International Journal of Medical and Surgical Sciences

Subjective and objective evaluation of nasal obstruction in patients treated at the Hospital de Clínicas, Paraguay

Rodrigo David González Insfrán — 2024-09-27

Nasal obstruction is characterized by insufficient airflow and increased resistance in the nasal cavities, affecting patients’ quality of life and sleep. This study aims to compare the efficacy of medical and surgical treatment in patients with Nasal obstruction, using subjective evaluations (NOSE and VAS scales) and objective evaluations (active anterior rhinomanometry). This is an experimental and prospective longitudinal study conducted at the Hospital de Clínicas, Paraguay. Forty patients with Nasal obstruction were included, divided into medical treatment (nasal corticosteroids) and surgical treatment (turbinoplasty, septoplasty, or both) groups. Pre- and post-treatment evaluations were performed using the NOSE and VAS scales, and active anterior rhinomanometry. The sample included 52.5% men and 47.5% women, with an average age of 32.18±11.59 years. The main cause of Nasal obstruction was chronic rhinitis (62.5%). Treatments showed significant improvements in subjective and objective evaluations. In the medical group, VAS improved by 2.63 points in women and 2.00 in men, while the surgical group showed more pronounced improvements. The NOSE also showed significant reductions, especially in patients undergoing combined turbinoplasty and septoplasty. Active anterior rhinomanometry reflected an increase in overall nasal flow in all treated groups. Both medical and surgical treatments are effective in improving Nasal obstruction, with greater benefits observed in surgical treatments. Subjective and objective evaluations are valuable and complementary tools for assessing treatment in patients with Nasal obstruction. These results highlight the importance of a comprehensive evaluation in the management of Nasal obstruction.

Chronic granulomatous intestinal disease: case report

Jesús Nicolás Larco Coloma — 2024-09-24

Chronic intestinal granulomatous disease is a disorder that directly compromises the entire immune system. The estimated incidence is one in a million inhabitants. Among the associated risk factors, the presence of chronic and recurrent infections stands out. In the present case, it is a 39-year-old female patient with a history of intestinal obstruction and endometriosis, who presents abdominal pain in the left abdomen and recurrent abdominal pain without an identifiable cause. Laboratory tests revealed leukocytosis and mild neutrophilia. The tomography showed intestinal dilation at the jejunoileal level without transition zones, and the serological tests were negative. Exploratory laparoscopy was performed and the presence of tumor implants was found in the omentum, extending to the abdominal, uterine, intestinal, and peritoneal regions, as well as sallow fluid at the abdominal level. Tumor markers are normal. Histopathology details fungal colonization with eosinophilic necrosis and presence of granulomas, negative immunohistochemistry for Aspergillus and negative Lowestein-jensen culture. Antifungal and antituberculous treatment was started, with a decrease in symptoms and improvement in the clinical picture.

Syncope as a clinical presentation of cardiac lymphoma: a case report

Juan Santiago Serna Trejos — 2024-10-11

Primary cardiac lymphoma, an extremely rare type of B-cell non-Hodgkin lymphoma, has an incidence of approximately 0.02-2% among malignant cardiac tumors. It is frequently associated with manifestations such as cardiac rhythm disturbances, refractory pericardial effusion and cardiac masses. Definitive diagnosis is achieved by biopsy, being essential to rule out hematogenous dissemination with PET-CT. The literature indicates a predominance of right chamber involvement and survival that varies significantly according to left ventricular involvement and the presence of arrhythmias. Therapeutic options are not well defined, but chemotherapy such as R-CHOP has shown efficacy, although the prognosis is generally poor due to complications such as disease progression, arrhythmias and sepsis. This case underscores the importance of considering cardiac lymphoma in patients with unexplained cardiac symptoms, highlighting the need for a multidisciplinary and specific diagnostic and therapeutic approach.