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Jun 2022 DOI 10.14302/issn.2641-5518.jcci-22-4171
Purpose Is it safe to excise only the external portion of the pacemaker wires? This presentation aims to find out the proper way to manage pacing wires postoperatively. Methods We report 5-cases of sub-xiphoid abscesses and sinuses after valve surgery. Each case presented with a recurrent abscess that opens and drains its contents through a sinus around the lower-most portion of the xiphoid process. The duration between open heart surgery and evolution of these abscesses varied between 18 and 60 months. Valve surgeries were mitral and/or aortic valve replacement. Surgeons usually insert pacemaker wires to control any persistent post-operative arrhythmias that can affect hemodynamic circulation. On the day of discharge, some surgeons (not in our center) usually excise the pacemaker wires. Results The remaining intra-thoracic portions underwent some degree of corrosion that caused a state of chronic inflammation, sinus track formation and abscess evolution. This indicated radiological examination and surgical exploration to extract these foreign bodies. These 5 cases were diagnosed and operated upon between 15th January 2022 and 1st March2022, all at Abo-Khalifa Emergency Hospital-Ismailia, Egypt. Conclusions This confirms the significance of total withdrawal of the external pacemaker wires. Surgeons should not apply tight sutures at the site of insertion of the wires.
Jul 2024
Vitamin D deficiency is known to affect bone healing 1. In this case report, the potential link between vitamin D, calcium, and phosphorus deficiency and periapical lesions is explored, offering fresh insights into the complex relationship between systemic health and dental pathology. This pathology is caused by a mutation in the PHEX gene on chromosome X, which encodes a protein necessary for vitamin D synthesis and phosphate reabsorption, which are essential for the mineralization of bone and teeth 23. A 25-year-old man with rickets and vitamin D deficiency presented to our clinic with recurrent abscesses in multiple teeth. Radiographic imaging revealed periapical lesions on multiple teeth with advanced endo-perio lesions on teeth 26 and 16, and a negative cold test on all his teeth. Despite successful endodontic treatment, the patient’s compromised metabolic healing raised concerns about the prognosis. This case report highlights the intricate interplay between vitamin and mineral deficiencies and dental health, emphasizing the need for cautious management and long-term follow-up.
Aug 2021 DOI 10.14302/issn.2379-8572.joa-21-3913
This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.
Nov 2020 DOI 10.14302/issn.2328-0182.japst-20-3618
Metronidazole is an antibiotic and useful for the antibacterial and antiprotozoal medication. This study was performed to investigate the impact of the Trivedi Effect®-Biofield Energy Healing Treatment on the structural properties and the isotopic abundance ratio of metronidazole using LC-MS and GC-MS spectroscopy. Metronidazole sample was divided into two parts, one part of metronidazole was considered as control (no Biofield Energy Treatment was provided), while the second part was treated with the Trivedi Effect®-Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Alice Branton and termed as a treated sample. The LC-MS spectra of both the samples of metronidazole at the retention time (Rt) 2.61 minutes exhibited the mass of the protonated molecular ion peak at m/z 172 M+H+ (calculated for C6H10N3O3+, 172.07). The LC-MS based isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 15N/214N or 17O/16O) in the treated metronidazole was significantly increased by 8.24% compared with the control sample. Thus,13C, 2H, 15N,and17O contributions from (C6H10N3O3)+ to m/z 173 in the treated sample were significantly increased compared with the control sample. The GC-MS based isotopic abundance ratio of PM+1/PM in the treated metronidazole was significantly increased by 5.92% compared with the control sample. Hence,13C, 2H, 15N, and217O contributions from (C6H9N3O3)+ to m/z 172 in the Biofield Energy Treated sample were significantly increased compared with the control sample. However, the isotopic abundance ratio of PM+2/PM in the treated metronidazole was significantly decreased by 18.2% compared with the control sample. Hence,18O contributions from (C6H9N3O3)+ to m/z 173 in the treated sample were significantly decreased compared with the control sample. The isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 15N/14N or 17O/16O) and PM+2/PM (18O/16O) in the treated metronidazole was significantly altered compared to the control sample. From the results, it can be hypothesized that the changes in isotopic abundance and mass peak intensities could be due to changes in nuclei possibly through the interference of neutrino particles via the Trivedi Effect® - Consciousness Energy Healing Treatment. The new form of treated metronidazole would be better designing novel pharmaceutical formulations that might offer better therapeutic response against bacterial and protozoal infection in the vagina (bacterial vaginosis), stomach (giardiasis, trichomoniasis, pseudomembranous colitis), joints (pelvic inflammatory disease), liver, skin, brain, and respiratory tract, aspiration pneumonia, rosacea, intra-abdominal infections, lung abscess, fungating wounds, periodontitis, amoebiasis, oral infections, etc.
Dec 2015 DOI 10.14302/issn.2576-182X.jbsc-14-582
Pituitary abscess is extremely rare and often misdiagnosed as pituitary tumor pre-operatively. We document a case of a 64-year-old lady presented to the outpatient department with complaints of headache and blurring vision of right eye for one month. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed Actinomyces infection. This case has been documented due to the extremely rare involvement of the pituitary gland by actinomyces infection. Pituitary abscess is a rare pathology, but it must be considered during evaluating sellar masses, since its prognosis depends on surgical drainage and on the use of specific antibiotics. We report, to our knowledge, the fourth case of Actinomyces israelii infection of the pituitary region.
Feb 2015 DOI 10.14302/issn.2578-2371.jslr-14-539
We present a rare case of a 46-year-old man who presented with recurrent fever and abdominal pain without other symptoms. Laboratory data were no specific for diagnosis. Abdominal imaging revealed a pseudotumor liver. A diagnosis of isolated liver tuberculosis with abscess component was confirmed with US-guided liver biopsy and histopathological examination. The patient received antibacillous drugs with success.