The Southeast Asian Journal of Case Report and Reviews

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/149642

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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Now showing 1 - 20 of 52

Steering through parotid calculi in a 35 year old female: A case report
(IP Innovative Publication Pvt. Ltd., 2024-04) Wadhawan, R; Shah, A; Bora, S; Bhat, JM; Marbaniang, N; Lanine, M; Deb, G.
Sialolithiasis, the predominant affliction affecting salivary glands, constitutes approximately half of all major salivary gland pathologies. The vast majority of salivary gland calculi, roughly 80-90%, are located in the submandibular gland, with 5-10% in the parotid gland, and an estimated 0-5% in the sublingual and other minor salivary glands. Typically, sialolithiasis manifests in adults between the ages of 30 and 60, with a greater occurrence in males. This malady is predominantly observed in adults and is infrequent in children. Herein, we present a case study of calculus retrieval in a 35-year-old woman, characterized by recurrent swelling and pain in the left parotid gland, exacerbated during meals due to ductal obstruction impeding saliva flow. This hindrance impedes gland drainage, resulting in inflamed ducts. Sialadenitis subsided following calculus removal.
Prolonged intravascular hemolysisand vitamin B12 deficiencyafter parasiticclearance in a case of complicated falciparum malaria
(IP Innovative Publication Pvt. Ltd., 2024-07) Chandra, SK; Dastidar, AG; Bandyopadhyay, S; Dutta, A; Samanta, R; Ganguly, S.
Background: Malaria is still a very threatening disease to tackle in India. The potential array of complications which can arise due to this infection is appreciably wide and many of these complications pose a significant life risk. Case report: Our patient, a 35-year-old gentleman presented with a complicated falciparum malaria infection. He developed an acute kidney insult, thrombocytopenia, septic shock, acidosis and anemia with a parasitemia of 3%. He was managed with artemisinin based therapy as per the latest guidelines and gradually his complications got tackled and he achieved parasitic clearance. But his anemia kept on worsening after fever resolution and parasitic clearence and he developed a picture of persistent intravascular hemolysis after recovery from the infection. Also, interestingly, his vitamin B12 level was significantly low despite being on a non-vegetarian diet and receiving oral B12 supplementation. Conclusion: This case highlights the importance of monitoring hemoglobin levels even after complete parasitic clearance as the intravascular hemolysis can also arise due to the usage of artemisinin based therapy, an entity called as post artemisinin delayed hemolysis. Also, this case showed the coexistence of low B12 state and poor B12 absorption in a young gentleman who had previously normal B12 levels. The association between malaria and poor B12 absorption needs to be explored further by more studies. Any association found can help in recommendations of B12 supplementation in malaria cases.
Spontaneous retroperitoneal hematoma – An unusual presentation in a child with dengue fever
(IP Innovative Publication Pvt. Ltd., 2024-07) Thapar, RK; Sahu, A; Nair, BT; Chhillar, P.
Background: Dengue fever is a syndrome caused by several arthropod-borne viruses, characterized by fever, myalgia or arthralgia, rash & thrombocytopenia. Various bleeding manifestations of dengue have been documented including petechiae, mucosal bleeding, pulmonary, GI, and cerebral hemorrhage. Abdominal hematoma presenting as acute abdominal pain is a rare complication of dengue fever and is frequently overlooked. There is a paucity of data in the current literature on such cases. Clinical Description: A 13-year-old male was admitted with a complaint of fever for 3 days and myalgia. The patient had hepatosplenomegaly and managed as dengue with warning signs with positive NS1 antigen and dengue IgM antibody Platelet count was 42×103/mm3. No history of any bleeding disorder, trauma, or exposure to anticoagulant drugs. On day 6 of admission, the patient developed acute pain in the right lumbar and inguinal region, along with a reduced ability to move the right leg. Hip joint movements on the right side were painful with no restriction. Management & Outcome: His coagulation profile was normal with a hemoglobin value of 10.5 g/dl and platelet count of 40×103/mm3. CECT abdomen- suggestive of retroperitoneal collection of fluid adjacent to right psoas muscle – consistent with retroperitoneal bleed.He was monitored, managed conservatively & showed gradual improvement. Platelet counts improved. Discharged at platelet count of 273×103/mm3 & when symptom-free.On follow-up after a month, he was asymptomatic. Conclusion: The possibility of a retroperitoneal hematoma should be considered in a case of unexplained lower abdominal pain & hip arthralgia with dengue fever. A high index of clinical suspicion and awareness can detect such cases with needful management.
Unique case of drug induced liver injury
(IP Innovative Publication Pvt. Ltd., 2024-01) Vashisth, J; Gautam, S; Rodge, G.
Drug-induced liver injury are common in Asian Countries 1 because of less awareness about the drugs causing liver injury when consumed in excess quantity or when unindicated. India is the most populous country right now and its population is not aware about the side effects caused by commonly used Ayurvedic drugs. 2
A case report on atorvastatin-induced myopathy
(IP Innovative Publication Pvt. Ltd., 2024-01) Oragala, S; Namilikonda, R; Sony, M; Chillara, T.
Statins are the most commonly used lipid-lowering drugs in cardiovascular patients. Atorvastatin is a majorly used statin. Atorvastatin will induce myopathy; it is a rare side effect. In my case report, the patient experiencing muscle cramps for 3 years on and off. He consulted a cardiologist. The doctor advised rosuvastatin. He has been on rosuvastatin for 6 months. From the last 6 months, he had not experienced any myopathy symptoms.
Chondroblastoma of scapula with aneurysmal bone cyst, unusual presentation at unusual location
(IP Innovative Publication Pvt. Ltd., 2024-07) Andola, SK; Soneji, DK; Panegar, N.
Chondroblastoma is a very rare tumour only 16% of cases are found in flat bones, pelvic bones are the most frequently involved. Chondroblastoma of scapula is extremely rare and around 20% chondroblastoma associated with ABC. A 65 years female presented with pain and limitation of right shoulder mobility from two months. Physical examination shows a tumor at the inferior angle of right scapula. On FNAC given as giant cell tumour with differential diagnosis ABC/Chondroblastoma. Excised tumour on histopathological examination confirmed chondroblastoma with areas of ABC. The clinical, radiological and histopathogical findings are necessary for evaluation of chondroblastoma. Complete excision, curettage of the tumour with a regular follow-up for any local recurrence or metastasis is the key to successful management of such case. The histopathological diagnosis should not be stopped at chondroblastoma a careful search for associated ABC is essential, as most cases of chondroblastoma associated with this lesion.
High volume stentolith in a case of neglected CBD stent: A case report
(IP Innovative Publication Pvt. Ltd., 2024-01) Anandh, SM; Raju, K; kumar, S; Harikrishnan, A; Palanigoundar, R; Babu, G.
Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) and stone extraction is widely accepted as the treatment of choice for a patient of any age with choledocholithiasis. Stentolith: It describes as a forgotten stent post ERCP which acts as nidus for stone formation. Stents has to be removed within 6 weeks. Longer periods of unattended stents leads to wide range of complications like cholangitis, pancreatitis, biliary stricture and biliary cirrhosis. Management involves either endoscopic retrieval of stents or surgical exploration.
Role of homoeopathic medicines in acute cases of urinary tract infection in females
(IP Innovative Publication Pvt. Ltd., 2024-04) Chauhan, BP; Katariya, KN.
Background: Urinary tract infection is the presence of microbial pathogen in normally sterile urinary tract. This study shows that cantharis (60%) act best in acute cases of UTI in female patient. 200 potencies use in 53.33% (16 cases) so, 200potency is mostly used for cure of the patient. Materials and Methods: prospective observational method of study. To see the effect of homeopathic medicines in acute cases of UTI in female 30 patients will be included in the study. Sampling technique: random sampling. Conclusions: in this study the maximum prevalence of UTI was noted in the age group of (21-50years). this study shows that cantharis (60%) act best in acute cases of UTI in female patient. From this 30 cases study it was understood that the homoeopathic medicine give a complete cure in 33.33% female patient and relief 40% female of patient only 3.3% female patient having not relief.
ST-segment elevation in chronic bleeding post-curettage with COVID-19 antibodies: A case report
(IP Innovative Publication Pvt. Ltd., 2024-01) Wijaya, WS; Krisnawati, I.
Background: Acute coronary syndrome has a variety of symptoms and remains poorly under diagnosed and under treatment in women, especially myocardial infarction or ischaemic with non-obstructive coronary arteries (INOCA) as the culprit. We present a case of an Indonesian adult female with hypoxemia and ST-elevation in post-curettage due to molar pregnancy and positive COVID-19 antibodies. Case Presentation: A 43-year-old Indonesian female was admitted due to confusion, dyspnoea, and chronic bleeding after the curettage. The electrocardiogram (ECG) showed ST-elevation in lead I and aVL. Her condition quickly stabilised after getting oxygen supplementation and nitro-glycerine with ST- elevation resolution and no neurological impairments. Due to COVID-19 pandemic, she was checked for a swab test which showed negative but positive on her antibodies test. Chest X-ray was normal, but the echocardiography showed mild left atrial dilatation. After standard atherosclerosis treatment and anticoagulant, her condition improved, despite recurring vaginal bleeding. During her outpatient follow- ups, suspected intrauterine leiomyoma was diagnosed by ultrasound. Discussion: Cytokines and inflammatory responses from prolonged bleeding, hormones, metabolic disturbances, and post-COVID-19 infection have the potential to provoke INOCA. Considering the complexity of our case, contributing factors to INOCA must be addressed to optimise the strategy. Further, imaging tests should be done to confirm the diagnosis.
Fatal, non-menstrual staphylococcal toxic shock syndrome associated with dental implant
(IP Innovative Publication Pvt. Ltd., 2024-01) Arikan, M; Yesilkaya, A; Akhan, A.
Background: Staphylococcal toxic shock syndrome (TSS) is a life-threatening disease that characterized by rapid onset of fever, rash, hypotension, and multi-organ failure. Case Report: A 58-year-old man presented to the emergency department (ED) with complaints of fatigue, myalgia, and blurred vision which had progressed over 48 hours. His medical history included hypertension and dental implant treatment that lasted 15 days. Despite aggressive medical treatment, which included multiple vasopressors, continuous renal replacement therapy in combination with CytoSorb® and broad- spectrum antibiotics, he died 16 hours after admission to the intensive care unit. Staphylococcus aureus was detected in his blood and ETA cultures after the patient’s death. Conclusion: Staphylococcal TSS is classified as menstrual and non-menstrual. Non-menstrual TSS cases have been documented with increasing frequency in the literature. We present a case of Staphylococcal TSS in a 58-year-old male patient who had a dental surgery history. Our patient died within a few hours after admission to the ICU with signs of multi-organ failure. We wanted to draw attention to this issue by presenting our patient
Lived experience of male spouses of poly cystic ovarian syndromediagnosed females: An exploratory study
(IP Innovative Publication Pvt. Ltd., 2024-07) Mathan, D.
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.
Coexistence of IgG4-related disease and tubercular lymphadenopathy in a rheumatoid arthritis patient
(IP Innovative Publication Pvt. Ltd., 2024-01) Chandra, SK; Dastidar, AG; Singhal, P; Sengupta, S; Bandyopadhyay, S.
Extrapulmonary tuberculosis is a very common cause of generalised lymphadenopathy especially in tuberculosis endemic regions like India. A 33-year-old lady who had been diagnosed with rheumatoid arthritis 5 years back and had received treatment with biologicals including adalimumab presented with a 3 week history of persistent fever associated with significant weight loss and abdominal fullness. Investigations pointed towards a picture of tubercular aetiology although, a definite microbiological diagnosis was not possible at this stage. Patient also had an underlying subacute thyroiditis with diffusely increased uptake in Tc99 scan. Considering the background risk factor of use of biologicals and typical clinical presentation resembling tuberculosis, a decision to start antitubercular therapy was taken. The fever resolved but it recurred after 2 weeks and then after an extensive workup, the diagnosis of coexistent IgG4- related disease along with microbiological diagnosis of tuberculosis was established. This case highlights the importance of an active search for coexistent pathologies in cases of lymphadenopathy with insufficient response to standard therapy.
Pregnancy in wilson's disease
(IP Innovative Publication Pvt. Ltd., 2024-07) Choudhary, S; Chaudhary, R.
Wilson’s disease is a rare autosomal recessive disorder with mutation of ATP 7B on chromosome 13q14 which leads to impaired biliary excretion and ceruloplasmin incorporation causing copper accumulation mainly in the liver and brain. This accumulation results in liver cirrhosis and nervous system manifestations such as neuropsychiatric symptoms, movement disorders and ataxia. Untreated Wilson’s disease usually causes subfertility and in cases where pregnancy does occur, it often results in spontaneous miscarriage. However, therapeutic evolution in the past decades has resulted in multiple successful pregnancy outcomes in patients with Wilson’s disease. We report such a case of successful pregnancy outcome in a women with Wilson’s disease.
Endoscopic thyroidectomy – A case report
(IP Innovative Publication Pvt. Ltd., 2024-07) Raju, K; Palanigoundar, R; Kumar, S; SM, A; Balakrishnan, P; Harikrishnan, A.
Minimally invasive surgery is increasingly employed in the treatment of thyroid diseases. Several minimal access approaches to the thyroid gland have been described. Minimally invasive surgery is rapidly expanding its role in almost all the surgical sub-specialties. There is also a growing demand for minimally invasive approaches, as nowadays, patients are more concerned about cosmesis in addition to their original surgery. Although its role in thyroid surgery has already been proven earlier, it is not yet accepted as a routine approach amongst many thyroid surgeons. The commonly performed surgeries have been endoscopic lobectomies. We have done one such procedure in our institution with a successful outcome.
A case of bilateral straatsma syndrome
(IP Innovative Publication Pvt. Ltd., 2024-04) Chawla, B; Garg, K; Gupta, K; Gupta, BK.
Straatsma syndrome is characterized by a constellation of conditions including amblyopia, nystagmus, and myopia. We present the case of a 10-year-old boy who complained of involuntary back-and-forth eye movements and reduced vision since birth. His visual acuity was measured at 2/60 in both eyes. Examination revealed horizontal pendular nystagmus without ocular misalignment. Fundus examination showed myopic changes, including an anomalous optic disc with extensive myelinated nerve fibers extending from the optic disc along the superior and inferior arcades to the fovea. Axial length measurements were 28.34 mm and 27.96 mm in the right and left eyes, respectively. SD-OCT imaging confirmed thickening of the retinal nerve fiber layer. Treatment included cycloplegic refraction and occlusion therapy, with regular follow-ups every three months utilizing contact lenses with cycloplegic refraction. The etiology of retinal fiber myelination remains unclear; however, it is hypothesized that blurred retinal imaging during critical ocular development stages may lead to axial elongation and subsequent myopia, potentially delaying the development of the lamina cribrosa and facilitating myelination extension.
Spontaneous rupture of uterine during pregnancy after laparoscopic myomectomy: A case report
(IP Innovative Publication Pvt. Ltd., 2024-04) Khanjani, S; Batebi, A.
The danger of future uterine rupture is a serious concern for women who become pregnant after uterine leiomyomectomy or adenomyomectomy, despite the fact that these procedures are commonly used to alleviate symptoms like dysmenorrhea or hypermenorrhea and improve fertility. Although it happens very infrequently, uterine rupture is the most dreaded pregnancy complication and is linked to a high rate of maternal and fetal morbidity and mortality. Here, we present a case of spontaneous uterine rupture during the third trimester of pregnancy.
Unusual case report: Nodule of heterotopic pancreatic tissue found attached to the gall bladder wall
(IP Innovative Publication Pvt. Ltd., 2024-04) Aithmia, R; Gupta, R; Raina, A.
The occurrence of heterotopic pancreas, an uncommon developmental abnormality, is frequently detected as an incidental finding. In a histopathological study, a 35-year-old woman with cholecystitis was unexpectedly found to have a 5 mm diameter heterotopic pancreatic tissue attached to the gallbladder wall, presenting as a nodule. Following the surgical removal of the gallbladder (cholecystectomy), the patient experienced a smooth recovery. Identifying this condition may offer valuable insights into its clinical significance.
Delayed presentation of traumatic hepatothorax: An anesthetic and surgical perspective
(IP Innovative Publication Pvt. Ltd., 2024-01) Al-Hindawi, A; Hamsley, SJ; Fasbinder, S; Fogelman, S; Molyneaux, I.
Background: Traumatic diaphragmatic hernia is an uncommon sequela of blunt and penetrating trauma. It is estimated that 0.8–1.6% of patients with blunt trauma develop diaphragmatic rupture. However, the diagnosis of this condition is often overlooked, with right-sided hernias missed more frequently than left- sided hernias. Early diagnosis and repair are essential to prevent future complications such as strangulation and ischemia of intra-abdominal organs, lung collapse, and cardiovascular demise. Case Report: A 17-year-old male (180 cm; 86 kg) with no comorbidities presented to the emergency department (ED) following a high-velocity, unrestricted, rear-ended motor vehicle crash (MVC). The patient was intubated and hemodynamically stabilized in the ED, with planned surgical exploration of the abdomen. Six days following the accident, the patient was extubated; he became increasingly hypoxic and tachypneic over the next day. A CT of the chest and pelvis was ordered, confirming the diagnosis of a post-traumatic right-sided diaphragmatic hernia. An exploratory laparotomy was scheduled. Difficulties with ventilation were encountered due to suspected lung compression by the liver and movement of the endotracheal tube into the right main lung bronchus. Conclusion: Traumatic diaphragmatic hernia should be considered in all patients presenting with abdominal trauma and should be suspected if respiratory distress arises during the patient’s clinical course. The recommended anesthetic approach is rapid sequence intubation with a cardiovascular-stable agent like etomidate and gastric decompression. Difficulties with intubation and ventilation should be anticipated due to the presence of the visceral organs within the thoracic cavity.
To study route of administration of homoeopathic medicine by Olfaction (Inhaler) in case of acute conjunctivitis
(IP Innovative Publication Pvt. Ltd., 2024-04) Shah, P; Labana, R.
The science behind monosodium glutamate: Flavor modulation, food palatability, and potential health effects
(IP Innovative Publication Pvt. Ltd., 2024-07) Dwivedi, M.
Background: Monosodium glutamate (MSG) is widely used as a flavor enhancer in food, known for its ability to modulate umami taste and improve overall food palatability. Despite its recognized benefits in the food industry, concerns about its safety and potential health effects have sparked widespread debate. This systematic review aims to provide an in-depth analysis of the molecular mechanisms underlying MSG’s flavor-enhancing properties, its role in food palatability, and the scientific evidence surrounding its health impacts. Objectives: To review the current state of knowledge regarding: 1. The molecular chemistry and mechanism of MSG in flavor modulation. 2. The role of MSG in enhancing food palatability and consumer preferences. 3. he safety assessments and potential health effects of MSG, including both benefits and concerns. 4. MSG’s future applications in food science, particularly in low-sodium formulations, food security, and geriatric nutrition. Materials and Methods: A comprehensive search of peer-reviewed literature was conducted using databases such as PubMed, Web of Science, and Google Scholar. Studies focusing on MSG’s chemistry, its application in food, sensory studies, and health-related research were included. Regulatory assessments from food safety agencies (FDA, WHO, EFSA) were also reviewed. Results: Flavor Modulation: MSG enhances the umami taste by interacting with specific glutamate receptors (T1R1/T1R3), contributing to a balanced flavor profile in various cuisines. It is especially effective in reducing the need for excess salt and fat in processed foods while maintaining palatability.Food Palatability: Sensory studies show that MSG significantly improves food satisfaction, particularly in low- sodium or low-fat products. Consumers often prefer MSG-enriched foods due to enhanced flavor perception and texture.Health Impacts: Regulatory bodies have classified MSG as safe for consumption, with no conclusive evidence linking it to neurotoxicity or adverse metabolic effects at typical dietary levels. Some studies suggest MSG may aid in reducing sodium intake and improving food palatability in special populations, such as the elderly.Public Perception: Despite the scientific consensus on its safety, public concerns remain, largely fueled by misconceptions about "Chinese Restaurant Syndrome" and misleading media reports. Conclusions: MSG plays a pivotal role in modern food science as a safe and effective flavor enhancer. While public concerns persist, scientific evidence supports its safety and potential health benefits when used appropriately. Further research should focus on long-term health effects, innovative applications in low-sodium food formulations, and educational initiatives to address public misconceptions about MSG.

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