Pain was sudden in onset, mild and dull aching type and was intermittent in nature, and aggravated at night; there was no specific reliving factor. There was no contributory medical history. On extra oral examination the patient had a deviated nasal septum towards the right side. A scar was seen on the on the right side of the face, medial to the pinna. A detailed history was obtained from the parents regarding the scar which revealed that the scar is the remnant of the preauricular skin tag which was present till the patient was 2 years of age.
Von hipple lindau disease and role of anti VEGFDr. Hina LoyaLayton Rahmatullah Benevolent TrustFree Base Eye Hospital, Korangi, KarachiAbstract:Von Hipple Lindau disease is an autosomal dominant condition in which there is mutation of VHL tumor suppressor gene.1, 2 The syndrome is named after Eugene von Hippel, who described the retinal tumors (1904), and Arvid Lindau, who described their association with other tumors (1926).3 A 25 year old girl was presented in Layton Rahamtullah Benevelont Trust Korangi Karachi, with decrease vision in left eye for last 6 months, with no other signs and symptoms. She was diagnosed as VHL on the basis of clinical findings and positive family history. Early diagnosis can lead to prompt treatment and improved
Leigh Syndrome: Case Series of Three Patients Purpose Leigh syndrome is a rare progressive neurodegenerative disorder with a poor prognosis. Typical imaging findings are one of the diagnostic criteria and may prompt the clinician to investigate for Leigh syndrome. To describe those characteristic magnetic resonance imaging (MRI) findings as well as clinical presentation, we present 3 cases of pediatric patients who met diagnostic criteria for Leigh syndrome at our institute in the last 5 years. Case 1 This is a 3-year-old boy presented with progressive muscle weakness and respiratory failure. He is the only child, born at full-term with uneventful perinatal period.
From ur study, we found that there is no significant rise in IOP with LMA insertion whereas ETT intubation produced a significant raise which persisted for two minutes. Today, LMA has come to be widely used as an alternative airway device during daycare anesthesia. The LMA has become a very attractive alternative to endotracheal tube. In this study, the efficacy of LMA in reducing IOP during ophthalmic surgeries in children is compared with that of conventional endotracheal
The history of the headache An acute onset of the headache of the patient’s life associated with a stiff neck. Figure 3 CT-scan & MRI An ill appearing patient on physical examination typically lead the health care practitioner to consider the diagnosis and order a CT (computerized tomography) scan of the head. If the CT scan is performed within 72 hours of the onset of the headache it will detect 93% to 100% of all aneurysms. Figure 4 Lumbar Puncture In the few cases that are not recognized by CT the health care practitioner may consider performing a lumbar puncture to identify blood in the cerebrospinal fluid that runs in the subarachnoid space. Angiography If the CT or the LP reveals the presence of blood angiography is performed to identify where the aneurysm is located and to plan treatment.
Then he was kept for observation for 3 days. The patient developed fever again (39oC) and parenteral paracetamol was able to decrease his temperature temporary for only 2 hours and kept rising again to 39oC. Parenteral antibiotics were started again for a week. However, the fever didn’t decline at all. Abdominal CT scan was performed but revealed nothing except cholelithiasis.
Introduction: Intussusception is a common gastrointestinal emergency in the pediatric population. This illness is a conversion in which a portion of the intestine telescopes into another adjacent distal segment of the intestine and causes bowel and ileocolic obstruction. Intussusception is considered a frequent cause of abdominal pain in pediatric patients. It is well described in infants, with an incidence of 0.1 to 0.4 % nonetheless it is less well-established in neonates.1, 2 In fewer than 10% of the patients, a surgical lead point can be determined as a plausible etiology. Cecal duplication as a lead-point of neonatal intussusception is extremely rare.
They concluded that in a population of medical intensive care unit spontaneously breathing patients, just before extubation, the presence of leaking around the endotracheal tube rules out postextubation stridor. On the other hand Engoren(12) in his study that was conducted in a cardiovascular ICU after cardiac surgery over 531 extubations in 524 cardiac surgery patients disagree with all previous results. Twenty patients among them had positive leak test (a leak ≤ 110 mL). None of the 20 patients with a positive leak test developed problems. Three patients had postextubation stridor.
Over the years, the cardiac catheterization has become essential in the evaluation and treatment of cardiac disease, cardiac catheterization indication have modified from a predominantly low risk profile of patients to include complex coronary lesions and high risk clinical conditions, including acute coronary syndromes(ACS), Considering the significant changes in the profiles of patients undergoing cardiac catheterization procedures. Moreover, the complication rates of the procedure can be anticipated to show comparable changes. Most of the studies reported that, complication rates of cardiac catheterization have been restricted largely to the practice prevalent several years earlier in recent times; the scenario of cardiac catheterization
This was reinforced with pericranial onlay patch also.Intraoperative valsalva maneuver showed no csf leak.Wound was closed in layers with prophylactic continous lumbar drainage.Post operative CT scan showed complete resolution of pseudomeningocele(Fig9) Fig9: Post operative CT scan after repair of dural leak and excision of pseudomeningocele sac. Lumbar drain was removed on 3rd day.patient was discharged of day 10 with no evidence of
No other motor, sensory, or cerebellar symptoms. No cognitive symptoms. She was under considerable stress at the time that this started, visiting a friend who had left facial and jaw cancer. He has died and she has been back home. Her stress level is decreasing and she is noticing that along with the decrease in stress, her symptoms are getting better.
Based on progress report dated 05/23/14, the patient reports of continued dull aching pain and burning sensation into the cervical spine. She received 2 cc of lidocaine with no epinephrine in the bilateral trapezius, cervical rhomboid, and cervical paraspinal muscles on this visit. Based on progress report dated 07/10/15, the patient complains of unchanged, sharp, dull and aching pain in the cervical spine, which radiates to the bilateral upper extremities. Baseline is 6-7/10 pain. Rest and medications help alleviate the pain.
He chest was clear, peripherally there was no clubbing and she was saturating at 97% on room air. Examination of her cardiovascular system revealed soft heart sounds. I could not appreciate any murmurs and there was no evidence of cardiac failure. Impression/Management: The mild to moderate emphysema is an expected find with her smoking history. It appears that she seems relatively asymptomatic, but we will perform some lung function tests to see whether or not she does have underlying COPD.
There is limited lumbar flexion. The patient is subsequently diagnosed with lumbar sacral spondylosis; sacroiliac joint arthritis; and low back pain. Treatment plan includes diagnostic bilateral sacroiliac joint injection under ultrasound guidance. Then if the patient received good relief, then she is to proceed with sacroiliac joint radiofrequency ablation. A course of physical therapy would be appropriate since she has not had any physical therapy for increasing range of motion since her surgery 8/4/2015.
A chest x-ray was also obtained which did not show any acute focal infiltrates, however it did show low lung volumes. At the present time, he states he is completely asymptomatic. He recently hiked Mount Major without difficulty and he is exercising on his treadmill on a daily basis, as well. He has no history of asthma, nor does he have any history of COPD PMH: Hypertension. Social History: The patient is married.