Showing 45 results for Type of Study: Case Report
Abdollatif Moini, Leila Mehraban,
Volume 22, Issue 2 (6-2019)
Abstract
Background and Aim: Mucormycosis represents a group of life threatening infections caused by fungi of the order mucorales. Mucormycosis results in higher rates of morbidity and mortality than many other infections. A high index of suspicion and considering risky factors are critical for diagnosis and early initiation of therapy is necessary to optimize outcomes. In this paper, we report a woman with pulmonary mucormycosis.
Case Report: A 47-year old woman with a history of uncontrolled diabetes presented with cough, hemoptysis, dyspnea and dysphagia from 3 weeks ago. On physical examination, course crackles, generalized wheezing and stridor were found along with fever. Laboratory testing demonstrated a high-titer ESR, CRP3+ and leukocytosis. The ENT examination revealed a mild erythema of the vocal cords. An initial chest-x-ray was compatible with a pulmonary infiltration in the right middle lobe. Ct-scan of the sinuses was unremarkable. Bronchoscopy findings and lung biopsy was consistent fibrinoleukocytic exudates with extensive necrosis and broad hyphae and was reported fungal infection in favor of mucormycosis. She was eventually treated with amphotericin B.
Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.1398.48 has been approved by research ethics committee at Arak University of Medical Sciences.
Conclusion: Mucormycosis has high mortality in diabetic patients and has even higher rates in uncontrolled diabetics. Therefore, due to underestimation and undertreatment of the condition, mucormycosis must be considered in diabetics underestimate pneumonia.
Alireza Sadighi,
Volume 22, Issue 6 (1-2020)
Abstract
The surgical extraction of third molars is the most frequent surgical procedure in oral surgery. Subcutaneous emphysema is an uncommon clinical condition caused by forceful injection of air into the loose connective tissue below the dermal layer, and mostly is the result of using a high-speed air-driven hand piece during surgical tooth extraction. Subcutaneous emphysema is seen mostly in the third and fifth decade of life and in the right mandibular wisdom tooth extraction surgery site. Emphysema can spread to deep spaces such as infratemporal, pterygomandibular, masseteric, lateral or retropharyngeal or mediastinum. This study presents a case report of subcutaneous emphysema occurred during the third molar extraction by using an air-driven hand piece in a 28-year-old female patient. This study has no specific ethical considerations. Informed consent was obtained from the patient to use her information and images. Case management and the issues relative to the diagnosis and prevention of this surgical complication are discussed. Trismus was present with maximum opening of about 30 mm, and no signs of dysphagia and dyspnea were reported. Patient was administered 4 million units of penicillin Intravenous (IV) every 4 hours, metronidazole 500 mg IV every 8 hours solved in 100-cc normal saline infused slowly, and rinsing mouth with 0.2% chlorhexidine every 8 hours. The patient was hospitalized for 36 hours and treated with antibiotic regimen, and then followed up for day 5 until complete resolution of swelling, maximum opening up to 50 mm, and lack of crepitation. No other local, systemic and infectious complications occurred.
Atieh Sadat Danesh, Fatemeh Nojavan,
Volume 23, Issue 1 (3-2020)
Abstract
Background and Aim: From the viewpoint of Iranian Traditional Medicine (ITM), hemorrhoidal bleeding is not only an organic disease; it also indicates the quality and quantity of blood and temperaments in the body. According to this view, bleeding from different areas has several causes, two important causes of which are: a. vascular hyperemia and consequent blooding in bleeding-prone areas, and b. changes in blood quality that cause the arteries to open and bleed. This study, by reporting a case of hemorrhoidal bleeding, is an evidence of some therapeutic principles in ITM.
Case Report: Patient was a 39-year-old married woman with four children and warm-wet temperament complaining of heavy menstrual bleeding for one year. After three months of herbal drug administration, menstrual bleeding became normal. One month later, she had hemorrhoidal bleeding. Her bleeding was treated based on ITM method by removing the black bile (Soda) from the body, phlebotomy and leech therapy around the anus.
Ethical Considerations: This study has been approved by the Research Ethics Committee of Arak University of Medical Sciences with code: IR.MUQ.REC.1396.110.
Conclusion: Based on ITM, it seems that the cause of hemorrhoidal bleeding in this case is vascular hyperemia and poor blood quality following symptomatic treatment of heavy menstrual bleeding.
Manijeh Zarei Mahmood Abadi, Talieh Zarifian, Dr Robab Teymouri,
Volume 24, Issue 4 (9-2021)
Abstract
Background and Aim: Acquisition skill in sentence producing is one of the criteria for speech development. By developing and increasing the age, we are witnessing the emergence of compound sentences in speech. Clinical treatments for language disorders in Iran are mostly based on the experiences of Speech Language Therapists or in accordance with English language norms. We need to examine how the length of utterance and compound sentences develop in Persian. The study aimed to report the development of compound sentences and Mean Length of Utterance (MLU) for a Persian-speaking child from 15 to 34 months.
Methods & Materials: In this longitudinal case report, based on Developmental-Descriptive model, MLU and emergence of simple compound sentences of a Persian speaking girl sampled and described from 15 to 34 months by daily scripting. R software version 4.0.2 was used for data analysis. Correlation of age with linguistic variables through Pearson correlation coefficient was evaluated.
Ethical Considerations: In this paper, the principles of publication ethics were considered.
Results: At the age of 21 months and 13 days, the child uttered her first simple two-word sentence, and at the age of 26 months and 29 days, she used a four-word compound sentence. With the emergence of compound sentences, the increase in the MLU has gained considerable speed. In a few days, we see the addition of a unit to the length of the sentence (word). There was a significant relationship between the MLU and age (r=0.925, P=0.001), Mean length of sentence and number of words in Persian speaking child (r=0.910, P=0.002) and total number of words and age (r=0.928, P<0.001).
Conclusion: Although several longitudinal studies have been conducted on the development of MLU and number of words in other languages, similar studies are rare in Persian. It is important to conduct studies of this type in order to make cross-linguistic comparisons and to study the linguistic universality and language specificity. By increasing age, we see an increase in the number of words in a child's vocabulary, the emergence of compound sentences, and an increase MLU. At 27 to 28 months, there is a dramatic change in the development expressive language as the compound sentences appear. It seems that emergence of compound sentences in the language output, also plays a significant role in increasing the MLU and can be considered in clinical language assessments.
Hesameddin Modir, Aidin Shakeri, Alireza Ghafouri, Gholamhassann Chaichi Nosrati, Shiva Alikhani, Ayda Khammari,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient remains in a state of controlled consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex using awake craniotomy.
Case Report: This report describes the anesthetic management of a 22-year-old male undergoing craniotomy with a fully awake technique. This was the first case of craniotomy performed entirely awake (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, After preoperative preparation and evaluation, scalp nerve blocks targeting the cranial nerves innervating the scalp and head muscles were administered at specific sites. Mild sedation was provided using oxygen supplementation, followed by surgical incision. The lesion was examined intraoperatively while the patient remained awake, and the tumor was safely excised under full wakefulness. A combination of local and regional anesthesia and light intravenous sedation was utilized. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were administered for sedation. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in stable condition, and the patient was transferred to the intensive care unit in good general condition, awake and fully alert.
Conclusions: Although maintaining analgesia and hemodynamic and adequate ventilation during fully awake craniotomy poses challenges, this technique is critical for intraoperative monitoring of cranial nerve function and preventing neurological deficits. By precisely administering scalp nerve blocks and carefully titrating sedatives (propofol, remifentanil, dexmedetomidine), we successfully performed the procedure under full wakefulness. With this method, potential surgical complications are prevented, and the patient also experiences satisfactory painlessness. Applying this technique was satisfactory for our patient.
