ACUTE MESENTERIC ISCHEMIA DUE TO SMA THROMBOSIS- A CASE REPORTS

INTRODUCTION:Acute mesenteric ischemia usually presents as abdominal pain that is out of proportion inrelation to tenderness; persistent vomiting, bloody diarrhea and shock. Sloughing of intestinal mucosa takes 3 hourswhile infarction of entire bowel thickness occurs in 6 hours. [1]- [3] CECT abdomen with mesenteric angiography isinvestigation of choice. If patient has presented after 24-48 hours, gangrene might have already occurred, resectionand anastomosis is done majority of cases with removal of vascular block under Doppler guidance or Injection ofpapaverine. Minimum bowel length required to be retained is 1.2 meters, otherwise the patient will have highmortality due to short bowel syndrome. [4]- [7]AIMS AND OBJECTIVES 1 ] To compare the surgical findings in various case scenarios having differentpresentations, patient factors and time of presentations with SMA thrombosis 2 ]To compare outcomes of surgicalintervention in different case scenariosCONCLUSION:SMA thrombosis was seen in non-covid time as well. Hypercoagulable state which corresponds toraised d-dimer and FDP, the cases of mesenteric ischemia due to SMA thrombosis are seen more commonly incovid-19 era. This series draws to attention that timely diagnosis and appropriate surgery with resection and properfollow up with anti-coagulant the morbidity and mortality is averted. Acute mesenteric ischemia is commonly due toemboli (45-50%) rather than thrombosis (20-25%). Non occlusive disease (5-15%) can be due to various causes e.g.,pancreatitis, sepsis, heart failure, etc. Early diagnosis is the key to successful management. Aggressive resuscitation,early revascularization with vascular intervention and exploratory laparotomy is done if evidence of peritonitis ispresent.[8]-[9] Postoperative fluid management due to short bowel syndrome and appropriate antibiotic coverage isnecessary to revive the patient. Long term TPN support for patients with short bowel patients is necessary. They arecandidates for intestinal transplantation if survived.[10]

Fibroadenoma in axillary accessory breast: a case report

The mass are among the possible alterations observed in the axilla. When found, the most frequent differential diagnosis are lymphadenopathy, metastatic lymphadenomegaly, lymphoma, lipoma or tumors in the apocrine glands. Besides that, the presence of accessory breast tissue must also be considered and, as the topical breast tissue, can be the target of breast diseases, either benign or malignant. Female patient, 23 years old, with the presence of hardened palpable node in the right axilla. At the ultrasound, it presented characteristics that classified it as Bi-Rads® 4. An aspiration biopsy of the node was performed with fine-needle, which resulted in unsatisfying material. After the explanation of the therapeutic choices, the patient opted for the excision of the axillary node. The anatomical pathological result showed a nodular formation compatible with fibroadenoma. The occurrence of a node in the axillary region is common. However, in the vast majority of times, it is merely an inflammatory response, manifested as a lymphadenomegaly. In case of chronic mass with suspicious characteristics, it is convenient to suspect the presence of lymphoid neoplasms, locoregional metastasis of breast cancer or melanoma and alterations in accessory breast tissue. In young patients, it is important to evaluate the existence of accessory breast tissue with the presence of suspicious axillary node, because, although controversial, some authors believe that such alterations occur more frequently in these patients. Additionally, in cases of inconclusive imaging, an excision of the lesion must be performed for a definite diagnosis.

The application of cognitive behavioral therapy on obsessive-compulsive disorder (case study) / 中华行为医学与脑科学杂志

The self-compiled obsessive-compulsive cognitive behavioral therapy manual was used for a systematic and standardized cognitive behavioral therapy (CBT) intervention for a study of obsessive-compulsive disorder.Based on the assessment of consultant's compulsive thinking and compulsive behaviors,14 sessions of the systematic and standardized CBT treatments were conducted for maladaptive cognitive and behavioral problems.Yale-Brown Obsessive Compulsive Scale (Y-BOCS),Hamilton Depression Scale (HAMD-17) and Hamiltonian anxiety (HAMA) were used to evaluate the change of the mood and symptoms before and after the cognitive and behavioral therapy.The symptoms of consultant were alleviated effectively and the overall function was significantly improved after 14 CBT treatments.The treatment reached the desired treatment goals.This study suggests that self-compiled cognitive behavior therapy manual is effective for the obsessive-compulsive disorder in practice and it has a guiding significance on the normative treatment of obsessive-compulsive disorder.

A case-control study on risk factors for intrauterine HBV infection / 重庆医学

Objective To explore the risk factors for hepatitis B virus (HBV) intrauterine infection to provide a scientific ev idence for itsprevention.Methods Three hundred and twelve pregnant women of HBsAg positive screened from April 2013 to May 2015 served as the research subjects and were followed up until 6 months after birth.The infantile mothers of HBsAg and/or HBV DNA positive were selected as the intrauterine infection case group,while other mothers served as the control group.The Logistic regression analysis was adopted to analyze the risk factors for intrauterine HBV infection.The questionnaire survey method was used to collect the basic data and time-resolved immunofluorescence assay was used to detect HBsAg.PCR was adopted to measure level of HBV DNA and automatic biochemistry analyzer was used to measure the hepatic functional parameters including ALT,AST,triglyceride and cholesterol.Results The single factor analysis results indicated that HBeAg,HBV DNA,contamination of amniotic fluid and sexual behavior during pregnancy were related to HBV intrauterine infection(P＜0.05).The multiple variate Logistic regression results showed that positive HBeAg(OR=2.76,95 ％ CI=1.19-7.94),positive HBV DNA(OR=9.62,95 ％ CI=2.58-35.33),and sexual behaviors during pregnancy (OR =1.53,95 ％ CI =1.07-6.40) were the risk factors for intrauterine HBV infection.Conclusion Pregnant women with positive HBeAg,positive HBV DNA and sexual behavior during pregnancy may be the high risk factors for neonatal intrauterine HBV infection.

Unilateral Incomplete Cleft Lip- Chieloplasty: A Case Report.

Orofacial clefts are the most prevalent craniofacial birth defects and these malformations transform an infant with severe functional and esthetic handicaps. Cleft lip and palate is a common malformation that occurs in about 2 in 1000 live births. The cleft can vary from a hardly visible furrow in the palate or on one side of the lip to bilateral complete clefts of the lip, alveolus and palate. Clefts of the lip, alveolus and palate are highly complicated malformations. The problems associated such as speech, function, esthetic, and socio-psychological and more precisely deleterious effect on the growth and development of teeth, alveolus and jaws. A specialized corrective surgery is mandatory and indicated in early months of life to achieve the best outcome to improve the function and appearance. We are presenting a case of unilateral incomplete cleft lip with primary repair in a 4months and 20days baby boy.

Tumor gigante en un paciente con melanoma / Giant tumor in a patient with melanoma

Se estudió un paciente masculino, negro, de 17 años de edad, caribeño, aparentemente sano hasta el año 2007 cuando aparece un tumor témporo-parieto-frontal izquierdo de crecimiento rápido, que compromete la cara. Al examen físico se constató, además, piel y mucosas pálidas con desnutrición severa. El diagnóstico histopatológico fue de melanoma maligno de células epiteloides...

The case of a black Caribbean patient aged 17 apparently healthy until 2007 when to appear a left temporal-parietal-frontal tumor of fast growth involving the face. At physical examination authors also confirmed a pale skin and mucosae with a severe malnutrition. The histopathological diagnosis was a malignant melanoma of epithelioid cells...

Boom in clinical research industry: A dangerous trend.

Over the last decade or so India has witnessed a phenomenal growth in the clinical trial industry. The projections forecast a continuing growth of this trend. It has been predicted that by 2011 India will be in charge of 15% of global clinical trials.1 The enthusiasm for the growth of this industry in India is shared not just by the major pharmaceutical companies and CROs but also equally so by government agencies.2 The raison d’être for medical research is that it should lead to maximum possible benefit to the largest number of people. Hence, an examination of the extent to which public good is served can act as a measure for objective analysis of this exponential increase in the clinical trial industry. After all it is the health and lives of the people that are at stake. On the face of it, it would seem that all trials testing the safety and efficacy of various molecules, by their very nature work towards public welfare as they are indispensible to the development of any drug including the life-saving ones. An increasing number of clinical trials at all stages in a product’s life cycle are funded by the pharmaceutical industry.3,4 It would then seem that the industry-sponsored medical research is necessarily furthering the larger objective of human wellbeing. However, the operations of the pharmaceutical industry, the nature of the processes involved and the operative motives are a bit too complex to facilitate this larger objective so simply, just as yet. This warrants a closer look at the various aspects of industry-sponsored clinical research.

A Case of Allergic Contact Dermatitis to Ophthalmic Ointment / 대한피부과학회지

Neomycin is one of the aminoglycoside antibiotics and not uncommonly causes allergic contact dermatitis. Wool alcohol is one of the most widely used lanolin bases and rarely has been reported to cause allergic contact dermatitis. A 63-year-old male presented with a pruritic, erythematous swelling on the right periorbital area. He had a cataract operation on his right eye 10 days ago and has applied several eye drops and topical antibacterial agents. Patch test with Korean standard antigens and ophthalmic preparations revealed strong positive reactions to neomycin sulfate and the Maxitrol ointment composed of dexamethasone, neomycin sulfate and polymyxin B, and positive reaction to wool alcohol. Neomycin may be the major causative agent to produce allergic contact dermatitis, and wool alcohol also has some relation to it.

A Case ot Acute sensory neuronopathy

We have had an opportunity to study a patient with acute sensory neuronopathy. The patient was a 32-yearold housewife; the rapidly spreaded tingling sensation along both arms and legs developed, rendering her severely ataxic. There was no history of antecedent illness, familial neurological disease, or exposure to toxins and special drugs. On examinations, there was no abnormality in her mental and cranial nerve function. There was no motor weakness. She showed the profound loss of kinesthetic sense which was acutely progressive and associated with severe sensory ataxia and pseudoathetosis. All tendon reflexes were absent. However, cutaneous senses were preserved. There was no significant abnormal laboratory finding except elevated CSF protein content. On electrophysiologic findings, the decrease in the amplitude of action potentials with only mild slowing of conduction velocities of sensory nerves were found even though motor nerve conduction studies were normal. Median and tibial somatosensory evoked potentials could be elicited, although the median N19 scalp response and tibial N45 waveforms were prolonged in latency. Plasmapheresis were provided; clinical features improved. However, the electrophy-siological abnormalites remained. Thus we wish to report an additional case of woman suffering from the acute sensory neuronopathy, complementing the cases described by Stemm, Schaumburg and Asbury.

Gram-negative Bacillary Meningitis: A Case Report of E. coli Meningitis in Adult

We treated a 66 year-old-male patient with non-traumatic spontaneous E. coli meningitis, whose cerebrospinal fluid showed turbid, and from which E. coli was cultured, and who had urinary tract infection and fatty liver disease which were thought to be predisposing factors to the meningitis. Gram-negative bacillary meningitis is a very rare condition after the neonatal period, and may be complicated by penetrating cranial injuries, neurosurgical interventions or such debilitating diseases as diabetes, liver cirrhosis, urinary tract infection, malignancy and alcholism, etc. It has a high mortality rate in spite of using various antibiotics.