International Journal of Medical and Pharmaceutical Case Reports

Melatonin Involvement in Syncope Associated with Sleep Disturbance: A Case Report

Osah Martins Onwuka — 2022-07-13

Background: Syncope or fainting associated with sleep disturbance is mostly diagnosed as vasovagal syncope and has also been linked to orthostatic or postural hypotension. The physiological basis of syncope associated with sleep disturbance is not fully elucidated. In this report a rare case of melatonin involvement in syncope associated with sleep disturbance was presented.

Case Presentation: A case of a 21-year-old female with syncope associated with sleep disturbance was examined with 1 hour post syncope melatonin concentration of 33pg/ml (daytime evaluation) which is on the increase when compared to its female referenced average value (10pg/ml daytime evaluation). Some vital physiological variables associated with syncope like heart rate, blood pressure, hemoglobin concentration and packed cell volume were normal compared to referenced value (Table 1 and Table 2).

Conclusion: Considering the evaluations presented, it is suggested that melatonin could be involved in the sleep disturbance induced syncope and this report has created de novo insight that will aid elucidation, diagnosis and intervention of syncope induced by sleep disturbance or obstruction.

Primary Systemic Amyloidosis of Tongue: Pitfall and Challenges in the Diagnosis

Agarwal Anshoo — 2022-08-11

Amyloidosis is caused by the deposition of insoluble fibrillary protein in tissues and organs resulting in severe organ dysfunction. The clinical presentation for the diagnosis of amyloidosis is nonspecific, making it one of the most underdiagnosed conditions. Treatment is now available and is effective in improving patients’ survival and quality of life. We present a case of generalized amyloidosis in a 71-year-old patient admitted with a diagnosis of benign neoplasm of the root of the tongue. Subsequently, she underwent surgical treatment followed by purulent-septic complications developed leading to death. Microscopic examination of the biopsy tissue revealed deposits of amyloid and the patient was diagnosed to have primary generalized amyloidosis. These facts confirm the essential need to differentiate tumors from amyloidosis. Hence, this paper aims to provide physicians with knowledge about the clinical presentation that raises the suspicion of amyloidosis, bearing in mind the importance of early diagnosis.

Modified Clinical Practice of Sariva Kshara Sutra with Partial Fistulectomy in the Management of Bhagandara (Fistula-In-Ano)

Niket Shah — 2022-06-28

Bhagandara is Ashta Mahagaroga (8 major disease) by Sushruta because of highest recurrence. Anorectal disorders are at peak, because to sedentary lifestyle and many other factors. 2 words Bhaga and Darana is bifurcation bhagandara, it is a common disease occurring in Anorectal region around the anus which may extends up to Genitalia. Pidika creation causes Bhagandara to develop, which is countered by opening up in the Guda Pradesh region with suffering and discharge. Kshara Sutra therapy is the one-of-a-kind, specific Parasurgical procedure that is employed in Fistula in Ano. Bhagandara is treated using a variety of modern scientific modalities, but to far no single modality has proven to be comprehensive for Fistula. The goal of the current study was to evaluate the modified way to treat fistula-in-ano with Sariva Kshara Sutra with partial fistulectomy. Case was taken from OPD/IPD of SHAH PILES FISTULA HOSPITAL, AHMEDABAD.

CASE 1: - Age 31 yrs. Male Patient came to our hospital with complain of pain, swelling, discharge in scrotal to anterior anal canal (scrotal extension) treated with Sariva Kshara Sutra with partial fistulectomy considering its a best procedure in the treatment of Bhagandara preserving the Sphincter it treats the track.

Plexiform Neurofibroma of Arm: A Case Report

O. R. Hamdaoui — 2022-08-08

Plexiform Neurofibroma (PNF) is a rare benign nerve tumor. It is usually considered pathognomonic of neurofibromatosis type 1 (NF1 or Von Recklinghausen disease). MRI is the examination of choice in the exploration of this pathology. It provides decisive arguments for the positive diagnosis, the evaluation of the prognosis and the follow-up of the lesions. Histological confirmation is sometimes necessary, especially in cases other than NF1. We report the observation of a 22-year-old woman who consulted for a mass of the left arm.

Pharmacognostic, Acute Toxicity Profile and Comparative Leaf Characteristics of Desmodium velutinum, Mallotus oppositifolius and Synedrella nodiflora

Ifeanyi Peter Onyeka — 2022-07-23

Plant leaf parameters such as stomatal index, stomata type, leaf microscopic features, and leaf powder microscopy are important taxonomic parameters used to properly identify species and to differentiate one species from another and these is a vital keys in the pharmacognostic study of the medicinal plants because leaf parameters play a vital role in distinguishing crude drugs even when they are fragmented or powdered. Also, extractive index, retention factor, ash value, and phytochemical parameters are vital in the standardization of crude drugs for the establishment of pharmacopeia and monograms. Therefore, the study seeks to validate the use of the phytochemistry and molecular systematics among Asteraceae, Euphorbiaceae, and Fabaceae to support their circumscription and therefore evaluated the pharmacognostic profile of Desmodium velutinum, Synedrella nodiflora and Mallotus oppositifolius folklorically used in South East Nigeria using standard laboratory protocols. The result of the leaf microscopy showed that Desmodium velutinum, Synedrella nodiflora, and Mallotus oppositifolius all had irregular shaped leaf epidermis, and stomata was present only in the abaxial surface respectively. The result showed both D. velutinum and S. nodiflora powder showed the presence of lignin, starch, cystoliths, tannin, and Oil body while calcium oxalate was absent whereas, Mallotus oppositifolius showed the presence of lignin, starch, tannin, and Oil body while calcium oxalate, and cystoliths were absent. Also the result of the TLC showed that M. oppositifolius had 3 visible spots with retention factors (RF) of 0.363, 0.425, and 0.5 in that order respectively, D. velutinum had 4 visible spot with retention factor (RF) of 0.425, 0.5, 0.550 and 0.66 in that order respectively while S. nodiflora had 6 visible spot with retention factor (RF) of 0.255, 0.363, 0.438, 0.538, 0.600 and 0.688 in that order respectively. The result also showed that methanol exhaustible extracted the phytochemicals in the crude dried plant. The acute toxicity studies showed that Desmodium velutinum, Synedrella nodiflora and Mallotus oppositifolius individually had LD₅₀ greater than 5000mg/kg. This study validates the claim that leaf parameters such as stomatal index, stomata type, leaf powder microscopy are important parameters used for the identification of crude drugs.