The Southeast Asian Journal of Case Report and Reviews
Permanent URI for this collection
Editor in Chief : Dr. B D Parmar,
ISSN: 2319 – 1090 (Online)
Frequency: 6issues a year
Language: English
Periodical of National Institute of Continuing Professional Development
Online Peer-reviewed journal
Web site: https://www.scopemed.org/?jid=83&sec=eboard/
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Item Uterine Lipoleiomyoma: Case report and review of literature(IP Innovative Publication Pvt. Ltd., 2025-06) Myes, D; Kaur, G; Sharma, C.Lipoleiomyomas of the uterus are rare benign variant of leiomyoma and the literature suggests an incidence rate between 0.03% and 0.2%. These tumours are usually seen in postmenopausal age group and are mainly asymptomatic. Histo-morphologically, they present with intermingling fascicles of smooth muscle cells, lobules of mature adipose tissue and intervening fibrous areas. Here, we report two cases of a 46-year-old perimenopausal who presented with heavy menstrual bleeding and a 74-year-old postmenopausal woman who presented with uterovaginal prolapse. A primary diagnosis of leiomyoma was made based on clinical and radiological features however, histopathological diagnosis revealed it to be lipoleiomyoma.Item Bicornuate bicollis didelphic uterus with renal anomaly: pregnancy risks and complications(IP Innovative Publication Pvt. Ltd., 2025-03) Siroliya, A; Chouksey, R.Congenital M黮lerian duct anomalies affect the female genital tract, including the fallopian tubes, uterus, cervix, and/or upper vagina. These anomalies occur due to agenesis or failed fusion of the paramesonephric ducts or failed resorption of the uterine septum during fetal development. The incidence of M黮lerian duct anomalies ranges from 0.5% to 5.0% [1].Bicornuate uterus accounts for approximately one-fourth of these anomalies.Item Discovering the efficacy of integrated therapies on renal disorders(IP Innovative Publication Pvt. Ltd., 2025-03) Balkrishna, Acharya; Upreti, J; Danodiya, V; Chauhan, M; Katiyar, P.Aim: The study aims to investigate the efficacy of integrated therapies, including yoga, naturopathy, and Ayurveda, in managing Chronic Kidney Disease (CKD) and improving patient抯 quality of life while addressing disease progression. Study Design: This research was designed as a single-center case series, conducted at the Patanjali Wellness Centre, Haridwar, Uttarakhand. Duration of the Study: The study took place from September 2023 to August 2024. Method: The study involved seven CKD patients (3 Female & 4 Male) aged between 29 and 63 years, who were treated as inpatients. The interventions included yoga asanas, pranayama, naturopathic therapies, dietary management, and Ayurvedic medications. Pre- and post-treatment evaluations were performed using physiological, biochemical and radiological assessments, including kidney function tests and ultrasonography. Results: Integrated therapies led to significant improvements in renal function markers and symptom relief. Serum creatinine levels decreased by 15�% in five out of seven patients, while blood urea levels dropped by 20�%. There was a noticeable improvement in electrolyte balance and a reduction in proteinuria. Ultrasound results showed reduced kidney inflammation and no progression of renal parenchymal damage. Patients also reported better sleep, reduced fatigue, and alleviation of symptoms like swelling and body pain. Conclusion: The findings from this holistic treatment approach highlight its potential in managing chronic conditions such as CKD and other diseases. The results suggest that integrative therapies may offer an alternative for patients seeking to reduce long-term dependence on conventional pharmacological treatments. However, further large-scale, well-controlled studies are necessary to substantiate these outcomes and establish their clinical efficacy.Item Endosalpingiosis of urinary bladder presenting as a polypoidal mass: A case report and review of clinicopathological features(IP Innovative Publication Pvt. Ltd., 2025-03) Sutradhar, A; Pandit, K.A 51 year of female presented to the outpatient department of a hospital with a complain of lower abdominal pain and heaviness for which an Ultrasonography of Kidney, Ureter and Bladder was advised which showed a hypoechoic cystic lesion (18.7x10.8mm) with mild vascularity in the indenting mid part of posterior wall of urinary bladder. The patient underwent Cystoscopy and Transabdominal excision of the Space occupying lesion. Histopathological study of the space occupying lesion demonstrated variably sized cystically dilated glands in the muscularis propria, lined by ciliated columnar tubal like epithelium. Immunohistochemically these glands were positive for PAX8. Accordingly, a diagnosis of endosalpingiosis of urinary bladder was made.Item Rising infertility rates and declining sperm counts: Investigating the impact of lifestyle factors, environmental pollutants, and endocrine disruptors on human reproductive health(IP Innovative Publication Pvt. Ltd., 2025-06) Dwivedi M.Background: Global fertility rates and sperm counts have been declining significantly over recent decades, raising concerns about human reproductive health. This decline is multifactorial, involving lifestyle dysregulation, exposure to environmental pollutants, and endocrine-disrupting chemicals (EDCs). Objectives: This review aims to elucidate the interconnected roles of lifestyle factors, environmental toxicants, and EDCs in contributing to reproductive dysfunction. It also explores current preventive strategies and highlights the need for multidisciplinary interventions. Materials and Methods: A comprehensive literature survey of epidemiological studies, meta-analyses, and mechanistic research was conducted to synthesize evidence on fertility decline and sperm count reduction globally. Results: Lifestyle factors such as poor diet, obesity, smoking, and stress disrupt hormonal balance and gamete quality. Environmental pollutants including heavy metals, air particulates, and pesticides cause reproductive toxicity through oxidative stress and DNA damage. EDCs interfere with hormonal signaling and induce epigenetic modifications affecting fertility. Regulatory frameworks and lifestyle interventions show promise in mitigating these effects, but further research and global collaboration are urgently needed. Conclusion: The fertility crisis reflects a complex interplay of modifiable and non-modifiable factors. Multidisciplinary efforts encompassing public health policies, individual lifestyle changes, and advanced research are critical to preserving reproductive health worldwide.Item Neonatal hyperbilirubinemia due to minor group (c antigen) incompatibility(IP Innovative Publication Pvt. Ltd., 2025-03) Kadirvel, K; Nithiyananthan, Y; Ezhilarasu, S.Background: A male neonate born at 37+4 weeks of gestation with a birth weight of 2.94 kg, cried immediately at birth, and was admitted to the Neonatal intensive care unit (NICU) soon after birth in view of antenatally detected positive indirect coombs test (ICT). At admission, baby had normal vital signs and systemic examination. The baby was pink without pallor and icterus. Cord blood investigations for hemolysis workup revealed elevated total bilirubin with low hemoglobin, elevated retic count and positive direct coombs test. The mother抯 and baby抯 blood group were B negative and AB positive, respectively. Double volume exchange transfusion was performed under strict aseptic condition and intensive phototherapy was given. A repeat haemolytic workup done at 36 hours of life reported positive DCT, low hemoglobin and elevated retic count and significant rise of bilirubin. Two doses of Intravenous immunoglobulin (IVIG) was administered in view of ongoing hemolysis and worsening hyperbilirubinemia. In view of persistent hemolysis, the baby抯 blood was tested for minor blood group incompatibility which revealed strongly positive anti-C antibodies. On day 8 of life, hemolytic workup was repeated which reported positive DCT (2+ compared to previous 4+), improved hemoglobin and normal bilirubin levels. On day 12 of life, hemolytic workup was normal. This established the diagnosis of anti-C hemolytic disease. On day 29 of life, hemolytic workup done on OPD basis reported low hemoglobin (8.2 g/dL) and positive DCT for which the infant was admitted, IVIg and PRBC transfusion was done in view of anaemia (Hb-8.2 g/dL). Subsequently, the parameters were normal. Currently, the infant is on follow-up and asymptomatic. Anti-C minor blood group incompatibility should be considered in the setting of hemolysis and persistent hyperbilirubinemia due to isoimmunization in neonates. Timely diagnosis and management can avert morbidity and mortality.Item Para-peritoneal inguinal hernia of ureter in paediatrics- A case report with review of literature(IP Innovative Publication Pvt. Ltd., 2025-03) Chopra, AK; Goyal, P; Shukla, AK; Gupta, P.Introduction and Importance: Inguinal hernias are the most commonly experienced disease in paediatric surgery. However, it is rare for the organs of the urinary system to prolapse as the contents of the hernia. Case Presentation: We report a case of a 2-month 4-day old male child with congenital Para peritoneal inguinal herniation of the ureter. Intraoperatively, we found an unfamiliar tubular loop structure arising from the deep inguinal ring in the left inguinal canal. The tubular structure, which may have been part of the ureter, was left in the inguinal canal to avoid damage. Postoperative drip infusion pyelography-computed tomography showed anatomical irregularity of the ureter in the inguinal canal. Follow-up in the 5th postoperative year showed no recurrence of hydrocele and complications associated with ureteral obstruction. Clinical Discussion: Inguinal ureteral hernias are rarely reported in children. Para peritoneal inguinal hernias are reported to be associated with vesicoureteral reflux and posterior urethral valve. Patients rarely present with symptoms like those observed in our case report. Whilst general surgical treatment is to return the ureter to the retroperitoneal space, we opted to leave the ureter in the inguinal canal to avoid unnecessary damage. However, this intraoperative management resulted in slight haematuria. The ureter should be placed back where it belongs, and postoperative monitoring using computed tomography may be important. Conclusion: This case provides valuable insight into preoperative diagnostic difficulties and intra- and postoperative management of an inguinal ureteral hernia in children, highlighting the importance of accurate diagnosis and appropriate surgical intervention in the treatment of this disease.Item Anaesthetic management of a pericardial cyst excision via right thoracotomy in a young female: A case report(IP Innovative Publication Pvt. Ltd., 2025-06) Waradkar, S; Madoo, NM; Ramesh, V.Pericardial cysts are rare benign mediastinal lesions that may present with compressive symptoms depending on their size and location. Anaesthetic management of patients undergoing excision of such cysts can be challenging due to their proximity to vital cardiopulmonary structures, the potential for intraoperative complications, and the need for one-lung ventilation (OLV) to facilitate surgical access during thoracotomy. We report the perioperative anaesthetic considerations in a 37-year-old female scheduled for excision of a pericardial cyst via a right thoracotomy approach.Item Bilateral thoracoscopic sympathectomy using EZ-Blocker for alternate lung isolation(IP Innovative Publication Pvt. Ltd., 2025-06) Mateen, MN; Baxi, V; Menon, N.Bilateral thoracoscopic sympathectomy is a minimally invasive surgical procedure indicated for conditions such as primary hyperhidrosis, a condition characterized by excessive sweating, most often affecting the palms, soles, and axillae. Lung isolation is crucial to optimize surgical exposure in thoracoscopic surgeries traditionally achieved using double-lumen endotracheal tubes or bronchial blockers. EZ-Blocker is an effective tool for achieving selective or alternate lung ventilation. We present the anesthetic management of an 18-year-old female undergoing bilateral thoracoscopic sympathectomy for hyperhidrosis, with a focus on alternate lung isolation using the EZ-Blocker.Item Tubercular longitudinally extensive transverse myelitis- A case report(IP Innovative Publication Pvt. Ltd., 2025-03) Kumawat, A; Ahlawat, R; Singh, PK.Tubercular infection of central nervous system (CNS) is still a major cause of morbidity and mortality in low to middle income countries. Spinal intramedullary tuberculosis (SIMT) is rarest form of CNS TB and manifests in the form of myelo radiculitis, intramedullary tuberculomas, anterior spinal artery thrombosis and transverse myelitis which is rarely fulfils criteria of a longitudinally extensive transverse myelitis (LETM). We present a rare case of acute transverse myelopathy in a 35 years old male patients, which unveiled previously undiagnosed pulmonary tuberculosis. The patient responded well to anti tubercular therapy and corticosteroids. This case will emphasize upon the fact that in endemic zones SIMT, especially tubercular LETM, should always be kept in the differential diagnoses of acute transverse myelopathy because delay in diagnosis will lead to long term morbidity and debility. Hence, the primary care physicians who get the cases earliest should cultivate a high index of suspicion to diagnose a potentially lifetime debilitating yet absolutely treatable clinical condition i.e. tubercular LETM.Item Anesthesia in high altitude: A clinical communication(IP Innovative Publication Pvt. Ltd., 2025-06) Abinav Sarvesh, SPS; Warik, A.High altitude refers to regions located above the elevations of 1,500 meters comparing sea level, where decreased atmospheric pressure results in hypobaric hypoxia. This environmental condition causes a range of physiological adaptations and can trigger altitude-related illnesses in unacclimatized individuals. Key syndromes include Acute Mountain Sickness (AMS), High-Altitude Pulmonary Edema (HAPE), High-Altitude Cerebral Edema (HACE), and Chronic Mountain Sickness (CMS). Understanding the classification of high-altitude regions, physiological changes, and illness mechanisms is crucial for prevention and management. This article outlines these components and provides guidance on the prevention and treatment strategies essential for maintaining health at high altitudes.Item A rare presentation of lung adenocarcinoma as posterior tracheal mass(IP Innovative Publication Pvt. Ltd., 2025-03) Michaela, C; Sugiri, YJ; Putra, NPP; Yudhanto, HS; Erawati, DR.Background: Lung adenocarcinoma is the kind of non-small cell lung cancer (NSCLC) that is most common. It accounts for around 40% of all instances of lung cancer and is the most prevalent subtype among nonsmokers, despite its strong association with smoking. Adenocarcinomas frequently occur in advanced stages, which has a worse prognosis and fewer treatment choices. Their clinical appearance varies greatly. Case Illustration: A 69-year-old lady who does not smoke has had a dry cough for a year, which has gotten worse over the past two months. She should see an ENT expert because her cough is accompanied by hoarseness and snoring. A laryngoscope reveals paresis of right vocal cord and a right tracheal mass on CXR. A neck CT reveals a thickened posterior tracheal wall with a suspicion of malignancy and lateral bowing of right vocal cord, but with no abnormality in chest CT. She was then referred to our pulmonology department for tissue sampling using bronchoscopy. Bronchoscopy showed an infiltrative stenoting with a suspicion due to malignancy. A forceps biopsy obtained via bronchoscopy reveals an adeno/adenosquamous carcinoma morphology. Further immunohistochemistry test shows a positive Napsin-A and negative TTF-1 and p40 consistent with adenocarcinoma with wild-type EGFR mutation. She was then treated with systemic chemotherapy as per our local protocol. After 3 series of chemotherapy, she came to our department for a follow-up with significant improvement in her symptoms. Conclusion: The high number of cases of lung adenocarcinoma, accompanied with subtle clinical presentation which often delay the diagnosis, should prompt clinicians to be more aware for the possibility of the disease even with no obvious abnormality in chest imaging.Item Lived experience of male spouses of poly cystic ovarian syndrome diagnosed females: An exploratory study(IP Innovative Publication Pvt. Ltd., 2024-12) D’almeida, JD; Mathen, D; Fernandes, SF; Biju, N.Polycystic ovarian syndrome (PCOS) is a heterogeneous clinical entity leading to development of metabolic, endocrine, and reproductive disorder. Obesity lowers the chances of successful conception and even lowers the success rate of assisted reproduction technique cycles, and this is a major concern for young couples and females in their prime reproductive age. But there are also studies also which shows reduces quality of life and sexual satisfaction and life satisfaction in females with PCOD. Hence, we should also consider the other partner in couples diagnosed with PCOD. Thus, when looking into the family dynamics of PCOD diagnosed females, psychological wellbeing of their husband should also be equally studied as their emotions are highly influenced by their wife’s mental wellbeing. Even after biological treatment of PCOD, their psychological distress persists, and can may hinder their future quality of life. The objective of the study was to explore the experience of male spouse of clinically PCOS diagnosed females. The study was a phenomenological qualitative research design, with researcher-developed guiding questions to help direct interviews. The data was collected using purposive sampling from hospitals based on the inclusion criteria of the study. 6 participants were finally selected based on these criteria and saturation point was attained for the study by then. The findings of the study was 3 major themes were discovered, which were Awareness about PCOS, perception of husbands on PCOS and perception of women. 9 subthemes were also discovered under these themes. Implications of the study was more awareness should be given to both male and female population about the disorder and also encouraging men to talk more about their mental health.Item A rare case of foreign body (Metal) in uterine cavity(IP Innovative Publication Pvt. Ltd., 2024-12) Ahmed, Z; Saxena, R; Nigar, A; Ahmed, I.Background: Uterus is a hollow, muscular organ present in the female pelvis. Rare occurrence of foreign body in the uterus can be seen in any age group. It is usually presented as bleeding per vaginum, foul- smelling vaginal discharge or pain in the supra-pubic region. It can lead to severe complications. Materials and Method s: This is a case report of a patient who came to Career Institute of Medical Sciences, Lucknow with primary infertility. She was diagnosed to have foreign body in uterus. This foreign body metal nail was confirmed on Ultrasonography followed by X-Ray, after 5 years of being an undiagnosed case. Results : Rare case of foreign body in uterus was seen which was removed by hysteroscopy and cervical incision. Conclusions : This was a rare case of foreign body metal nail in uterus which was inserted by some local doctor/quack for treatment of infertility. This shows us the importance of visiting specialized doctors for treatment.Item A study to evaluate the effectiveness of multidisciplinary educational approach on knowledge regarding code blue protocol management among nurses working at hospital, Koppal District(IP Innovative Publication Pvt. Ltd., 2024-12) Sumangala, B R; Kudari, A.Background: Code Blue is a unique commonly code used to sound code group for waning or cardiac arrest clients in hospital. Code blue is usually used to instruct a patient demanding restoration or in necessity of rapid medical attention, most frequently as the consequence of a respiratory or cardiac halt. Each hospital as an amount of its policies, sets a strategy to recognize which unit deals staffs of code blue attention. It is paramount for every trained nurse to have a satisfactory knowledge concerning the code blue procedure or protocol to lessen the mortality ratio particularly in critical care units. Aim of the study: was to assess the multidisciplinary educational method on Code Blue protocol management amongst nurses employed at hospital. Research design: In this study pre-experimental one group pre-test post-test design was used. Sampling and sample size: Total of 60 subjects were selected by using non-randomized convenient sampling technique. Data collection methods: Knowledge questionnaire regarding Code Blue protocol management was used to assess the knowledge of staff nurses. Data analysis: The data were collected and analyzed by using descriptive and inferential statistics. The study result demonstrates that the knowledge before intervention was, 72% (43) of the nurses were come under poor level of knowledge, 23% (14) were represent under average level of knowledge and the minimum 5% (03) were goes under good knowledge level. Whereas after teaching, 85% (51) of the nurses were had good knowledge level, 12% (07) were got an average level of knowledge and simply 3% (02) nurses had poor knowledge. In case of association between the selected sociodemographic variables such as age, gender, educational qualification, area of working in the hospital, cadre of nurse and Mean Pre-intervention knowledge found to be non-significant at 0.05 level. Whereas in another category, i.e. in experience in nursing service found to be significant at 0.05 level, (chi-square=11.05) (p=0.025).Item Occupational health challenges among faculty in medical colleges in India: A comprehensive review(IP Innovative Publication Pvt. Ltd., 2024-12) Christian, D.Purpose of Review: This systematic review explores the occupational health issues encountered by faculty members in medical colleges throughout India, focusing on both physical and psychological challenges. Faculty in these settings face distinct stressors stemming from the rigorous demands of academic and clinical responsibilities. Key Findings: The review identifies several primary challenges, including work-related musculoskeletal disorders, exposure to infectious diseases, mental health issues, elevated stress levels, burnout, and the weight of administrative burdens. These findings underscore a critical need for the development and implementation of targeted occupational health policies and supportive systems tailored specifically for medical educators. Implications for Future Research: This review highlights the urgent requirement for further research aimed at devising effective intervention strategies that address the unique occupational health needs of faculty in academic medical institutions. Such research will be instrumental in fostering healthier work environments and enhancing the overall well-being of medical faculty, thereby ultimately improving educational outcomes in medical education.Item Hypothalamo-pituitary-adrenal axis dysfunction presenting as a life threatening acute medical emergency: A case study(IP Innovative Publication Pvt. Ltd., 2024-12) Sharma, J; Dey, P; Saha, A; Naoshram, N; Dutta, M.Hypothalamo-pituitary-adrenal axis dysfunction can present clinically as one of the few endocrinological emergencies found in daily clinical practice. The HPA axis primarily deals with stress response, energy metabolism, immune function and neuropsychiatric function. Unfortunately the clinical presentation of HPA axis dysfunction is non-specific and often progresses insidiously resulting in late diagnosis, or in severe cases present with acute circulatory collapse. Here we present a case where a 60 year-old lady who presented with shock, altered mental status, bradycardia and hypoglycemia, was found to have HPA axis dysfunction and was managed effectively with glucocorticoids along with other supportive management.Item Cyclopia: A rare case of congenital anomaly associated with holoprosencephaly(IP Innovative Publication Pvt. Ltd., 2024-12) Ambra, N.Cyclopia is a rare congenital disorder characterized by the fusion of the eyes, typically as part of holoprosencephaly, resulting from a failure of the forebrain to divide during fetal development. Occurring in approximately 1 in 13,000 to 20,000 births, many cases go undetected due to early miscarriages. The condition is associated with significant facial deformities, including an absent or severely underdeveloped nose and malformed ears. This case report details a 31-year-old woman who presented at 27 weeks of gestation with abdominal pain and bleeding. Ultrasound revealed a single-lobed brain, hypotelorism, and cyclopia in the fetus. A vaginal delivery was planned, resulting in the birth of an 800-gram baby boy with severe facial anomalies who died shortly after birth. Holoprosencephaly encompasses varying degrees of brain malformation, with cyclopia being the most severe form. The absence of effective treatments necessitates early diagnosis and potential legal abortion to prevent suffering. Risk factors include maternal dietary choices and genetic mutations, particularly in the Sonic Hedgehog (SHH) gene. Awareness and education regarding these risks are crucial for prospective parents, as early detection through ultrasound can guide management strategies and reduce harm to both the newborn and the mother.Item A rare case of idiopathic tumoral calcinosis of bilateral hip joint: A case report(IP Innovative Publication Pvt. Ltd., 2024-12) Kalluraya, S; Pawar, V; Naik, RB; Panda, J; Ansar, M.Tumoral calcinosis or Teutschlaender disease is a relatively rare pseudotumor of unknown origin, characterized by the accumulation of calcium salts in peri-articular soft tissues despite normal plasma levels of calcium and parathyroid hormone. We report a case of tumoral calcinosis in a 26-year-old male patient presenting with a firm mass of soft tissue and limitation of bilateral hip joint. Laboratory investigations revealed a serum calcium level of 10.1mg/dl (Normal) and a serum phosphorous level of 4.2 mg/dl (Normal). PTH level was within normal limit (12.9 pg/dl) with vitamin D level of 40.2 nmol/L (Insufficient). Patient was taken up for surgery, en-bloc excision was done. A biopsy of the soft-tissue masses was sent for histopathology, which was suggestive of lobules of calcific material surrounded by histiocytic giant cells and was diagnosed as tumoral calcinosis. After 6 months of followup patients is doing well with good range of movement at left hip joint with no signs of recurrance. In coclusion, early recognition of Tumoral calcinosis and appropriate management are crucial to mitigate symptoms and improve patient outcomes.Item Gastric neuroendocrine hyperplasia and dysplasia in a patient with Lynch Syndrome(IP Innovative Publication Pvt. Ltd., 2024-12) Yihan, LI.Background: Lynch syndrome (LS), previously known as hereditary non-polyposis colorectal cancer (HNPCC), is an autosomal dominant disorder that predisposes individuals to various malignancies, most commonly adenocarcinomas. While low-grade neuroendocrine tumors (NETs) associated with Lynch syndrome are rarely reported, gastric neuroendocrine tumors (g-NETs) account for less than 1% of all gastric tumors. Case Report: This case report presents a rare occurrence of gastric neuroendocrine hyperplasia and dysplasia in a 68-year-old female diagnosed with Lynch syndrome. The patient, previously treated for well- differentiated adenocarcinoma of the colon, was found to have a polyp in the gastric fundus during routine surveillance. Histological analysis revealed adenocarcinoma alongside neuroendocrine cell proliferation, confirmed by synaptophysin immunostaining. Conclusion: This case highlights a novel association between Lynch syndrome and gastric neuroendocrine hyperplasia/dysplasia. This finding raises awareness among clinicians regarding Lynch syndrome in patients with low-grade NETs or neuroendocrine precursors and underscores the need for comprehensive surveillance and further research to understand the underlying mechanisms and clinical implications. It suggests that mutations in mismatch repair (MMR) deficiency may play a role in neuroendocrine cell proliferation, expanding the spectrum of Lynch syndrome-associated tumors, and pointing to new directions for studying the molecular pathways and pathogenesis of NETs.