International Journal of Medical and Pharmaceutical Case Reports https://journalijmpcr.com/index.php/IJMPCR <p style="text-align: justify;"><strong>International Journal of Medical and Pharmaceutical Case Reports (IJMPCR) (ISSN: 2394-109X)</strong> aims to publish case reports in the areas of medical and pharmaceutical sciences. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> en-US contact@journalijmpcr.com (International Journal of Advances in Nephrology Research) contact@journalijmpcr.com (International Journal of Advances in Nephrology Research) Sat, 23 Mar 2024 07:03:07 +0000 OJS 3.3.0.11 http://blogs.law.harvard.edu/tech/rss 60 Challenges of Cutaneous Care in Hyperthyroidism: A Case Report https://journalijmpcr.com/index.php/IJMPCR/article/view/366 <p>Cutaneous manifestations of thyroid disease are one of the first notable signs of thyroid hormone dysregulation. Skin changes in hyperthyroidism vary from individual to individual. In dark skinned Africans it may be challenging to detect these dermatoses and care for the patients with these dermatoses if they arise. Making the actual cutaneous diagnosis in hyperthyroidism may be impaired by co-morbidities, drug-drug interactions, hypersensitive reactions, unusual presentation of common diseases, immunosuppression that may result to opportunistic infections and similar presentations of dermatoses. There may be dermatoses that may co-exist with other dermatoses within the same site. The peculiarity of our case report is that we present three females with hyperthyroidism that cut across different age groups with different cutaneous lesions. This case report aims to present the challenges of making accurate skin diagnosis and challenges that arise in actually caring for them. Counselling the patient on the appropriate care and prognosis of these skin lesions would help in improvement of quality of life and unwanted expectations</p> Amaewhule, MN , Amadi, ES , Korubo, IF., Gomba, VE, Wokekoro, PJ, Wariboko, C., Figilo, IM Douglas, BI, Robinson-Elechi, E., Harry, MD , Onyenma, PO Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/366 Sat, 23 Mar 2024 00:00:00 +0000 Through Indian Eyes: A Case Series on Steroid-induced Secondary Cataract https://journalijmpcr.com/index.php/IJMPCR/article/view/367 <p>Lichen planus, a chronic autoimmune dermatological disorder, often necessitates the use of topical corticosteroids for symptom management. However, this case series highlights the emergence of topical steroid-induced secondary cataracts in two patients, emphasizing a previously underrecognized complication. Both patients, females aged 36 and 43, presented with gradual vision loss in their left eyes, attributed to prolonged corticosteroid use for lichen planus and skin allergies, respectively. Ophthalmological examinations confirmed the diagnosis, leading to cataract surgeries. The pathogenesis involves complex cellular and molecular mechanisms, emphasizing the need for vigilant monitoring during corticosteroid therapy. Moreover, the lack of stringent reporting systems for adverse drug reactions in India underscores the necessity for comprehensive monitoring to mitigate economic and quality of life burdens. The study emphasizes the importance of judicious corticosteroid use, tapering regimens, and patient education to minimize complications while effectively managing dermatological conditions. This underscores the critical need for heightened awareness, surveillance, and patient-centred approaches to mitigate the risk of corticosteroid-induced secondary cataracts, ensuring optimal therapeutic outcomes and long-term ocular health.</p> B S Girish, C S Meghana , Joel M. Johns , R. Srinivasan Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/367 Tue, 26 Mar 2024 00:00:00 +0000 Case Report on Brown Tumor: An Unusual Expression of Renal Osteodystrophy and Secondary Hyperparathyroidism https://journalijmpcr.com/index.php/IJMPCR/article/view/368 <p>The new term of ‘Chronic Kidney Disease- Mineral and Bone Disorders’ has been introduced to encompass a wide-ranging syndrome, capturing various abnormalities in bone and mineral metabolism seen in patients with chronic kidney disease. Multifactorial disorders affecting mineral metabolism and bone structure emerge early in the progression of Chronic Kidney Disease. Brown tumors, an uncommon type of bone lesion are distinctive manifestations of high-turnover bone disease. In this case, a patient with chronic kidney disease (dialysis dependent) with IgA nephropathy that presented with multiple osseous lesions of bilateral ribs, sternum, scapula, clavicle, mandible and vertebral bodies. The case highlights the significance of considering brown tumors in the differential diagnosis and management of patients with both an osseous mass and chronic kidney disease. Failing to establish an accurate diagnosis may result in unnecessary additional diagnostic procedures and extensive surgery, ultimately increasing patient morbidity. Through this case report, the importance of preventing, early diagnosing, and treating secondary hyperparathyroidism to reduce the prevalence of high-turnover bone disease and associated complications such as brown tumors is emphasized.</p> Abhishek S Krishna , Harikrishnan V Nair , Sandeep K F, Shaiju S Dharan, Dhanya Dharman Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/368 Tue, 02 Apr 2024 00:00:00 +0000 Nightmares Associated to Nevirapine during Chemoradiotherapy for Carcinoma Tongue https://journalijmpcr.com/index.php/IJMPCR/article/view/372 <p>Nevirapine, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is a drug used in the management and treatment of HIV. It is considered safe for use in conjunction with platinum-based chemotherapy. Chemotherapy is a staple of cancer treatment and is used routinely in the management of malignancies of the head and neck. However, managing HIV-positive cancers presents challenges due to individual side effects and drug interactions. Drug interactions can potentiate or reduce drug metabolism, reduce excretion, or cause adverse drug reactions.</p> <p>Herein, we describe a case of new-onset nevirapine-induced nightmares that was noted in a patient undergoing chemoradiotherapy with cisplatin.</p> Bhooshan Zade , Vrushab Rao Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/372 Thu, 11 Apr 2024 00:00:00 +0000 Rare Case of Infective Endocarditis Due to Gemella Morbillorum in Patient with Bicuspid Aortic Valve https://journalijmpcr.com/index.php/IJMPCR/article/view/375 <p>Infective endocarditis caused by Gemella morbillorum is one of the rare causative microorganisms of endocarditis and only a few cases have been reported in the literature so far. We describe a case of Gemella morbillorum endocarditis in a 37-year-old Moroccan man who had a congenitally bicuspid aortic valve. He presented to our institution with a 1.5-month history of fever, and the onset of a motor deficit in the right hemibody one day prior to consultation. A transthoracic echocardiogram showed two large, echogenic and mobile vegetations (30×8 mm) with perforation of the left cusp and fistulized abscess of the anterior mitral leaflet measuring approximately 16x20mm. Blood cultures of the patient grew pan-sensitive <em>Gemella morbillorum</em>. The patient fulfilled the Duke’s criteria for infective endocarditis. The patient was successfully treated with antibiotics and aortic and mitral valves replacement.</p> Dghoughi Sarah , Jama Dounia , Charif Hanae, Mounaouir Karim , Bouziane Maha , Haboub Meryem , Bennouna El Ghali , Drighil Abdenasser , Habbal Rachida Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/375 Sat, 27 Apr 2024 00:00:00 +0000 A case report on Transthyretin Cardiac Amyloidosis https://journalijmpcr.com/index.php/IJMPCR/article/view/376 <p><strong>Introduction : </strong>Cardiac amyloidosis is due to the extracellular accumulation of insoluble fibrillar proteins which progressively alter the function of the myocardium. The prognosis depends on the severity of the cardiac involvement. Transthyretin cardiac amyloidosis (TTR) is the most common. It can be wild-type (ATTRwt), hereditary (ATTRv) or senile (wild TTR). The diagnosis of cardiac amyloidosis has greatly improved in the last decade and is based on multimodal imaging, mainly echocardiography and bone scintigraphy<strong>.</strong></p> <p><strong>Case Report: </strong>We report the case of a male patient hospitalized for heart failure due to transthyretin cardiac amyloidosis.</p> <p><strong>Conclusion: </strong>Recognition of this pathology is essential because cardiological management is specific and conventional treatments for heart failure can be harmful. Only specific treatments can slow down or stop the infiltration process.</p> G. Ziani, H. Souilk, R. El Azouzi , A. Ameur, N. Doghmi, M. Cherti Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/376 Sat, 27 Apr 2024 00:00:00 +0000 Antiphospholipid Syndrome and Impaired Wound Healing After CABG https://journalijmpcr.com/index.php/IJMPCR/article/view/370 <p>This case highlights a 47-year-old patient with antiphospholipid syndrome and a prior stroke who underwent CABG for triple vessel disease. Despite a 7-day hospital stay, delayed wound healing at the intervention site ensued, compounded by a bacterial infection. Treatment involved betadine wound care and dermatologist follow-up. The patient's medications included Acetylsalicylic acid, atorvastatin, bisoprolol, Valsartan, and warfarin. This case underscores the significance of recognizing poor wound healing in antiphospholipid syndrome patients’ post-surgery, necessitating vigilant management to mitigate complications and preserve quality of life.</p> Jafrin Sadiq Abdul Razack, Saud Khaled Aldoseri , Sahil Asgar Ali, Syeda Juveria Hussaini , Firas Raouf Alani Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/370 Fri, 05 Apr 2024 00:00:00 +0000 Tuberculous Pericarditis: A Case Report in South-east Nigeria https://journalijmpcr.com/index.php/IJMPCR/article/view/371 <p>Tuberculosis is a chronic infection and a common cause of chronic pericardial effusion. Approximately 1-2% of patients with pulmonary tuberculosis (PTB) develop tuberculous pericarditis (TBP) and it is less common in the developed world than in developing countries where active tuberculosis is endemic. In these countries with high endemicity, TBP is the most common form of pericarditis and is often associated with HIV. The clinical picture is usually that of a chronic systemic illness in a patient with pericardial effusion. The index case is that of a 24 year old male, who had presented to our medical outpatient clinic with a history of cough and chest pain of 9 and 2 days duration respectively. Diagnosis was made following echocardiography, electrocardiography (ECG), Chest X-ray (CXR) and culture findings which showed features in keeping with tuberculous pericarditis. His clinical condition improved significantly following pericardiocentesis and TB treatment was subsequently instituted. He was discharged for outpatient follow-up 5 days after pericardiocentesis. TBP can be difficult to diagnose and often goes undetected especially in resource poor countries. Accurate and early diagnosis is important as it is a dangerous disease if left untreated.</p> Okpara Titus Chukwubuzo, Okoli Paul Chibuike , Chime Peter Ekpunobi , Eze Uchenna Gerald , Agu Grace Uchechukwu, Anike Raphael Ugwu , Ekwo Jude Chukwudi, Ozougwu Augustine Obumneme , Ngwoke Anthonia Onyinye, Ogu Rita Ifeoma-Ossy, Enukora Nkiru , Magaji Nyamaai Cephas Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/371 Sat, 06 Apr 2024 00:00:00 +0000 Fulminant Hepatitis Secondary to Anti-tuberculosis Drug-induced Hepatotoxicity Complication, Its Prevention Strategies and Management: A Case Report https://journalijmpcr.com/index.php/IJMPCR/article/view/373 <p><strong>Aim:</strong> Tuberculosis remains a public health problem around the world. Hepatotoxicity is a serious side effect of anti-tuberculosis treatment. Fulminant hepatitis is a rare form but considered very serious outside of liver transplantation. It can occur several weeks or months after the start of treatment.</p> <p><strong>Presentation of Case:</strong> We report the case of a 34-year-old single male patient treated for pleural tuberculosis in whom fulminant hepatitis appeared after four months of treatment with Isoniazid and Rifampicin. Despite a treatment in intensive care unit He had a fatal outcome because of lack of liver transplantation.</p> <p><strong>Discussion:</strong> Hepatotoxicity varies from biological hepatitis to fulminant hepatitis. Application of personalized strategy of genetic analysis and pharmacological drug monitoring to optimize treatment is the most safe to avoid antituberculosis drug induced hepatotoxicity but not available in all healthcare centers of developing countries. There was any change of anti-tuberculosis protocol because of the risk of bacterial resistance. The protocol includes association between several medicines potentially toxics for a long duration. For some moderate forms of&nbsp;&nbsp; tuberculosis (nodals, pleural), it’s necessary to ask if duration of antiviotherapy can be reduced.</p> <p><strong>Conclusion:</strong> Prevention of hepatotoxicity starts with identifying risk factors, regular clinical and biological assessment and informing patients of symptom that can indicate toxicity to react early.</p> Salaheddine Fjouji, Abdelhafid Houba, Chakib Chouikh, Imad Rahali, Hicham Bakkali, Nawfal Doghmi, Hicham Balkhi Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/373 Thu, 11 Apr 2024 00:00:00 +0000 Cardiac Tamponade: An Unusual First Case Presentation of Systemic Lupus Erythematosus https://journalijmpcr.com/index.php/IJMPCR/article/view/374 <p>This case is reported for the rarity of cardiac tamponade as a first manifestation of systemic lupus erythematosus (SLE). Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with worldwide prevalence, affecting almost every organ in the body. A 27-year-old woman presented to our hospital after two months of progressive shortness of breath, generalized edematous syndrome and diffuse, non-migratory arthralgias; the patient's shortness of breath was exacerbated on exertion and associated with a vague sensation of chest tightness. Transthoracic echocardiography revealed a large circumferential pericardial effusion with an echo-free space of 34 mm in apical view and 36 mm in subcoastal view with an oscillating heart and diastolic collapse of the right ventricle and atrium. This case is reported for the rarity of cardiac tamponade as a first manifestation of SLE. Because pericarditis is more common in SLE patients, the low frequency of tamponade may be partially explained by the extensive use of non-steroidal anti-inflammatory medications (NSAIDs) and steroids, which effectively reduce pericardial inflammation. We emphasize the importance of including SLE in the differential diagnosis of patients presenting with cardiovascular symptoms, as cardiac tamponade and pleural effusion are uncommon early presentations of SLE. Early detection and diagnosis are essential for prompt intervention and better patient outcomes.</p> Dghoughi Sarah, Jama Dounia, Charif Hanae, Mounaouir Karim, Bouziane Maha, Haboub Meryem, Bennouna El Ghali, Drighil Abdenasser, Habbal Rachida Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/374 Fri, 19 Apr 2024 00:00:00 +0000 Lupus Journey: The Challenge of Obstructıve Hydrocephalus https://journalijmpcr.com/index.php/IJMPCR/article/view/377 <p>Systemic lupus erythematosus (SLE) is a complex autoimmune condition known for its diverse clinical presentations. Neuropsychiatric SLE refers to neurological or psychiatric symptoms that arise once other potential causes have been ruled out. While hydrocephalus occurring in the context of SLE is exceedingly rare and its underlying mechanism remains elusive, its recognition is crucial for informed management decisions. A 20-year-old female patient, diagnosed with SLE, had been under our rheumatology clinic's care for two years. She recently presented with confusion, which emerged a year after her initial diagnosis. Brain tomography revealed obstructive hydrocephalus, and subsequent investigations ruled out other potential causes, linking the condition to her clinical SLE. After consulting with a neurosurgeon, a ventricular drainage catheter was inserted. In response to this hydrocephalus development, a regimen of pulse steroid therapy was administered. Following this, mycophenolate mofetil was prescribed as an immunosuppressant agent and her clinical condition was successfully stabilized.</p> Dilara Bulut Gökten, Murat Gökten , Ridvan Mercan Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/377 Wed, 08 May 2024 00:00:00 +0000 Insights into Nephrotic Syndrome in Pediarics: Case Series Analysis https://journalijmpcr.com/index.php/IJMPCR/article/view/378 <p>Nephrotic syndrome (NS) is one of the most common childhood kidney diseases. NS can affect children of any age from infancy to adolescence and predominantly occurs in the age group of 1–6 years. It is an illness caused by idiopathic diseases like minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS), membrane proliferative Glomerulonephritis, membranous Glomerulonephritis and is characterized by increased permeability across the glomerular filtration barrier. NS is classified as primary, secondary, and congenital. It consists of four clinical features like severe proteinuria, edema, hyperlipidaemia, hypoalbuminemia. The main cause of nephrotic syndrome are diseases associated with drugs and rarely genetic disorders. The pathogenesis of the disease affects various biological functions linked to loss of proteins negatively, which results in systemic complications which may be disease and drug-associated complications. Using drugs to treat NS leads to several complications which include improper growth, metabolism, behavior change inpatient. Itis a chronic relapsing disease for most of the steroid response drugs for treatment of nephrotic syndrome. Glucocorticoids, immunosuppressants and biological agents are used for the treatment of the diseases. In this case series, we presented a case series of nephrotic syndrome in pediatrics. Total 4 patients were taken into considerations. The patients came with a chief complaints of swelling of face, foamy urine, abdominal pain, dark coloured urine with decreased urine output, joint pains. The laboratory investigations for all the 4 patients showed that there were decrease in albumin levels (hypoalbuminemia), decrease in serum creatinine levels and protein in urine, although kidney biopsy couldn’t be perform but the diagnosis was made based on clinical and laboratory findings. The patients were mainly treated with prednisolone, pantoprazole, enalapril, nifedipine, amoxiclav, and even albumin transfusion were done. NS was successfully managed and fortunately the patients recovered.</p> Vankodoth Sireesha, Asiya Sultana, P. Ramya Sri, Ayesha Mateen, M. Shiva, T. Rama Rao Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/378 Fri, 17 May 2024 00:00:00 +0000 Pericardial Effusion as an Early Indicator of Breast Cancer Recurrence: A Case Report https://journalijmpcr.com/index.php/IJMPCR/article/view/379 <p><strong>Background:</strong> Pericardial effusion, though uncommon, poses a significant threat to patient well-being, particularly when associated with underlying malignancies such as breast cancer recurrence. Timely recognition and intervention are crucial for improved prognosis and patient outcomes.</p> <p><strong>Case Presentation:</strong> We present the case of a 51-year-old woman with a history of treated breast cancer who presented with rapidly worsening dyspnea. Clinical examination and diagnostic tests revealed a large pericardial effusion secondary to breast cancer recurrence, highlighting the diagnostic and therapeutic challenges associated with this condition.</p> <p><strong>Discussion:</strong> Breast cancer recurrence involving the pericardium signifies advanced disease and presents significant management complexities. Evaluation typically involves transthoracic echocardiography and pericardiocentesis, with treatment strategies focusing on systemic chemotherapy and symptom management.</p> <p><strong>Conclusion:</strong> Pericardial effusion can serve as an early indicator of breast cancer recurrence and requires a multidisciplinary approach for optimal management. Early recognition and intervention are paramount in improving patient outcomes and quality of life.</p> Badr Abdalani, Omar Moufid, Meriem Amri, Saleh Obeidat, A. Assklou, M. GH. Benouna, A. Drighil, R. Habbal Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://journalijmpcr.com/index.php/IJMPCR/article/view/379 Tue, 21 May 2024 00:00:00 +0000