Journal of Clinical Case Reports Medical Images and Health Sciences

Myoclonic status secondary to cefepime toxicity by Camila Ramírez in Journal of Clinical Case Reports Medical Images and Health Sciences  Abstract Adverse drug reactions (ADRs) are defined as any harmful and unwanted effect that occurs at doses used for therapeutic or prophylactic purposes, being a frequent cause of mortality and morbidity. We present the case of a 36-year-old female patient with a history of HIV without antiretroviral therapy, in stage B2 (undetectable viral load, CD4 208) who was admitted due to emergency dialysis secondary to obstructive nephropathy due to ureterolithiasis. During hospitalization, she presented diarrheal episodes with isolation of Klebsiella pneumoniae in stool culture, which is why the treating service started therapy with cefepime not adjusted to renal function. Subsequently, she presented a sudden picture of altered state of consciousness, myoclonic and myoclonic status, for which extension studies were performed, with CT, electrolytes, gluc...

 Ulcerative syphilis (malignant syphilis) in a patient with human immunodeficiency virus infection. About a case by Camila Ramírez in Journal of Clinical Case Reports Medical Images and Health Sciences Abstract We present the case of a 59-year-old male patient diagnosed with HIV infection since 2008 on intermittent antiretroviral therapy with dolutegravir+lamivudine/abacavir, stage C3 (viral load 29,855 and CD4 count 40) who was admitted for clinical picture of two months of evolution consisting of the appearance of non-pruritic nodular ulcerated cutaneous lesions on the face and lower limbs associated with loss of visual acuity in the left eye, on physical examination with ulcerated lesions with necrotic and hyperkeratotic edges, for which reason they were requested extension studies within which he presented reactive VDRL, which is why a skin biopsy was requested due to the suspicion of malignant syphilis, as well as lumbar puncture and ophthalmological assessment confirming Neu...

 A Case Study on a Collegiate Baseball Player with Long Thoracic Nerve Palsy by JC Montemayor in Journal of Clinical Case Reports Medical Images and Health Sciences Abstract A collegiate baseball player complained of right posterior shoulder girdle discomfort while throwing. Physical examination of the dominate arm (right) showed winging of the right scapula and a loss in range of motion (ROM) into shoulder flexion and abduction of the affected right side. An EMG study was taken by a neurologist and showed an absence right serratus anterior activity thus confirming the diagnosis of a long thoracic nerve injury. A suggested mechanism for this injury includes lifting an arm over head while turning the head to the contralateral side of the raised arm. Rehabilitation of this injury was taken through the conservative approach of formal physical therapy. Exercises were completed 3-4 days a week to strengthen the scapular stabilizers, including the rhomboids, lower and middle trapezius t...

CATCH THEM YOUNG – WATCH THEM GROW” Management of developing malocclusion in early and late mixed dentition period using versatile 2x4 appliance by K.Sudheer kumar in Journal of Clinical Case Reports Medical Images and Health Sciences  Abstract The mixed dentition period is considered one of the most ideal ages for undergoing interceptive orthodontic treatment. Children possess a higher perception of dental esthetics. Dental malocclusions were found to affect the self-esteem of the children during this period. American Association of Orthodontics recommends that a child can undergo orthodontic treatment at the early age of 7 years. Certain malocclusions can be corrected during the mixed dentition period which aids in the normal growth of jaws and surrounding structures. This article describes successful management of two cases with angles class 2 division 2 malocclusion treated using 2 x 4 appliance. The 2 x 4 appliance is a partially fixed orthodontic appliance that is used in ch...

Audit on incidence of Trastuzumab induced Cardiac toxicity in day care Oncology at a tertiary care hospital, Karachi, Pakistan by Arifa Aziz in Journal of Clinical Case Reports Medical Images and Health Sciences  Abstract Background:  Trastuzumab is a monoclonal antibody that inhibits tumor cell growth by binding to the extracellular region of the HER 2 protein and blocking the signalling pathway with overexpressed HER 2 positive breast cancer patients. Mostly presented at an advanced stage and have a significantly shortened disease-free and overall survival. Our objective is to find out the frequency of cardiac toxicity with trastuzumab given subcutaneous,  Method:  Questionnaire form for audit was developed which included questions on shortness of breath, palpitation, edema feet, chest pain and echocardiogram report. Trastuzumab is given through subcutaneous route at dose of 600 mg and eechocardiogram monitored at every 3 months. Data collected from April 2022 ti...

Persistent knee pain following unicompartmental knee arthroplasty despite no identified cause and proactive patient use of standard and alternative therapies by  Gregor Reid in Journal of Clinical Case Reports Medical Images and Health Sciences  Abstract A 63-year-old fit male reported medial knee pain of 6/10 following a season of indoor soccer in 2018. Despite cessation of soccer, the pain continued and in October 2019 an X-ray showed moderate osteoarthritis in the medial compartment. In 2020, MRI showed a tear in the medical meniscal body. Arthroscopy was performed with partial medial meniscectomy and debridement of the medial compartment with the aim of reducing the pain. However, neuropathy arose at the intrapatellar branch of the saphenous nerve, and this was not offset by recommended treatment using Durolane injection, physiotherapy and local use of CBD and pregabalin, gabapentin triple cream. Due to the medial bone on bone contact, it was decided that a un...