ISSN 2326-7283
Case Report
Case Report
Vincristine-induced unilateral ptosis in a child with Wilms’ tumor
Sinan Akbayram1, Fesih Aktar2, Murat Doğan2, Cihangir Akgün2, Mustafa Izmirli3, Hüseyin Çaksen2, AhmetFaik Oner1
1Department of Pediatric Hematology, YuzuncuYil University Faculty of Medicine, Van, Turkiye.
2Department of Pediatrics, YuzuncuYil University Faculty of Medicine, Van, Turkiye.
3Department of Radiation Oncology, YuzuncuYilUniversity Faculty of Medicine, Van, Turkiye.
*Correspondingauthor E mail: [email protected] Tel. 0 +90- (505) 669 00 64
Accepted 27 June, 2013
Abstract
This report describes the successful management of vincristine-induced unilateral ptosis with pyridoxine and pyridostigmine in a three year old girl with Stage 2a Wilms tumor. Vincristine as an antineoplastic drug causes neurotoxicity frequently. We report here about a 3-year-old girl having a vincristine-induced cranial polyneuropathy and a complete remission due to the therapy with pyridoxine and pyridostigmine. The 3-year-old girl was diagnosed with a Wilms tumor. Following nephroureterectomy she was treated with four cycles of actinomycin D (250 mg/m2), six cycles of adriamycine (20 mg/m2), six cycles of etoposide (100 mg/m2) and nine cycles of vincristine sulphate (1.4 mg/m2). One day after the last vincristine sulphate treatment, she developed unilateral ptosis without pupillary or other oculomotor dysfunction. A neuroprotective and neuroregenerative treatment of this vincristine-induced cranial neuropathy was attempted with pyridoxine (150 mg/m2/dayper oral bid) and pyridostigmine (3 mg/kg/dayper oral bid). The unilateral ptosis markedly improved after two weeks of pyridoxine and pyridostigmine treatment and completely resolved after 4 weeks.
Key words: Ptosis,vincristine sulphate, Wilms’ tumor, pyridoxine, pyridostigmine.
Akgün C, Aktar F, Çaksen H and Oner AF, Izmirli M, Akbayram S, Doğan M
Page: 54 - 55
Case Report
African Journal of Internal Medicine ISSN: 2326-7283 Vol. 2 (7), pp. 052-053, September, 2013. © International Scholars Journals
Case Report
A case of narcolepsy mistaken for epilepsy
Fesih Aktar1, Mehmet Selçuk Bektaş1, Murat Başaranoğlu1, Mehmet Açıkgöz1, Hayrettin Temel1, Murat Kanğın2, and Hüseyin Çaksen1
1Department of Pediatrics, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.
2Department of Pediatrics, Diyarbakır Obstetric and Child Diseases Hospital, Diyarbakır, Turkey.
*Corresponding author. E-mail: [email protected]
Accepted 24 June, 2013
Abstract
Narcolepsy-cataplexy syndrome is a disease characterized by an irresistible sleep attacks during the day, a sudden decrease in the muscle tone that occurs in resulting excitement, sleep paralysis and hallucinations that may occur while falling asleep or awakening. Narcolepsy is uncommon in children but may sometimes occur in adolescence. In approximately 50% of the cases, the beginning of the syndrome is between the age of 10-20 and 5% are under 10 years of age. A fifteen year-old male patient was brought to our clinic with the complaint of sleeping too much and this has lasted for the past 3 years. According to his anamnesis, his eyes switch just before falling asleep, periodic limb movements of sleep form at upper and lower extremities when falling asleep, an irresistible need of sleeping arises during the day and he sleeps wherever he is. An epilepsy diagnosis has been established for the patient in another center and also carbamazepine and levetiracetam treatments are applied for one year but the symptoms are still present. A narcolepsy diagnosis has been established and tricyclic antidepressant treatment has been started. Amelioration has been observed in the narcolepsy symptoms of the patient who undergoes the 4th month of treatment. The case has been presented in order to show that narcolepsy might interfere with epilepsy.
Key words: irresistible sleep attacks, epilepsy, sleep paralysis, male patient, narcolepsy.
Açıkgöz M, Başaranoğlu M, Aktar F, Kanğın M and Çaksen H, Temel H, Bektaş MS
Page: 52 - 53
Research Article
African Journal of Internal Medicine ISSN: 2326-7283 Vol. 2 (6), pp. 047-051, August, 2013. © International Scholars Journals
Full Length Research Paper
The Rejuvenation of Cardiac Catheterization for congenital heart diseases in Nigeria: Profiles, Challenges and Prospects
1BA Animasahun, 2A Johnson, 3OO Ogunkunle, 4OA Idowu, 5Sunita Maheshwari, 1OF Njokanma, 6F Bode-Thomas, 3SI Omokhodion
1Department of Paediatrics and Child Health, Lagos State University, College of Medicine, Ikeja, Lagos, Nigeria.
2First Cardiology Consultants, No 20A Thompson Avenue, Ikoyi, Lagos, Nigeria.
3Department of Paediatrics, University College Hospital, Ibadan, Nigeria.
4Reddington Multispecialist Hospital 13, Idowu Martins Street, Victoria Island, Lagos, Nigeria.
5Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, India.
6Jos University Teaching Hospital Jos, Plateau State, Nigeria.
*Corresponding author. E-mail:[email protected]. Tel. +2348037250264
Accepted 15 April, 2013
Abstract
Cardiac catheterization had not been available locally for about three decades but resurfaced about 3 years ago. This study aimed at documenting the profiles of the patients who had undergone cardiac catheterization since its availability, the challenges encountered and the prospects associated with the procedure at the study. Patients referred for cardiac catheterization between May 2010 and September 2012 were studied consecutively. Profile of the patients including diagnosis at referral and indication for cardiac catheterization were documented. Twenty-four patients were recruited into the study, 21 (87.5%) from public hospital and 3 (12.5%) from private hospital. The age ranged between one to 62 years with a mean age + SD of 14.5+ 9.0 years. 66.7% were females while 33.3% were males with M/F of 1: 2. Fifteen (62.5%) had acyanotic congenital heart disease while 9 (37.5%) had cyanotic congenital heart disease. Thirteen had diagnostic cardiac catheterization while eleven had device closure of acyanotic congenital heart defect. Diagnostic and interventional cardiac catheterization is now available in Nigeria, high degree of manpower training, cost and local availability of consumables are major limiting factor to its use. Regional and International collaboration could be mutually beneficial.
Keywords: Cardiac catheterization, congenital heart disease, cyanosis, acyanosis, profile.
Maheshwari S, Idowu OA, Ogunkunle OO, Bode-Thomas F and Omokhodion SI, Animasahun BA, Johnson A, Njokanma OF
Page: 47 - 51
Research Article
Full Length Reseach Paper
¹Clinical Laboratory of Physiology, Medical School of Sousse, University of Sousse –Tunisia.
²Department of Chemical Engineering, Penn State University – USA.
*Corresponding author. E-mail: [email protected]. Tel: (+216) 73 222 600Fax. (+216) 73 224 899).
Abstract
Obesity and asthma are associated disorders but the mechanisms responsible for this relationship are unclear. Exhaled nitric oxide has been proposed as a non invasive marker of airway inflammation in asthma. The aim of this study was to investigate the relationship between exhaled nitric oxide, body mass index (BMI) and airway hyper-responsiveness to methacholine. Fifty two (21 lean and 31 obese) healthy women were recruited and examined in the Clinical Laboratory of Physiology located in the Medical School of Sousse. The average ages (± s.e.) of the two groups of lean and obese were 35.6±2.1 and 37.4±1.9 years, respectively. Their corresponding mean BMI (± s.e.) were 22.1±0.3 and 37.7±1.2 kg.m¯², respectively. Pulmonary function tests, exhaled NO and airway hyper-responsiveness were investigated in the two groups. Our data indicate that: (1) exhaled NO levels were significantly correlated BMI (r=0.85; p<0.001) as well as with the efficacy of the MCH agonist promoting the maximal response (r=0.45; p=0.001); and 2) the mean of exhaled NO was significantly higher in obese than in lean group (p<0.001). We concluded that obesity induced airway hyper-reactivity in obese women through airway inflammation as evidenced by the significant association between exhaled NO and BMI.
Key words: Airway hyper-reactivity, asthma, inflammation, obesity, women.
Rouatbi S, Turkia WB, Chouchane A, Tabka Z and Ben-Jebria AA, Miâdi-Messaoud H
Page: 42 - 46
Case Report
African Journal of Internal Medicine ISSN: 2326-7283 Vol. 2 (5), pp. 037-041, July, 2013. © International Scholars Journals
Case Report
Successful right nephrectomy and left tumourectomy for sporadic bilateral synchronous renal cell carcinoma
A Murinello1, P Guedes1, AM Figueiredo1, P Gomes1, LA Monteiro2, HS Damásio1, NC Ribeiro3, L Mota4, A Carvalho5, C Teiga3, M Albergaria3, A Serrano1
1Internal Medicine 1 Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
2 Urology Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
3 Radiology Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
4 Intensive Care Unit, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
5Pathology Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
Corresponding author. E-mail: [email protected], [email protected], [email protected].
Tel: +351 918626874, Fax: +351 217924304.
Accepted 2 May, 2013
Abstract
Renal cell carcinoma (RCC) is by far the most frequent type of kidney cancer, but synchronous bilateral neoplasms are rare, even more so in sporadic forms of RCC. An increasing amount of tumours are being found spuriously while small and before causing any symptoms, thus allowing less invasive surgery with potentially brighter outcomes. We report a 49-year-old Caucasian male who presented to the Emergency Department with a seven-day course of productive cough, worsening dyspnoea, and anorexia. He had no history of fever or any pain, and showed no abdominal or urinary complaints whatsoever. His physical exam was irrelevant apart from an enlarged liver, and kidney function tests were normal. Workup eventually revealed synchronous bilateral clear cell RCC and the patient underwent a successful total right nephrectomy with left tumourectomy. Two years on, he remains asymptomatic and with normal renal function. This case shows the seldom seen coexistence of sporadic RCC in both kidneys. We stress the fact that the patients frequently don’t show any urinary symptoms, which can delay the correct diagnosis and hinder treatment. Tumours found on an early stage can be dealt with using less drastic measures that spare nephrons and elude, or at least postpone, definitive haemodialysis.
Key words: kidney cancer, sporadic bilateral synchronous renal cell carcinoma, clear cell renal cell carcinoma, guided percutaneous diagnostic kidney biopsy, nephron-sparing surgery.
Mota L, Damásio HS, Guedes P, Ribeiro NC, Gomes P, Carvalho A, Murinello A, Teiga C, Albergaria M and Serrano A, Figueiredo AM, Monteiro LA
Page: 37 - 41
Research Article
African Journal of Internal Medicine ISSN: 2326-7283 Vol. 2 (5), pp. 031-036, July, 2013. © International Scholars Journals
Full length Research Paper
Serotype infectivity and phylogenetic of dengue virus cause of dengue fever (DF), dengue hemorrhagic fever (DHF), and engue shock syndrome (DSS) in surabaya-Indonesia
1,5Fedik A. Rantam, 2Purwati AN, 4Sasmono T, 6David Lee, 1Eryk H, 1Helen S,
1Deya K, 1Anas P, 3 Benediktus Y, 3Soegijanto S, 1Nasronudin
1DHF-Laboratory Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
2Department of Internal Medicine, Tropic Division, RSUD. Dr. Soetomo Teaching Hospital School of Medicine, Airlangga University, Surabaya, Indonesia.
3Department of Pediatric, Tropic division, RSUD. Dr. Soetomo Teaching Hospital School of Medicine, Airlangga University, Surabaya, Indonesia.
4Dengue Virus Lab. BM-Eijkman Institute, Jakarta, Indonesia.
5Laboratory of Virology and Immunology, Department of Microbiology, Faculty of Veterinary Medicine. Airlangga University.
6Environment National Institute, National University, Singapore.
*Corresponding author. E-mail: [email protected]
Accepted 30 April 2013
Abstract
Infection with DENV causes a spectrum of clinical disease ranging. The aim of this study is to investigate the infectivity of DENV with degree of severity dengue infection in Surabaya. Dengue infection was established by IgM anti dengue, and two step multiplex RT PCR and Nucleotide sequence. Grading of degree severity infection follow the WHO criteria 2011. DSS cases found 3 from 36 patients caused by DENV 2. The most uninfective was DENV 1, and the most prevalence dengue infection caused by DENV 3. The infectivity of dengue infection shown 16 patients lead to severity with plasma leakage. All of sera patients detecting using multiplex RT-PCR were positive, but it were analyzed using Duo ELISA only 22 serum sera positive IgM and IgG from 36 sera.. The Phylogenetic analysis indicates that the isolates from 2011 to 2012 close related with dengue isolate from 1998 and belong to 2009 to 2020.In this study it indicates that DENV 2 predominantly is the cause of DSS.
Key words: Dengue virus, infectivity, envelop gene, phylogenetic analysis.
Rantam FA, Benediktus Y, Lee D, Anas P, Purwati AN, Eryk H, Soegijanto S and Nasronudin, Helen S, Sasmono T, Deya K
Page: 31 - 36