Journal of Case Reports in Practice
Volume:3 Issue: 2, Apr 2015

Epidemiologic study indicates that low speed traffic crashes are associated with a relatively low risk of significant injury. This fact is often used to defend legal actions in cases in which it is alleged that a significant injury has resulted from a low speed crash. Injury causation following a low speed collision can only be assessed by comparing the risk of injury from the crash to the risk of the injury occurring at the same point in time, but absent the exposure to the crash. As a practical matter in a clinical setting, this means that a history of close temporal proximity between the collision and the onset of symptoms is the strongest indication of causality, irrespective of a low injury risk associated with the collision. In the present case study an acute superior endplate fracture and bilateral facet fracture was observed in the lower lumbar spine in a 49 year old female occupant of a vehicle that was struck from behind at low speed. Injuries to the patient’s neck and shoulder were ultimately diagnosed as intervertebral disk derangements and glenoid labrum tear, respectively. As a result of the injuries the patient underwent four spine surgeries and an arthroscopic procedure on her shoulder. Various experts for the insurer asserted that the injuries and subsequent need for treatment were unrelated to the collision, in part based on the low risk of such injuries from a low speed crash. The methodologic and logical errors committed by the insurer’s experts in arriving at these conclusions are discussed.

Traumatic pulmonary pseudocysts are rare cavitary lesions of the lungs that develop after chest trauma. The lesions often occur in young adults and males. Other cavitary lesions of the lungs must be taken into consideration when distinguishing the diagnosis, and it must be kept in mind that computerized tomography is more effective than chest radiography in the diagnosis of traumatic pulmonary pseudocysts. Conservative therapy is recommended in its treatment. The current report presents an 18-year-old patient who was admitted to emergency department and then thoracic surgery clinic, after sustaining a motor vehicle accident and discharged as a healthy person.

Tuberculosis (TB) being a disease predominantly occurring in developing countries presents variedly and the occurrence of extra-pulmonary TB without primary pulmonary is a challenge even in the present era. Here we report a case of an 18 year old female presenting with symptoms of diffuse dull aching pain abdomen for 2 to 3 months with poor appetite who had history of significant weight loss with irregular bowel habits. Though CT of abdomen showed polypoidal growth in right colon with mesenteric lymphadenopathy, colonoscopy and guided biopsy failed to give histological diagnosis. Ultrasonography (USG) guided FNAC from mesenteric lymph node showed acid fast bacilli thus helping diagnosis and preventing radical procedures. Thus authors feel the need to share their experience to sensitize clinicians about the usefulness of USG guided aspiration to diagnose such cases of ileocaecal growth.

A 44-year-old female with a remote history of autoimmune hepatitis (AIH) in remission presented with fatigue and scleral icterus, and developed fulminant liver failure within 24 hours of admission. The initiation of therapy was delayed due to the incidental finding of cholelithiasis and suspected cholecystitis. The patient was initiated on empiric antibiotics, but deteriorated rapidly. The clinical picture and history was consistent with acute severe AIH, but a low serum ceruloplasmin level and laboratory features of hemolytic anemia pointed towards fulminant Wilson’s disease. She was initiated on pulse-dose steroids, but ultimately expired from acute severe liver dysfunction and multi-organ failure. The case highlights the clinical features of AIH in the acute setting, and seeks to discuss the role of serum ceruloplasmin levels in patients with liver disease.

Ozone treatment has a direct lethal effect on virus during both acute and chronic phases of Hepatitis B disease. Various studies showed that ozone has %100 lethal effect on virus. Aim of this case report is to evaluate the possible role of ozone therapy in treatment of patients with chronic hepatitis B. A 23 years old female patient, HBsAg(+) and HBeAg(+) was detected. Ozone treatment was performed with major and minor autohemotherapy. By applying twice a week, 12 sessions of major autohemotherapy, 5 sessions of minor autohemotherapy were completed. The treatment after the 12th session was scheduled as once a week in the first month, once every two weeks in the second month and monthly after the 5th month. The patient was called for control once every two months after the 20th session when no clinical symptom was detected after a single major and minor autohemotherapy. We consider that treatment of medical ozone on patient with chronic hepatitis B is effective. But further evaluation and larger controlled trials are needed.

To report two cases of pachydermoperiostosis and to improve the clinic methods of diagnosing and treating this disease. Two pachydermoperiostosis patients in Huashan hospital were reported; the laboratory tests, imaging, and pathology tests had been taken; the related literatures were analyzed. After all the tests, both of the patients were diagnosed with PDP and treated with isotretinoin and clindamycin, one of them took the knee joint synovium resection with no recurrence in the two years after the operation. The patients were diagnosed with PDP by clinical and imaging manifestations.