture in a patient during preoperative analgesia, treated by surgery. Data were obtained through a review of the medical record, interview with the patient, photographic record of the diagnostic methods and review of the literature. Patient A. C., female, 28 years old, 55 kg, 1.64 m, GIPI, with previous history of pain in right hypochondrium, associated with nausea and vomiting, diagnosed with choledocholithiasis and taken to the surgical center for conventional cholecystectomy. During insertion of the catheter for anesthesia in the thoracic epidural space, the patient reported paresthesia in the right lower limb. When withdrawing needle-catheter assembly under resistance, there was rupture of the same. It was decided to perform imaging tests, which showed a catheter fragment in the computed axial tomography. Since the patient was symptomatic, an emergency surgical procedure was performed. Keywords: epidural anesthesia; complications; epidural catheter; break.

scholarly journals Hepatic Tuberculosis Mimicking Biliary Cystadenoma: A Radiological Dilemma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Rajaram Sharma ◽  
Amit Kumar Dey ◽  
Kartik Mittal ◽  
Prasad Udmale ◽  
Udai Singh ◽  
...  
Keyword(s):  
Previous History ◽  
Treatment Protocol ◽  
Final Diagnosis ◽  
Pulmonary Involvement ◽  
Liver Lesion ◽  
Rare Entity ◽  
Biliary Cystadenoma ◽  
Normal Limits ◽  
Hepatic Tuberculosis ◽  
History Of

Primary involvement of liver in tuberculosis is a rare entity. It is difficult to diagnose in absence of previous history of tuberculosis or concurrent pulmonary involvement. It is usually misdiagnosed as neoplastic liver lesion, which misdirects the treatment protocol and delays proper treatment. Here we are presenting a case of 36-year-old male patient with vague right upper quadrant abdominal pain. All the laboratory values were within normal limits. Radiological investigations were in favor of biliary cystadenoma but final diagnosis was primary focal involvement of liver in tuberculosis which was histopathologically proven to be tuberculous granulomas on biopsy of the resected mass.

scholarly journals Reductions in endometriosis-associated pain among women treated with elagolix are consistent across a range of baseline characteristics reflective of real-world patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mauricio S. Abrao ◽  
Eric Surrey ◽  
Keith Gordon ◽  
Michael C. Snabes ◽  
Hui Wang ◽  
...  
Keyword(s):  
Previous History ◽  
Clinical Trial Registration ◽  
Significant Treatment ◽  
Pooled Data ◽  
Link Type ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
History Of ◽  
Baseline Characteristics

Abstract Background Elagolix is an oral, gonadotropin-releasing hormone (GnRH) receptor antagonist, that significantly reduces dysmenorrhea and non-menstrual pelvic pain (NMPP) in women with moderate to severe endometriosis-associated pain. Methods Data were pooled from two 6-month, placebo-controlled, phase 3 studies (Elaris Endometriosis [EM]-I and II) in which 2 doses of elagolix were evaluated (150 mg once daily and 200 mg twice daily). Pooled data from > 1600 women, aged 18–49, were used to evaluate the efficacy of elagolix and health-related quality of life (HRQoL) in prespecified subgroups of women with various baseline characteristics. Results Of the 1686 women treated, 1285 (76.2%) completed the studies. The percentages of women with clinically meaningful reductions in dysmenorrhea and NMPP were generally consistent by subgroup. Significant treatment by subgroup interaction was demonstrated for dysmenorrhea response in baseline analgesic use (p < 0.01) and previous history of pregnancy (p < 0.05) subgroups, and for NMPP response in the baseline NMPP score (p < 0.05) and history of pregnancy (p < 0.05) subgroups. Patient-reported reduction in pain at month 3 was significant across all subgroups taking elagolix 200 mg BID, and significant across most subgroups with elagolix 150 mg QD. Women across subgroups experienced improvement within each domain of the Endometriosis Health Profile-30 (EHP-30), although significant treatment by subgroup interactions were observed in several categories. Conclusions Elagolix was effective in reducing dysmenorrhea and NMPP, and improving HRQoL, compared with placebo across numerous subgroups of women with various baseline characteristics, covering a broad segment of the endometriosis disease and patient types. Clinical trial registration: ClinicalTrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT01620528; https://www.clinicaltrials.gov/ct2/show/NCT01931670.

scholarly journals Early Attention Impairment in a Patient with COVID-19

2020 ◽  
Author(s):  
Júlio César Tolentino ◽  
Ana Lúcia Taboada Gjorup ◽  
Guilherme Janeiro Schmidt ◽  
Sergio Luis Schmidt
Keyword(s):  
Oxygen Saturation ◽  
Previous History ◽  
Ambient Air ◽  
Polymerase Chain Reaction Analysis ◽  
Attention Problems ◽  
High Resolution Computed Tomography ◽  
Patient Reported ◽  
History Of ◽  
Polymerase Chain ◽  
Attention Impairment

A 47-year-old physician suddenly noticed a persistent difficulty maintaining attention. He was awake, alert, and oriented. After two hours he developed fever, ageusia, and anosmia. He denied any previous history of psychiatric illness and was hydrated at the time of the subjective attention impairment. On admission, the patient remained oriented. He reported the persistence of attention problems, anosmia, and mild fatigue. The oxygen saturation 99% while he was breathing ambient air. Laboratory tests were unremarkable. A high-resolution computed tomography of the chest was normal. Nasopharyngeal and throat swabs specimens on reverse transcription-polymerase chain reaction analysis tested positive for SARS-CoV2. On illness day 3, the examination was unchanged, but he continued to complain of difficulties to stay focused. Then, he performed an objective attention test. The test demonstrated a moderate attentional impairment. On day 6, the patient reported a subjective worse in his concentration and performed a second test. Although his physical examination remained normal, the attention performance was worse as compared to day 3. Eight hours after worsening of attention impairment, the patient&rsquo;s oxygen saturation dropped to 94%. From illness days 9 to 14, the patient evolved with clinical improvement. On day 10, a third objective attention test indicated a mild deficit. On day 16, he did not report any other symptom and the attention test was completely normal. Then, the patient returned to work. Neurological symptoms had been previously described in COVID- 19 patients. However, no previous research had investigated early cognitive deficits preceding the traditional symptoms.

scholarly journals A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome

2019 ◽  
Vol 7 ◽  
pp. 232470961985276
Author(s):  
Anthony Karapetians ◽  
Tushar Bajaj ◽  
Amanda Valdes ◽  
Arash Heidari
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Distribution Width ◽  
Bortezomib Treatment ◽  
Patient Reported ◽  
Oral Steroids ◽  
History Of ◽  
Intravenous Steroids ◽  
Positive Direct ◽  
Evan’S Syndrome

Multiple myeloma is defined as the neoplastic proliferation of plasma cells resulting in a monoclonal gammopathy. The classic presentation of a patient is someone who presents with bone pain, osteopenia, or new onset fractures. We present a case of multiple myeloma presenting as Evan’s syndrome (ES). Evan’s syndrome is autoimmune hemolytic anaemia with autoimmune thrombocytopenia. A 44-year-old female was referred from her primary physician to the hospital as laboratory testing revealed haemoglobin of 5 gm/dL. The patient reported a two-month history of fatigue and a sixty-pound weight loss. Laboratory results demonstrated autoimmune hemolytic anaemia, C3 positivity, elevated immunoglobulin (Ig)G, elevated lactate dehydrogenase (LDH), low haptoglobin, elevated reticulocyte count, elevated RDW-CV (red blood cell distribution width-corpuscular volume), positive direct Coombs test, thrombocytopenia, and proteinuria, all of which led to an underlying ES. The patient was started on intravenous steroids followed by oral steroids. A flow cytometry, serum protein electrophoresis, and cytogenetics were obtained. A bone marrow biopsy revealed multiple myeloma and she was started on Bortezomib treatment. We present the fifth reported case of Evan’s syndrome and multiple myeloma.

SAT0231 MULTIDIRECTIONAL DYSFUNCTION OF THE IMMUNE RESPONSE IN SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1058-1058
Author(s):  
G. A. Ramirez ◽  
A. Sorce ◽  
B. A. Mazzi ◽  
L. Moroni ◽  
E. Della Torre ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immune Response ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Previous History ◽  
Incidence Rates ◽  
Systemic Lupus ◽  
Recent Infection ◽  
History Of

Background:Systemic lupus erythematosus (SLE) is a multi-organ immune-mediated disease characterised by autoimmunity. Dysfunction in immune tolerance towards allergens and protection from infections has less been studied. Human leukocyte antigen (HLA) genotype affects the risk of developing SLE. Little is known on the role of HLA in shaping SLE phenotype.Objectives:To test for potential associations among active SLE, occurrence of infections and hypersensitivity reactions (HyR) at a clinical level and assess whether these events segregate with patients’ HLA-DRB1 typing.Methods:224 patients with SLE were prospectively followed up over the course of 1267 consecutive visits with a median interval of five months between each visit. HyR occurring within one month before or after each visit and occurrence of at least one infection leading to antimicrobial treatment and/or absence from work in the interval between each visit were recorded. Disease activity was estimated through the systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K). Remission was surrogated by the Lupus Low Disease Activity State (LLDAS). Demographics and general disease features including a previous history of allergy were retrospectively assessed. HLA-DRB1 genotype was obtained from 188 patients. Data are expressed as median [interquartile range], unless otherwise specified.Results:Incidence rates for HyR and infections were 80/1000 person-years and 45/100 person-years. Culprit agents for HyR were drugs in 61% of cases, inhalants, food or other allergens in the remainder 42%. Most frequent sites for infections were the airways (55%), skin and mucosae (16%), the genital and/or urinary tracts (14%) and the gastrointestinal tract (7%). LLDAS was inversely associated with HyR (χ2=20.912; p<0.0001) or infections (χ2=8.234; p=0.005). patients with a recent HyR had a shorter disease duration (9 [2-15] vs 13 [8-22] years; p=0.006) and higher SLEDAI-2K scores (4 [3.5-11] vs 3 [2-4]; p<0.001) compared to patients without recent HyR. HyR were more frequently observed close to recent infections (χ2=15.509; p<0.0001). Patients with HLA-DRB1*11:01 (n=28/188) had more frequently a history of allergy than patients with other HLA-DRB1 genotypes (χ2=4.944; p=0.035). Among patients with at least four prospective visits, HLA-DRB1*11:01 carriers reported a recent infection more frequently (25% [13-40%] vs 14% [0-29%]; p=0.044) and HLA-DRB1*07:01 carriers less frequently (0% [0-17%] vs 18% [11-33%]; p=0.026) compared to patients with other HLA-DRB1 genotypes.Conclusion:These data suggest that immune dysfunction in SLE not only affects tolerance to self antigens but also antimicrobial and allergic responses and that genetically determined HLA-restricted mechanisms of antigen presentation might influence the shape of this dysfunctional immune response in patients with SLE.References:[1]Teruel M et al. Curr Opin Rheumatol, 2016[2]Sequeira JF et al., Lupus, 1993[3]Danza A et al, Lupus, 2013[4]Park H et al., Allergy Asthma Immunol Res, 2012[5]Quiralte J et al., J Allergy Clin Immunol, 1999Disclosure of Interests:Giuseppe Alvise Ramirez: None declared, Andrea Sorce: None declared, Benedetta Allegra Mazzi: None declared, Luca Moroni: None declared, Emanuel Della Torre: None declared, Giselda Colombo: None declared, Mona-Rita Yacoub: None declared, Enrica Bozzolo: None declared, Lorenzo Dagna Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unresctricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Consultant of: Prof Lorenzo Dagna received consultation honoraria from Abbvie, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Angelo Manfredi: None declared

scholarly journals Acquired Skin Fragility Syndrome in a Juvenile Cat Following a Routine Ovariohysterectomy

2020 ◽  
Vol 49 ◽  
Author(s):  
Ebru Karakaya Bilen ◽  
Mustafa Barış Akgül
Keyword(s):  
Acute Stress ◽  
Systemic Disease ◽  
Animal Health ◽  
Previous History ◽  
Treatment Protocol ◽  
Specific Treatment ◽  
Hepatic Diseases ◽  
Skin Fragility ◽  
History Of ◽  
Scapular Region

Background: Acquired skin fragility syndrome (ASFS) is a rare condition, which is characterized by spontaneous fragility of the skin and an absence of hyperextensibility. Even though the real pathogenesis of ASFS remains unknown that is reported generally with some iatrogenic causes and severe diseases. Thus, based on the clinical findings this is the first report of describes the case and treatment of feline acquired skin fragility syndrome following a routine ovariohysterectomy.Case: An 8-month-old domestic shorthair female cat was brought to the Siirt University Animal Health Application and Research Center for ovariohysterectomy operation. Before the operation physical examination of the animal revealed body temperature, heart rate, respiratory rate, the color of mucosas, and lymph nodes were determined normally. Besides, there is no hematological and biochemical problem detected. The cat had no previous history of several infections or systemic disease. A routine ovariohysterectomy procedure was applied under general anesthesia and the cat was discharged on the same day. Three days after that a spontaneously developed cutaneous laceration below the left scapular region was determined by the cat owner. During the clinical examination, it was determined that the cat was sensitive to touch against the left scapular area. Multiple spontaneous skin tear was revealed over the left scapular region while shaving for better inspection but did not obtain any problem with incision line. To identify the underlying cause of skin tearing, hematological and biochemical tests were done but the animal’s results were found within the normal references. Also, rapid blood tests were performed for feline leukemia virus and immunodeficiency virus, and none of them were positive. Additionally, the skin was not hyperextensible. Although the clinicopathological abnormalities were observed on the skin, there were no abnormalities in the vital signs of the cat. Based on the clinical status of the cat, daily regular wound cleaning and a wet-to-dry bandage were applied for two weeks. Skin therapy based on the use of dexpanthenol, vitamin E, and vitamin C with zinc was preferred to improve skin health. All lesions on the skin of the cat completely recovered and a follow-up visit for several weeks was recommended to the cat owner.Discussion: There have been reports that acquired skin fragility syndrome may be related to hepatic diseases, some feline viral infections, hyperadrenocorticism, or use of a long time progestational drugs. Also, acquired skin fragility syndrome can be seen in a congenital disorder known as cutaneous asthenia which is described generally in young cats. Cutaneous asthenia and acquired skin fragility syndrome are difficult to distinguish from each other even though histological examination was made. Although the cat in this report is young, there was no history of skin problems and skin hyperextensible until presentation. No specific treatment protocol described for this skin problem has been reported. Moreover, vitamins and minerals may be used for wound treatment and strengthening the skin. Ovariohysterectomy is the most common surgical technique used for sterilization of cats however; it can cause some complications, such as acute stress. Unfortunately, the exact etiology is not detected in this case report but it is thought to be that stress of ovariohysterectomy might be triggered to spontaneous skin tearing.

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