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Nov 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3612
Sah BikashCorresponding author
Associate Professor, Department of Forensic Medicine and Toxicology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. The depressant effect of alcohol further complicates the diagnosis. We report a case of a young male who was unable to seek medical support and was found dead within 12 hours of the onset of abdominal discomfort following acute alcohol intoxication. At autopsy, rupture of the urinary bladder with blood and blood clots was found in the pelvic cavity with no any corresponding external injury. Spontaneous rupture of the urinary bladder is a rare cause of death in acute alcohol intoxication. In order to further understand this rare condition, the review of related literature has been done.
Jul 2019 DOI 10.14302/issn.2641-5518.jcci-19-2909
Lane AndrewCorresponding author
Sydney Medical School, University of Sydney
An 81-year-old male presented to the Emergency Department with urinary retention, subsequent to passing blood clots. A three-way catheter was inserted for continuous bladder irrigation. 48 hours later he deteriorated, with worsening tachypnea and hypoxaemia. Clinical examination and chest x-ray suggested pulmonary odema, managed with intravenous furosemide, and non-invasive ventilation. His irrigation circuit-chart showed he had received 10 litres Normal Saline via the afferent limb, but only 3 litres recorded at the efferent limb. It was suspected the catheter was adjacent to a vascular-cystic interface, however an urgent contrast CT revealed the irrigating catheter perforating the bladder, being situated in the abdominal cavity (see 3 images). His arterial blood-gas analysis demonstrated the expected normal anion-gap academia, however his Strong Ion Difference calculations, sodium-chloride difference of 13 and a normal albumin level, perfectly demonstrated the expected calculated BE of -13. The catheter was withdrawn, and the patient made a full recovery.
Oct 2017 DOI 10.14302/issn.2576-182X.jbsc-17-1809
Ronchetti GabrieleCorresponding author
Neurosurgery, Department of Surgery and Translational Medicine, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy
Rupture of an intracranial aneurysm may cover for a long time clinical and radiological signs of a coexistent tumor. We report the delayed diagnosis of glioblastoma in a 65-years old female with recent history of subarachnoid hemorrhage. In the literature are described few similar cases: we briefly discuss the management in the rare occurrence of a double neurosurgical disease.
Jun 2016 DOI 10.14302/issn.2578-2371.jslr-16-1068
Seetahal ShivaCorresponding author
Heart of Florida Regional Medical Center, Davenport, FL
A case report of massive splenic rupture with atypical presentation. It covers diagnostic work‑up, stabilization, and operative decision‑making.
Aug 2019 DOI 10.14302/issn.2574-4526.jddd-19-2963
J. Demos NicholasCorresponding author
Professor of Surgery, Rutgers Biomedical and Health Sciences, 65 Bergen St, Newark, NJ 07103
Four cases are reported with splanchnic aneurysms of the branches of the main arteries. Three of the cases presented as emergencies. Possible rupture was present in Case 2 and true rupture in Case 4. The etiology of Cases 1 and 2 may have been a floxacin antibiotics, Table 1. This report is the first clinical chronological association of the antibiotics and arterial and aortic pathology. This association was supported by nationwide research by Pasternak, 11. Detailed experimental work done on mice showed connective tissue fragmentation and arterial cell injury. Apparently, the above antibiotic induced mitochondrial DNA damage and dysfunction, 9.
Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1784
Minakshi RohillaCorresponding author
Objective: Mullerian anomalies of the female genital tract are rare and unicornuate uterus is one such variant: it may present with a rudimentary horn with or without a communication. Pregnancy is rare in a non communicating horn and majority of them end up in rupture during first trimester. The ones which progress to fetal viability are around 10 % and may end up in catastrophic hemorrhage with fetal loss at any time. Case report: We hereby report a rare case of unruptured rudimentary horn pregnancy associated with placenta accreta and delivery of a live born fetus at 34 weeks period of gestation. Around ten cases of such an association have been reported in the past. Conclusion: Diagnosis of pregnancy in a non communicating horn of a unicornuate uterus is challenging especially at term. High index of suspicion and timely delivery of a live fetus has major role in achieving best maternal and neonatal outcome.
Feb 2017 DOI 10.14302/issn.2374-9431.jbd-17-1429
Yasmin-AktarCorresponding author
Bangladesh Medical College Hospital (BMCH), Dhaka, Bangladesh
Objectives: To observe pregnancy outcomes in gestational diabetes mellitus (GDM) under treatment. Methods: Pregnant mothers (N=191) diagnosed with GDM (n=91, age: 27.44±4.91yr; body mass index, BMI: 26.88±4.16 kg/m2; mean±SD) on the basis of WHO 2013 criteria were compared with non-GDM (n=100, age: 26.01±4.81yr, BMI: 25.53±3.77 kg/m2, mean±SD) for pregnancy outcome irrespective of gestational age. HbA1c was also measured in all mothers. Gestational hypertension, preeclampsia, premature rupture of membrane (PROM), hydramnios, recurrent urinary tract infection (UTI), recurrent moniliasis, intrauterine growth retardation (IUGR), intra uterine death (IUD), mode of delivery, birth weight, birth injury, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress syndrome (RDS), congenital anomaly were recorded at every trimester. 160 mothers (GDM=75, non-GDM=85) could be followed for outcomes to the end of pregnancy. All the GDM mothers were offered standard treatment throughout pregnancy period. Results: HbA1c was significantly higher in GDM than that in non-GDM (5.42±0.61 vs. 4.98±0.44%, mean±SD; p<0.001).Outcome events in GDM and non-GDM were: gestational hypertension- 3.6% vs. 2.3% (p=0.621), preeclampsia- 2.4% vs. 0% (p=0.150), PROM- 4.9% vs. 0% (p=0.037), hydramnios- none in any group, recurrent UTI- 12.3% vs. 4.7% (p=0.073), recurrent moniliasis- 0.0% vs. 2.3% (p=0.165), caesarian section- 85.3% vs. 72.9% (p=0.056), small for gestational age (SGA)- 26.4% vs. 36.7% (p=0.246), large for gestational age (LGA)- 1.4% vs. 0%, p=0.246, IUGR- 2.3 vs. 2.5% (p=0.952), neonatal hypoglycemia- 2.7% vs. 0.0% (p=0.130), hyperbilirubinemia- 12.0% vs. 11.8% (p=0.963), RDS- 0.0% vs. 2.4% (p=0.181) and birth injury- 0.0% vs. 1.2% (p=0.346), congenital anomaly- 4.0% vs. 1.2% (p=0.254) and abortion- 1.3% vs. 0.0% (p=0.286). Preterm delivery (12.0% vs. 7.1%, p=0.285) and caesarean section (85.3% vs. 72.9%, p=0.056) were more in GDM. Conclusions: Despite treatment, adverse events were relatively higher but non-significant in GDM.
Jan 2017 DOI 10.14302/issn.2379-8572.joa-16-1364
Suat BiliciCorresponding author
Istanbul Training and Research Hospital, Otorhinolaryngology Department
Objectives The aim of this study was to compare the functional outcomes (including swallowing, respiration and phonation) of supraglottic horizontal laryngectomy (SGHL) and supracricoid partial laryngectomy (SCPL). Methods The clinical and pathological data were evaluated for 36 previously untreated patients who were diagnosed with laryngeal carcinoma and underwent SGHL or SCPL at the Department of Otorhinolaryngology-Istanbul Training and Research Hospital from 2010 to 2016. Removal of the nasogastric tube, decannulation and hospitalisation times were recorded in both groups and postoperative complications were noted. Results The SGHL group contained 15 patients and the SCPL group contained 21 patients (14 cases of cricohyoidoepiglottopexy (CHEP) and 7 cases of cricohyoidopexy (CHP)). The mean age of the subjects was 57.4 years in the SGHL group, and 59.7 in the SCPL group. Patients in the SGHL group were decannulated after 65.2 days, whereas the average decannulation time was 72.6 days in the SCPL group. This difference in decannulation time between the groups was not statistically significant (p>0.05). The mean hospitalisation time was 23 days, with no statistically significant difference between the groups (>0.05). The nasogastric tube was removed from the patients after 37.9 days in the SGHL group and after 35.8 days in the SCPL group. No statistically significant difference was determined in the time to start feeding between the groups (p>0.05). Surgical wound infection, the occurrence of pharyngo-cutaneous fistulas and rupture of the pexy sutures were complications. Conclusion Functional outcomes of SCPL were similar to those of patients who underwent SGHL. The preservation of the hyoid bone is the most important consideration for preserving the swallowing function.
Sep 2016 DOI 10.14302/issn.2381-862X.jwrh-15-771
Jain SangeetaCorresponding author
Department of Obstetrics & Gynecology, University of Texas Medical Branch at Galveston, TX
Objective The tocodynamometer (TOCO) has poor sensitivity and specificity in monitoring uterine contractions, especially in obese patients. The intrauterine pressure catheter (IUPC) can be used to monitor adequacy of contractions, but only after amniotomy. Transabdominal uterine electromyography (EMG) and the TOCO were compared to the gold standard IUPC for monitoring uterine contractions. Methods Forty term pregnant women in labor with ruptured membranes were consented for this study. The root mean square (RMS) plot from EMG signals was compared to IUPC and TOCO recordings for 20 to 40 minutes. A comparison between the total contraction number, frequency, and the difference in contraction peak time was made using Student-t test or ANOVA (P<0.05 was significant). Results There was no significant difference in the contraction number and frequency when comparing the RMS, TOCO, and IUPC. The paper tracings had a greater standard deviation (8.57) than the digitally saved data (3.93). The mean peak time difference between TOCO and IUPC was 0.74 seconds (P=0.78; SD 5.2). For RMS vs. IUPC peaks, the mean peak difference between was 0.13 seconds (P=0.95; SD 3.93). Conclusions Uterine electrical activity measured with transabdominal uterine EMG may be used to monitor labor in patients as an alternative to the TOCO and the IUPC.
May 2015 DOI 10.14302/issn.2470-0436.jos-14-441
M Ghoneim EhabCorresponding author
Professor of Ophthalmology, Ophthalmology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Purpose: To describe a new intraocular lens that can be implanted in case of rupture of the posterior capsule and lack of capsular support. Methods: This experimental study was carried out on ten Flanders rabbits. The right eye of each rabbit underwent intra capsular lens extraction and two peripheral iridectomies, and the new lens was implanted with an optic rest in the posterior chamber. Additionally, the haptics rest in the angle of the anterior chamber through peripheral iridectomies. Main outcome measures were lens stability inside the eye and complications regarding this technique. Results: Intraocular lenses remained in a stable position with only a mild inflammatory reaction; four eyes developed hyphema that disappeared 10 days after surgery. Conclusion: The new lens design has good intraocular stability when posterior capsular support is absent and only produced minimal inflammation inside the eye.