Clinics and Practice

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Open AccessCase Report

An Unusual Pituitary Mass Revealing a Primary Hypothyroidism!

by Amal Moumen, Azzelarab Meftah, Hamza El jadi, Souad Elmoussaoui and Ghizlaine Belmejdoub

Clin. Pract. 2015, 5(1), 733; https://doi.org/10.4081/cp.2015.733 - 31 Mar 2015

Cited by 6 | Viewed by 494

Autoimmune hypothyroidism is a common medical condition. Its revelation by thyrotrophic hyperplasia is an unusual and may be misdiagnosed as a pituitary adenoma. A 35-year-old man is referred to us for endocrinological assessment before surgery of a pituitary macroadenoma with bitemporal hemianopsia. Biological [...] Read more.

Autoimmune hypothyroidism is a common medical condition. Its revelation by thyrotrophic hyperplasia is an unusual and may be misdiagnosed as a pituitary adenoma. A 35-year-old man is referred to us for endocrinological assessment before surgery of a pituitary macroadenoma with bitemporal hemianopsia. Biological data reveal profound primary hypothyroidism. With thyroid hormone substitution, the thyroid function was normalized. Follow-up magnetic resonance imaging, showed the complete shrinkage of the pituitary mass attesting of a thyrotrophic pituitary hyperplasia. This case highlights the importance of a multidisciplinary assessment of pituitary masses to avoid unnecessary surgery and to prevent consequences of sellar masses. Full article

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Open AccessArticle

Helicobacter pylori Gastritis, a Presequeale to Coronary Plaque

by Shrikant C. Raut, Vinayak W. Patil, Shubhangi M. Dalvi and Girish D. Bakhshi

Clin. Pract. 2015, 5(1), 717; https://doi.org/10.4081/cp.2015.717 - 30 Mar 2015

Cited by 9 | Viewed by 583

Abstract

Helicobacter pylori are considered the most common human pathogen colonizing gastric mucosa. Gastritis with or without H. pylori infection is associated with increase in levels of homocysteine and high-sensitivity C-reactive protein (hs-CRP) but a more pronounced increase is noted in gastritis with H. [...] Read more.

Helicobacter pylori are considered the most common human pathogen colonizing gastric mucosa. Gastritis with or without H. pylori infection is associated with increase in levels of homocysteine and high-sensitivity C-reactive protein (hs-CRP) but a more pronounced increase is noted in gastritis with H. pylori infection. Increasing level of homocysteine, due to decreased absorption of vitamin B₁₂ and folic acid, together with increased CRP levels in gastritis with H. pylori infection may be the earliest event in the process of atherosclerosis and plaque formation. Retrospective study conducted at tertiary care hospital in Mumbai by Department of Biochemistry in association with Department of Surgery. Eighty patients who underwent gastroscopy in view of gastritis were subjected to rapid urease test for diagnosis of H. pylori infection. Vitamin B₁₂, folic acid, homocysteine and hs-CRP were analyzed using chemiluminescence immuno assay. Student’s t-test, Pearson’s correlation and linear regression used for statistical analysis. Patients with H. pylori gastritis had significantly lower levels of vitamin B₁₂ (271.6 ± 101.3 vs. 390.6 ± 176.7 pg/mL; P = 0.0005), as well as higher levels of homocysteine (17.4 ± 7.4 vs. 13.8 ± 7.8 mmol/L; P = 0.037) and hs-CRP (2.5 ± 2.9 vs. 1.2 ± 1.1 mg/L; P = 0.017), than in patients without H. pylori gastritis. However, folic acid showed (8.9 ± 3.2 vs. 10.0 ± 3.6 ng/mL; P = 0.171) no significant difference. Elevated homocysteine and hs-CRP in H. pylori gastritis may independently induce endothelial dysfunction, leading to cardiovascular pathology. Full article

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Open AccessCase Report

Bilateral Inguinal Hernias Containing Ovaries

by Gurudutt Bhaskar Basrur

Clin. Pract. 2015, 5(1), 708; https://doi.org/10.4081/cp.2015.708 - 30 Mar 2015

Cited by 3 | Viewed by 353

Abstract

Inguinal hernias are rare in females. The authors report a case of bilateral inguinal hernias in a 10-year-old female. On exploration, the patient was found to be having a sliding hernia containing incarcerated ovary as contents on both sides. Peroperatively the contents were [...] Read more.

Inguinal hernias are rare in females. The authors report a case of bilateral inguinal hernias in a 10-year-old female. On exploration, the patient was found to be having a sliding hernia containing incarcerated ovary as contents on both sides. Peroperatively the contents were reduced, the sac was transfixed at its base and the redundant sac was excised. The repair of this form of hernias is more difficult because of adhesions between the contents and the wall of the sac and risk of damage during dissection. A description of this clinical presentation in the pre operative assessment and operative management are discussed in this report. Full article

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Open AccessCase Report

Essentials in Cardiac Arrest during Cesarean Section

by Susan W.J.D. van Liempt, Katrin Stoecklein, Ming Y. Tjiong, Lothar A. Schwarte, Christianne J.M. de Groot and Pim W. Teunissen

Clin. Pract. 2015, 5(1), 668; https://doi.org/10.4081/cp.2015.668 - 17 Feb 2015

Cited by 6 | Viewed by 496

Abstract

Cardiac arrest during cesarean section is very rare. Obstetrical teams have low exposure to these critical situations necessitating frequent rehearsal and knowledge of its differential diagnosis and treatment. A 40-year-old woman pregnant with triplets underwent cesarean sections because of vaginal bleeding due to [...] Read more.

Cardiac arrest during cesarean section is very rare. Obstetrical teams have low exposure to these critical situations necessitating frequent rehearsal and knowledge of its differential diagnosis and treatment. A 40-year-old woman pregnant with triplets underwent cesarean sections because of vaginal bleeding due to a placenta previa at 35.2 weeks of gestation. Spinal anesthesia was performed. Asystole occurred during uterotomy. Immediate resuscitation and delivery of the neonates eventually resulted in good maternal and neonatal outcomes. The differential diagnosis is essential and should include obstetric and non-obstetric causes. We describe the consideration of Bezold Jarisch reflex and amniotic fluid embolism as most appropriate in this case. Full article

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Open AccessCase Report

A Recurrent Giant Cell Tumor of Bone Treated with Denosumab

by Nicola Stadler, Thomas Fingernagel, Stefan G. Hofstaetter and Klemens Trieb

Clin. Pract. 2015, 5(1), 697; https://doi.org/10.4081/cp.2015.697 - 10 Feb 2015

Cited by 7 | Viewed by 412

Abstract

Although the giant cell tumor of bone is generally classified as a benign tumor it can rarely metastasize and has a potential risk of local recurrence. We want to report about a female patient who suffered from a recurrence of a giant cell [...] Read more.

Although the giant cell tumor of bone is generally classified as a benign tumor it can rarely metastasize and has a potential risk of local recurrence. We want to report about a female patient who suffered from a recurrence of a giant cell tumor of bone after the implantation of a total endoprosthesis of the knee joint. We have treated her with denosumab, which is a receptor activator of nuclear factor kappa-B ligand inhibitor. In this case report we want to present a new option to treat this kind of neoplasm. Full article

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Open AccessCase Report

Bilateral Endoscopic Endonasal Marsupialization of Nasopalatine Duct Cyst

by Yohei Honkura, Kazuhiro Nomura, Hidetoshi Oshima, Yusuke Takata, Hiroshi Hidaka and Yukio Katori

Clin. Pract. 2015, 5(1), 748; https://doi.org/10.4081/cp.2015.748 - 05 Feb 2015

Cited by 7 | Viewed by 606

Abstract

Nasopalatine duct cysts are the most common non-odontogenic cysts in the maxilla, and are conventionally treated through a sublabial or palatine approach. Recently, the endoscopic approach has been used, but experience is extremely limited. We treated a 29-year-old male with nasopalatine duct cyst [...] Read more.

Nasopalatine duct cysts are the most common non-odontogenic cysts in the maxilla, and are conventionally treated through a sublabial or palatine approach. Recently, the endoscopic approach has been used, but experience is extremely limited. We treated a 29-year-old male with nasopalatine duct cyst by endoscopic marsupialization, but paresthesia of the incisor region occurred after surgery. This paresthesia gradually remitted within 6 months. The nasopalatine nerve, which innervates the upper incisor region, enters two lateral canals separately at the nasal floor and exits the central main canal at the palate. Damage to the bilateral nasopalatine nerves might lead to paresthesia, so we recommend careful examination for nerve fibers during endoscopic surgery, especially if fenestration is performed on both sides. Full article

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Open AccessCase Report

Primary Retroperitoneal Mucinous Cystic Tumors with Borderline Malignancy: A Case Report and Literature Review

by Megumi Manrai, Naoki Takesita, Hiroaki Ishida, Akiko Takashima, Tomohiro Adachi, Izumi Sasaki, Kei Yokokawa, Wataru Tokuyama, Nobuyuki Hiruta and Toshihiko Kinoshita

Clin. Pract. 2015, 5(1), 722; https://doi.org/10.4081/cp.2015.722 - 05 Feb 2015

Cited by 9 | Viewed by 448

Abstract

Primary retroperitoneal mucinous cystic tumors with borderline malignancy are rarely encountered. To date, only 12 cases have been reported in the literature. In this report, we present an additional case. A 65-year-old nulliparous woman complained of abdominal fullness. Her medical history included a [...] Read more.

Primary retroperitoneal mucinous cystic tumors with borderline malignancy are rarely encountered. To date, only 12 cases have been reported in the literature. In this report, we present an additional case. A 65-year-old nulliparous woman complained of abdominal fullness. Her medical history included a hysterectomy and a single salpingo-oophorectomy performed 25 years prior to the present event. Physical examination revealed a large cystic mass in the abdomen and pelvis. During laparotomy, a cystic tumor measuring 21 × 14 cm in size was observed in the left retroperitoneal space. The tumor was resected, and the final diagnosis was primary retroperitoneal mucinous cystic cancer with borderline malignancy. Full article

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Open AccessCase Report

Congenital Prepubic Sinus Accompanied by Prevesical Abscess

by Hideki Kobayashi, Teruhisa Nomura, Yaburu Haneda, Norifumi Sawada, Isao Araki and Masayuki Takeda

Clin. Pract. 2015, 5(1), 701; https://doi.org/10.4081/cp.2015.701 - 05 Feb 2015

Cited by 6 | Viewed by 497

Abstract

Congenital prepubic sinus is an extremely rare anomaly. The etiology is uncertain and the anatomical features often differ from each other. We report a 22-year-old woman with a congenital prepubic sinus accompanied by a prevesical abscess. She was admitted to our hospital with [...] Read more.

Congenital prepubic sinus is an extremely rare anomaly. The etiology is uncertain and the anatomical features often differ from each other. We report a 22-year-old woman with a congenital prepubic sinus accompanied by a prevesical abscess. She was admitted to our hospital with high-grade fever and low abdominal pain. Computed tomography revealed a prevesical abscess. After treatment of the prevesical abscess, we completely excised the congenital prepubic sinus. To our knowledge, this is the first reported case that accompanied by prevesical abscess on a congenital prepubic sinus. Moreover, this case represents the oldest reported age of a patient with a congenital prepubic sinus. Full article

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Open AccessCase Report

An Important Cause of Pes Planus: The Posterior Tibial Tendon Dysfunction

by Kemal Erol, Ali Yavuz Karahan, Ülkü Kerimoğlu, Banu Ordahan, Levent Tekin, Muhammed Şahin and Ercan Kaydok

Clin. Pract. 2015, 5(1), 699; https://doi.org/10.4081/cp.2015.699 - 05 Feb 2015

Cited by 8 | Viewed by 1333

Abstract

Posterior tibial tendon dysfunction (PTTD) is an important cause of acquired pes planus that frequently observed in adults. Factors that play a role in the development of PTTD such as age-related tendon degeneration, inflammatory arthritis, hypertension, diabetes mellitus, obesity, peritendinous injections and more [...] Read more.

Posterior tibial tendon dysfunction (PTTD) is an important cause of acquired pes planus that frequently observed in adults. Factors that play a role in the development of PTTD such as age-related tendon degeneration, inflammatory arthritis, hypertension, diabetes mellitus, obesity, peritendinous injections and more rarely acute traumatic rupture of the tendon. PTT is the primary dynamic stabilizer of medial arch of the foot. Plantar flexion and inversion of the foot occurs with contraction of tibialis posterior tendon, and arch of the foot becomes elaveted while midtarsal joints are locked and midfoot-hindfoot sets as rigid. Thus, during the walk gastrocnemius muscle works more efficiently. If the PTT does not work in the order, other foot ligaments and joint capsule would be increasingly weak and than pes planus occurs. We present a 10-yearold female patient diagnosed as PTTD and conservative treatment with review of the current literature. Full article

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Open AccessCase Report

Till Surgery Do Us Part: Unexpected Bilateral Kissing Molars

by Narayanankutty Anish, Velayudhannair Vivek, Sunila Thomas, Vineet Alex Daniel, Jincy Thomas and Prasanna Ranimol

Clin. Pract. 2015, 5(1), 688; https://doi.org/10.4081/cp.2015.688 - 02 Feb 2015

Cited by 8 | Viewed by 641

Abstract

The occurrence impacted teeth, single or multiple is very common. But, phenomenon of kissing molars is an extremely rare phenomenon. Mandibular third molars are the most common impacted teeth. Mandibular first or second molars does not share the same frequency of occurrence. But, [...] Read more.

The occurrence impacted teeth, single or multiple is very common. But, phenomenon of kissing molars is an extremely rare phenomenon. Mandibular third molars are the most common impacted teeth. Mandibular first or second molars does not share the same frequency of occurrence. But, there are rare cases in which the occlusal surfaces of impacted molars are united by the same follicular space and the roots point in the opposite direction, and are termed as kissing molars. Sometimes, these teeth will be associated with pathologies. This article reports a rare case of mandibular bilateral kissing molars. Full article

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Open AccessCase Report

Staphylococcus lugdunensis Gluteal Abscess in a Patient with End Stage Renal Disease on Hemodialysis

by Mansoor Mehmood and Faisal A. Khasawneh

Clin. Pract. 2015, 5(1), 706; https://doi.org/10.4081/cp.2015.706 - 28 Jan 2015

Cited by 3 | Viewed by 476

Abstract

A 57-year-old end stage renal disease patient on hemodialysis (HD) presented with sepsis secondary to right buttock abscess and overlying cellulitis. She was started on broad-spectrum antibiotic therapy and underwent incision and drainage with marked improvement. Her cultures grew methicillin-resistant Staphylococcus lugdunensis. [...] Read more.

A 57-year-old end stage renal disease patient on hemodialysis (HD) presented with sepsis secondary to right buttock abscess and overlying cellulitis. She was started on broad-spectrum antibiotic therapy and underwent incision and drainage with marked improvement. Her cultures grew methicillin-resistant Staphylococcus lugdunensis. This bacterium is more virulent than other coagulase negative staphylococci and has been implicated in causing a variety of serious infections but it has been underreported as a cause of skin infections in HD patients and possible other patient populations. Full article

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Clin. Pract., Volume 5, Issue 1 (January 2015) – 11 articles

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