scholarly journals Pyoderma gangrenosum: An ulcerative variant developing at a paraincisional LSCS scar site

2021 ◽  
Vol 12 (2) ◽  
pp. 153-155
Author(s):  
Kritika Pandeyy ◽  
Mansak Shishak ◽  
Neeraj Yadav
Keyword(s):  
Pyoderma Gangrenosum ◽  
Multidisciplinary Approach ◽  
Immunosuppressive Agents ◽  
Scar Tissue ◽  
Interesting Case ◽  
Lower Segment ◽  
Clinical Presentations ◽  
Oral Corticosteroids ◽  
Initiation Of Therapy ◽  
Prompt Diagnosis

Pyoderma gangrenosum (PG) is an uncommon entity based on a diagnosis of exclusion. It can manifest itself mimicking various ulcerative cutaneous conditions and nonhealing wounds. With its less known etiology and presentation, there is a danger of mistreatment. Herein, we present an interesting case of pyoderma gangrenosum in a young woman, developing around the area of a lower segment Cesarean scar, but not involving the scar tissue. The PG was not associated with any underlying systemic ailments and responded well to a tapering dose of oral corticosteroids. Prompt diagnosis and initiation of therapy lead to a good response and favorable prognosis. Recognizing the atypical clinical presentations of PG is pertinent. Treatment with immunosuppressive agents and a multidisciplinary approach are recommended.

scholarly journals Nutritional Optic Neuropathies: State of the Art and Emerging Evidences

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2653
Author(s):  
Matilde Roda ◽  
Natalie di Geronimo ◽  
Marco Pellegrini ◽  
Costantino Schiavi
Keyword(s):  
Bariatric Surgery ◽  
Optic Neuropathy ◽  
Multidisciplinary Approach ◽  
State Of The Art ◽  
Signs And Symptoms ◽  
Therapeutic Strategies ◽  
Scientific Interest ◽  
Optic Nerve Atrophy ◽  
Prompt Diagnosis

Nutritional optic neuropathy is a cause of bilateral, symmetrical, and progressive visual impairment with loss of central visual acuity and contrast sensitivity, dyschromatopsia, and a central or centrocecal scotoma. The clinical features are not pathognomonic, since hereditary and toxic forms share similar signs and symptoms. It is becoming increasingly common due to the widespread of bariatric surgery and strict vegetarian or vegan diets, so even the scientific interest has recently increased. In particular, recent studies have focused on possible pathogenetic mechanisms, and on novel diagnostic and therapeutic strategies in order to prevent the onset, make a prompt diagnosis and an accurate nutritional supplementation, and to avoid irreversible optic nerve atrophy. Nowadays, there is clear evidence of the role of cobalamin, folic acid, thiamine, and copper, whereas further studies are needed to define the role of niacin, riboflavin, and pyridoxine. This review aims to summarize the etiology, diagnosis, and treatment of nutritional optic neuropathy, and it is addressed not only to ophthalmologists, but to all physicians who could come in contact with a patient with a possible nutritional optic neuropathy, being a fundamental multidisciplinary approach.

Compression neuropathies of the forearm: anatomy, clinical features and management

2021 ◽  
pp. 1-10
Author(s):  
Alexander Scarborough ◽  
Robert J MacFarlane ◽  
Michail Klontzas ◽  
Rui Zhou ◽  
Mohammad Waseem
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Permanent Damage ◽  
Peripheral Nerve Lesions ◽  
Clinical Presentations ◽  
Wide Range ◽  
Prompt Diagnosis

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.

Associated Injuries Related to Patients With Facial Fractures

2022 ◽  
pp. 194338752110690
Author(s):  
Rajarshi Ghosh ◽  
Kulandaswamy Gopalkrishnan
Keyword(s):  
Multidisciplinary Approach ◽  
Clavicle Fracture ◽  
The Body ◽  
Spine Injury ◽  
Associated Injuries ◽  
Facial Fractures ◽  
Facial Fracture ◽  
Fracture Management ◽  
Type Of Injury ◽  
Prompt Diagnosis

Purpose To find out the incidence, type, and severity of injuries in other parts of the body in patients diagnosed with facial fractures. The study also analyzed any correlation between these injuries and facial fractures. Material & Methods A retrospective study of 991 patients with facial fractures during the period of 2006-2016. Results 111 patients reported associated injuries (11.1%). The most common type of injury was limb injury (33.33%), followed by head injury (22.5%), clavicle fracture (14.7%), rib fracture (10.9%), cervical spine injury (5.4%), and other injuries constituted (13.2%). Multiple associated injuries were observed in 14% of patients. Conclusion The findings show that facial fracture management is a multidisciplinary approach. Prompt diagnosis and proper management are important to reduce the mortality rate and improve the prognosis of the patient.

scholarly journals LOW BACK PAIN

2021 ◽  
Vol 2 (1) ◽  
pp. 13-17
Author(s):  
Andaru Cahya S ◽  
Widodo Mardi Santoso ◽  
Machlusil Husna ◽  
Badrul Munir ◽  
Shahdevi Nandar Kurniawan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Multidisciplinary Approach ◽  
World Population ◽  
Common Symptom ◽  
Low Back ◽  
Red Flags ◽  
Pain Attack ◽  
Primary Health ◽  
Clinical Presentations

Low back pain is the most common symptom found in the primary health care and is the number one cause of disability throughout worldwide. It is estimated that around 60 – 80% the world population will experience back pain during their lifespan. There are three different source of pain in the spine: axial-lumbosacral, radicular and reffered pain. All of these source brings different clinical presentations. Low back pain could be classified as acute, subacute and chronic low back pain. The pain could be nociceptive or neuropathic, the most common symptoms reported are “pressure pain” and “pain attack”. The physician should be aware of “red flags” symptoms that lead into more serious condition beside back pain and, therefore the patient has to be investigated to further examination whenever these symptoms present. The management of low back pain consist of severe modalities, both therapeutic and rehabilitative procedure. Oftentimes, the management needed multidisciplinary approach. It is important to general practitioners to identify and treat low back pain appropriately to reduce the burden of the disease and to prevent the disabilties caused by this condition.

scholarly journals An Interesting Case of a Butcher Who Attempted to Cut His Neck

2018 ◽  
Vol 26 (3) ◽  
pp. 222-226
Author(s):  
N R Ankale ◽  
R S Mudhol ◽  
Rajesh Radhakrishna Havaldar ◽  
Anju Singh
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Case Report ◽  
Multidisciplinary Approach ◽  
Interesting Case ◽  
Effective Management ◽  
Early Assessment ◽  
Severe Injuries ◽  
Alcohol Abstinence ◽  
Supraglottic Larynx

Introduction Cut throat injuries are well recognized in homicide but less recognized in suicides. The incidence of suicide is increasing worldwide owing to the more stressful strenuous lifestyle and other risk factors like substance abuse. Suicide by incising one’s own throat is associated with hesitation marks whereas homicidal wounds are not. Case Report We present an interesting case of a suicidal cut throat of the victim being a butcher who was on alcohol abstinence since 3 days with severe injuries of supraglottic larynx and cricopharynx, surprisingly without any evidence of hesitation marks. He underwent immediate neck exploration and suturing of the injured structures without the need of a tracheostomy. Discussion A multidisciplinary approach by Otolaryngologists, Psychiatrists, Intensivists, and Anaesthetists is required in the effective management of these victims. A thorough proper early assessment can totally avoid the need of tracheostomy which is recommended in practice, hence preventing complications arising out of this unnecessary but advocated procedure.

scholarly journals Secondary Sarcomas: Biology, Presentation, and Clinical Care

2020 ◽  
pp. 463-474
Author(s):  
Vanessa Eulo ◽  
Harry Lesmana ◽  
Leona A. Doyle ◽  
Kim E. Nichols ◽  
Angela C. Hirbe
Keyword(s):  
Genetic Disorders ◽  
Clinical Care ◽  
Immunosuppressive Agents ◽  
Chemical Exposure ◽  
Neurofibromatosis Type ◽  
Li Fraumeni Syndrome ◽  
Patients With Cancer ◽  
Dicer1 Syndrome ◽  
Prompt Diagnosis

Secondary sarcomas are a subset of sarcomas that occur in patients with prior cancer diagnoses and are associated with environmental or genetic factors. Although secondary sarcomas are rare in general, there are predisposing factors that can substantially increase this risk in certain populations. Herein, we review the environmental factors with the strongest association of sarcoma risk, including chemical exposure, certain viruses, cytotoxic and immunosuppressive agents, chronic edema, and radiation exposure. Additionally, the most common genetic disorders that carry a predisposition for sarcoma development will be discussed, including hereditary retinoblastoma (RB), Li-Fraumeni syndrome (LFS), neurofibromatosis type 1 (NF1), and DICER1 syndrome. Although treatment does not generally differ for sporadic versus secondary sarcomas, awareness of the risk factors can alter therapeutic strategies to minimize risk, aid prompt diagnosis by increasing clinical suspicion, and allow for appropriate surveillance and genetic counseling for those patients with cancer predisposition syndromes.

Abdominal Manifestations of Neuroendocrine Tumors

2019 ◽  
Vol 03 (01) ◽  
pp. 014-029
Author(s):  
Leonardo Marcal ◽  
Madhavi Patnana ◽  
Sireesha Yedururi ◽  
Hubert Chuang ◽  
Catherine Devine ◽  
...  
Keyword(s):  
Small Bowel ◽  
Neuroendocrine Tumors ◽  
Multidisciplinary Approach ◽  
Imaging Techniques ◽  
Tumor Biology ◽  
Imaging Features ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
New Developments ◽  
Clinical Presentations ◽  
Unites States

AbstractDespite being rare, the incidence and prevalence of gastroenteropancreatic neuroendocrine tumors (NETs) is rising. They are a heterogeneous group of tumors with differences in clinical presentations, genetics, and imaging features. Advances in pathological classification, imaging (including recent radiotracer approval for functional imaging in the Unites States), and therapy have impacted management of these tumors. It is important in the multidisciplinary approach to patient care to be familiar with the tumor biology, imaging techniques for diagnosis and staging, and therapeutic options. This article will discuss these new developments, particularly focusing on pancreatic and small bowel NETs.

scholarly journals Pyoderma Gangrenosum as a Presenting Feature of Undifferentiated Spondyloarthropathy with Erosive Inflammatory Arthritis

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Jaspreet Kaler ◽  
Sandra Sheffield ◽  
Myint Thway ◽  
Karishma Ramsubeik ◽  
Gurjit Kaeley
Keyword(s):  
Inflammatory Bowel Disease ◽  
Lower Extremity ◽  
Pyoderma Gangrenosum ◽  
Bowel Disease ◽  
Inflammatory Arthritis ◽  
Sexually Transmitted ◽  
Clinical Presentations ◽  
Axial Spondyloarthropathy ◽  
Rapid Healing ◽  
Inflammatory Bowel

Pyoderma gangrenosum is a rare inflammatory condition with varying clinical presentations and severity. It is commonly seen in association with an underlying condition, most common of which is inflammatory bowel disease. We report a case of a 26-year-old male who came to the emergency department with increasing lower extremity ulcers, intermittent hematochezia, and pain in the small joints of his hands. After excluding a broad list of differentials for lower extremity ulcers, the diagnosis of pyoderma gangrenosum was made. He was also found to have erosive changes at multiple proximal interphalangeal joints and jug-like syndesmophytes at T12 and L1 on CT scan. Although there was evidence of a spondyloarthropathy, there was no evidence of inflammatory bowel disease on colonoscopy, psoriasis, or sexually transmitted infections. After multiple failed trials of medications including azathioprine and sulfasalazine, 4 weeks of Adalimumab resulted in rapid healing of pyoderma gangrenosum lesions and improvement in his synovitis. Coupled together, this suggests a diagnosis of pyoderma gangrenosum associated with undifferentiated spondyloarthropathy and erosive inflammatory arthritis. This case is suggestive of spondyloarthropathy going underdiagnosed and untreated in other patients with pyoderma gangrenosum as lower extremity ulcerations can be the primary complaint for seeking treatment. Although rare, axial spondyloarthropathy associated with pyoderma gangrenosum should be kept as an associated differential diagnosis when faced with pyoderma gangrenosum.

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