Publisher: Sage Publications   (Total: 1166 journals)

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Showing 1 - 200 of 1166 Journals sorted alphabetically
AADE in Practice     Hybrid Journal   (Followers: 6)
Abstracts in Anthropology     Full-text available via subscription   (Followers: 29)
Academic Pathology     Open Access   (Followers: 6)
Accounting History     Hybrid Journal   (Followers: 18, SJR: 0.527, CiteScore: 1)
Acta Radiologica     Hybrid Journal   (Followers: 1, SJR: 0.754, CiteScore: 2)
Acta Radiologica Open     Open Access   (Followers: 2)
Acta Sociologica     Hybrid Journal   (Followers: 39, SJR: 0.939, CiteScore: 2)
Action Research     Hybrid Journal   (Followers: 53, SJR: 0.308, CiteScore: 1)
Active Learning in Higher Education     Hybrid Journal   (Followers: 398, SJR: 1.397, CiteScore: 2)
Adaptive Behavior     Hybrid Journal   (Followers: 9, SJR: 0.288, CiteScore: 1)
Administration & Society     Hybrid Journal   (Followers: 18, SJR: 0.675, CiteScore: 1)
Adoption & Fostering     Hybrid Journal   (Followers: 25, SJR: 0.313, CiteScore: 0)
Adsorption Science & Technology     Open Access   (Followers: 9, SJR: 0.258, CiteScore: 1)
Adult Education Quarterly     Hybrid Journal   (Followers: 262, SJR: 0.566, CiteScore: 2)
Adult Learning     Hybrid Journal   (Followers: 51)
Advances in Dental Research     Hybrid Journal   (Followers: 11, SJR: 1.791, CiteScore: 4)
Advances in Developing Human Resources     Hybrid Journal   (Followers: 35, SJR: 0.614, CiteScore: 2)
Advances in Mechanical Engineering     Open Access   (Followers: 156, SJR: 0.272, CiteScore: 1)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 20)
Advances in Structural Engineering     Full-text available via subscription   (Followers: 51, SJR: 0.599, CiteScore: 1)
AERA Open     Open Access   (Followers: 14)
Affilia     Hybrid Journal   (Followers: 6, SJR: 0.496, CiteScore: 1)
Africa Spectrum     Open Access   (Followers: 17)
Agrarian South : J. of Political Economy     Hybrid Journal   (Followers: 3)
Air, Soil & Water Research     Open Access   (Followers: 13, SJR: 0.214, CiteScore: 1)
Alexandria : The J. of National and Intl. Library and Information Issues     Full-text available via subscription   (Followers: 68)
Allergy & Rhinology     Open Access   (Followers: 5)
AlterNative : An Intl. J. of Indigenous Peoples     Full-text available via subscription   (Followers: 39, SJR: 0.194, CiteScore: 0)
Alternative Law J.     Hybrid Journal   (Followers: 12, SJR: 0.176, CiteScore: 0)
Alternatives : Global, Local, Political     Hybrid Journal   (Followers: 12, SJR: 0.351, CiteScore: 1)
Alternatives to Laboratory Animals     Full-text available via subscription   (Followers: 11, SJR: 0.297, CiteScore: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 26, SJR: 0.982, CiteScore: 2)
American Economist     Hybrid Journal   (Followers: 7)
American Educational Research J.     Hybrid Journal   (Followers: 260, SJR: 2.913, CiteScore: 3)
American J. of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 23, SJR: 0.67, CiteScore: 2)
American J. of Cosmetic Surgery     Hybrid Journal   (Followers: 9)
American J. of Evaluation     Hybrid Journal   (Followers: 18, SJR: 0.646, CiteScore: 2)
American J. of Health Promotion     Hybrid Journal   (Followers: 35, SJR: 0.807, CiteScore: 1)
American J. of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 47, SJR: 0.65, CiteScore: 1)
American J. of Law & Medicine     Full-text available via subscription   (Followers: 12, SJR: 0.204, CiteScore: 1)
American J. of Lifestyle Medicine     Hybrid Journal   (Followers: 7, SJR: 0.431, CiteScore: 1)
American J. of Medical Quality     Hybrid Journal   (Followers: 13, SJR: 0.777, CiteScore: 1)
American J. of Men's Health     Open Access   (Followers: 9, SJR: 0.595, CiteScore: 2)
American J. of Rhinology and Allergy     Hybrid Journal   (Followers: 11, SJR: 0.972, CiteScore: 2)
American J. of Sports Medicine     Hybrid Journal   (Followers: 249, SJR: 3.949, CiteScore: 6)
American Politics Research     Hybrid Journal   (Followers: 36, SJR: 1.313, CiteScore: 1)
American Review of Public Administration     Hybrid Journal   (Followers: 28, SJR: 2.062, CiteScore: 2)
American Sociological Review     Hybrid Journal   (Followers: 358, SJR: 6.333, CiteScore: 6)
American String Teacher     Full-text available via subscription   (Followers: 3)
Analytical Chemistry Insights     Open Access   (Followers: 26, SJR: 0.224, CiteScore: 1)
Angiology     Hybrid Journal   (Followers: 5, SJR: 0.849, CiteScore: 2)
Animation     Hybrid Journal   (Followers: 15, SJR: 0.197, CiteScore: 0)
Annals of Clinical Biochemistry     Hybrid Journal   (Followers: 10, SJR: 0.634, CiteScore: 1)
Annals of Otology, Rhinology & Laryngology     Hybrid Journal   (Followers: 20, SJR: 0.807, CiteScore: 1)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 59, SJR: 1.096, CiteScore: 2)
Annals of the American Academy of Political and Social Science     Hybrid Journal   (Followers: 51, SJR: 1.225, CiteScore: 3)
Annals of the ICRP     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Anthropocene Review     Hybrid Journal   (Followers: 8, SJR: 3.341, CiteScore: 7)
Anthropological Theory     Hybrid Journal   (Followers: 48, SJR: 0.739, CiteScore: 1)
Antitrust Bulletin     Hybrid Journal   (Followers: 14)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2, SJR: 0.635, CiteScore: 2)
Antyajaa : Indian J. of Women and Social Change     Hybrid Journal   (Followers: 1)
Applied Biosafety     Hybrid Journal   (Followers: 1, SJR: 0.131, CiteScore: 0)
Applied Psychological Measurement     Hybrid Journal   (Followers: 21, SJR: 1.17, CiteScore: 1)
Applied Spectroscopy     Full-text available via subscription   (Followers: 27, SJR: 0.489, CiteScore: 2)
Armed Forces & Society     Hybrid Journal   (Followers: 25, SJR: 0.29, CiteScore: 1)
Arthaniti : J. of Economic Theory and Practice     Full-text available via subscription  
Arts and Humanities in Higher Education     Hybrid Journal   (Followers: 49, SJR: 0.305, CiteScore: 1)
Asia Pacific Media Educator     Hybrid Journal   (Followers: 1, SJR: 0.23, CiteScore: 0)
Asia-Pacific J. of Management Research and Innovation     Full-text available via subscription   (Followers: 3)
Asia-Pacific J. of Public Health     Hybrid Journal   (Followers: 15, SJR: 0.558, CiteScore: 1)
Asia-Pacific J. of Rural Development     Hybrid Journal   (Followers: 2)
Asian and Pacific Migration J.     Full-text available via subscription   (Followers: 8, SJR: 0.324, CiteScore: 1)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2, SJR: 0.305, CiteScore: 0)
Asian J. of Comparative Politics     Hybrid Journal   (Followers: 5)
Asian J. of Legal Education     Full-text available via subscription   (Followers: 4)
Asian J. of Management Cases     Hybrid Journal   (Followers: 6, SJR: 0.101, CiteScore: 0)
ASN Neuro     Open Access   (Followers: 2, SJR: 1.534, CiteScore: 3)
Assessment     Hybrid Journal   (Followers: 19, SJR: 1.519, CiteScore: 3)
Assessment for Effective Intervention     Hybrid Journal   (Followers: 15, SJR: 0.578, CiteScore: 1)
Australasian J. of Early Childhood     Hybrid Journal   (Followers: 7, SJR: 0.535, CiteScore: 1)
Australasian Psychiatry     Hybrid Journal   (Followers: 18, SJR: 0.433, CiteScore: 1)
Australian & New Zealand J. of Psychiatry     Hybrid Journal   (Followers: 30, SJR: 1.801, CiteScore: 2)
Australian and New Zealand J. of Criminology     Hybrid Journal   (Followers: 547, SJR: 0.612, CiteScore: 1)
Australian J. of Career Development     Hybrid Journal   (Followers: 5)
Australian J. of Education     Hybrid Journal   (Followers: 51, SJR: 0.403, CiteScore: 1)
Australian J. of Management     Hybrid Journal   (Followers: 13, SJR: 0.497, CiteScore: 1)
Autism     Hybrid Journal   (Followers: 358, SJR: 1.739, CiteScore: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 17)
Avian Biology Research     Hybrid Journal   (Followers: 6, SJR: 0.401, CiteScore: 1)
Behavior Modification     Hybrid Journal   (Followers: 14, SJR: 0.877, CiteScore: 2)
Behavioral and Cognitive Neuroscience Reviews     Hybrid Journal   (Followers: 27)
Behavioral Disorders     Hybrid Journal   (Followers: 2)
Beyond Behavior     Hybrid Journal   (Followers: 2)
Bible Translator     Hybrid Journal   (Followers: 13)
Biblical Theology Bulletin     Hybrid Journal   (Followers: 24, SJR: 0.184, CiteScore: 0)
Big Data & Society     Open Access   (Followers: 55)
Biochemistry Insights     Open Access   (Followers: 7)
Bioinformatics and Biology Insights     Open Access   (Followers: 12, SJR: 1.141, CiteScore: 2)
Biological Research for Nursing     Hybrid Journal   (Followers: 7, SJR: 0.685, CiteScore: 2)
Biomarker Insights     Open Access   (Followers: 1, SJR: 0.81, CiteScore: 2)
Biomarkers in Cancer     Open Access   (Followers: 11)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 14)
Biomedical Informatics Insights     Open Access   (Followers: 8)
Bioscope: South Asian Screen Studies     Hybrid Journal   (Followers: 4, SJR: 0.235, CiteScore: 0)
BMS: Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique     Hybrid Journal   (Followers: 4, SJR: 0.226, CiteScore: 0)
Body & Society     Hybrid Journal   (Followers: 29, SJR: 1.531, CiteScore: 3)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Brain and Neuroscience Advances     Open Access  
Brain Science Advances     Open Access  
Breast Cancer : Basic and Clinical Research     Open Access   (Followers: 12, SJR: 0.823, CiteScore: 2)
British J. of Music Therapy     Hybrid Journal   (Followers: 9)
British J. of Occupational Therapy     Hybrid Journal   (Followers: 253, SJR: 0.323, CiteScore: 1)
British J. of Pain     Hybrid Journal   (Followers: 31, SJR: 0.579, CiteScore: 2)
British J. of Politics and Intl. Relations     Hybrid Journal   (Followers: 39, SJR: 0.91, CiteScore: 2)
British J. of Visual Impairment     Hybrid Journal   (Followers: 14, SJR: 0.337, CiteScore: 1)
British J.ism Review     Hybrid Journal   (Followers: 18)
BRQ Business Review Quarterly     Open Access   (Followers: 1)
Building Acoustics     Hybrid Journal   (Followers: 4, SJR: 0.215, CiteScore: 1)
Building Services Engineering Research & Technology     Hybrid Journal   (Followers: 3, SJR: 0.583, CiteScore: 1)
Bulletin of Science, Technology & Society     Hybrid Journal   (Followers: 9)
Business & Society     Hybrid Journal   (Followers: 15)
Business and Professional Communication Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.348, CiteScore: 1)
Business Information Review     Hybrid Journal   (Followers: 17, SJR: 0.279, CiteScore: 0)
Business Perspectives and Research     Hybrid Journal   (Followers: 3)
Cahiers Élisabéthains     Hybrid Journal   (Followers: 1, SJR: 0.111, CiteScore: 0)
Calcutta Statistical Association Bulletin     Hybrid Journal   (Followers: 1)
California Management Review     Hybrid Journal   (Followers: 37, SJR: 2.209, CiteScore: 4)
Canadian Association of Radiologists J.     Full-text available via subscription   (Followers: 2, SJR: 0.463, CiteScore: 1)
Canadian J. of Kidney Health and Disease     Open Access   (Followers: 8, SJR: 1.007, CiteScore: 2)
Canadian J. of Nursing Research (CJNR)     Hybrid Journal   (Followers: 15)
Canadian J. of Occupational Therapy     Hybrid Journal   (Followers: 168, SJR: 0.626, CiteScore: 1)
Canadian J. of Psychiatry     Hybrid Journal   (Followers: 28, SJR: 1.769, CiteScore: 3)
Canadian J. of School Psychology     Hybrid Journal   (Followers: 12, SJR: 0.266, CiteScore: 1)
Canadian Pharmacists J. / Revue des Pharmaciens du Canada     Hybrid Journal   (Followers: 3, SJR: 0.536, CiteScore: 1)
Cancer Control     Open Access   (Followers: 2)
Cancer Growth and Metastasis     Open Access   (Followers: 1)
Cancer Informatics     Open Access   (Followers: 4, SJR: 0.64, CiteScore: 1)
Capital and Class     Hybrid Journal   (Followers: 10, SJR: 0.282, CiteScore: 1)
Cardiac Cath Lab Director     Full-text available via subscription   (Followers: 1)
Cardiovascular and Thoracic Open     Open Access   (Followers: 1)
Career Development and Transition for Exceptional Individuals     Hybrid Journal   (Followers: 10, SJR: 0.44, CiteScore: 1)
Cartilage     Hybrid Journal   (Followers: 6, SJR: 0.889, CiteScore: 3)
Cell Transplantation     Open Access   (Followers: 5, SJR: 1.023, CiteScore: 3)
Cephalalgia     Hybrid Journal   (Followers: 8, SJR: 1.581, CiteScore: 3)
Cephalalgia Reports     Open Access   (Followers: 4)
Child Language Teaching and Therapy     Hybrid Journal   (Followers: 34, SJR: 0.501, CiteScore: 1)
Child Maltreatment     Hybrid Journal   (Followers: 11, SJR: 1.22, CiteScore: 3)
Child Neurology Open     Open Access   (Followers: 6)
Childhood     Hybrid Journal   (Followers: 19, SJR: 0.894, CiteScore: 2)
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
China Information     Hybrid Journal   (Followers: 9, SJR: 0.767, CiteScore: 2)
China Report     Hybrid Journal   (Followers: 11, SJR: 0.221, CiteScore: 0)
Chinese J. of Sociology     Full-text available via subscription   (Followers: 5)
Christian Education J. : Research on Educational Ministry     Hybrid Journal   (Followers: 1)
Chronic Illness     Hybrid Journal   (Followers: 6, SJR: 0.672, CiteScore: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 12, SJR: 0.808, CiteScore: 2)
Chronic Stress     Open Access  
Citizenship, Social and Economics Education     Full-text available via subscription   (Followers: 6, SJR: 0.145, CiteScore: 0)
Cleft Palate-Craniofacial J.     Hybrid Journal   (Followers: 8, SJR: 0.757, CiteScore: 1)
Clin-Alert     Hybrid Journal   (Followers: 1)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32, SJR: 0.49, CiteScore: 1)
Clinical and Translational Neuroscience     Open Access   (Followers: 1)
Clinical Case Studies     Hybrid Journal   (Followers: 3, SJR: 0.364, CiteScore: 1)
Clinical Child Psychology and Psychiatry     Hybrid Journal   (Followers: 45, SJR: 0.73, CiteScore: 2)
Clinical EEG and Neuroscience     Hybrid Journal   (Followers: 8, SJR: 0.552, CiteScore: 2)
Clinical Ethics     Hybrid Journal   (Followers: 13, SJR: 0.296, CiteScore: 1)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3, SJR: 0.537, CiteScore: 2)
Clinical Medicine Insights : Blood Disorders     Open Access   (Followers: 1, SJR: 0.314, CiteScore: 2)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 8, SJR: 0.686, CiteScore: 2)
Clinical Medicine Insights : Case Reports     Open Access   (Followers: 1, SJR: 0.283, CiteScore: 1)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 4, SJR: 0.425, CiteScore: 2)
Clinical Medicine Insights : Ear, Nose and Throat     Open Access   (Followers: 2)
Clinical Medicine Insights : Endocrinology and Diabetes     Open Access   (Followers: 34, SJR: 0.63, CiteScore: 2)
Clinical Medicine Insights : Oncology     Open Access   (Followers: 3, SJR: 1.129, CiteScore: 3)
Clinical Medicine Insights : Pediatrics     Open Access   (Followers: 3)
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Medicine Insights : Reproductive Health     Open Access   (Followers: 1, SJR: 0.776, CiteScore: 0)
Clinical Medicine Insights : Therapeutics     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Medicine Insights : Women's Health     Open Access   (Followers: 4)
Clinical Nursing Research     Hybrid Journal   (Followers: 34, SJR: 0.471, CiteScore: 1)
Clinical Pathology     Open Access   (Followers: 5)
Clinical Pediatrics     Hybrid Journal   (Followers: 25, SJR: 0.487, CiteScore: 1)
Clinical Psychological Science     Hybrid Journal   (Followers: 16, SJR: 3.281, CiteScore: 5)
Clinical Rehabilitation     Hybrid Journal   (Followers: 78, SJR: 1.322, CiteScore: 3)
Clinical Risk     Hybrid Journal   (Followers: 5, SJR: 0.133, CiteScore: 0)
Clinical Trials     Hybrid Journal   (Followers: 22, SJR: 2.399, CiteScore: 2)
Clothing and Textiles Research J.     Hybrid Journal   (Followers: 28, SJR: 0.36, CiteScore: 1)
Collections : A J. for Museum and Archives Professionals     Full-text available via subscription   (Followers: 3)
Common Law World Review     Full-text available via subscription   (Followers: 17)
Communication & Sport     Hybrid Journal   (Followers: 8, SJR: 0.385, CiteScore: 1)
Communication and the Public     Hybrid Journal   (Followers: 2)
Communication Disorders Quarterly     Hybrid Journal   (Followers: 15, SJR: 0.458, CiteScore: 1)
Communication Research     Hybrid Journal   (Followers: 24, SJR: 2.171, CiteScore: 3)
Community College Review     Hybrid Journal   (Followers: 8, SJR: 1.451, CiteScore: 1)
Comparative Political Studies     Hybrid Journal   (Followers: 293, SJR: 3.772, CiteScore: 3)
Compensation & Benefits Review     Hybrid Journal   (Followers: 8)
Competition & Change     Hybrid Journal   (Followers: 12, SJR: 0.843, CiteScore: 2)

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Similar Journals
Journal Cover
Clinical Medicine Insights : Case Reports
Journal Prestige (SJR): 0.283
Citation Impact (citeScore): 1
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1179-5476
Published by Sage Publications Homepage  [1166 journals]
  • Incidental Delayed Diagnosis of Isolated Diffuse Ganglioneuromatosis
           Caused the Death of a 6-Year-Old Boy: Case Report

    • Authors: Haya Mohammed Kheir, Mouhannad Dayoub, Nour Haidar, Hanin Mansour, Ammar Omran, Ali Ibrahim, Zuheir Alshehabi
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Intestinal diffuse ganglioneuromatosis is a rare, benign, neoplastic condition characterized by disseminated proliferation of neural elements. It has an established association with several systemic disorders including: multiple endocrine neoplasia IIB (MEN IIB) and von Recklinghausen’s disease. However, isolated GNs are very rare and sporadic. We report a case of a 6-year-old patient was referred to the emergency department due to a colon perforation during endoscopy. He then underwent sigmoidectomy and the pathologic studies revealed prominent signs of diffuse ganglioneuromatosis. Unfortunately, the patient died the day after because of the late diagnosis and treatment. Such presentation emphasizes the importance of considering diffuse ganglioneuromatosis, among other causes, in patients with intractable GI symptoms despite medical treatment.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-10-04T01:12:39Z
      DOI: 10.1177/11795476211049864
      Issue No: Vol. 14 (2021)
  • A Case of Cushing’s Disease Presenting with Isolated Suicidal

    • Authors: Sultan Dheafallah Al-Harbi, Abdulrahman Hassan Mashi, Naji Jamal AlJohani
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Cushing’s disease is an abnormal secretion of ACTH from the pituitary that causes an increase in cortisol production from the adrenal glands. Resultant manifestations from this excess in cortisol include multiple metabolic as well as psychiatric disturbances which can lead to significant morbidity and mortality. In this report, 23-year-old woman presented to mental health facility with history of severe depression and suicidal ideations. During evaluation, she found to have Cushing’s disease, which is unusual presentation. She had significant improvement in her symptoms with reduction of antidepressant medications after achieving eucortisolism. Cushing syndrome can present with wide range of neuropsychiatric manifestations including major depression. Although presentation with suicidal depression is unusual. Early diagnosis and prompt management of hypercortisolsim may aid in preventing or lessening of psychiatric symptoms The psychiatric and neurocognitive disorders improve after disease remission (the normalization of cortisol secretion), but some studies showed that these disorders can partially improve, persist, or exacerbate, even long-term after the resolution of hypercortisolism. The variable response of neuropsychiatric disorders after Cushing syndrome remission necessitate long term follow up.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-09-29T07:38:49Z
      DOI: 10.1177/11795476211027668
      Issue No: Vol. 14 (2021)
  • Prominent Hyperproinsulinemia in a Middle Age Patient

    • Authors: Hiroshi Yoshino, Kyoko Kawakami, Kei Yoshino, Gen Yoshino
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:Insulin is synthesized in the β-cells from preproinsulin. Preproinsulin becomes proinsulin after leaving the signal peptide. Proinsulin is separated into C-peptide and insulin by 2 enzymes. Hyperproinsulinemia is suspected to be a pancreatic β-cell defect that is augmented by the increased demand placed on the β-cell by hyperglycemia.Case presentation:A 39-year-old Japanese man visited to Shin-suma hospital in May 2013. Liver dysfunction, dyslipidemia, and hyperuricemia had been found in medical checkups in his workplace. Therefore, he visited Shin-suma hospital in order to receive intensive examination. Diet and exercise therapy were initiated. In November 2013, intact proinsulin and proinsulin per insulin (PI/I) ratio were evaluated as part of an ongoing study. His intact proinsulin level and PI/I ratio were markedly elevated. A 75 g oral OGTT revealed that his glucose tolerance was impaired. His glycosylated hemoglobin was 6.9%. He was diagnosed as having type 2 diabetes mellitus. Although, diet and exercise therapy continued, his hyperproinslinemia and diabetes mellitus remained. Therefore, aloguliptin was started in order to recover insulin secretion in November 2014. Thereafter, pioglitazone was added to improve insulin resistance. Finally, luseogliflozin was commenced to expect glucose-lowering effects. His HbA1c was stabilized. To the best of our knowledge, there have been few reports of patients with hyperproinsulinemia.Conclusion:When the physicians face treatment resistance in diabetes mellitus, we emphasize that evaluation of proinsulin should be considered as one of the methods.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-09-01T11:30:26Z
      DOI: 10.1177/11795476211042241
      Issue No: Vol. 14 (2021)
  • Non-Operative Management of Bronchobiliary Fistula Due to Proximal
           Migration of Biliary Stent in a Patient With Unresectable Klatskin Tumor

    • Authors: Ievgen Tsema, Viktor Slobodianyk, Dmytro Rahushyn, Denys Myrhorodskiy, Oleh Yurkiv, Andrii Dinets
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:One of the methods for the biliary tree decompression in the case of Klatskin tumor is transpapillary stenting, which could be completed by stent migration in 4% to 10% of cases. Approximately half of the stent migrations are in the proximal direction. In this study, we reported a rare case of proximal trans-diaphragmatic stent migration to the lower lobe of the right lung with the formation of a biliary-bronchial fistula (BBF).Case presentation:A 60-year-old woman was diagnosed with hilar cholangiocarcinoma (type 3B by Bismuth-Corlette) complicated by posthepatic jaundice. To relieve jaundice there were performed endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, endobiliary stent placement (10 Fr, 150 mm). A restenting (11.5 Fr, 130 mm) was performed in 2.5 months due to endobiliary tube occlusion. In the next 2 months, coughing attacks and biliptysis have appeared in the patient. A CT scan showed penetration of the liver, diaphragm, and lower lobe of the right lung with the proximal part of the stent and caused BBF formation. Anti-inflammatory and antibacterial therapy was administrated for 14 days and BBF was closed. Stent retrieval from the right hemithorax and endobiliary restenting was performed in 9 months after primary stenting. During follow-up, appropriate positioning and functioning of the stent were observed.Conclusion:BBF formation is a rare complication of endobiliary stenting, which can be successfully treated by anti-inflammatory and antibiotic therapy, followed by transpapillary stent retrieval.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-08-31T10:21:02Z
      DOI: 10.1177/11795476211043067
      Issue No: Vol. 14 (2021)
  • Gangrenous Cholecystitis as a Potential Complication of COVID-19: A Case

    • Authors: Walid Alam, Karam Karam
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      While primarily a respiratory disease, COVID-19 can affect several organ systems and has been recently linked to cases of acalculous cholecystitis. We present a previously healthy elderly patient who presented to the emergency department with sepsis and was found to have COVID-19 after initially testing negative on PCR, along with suspected concomitant acalculous gangrenous cholecystitis. The patient passed away before any surgical intervention could be made. This case aims to discuss the potential relationship between acalculous cholecystitis and COVID-19.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-08-27T12:04:00Z
      DOI: 10.1177/11795476211042459
      Issue No: Vol. 14 (2021)
  • Huge Paratubal Cyst: A Case Report and a Literature Review

    • Authors: Brahmana Askandar Tjokroprawiro
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Paratubal cysts may mimic ovarian cysts, and most of them are diagnosed postoperatively. They originate from the mesosalpinx between the ovary and the fallopian tube. Only a few are large, and most paratubal cysts are less than 10 cm. We report a huge paratubal cyst in a 30-year-old woman, whose only preoperative complaint was abdominal distention over 4 months. Conservative surgery was performed with cyst removal while preserving the ovaries and tubes. A paratubal cyst should be included in the differential diagnosis of a large pelvic masses, especially in the reproductive age.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-08-21T07:26:13Z
      DOI: 10.1177/11795476211037549
      Issue No: Vol. 14 (2021)
  • Surgical Repair of a Transannular Rupture During Transfemoral
           Transcatheter Aortic Valve Replacement

    • Authors: Ryaan EL-Andari, Sabin J Bozso, Jimmy JH Kang, Vinod K Manikala, Michael C Moon, Mohammed Al-Aklabi, Robert C Welsh, Jeevan Nagendran
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Annular rupture is a rare but life-threatening complication of transcatheter aortic valve replacement (TAVR). Mortality rates are high if immediate intervention, most often necessitating surgical repair, is not performed. Herein, we describe an 87-year-old man who, after deployment of TAVR, experienced acute decompensation and required urgent conversion to a midline sternotomy to repair an aortic annular rupture. This case demonstrates an example of a rare but severe complication of TAVR. This report provides an in-depth description of the surgical approach to repair an aortic annular rupture and demonstrates the utility of performing minimally invasive procedures inside a hybrid operating room.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-08-06T10:03:49Z
      DOI: 10.1177/11795476211038126
      Issue No: Vol. 14 (2021)
  • First Reported Case of Anti-Ampa Receptor Encephalitis in a Vietnamese

    • Authors: Nguyen Le Trung Hieu, Nguyen Minh Duc, Thieu-Thi Tra My, Bui Hieu Anh, Mai Tan Lien Bang, Pham Minh Thong
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:Autoimmune encephalitis refers to a group of diseases characterized by the presence of antibodies that directly attack receptors on the neuron surface and are associated with cognitive and behavioral disorders. Alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor autoimmune encephalitis is very rare and has been reported in only a few individual cases, with little clinical experience.Case report:We describe the clinical manifestation and disease course of the first diagnosed case of anti-AMPA receptor encephalitis at the Neurology Department of Children’s Hospital 2 in November 2020. A previously healthy 10-year-old presented with symptoms over 2 periods. During each period, the patient presented with multiple focal seizures, a cognitive-behavioral disorder, and amnesia. The brain magnetic resonance imaging (MRI) results were persistently normal. Electroencephalography (EEG) recorded many focal spikes and spike waves. Antibodies against N-methyl D-aspartate (NMDA) were not detected. Antibodies against AMPA receptors were detected in the serum and cerebrospinal fluid using an indirect fluorescent antibody test. This patient was treated with immunotherapy, including methylprednisolone and intravenous immunoglobulin (IVIG), and antiepileptic drugs, such as oxcarbazepine, topiramate, and levetiracetam. The seizures were controlled, but the cognitive-behavioral disorder was only partially resolved.Conclusion:This case report contributes to the clinical understanding of anti-AMPA receptor encephalitis disease manifestation, the response to the immunotherapy, and relapse.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-08-06T10:00:57Z
      DOI: 10.1177/11795476211037782
      Issue No: Vol. 14 (2021)
  • Successful Treatment of Anti-MDA5 Antibody-Positive
           Dermatomyositis-Associated Rapidly Progressive-Interstitial Lung Disease
           by Plasma Exchange: Two Case Reports

    • Authors: Rina Takahashi, Tadashi Yoshida, Kohkichi Morimoto, Yasushi Kondo, Jun Kikuchi, Shuntaro Saito, Sho Ishigaki, Yuko Kaneko, Tsutomu Takeuchi, Hiroshi Itoh, Mototsugu Oya
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Background:Patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM) are frequently accompanied by rapidly progressive-interstitial lung disease (RP-ILD). They are often refractory to intensive immunosuppressive therapy and have poor prognosis.Case presentation:A 73-year-old woman presented with fever, cold symptoms, and skin eruption for a month. She also exhibited muscle weakness on upper extremities slightly. The titer of anti-MDA5 antibody was extremely high, and computed tomography showed ground glass opacity and reticular shadows in the lungs. She was diagnosed as anti-MDA5 antibody-positive classical DM-associated RP-ILD and treated with intensive immunosuppressive therapy. However, the titer of anti-MDA5 antibody did not decrease satisfactorily, and plasma exchange was alternatively initiated. The titer decreased remarkably, and she obtained disease remission. Similarly, a 63-year-old woman presented with stiffness of the neck and hands, fever and cough. She was also diagnosed as anti-MDA5 antibody-positive classical DM-associated RP-ILD, because she had skin eruptions, slight muscle weakness, an elevation in anti-MDA5 antibody, and RP-ILD. She was unresponsive to intensive immunosuppressive therapy, but plasma exchange successfully improved the titer of anti-MDA5 antibody, the symptoms, and the findings of computed tomography.Conclusions:Although anti-MDA5 antibody-positive DM-associated RP-ILD has a high mortality rate, this report suggests the usefulness of plasma exchange to improve the prognosis.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-07-27T11:47:40Z
      DOI: 10.1177/11795476211036322
      Issue No: Vol. 14 (2021)
  • A Case of Successfully Implanted Dual Chamber Pacemaker in a Young Patient
           with Dextrocardia and Sick Sinus Syndrome

    • Authors: Aurora Bakalli, Imri Jashari, Xhevdet Krasniqi, Lidvana Spahiu
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Dextrocardia is a rare congenital anomaly, whereas its association with sick sinus syndrome in young adults without accompanying heart abnormalities is exceptional. We report a case of a 38 year old female patient who was admitted to our hospital due to syncope as a consequence of sinus pauses up to 4.9 seconds. She was also diagnosed with situs inversus totalis, with mirror image dextrocardia. Pacemaker implantation was indicated. Under local anesthesia, from the left subclavian vein, the guide wire was passed through superior vena cava to the right atrium and ventricle without any obstacles. In conclusion, situs inversus totalis with mirror image dextrocardia may present in combination with sick sinus syndrome as early as the fourth decade of life. Implantation of pacemaker leads from the left subclavian vein appears accessible and safe in patients with dextrocardia with situs inversus (mirror image).
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-07-02T01:34:59Z
      DOI: 10.1177/11795476211017733
      Issue No: Vol. 14 (2021)
  • Intentional Ingestion of a Metallic Wire Causing Perforation and
           Retroperitoneal Abscess: A Case Report

    • Authors: Mehdi Tavallaei, Mahsa Bahadorinia, Arsh Haj Mohamad Ebrahim Ketabforoush
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Foreign body ingestion is a frequent condition, with the majority of foreign bodies (FBs) tending to spontaneously proceed along the gastrointestinal tract without any major complications. A wide range of procedures are available to remove FBs; however, a real challenge exists in managing sharp, rigid, and long foreign objects, which are related to higher rates of complications. A 34-year-old man who intentionally swallowed a metallic wire of 20 cm length, presented to our ED with abdominal pain 2 weeks after the ingestion. The FB had migrated to the stomach and duodenum. Complications included perforation of the duodenum and ascending colon and a retroperitoneal abscess. FB removal was done via laparotomy, followed by the repair of perforations and damaged tissues. This case highlights the complications of a FB presence in the gastrointestinal tract for 14 days and emphasizes the importance of urgent and appropriate management of such conditions.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-06-30T12:37:35Z
      DOI: 10.1177/11795476211025919
      Issue No: Vol. 14 (2021)
  • Successful Outcomes of Critically Ill Patients with Extreme Metabolic
           Acidosis Treated with Structured Approach: Case Series

    • Authors: Sasa Dragic, Danica Momcicevic, Biljana Zlojutro, Milka Jandric, Tijana Kovacevic, Vlado Djajic, Ognjen Gajic, Pedja Kovacevic
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:Hydrogen ion concentration which is expressed as pH value is in human blood maintained in narrow physiological range (7.36-7.44 in arterial blood). This range is crucial for normal functioning of most biochemical reactions. Extreme acidosis with pH 
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-06-27T07:12:37Z
      DOI: 10.1177/11795476211025138
      Issue No: Vol. 14 (2021)
  • Caesarean Scar Endometriosis May Require Abdominoplasty

    • Authors: Barczyński Bartłomiej, Sobstyl Małgorzata, Frąszczak Karolina, Sobstyl Anna
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Endometriosis is defined as an ectopic presence of endometrium-like tissue outside uterine cavity, which most commonly involves intraperitoneal organs. However, one of the less frequent forms of the disease is abdominal wall endometriosis usually developing in surgical scars following obstetric and gynaecological surgeries involving uterine cavity entering, that is, caesarean section, myomectomy or hysterectomy. In this case report we present a case of a patient with extensive caesarean scar endometriosis, who required complex surgical management. Successful surgical treatment involved not only radical tumour resection and application of mesh in postoperative hernia prevention but also adequate wound closure ensuring satisfactory cosmetic results, which was most challenging. The abdominal wall defect could not be sutured by traditional technique, thus polypropylene mesh was used and partial abdominoplasty was performed. The wound healed without complication and 24-month follow-up showed no evidence of local recurrence and satisfactory cosmetic result. In case of extensive endometrial abdominal wall tumours surgical treatment may involve application of advanced plastic surgery techniques, like abdominoplasty or skin/musculocutaneous flaps transposition.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-06-25T10:25:07Z
      DOI: 10.1177/11795476211027666
      Issue No: Vol. 14 (2021)
  • Urinary Retention as the Presenting Clinical Manifestation of Unstable
           Thoracic Spinal Fracture with Diffuse Idiopathic Skeletal Hyperostosis

    • Authors: Hisashi Hamaguchi, Tetsuya Yumoto, Soichiro Mae, Ayumu Takeshita, Minae Aoyama, Keiya Yamana, Atsunori Nakao
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Patients with diffuse idiopathic skeletal hyperostosis (DISH) are at high risk for unstable vertebral fracture, which can be frequently missed. An 80-year-old man with pre-existing muscle lower limb weakness due to frailty was referred from another hospital, presenting with progressive urinary retention and its related symptoms, which had been treated as a urinary tract infection at previous hospital. One week prior to our visit, he had fallen. On arrival, he appeared lethargic and unable to follow commands. He denied any back pain. Computed tomography identified a T10 fracture and dislocation associated with DISH. Although immediate surgical fixation was performed, the patient did not recover from the neurological deficits. Diagnostic delay of DISH-associated vertebral fracture can occur due to both patients’ and clinicians’ delayed action. We believe this case report can help clinicians recognize this potentially devastating condition.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-06-23T11:22:45Z
      DOI: 10.1177/11795476211027988
      Issue No: Vol. 14 (2021)
  • Global Hypertrophic Calcification of Shoulder Joint Capsule

    • Authors: Abdulkarim Yousef Aldehaim, Abdurhman Saud Alarfaj
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Background:Calcification around the shoulder joint usually occur inside or around the tendons of the rotator cuff. We herein report on a case of global hypertrophic calcification of shoulder joint capsule in a patient with Rheumatoid arthritis.Case Report:An 86 years-old male with a long-standing history of seropositive Rheumatoid arthritis. The treatment for his Rheumatoid arthritis included Methotrexate and Hydroxychloroquine initially, but due lack of control, adalimumab was added with excellent control of his arthritis. He has progressively experienced an increasing pain and stiffness in his shoulders, in addition to an increasing limitation of shoulder movement. Magnetic Resonance Imaging revealed severe arthritis with remoulding deformity with extensive capsular calcification, intra-articular loose-bodies.Discussion:This phenomenon of calcification of shoulder capsule has not been reported before. The pathophysiology of calcific tendinopathy of the shoulder remains controversial. The calcific deposits consist of poorly-crystallized hydroxyapatite.Conclusion:Global hypertrophic calcification of shoulder joint capsule is unique and unreported in the literature. We can postulate that the long-standing inflammation of the synovial lining of the capsules had a major part. Moreover, Diabetes Mellitus, smoking, and repetitive manoeuvres are recognized contributing factors as well for similar conditions. Genetic predisposition seems to play a role as well. We think all those have played part in the development of this unprecedented presentation. Management should be tailored to target specific symptoms for pain, rigidity, and decreasing calcification size. Several options are available, including Kinesiotherapy, electrotherapy modalities, iontophoresis, electroshock wave therapy, and finally surgical approaches for progressive and refractory cases.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-06-12T08:23:28Z
      DOI: 10.1177/11795476211025351
      Issue No: Vol. 14 (2021)
  • Imaging Findings of Lipomatous Hypertrophy of the Interventricular Septum:
           A Case Report

    • Authors: Selvakumar Subbaraman, Seena Cheppala Rajan, Saveetha Veeraiyan, Paarthipan Natarajan
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Primary cardiac tumors are rare. We report a case of lipomatous hypertrophy of the interventricular septum in a healthy, asymptomatic, 16 year old female, diagnosed initially by echocardiogram. Non contrast Computed tomography (CT) and Cardiac magnetic resonance imaging (CMR) were also performed to confirm the diagnosis of this rarely reported condition. Lipomatous hypertrophy of the interventricular septum is a rare form of benign cardiac tumor characterized by the proliferation of adipose tissue (fat) in the interventricular septum. This clinical entity has to be differentiated from cardiac lipoma which is a benign, encapsulated tumor. CMR helps is differentiating between the 2 conditions. As the lesion was neither causing compression of the ventricle nor obstruction to blood flow, she was managed conservatively and advised follow up.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-06-12T08:22:54Z
      DOI: 10.1177/11795476211024848
      Issue No: Vol. 14 (2021)
  • COVID-19 and Male Sexual Functioning: A report of 3 Recovered Cases and
           Literature Review

    • Authors: Nader Salama, Saeed Blgozah
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      COVID-19 is a new global pandemic. It can affect multiple body systems and functions. However, the relationship between COVID-19 and male sexual activity did not yet get much consideration. Herein, we report the impact of COVID-19 on sexual function in 3 men who recovered from the disease. Compared with their condition before catching the infection, the men showed, in different degrees, a decline in all aspects of sexual function as assessed by the international index of erectile function. They started to develop premature ejaculation or exacerbate an already existing condition according to the premature ejaculation diagnostic tool scoring. Beck’s depression inventory revealed deterioration of the men’s moods up to severe depression. The sex-related hormones (testosterone-total and free, luteinizing hormone, follicle-stimulating hormone, prolactin, and estradiol) of these men were within normal levels. To the best of our knowledge, this is the first case report documenting deleterious changes in mood and several aspects of sexual functioning in males after recovery from the COVID-19 using validated measurement tools. Follow-up and psychological support of the recovered men may help mend their moods and consequently upgrade their sexual functioning.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-05-28T09:24:10Z
      DOI: 10.1177/11795476211020593
      Issue No: Vol. 14 (2021)
  • Laryngotracheal Complications in Intubated COVID-19 Patients

    • Authors: Kishore Sandu
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      During the current COVID-19 pandemic, several emerging cases of laryngotracheal stenosis following prolonged intubation and tracheostomy are being reported. The patients’ pre-existing comorbidities, the disease itself and the pronation maneuvers increase the risk for endolaryngeal and tracheal damage. In this commentary, we report 4 such patients with acquired severe laryngotracheal stenosis. We describe their airway lesions, the surgical treatment they received, and the outcomes.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-05-28T09:17:54Z
      DOI: 10.1177/11795476211020590
      Issue No: Vol. 14 (2021)
  • Seronegative Arthritis as a Complication of Whipple’s Disease

    • Authors: Rebecca DeBoer, Sahani Jayatilaka, Anthony Donato
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Whipple’s disease (WD) is an uncommon cause of seronegative arthritis. WD is known for its gastrointestinal symptoms of diarrhea, weight loss, and abdominal pain. However, arthritis may precede gastrointestinal symptoms by 6 to 7 years. We describe a case of an 85-year-old Caucasian male with multiple joint complaints, not responsive to traditional treatments for conditions such as rheumatoid arthritis and osteoarthritis. We suggest that WD be considered for seronegative arthritis especially affecting large joints.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-05-18T06:01:53Z
      DOI: 10.1177/11795476211017717
      Issue No: Vol. 14 (2021)
  • Isolated Congenital Mastoid Cholesteatoma with no Involvement of Aditus Ad
           Antrum and Middle Ear

    • Authors: Pace Annalisa, Iannella Giannicola, Rossetti Valeria, Messineo Daniela, Visconti Irene Claudia, Polimeni Roberta, Milani Alessandro, Magliulo Giuseppe
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Cholesteatoma is a non-neoplastic, keratinized squamous epithelial lesion that affects the temporal bone. The middle ear is the most frequent, while the isolated cholesteatoma of the mastoid is rare. The aim of this study was to describe a rare case of isolated mastoid cholesteatoma with no involvement of aditus ad antrum and middle ear including a literature review of the topic. This case report describes the case of a 58 years old female with a cholesteatoma isolated in the mastoid region, evidenced by imaging (computer tomography and magnetic resonance). A mastoidectomy was performed: mastoid process was completely involved, but antrum was not reached. Moreover, it reached the soft tissue of stylomastoid foramen as well as the posterior belly of the digastric muscle. In the literature few articles described cases of cholesteatoma isolated in the mastoid region. Research was conducted using PubMed and reference list and there were considered only reports about cholesteatoma exclusively located in the mastoid process without involvement of antrum or middle ear. Fourteen articles were included in this review, with a total number of 23 cases of cholesteatoma isolated in the mastoid region. All papers analyzed reported the cases of isolated mastoid cholesteatoma that presented a congenital origin. Its diagnosis is difficult, therefore, imaging evaluation is mandatory and surgery is the treatment of choice. Mastoid cholesteatomas without involvement of aditus ad antrum and middle ear are rare and only 23 cases are reported in literature. Our case is in line with all clinical and diagnostic features of this rare disease, but it is the only one that evidenced an exposure of the soft tissue of stylomastoid foramen as well as the posterior belly of the digastric muscle. The treatment of choice was the surgical one, avoiding damaging of important anatomo-functional structure.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-05-11T04:47:57Z
      DOI: 10.1177/11795476211014032
      Issue No: Vol. 14 (2021)
  • Pelvic and Lumbar Pain Revealing Bone Sarcoidosis: A Case Report

    • Authors: Yahya Charifi, Younes Dkhissi, Meryem Haloua, Youssef Alaoui Lamrani, Ghizlane Berrady, Meryem Boubbou, Afaf Amarti, Mustapha Maaroufi, Badreeddine Alami
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      A 54-years-old woman suffered from a bilateral pelvic and lumbar pain. She had a systemic investigation shows a diffuse bone lesions. A biopsy of iliac bone was done and revealed sarcoidosis. Bony manifestations of sarcoidosis are rare and challenging to diagnose. Our report shows that MRI with diffusion weighted sequences is a simple and non invasive technique to evaluate bone infiltration. It helps to distinguish inflammatory disease from metastatic lesions and to guide the osseous biopsy. Moreover, fluorodeoxyglucose PET scan, are useful in establishing the extent of damage and measuring disease activity.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-05-04T05:21:59Z
      DOI: 10.1177/11795476211014788
      Issue No: Vol. 14 (2021)
  • Aggressive Behavior of Warty Squamous Cell Carcinoma of the Vagina
           Associated with Uterine Prolapsed: Unusual Report

    • Authors: Bouhani Malek, Zemni Ines, Sakhri Saida, Sahroui Ghada, Slimene Maher, Rahal Khaled
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Warty squamous cell carcinoma (WSCC), is a rare variant of squamous cell carcinoma that occurs mostly in younger women, but can occur in old women. It is due to human papillomavirus (HPV) infection. This rare entity has been described in several organs such as vulva, cervix, and penis. To the best of our knowledge WSCC of vagina associated with the third-degree of uterine prolapse has never been reported in the literature. We present an exceptional case of WSCC of vagina occurred in a 77-year-old woman with long disease duration. The physical exam found a large ulcer-budding lesion of the middle and lower third of the vagina that depends on the left vaginal wall. The full work-up concluded to stage IVA of FIGO classification, due to the bladder involvement. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic node dissection, left partial cystectomy with left ureteral reimplantation and total vaginectomy, followed by adjuvant radiotherapy. The patient had no recurrence during 8 years of regular follow-up. WSCC can express locally aggressive behavior, such we reported; despite it appears to be less aggressive than the typical well-differentiated squamous cell carcinoma. That leads to individualize WSCC from other verruciform neoplasms.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-04-28T10:59:57Z
      DOI: 10.1177/11795476211011206
      Issue No: Vol. 14 (2021)
  • Clinical Case of Surreptitious Hypoglycemia Due to Deliberate Insulin
           Analog Administration

    • Authors: Marina Yukina, Nurana Nuralieva, Ekaterina Troshina, Natalya Malysheva, Zamira Zuraeva, Alina Bratchikova
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Hypoglycemic syndrome is a life-threatening condition that can lead to hypoglycemic coma and death. Surreptitious hypoglycemic syndrome is the deliberate use of insulin preparations or oral hypoglycemic drugs aimed to reduce blood glucose level. If human insulin is injected, high level of immunoreactive insulin (IRI) and low level of C-peptide at the moment of hypoglycemia are always detected. However, the fact of deliberate administration of insulin analogs is difficult to prove. In these cases if insulin kit test with low cross-reactivity with insulin analogs is used, the low levels of IRI and C-peptide will be suspected. Some experts suggest the presence of cross reactivity with analogs of insulin in a number of commercial kits, which makes it possible to detect cases of surreptitious hypoglycemia. We present a clinical case of a patient with surreptitious hypoglycemia due to the administration of insulin analogs and discuss the problems of its laboratory diagnosis.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-04-21T07:13:21Z
      DOI: 10.1177/11795476211009234
      Issue No: Vol. 14 (2021)
  • Aseptic Meningitis after Recovery from SARS-CoV-2 in an Allogeneic Stem
           Cell Transplant Recipient

    • Authors: Fahmin Basher, Jose F Camargo, Meilin Diaz-Paez, Lazaros J Lekakis, Denise L Pereira
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      SARS-CoV-2 emerged as a worldwide pandemic in late 2019 and initially was described as a primary respiratory illness. The clinical manifestations of COVID-19 are now known to encompass nearly all organ systems, including the central nervous system. We present a case of an allogeneic hematopoietic stem cell transplant recipient who recovered from documented SARS-CoV-2 infection and later presented with symptoms of meningitis. While cerebrospinal fluid analysis did not reveal any bacterial or viral etiologies, evidence of an inflammatory state, including ophthalmologic findings of episcleritis, indicate what is likely the first reported case of aseptic meningitis associated with SARS-CoV-2 infection after initial clinical recovery.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-04-19T09:05:53Z
      DOI: 10.1177/11795476211009811
      Issue No: Vol. 14 (2021)
  • A Case of SARS-CoV-2 Clinical Relapse after 4 Negative RT-PCR Tests in
           Greece: Recurrence or Reinfection'

    • Authors: Fotis Konstantinou, Ioanna Skrapari, Eleni Bareta, Nikolaos Bakogiannis, Anna-Maria Papadopoulou, Chris Bakoyiannis
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      SARS-CoV-2 pandemic is the greatest public health concern of the year 2020. There are several worldwide reports of patients who have managed to recover from SARS-CoV-2 infection with negative PCR test results, that for unknown reasons convert back to positive PCR. We report a case of a patient in our hospital who developed positive PCR test results for SARS-CoV-2, after 4 consecutive results that were negative, along with a full-blown clinical syndrome of SARS-CoV-2 infection.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-04-13T06:16:55Z
      DOI: 10.1177/11795476211009813
      Issue No: Vol. 14 (2021)
  • Definitive Radiotherapy for Penoscrotal Extramammary Paget’s Disease: A
           Case Report with Long-Term Follow-Up

    • Authors: Gen Suzuki, Kazutaka Machida, Akito Asato, Sho Seri, Chika Ikemoto, Hideya Yamazaki, Kei Yamada, Tetsuya Katsumori
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Penoscrotal extramammary Paget’s disease (EMPD) is a rare intraepithelial adenocarcinoma in older male patients, and no effective nonsurgical treatment strategies are currently available. The aim of this study was to report the usefulness of external radiotherapy (RT) for penoscrotal EMPD in an inoperable elderly patient. This report presents the treatment of an 89-year-old man with widespread penoscrotal EMPD. A multidisciplinary treatment team decided on radical RT. The patient received a radiation dose of 61.8 Gy in 30 fractions through electron and photon beams. His treatment tolerance was good, and no severe toxicity had been observed up the last follow-up. At 6.5 years after the RT, the patient showed no evidence of recurrence. Definitive RT resulted in excellent disease control and minimal toxicity; thus, it could be a promising nonsurgical therapeutic option for penoscrotal EMPD, even in extremely elderly individuals.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-04-10T11:17:22Z
      DOI: 10.1177/11795476211009251
      Issue No: Vol. 14 (2021)
  • Three Cases of Aphasic Status Epilepticus: Clinical and Electrographic

    • Authors: Jung-Ju Lee, Jong-Moo Park, Kyusik Kang, Ohyun Kwon, Woong-Woo Lee, Byung-Kun Kim
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Aphasic status epilepticus (ASE) is unusual and has clinical characteristics similar to those of other disorders. Herein, we report 3 cases of ASE. A left-handed man (patient 1) showed continuous aphasia after the administration of flumazenil. He had underlying alcoholic liver cirrhosis and traumatic brain lesions in the right hemisphere. Electroencephalography (EEG) revealed periodic epileptiform discharges in the right frontotemporal area, which were intervened by rhythmic activity with spatiotemporal evolutions. A right-handed woman (patient 2) showed recurrent aphasia. Blood tests revealed a high blood glucose level (546 mg/dL) and high serum osmolality (309 mMol/L). Her EEG showed rhythmic activity in the left frontotemporal area with spatiotemporal evolutions on a normal background rhythm. She became seizure-free after the administration of an antiepileptic drug and strict glucose regulation. A right-handed woman (patient 3) developed subacute aphasia a week before hospital admission. She had a gradual decline of cognition 1 year before. Her EEG showed intermittent quasi-rhythmic fast activity in the frontotemporal area bilaterally, with fluctuating frequency and amplitude. The patient became seizure-free after the administration of an antiepileptic drug. Brain single-photon emission tomography performed after seizure control showed decreased perfusion in the left frontotemporal area. After discharge, her cognitive function gradually declined to a severe state of dementia. ASE can be caused by diverse etiologies; it is usually caused by cerebral lesions and less frequently by non-lesional etiologies or degenerative disorders. Adequate treatment of underlying disorders and seizures is critical for curing the symptoms of ASE.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-04-10T11:15:22Z
      DOI: 10.1177/11795476211009241
      Issue No: Vol. 14 (2021)
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis and
           Malignancy: A Case of a Patient Diagnosed with Renal Failure and Pulmonary
           Carcinoma Concurrently

    • Authors: Maki Asakura, Tetsu Akimoto, Ken Ohara, Takahiro Masuda, Yuko Ono, Osamu Saito, Daisuke Nagata
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      A 70-year-old man presented with proteinuria, microscopic hematuria, and an increased level of serum creatinine. A systemic workup revealed that the patient had bronchogenic carcinoma and anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis concurrently. Despite the increase in the cumulative number of publications on paraneoplastic glomerulopathies, an awareness of the link between cancer and ANCA-associated glomerulonephritis is lacking. We strongly recommend the accumulation of more cases similar to our own, thereby allowing us to clarify the management strategies as well as the nature of this disease condition more precisely.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-03-29T06:36:29Z
      DOI: 10.1177/11795476211004604
      Issue No: Vol. 14 (2021)
  • Diffuse Alveolar Hemorrhage after Receiving Oral Levonorgerstrel for
           Emergency Contraception: A Case Report

    • Authors: Athina Georgopoulou, Efthymia Papadopoulou, Marianna Moyseos, Sofia-Chrysovalantou Zagalioti, Christos Hatzis, Dimitrios Karanasios, Stavros Tryfon
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:Drug-induced diffuse alveolar hemorrhage (DAH) has been associated with the administration of various medications, among which levonorgestrel (LN) has not been reported until now.Case Presentation:This case study describes a 42-year-old woman who presented with hemoptysis, hypoxemia, and radiological depiction of ground glass opacities, 3 days after she had received emergency contraceptive medication containing levonorgestrel. Emergent bronchoscopy was performed, and BAL was diagnostic of diffuse alveolar hemorrhage (DAH). A thorough diagnostic approach was followed, in order to detect the underlying pathological condition that induced DAH. The absence of other identifiable pathological conditions in this patient raised suspicion of LN’s potential causative role.Conclusion:DAH has not been reported as an adverse effect of LN until now. However, LN has been found to exert immunomodulatory effects and to present potential for manifestations of vasculitis as well as severe hypersensitivity reactions. These mechanisms may have been implicated in the development of DAH in our patient, who presented no other pathological conditions.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-03-27T12:07:44Z
      DOI: 10.1177/11795476211005821
      Issue No: Vol. 14 (2021)
  • Corrigendum to “Diagnosis of Adult Onset Still’s Disease in a Patient
           Who has recovered from Coronavirus-19”

    • Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.

      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-03-19T06:10:15Z
      DOI: 10.1177/11795476211007045
      Issue No: Vol. 14 (2021)
  • A 9-Month-Old with Skeletal Abnormalities and a Consanguineous Sibling
           with Mucopolysaccharidosis IVA: The Role of Urinary Glycosaminoglycan
           Testing in Disease Diagnosis and Treatment Monitoring

    • Authors: Eric Goldman, Angela Vu, Kelly Dietz, Stefani N Thomas
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Mucopolysaccharidosis IVA (MPS IVA) is a rare autosomal recessive lysosomal storage disorder resulting from N-acetylgalactosamine-6-sulfatase (GALNS) deficiency that occurs in approximately 1 in 76 000 to 1 in 640 000 live births. Given that the diagnosis of MPS IVA relies heavily on the results of initial urine glycosaminoglycan (GAG) screening, cases that present with falsely normal urine GAG concentrations can delay the diagnosis and follow-up care for patients. This case study follows a patient diagnosed with MPS IVA at 9 months of age based on relation to a consanguineous 3-year-old sibling with MPS IVA and the use of direct enzyme activity analysis. Details regarding skeletal presentation and identification of genetic variants are presented along with data on follow-up urinary GAG monitoring during treatment with enzyme replacement therapy and treatment for a growth hormone disorder.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-03-06T08:42:08Z
      DOI: 10.1177/1179547621999409
      Issue No: Vol. 14 (2021)
  • Diagnosis of Adult Onset Still’s Disease in a Patient Who has
           recovered from Coronavirus-19

    • Authors: Abdullah Alshablan, Reem Jabbad, Sarah Tayeb, Tariq Albeshri, Suvarna Raju Yelamanchili, Nada Rabie, Fahdah Almutairi, Mohammed Samannodi
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:Adult Still’s disease (ASD) is an uncommon inflammatory disorder characterized by fevers, a salmon-colored rash, and arthritis. Cytokines storm syndrome related to Coronavirus-19 (COVID-19) usually occur in acute period of COVID-19 and can mimic clinical features of ASD.Case report:We present a case of a 27-year-old male who was hospitalized in July 2020 due to fever, sore throat, multiple joint pain, and body rash for 2 weeks. Patient recovered from COVID-19 8 weeks ago but his nasopharyngeal SARS CoV-2 PCR was still positive on current hospitalization. Post COVID-19 cytokines storm syndrome post COVID-19 was suspected but after further assessment and investigations, diagnosis of ASD was established and patient was treated with corticosteroids therapy and had favorable outcome.Conclusion:During COVID-19 pandemic, diagnosis of many other diseases either were delayed or missed. We encourage all clinicians to have a broader differential diagnosis to improve patient care and outcome.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-02-20T07:18:59Z
      DOI: 10.1177/1179547621996306
      Issue No: Vol. 14 (2021)
  • Virtual Reality Augmented Feedback Rehabilitation Associated to Action
           Observation Therapy in Buccofacial Apraxia: Case Report

    • Authors: Daniele Emedoli, Maddalena Arosio, Andrea Tettamanti, Sandro Iannaccone
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Background:Buccofacial Apraxia is defined as the inability to perform voluntary movements of the larynx, pharynx, mandible, tongue, lips and cheeks, while automatic or reflexive control of these structures is preserved. Buccofacial Apraxia frequently co-occurs with aphasia and apraxia of speech and it has been reported as almost exclusively resulting from a lesion of the left hemisphere. Recent studies have demonstrated the benefit of treating apraxia using motor training principles such as Augmented Feedback or Action Observation Therapy. In light of this, the study describes the treatment based on immersive Action Observation Therapy and Virtual Reality Augmented Feedback in a case of Buccofacial Apraxia.Participant and Methods:The participant is a right-handed 58-years-old male. He underwent a neurosurgery intervention of craniotomy and exeresis of infra axial expansive lesion in the frontoparietal convexity compatible with an atypical meningioma. Buccofacial Apraxia was diagnosed by a neurologist and evaluated by the Upper and Lower Face Apraxia Test. Buccofacial Apraxia was quantified also by a specific camera, with an appropriately developed software, able to detect the range of motion of automatic face movements and the range of the same movements on voluntary requests. In order to improve voluntary movements, the participant completed fifteen 1-hour rehabilitation sessions, composed of a 20-minutes immersive Action Observation Therapy followed by a 40-minutes Virtual Reality Augmented Feedback sessions, 5 days a week, for 3 consecutive weeks.Results:After treatment, participant achieved great improvements in quality and range of facial movements, performing most of the facial expressions (eg, kiss, smile, lateral angle of mouth displacement) without unsolicited movement. Furthermore, the Upper and Lower Face Apraxia Test showed an improvement of 118% for the Upper Face movements and of 200% for the Lower Face movements.Conclusion:Performing voluntary movement in a Virtual Reality environment with Augmented Feedbacks, in addition to Action Observation Therapy, improved performances of facial gestures and consolidate the activations by the central nervous system based on principles of experience-dependent neural plasticity.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-02-15T10:57:18Z
      DOI: 10.1177/1179547621994579
      Issue No: Vol. 14 (2021)
  • Challenges in the Management of Thyrotoxicosis Associated with Atrial
           Fibrillation and Heart Failure: Two Case Reports

    • Authors: Abid M Sadiq, Nyasatu G Chamba
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Background:Thyrotoxicosis is a clinical syndrome with high amounts of free thyroid hormone levels causing elevated thyroid hormone function in body tissues. Prolonged effects of free thyroid hormones may lead to cardiac complications such as atrial fibrillation (AF) and heart failure (HF).Case 1:A 31-year-old female, was admitted due to difficulty in breathing, generalised body swelling and jaundice. She was dyspnoeic with an irregular heart rate, and presented with abnormal vitals, liver and thyroid function tests which were diagnostic for thyroid storm. She was managed over 32 days in-hospital stay with carbimazole, propranolol, hydrocortisone, digoxin and furosemide. Unfortunately, she was readmitted 6 months later with worsened HF symptoms and passed away.Case 2:A 57-year-old female, was admitted due to difficulty in breathing, bilateral lower limb swelling and jaundice. She was tachypnoeic with an irregular heart rate, and presented with abnormal liver enzymes and thyroid function tests which were diagnostic for thyrotoxicosis. She was managed with carbimazole, propranolol, digoxin and furosemide, and was discharged on the 6th hospital day.Conclusion:Prolonged untreated thyrotoxicosis increases the risk of AF and HF. Early and monitored treatment and follow-up of hyperthyroidism is key to the management of AF and HF in achieving a better outcome.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-02-15T10:56:58Z
      DOI: 10.1177/1179547621994573
      Issue No: Vol. 14 (2021)
  • Appearance of Acute Inflammatory State Indicates Improvement in Atopic
           Dermatitis Cases Under Classical Homeopathic Treatment: A Case Series

    • Authors: Seema Mahesh, Mahesh Mallappa, Olga Habchi, Vasiliki Konstanta, Cristina Chise, Panagiota Sykiotou, George Vithoulkas
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      The Continuum theory and the Levels of Health theory propound the idea that return of efficient acute inflammation (high fever) heralds true improvement in chronic inflammatory states. We present 6 cases of atopic dermatitis (AD), which had stability in their improvement for 1 year or more, under classical homeopathy. The cases were retrospectively assessed with selected based on the Hanifin Rajka atopic dermatitis diagnostic criteria and the follow ups evaluated according to changes on SCORing Atopic Dermatitis scale (SCORAD) scale. The pictures are presented as evidence. Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homeopathic intervention was used to assess the effect of homeopathy in these cases. All the cases improved and stabilised with complete skin clearance (those that relapsed within 1 year were not included). These patients had not suffered high fevers/acute inflammatory diseases since onset/aggravation of AD. Five of the 6 cases developed acute inflammatory diseases as the chronic condition improved. The last case showed return of an old, lesser pathology. The control cases – which were selected for non-improvement under classical homeopathy also showed remarkable skin clearance when there was appearance of acute inflammatory states. In this study, there is a mutually exclusive relationship between efficient acute inflammation and chronic inflammation, which is in accordance with the 2 theories considered here. Further scientific studies are necessary to establish the phenomenon at tissue level.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-02-11T10:21:29Z
      DOI: 10.1177/1179547621994103
      Issue No: Vol. 14 (2021)
  • Surgical Repair of Internal Carotid Artery Aneurysm: Case Report

    • Authors: Nazım Kankılıç, Mehmet Salih Aydın, Mustafa Göz
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Extracranial carotid artery aneurysms are extremely rare aneurysms. Treatment options are conventional open surgery, endovascular surgery, and conservative treatment. Surgical treatment of such aneurysms is challenging and it is important to determine the treatment strategies wisely. There is still no definite association for treatment modalities. In this case report, we present open surgical treatment of a 58-year-old female patient with internal carotid artery aneurysm. The patient was admitted to our clinic with spontaneous pulsatile mass in the right jugular region. Computed tomography angiography shown right internal carotid artery aneurysm. Aneurysm cranial distance was enough to perform end to end anastomosis. Aneurysm was excised by preserving cranial nerves. No complications developed during the postoperative period.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-02-05T06:20:15Z
      DOI: 10.1177/1179547621991893
      Issue No: Vol. 14 (2021)
  • Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance
           Imaging in a Young Patient

    • Authors: Van Trung Hoang, Cong Thao Trinh, Hoang Anh Thi Van, Thanh Tam Thi Nguyen, Vichit Chansomphou, Ngoc Trinh Thi Pham, Minh Tri Thi Vo, Hoang Quan Nguyen, Duc Thanh Hoang
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-01-20T07:09:59Z
      DOI: 10.1177/1179547621989673
      Issue No: Vol. 14 (2021)
  • Atypical Presentation of Celiac Disease: Recurrent Acute Small Bowel

    • Authors: El Qadiry R, Lalaoui A, Nassih H, Aitsab I, Bourrahouat A
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Context:Intussusception is the most common cause of small bowel obstruction in children under 4 years of age. Intussusception is not a widely recognized complication of celiac disease.Case Report:We present a clinical case of a 23-month-old boy with a 1-month history of watery diarrhea complicated by 2 episodes of intestinal obstruction, both had required surgery. He presented with acute and severe abdominal distention with bilious vomiting, and an appearance of intussusception on abdominal ultrasound. Upon further investigation, the diarrhea was found to be malabsorptive. The diagnosis of celiac disease was confirmed by the presence of specific serum autoantibodies (IgA Tissue transglutaminase and endomysium Antibodies >200 UI/ml with normal serum IgA level). He started a gluten-free diet and his symptoms were almost completely resolved.Conclusion:Recurrent intussusception may be associated with celiac disease, so celiac serology is recommended in children with recurrent intussusceptions. However, intestinal tuberculosis and lymphoma associated with enteropathy should be considered in the differential diagnosis. Intussusception in celiac disease is usually transient and should be managed expectantly rather than early surgical reduction.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-01-13T09:19:52Z
      DOI: 10.1177/1179547620986152
      Issue No: Vol. 14 (2021)
  • Delayed Bladder Perforation Related to Immediate Single Dose Intravesical

    • Authors: Adel Alrabadi, Mohannad Abuhamad, Hammam Mansi, Sohaib Alhamss, Nadwa Bustami, Saddam Al Demour, Mousa A Al-Abbadi
      Abstract: Clinical Medicine Insights: Case Reports, Volume 14, Issue , January-December 2021.
      Introduction:Intravesical chemotherapy instillation immediately after tumor resection is a well-known practice in the management of non-muscle invasive bladder cancer. Despite being largely well tolerated in most cases, it is not devoid of severe and life-threatening complications.Case Presentation:We present an unusual case of bladder perforation that happened 2 weeks after bladder tumor resection. The patient had received single dose intra-vesical instillation of doxorubicin after TUR-BT. Conservative managements failed to achieve bladder healing; as a result, open surgical repair was performed. To the best of our knowledge, this is the first reported case of bladder perforation after intra-vesical doxorubicin instillation.Conclusion:The occurrence of such a rare serious complication in a mostly safe intervention must be taken into consideration. A high index of suspicion, timely management, and proceeding to more invasive surgical treatments when necessary are cornerstones in the management and preserving the bladder.
      Citation: Clinical Medicine Insights: Case Reports
      PubDate: 2021-01-08T06:49:28Z
      DOI: 10.1177/1179547620986158
      Issue No: Vol. 14 (2021)
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