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Successful treatment of highly recurrent facial

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Offer Details: Shortly after take-off, the patient experienced an inability to equalize ear pressure in his right ear, followed by right-sided otalgia, unilateral right-sided facial droop, paralysis, and numbness. With mild success, the patient initially attempted self-treatment during flights, which included yawning and the Toynbee maneuver to equalize ear pressures, applying pressure with a hot water See more ...

Hemophagocytic lymphohistiocytosis in a patient with COVID

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Offer Details: However, his respiratory failure only improved gradually, and he was weaned off the respirator 11 days later. Conclusion. COVID-19 may induce a hyperinflammatory clinical picture and in some cases develop into hemophagocytic lymphohistiocytosis. In our patient’s case, therapeutic interleukin-6 blockade abrogated signs of hyperinflammation but did not seem to improve pulmonary function See more ...

Unusual and delayed presentation of chronic uterine

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Offer Details: Uterine inversion is a rare but known complication following parturition and may prove fatal due to neurogenic shock or postpartum hemorrhage if not corrected immediately. The incidence is variable, occurring in 1 in 2000 to 1 in 50,000 deliveries, as reported in the past. Nowadays, the incidence is declining due to better antenatal care and increasing institutional deliveries. However, in a See more ...

An adolescent girl with signs and symptoms of anaphylaxis

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Offer Details: She was weaned off fluoxetine, and angioedema attacks decreased. When discharges were planned, she repeatedly became suicidal or reported another angioedema episode. She was observed to be triggering angioedema attacks by secretly eating food (for example cookies with nuts) that she was told not to eat because of potential anaphylactic reaction. She identified a fear of going home and a need See more ...

CASE REPORT Open Access Persistent negative visual aura in

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Offer Details: her to frequently fall out of bed or off chairs when rising from them. This first-episode visual symptom was con-stant and was not accompanied by any positive visual phenomena. She had no previous history of visual aura and experienced no tingling, numbness or weakness of the limbs. She had a history of headache from the age of 13, occurring at a frequency of once per month, as is consistent See more ...

Sclerosing peritonitis presenting as complete mechanical

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Offer Details: Sclerosing peritonitis or abdominal cocoon syndrome is characterized by small bowel loops completely encapsulated by a fibrocollagenous membrane in the center of the abdomen. Although cocooning of the abdomen is mostly seen in patients on peritoneal dialysis, it can occur de novo; it very rarely manifests as complete mechanical bowel obstruction. See more ...

Management of irreducible unilateral facet joint

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Offer Details: If the cervical spine was still hard to reduce, the zygapophyseal apex of the lower vertebra of locked facet would be drilled off or removed, to restore normal alignment. However, this position cannot be maintained without pressure and fixation when severe ligamentous rupture exists. Therefore, wire rope fixation of the adjacent spinous process was used as a posterior tension band. Wire rope See more ...

Use of an intraoperative navigation system and

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Offer Details: After the resection spot was confirmed, the SP was pinched off using bone-holding forceps while the thicker portion was cut down by piezoelectric surgery (Fig. 6). The resected SP was then taken out (Fig. 7), and a prophylactic drain was left in place before closing the wound on the next day of surgery. The operation time was 37 minutes. The See more ...

Use of an intraoperative navigation system for retrieving

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Offer Details: Endodontic files, burs, and occasionally, other dental instruments tend to break off during surgical procedures because of defective manufacturing, stress, fatigue, rust, or poor handling . The diameter, length, and position of the fragment within the root canal can all influence its nonsurgical or surgical removal. Periapical surgery in the mandibular premolar and molar areas presents certain See more ...

Acute presentation of a giant intrathyroidal parathyroid

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Offer Details: At 1-year postoperative, she was weaned off calcium and alfacalcidol. A follow-up ultrasound showed unremarkable residual thyroid. Conclusions. Any patient with an isolated hypercalcemia warrants a thorough work-up. Hungry bone syndrome is a potentially avoidable condition; thus the clinician should be highly attuned to the risk of hungry bone syndrome post-parathyroidectomy, which correlates See more ...

A rare presentation of pulmonary sarcoidosis as a solitary

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Offer Details: Sarcoidosis is a systemic, chronic granulomatous disease of unknown etiology that commonly affects the lungs [].Whereas some patients with pulmonary sarcoidosis are asymptomatic, many report cough, dyspnea, fatigue, unintentional weight loss, and night sweats [].Because of its nonspecific symptomology, computed tomographic (CT) scans are instrumental for diagnosis [1, 2]. See more ...

Kaplan anastomosis of the ulnar nerve: a case report

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Offer Details: It gave off three branches along its course. The first branch emerged just proximally to the ulnar styloid process and ran towards the radiocarpal joint. It was located between the abductor digiti minimi and the deep ramus of the ulnar nerve where the Kaplan anastomosis gave off two branches. One branch ran towards the abductor digiti minimi muscle, while the other ran towards the fifth See more ...

Serous retinal detachment after panretinal

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Offer Details: At this point, he accepted a single off-label injection of 1.25 mg bevacizumab (Avastin; Genentech, South San Francisco, CA, USA) in each eye. Eleven days after the bilateral injection, the serous RD had regressed completely in his left eye, and there was a substantial regression in his right eye (Fig. 2 lower panel), which subsequently regressed completely over the following 2 weeks. See more ...

Vitamin D treatment for chronic urticaria: a case report

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Offer Details: Treatments involve non-sedating antihistamines in escalating off-label doses, omalizumab, anti-inflammatory medications such as hydroxychloroquine, and, in some patients, immunosuppressants such as cyclosporine. We report a case of a 14-year-old white boy with refractory chronic autoimmune vitamin D-responsive urticaria. Case presentation . In October 2017, our 14-year-old white male patient See more ...

Persistent negative visual aura in migraine without

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Offer Details: Persistent migraine aura without headache is an extremely rare condition. The International Headache Society defines various subtypes of migraines, including “persistent migraine aura without infarction” and “typical aura without headache.” We describe the case of a 21-year-old Asian woman with a history of migraine without aura who had (as her first aura episode) persistent negative See more ...

Complete migration of a composite mesh into small bowel

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Offer Details: The initial necrosis of the bowel wall due to the inflammation would have been sealed off by the surrounding bowel loops, preventing an abscess formation. Once the mesh was slowly internalized, it is possible that the opening would simultaneously have been sealed off by the bowel loops; hence, the bowel mass detected during this laparotomy would have formed. Similar silent erosion by a See more ...

Successful long-term management of choroidal

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Offer Details: Off-label treatment of his RE with intravitreal injection of bevacizumab (1.25mg/50μL) once a month was initiated in December 2007, but discontinued after 3 months in February 2008 due to lack of efficacy (no improvement in visual acuity).In September 2008, He reported reduced visual acuity in his LE. Eye examinations (fundus photography, fluorescent angiography and OCT) revealed changes in See more ...

Femoroacetabular impingement and its implications on range

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Offer Details: The CE angle of 28° was within the normal range, and not larger than the cut-off point of 35° for a pincer type. An additional MRI scan did not reveal any labrum or cartilage pathology, or loose bodies. We agreed to perform an arthroscopy and shave the femoral head-neck junction if a cam lesion was found. During arthroscopy the suspected cam lesion was seen on the anterosuperior side of the See more ...

Full-term extrauterine abdominal pregnancy: a case report

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Offer Details: Extrauterine abdominal pregnancy is extremely rare and is frequently missed during antenatal care. This is a report of a full-term extrauterine abdominal pregnancy in a primigravida who likely had a ruptured ectopic pregnancy with secondary implantation and subsequently delivered a healthy baby. A 23-year-old, Middle Eastern, primigravida presented at 14 weeks gestation with intermittent See more ...

Treatment of pseudobulbar affect (PBA) in a patient with a

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Offer Details: Before the approval of DM/Q in 2011, PBA and similar syndromes involving emotional incontinence were, and still are, treated off-label with antidepressants, including tricyclic antidepressants such as amitriptyline and selective serotonin reuptake inhibitors such as fluvoxamine . See more ...

Prucalopride reduces the number of reflux episodes and

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Offer Details: Treatment of persistence to proton pump inhibitors or non-acid reflux episodes in patients with gastroesophageal reflux disease is challenging. Prucalopride, a selective high affinity serotonin (5-HT4) receptor agonist, might offer a possible new therapeutic alterative. We report four chronically constipated female gastroesophageal reflux disease-patients with reflux symptoms and an increased See more ...

Madurella mycetomatis infection of the buttock in an

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Offer Details: substructure and with colors ranging from off-white to pinkish, whereas fungal grains are rather firm and are composed of microscopically recognizable hyphae, which are either black or whitish. The most common agents of black-grain mycetoma are classified in the genus Madurella,suchasMadurella mycetomatis and Madurella grisea [1, 4]. Although rare as an import pathology, mycetoma must be See more ...

New congenital coronary artery anomaly – double supply of

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Offer Details: It gave off septal perforators, then reentered the medial LAD, and both vessels ran after the anastomosis in the AIVS as a single vessel. This course can be associated with limiting coronary blood flow, when dilation of the aorta occurs during exercise or due to the stretch of the intramural segment. The FFR measurements during the infusion of increasing doses of dobutamine showed that this See more ...

Journal of Medical Case Reports BioMed Central

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Offer Details: It gave off three branches along its course. The first branch emerged just proximally to the ulnar styloid process and ran towards the radiocarpal joint. It was located between the abductor digiti minimi and the deep ramus of the ulnar nerve where the Kaplan anastomosis gave off two branches. One branch ran towards the abductor digiti minimi muscle, while the other ran towards the fifth See more ...

The extremely rare vascular variant of a segmental

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Offer Details: In anatomic terms, the uterine artery runs down the retroperitoneal space of the lateral pelvic wall (first or descending segment), travels intraperitoneally through the broad ligament (second or transverse segment), and then gives off ascending branches to the uterine body and descending branches to the cervix uteri at the uterine margin (third or ascending segment). See more ...

Mirtazapine treatment of diabetic gastroparesis as a novel

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Offer Details: Mirtazapine is a serotonergic 5-hydroxytryptamine 2/3 (5HT2/3) receptor antagonist and noradrenergic antidepressant , which has been used off-label for management of gastroparesis in the cases as described. Its exact mechanism of action for gastroparesis is unclear but thought related to serotonergic and noradrenergic effects. Its effects on relieving gastroparesis are thought to be related to See more ...

Treatment resistant adolescent depression with upper

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Offer Details: To the best of our knowledge, this is the first report of a case of treatment-resistant depression in which the patient was evaluated for sleep disordered breathing as the cause and in which rapid palatal expansion to permanently treat the sleep disordered breathing produced a prolonged symptom-free period off medication. An 18-year-old Caucasian man presented to our sleep disorders center See more ...

Intraovarian injection of autologous human mesenchymal

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Offer Details: Premature ovarian failure is a relatively common condition that affects 1–3% of adult women. Premature ovarian failure occurs when there is loss of ovarian function in women younger than 40 years of age. The causes are mostly iatrogenic or idiopathic. Amenorrhea and infertility are the most important clinical manifestations. So far, no therapeutic intervention has been proved effective in See more ...

Eucalyptus oil poisoning: two case reports | Journal of

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Offer Details: Both the patients were successfully weaned off the ventilator and extubated on the second day of admission. They were discharged 2 days later on a tapering regimen of antiseizure medications. They were subsequently lost to follow-up. Table 2 pH and bicarbonate levels (arterial blood gas analysis) of two patients in serial order . Full size table. Discussion. Eucalyptus oil poisoning is more See more ...

Unusual trichobezoar of the stomach and the intestine: a

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Offer Details: In addition, parts of the tail can break off and migrate to the small intestine, causing intestinal obstruction [6–8]. Trichobezoars may not be recognized in their early stages because of their nonspecific presentation, or even lack of symptoms. Following the introduction of minimally invasive surgery and endoscopy with mechanical and laser fragmentation techniques, some authors have See more ...

Acute compartment syndrome of the lower limb following

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Offer Details: Acute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Prompt diagnosis is crucial to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk See more ...

Autistic symptoms in Greig cephalopolysyndactyly syndrome

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Offer Details: The partial score of the C domain, however, reached the cut-off for the “spectrum” (2). Table 2 Father’s neuropsychological findings. Full size table. Discussion. GCPS is a rare autosomal dominant condition characterized by high variability of the phenotype. However, a minor intrafamilial severity is generally described among multiplex families (more than one member affected) . A good See more ...

Factitious cheilitis: a case report | Journal of Medical

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Offer Details: Factitious cheilitis is a chronic condition characterized by crusting and ulceration that is probably secondary to chewing and sucking of the lips. Atopy, actinic damage, exfoliative cheilitis, cheilitis granulomatosa or glandularis, contact dermatitis, photosensitivity reactions and neoplasia should be considered in the differential diagnosis of crusted and ulcerated lesions of the lip. See more ...

Locally advanced breast cancer made amenable to radical

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Offer Details: Tissue fixation can be obtained even at concentrations of 50%; therefore, a saturated solution was deemed unnecessary. After using Mohs paste, necrotic tissue is formed. In many cases, necrotic tissue is removed bluntly, without local anesthesia, or it falls off naturally. After removal, an ulcer might form, and exudates might reduce; however See more ...

Effect of intravitreal dexamethasone on macular edema in

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Offer Details: Following an intravitreal injection of ranibizumab, off-label administration of intravitreal dexamethasone was considered to reduce the edema. An almost complete resolution of the edema in the macular area was observed 1 week after the injection. Finally, laser photocoagulation and transconjunctival cryotherapy were performed; the patient developed “ablatio fugax” after cryotherapy. In our See more ...

Stab injury to the preauricular region with laceration of

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Offer Details: Provisory tamponade of the wound was achieved at the place of aggression by two off-duty doctors, who pressed a piece of clothing against the wound. The patient was initially transferred to a district hospital, where profuse arterial bleeding was observed by the general surgeon on call. A temporary compressive dressing was applied under local anesthesia. Subsequently, the patient was See more ...

Acute coronary ischemia during alcohol withdrawal: a case

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Offer Details: The potential of alcohol withdrawal to cause acute coronary events is an area that needs the urgent attention of clinicians and researchers. We report the case of a 52-year-old heavy-alcohol-using Sri Lankan man who developed electocardiogram changes suggestive of an acute coronary event during alcohol withdrawal. Despite the patient being asymptomatic, subsequent echocardiogram showed See more ...

Post-coital intra-cerebral venous hemorrhage in a 78-year

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Offer Details: He had been lying in a supine position with his head hanging off the bed in a slightly downwards position. The patient was brought to the hospital few hours later. On admission, neurological examination showed a right hemianopia with alexia. His systolic blood pressure was 115 mmHg and the diastolic pressure was 60 mmHg. A thorough review of familial and personal clinical histories suggested See more ...

Coil embolization of intralobar pulmonary sequestration

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Offer Details: Computed tomography of the chest demonstrated left lower lobe intralobar pulmonary sequestration fed by a large tortuous vessel branching off of the descending thoracic aorta. Surgical resection of the sequestration is the current standard treatment strategy of symptomatic intralobar pulmonary sequestration. The cardiothoracic surgeon noted that given the size and location of arterial blood See more ...

Increased replication of CD4 + naive T cells and changes

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Offer Details: She was classified as in clinical remission off medication for over 12 months, as according to published criteria for disease remission . Disease exacerbation at the time of evaluation was verified by clinical examination (extended oligoarthritis with painful joints of the upper and lower extremities) and increased laboratory parameters (C-reactive protein level [CRP] 5.14mg/dL; erythrocyte See more ...

Robotic voluminous paraesophageal hernia repair: a case

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Offer Details: The treatment for sliding esophageal hernia with mild gastroesophageal reflux is usually conservative, but surgical treatment is recommended for refractory sliding esophageal hernia, paraesophageal hernia liable to prolapse, or paraesophageal hernia with ulceration and/or stenosis. Robotic surgery overcomes laparoscopic pitfalls by providing steady-state three-dimensional visualization See more ...

Exertional fat embolism after hip joint replacement: a

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Offer Details: We present the case of a patient with exertional fat embolism on isolated exercise of his right leg two and four months after right total hip joint replacement. His immediate post-operative period had also been complicated by an acute episode of chest pain and hypotension, treated as acute coronary syndrome. To the best of our knowledge, this is the first reported case of exertional fat See more ...

A patient with severe polytrauma with massive pulmonary

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Offer Details: The partial pressure of oxygen in arterial blood/fraction of inspired oxygen ratio was remarkably improved by veno-venous extracorporeal membrane oxygenation, and the patient was successfully weaned off from the veno-venous extracorporeal membrane oxygenation on day 7. There was an obvious inverse correlation between lactate level and partial pressure of oxygen in arterial blood/fraction of See more ...

Filshie clip migration with multiple groin hernias: a case

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Offer Details: Filshie clip migration is a rare complication of tubal occlusion, with the incidence reported between 0.1 and 0.6% [].Wong et al. reported Filshie clips within hernias, external to the hernial sac.To the best of our knowledge, there is only one previous case study reporting a Filshie clip within a hernial sac [].The Filshie clip sterilizes woman by clamping the fallopian tubes, causing See more ...

Prolonged high-dose intravenous magnesium therapy for

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Offer Details: He was weaned off the ventilator on day 28 and was discharged from the ICU in a stable condition on day 32. Demographic, therapy and outcome data are presented in Table 1. Autonomic nervous system instability was not a problem, as all patients (except for patient 1 during a 5-day episode of sepsis) maintained cardiovascular stability. Intravenous Mg therapy resulted in excellent muscle spasm See more ...

Ruxolitinib found to cause eyelash growth: a case report

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Offer Details: The medication is off-label for HES but has been reported to be successful in eosinophilic leukemia. Ruxolitinib (Jakafi®) has been reported to aid in refractory alopecia areata. Our patient noted that his eyelashes grew significantly. This is the first case in which eyelash growth has been reported. Case presentation . A 77-year-old Asian man presented with sudden onset pruritus. There was See more ...

Peritonitis secondary to traumatic duodenal laceration in

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Offer Details: A pancreatic pseudocyst is a common sequela of severe acute pancreatitis. Commonly, it presents with abdominal pain and a mass in the epigastrium several weeks after the acute episode and can be managed conservatively, endoscopically or surgically. We report a patient with a pancreatic pseudocyst awaiting endoscopic therapy who developed a life-threatening complication following a rather See more ...

Bilateral pulmonary embolism while receiving tranexamic

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Offer Details: She claimed she still experienced pleuritic chest pain on and off in addition to a new intermittent interscapular pain. A repeat D-dimer test result came back negative (0.35 μg/ml; normal range, 0.05 to 0.50 μg/ml). Likewise, results of her physical examination and recheck of her routine blood tests, including troponin I, clotting screen, and inflammatory markers, were all within normal See more ...

Necrotizing fasciitis following saphenofemoral junction

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Offer Details: A positive finger test is defined by lack of resistance of the subcutaneous tissues to finger dissection off the deep fascia. Rapid frozen section tissue biopsies can be sent, but most practitioners advocate a rapid debridement. Radiological studies are occasionally used but should not be performed routinely as this delays treatment. The gold-standard diagnostic modality is operative See more ...

Unusual acute lupus hemophagocytic syndrome – a test of

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Offer Details: She complained of significant hair loss and on and off confusional episodes over the last 2 weeks, but denied symptoms of focal infections including respiratory symp-toms. Also, she disaffirmed any history of arthritis and fea-tures of autoimmune diseases such as photosensitive rashes, oral ulcers, or symptoms of Raynaud’s phenomenon. On examination her body mass index was 16 kg/m2. She was See more ...

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