by Anup Kumar Tiwary, Firdous Jahan, Dharmendra Kumar Mishra and S.S. Chaudhary
Case Report
Eccrine syringofibroadenoma (ESFA) is a very rare benign tumour of intraepidermal part (acrosyringium) of eccrine sweat duct. Based on the evidence of known aetiological factors, two forms have been proposed: reactive ESFA and non-reactive ESFA. Rarely, non-reactive forms have been seen to be associated with ectodermal dysplasia. Reactive type has been considered as hyperplastic or hamartomatous response to many inflammatory and neoplastic dermatoses. Owing to its clinical similarity with other chronic dermatoses like deep mycoses, squamous cell carcinoma, diabetic foot ulcer or leprous neuropathic ulcer, it may remain misdiagnosed. Distinctive histopathological features with or without immunostaining usually confirm the diagnosis. ESFA is a very rare entity as to the best of my knowledge, only around 50 cases have been reported all over the world till date. Herein we report a case of reactive solitary ESFA on the right foot in a 65 years old male.coupons for viagra
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American Journal of Medical Case Reports. 2016, 4(2), 71-73. DOI: 10.12691/ajmcr-4-2-10
Pub. Date: March 23, 2016
14098 Views2953 Downloads3 Likes
by Sharmin Jahan, Hasanat MA, Md Enayet Hussain, Reazuddin Danesh, Nusrat Sultana, Mashfiqul Hasan and Fariduddin M
Case Report
Cyclic Cushing syndrome is a rare disorder, characterized by repeated episodes of cortisol excess interspersed by periods of normal cortisol secretion. We report a 15-year-old boy with clinical Cushing syndrome and intermittent central Adrenocorticotropic hormone(ACTH) hypersecretion for a period of 8 years. Periods of hypercotisolemia as evidenced clinically and/or biochemically alternated with periods of eucortisolemia leading to much diagnostic dilemma. Ultimately, we were able to demonstrate the episodes of three peaks and two troughs of cortisol secretion favoring our diagnosis. His initial sellar MRI was negative, later high resolution dynamic sellar MRI unmasked a Pituitary micro-adenoma. In the absence of consensus for trans-sphenoidal adenomectomy (TSA) medical management in the form of sodium valproate was prescribed. At present he is on regular follow-up with marked clinical improvement.discount prescription drug cards
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American Journal of Medical Case Reports. 2016, 4(2), 65-70. DOI: 10.12691/ajmcr-4-2-9
Pub. Date: March 11, 2016
21081 Views4092 Downloads3 Likes
by Ahmet Z. Burakgazi and James W. Schmidley
Case Report
HIV infection can cause neurological complications at all stages of the disease. Bilateral facial paralysis is not common in HIV, and more likely to have a systemic cause such as GBS, brain stem encephalitis, sarcoidosis, Lyme disease, syphilis or bacterial meningitis. Although HIV-associated bilateral facial palsy is very rare, it should be included in the differential diagnosis in unexplained cases, particularly in high-risk patients. We report a unique case of bilateral facial nerve palsy as an initial presenting symptom of AIDS, with an updated literature review.at home abortions
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American Journal of Medical Case Reports. 2016, 4(2), 62-64. DOI: 10.12691/ajmcr-4-2-8
Pub. Date: March 02, 2016
7355 Views3126 Downloads
by Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Robert Adrah, Jason Yi and Mujibur Majumder
Case Report
Gastrointestinal sarcoidosis is a rare clinical entity. Diagnosis of isolated gastric sarcoidosis is difficult as it is usually asymptomatic; when symptomatic it presents with non-specific symptoms such as abdominal pain, nausea and vomiting. We here present a case of a 32-year-old black lady who presented with non-specific abdominal complaints; a diagnosis gastric sarcoidosis was established following endoscopic biopsy. Here symptoms resolved promptly with steroidal therapy as with most cases. Gastric sarcoidosis should be suspected in sarcoid patients who present with nonspecific abdominal complaints. This case serves as an important clinical reminder of the atypical manifestations of sarcoidosis.azithromycin pill
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American Journal of Medical Case Reports. 2016, 4(2), 58-61. DOI: 10.12691/ajmcr-4-2-7
Pub. Date: March 01, 2016
20311 Views4063 Downloads1 Likes
by Amornpol Anuwatworn, Kashif Abbas Shaikh, Maheedhar Gedela, Amol Raizada and Marian Petrasko
Case Report
Fibromuscular dysplasia is a non-inflammatory and non-atherosclerotic arteriopathy commonly affecting medium-size renal, carotid, and vertebral arteries. Involvement of the coronary artery is very rare but may cause life-threatening spontaneous dissection. Because it is rare, this disease may go unrecognized. A unique angiographic finding of non-coronary arteries can make an early diagnosis, and prompt treatment is paramount. In this paper, we report on a multiple vessel coronary artery dissection in a female patient who presented with acute stroke symptoms secondary to spontaneous dissection of the left vertebral artery. To date, this is the first case report of the spontaneous dissection of six branches of coronary arteries and the vertebral artery due to fibromuscular dysplasia.neurontin 400mg
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American Journal of Medical Case Reports. 2016, 4(2), 55-57. DOI: 10.12691/ajmcr-4-2-6
Pub. Date: March 01, 2016
11378 Views5047 Downloads1 Likes
by Shivali P. Marketkar, Taslima Hossain, W. Dwayne Lawrence and M. Ruhul Quddus
Case Report
Pure signet-ring cell carcinomas of the uterine corpus usually raise the suspicion for a metastatic tumor from other primary sites, e.g., breast or the gastrointestinal tract. And if primary in the uterus, it is more commonly of uterine cervical origin with secondary involvement of the corpus. In general, pure mucinous carcinoma of the endometrium is rare and pure signet-ring cell carcinoma, a form of mucinous carcinoma, is even rarer. Only sparse case reports of primary mucinous adenocarcinoma of the uterine corpus with signet-ring cell features have been described in literature. We report here a case of pure mucinous signet-ring cell carcinoma of the uterine corpus in a 63 year-old morbidly obese woman.levofloxacin 250mg
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American Journal of Medical Case Reports. 2016, 4(2), 51-54. DOI: 10.12691/ajmcr-4-2-5
Pub. Date: February 27, 2016
11931 Views3324 Downloads
by Hassan Tahir, Saad Ullah, Hassan Zeb, Muhammad Naeem and Vistasp Daruwalla
Case Report
Bariatric surgery is the current modality of choice for weight loss in morbid obese patients. Although bariatric surgery is well known to improve obesity related complications, however, patients may be affected by early and late complications. Nutritional deficiency is one of the late complications of bariatric surgery which is more common in patients who are non compliant with dietary recommendations. American Society for Metabolic & Bariatric Surgery stresses the importance of long term regular follow up for dietary adherence assessment and nutritional deficiency screening tests. Thiamine deficiency, though rare, is increasingly seen due to increasing population of patients with gastric bypass surgery. Thiamine deficiency after bariatric surgery usually presents with neurological symptoms, most commonly as Wernicke Encephalopathy or dry Beriberi, and in almost all such cases, thiamine deficiency is very severe. Isolated ascending sensory neuropathy is a very rare presentation, which was seen in out patients with mildly low thiamine levels.
American Journal of Medical Case Reports. 2016, 4(2), 48-50. DOI: 10.12691/ajmcr-4-2-4
Pub. Date: February 25, 2016
13781 Views4769 Downloads2 Likes
by Orivaldo Alves Barbosa, Herivaldo Ferreira da Silva, Priscila Dourado Evangelista, José Gerardo Araujo Paiva, Cristiane Ferreira da Silva, João Paulo Uchoa Fontenele and José Walter Correia
Case Report
The cryoglobulinemia , particularly type 1 or monoclonal, is a rare disease with variable severity and diverse clinical manifestations and may lead to death due to multisystem failure and secondary infections. The early recognition and treatment of this disease are essential for a good prognosis. We report a case of cryoglobulinemic disease associated with Monoclonal gammopathy of Undetermined Significance with fatal outcome.discount prescription coupons
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American Journal of Medical Case Reports. 2016, 4(2), 44-47. DOI: 10.12691/ajmcr-4-2-3
Pub. Date: February 24, 2016
12001 Views3815 Downloads3 Likes
by Muhammad Omar, Joel Tjarks, Kashif Abbas Shaikh, Kalyan Chakravarthy Potu, Uma M Mothapothula and Maheedhar Gedela
Case Report
Malignant mixed Müllerian tumors (carcinosarcomas) are biphasic tumors of the uterus and uterine cervix with carcinomatous and sarcomatous components. Malignant mixed Müllerian tumors (MMMT) are rare tumors, accounting for <5% of uterine cancers. They most commonly metastasize to the vagina, pelvic wall, lungs, and ovaries. We report a unique case of MMMT, which developed in a 69-year-old woman after she presented with hip and knee pain. Ultimately, her pain was found to be caused by metastatic tumor deposits in her psoas muscle. The primary tumor was found to be a MMMT of the uterine corpus. We recommend practitioners be aware of this entity and include it and other metastatic lesions in their differential diagnosis in difficult cases of non-resolving pain.zithromax pill
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American Journal of Medical Case Reports. 2016, 4(2), 41-43. DOI: 10.12691/ajmcr-4-2-2
Pub. Date: February 23, 2016
12987 Views4188 Downloads
by Hussain Ibrahim, Purushothaman Muthusamy and Nashmia Riaz
Case Report
Stress cardiomyopathy has an association with emotional or physical stressors and is found to be more common in postmenopausal women. It has a similar presentation as acute myocardial infarction. Involvement of apex at the initial presentation and recurrence at the mid ventricular segment is rare. We describe a case of a 46 year old female with apical involvement at the initial presentation but mid ventricular involvement at the recurrence. 46 year old woman developed sharp chest pain while giving awards at an honors assembly. She was brought to the ER and was found to have a troponin level elevation without any EKG changes. Cardiac cath did not show coronary artery disease. ECHO revealed a low EF of 30 % with apical ballooning. Patient's symptoms resolved and her EF normalized on repeat ECHO. 2 years later patient developed similar symptoms. She had a troponin elevation without EKG changes. ECHO revealed mid-ventricular ballooning with a low EF. Patient's symptoms again resolved and repeat ECHO showed a normalized EF. Our patient had two different episodes of stress cardiomyopathy. Recurrence rate has been reported up to 11.4 percent in previous studies (5). This case is unique as recurrence was at different anatomic locations i.e apex followed by the mid ventricular segments. Further research is needed to understand the underlying mechanisms associated with the stress cardiomyopathy as current hypothesis do not completely explain the disease.drug coupon card
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American Journal of Medical Case Reports. 2016, 4(2), 38-40. DOI: 10.12691/ajmcr-4-2-1
Pub. Date: February 22, 2016
10950 Views2811 Downloads5 Likes