Niger J Clin Pract
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Case Reports
Etiologic dilemma and challenges of management of nodular vasculitis in tertiary health-care facility: A case report.
Nodular vasculitis is a rare inflammatory disease of the skin and subcutaneous fat tissue, characterized by crops of small, tender, erythematous nodules on the legs, mostly on the calves and shins. We present a 17-year-old adolescent female who presented with a six-month history of cough; recurrent fever and bilateral lower limb multiple ulcerated nodules of 1-month duration. ⋯ Histology of nodule biopsy revealed extensive caseous and coagulative fat necrosis, granulomatous inflammation with epitheloid macrophages and multinucleated giant cells surrounding the necrosis, and lymphoid infiltration of vessel walls with fibrous thickening of the intima, typical of Whitfield-type erythema induratum. There was initial but very transient response to antibiotic treatment, with further deterioration and eventual death from overwhelming sepsis.
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Percutaneous endoscopic gastrostomy (PEG) procedures are performed under sedation in critically ill patients who cannot be fed orally. ⋯ Propofol-ketamine should be preferred for sedoanalgesia during PEG procedures because of the lower dose of propofol, more stable blood pressure, and greater peripheral oxygen saturation. In addition, we believe ketamine-propofol is safer based on its low complication rate.
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Morgagni hernia (MH) is a rare congenital defect of the diaphragm. Although the various surgical method has been proposed, there is no surgical consensus. ⋯ In conclusion, our method is characterized by a shorter operation time, early return to feeding, early discharge, excellent cosmetic results, low cost, and low recurrence rate. Further prospective trials are needed to compare our novel scarless technique to other methods.
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To identify individuals with an increased mortality and morbidity risk after surgery, different parameters showing impaired tissue perfusion/oxygenation have been investigated, and the balance between tissue oxygen consumption and oxygen delivery has been evaluated in detecting organ failure. ⋯ The ΔPCO2 were found to have a poor ability to predict the development of complications during the intensive care and early postoperative period in patients undergoing open-heart surgery.
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The mechanism involved in the pathogenesis of preeclampsia (PE) remains uncertain, and the research into a better understanding, its possible prediction, and subsequent prevention continues. ⋯ This study therefore reveals significantly lower levels of immunoglobulins and trace elements among the preeclamptic subjects. These micronutrient deficiencies and low levels of immunoglobulins could be risk factors for the development of high blood pressure and PE.