Herpes zoster ophthalmicus (HZO) is a disease which occurs when the ophthalmic division of the trigeminal nerve is impaired as a result of reactivation of the varicella-zoster virus. Ophthalmic involvement has been considered the most important and potentially serious of all sites of Herpes Zoster virus. Objective of thispresent case study was to understand the modes of presentation and manifestations (ocular and extraocular) of HZO.This case study was conducted in the Outpatient Department of Ophthalmology at Indira Gandhi Medical College, Shimla (Himachal Pradesh). The Patient diagnosed with HZO was underwent a comprehensive ocular and extraocularexamination. The ocular manifestations of HZO in the Patient was acute vesicular, dermatomal ,painful, unilateral skin rash, hyperesthesia over his left forehead skin, Hutchinson sign present,Conjunctivitis in left eye with no exudates or obvious corneal scarring , Superficial punctate keratitis, stromal keratitis,Visual acuity Right eye-6/12, Left eye -6/18, IOP digitally normal bilaterally, Fundus cannot be assessed (CNBA) in the left affectedeye, normal ocular movements in all planes with no diplopia, normal direct and consensual pupillary reflexes. Patient was medically treated with antiviral, antibiotic, cycloplegic and other supportive drugs and followed up.
Necrotizing enterocolitis (NEC) is an acquired, multifactorial syndrome characterized by segmental, inflammatory, or ischemic necrosis of the small and large bowel. Although in adults the incidence of NEC is much lower and has lower mortality, the degree of morbidity remains high. As AMI may lead to fatal intestinal gangrene early diagnosis and treatment are paramount
As a resource constraint country, it was a difficult task to introduce percutaneous pulmonary valve implantation (PPVI) with MelodyTM. We aimed to see the outcome of our cases in this background. Retrospective analysis of six cases who had PPVI with MelodyTM in Combined Military Hospital, Bangladesh. Inclusion criteria were dysfunctional conduit between right ventricle (RV) and pulmonary artery causing (a) Symptoms of exceptional dyspnoea of various grade(NYHA II,III, IV) (b) RVEVD >150ml/m2+regurgitant fraction >40% (c) RVOT peak instantaneous gradient > 30 mm Hg. (d) RV dysfunction (RVEF<40%). Patient fulfilled above criteria were selected and outcome were analyzed. Mean age was 9 .56 + 2.96 years, weight was 28.75 + 8.61 kg, height was 137.5 + 17.52 cm. Mean age at surgery was 4.25+2.72 years. Female were 66.66%. Aortic homograft was used in 66.66 % cases. Eighteen mm Ensemble was used in four (66.66%) cases and 20mm and 22 mm in one each. Immediate result was excellent with no residual PS in two cases and negligible residual flow acceleration across pulmonary valve in four cases. No PR seen in all except one. One patient developed bacterial endocarditis after 3 years and was treated. Aim of PPVI is to prolong the life expectancy of conduits which were placed surgically from right ventricle to pulmonary artery. It significantly reduces the number of surgeries to change conduit in total life span of patient
Abstract: Recent progress regarding the potential benefit of dietary antioxidants in the treatment of chronic diseases with a special focus on immune system and neurodegenerative disorders will be discussed here. It is well established that reactive oxygen species (ROS) play an important role in the etiology of numerous diseases, such as atherosclerosis, diabetes and cancer. Among the physiological defense system of the cell, the relevance of antioxidant molecules, such as glutathione and vitamins is quite well established. Recently, the interest of researchers has, for example, been conveyed on antioxidant enzyme systems, such as the heme oxygenase/biliverdin reductase system, which appears modulated by dietary antioxidant molecules, including polyphenols and beta-carotene. These systems possibly counteract oxidative damage very efficiently and finally modulate the activity of oxidative phenomena occurring, for instance, during pathophysiological processes. Although evidence shows that antioxidant treatment results in cytoprotection, the potential clinical benefit deriving from both nutritional and supplemental antioxidants is still under wide debate. In this line, the inappropriate assumption of some lipophylic vitamins has been associated with increased incidence of cancer rather than with beneficial effects. Background: This study aims to investigate the effect of antioxidants supplement on clinical outcomes and antioxidant parameters in rheumatoid arthritis (RA). Methods: The pre-post study was conducted on 40 female patients with RA in 12 weeks that taken daily one Selenplus capsule contained 50 μg selenium, 8 mg zinc, 400 μg vitamin A, 125 mg vitamin C, and 40 mg vitamin E. About 5 mL venous blood sample was taken from all participants and disease activity score (DAS) was determined by DAS-28 formula and high-sensitive C-reactive protein (hs-CRP). Glutathione peroxidase (GPX) and superoxide dismutase (SOD) were measured by spectrophotometric kit and catalase
Abstract: Boerhaave's syndrome is a rare but lethal disease involving the gastrointestinal tract. It is a spontaneous esophageal perforation with complete transmural tear caused by a sudden increase of intraluminal pressure in the esophagus. The disease is associated with high mortality of more than 40% with early surgical intervention. Delayed surgical intervention more than 7 days after the initial presentation is associated with nearly 100% mortality. The classical Mackler's triad of symptoms is rare. The reported rate of misdiagnosis is high. Delayed presentation, misdiagnosis, and intervention is associated with poor healing, increased complications, prolonged hospital stay, and increased mortality. We report two cases of Boerhaave's syndrome. One case presented early within 24hours with classical symptoms, while another presented late after 7 days with atypical symptoms and a delayed diagnosis elsewhere. Both the cases where managed by recommended standard practices. Despite minimal complications, the patient with early presentation had a comparatively good healing, early recovery, and short hospital stay. The patient with delayed presentation had already developed multiple complications at presentation to our setup. Though this patient required a prolonged hospital stay, an intensive, imaginative, and aggressive multidisciplinary care resulted in a good recovery. A high index of suspicion and early intervention helped in the recovery and prevention of complications in patients presenting early. Good multidisciplinary care resulted in a good recovery in the patient with delayed presentation. With a good and imaginative multidisciplinary care, even a condition with a mortality rate as high as 100% can be managed successfully.
Keywords Boerhaave Syndrome, Mediastinitis, Esophageal Perforation.
Objective: To determine the epidemiological and histological aspects of primary malignant bone tumors in Cameroon. Materials and Methods: A descriptive retrospective study of patients with confirmed malignant primary bone tumors biopsy presented between January 2004 and December 2017 in all anatomo-pathological laboratories in Yaounde and Douala, which are the two biggest towns in Cameroon. Patients with multiple myeloma and lymphoma were excluded. Results: A total of 234 bone tumors were found. 56.41% (132 cases) of these tumors were benign tumor, 38.41% (90 cases) were malignant tumors and only 12 (5.11%) were metastases. The average age of the patients with malignant tumors was 27.95 ± 17. 93 years, with extremes of 5 and 80 years. Female was the most represented with 51.11% (46 cases), with a male-to-female sex ratio of 0.96. The site most affected by malignant bone tumors was the femur 33.3% (30 cases), the tibia 22.2% (20 cases). Osteosarcoma was the most common histological diagnosis (52 cases, 57.8%); followed by Ewing’s sarcoma (15 cases, 16.6%) and chondrosarcoma (11 cases, 12.2%), fibrosarcoma (5 cases, 5.6%), angiosarcoma (4 cases, 4.4%) and liposarcoma (3 cases, 3.3%). Conclusion: Primary malignant bone tumors occurred between first and second decade of life with male preponderance. Osteosarcoma was the most common malignant bone tumors, respectively. The femur and tibia was the preferred affected site.
Keywords Malignant tumor, Bone, Cameroon
Non-Hodgkin’s lymphoma is a rare primary neoplasm of the epidural spine of the
elderly. Although lymphomatous involvement of vertebral bodies will be recognized as
marked high signal on STIR images, the radiological features are still unspecific, which
make it difficult for identification. We report a case of a 86-year-old man complaining of
serious lower lumbar pain and lower limbs muscle weakness. The PET-CT scan showed
invasion of the fifth lumbar vertebra without migration. As the posterior vertebral body wall
collapsed, never roots were compressed by the instability. The Spinal Instability Neoplastic
Score (SINS) was 13. Vertebroplasty was performed to consolidate the vertebral and
followed by decompression and interal fixation, afterward, the pain and lower limb
weakness was relieved. The histopathological examination revealed a diffuse lymphoma. RminiCHOP
chemotherapy was applied following the surgery in the department of
hematology. Until the 12 months follow-up, the clinical result was satisfied.