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CT Scan of the Foot in Patients with Chronic Non-Healing Diabetic Foot Ulcer

Case Reports in Clinical Medicine 2020年第11期9卷 335-342页

作者： M. Rubina Fathimaa arcot rekha Saveetha Medical College and Hospital (SIMATS) Chennai India

Background: Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or the body’s inability to utilize it. The prevalence of diabetes mellitus is growing rapidly worldwide. Statistics show that in the year 2014, there were a total of 422 million cases of DM. Diabetes mellitus is a major cause of heart attacks, kidney failure, blindness and leg amputations. Diabetic foot ulcers are quite common and are estimated to affect nearly 15% of all diabetic patients during their lifetime. In long standing diabetic patients with chronic non-healing ulcers, bony changes or deformities are not uncommon. These bony changes can be identified using CT scans. Materials and Methods: An observational study was conducted on a total of 40 patients with chronic non-healing ulcer attending the surgery outpatient department of Saveetha Medical College, Chennai, Tamilnadu. The CT-scans of their foot were observed for deformities or bony changes. Results: Out of 40 patients, 67.5% were males and 32.5% were females. A maximum number of subjects fell under the age group of 51 - 60 years. The most common site of the ulcer was found to be in the plantar surface of big toe (53%). Among the 40 patients, 33 of them were found to have bony abnormalities on the CT scan of foot and no apparent changes were seen in the rest. Bone erosions (35%), osteopenic changes (22.5%), Charcot’s joint (2.5%), osteophyte formation (12.5) and reduced joint space (10%) were the predominant changes observed on the CT scans of the study population.

关键词： Diabetic Foot Ulcer Bony Abnormalities CT Scan Bone Erosions Charcot’s Joint Osteophyte Formation Reduced Joint Space Osteopenic Changes Plantar Surface of Big Toe

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Awareness of Breast Cancer in Lower Socioeconomic Status Women Attending the Surgery Outpatient Department of a Tertiary Care Teaching Institution

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Case Reports in Clinical Medicine 2019年第8期8卷 205-215页

作者： S. Keerthana arcot rekha Saveetha Medical College and Hospital (SIMATS) Chennai India

Background: Worldwide breast cancer represents nearly a quarter (25%) of all cancers and is the most common female cancer. Objective: The present study was conducted to check the awareness of breast cancer warning signs & symptoms, available investigations and treatment options among women of a suburban area in Chennai, Tamilnadu (India). Materials and Methods: A cross-sectional, prospective study was conducted amongst women attending the surgery outpatient department of a tertiary care teaching institution in Chennai, Tamilnadu (India), using a semi-structured questionnaire. The questionnaires were administered during one to one interview by trained research assistants. Results: The study population showed poor awareness of warning signs like changes in position of nipple, pulling in of nipple, nipple rash, changes in size of nipple, puckering/dimpling of breast skin colour changes in breast skin, lump under armpit, changes in size and shape of breast. Conclusion: The observations indicated that the level of awareness and knowledge about the presentation and management of breast cancer is suboptimal among women in Thandalam (suburban Chennai).

关键词： Breast Cancer Awareness Questionnaire Mammogram Barriers Screening Chennai Tamilnadu India

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Tuberculous Olecranon Bursitis

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Case Reports in Clinical Medicine 2014年第5期3卷 281-285页

作者： arcot rekha Keerthi Kumaran Parimuthukumar Sri Ramachandra Medical College Sri Ramachandra University Chennai India

Olecranon bursal involvement due to tuberculosis is not often seen in literature. Involvement is often seen in the subdeltoid and trochanteric bursa, with concomitant skeletal involvement. We report a patient with iso... 详细信息

关键词： Olecranon Bursa Tuberculosis

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Cutaneous B cell lymphoma presenting as a soft tissue swelling

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Case Reports in Clinical Medicine 2013年第2期2卷 143-146页

作者： arcot rekha Santhosh Vivekanandan A. Ravi Sri Ramachandra University Chennai India

Cutaneous lymphomas are classified as B cell and T cell lymphomas which are seen very rarely. They present as papules or nodules in the absence of any extracutaneous involvement. We present a patient who had a diffuse... 详细信息

关键词： Cutaneous Primary Lymphoma Diffuse Type

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Ewings Sarcoma-Primitive Neuroectodermal Tumour-Rare Extraosseous Presentation

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Case Reports in Clinical Medicine 2016年第3期5卷 95-100页

作者： arcot rekha Prabhu Purushothaman Rufus Ranjitsingh Edwin Anukiran Ravichandran Sri Ramachandra Medical College and Research Institute Chennai India

Introduction: Ewings sarcoma is uncommon in extra osseous locations. They belong to Ewings family of tumours and the primitive neuroectodermal tumour is often diagnosed based on immuno histochemistry and molecular genetic studies. Discussion: A 50-year-old gentleman presented with complaints of a swelling in the right thigh. With a diagnosis of soft tissue sarcoma, the patient underwent a wide local excision of the tumour. We review literature of the small round blue cell tumour. Conclusion: Extraosseous Ewings sarcoma presenting as a thigh swelling is uncommon. The sarcoma was vimentin positive and CD99 membrane positivity.

关键词： Ewings Sarcoma Extra Osseous Primitive Neuroectodermal Tumour

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Organoaxial Gastric Volvulus—Chronic Hematoma and a Gastric Twist

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Case Reports in Clinical Medicine 2019年第6期8卷 152-156页

作者： Sivaram Sridharan Govindarajalu Muthukumaran arcot rekha Touzeen Hussain Department of General Surgery Saveetha Medical College Hospital Tamil Nadu India Sridharan

A 70-year-old male presented with gastric volvulus secondary to a hematoma that caused an organoaxial rotation. Contrast-enhanced CT was contributory to the diagnosis. The patient underwent laparotomy with gastrojejunostomy and jejunojejunostomy. We present our findings and review the literature of this uncommon pathology. A written informed consent was obtained from the patient for publication of this case.

关键词： Organoaxial Gastric Volvulus Chronic Hematoma

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Carcinoma of the Ovary Presenting as Cutaneous Metastases

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Case Reports in Clinical Medicine 2016年第11期5卷 500-504页

作者： Monisha Venugopal Naresh Duthaluri Prabhu Purushothamanan Anukiran Ravichandran arcot rekha Sri Ramachandra Medical College and Research Institute Sri Ramachandra University Chennai India

Introduction: Cutaneous metastasis is common from malignancies of the genitourinary system and occasionally from the digestive system. Cutaneous metastases, due to ovarian carcinoma as a presenting feature, being diagnosed on cytology, are uncommonly reported. Case Report: A 70-year-old lady presented with a cutaneous nodule and progressive abdominal distension. Investigations for metastatic nodule showed it to be a lesion from the ovary. Discussion: Carcinoma ovary is often diagnosed when patients present with ascites and the association with a parietal wall deposit is uncommon. The occurrence of a parietal wall nodule when the ascites is negative for malignant cells is not previously documented. Conclusion: We discuss literature of the malignancies that present with a parietal wall metastases and the management of ovarian carcinoma.

关键词： Carcinoma Ovary Cutaneous Nodule Cytology

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Fungal Carbuncle Due to <i>Apophysomyces elegans</i>—A Case Report

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Case Reports in Clinical Medicine 2019年第1期8卷 21-28页

作者： Dev Merlin Samuel Narayanasami Bharath Manoj Prabu Khalilur Rahman arcot rekha Saveetha Medical College and Hospital Saveetha Institute of Medical and Technological Sciences Chennai India

Background: Deep seated cutaneous fungal infection is a rare entity in surgical practice and is very often under diagnosed. Due to the atypical presentation and slow but aggressive progression of the disease, the associated mortality is high. Aim: The aim of this article to update clinicians about the peculiar presentation of mucormycosis caused by Apophysomyces elegans. Case Presentation: A 50 year old gentleman with a painful swelling and fever was admitted into our care. He had history of trivial trauma and no medical comorbid. His initial labs came back relatively unremarkable. He did not respond to an empirical antibacterial regimen and progressively worsened. The region was debrided and found to have granular secretions with sloughed tissue. On opening the dressing post operatively, a fungal mould was found. Fungal etiology was suspected and KOH mount confirmed the diagnosis. He was started on empirical IV antifungals, and local therapy while awaiting culture and sensitivity reports. However, he progressively deteriorated and succumbed to the disease eventually. Conclusion: Here we describe a deep seated cutaneous fungal infection in an immunocompetent patient and the challenges we faced during the course of his management. Fungal etiology is generally encountered in immunocompromised hosts. Deep seated cutaneous fungal infections with poor response to antifungal therapy and systemic sepsis led to this patients’ demise. This being the case, the onus is on the clinicians to diagnose a fungal etiology early and start appropriate anti fungal measures.

关键词： Mucormycosis Deep Seated Cutaneous Fungal Infections Apophysomyces elegans

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A Rare Interstitial Type of Post Appendectomy Incisional Hernia

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Case Reports in Clinical Medicine 2021年第5期10卷 146-151页

作者： Katari Gopalakrishnan Vishnukumar Sudharshan S. Murthy Abishek Kandasamy Rajasabapathy Kulandaiyagounder Ramaswamy Manoj Prabu arcot rekha Saveetha Medical College Chennai India

Intraparietal Hernias are hernias occurring in the anterior abdominal wall at different anatomical planes. An interparietal hernia has a hernial sac that passes between the layers of the anterior abdominal wall. Appendectomy is a very common surgical procedure, and post appendectomy incisional hernia is a very rare complication. Here we present a case of a 24-year-old male with swelling in the right hypochondrium and lumbar region with an open appendectomy scar. He was diagnosed to have an interparietal hernia in the anterior abdominal wall. After obtaining consent patient was taken up for surgery. At surgery, the patient was found to have a defect in the transverse abdominis muscle with a medial leaf far from the incision site. Open repair of the defect along with double breasting of external oblique done. Interparietal hernias are rare in post appendectomy scar and this case is of significance since it Highlights a rare interstitial type incisional hernia, as a complication of post appendectomy scar, and not many cases reports are mentioned in literature.

关键词： Interparietal Hernia Post Appendectomy Incisional Hernia Interstitial Type Abdominal Wall Defect Double Breasting

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Schwannomas—Atypical Presentation and Challenges

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Case Reports in Clinical Medicine 2019年第4期8卷 93-98页

作者： R. Vijai J. Ruban Kumar R. Arihanth Manoj Prabu Narayanasami Bharath Khalilur Rahman arcot rekha Saveetha Medical College and Hospital Chennai India

Introduction: Neurogenic tumors include schwannomas and neurofibro-mas. They occur often in the head and neck. However, their occurrence on the vagus is uncommon. A high index of suspicion is needed to order imaging in pelvic lesions that present atypically. Discussion: Schwannomas are hypointense on T1 and heterogeneously hyperintense on T2 on MRI. The histopathological appearance with Antoni type A and type B is typical of Schwannoma. Conclusion: Schwannomas are slow growing benign tumors that are separable from the parent nerve. Recurrence is uncommon after resection.

关键词： Cervical Presaccral IHC

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