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 60

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.
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.
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).
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.
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.
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.
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.
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.
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.

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