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Prevalece and Topography Anatomy of Dilated Virchow-Robin Spaces
Arlenin Espaillat,
Manuel Encarnacion Ramirez,
Rossi Barrientos,
Renat Nurmukhametov,
Ismael Peralta,
Cesar Coats,
Franklin Marmol,
Oskaury Jimenez,
Rafael Fermin,
Santiago Valenzuela,
Dilara Akkad
Issue:
Volume 3, Issue 2, June 2022
Pages:
11-20
Received:
11 March 2022
Accepted:
15 April 2022
Published:
22 April 2022
DOI:
10.11648/j.wjmcr.20220302.11
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Abstract: Virchow-Robin spaces are easily mistaken for resembling pathologies – lacunar infarcts, periventricular cystic leukomalacia, multiple sclerosis, and many others due to their imaging properties. We performed an observational study to determine the topographic distribution and prevalence of dilated Virchow-Robin spaces (dVRS) in patients undergoing magnetic resonance imaging (MRI) and computed tomography (CT). The study was conducted in the Department of Neuroradiology, CEDIMAT – an advanced medicine and telemedicine diagnostic center in the Dominican Republic, between June 2017 and June 2018. A total of 197 scans, 87 MRI and 127 CT, were investigated retrospectively. The center’s neuroradiologist described morphologic and topographic characteristics. Results obtained concluded a dVRS prevalence of (2.31%), most commonly in subjects 60 to 79 years of age (36.55%) and a dominant occurrence in females (52.79%). Regarding location, type II was the most frequent (42.50%). When classifying according to number of dVRS present in the white matter (WM), grade 1 was the highest (99.49%). In the basal ganglia, grade 1 was also the most encountered (98.48%). The largest diameter of a dVRS was located rostrocaudally (Z) (89.34%) with an average of 7.47mm. Lacunar infarctions were the most common differential diagnosis (22.06%). However, there was no established differential diagnosis in (68.14%). dVRS occurrences were most frequently associated with cortical atrophy (19.11%), leukoaraiosis (7.72%), and microvascular diseases (4.88%) on imaging, while (47.46%) of the cases were not concomitant with any diagnosis. The results of this study allow for better recognition of dVRS and differentiation from various pathologies, specifically lacunar infarctions.
Abstract: Virchow-Robin spaces are easily mistaken for resembling pathologies – lacunar infarcts, periventricular cystic leukomalacia, multiple sclerosis, and many others due to their imaging properties. We performed an observational study to determine the topographic distribution and prevalence of dilated Virchow-Robin spaces (dVRS) in patients undergoing m...
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A Case Report: Post COVID Immune Thrombocytopenia
Issue:
Volume 3, Issue 2, June 2022
Pages:
21-24
Received:
26 February 2022
Accepted:
22 April 2022
Published:
28 April 2022
DOI:
10.11648/j.wjmcr.20220302.12
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Abstract: Immune thrombocytopenia is a condition in which our body destroys its own platelets. It is characterized by platelet count less than 100,000/uL which can lead to easy bruising and bleeding. ITP can be primary or secondary. Secondary causes are diverse and include viral infections. The novel corona virus is known to affect mainly respiratory system along with the involvement of multiple other systems. It presents with non specific symptoms such as fever, fatigue, cough, dyspnea and might lead to a few rare complications post COVID with ITP being on of them. One of the potential cause of ITP is attributed to this viral infection. This is a case of 29 year old female who presented with easy bruising on the both upper and lower limbs 1 week after being tested negative for corona virus infection on PCR. Platelet count on admission was 59,000/uL. She was diagnosed as ITP caused by corona virus after ruling out other hematological causes of thrombocytopenia. The further workup did not reveal the pathophysiology of ITP caused by this virus. However the patient was treated with glucocorticoids which improved the condition gradually. The patient was discharged and a followup was advised.
Abstract: Immune thrombocytopenia is a condition in which our body destroys its own platelets. It is characterized by platelet count less than 100,000/uL which can lead to easy bruising and bleeding. ITP can be primary or secondary. Secondary causes are diverse and include viral infections. The novel corona virus is known to affect mainly respiratory system ...
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Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation
Adolfo Leyva-Alvizo,
Cristina Villar-Canton,
Alberto Riojas-Garza
Issue:
Volume 3, Issue 2, June 2022
Pages:
25-28
Received:
12 April 2022
Accepted:
26 April 2022
Published:
10 May 2022
DOI:
10.11648/j.wjmcr.20220302.13
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Abstract: Increased incidence of thromboembolic events in patients with severe COVID-19 infection has been documented. Acute limb ischemia as a complication in critically ill patients due to coagulopathy has been reported, worsening prognosis and increasing limb amputation rate. Delayed recognition could lead to irreversible ischemia and clinical deterioration requiring amputation. We present the case of a 54-year-old male with severe COVID-19 infection who developed clinical deterioration and acute lower limb ischemia at day 7 of hospitalization in the intensive care unit. Skin color changes suggested necrotic tissue and skin bullae. Arterial doppler ultrasound revealed a thrombus on the distal superficial femoral artery with absence of blood flow. Irreversible ischemia was diagnosed. The patient underwent an above the knee amputation, showing favorable clinical evolution during the next three days. Nonetheless, septic shock persisted, and 14 days later the patient presented cardiorespiratory arrest and passed away. Acute limb ischemia could present as a complication in critically ill patients treated in the intensive care unit, increasing amputation rate and worsening prognosis. In patients with critical management, physical examination and laboratory analyses are essential for clinical evolution concerning peripheral vascular disease. Efforts should be made to diagnose such complications on time with a more rigorous and protocolized limb perfusion examination.
Abstract: Increased incidence of thromboembolic events in patients with severe COVID-19 infection has been documented. Acute limb ischemia as a complication in critically ill patients due to coagulopathy has been reported, worsening prognosis and increasing limb amputation rate. Delayed recognition could lead to irreversible ischemia and clinical deteriorati...
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Rare Case of Ruptured Live Tubal Ectopic Twin Pregnancy
Shalini Malhotra,
Safaa Khalil,
Sweety Kumari
Issue:
Volume 3, Issue 2, June 2022
Pages:
29-32
Received:
22 April 2022
Accepted:
7 May 2022
Published:
24 May 2022
DOI:
10.11648/j.wjmcr.20220302.14
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Abstract: This article aims to report a rare case of a primigravida with live twin ectopic pregnancy at 12 weeks gestation, seen at Al Qassimi Women & Children Hospital, Sharjah, which was successfully diagnosed and managed upon arrival with no maternal morbidity. The patient presented in Emergency department with severe abdominal pain, by her dates she was in late first trimester of pregnancy with no prior early pregnancy scan. She was tachycardic with generalized abdominal tenderness with guarding and rigidity on examination. Bedside ultrasound was suspicious of twin ectopic with hemoperitoneum; findings were confirmed urgently with scan in radiology department. In view of patient’s condition, urgent laparotomy was done which showed ruptured right tubal ampullary twin pregnancy with hemoperitoneum. Right salpingectomy was done, 2 units of blood were transfused intraoperatively. She has an uneventful postoperative period was discharged in good condition on the third day. his case stresses on the importance of being extra vigilant in a busy Emergency department where low risk late first trimester pregnancies present with acute abdomen with no prior scans need urgent ultrasound to identify this rare diagnosis of twin ectopic and manage effectively and rapidly to avoid major morbidity to the patient.
Abstract: This article aims to report a rare case of a primigravida with live twin ectopic pregnancy at 12 weeks gestation, seen at Al Qassimi Women & Children Hospital, Sharjah, which was successfully diagnosed and managed upon arrival with no maternal morbidity. The patient presented in Emergency department with severe abdominal pain, by her dates she was ...
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Knowledge and Practice of Standard Precautions Among Health Care Workers Amidst COVID-19 in Public Secondary Health Facilities in Makurdi Metropolis, Nigeria
Nguungwan Eunice Seer-Uke,
Umar Dahiru,
Andrew Aor Tyoakaa,
Orfega Zwawua,
Susan Sewuese Aondoaver
Issue:
Volume 3, Issue 2, June 2022
Pages:
33-37
Received:
23 April 2022
Accepted:
13 May 2022
Published:
16 June 2022
DOI:
10.11648/j.wjmcr.20220302.15
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Abstract: This study assessed the knowledge and practice of standard precautions among health care workers amidst COVID-19 in public secondary health facilities in Makurdi Metropolis, Benue State of Nigeria. Cross-sectional research design was used for the study. The sample for the study was one hundred and seventy-two (172) health workers in Makurdi metropolis who were selected using simple random and purposive sampling procedures respectively. The self-structured questionnaire was used to collect data. The chi square statistic was used to test the hypotheses at 0.05 level of significance. The analyses were conducted using the statistical package for social sciences (SPSS v21). The result of the study showed that, health workers in Makurdi Metropolis have good knowledge of infection control (2 = 78.372, df = 3, P < 0.05), injection safety (2 = 16.233, df = 3, P < 0.05), hand hygiene (2 = 125.070, df = 3, P < 0.05), personal protective equipment (2 = 87.116, df = 3, P < 0.05) and used of safety boxes (2 = 87.767, df = 3, P < 0.05) but the practice of infection control (2 = 1.674, df = 3, P > 0.05), injection safety (2 = 2.651, df = 3, P > 0.05), hand hygiene (2 = 4.000, df = 3, P > 0.05), personal protective equipment (2 = 3.674, df = 3, P > 0.05) and used of safety boxes (2 = 5.628, df = 3, P > 0.05) was poor. It was recommended among others that, there should be regular educational programmes such as workshops and seminars on infection control for all health care workers especially in primary health care centers who are involved in the care of patients at various levels. There should be frequent and consistent on the job training and critical supervision of health workers on proper usage of available injection equipment by those who are knowledgeable in this area and provision of stocks of other injection equipment like needle and syringe to avoid reusing the available ones.
Abstract: This study assessed the knowledge and practice of standard precautions among health care workers amidst COVID-19 in public secondary health facilities in Makurdi Metropolis, Benue State of Nigeria. Cross-sectional research design was used for the study. The sample for the study was one hundred and seventy-two (172) health workers in Makurdi metropo...
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