by Perry Wengrofsky, Ghassan Mubarak, Ahmed Shim, Pramod Theetha Kariyanna, Adam Buzidkowski, Jacob Schwartz and Samy I. McFarlane
Original Research
Marijuana abuse is rapidly growing and currently it is the most common drug of abuse in the United States due to increased legalization for recreational and medicinal use. Delta 9-tetrahydrocannibol, the main psychoactive compound in marijuana, acts via the endocannabinoid system to elicit various cardiovascular physiological effects, and has been associated with many adverse cardiovascular effects such as acute coronary syndrome, arrhythmias, and sudden cardiac death that have previously been reported by our group and others. We present a case of a 30-year-old African-American male with no cardiovascular disease (CVD) risk factors with recurrent ST-segment elevation myocardial infarctions (STEMI) whose coronary angiography revealed recurrent 100% occlusion of the left anterior descending artery (LAD) in the setting of marijuana smoking. It was the patient’s third STEMI with 100% occlusion of the LAD with each STEMI secondary to thrombosis of a different region of the LAD. Marijuana use was confirmed by urine toxicology screening at each STEMI presentation. Coronary angiography on multiple occasions was negative for stenosis of other epicardial coronary arteries, and coronary calcium scoring was zero. Evaluation for other cardiovascular risk factors including family history of premature coronary artery disease, dyslipidemia, diabetes, and hypercoagulable disorders was negative. Further studies are required to elucidate the mechanisms of marijuana-associated coronary thrombosis and myocardial infarction.
American Journal of Medical Case Reports. 2018, 6(8), 163-168. DOI: 10.12691/ajmcr-6-8-5
Pub. Date: September 18, 2018
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by Aziz Zakaria, Ibnouelghazi Naouar, Aboulouidad Salma, Lakouichmi Mohamed and Mansouri Hattab Nadia
Case Report
The neglected congenital muscular torticollis (NCMT) of the adult is rare. It is due to a fibrous retraction of the sternocleidomastoid muscle. Observation: Patient, aged 17, consulted for a neglected congenital muscular torticollis. The Clinical and radiological investigations showed severe craniofacial dysmorphosis. Discussion: NCMT is a common abnormality of the child who must be treated before the age of ten. When neglected, the consequences on craniofacial growth are of order morphological, functional and psychological. We report the case of a NCMT having resulted in severe and dramatic abnormalities of the cephalic extremity.
American Journal of Medical Case Reports. 2018, 6(8), 161-162. DOI: 10.12691/ajmcr-6-8-4
Pub. Date: September 07, 2018
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by Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Abdullah Mahmood, Mitchell Hare, Nicholas Taklalsingh and Isabel M. McFarlane
Case Report
Idiopathic inflammatory myopathy (IIM) is a rare autoimmune myopathy that includes polymyositis, dermatomyositis, inclusion body myositis and autoimmune necrotizing myositis. Cardiac involvement was considered a rare occurrence in IIM however, recent reports suggests that cardiac involvement is a common feature and portends poor prognosis as it is usually encountered in advanced disease. IIM leads to myocarditis with subsequent development of myocardial fibrosis, cardiac conduction system disease and cardiomyopathy resulting in both systolic and diastolic heart failure. Conduction abnormalities such as first, second and third degree atrioventricular blocks, right and left bundle branch blocks associated with IIM have been reported. We present a case of a 44-year-old woman with biopsy proven-IIM whose left ventricular ejection fraction (LVEF) and electrocardiogram (ECG) were recorded as normal two years prior. On presentation to our hospital ECG revealed atrial tachycardia and 2D echocardiogram revealed heart failure with reduced ejection fraction (20-30%). Patient quickly progressed to complete heart block. A cardiac resynchronization therapy-defibrillator (CRT-D) insertion was planned but patient succumbed to sepsis.
American Journal of Medical Case Reports. 2018, 6(8), 157-160. DOI: 10.12691/ajmcr-6-8-3
Pub. Date: August 23, 2018
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by David Olorunfemi Samuel, Musa Bolanle Olufunke and Oyeleke Kikelomo Ganiyat
Original Research
INTRODUCTION: HCV is recognized as the major cause of transfusion associated and sexually transmitted sporadic chronic non-A non-B hepatitis. There is a high degree of genetic variability from HCV genomes isolated from infected patients. Currently, HCV isolates are classified into at least six major genotypes and numerous sub- genotypes. The genetic diversity of HCV and the clinical and virological relevance of HCV genetic classification schemes remain important areas of active research. OBJECTIVES: The objective of this study was to determine the genotypic profile of hepatitis C virus (HCV) in patients who are infected with chronic HCV with or without liver cirrhosis and hepatocellular carcinoma, receiving treatment at the medical outpatient department (MOPD) of the Bingham University Teaching Hospital Jos Nigeria with a view to seeing which of these genotypes is more prevalent. METHODS: This prospective cohort study enrolled patients who were clinically diagnosed to have chronic HCV infection and subsequently confirmed by polymerase chain reaction (PCR) using the light cycler. Patients attending the clinic from December 2012 to December 2014 who had all the relevant investigations done were enrolled in the study. This was regardless of whether they were profiled for commencement of treatment or not due to disease stage. RESULTS: A total of 48 patients were enrolled for the study during the period. Out of this figure, genotype 1 patients accounted for 34 (70.8 %) to emerge the leading genotype in the centre. This was followed by genotype 4 with a very low value of 7(14.6 %) as the second while genotype 2 had 6 (12.5 %) and genotype 3 had only 1 (2.1 %) patient. CONCLUSION:The study has revealed that HCV genotype 1 is the most prevalent among the population studied followed by genotype 4 while other genotypes 2 and 3 were also encountered but with lesser prevalence.
American Journal of Medical Case Reports. 2018, 6(8), 152-156. DOI: 10.12691/ajmcr-6-8-2
Pub. Date: August 23, 2018
9058 Views2138 Downloads
by Abdulaziz Saeed Alharbi and Syed Saeed Ahmed
Case Report
Cleidocranial dysplasia (CCD) is a rare autosomal dominant genetic disorder which is characterized by its unique intraoral and extra features. Sometimes the disease occurs spontaneously. Here we describe a case of spontaneous occurrence from Saudi Arabia due to its extreme rarity in this continent.
American Journal of Medical Case Reports. 2018, 6(8), 149-151. DOI: 10.12691/ajmcr-6-8-1
Pub. Date: August 23, 2018
4162 Views1051 Downloads3 Likes