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A Case Report Highlighting Some of the Difficulties Faced Diagnosing Appendicitis in Children

Case Report of International Journal of Case Reports A Case Report Highlighting Some of the Difficulties Faced Diagnosing Appendicitis in Children S. Lewis, A. Rasheed Royal Gwent Hospital Introduction: In England 12,000 children are diagnosed with appendicitis each year. The diagnosis of appendicitis is difficult especially in children. There are many other diagnoses which mimic appendicitis including Meckel’s diverticulum, intussusception, gastroenteritis and mesenteric adenitis. Unfortunately there is no gold standard in the diagnosis of appendicitis and often clinicians are hesitant to submit a child to radiological investigations. Presentation of the case: An eleven year old boy, of Bangladeshi origin, presented to the Royal Gwent Hospital, South Wales, with an acute onset of centralised abdominal pain and vomiting. Following a period of observation and re-examination his pain had localised to the right iliac fossa and it was decided on clinical grounds to perform a laparoscopy for suspected appendicitis. Intra-operative findings showed an intussusception of the small bowel secondary to a mucosal lesion. Histology showed high grade non-Hodgkin’s lymphoma with a pattern suggestive of Burkitt’s lymphoma. Conclusion: The case highlights the importance of accurate diagnosis of appendicitis and the difficulties of managing abdominal pain in children. More needs to be done to develop a better criterion and judicial use of imaging to guide surgical intervention. Keywords: Appendicitis, Alvarado, Ultrasound, Computer Topography, Laparoscopy ...

Intraventricular Tuberculoma : Single Case Report from Tertiary Care Centre in Eastern India

Case Report of International Journal of Case Reports Intraventricular Tuberculoma : Single Case Report from Tertiary Care Centre in Eastern India Pan Koushik 1, Sen Barun Kumar2 1.Registrar,Dept.of neurology,Ramakrishna mission seva pratisthan,VIMS,kol-94 2.Asst.Professor, Dept.of neurology,Ramakrishna mission seva pratisthan,VIMS,kol-94 Intraventricular tuberculomas as a manifestation of CNS tuberculosis is a rare finding.Suspicion for tuberculosis in these lesions is by the constitutional symptoms like low grade fever, weight loss, presence of tuberculosis elsewhere, contact with a TB patient, low socioeconomic status, occurrence in an endemic region, raised ESR, abnormal Chest X Ray findings, positive mantoux test. It is difficult to make a differential diagnosis from lesions if no systemic tuberculosis is present. Medical treatment is the preferred management method of this disease, and surgical intervention should be considered in certain situations. We report a case of an intraventricular tuberculoma in a 15- year-old girl and we discuss the pathogenesis and the radiological findings according this location. Keywords: Intraventricular Tuberculoma, Case Report, Tertiary Care Centre, Eastern India ...

Loading Doses of Bevacizumab in Branch Retinal Vein Occlusion (BRVO): a Case Report

Case Report of International Journal of Case Reports Loading Doses of Bevacizumab in Branch Retinal Vein Occlusion (BRVO): a Case Report Andi Arus Victor Vitreoretina Division, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo National General Hospital Background: Branch retinal vein occlusion (BRVO) is a sight threatening condition which may result well when promptly diagnosed and treated. Current trend of BRVO therapy uses anti-vascular endothelial growth factor (anti-VEGF) such as bevacizumab, ranibizumab and aflibercept as agents of choice. Previous studies have proven effectiveness of six monthly injections of anti-VEGF as loading doses before switching to pro-renata regimen in BRVO. We would like to report a case with lower frequency of bevacizumab injection as anti-VEGF in a case of BRVO with satisfactory outcome. Case presentation: A 52-year old male presented with sudden painless vision loss on right eye since 2 months prior to examination. Patient had been taking medications regularly for hypertension and dyslipidemia. Patient had also been previously diagnosed with peripheral artery disease. Patient came with BCVA of 0.1 and negative pinhole on right eye while BCVA for left eye was 1.0. Relative afferent pupillary defect was positive on the right eye. Intraocular pressure and anterior segment were within normal limits for both eyes. Upon fundus examination of the right eye, findings included 0.3 CDR, dilated and tortuous retinal veins, multiple scattered preretinal hemorrhages, and macular edema. Upon posterior segment evaluation of the left eye, no abnormalities was found. Patient was then diagnosed with BRVO of the right eye and received three monthly injections of bevacizumab. Patient’s BCVA and anatomic condition improved with final BCVA of 0.5 on the right eye. Patient was monitored monthly for the next six months and there was no deterioration on the anatomical and functional outcomes. Conclusion: Lower frequency of monthly bevacizumab injection could ...

Broncho-Oesophageal Fistula Complicating Carcinoma of the Oesophagus

Case Report of International Journal of Case Reports Broncho-Oesophageal Fistula Complicating Carcinoma of the Oesophagus Moemenam O.O1, Madukaife V. O2, Ray-Offor OD2 1Department of Radiology, Federal Medical Centre, Owerri. Imo State. 2Department of Radiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State Broncho-oesophageal fistula refers to an abnormal communication between a bronchus and the oesophagus. Broncho-oesophageal fistula is rare and can be either congenital or acquired. Congenital fistulas are usually diagnosed in the neonatal period as they present with respiratory distress and cyanosis during feeding. Whereas developmental anomaly is the commonest cause in infancy and childhood, the aetiology in adults is most frequently secondary to an oesophageal malignancy1. Non-malignant causes of fistulae are rare. Diagnosis of a broncho-oesophageal fistula may sometimes be difficult because of an insidious and non-specific clinical course2. A rare case of broncho-oesophageal fistula due to carcinoma of the oesophagus, which was discovered incidentally during a barium swallow study is presented. SUMMARY A 68-year-old man with dysphagia who was diagnosed to have carcinoma of the oesophagus, which was complicated by broncho-oesophageal fistula is presented. The role of radiology in the management of this condition is discussed. Conflict of Interest: The authors have no conflict of interest to disclose. Keywords: Broncho-Oesophageal Fistula Complicating Carcinoma, Oesophagus ...

Diagnosis and monitoring of Alzheimer Disease with saliva biomarker BACE1

Research Article of International Journal of Aging Research Diagnosis and monitoring of Alzheimer Disease with saliva biomarker BACE1 Dr SJ Kellner and Prof M Ferchichi Mesencell Biotech International Ltd, 20-22 Wenlock Road, London, N1 7GU, United Kingdom Alzheimer’s disease (AD) is characterized by the slow decline of cognition and functional abilities over time. The diagnosis for probable and possible AD relies principally on clinical criteria. The confirmation of the disease is made post-mortem by identifying extracellular senile plaques and intraneuronal fibrillary tangles in the brains of subjects with clinically defined dementia. However, the field critically lacks validated AD specific peripheral biomarkers to support the diagnosis in living patients or for early detection of patients at risk before symptoms appear. BACE1 (Beta site amyloid precursor protein cleaving enzyme 1) cleaves Amyloid Precursor Protein (APP) at two beta sites and represents a key target enzyme in the monitoring and possible treatment of AD. In our preliminary study, we evaluated the usefulness of salivary BACE1 to determine risk to develop AD in clinically normal patients. A preliminary in house laboratory grading system for BACE1 content in saliva was established with high levels of salivary BACE1 present in older patients and putatively at risk to develop AD. BACE1 seems to be a useful biomarker to help diagnose AD and to monitor disease progression, and remarkably regression, when treated with stem cell secretome. Keywords:Biomarkers, Alzheimer Disease, Mesenchymal stem cells, amyloid beta, amyloid precursor protein, amyloid plaques, BACE1, neprilysin, micro RNA, UHC-L1, disease monitoring, saliva ...

Geriatrics and e-Technology: a personalized follow-up of elderly residents in nursing homes to anticipate the decompensation of geriatric syndromes. Rationale for a first prospective study Ger-e-Tech

Review Article of International Journal of Aging Research Geriatrics & e-Technology: a personalized follow-up of elderly residents in nursing homes to anticipate the decompensation of geriatric syndromes. Rationale for a first prospective study Ger-e-Tech A.A. Zulfiqar1,2, A. Hajjam3, B. Gény2, S. Talha2,4, M. Hajjam5, J. Hajjam6, S. Ervé6, E. Andrès 2,7 1Department of Geriatrics, University Hospital of Rouen, Saint-Julien Hospital, 76141 Le Petit Quevilly, France; 2Research Unit EA 3072 “Mitochondrie, Stress oxydant et Protection musculaire”, Faculté de Médecine de Strasbourg, Université de Strasbourg (UdS), 4 rue Kirschleger, 67091 Strasbourg, France; 3Research Unit EA 4662 “Nanomédecine, Imagerie, Thérapeutiques”, Université de Technologie de Belfort-Montbéliard (UTBM), Belfort-Montbéliard, France; 4Service de Physiologie et d’Explorations fonctionnelles, Hôpitaux Universitaires de Strasbourg (HUS), 1, porte de l’Hôpital, 67091 Strasbourg cedex, France; 5PREDIMED Technology, Mulhouse, France; 6Centre d’expertise des Technologies de l’Information et de la Communication pour l’autonomie (CenTich) et Mutualité Française Anjou-Mayenne (MFAM), Angers, France; 7Department of Internal Medicine, Diabetes, University Hospital of Strasbourg, 1, porte de l’Hôpital, 67091 Strasbourg cedex, France The objective of the GER-e-TEC project is to provide recorded personalized medical monitoring of residents in nursing homes using an intelligent telemedicine platform. It will assist healthcare staff by automatically processing the information from sensors and questionnaires to provide early detection and escalate alerts to enable health professionals, operating in retirement homes, to optimize patient care. Keywords: telemedicine; nursing home; Ger-e-Tech; geriatric syndrome ...