Present Case Report Research Articles

A Case Report of Atypical Presentation of Metastatic Breast Cancer as Peri-Bronchial Mediastinal Lesion

A Case Report of Atypical Presentation of Metastatic Breast Cancer as Peri-Bronchial Mediastinal Lesion

Connective Tissue Graft May Compensate for Residual Bone Defect of the Implant in the Esthetic Zone: A Case Report with 7-year Follow-up

The present case report aimed to demonstrate the case using a connective tissue graft (CTG) to compensate for a residual defect after guided bone regeneration (GBR) in the anterior maxillary area. An extensive number of studies have reported successful outcomes of horizontal bone augmentation, but it was also demonstrated that a complete resolution of the defect may not be achieved in all cases. In the present case report, the patient underwent implant placement simultaneously with GBR at the anterior maxillary area. After 4 months, partial regeneration of the initial defect was observed. To compensate for such residual defect, a CTG was applied. Other expectations by the CTG were to enhance tissue volume and phenotype. The final prosthesis was delivered after 3 months. Up to 7 years, favorable radiographic and clinical situations were observed. In conclusion, a CTG may compensate for residual bone defect of the implant in the esthetic zone.

A rare case of mucocele of the Blandin and Nuhn glands with review of literature

Oral mucocele is the most common benign minor salivary gland lesion of the oral cavity. Usually it occurs on lower lip, buccal mucosa and ventral surface of the tongue and rarely seen on ventral surface of the tongue, floor of mouth and palate. It is classified in two types of lesions, one is extravasation type which is more common and other is retention type. We present case report of a 37-year-old healthy male with complaint of swelling on ventral surface of the tongue, which was sessile, soft and fluctuant with smooth overlying mucosa with diagnosis of mucocele associated with Blandin and Nuhn gland. Management included marsupialization and drainage of thick mucus secretions. This article discusses on clinical features, diagnosis and management of mucoceles associated with Blandin and Nuhn gland.

Infective endocarditis in an adult with undiagnosed tetralogy of Fallot: a case report of a rare presentation.

Unrepaired tetralogy of Fallot (TOF) is uncommonly diagnosed in adulthood and only 3% of patients survive to reach the age of 40 without surgical repair. If unrepaired, these patients are at risk for infective endocarditis (IE). In this report, we present a case of a middle-aged, previously healthy female whose only complaint was unexplained fever. Echocardiography led to the discovery of undiagnosed TOF complicated with IE with a vegetation on the right ventricular (RV) side of the ventricular septal defect (VSD) which was appropriately managed with antibiotics. In rare cases of acyanotic TOF where there is a lesser degree of right ventricular outflow tract obstruction (RVOTO), patients may survive into adulthood and can be asymptomatic till becoming initially presented with complications such as infective endocarditis.

Rare and first case report of a diffused cutaneous leishmaniasis from Uttar Pradesh state, India

Kala-azar is common in Bihar and some bordering areas of Uttar Pradesh but cutaneous, diffused and mucocutaneous leishmaniasis is not yet reported in areas of Uttar Pradesh, India. A rare case of diffuse cutaneous leishmaniasis was reported from a resident of Karaundi village of Deoria district, with no history of travelling to endemic areas with this disease. The present case report raises the alarm for the presence of this disease in this region and also it raises the question of whether the vector is present with compatibility to carry this parasite as well which has not been reported till present. Future molecular diagnosis and vector studies are required to confirm this and also to prevent future outbreaks.

CONGENITAL PULMONARY AIRWAY MALFORMATION IN A NEWBORN: A CASE REPORT

Congenital pulmonary airway malformation (CPAM) is one of the many causes of respiratory distress, generally occurring in about 7 % of infants in the early neonatal period. This article describes a clinical case of CPAM in a neonate who presented with signs of severe respiratory failure from the fi rst hours of life. The repeated occurrence of pneumothorax, development of pneumonia and hypoxicischemic damage of the central nervous system complicated the course of the disease in this child during the neonatal period. The clinical features of the course of the disease and their correlation with the results of laboratory and instrumental studies are analyzed. The results of dynamic radiography of the thoracic organs and spiral computed tomography (CT) of the lungs are presented. The presented clinical case shows that congenital lung pathology, namely malformation of the pulmonary airways, may be an unrecognized cause of respiratory distress in the neonatal period for a long time. The presented case report shows that congenital lung pathology, especially CPAM, in neonates may be an unrecognized cause of respiratory distress for a long time. In order to diagnose this disease promptly, a comprehensive evaluation of the child should include not only a chest x-ray, which is not always informative in the early stages, but also a CT scan of the lungs. Optimizing the choice of diagnostic measures contributes to increasing the eff ectiveness of treatment, including surgical treatment, and preventing the development of possible complications, improves the prognosis for life and health of children with the specifi ed pathology.

Case Study on effect of Tamra Shalaka Agnikarma in the management of Kadara (Foot corn)

Ayurveda has a deep and all-encompassing understanding of life and health as a science. Over the course of many years, Ayurveda various branches have developed, with the primary focus being on disease prevention and treatment. There are a few illnesses known as Kshudra-Roga that have straightforward pathologies but are challenging to treat. Foot corn can be correlated with Kadara in Ayurveda, and it is one among the 44 Kshudra Rogas mentioned by Acharya Sushruta. Kshudra means little, diminutive or tiny means they are less severe when compared to Mahavyadhi. Acharya Bhoj describes it as Mamsakeela. Its form is identical to Koalmatra's. The pathophysiology of these conditions is caused by the vitiation of Meda and Rakta Dhatu and the dosha of Kapha and Vata. It is localized because the affected skin develops hyperkeratosis on the tips of the toes, the sole, and the inter phalangeal joints as a result of thorn puncture, continual friction, individual susceptibility, and other factors. Corn in western medical literature exhibit striking similarities in their presentations. Salicylic acid treatment, corn caps, and invasive techniques such as laser, chemical, electric, and cryotherapy cauterization, as well as surgical excision, are used in the management of corn. However, there is a greater probability of recurrence and the results of these operations are not good. However, the after effects of corn surgery are promising due to its recurrence and wound healing. Agnikarma (Cauterisation) is the best treatment for the Kadara. This present Case report describes a case of Kadara (Foot corn) diagnosed as per clinical features and managed successfully by Agnikarma.

Non-Neoformans Cryptococcal Infections in the Post-Coronavirus Disease-19 (COVID-19) Era: Are We Ready to Face the Emerging Challenge?

AbstractCoronaviruses are a large group of viruses that infect animals as well as humans, while it is also suggested that, rarely, coronaviruses that infect animals can evolve and infect humans. Current evidence suggests that severe acute respiratory syndrome (SARS) coronavirus-2 leads to coronavirus disease-19 (COVID-19), the respiratory illness responsible for COVID-19 pandemic, while it has a zoonotic origin, closely related to the bat-origin SARS-like coronavirus. Also, as per the current knowledge, the disease may induce significant and persistent lymphopenia which in turn may increase the risk for various opportunistic infections. Cryptococcus laurentii is one such rare, but serious fungal infection which has been reported in post-COVID-19 disease and is a rising cause of concern since it can turn out to be fatal. The infection is caused by a non-neoformans rare human pathogen. The present case report describes the case of a 45-years old male patient who reported to the Outpatient Department (OPD) for a routine dental complaint with a grossly destructed tooth in left lower back tooth region due to extensive carious involvement, while, simultaneously, presenting with fever since 5 days in the post-COVID-19 phase, and was later diagnosed as being positive for C. laurentii infection on urine culture sensitivity test.

Basti as Ardha Chikitsa in the management of Vata-Pitta Samsrushta Grudrasi - A Case Report of Lumbar Spondylosis

Lumbar Spondylosis is the commonly observed chronic degenerative disorder especially in the geriatric age group. This signifies that disorder is majorly due to Dhatu Kshaya (~depletion of body building and sustaining factors). In the present case report of Lumbar Spondylosis, was diagnosed as Vata Pitta Samsrushta Grudrasi (~sciatica formed by Vata and Pitta Dosha in their equal dominance) with the application of Trividha Bodhya Samgraha (~cause, situation and nature of disease). A 53 year housewife hailing from rural sector of Jangala Desha (dry area) reported with severe burning sensation in right foot, low backache, referred pain in right calf associated with numbness. Vata and Pitta were elicited as Sthanika (~functional unit of its own place) and Agantu Dosha (~functional unit entered from other part) respectively through Samsarga Dosha Laxana. Yapana Basti (~Enema Therapy) schedule was designed to pacify Pakvashayagata Vata-Pitta (~Vata and Pitta situated in lower gut). Qualitative assessment done before and after treatment revealed successful outcomes where score reduced from 12 to 2 indicating improved quality of life. Basti acts as Ardha Chikitsa (~half treatment) when proper Yukti (planning) is applied in designing protocol, selecting appropriate formulations by incorporating multiple Chikitsa Siddhanta (~treatment principle) such as Sthanivat Chikitsa.

Ayurvedic management of Autism - A Case Report

Ayurveda, an ancient system of medicine in India, offers a holistic approach to health and wellness. When applied to Autism, Ayurveda emphasizes individualized treatment plans that balance the body's Doshas (Vata, Pitta, and Kapha) through diet, herbal remedies, lifestyle modifications, and therapies like Panchakarma. This approach aims to address both physical and mental imbalances, which are believed to contribute to Autism spectrum disorders (ASD). In this article, presentation of an interesting case of autism, not responding to the conventional protocol in modern medicine, managed with Ayurvedic treatment. The present case report demonstrates clinical and ISAA score changes with Ayurvedic medicinal interventions.

Holohemispheric Hemorhhage in Infantile Acute Subdural Hematoma: Serial Neuroimaging Analysis

Background: An acute subdural hematoma (ASDH) in infants without any external sign of trauma is differently recognized as shaken baby syndrome (SBS) / abusive head trauma (AHT) in the United States or as infantile acute subdural hematoma (IASDH) due to minor head trauma in Japan. The present case report aimed to demonstrate that IASDH can occur after a mild head impact if the dural border cell layer is disrupted in an infant with cranio-cerebral disproportion (CCD). Case description: A 5-month-old, male patient fell from a baby bed and struck his occiput against a mat. He began to cry and soon thereafter demonstrated signs of altered consciousness. He was taken to a pediatric hospital where computed tomography (CT) revealed a thin subdural hematoma (SDH) surrounding the entire right cerebral hemisphere. Fundoscopy found a right-sided retinal hemorrhage. Magnetic resonance imaging (MRI) on hospital day 4 revealed a thin, high-intensity ASDH surrounding the entire, cerebral convexity on the right side. In addition, benign enlargement of the subarachnoid space (BESS) and large sylvian fissure (LSF) were noted. On hospital day 12 and 18, follow-up MRI revealed a residual SDH with minimal reduction. The patient had an uneventful clinical course and met all the normal, developmental milestones as of his current age of 3 years. Conclusion: The present case is invaluable because it demonstrates that ASDH can occur as a result of a mild, occipital impact. Particularly relevant here is the thin, holohemispheric appearance of the hematoma on neuroimaging studies, which has been suitably termed, holohemispheric subdural hematoma (HHSDH). Also noteworthy is the long-term presence of the HHSDH with minimal reduction of the SDH. The HHSDH may be caused by entrapment of the hematoma in the dural border cell layer in the absence of any communication with the surrounding structures.

Eye Mapping: Innovative Technique for Precise Iris Positioning in Prosthetic Eye.

The aim of this technique is to institute "Augmented Reality Tool" in the field of maxillofacial prosthesis for an accurate and precise iris positioning in a prosthetic eye. A congenital defect, irreversible damage, a painful blind eye, sympathetic ophthalmia, or the requirement for histological confirmation of a suspected illness can all result in the absence or loss of an eye. In such circumstances, meticulous preoperative, surgical, and prosthetic planning using a multidisciplinary approach is imperative for successful rehabilitation. Augmented reality filter was used to provide precise mapping of facial landmarks and to aid in iris positioning. Smartphone device (S22) was used and artificial intelligence (AI)-generated Instagram application was unfurled and augmented reality (AR) filter was instituted. The filter available in the application made it possible to see and confirm the iris shell's location in three dimensions from various angles. The dimensions thus provided, aided in the correct positioning of the iris in the prosthetic eye. Iris positioning stands as one of the crucial steps in fabricating a patient-specific ocular prosthesis. In the present case report, iris positioning was done using AI has provided an excellent esthetics results and patient compliance was met with satisfaction. Accurate positioning of iris can be done using AR tool which is popular, easily accessible, less technique sensitive, and can be performed with slightest efforts in small clinical set-ups. Relating to patient, it is comfortable, economic, and trouble-free procedure. How to cite this article: Zilpilwar NR, Nimonkar SV, Chitlange P, et al. Eye Mapping: Innovative Technique for Precise Iris Positioning in Prosthetic Eye. J Contemp Dent Pract 2024;25(7):711-714.

Clinical Management of Postpartum Cervico-Vaginal Prolapse in Graded Murrah Buffalo: A Case Report

The present case report describes the postpartum cervico-vaginal prolapse and its clinical management in a graded Murrah buffalo with the history of parturition a day ago, presented to the Veterinary Clinical Complex, Korutla. The prolapsed mass was having lacerations, mild straining and bleeding. After thorough cleaning and reduction of edema, the prolapsed mass was properly repositioned. A rope truss was applied to prevent reoccurrence of prolapse. The animal showed a good response to manual correction and no complications were observed. Early diagnosis and timely intervention will help in effective management of postpartum cervico-vaginal prolapse in a buffalo.

A Case Report of a Rare Presentation of Semimembranosus Tibial Plateau Avulsion: The Bony Ramp Lesion

Background: Tibial plateau posteromedial rim avulsions by semimembranosus tendon are a rare entity that have been reported in a few studies so far with controversial mechanisms. They are reported to accompany anterior cruciate ligament (ACL) or meniscal injuries. Their main fracture planes are usually placed in the coronal plane. Case Report: The patient was a 52-year-old man with a hyperextension-valgus tibial plateau fracture. The imaging studies revealed a compression fracture of the lateral and an avulsion fracture of the posteromedial plateau. However, no soft-tissue injuries were detected. The fragment was avulsed in the axial plane and covered by the medial meniscal posterior horn, creating the pattern of a longitudinal tear in the meniscal ramp lesion, but actually without any soft-tissue injuries. It was fixated using the tension band wiring technique with two Kirschner wires (K-wires) and one cancellous screw. Radiological and functional outcomes were excellent at 12-month follow-up. Conclusion: This fracture pattern merits special attention due to its unusual presentation, causing the meniscal posterior horn to separate from the articular surface. “Bony ramp lesion” best describes the simultaneous separation of the posterior horn of the medial meniscus (PHMM) and its underlying bony fragment without the meniscal tear that takes place in an actual medial meniscal ramp lesion.

Different faces of Mycoplasma pneumoniae in children - cardiological and skin complications- case reports and literature review

Mycoplasma pneumoniae is one of the main pathogens responsible for atypical pneumonia, especially in children over the age of 5, where it accounts for about 40% of cases of extramedullary pneumonia. In addition to respiratory-related symptoms, it can lead to a variety of extrapulmonary manifestations associated with involvement of other organs. In this article, we present case reports of two pediatric patients with detected M. pneumoniae infection with associated cardiac and skin complications. The first case report describes an 11.5-year-old boy who was admitted to the Department of Pediatrics because of chest pain, fever and moist cough for several days, who was diagnosed with myocarditis during M. pneumoniae infection. The second case report describes a 17-year-old girl with a recent respiratory infection who was admitted to the hospital for pain, swelling, blistering of the lips and oral mucosa. Mycoplasma pneumoniae infection can lead to extrapulmonary complications in children, which can produce nonspecific symptoms, so clinical vigilance and early recognition are important to minimize the risk of complications.

Use of Advanced Platelet-Rich Fibrin for the Treatment of Multiple Adjacent Mucogingival Recessions: A Technical Report of the Fibrin-Assisted Soft-Tissue Promotion Protocol.

Platelet-rich fibrin (PRF) has had a marked impact on regenerative medicine due to its widespread ability to promote angiogenesis to defective tissues. Particularly in the dental field, evidence from randomized clinical trials has further shown that PRF facilitates greater soft-tissue regeneration when compared with hard tissues. Recently, the fibrin-assisted soft-tissue promotion (FASTP) technique has been developed as a means to promote soft-tissue regeneration of mucogingival recessions utilizing PRF. Within the present case report, a 28-year-old male presented with multiple adjacent mucogingival recessions in the maxilla ranging in probing depths (1-3 mm) and gingival recessions (1-5 mm). For optimal regenerative outcomes, the use of advanced PRF (A-PRF; 1300 RPM for 8 min) has been utilized to enhance regenerative outcomes by fully taking advantage of the low-speed centrifugation concept (LSCC). This case report highlights the latest surgical concepts, centrifugation protocols, and use of the LSCC to regenerate multiple adjacent mucogingival recessions in the esthetic zone.

Total Temporomandibular Joint Replacement by Samsid Customized Joint Prosthesis: A Case Report with 16 Years of Follow-Up

AbstractTotal temporomandibular joint replacement (TMJR) is a surgical intervention employed for the management of advanced temporomandibular joint (TMJ) disorders, particularly when autogenous grafts are not recommended. With stainless steel implant of glenoid fossa attempted for the correction of ankylosis in the 1960s, total TMJR—which minimizes foreign body reaction and consists of highly biocompatible materials such as Cr-Co-Mo alloy, titanium, and ultra-high-molecular-weight polyethylene—began to be applied. These alloplastic prostheses are available in both standardized and customized forms, comprising components for the mandibular condyle and glenoid fossa. The present case report presents India's first TMJR in a 12-year-old female patient with TMJ ankylosis. Total TMJR was done in her with India's first customized TMJ prosthesis (Samsid TMJ prosthesis), which was designed and manufactured by the author for the first time in India. This study presents a 16-year follow-up of customized TMJR, addressing TMJ ankylosis. Our research showcases the long-term success of Samsid TMJ prostheses in improving pain, oral function, diet, and overall quality of life. The case report also highlights the potential of Samsid TMJ prostheses as a valuable solution for TMJ patients, emphasizing the importance of tailored solutions for lasting joint function restoration. The results presented indicate that the Samsid patient-fitted total TMJR system remains a secure, efficient, and dependable long-term treatment option for the particular patient demographic examined in this research.

MANAGEMENT OF PREPARTUM CERVICO-VAGINAL PROLAPSE IN A HOLSTEIN FRIESIAN CROSSBRED COW

The present case report explains management of cervico-vaginal prolapse in a eight months pregnant Holstein Friesian crossbred cow. The proper therapeutic and management practices were applied for easy reposition and correction of cervico-vaginal prolapse. The results conclude that cervico-vaginal prolapse occurs due to one or more etiological factors including impaired endocrine function due to feeding with mustard fodder.

Effect of one-month shatkarma intervention on hypertriglyceridemia: a case study

High triglyceride levels can increase the risk of heart disease, so finding effective ways to manage them is important. Traditional yoga practices, especially Shatkarma, are being looked at for their potential benefits on cardiovascular health. This present case report explores one-month Shatkarma intervention on hypertriglyceridemia of a middle-aged male. A 58-year-old man with very high triglycerides (598.77 mg/dl) was admitted to Patanjali Ayurveda Hospital, based on his pre-examination he was transferred to Shatkarma department for further procedure. He then participated in a one-month Shatkarma program, which included Shankha Prakshalana (done once), Kunjal Kriya (twice a week), and Jal Neti and Trataka (alternate day). After the month-long program, his triglyceride levels dropped significantly from 598.77 mg/dl to 114.5 mg/dl. This case shows that Shatkarma practices can significantly lower triglyceride levels. The results suggest that combining traditional yoga practices with conventional treatments could be a helpful way to manage high triglycerides. However, since everyone’s body responds differently; more research is needed to fully understand how these practices work and their long-term benefits.

Five- and 18-Year Outcome of Two Cases with Full-Arch Rehabilitations Ad modum All-on-4 in the Presence of Challenging Conditions.

Placing implants in fresh postextraction sites is a borderline rehabilitation procedure. The purpose of this report is to describe the pre-, per-, and postoperative procedures for maintaining long-term stability of two full-arch rehabilitations through the All-on-4 protocol, performed in the presence of challenging conditions. Two patients were referred for full-arch rehabilitation with immediate function, with both patients presenting infection in the jaws: patient 1 with an implant (position #45) inserted in a cystic cavity; patient 2 with one implant (position #24) inserted transsinus after the removal of a cyst on the base of the maxillary sinus and another implant (position #15) inserted with a dehiscence. Both patients received a preoperative dental hygiene appointment, a regenerative surgical protocol, and were enrolled in a postoperative maintenance protocol. After surgery a provisional prosthesis was provided ensuring immediate function, and 6 months after surgery, the final prosthesis was delivered. During the follow-up appointments (final follow-up at 5 and 18 years), the implants were stable, and no infection was observed for both patients. The present case report describes two full-arch rehabilitations in immediate function, supported by dental implants inserted in the presence of challenging conditions that do not represent the norm, rather are highly demanding for the clinical team, warranting caution in the interpretation of the results.