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Hannah Hughes, Andrew Hughes, Colin G Murphy
[This corrects the article DOI: 10.7759/cureus.1931.].
June 15, 2018: Curēus
M N Baig, Usman Baig, Bill Curtin
Hip dysplasia is an abnormal development of the hip that consists of a spectrum of different abnormalities featuring an abnormal relation of the femoral head to the acetabulum. It can be treated in early childhood when it is diagnosed. Later in adult life, it is more challenging. We present a case of a 50-year-old woman who presented to us with adult hip dysplastic changes; we undertook the care of her left hip and treated her surgically.
June 7, 2018: Curēus
Adimulam Ganga Ravindra, Manju Rajaram, Dharm Prakash Dwivedi, Madhusmita Mohanty Mohapatra, Chinnakali Palanivel, Jayalakshmi Ramakrishnan, Vinod Kumar Saka
Background Patient compliance with the two-day Revised National Tuberculosis Control Programme's (RNTCP) diagnostic process for pulmonary tuberculosis (TB) is poor in high case load settings, with a high dropout rate observed on the second day. Hence, the World Health Organization (WHO) has recommended the same-day (spot-spot) sputum test for high-burden TB countries to help reduce diagnostic dropouts. This study addresses the paucity of comparative data on the accuracy and agreement of the two methods, while the WHO recommendations are yet to be implemented by the RNTCP...
June 7, 2018: Curēus
James R Kimber, Syed Rafay Ali Sabzwari, Hiwot Ayele
Arrhythmogenic right ventricular cardiomyopathy (ARVC), is a heritable condition that is an important, and under-recognized cause of sudden cardiac death. Microscopically, it is represented by fibrofatty replacement of myocardium involving the right ventricular inflow area, apex, and infundibulum. Common clinical manifestations of ARVC include palpitations, syncope, chest pain, dyspnea, and sudden cardiac death. This is a case of a 25-year-old male with a history of thalassemia, and tonic-clonic seizure status post head trauma with cystic encephalomalacia in left parietal lobe who described recurrent syncope...
June 7, 2018: Curēus
Arkadiusz P Wysocki, Skyle Murphy, Ingrid Baade
Introduction Expert opinion recommends that surgeons perform a laparoscopic cholecystectomy (LC) in a standardized manner by dissecting the hepatobiliary triangle lateral to the cystic artery lymph node (LN) to minimize the rate of a major bile duct injury. Methods To determine whether surgeons performed a laparoscopic cholecystectomy in a standardized manner, the study assessed the variability in the frequency of an LN excision. All LCs that were performed at a single hospital were identified from a prospective dataset...
June 7, 2018: Curēus
Saeed Ali, Zeeshan Sattar, Sana Hussain, Farhan Sattar, Daniel Tambunan
Priapism, a persistent erection of the penis which has no association with sexual activity and lasts longer than four hours, is a urologic emergency. It can be classified into ischemic, nonischemic, and stuttering categories. The pathophysiology of stuttering priapism is not well understood; however, the dysregulation of nitric oxide and phosophodiesterase-5 (PDE5) has been put forward as a possible mechanism. A 35-year-old male with a history of recurrent priapism presented with continuous penile erection for more than 48 hours...
June 7, 2018: Curēus
Mark Bilinyi Ulanja, Mohamed Taha, Arshad Al-Mashhadani, Bryce D Beutler, Marwah Al-Tekreeti, Christie Elliot, Santhosh Ambika
Metastasis from breast cancer to the gastrointestinal (GI) tract is uncommon, and such events presenting as GI bleeding are exceedingly rare. In some individuals, the absence of classical findings of primary breast cancer coupled with the non-specific nature of GI symptoms may make early detection and diagnosis challenging. Our patient is a 75-year-old female who presented with symptomatic anemia manifesting as progressive dizziness, weakness, and early satiety that developed eight days after right knee arthroplasty...
June 7, 2018: Curēus
Ibrar Anjum, Syeda S Jaffery, Muniba Fayyaz, Abdullah Wajid, Armghan H Ans
Sugar-sweetened beverages containing caffeine are widely used among humans nowadays and can have negative consequences on the overall health. Our study aims to discuss the effects of these sugar-sweetened beverages (SSB) and how they can impact the health in different ways particularly on the brain. Some of the mechanisms by which soft drinks can exert adverse effects include an increase in glutathione-6-dehydrogenase level, increased levels of gamma-aminobutyric acid (GABA), glutamate and dopamine alteration in brain waves on electroencephalography (EEG) eventually leading to stroke and dementia...
June 7, 2018: Curēus
Promil Kukreja, Joel Feinstein, Hari K Kalagara, Samuel R Huntley, Sung R Lee, Sameer Naranje, Ashish Shah
The planning and implementation of an effective postoperative pain management program depend on the surgical technique for total knee arthroplasty (TKA), the type of regional anesthesia, and the multimodal analgesia regimen. It is imperative to understand the surgical anatomy of TKA and the relevant nerve supply of the knee for optimum perioperative patient satisfaction with respect to pain management in the patient undergoing TKA. The commonly used regional techniques have their own specific benefits and limitations...
June 7, 2018: Curēus
Ahsan Zil-E-Ali, Muniba Fayyaz, Arooj Fatima, Zubair Ahmed
Necrotizing fasciitis is a progressive inflammatory disease that requires an early diagnosis to avoid limb salvage and other deadly manifestations. The current protocol is the microbiological and histopathological sampling of the tissue. Once the diagnosis is made, it should be managed with antimicrobial therapy, debridement, and surgical interventions. Such interventions can be invasive and increase the time to treat, which may increase morbidity. Our article discusses procalcitonin, C-reactive protein, and other markers, such as "pain out of proportion," lactate, creatinine, and creatine kinase, to make a quicker diagnosis before proceeding with invasive procedures...
June 7, 2018: Curēus
Cara Clure, Colleen Rivard
Herpes simplex virus (HSV) is a common sexually transmitted infection. Although primary HSV typically presents with ulcerations, atypical presentations are possible. Only one other case report of HSV manifesting as a cervical mass exists. A 35-year-old immunocompetent female with dysuria was found to have a cervical mass concerning for cancer. She had a history of abnormal pap smears and a loop electrosurgical excision procedure   (LEEP) with poor follow-up. The patient was taken to the operating room for biopsies and staging and was found to have new vulvar ulcers...
June 6, 2018: Curēus
Corina Iorgoveanu, Ahmed Zaghloul, Aakash Desai, Kathir Balakumaran, Muhammad Y Adeel
Brugada syndrome (BrS) is an inherited channelopathy disease, caused by genetic changes in transmembrane ion channels. It has an increased risk of sudden cardiac death (SCD) in the absence of a structural heart disease. We report a case in which the presenting electrocardiogram (EKG) exhibited a type 1 Brugada-like pattern during an adrenal crisis with transformation into a type 2 Brugada-like pattern as the crisis improved.
June 6, 2018: Curēus
Atul Ratra, Samuel Campbell
A common origin of the celiac trunk and superior mesenteric artery (SMA), also termed as celiomesenteric trunk (CMT), is a rare occurrence. We report a rare case of symptomatic CMT stenosis requiring multiple interventions. The patient underwent an initial superior mesenteric artery bypass graft but required a subsequent endoluminal intervention. We present this case for the rarity of CMT stenosis and its potential to cause recurrent mesenteric ischemia. The treatment outcome in this patient suggests that revascularization of the SMA alone can result in adequate perfusion of the entire mesenteric bed and resolve symptoms of mesenteric ischemia including weight loss and food avoidance...
June 6, 2018: Curēus
Jeffrey A Miskoff, Moiuz Chaudhri
Mycobacterium chimaera is an indolent nontuberculous mycobacterium which is abundant in soil, dust, and water. Although lacking recognition garnered by other mycobacteria (i.e., M. tuberculosis), it has been recognized as an emerging opportunistic threat to patients undergoing coronary bypass surgery and open heart procedures requiring extracorporeal devices. Here, we present a case of an individual initially seen in the inpatient setting without a history of such procedures or other risk factors commonly associated with mycobacterium-laden infections...
June 6, 2018: Curēus
Muhammad Wajih Ullah, Sunita Lakhani, Sunder Sham, Fariha Ashraf, Wardah Siddiq, Tariq Siddiqui
Bacterial infective endocarditis is a rare but a life-threatening infection during pregnancy. Infective endocarditis during pregnancy is often associated with a congenital heart condition or an earlier history of rheumatic heart disease. In pregnant women with infective endocarditis, the maternal and fetal mortality rate can reach as high as 33% and 29%, respectively. In most cases, infective endocarditis runs a subacute course and involves the mitral valve, nonetheless, rarely it can involve the aortic valve as well...
June 5, 2018: Curēus
Ather Muneer, Ahsen Farooq, Junaid H Farooq, Muhammad Siddique Qurashi, Immad A Kiani, Javeria S Farooq
Purpose The primary objective of this study was to assess the overall frequency of primary headaches in subjects with a moderate to severe major depressive disorder. A further objective was to determine the frequency of primary headache sub-types in this population. Materials and methods This descriptive, cross-sectional study was conducted at the outpatients' clinic of the department of psychiatry, Pakistan Railways Teaching Hospital, an affiliate of Islamic International Medical College, Rawalpindi. The duration of the study was from December 2016 to May 2017...
June 5, 2018: Curēus
Doris George, Amar-Singh Hss, Azmi Hassali
Background and objectives In Malaysia, the national voluntary non-punitive Medication Error Reporting System (MER-S) has been available since 2009, with compiled reports indicating the underreporting of various medication errors (ME). This survey intends to determine the ME reporting practice among healthcare professionals and the acceptance of ME reporting by utilising smartphone application if it is available. Design A cross-sectional survey was conducted for two months in 2017 among doctors and pharmacists in publicly funded healthcare facilities in Perak, Malaysia...
June 5, 2018: Curēus
Usman Tariq, Muhammad Saad Sohail, Zainab Fatima, Amina Khan, Abu Baker Sheikh, Shimron I Bhatti
The lungs are a common site of metastatic spread of an osteosarcoma. An affiliated simultaneous bilateral spontaneous pneumothorax (SBSP) is a rare clinical sequela of this malignancy. In this case report, we present the clinical circumstances of a young teenager who presented to our clinical setting following a diagnosis of osteosarcoma. We also illustrate the postulated pathophysiology, the tools for diagnosis and a subsequent management for this rare clinical entity.
June 5, 2018: Curēus
James McMillan
Serial observations obtained over more than eight years and 10,000 patient encounters in a general ophthalmology practice serving a population highly prone to chronic vitamin D (D3) deficiency, facilitated by the Oculus Pentacam Scheimpflug imaging system (Oculus Optikgeräte GmbH, Wetzlar, Germany), resulted in the recognition of consistent, predictable, and highly reproducible patterns of mechanical, optical, and physiologic change in the cornea and other ocular structures correlated to adequate vs. inadequate vitamin D availability...
June 5, 2018: Curēus
Syed Rafay Ali Sabzwari, Khurram Butt, Nimra Khan, Kailyn Mann, Tarick Sheikh, Chandra Bomma
Takotsubo cardiomyopathy (TCM), or apical ballooning syndrome, is a distinct nonischemic cardiomyopathy mimicking acute coronary syndrome. A 76-year-old female presented with ST elevation in the inferior lead and a troponin level of 0.81 ng/dL. An immediate coronary angiography showed non-obstructive coronary artery disease. A subsequent ventriculogram and echocardiogram showed anteroapical and distal inferior wall hypokinesis suggestive of TCM. Despite therapy with beta blocker, she was observed to have two significant sinus pauses, one eight-second, and a second 29-second pause...
June 5, 2018: Curēus
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