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13
100067
34
Histological study concluded in multinodular colloid goiter.
[]
100067
35
The patient was discharged from the hospital after 20 days in good health.
[]
100075
1
A 13-year-old boy diagnosed with WHO diagnostic criteria of probable NS was referred from Atanga HC III in Pader district where he was enrolled and undergoing care at the nodding syndrome treatment center; he came with a history of progressive swelling and pain in the right lumbar region.
[]
100075
2
The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics.
[]
100075
3
These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss.
[]
100075
4
The patient reported a history of falling from a tree during one of the nodding episodes in October 2012 and hit his abdomen onto a tree branch.
[]
100075
5
On further probe on his childhood history, his mother reported that he was born normally at home by a Traditional Birth Attendant (TBA) in one of the Internally Displaced peoples (IDP) camps in 2000.
[]
100075
6
She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD).
[]
100075
7
She reported that during her pregnancy, she had exclusive feeding on the relief food provided by WFP (beans, yellow posho and cooking oil) during the IDP camps and denies history of ingestion of herbs or medications which caused adverse events during and after the pregnancy.
[]
100075
8
She reported that her child had a normal physical, cognitive and social childhood development before the onset of nodding which began in May 27th 2011 immediately after returning home from IDP camps.
[]
100075
9
The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin.
[]
100075
10
She reported that in spite of these medications the child continued to have seizures and nodding at least twice a day and had since dropped out of school.
[]
100075
11
On general examination, he was dehydrated, febrile and moderately wasted.
[]
100075
12
There was a right lumbar region mass, tender, indurated and non-fluctuant.
[]
100075
13
The spleen and liver were not palpable.
[]
100075
14
There was no renal or supra-pubic tenderness.
[]
100075
15
The rectum was full of faecal material which was of normal colour and consistency.
[]
100075
16
The anal tone was normal and there was no blood on examining fingure.
[ [ "normal", "tone" ] ]
100075
17
Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia.
[]
100075
18
There were immature granulocytes and atypical lymphocytes seen on the peripheral film report.
[]
100075
19
Other laboratory results including liver function tests (ALT, AST) were elevated while serum protein levels were low; renal functions tests (serum creatinine, blood urea and nitrogen level), and serum electrolytes (K+, Na+, Cl-, HC03-) which were within normal ranges.
[ [ "elevated", "AST" ], [ "elevated", "ALT" ], [ "elevated", "tests" ], [ "low", "levels" ], [ "within normal ranges", "tests" ], [ "within normal ranges", "level" ] ]
100075
20
Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall.
[]
100075
21
The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted.
[]
100075
22
He received supplementary food rehabilitation and his seizure medication was changed to Sodium Valproate 200mg once a day under direct observation therapy (DOTS) and close monitoring of the vital signs.
[]
100075
23
The patient continued to have regular follow up in the surgical ward; seizures and nodding stopped completely from the time of intervention in the hospital.
[]
100075
24
With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life.
[]
100075
25
A subsequent review of the haematological and clinical chemistry findings 2 weeks later showed that renal function tests, serum electrolytes were normal except the liver enzymes level were elevated and were still high.
[ [ "normal", "tests" ], [ "normal", "electrolytes" ], [ "elevated", "level" ], [ "high", "level" ] ]
100114
1
A 77-year-old Tunisian woman was hospitalized because of massive painful ascites.
[]
100114
2
Her family history did not include any autoimmune disease.
[]
100114
3
She denied a history of hepatitis, jaundice or alcohol use.
[]
100114
4
She had a history of diabetes, hypertension treated by glinide and calcium blocker.
[]
100114
5
She was explored 4 years prior to admission for exudative pleuritis of the right lung without any established diagnosis after multiple explorations including thoracoscopy with biopsies.
[]
100114
6
On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C.
[ [ "150/70 mmHg", "pressure" ], [ "80 /mn", "rate" ], [ "37°C", "temperature" ] ]
100114
7
The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation.
[]
100114
8
She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema.
[]
100114
9
Laboratory investigations showed: leucopenia with white blood cell count = 3100/mm3, lymphopenia = 840/mm3, hemoglobin = 10.5g/dL ; low serum albumin level = 29g/L, 47;-globulin = 19g/L. blood glucose levels = 180 mg/dl and hemoglobin A1c = 8.6 %.
[ [ "3100/mm3", "count" ], [ "840/mm3", "lymphopenia" ], [ "10.5g/dL", "hemoglobin" ], [ "29g/L", "level" ], [ "19g/L", "globulin" ], [ "180 mg/dl", "levels" ], [ "8.6 %", "hemoglobin" ] ]
100114
10
Urine analysis showed trace protein (0.03g/24h).
[ [ "0.03g/24h", "protein" ] ]
100114
11
Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits.
[ [ "normal limits", "cholesterol" ], [ "normal limits", "rate" ], [ "normal limits", "nitrogen" ], [ "normal limits", "count" ], [ "normal limits", "tests" ], [ "normal limits", "creatinine" ], [ "normal limits", "time" ] ]
100114
12
Tests for HBsAg and HCV were negative.
[ [ "negative", "Tests" ] ]
100114
13
Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis.
[]
100114
14
Neither lymphadenopathy nor liver abnormality was present.
[]
100114
15
A chest X-ray film disclosed bilateral pleural effusion.
[]
100114
16
Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells.
[ [ "170 cells mm3", "contained" ], [ "46g/L protein", "contained" ] ]
100114
17
Cultures for bacteria and mycobacteria gave no growth.
[]
100114
18
Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative.
[ [ "negative", "investigation" ], [ "negative", "test" ], [ "negative", "research" ] ]
100114
19
Echocardiogram and electrocardiogram were normal.
[ [ "normal", "electrocardiogram" ], [ "normal", "Echocardiogram" ] ]
100114
20
Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion.
[]
100114
21
Pelvic examination was normal.
[ [ "normal", "examination" ] ]
100114
22
Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices.
[]
100114
23
An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis.
[]
100114
24
Histological examination of the peritoneum showed non specific chronic inflammation.
[]
100114
25
Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia.
[]
100114
26
An additional serologic survey revealed markedly elevated anti-nuclear antibody (ANA) titer of 1/1600 and a significantly elevated titer of antibody to double-stranded DNA (83 IU/mL ; normal < 30 IU/mL).
[ [ "1/1600", "titer" ], [ "83 IU/mL", "titer" ], [ "positive", "serum" ] ]
100114
27
She had also positive serum antibody against the Smith antigen and low serum level of C3 complement component: 67 mg/dL (serum normal range: 84 – 151).
[ [ "67 mg/dL", "level" ], [ "84", "serum" ], [ "151", "serum" ] ]
100114
28
Relying on these findings, the patient was diagnosed with SLE since 4 of the 11 diagnostic criteria of the American College of Rheumatology were met.
[]
100114
29
The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission.
[ [ "7", "score" ] ]
100114
30
Hydroxychloroquine 200 mg daily in combination with diuretics was initiated.
[]
100114
31
One month later, there was no detectable ascitic fluid and no pleural effusions.
[]
100114
32
Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
[]
100129
1
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic.
[]
100129
2
She had a 2 year history of frequent non-pulsating headaches.
[]
100129
3
Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity.
[]
100129
4
There was no nausea or aura like symptoms accompanying the headache.
[]
100129
5
Headaches were lasting for hours.
[]
100129
6
The pain was bilateral, generalized and pressing in quality.
[]
100129
7
The family history for headache was negative.
[]
100129
8
She had a history of seizures occurring in the fifteenth day of life described as attacks of tonic clonic contractions and that's when she was diagnosed with SWS.
[]
100129
9
At the age of 6 she had a history of callosotomy to control her seizures.
[]
100129
10
At the age of 18 during a laser treatment done in order to get rid of her port wine birthmark she had her first seizure since callosotomy.
[]
100129
11
After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then.
[]
100129
12
According to the story taken from her parents even though she had a normal development at infancy she barely graduated from elementary school and she's hardly literate.
[]
100129
13
There was nothing significant on her family history except for her elder sister's port wine stain on her face.
[]
100129
14
The elder sister had no feature of SWS and no researches were done regarding her stain.
[]
100129
15
She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches.
[]
100129
16
She was also inscribed NSAID drugs.
[]
100129
17
After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same.
[]
100129
18
At her physical examination a facial nevus -occurred due to choroid angioma-on the right forehead, right eyelid, nasal wing and the cheek was observed.
[]
100129
19
Intra oral examination showed a right sided overgrowth of gingiva.
[]
100129
20
Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement.
[]
100129
21
On her extremities a mild asymmetry was visible.
[]
100129
22
Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size.
[]
100129
23
On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye.
[]
100129
24
On her psychiatric examination she showed signs of anxiety disorder.
[]
100129
25
Her neurological examination was not remarkable except for her hemiparesis.
[ [ "not remarkable", "examination" ] ]
100129
26
Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area.
[]
100129
27
Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side.
[]
100129
28
Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left.
[]
100129
29
In addition to that, T2 weighted MRI shows extensive venous formations around corpus of right lateral ventricle and at Gallen vein localization and widespread vascular formations are seen at perivascular space, anterior to third ventricle at Willis polygon localization and at right temporooccipital area at quadrigeminal cistern localization.
[]
100129
30
She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
[ [ "75 points", "test" ] ]
100129
31
Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
[ [ "75 points", "test" ] ]
100184
1
An eleven year old girl presented to the paediatric eye clinic of the University College Hospital, Ibadan, Nigeria with a history of squint and poor vision.
[]
100184
2
Her mother had noticed a misalignment of the eyes three years previously and the patient had been complaining about poor distance vision for about a year.
[]
100184
3
There was no history of antecedent trauma to the head or face.
[]
100184
4
There was no history of double vision (diplopia) or pains on ocular movements.
[]
100184
5
There was no associated headache, fever, vomiting, joint pains or skin rashes/lesions.
[]
100184
6
The review of systems was essentially normal and she had enjoyed good health since early childhood.
[ [ "normal", "review" ] ]
100184
7
Her pregnancy and delivery were uneventful; and her development was normal.
[]
100184
8
All other family members were well and there was no family history of squint.
[]
100184
9
Unaided visual acuity was 6/24 in the right eye and counting fingers (CF) in the left eye.
[ [ "6/24", "acuity" ] ]
100184
10
During refraction, her visual acuity improved to 6/9 and 6/60 in the right and left eyes respectively.
[ [ "6/9", "acuity" ], [ "6/60", "acuity" ] ]