International Journal of Medical and Surgical Sciences

Chronic subdural hematoma

Dra. Blanca Piedra Herrera, Dra. Yanet Acosta Piedra — Sat, 09 Jan 2021 00:00:00 +0000

Chronic subdural hematoma (CSH) is a common neurosurgical pathology that is recognized as a consequence of minor head injuries that are usually diagnosed in senile patients, although it can occur in young patients without a history of trauma.

The objective of this work is the presentation of a patient with a bilateral CSH, with unusual characteristics.

Clinical case: a 46-year-old female patient with no history of head trauma or other concomitant pathology is presented, who consulted for a 15-day-old headache. Physical examination confirmed mydriasis, Hutchinson’s pupil, bilateral papilledema and exophoria of the right eye, third cranial nerve palsy, and trunk ataxia. She was cataloged with Glasgow 13. Early anti-cerebral edema treatment was performed and the manifestations largely disappeared. A computed tomography scan diagnosed a bilateral fronto temporal subdural hematoma with displacement of the midline structures to the left. She underwent emergency surgery and was discharged completely recovered three days later. Conclusion: HSC can present with different clinical forms, simulating expansive tumor processes, cerebrovascular attacks, dementias or neurological entities of another nature. The case management by clinicians and neurosurgeons was quick and effective, which explains that the patient had an early and complete recovery. In these cases, medical action is decisive in the success of the treatment.

Unusual Clinical Manifestation of Epidermoid Cyst Mimicking Basal Cell Carcinoma

Dr. Khairuddin Djawad — Mon, 11 Jan 2021 00:00:00 +0000

Epidermoid cyst is a type of cutaneous cyst commonly found in daily practice. The facial area is the most common area for emergence of this benign condition. Simple extirpation is usually performed to remove epidermoid cysts. However, in rare cases, epidermoid cysts can evolve into malignancies such as basal cell carcinoma (BCC) or can mimic them, which adds difficulty when making a proper diagnosis. In cases of doubt, histopathology plays a key role in aiding diagnosis. This case report is about a 33-year-old woman with suspected nodular lesion that mimicked BCC, but after histopathological analysis was confirmed to be epidermoid cyst.

Morphological and biochemical effects of carnosic acid on human hepatocellular carcinoma HepG2 cells

Mon, 11 Jan 2021 00:00:00 +0000

Antecedentes / objetivo : La muerte celular autofágica y la apoptosis de células tumorales se ha convertido en uno de los principales objetivos en el tratamiento del cáncer, mientras que las líneas celulares tumorales se utilizan principalmente en estudios para proporcionar datos importantes para la evaluación de posibles sustancias anticancerígenas. En este estudio, nuestro objetivo fue evaluar los cambios morfológicos y bioquímicos, incluida la tasa de apoptosis y los niveles de alfa fetoproteína (AFP) a diferentes concentraciones de ácido carnósico (CA) en células de carcinoma hepatocelular humano HepG2.

Materiales y métodos : Carcinoma hepatocelular humano (células HepG2 de séptimo pase) .Las líneas celulares se cultivaron en cubreobjetos de vidrio Schott D263M de 11 µM colocados en placas de 12 pocillos y se trataron con DMSO, concentraciones de CA 1, 2,5, 5 y 10 µM durante 24 horas. 48 y 72 horas. Los datos morfológicos y bioquímicos se registraron diariamente, incluidas las tasas de apoptosis demostradas por Caspasa 3, las expresiones de Anexina V bajo luz invertida y microscopía de inmunofluorescencia, luego se analizaron los datos para determinar la significación estadística. Los niveles de AFP, albúmina y proteínas totales se analizaron espectrofotométricamente para evaluación bioquímica.

Resultados : Nuestros resultados mostraron que CA inhibió significativamente la proliferación de células HepG2 de una manera dependiente de la dosis y el tiempo y causó significativamente la formación de vacuolas autofágicas comenzando desde 5 µM y alcanzando significancia a concentraciones de 10 µM. Se observó una disminución significativa en la AFP cuando se examinaron las expresiones de 48 y 72 horas, alcanzando el nivel más bajo a las 72 horas en el grupo de CA 10 µM. Además, el aumento en los niveles de albúmina alcanzó significación solo en el grupo de 48 h, mientras que también se observaron aumentos no significativos en los grupos de 24 hy 72 h.

Conclusión: Nuestro estudio actual demuestra un aumento significativo en las tasas de apoptosis por el ácido carnósico principalmente a concentraciones de 10 µM, lo que respalda su efecto anticancerígeno en las células HepG2. Estos hallazgos también están respaldados por cambios en los análisis bioquímicos de los niveles de albúmina y AFP a concentraciones de 10 µM.

Evaluation of the prescription of oral hypoglycemic agents in the adult population with type 2 diabetes mellitus

Sat, 09 Jan 2021 00:00:00 +0000

Errors in the prescription of drug treatment for type 2 diabetes are detected at the primary level of care. the purpose of this study was to evaluate the quality of the prescription of oral hypoglycemic agents in patients attended in the family doctor's offices of the Hermanos Cruz University Polyclinic, Pinar del Río distrit, Cuba. A descriptive and cross-sectional study of the use of medications was carried out, classified within these as indication-prescription with elements of the therapeutic scheme and factors that condition prescription habits. The universe was made up of 1575 patients diagnosed with type 2 diabetes mellitus treated with oral hypoglycemic agents who belonged to the 20 family medical offices. The study sample was carried out by the non-probabilistic sampling method (for convenience) (n = 846). The information was obtained from the clinical history and control card of the patients to acquire these medications. The age of 40-49 years, the female sex and between 5-10 years of evolution of the disease predominated. The first line of treatment was not used in 43.6% of the cases; no case had laboratory studies for the use of Metformin. The prescription and dose was adequate, but not its rational use. The most frequent interactions were pharmacokinetic ones.

The rational use of oral hypoglycemic agents was deficient, which makes it necessary to expand the dissemination of a treatment protocol to improve the use of these drugs at the primary level of care.

Order and chronology of temporary teeth breaking

Thu, 21 Jan 2021 00:00:00 +0000

The order and chronology of the temporary tooth eruption is an expression of the child's growth and influences his later dental development. Having knowledge about the average age of emergence of each tooth is useful to establish a diagnosis, prevention and treatment of malocclusions, for which the objective of this research is to characterize the pattern of emergence of primary dentition in children in Cerro district, Havana, Cuba. For this, a descriptive observational study was designed in 370 children of both sexes between 0 and 36 months of age, in said clinic during September / 2017 to January / 2020. The variables were studied: age, sex, tooth, hemiarcade and chronology of the dental outbreak. Frequency distributions were made to all the variables under study and the results are presented in statistical tables. The t-Student test was used to verify significant differences. The main results obtained were that the teeth of the maxillary arch erupted before those of the mandibular, except for the central incisors and the lower left lateral incisor. Although the fact that the dental flare began first in males in both arches (5,86 months in the maxilla, ± 0,92; and in the mandible 4,92 months ± 1,09), the time period of outbreak was somewhat faster in females (19,83 months in the maxilla and 21,64 months in the mandible) and males (20,26 months and 22,16 months), but without significant differences (p <0, 05). It is concluded that the eruption pattern was similar to that described in the literature, except for slight advancement for the central incisors and delay in second primary molars.

Surviving Complications of Retroperitoneal Fibrosis with Intermittent Relapses over a Period of 20 years: Case report and literature Review

Sat, 09 Jan 2021 00:00:00 +0000

Idiopathic retroperitoneal fibrosis is a rare fibro-inflammatory disease of varied etiology which usually originates around aorta and spreads caudally along Iliac vessels into adjacent
retroperitoneum causing ureteral obstruction as the most frequent complication.
A 53-year-old male patient presented with complaint of mild pain in both the legs off and on. On investigating further, we found that he had been struggling with intermittent relapses every 3-4 years for last 20 years since he was first diagnosed with Idiopathic Retroperitoneal Fibrosis. He was
33-year-old when he first developed the symptoms of anuria for 48 hours and was diagnosed with Idiopathic retroperitoneal fibrosis. This was followed by atrophy of left kidney and hypertension 6 years later, then hypothyroidism after another 3years and finally involvement of Inferior Vena
Cava and acute Deep Vein Thrombosis of lower limbs after another 3-4 years. His deep vein thrombosis was well managed in time. He was put on glucocorticoids everytime he had a relapse and a complication.
We did a review of literature to understand recent advances about its pathogenesis, diagnosis, investigations and management. We searched in PubMed using terms like retroperitoneal fibrosis
alone and in combination with related terms such as Inferior Vena Cava thrombosis, Deep Vein Thrombosis, Tamoxifen, Methotrexate. This case is unique as it is very rare to find acute Deep Vein Thrombosis in Idiopathic retroperitoneal fibrosis without development of any collaterals
when Inferior Vena Cava lumen is compromised to almost complete obstruction. After a follow up of 20 years patient is doing well in terms of physical activity and psychological
wellbeing with anti-hypertensives, thyroxine and anti-coagulants. Is the disease-free interval actually free of the disease or it just subsided with immunosuppressants to become active after some time?