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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).
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A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. 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. On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. 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 %. Urine analysis showed trace protein (0.03g/24h). Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. Tests for HBsAg and HCV were negative. Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. Neither lymphadenopathy nor liver abnormality was present. A chest X-ray film disclosed bilateral pleural effusion. Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. Cultures for bacteria and mycobacteria gave no growth. Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. Echocardiogram and electrocardiogram were normal. Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. Pelvic examination was normal. Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. Histological examination of the peritoneum showed non specific chronic inflammation. Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. 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). 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). 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. The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission. Hydroxychloroquine 200 mg daily in combination with diuretics was initiated. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
|
EN100114
|
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.
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A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. 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. On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. 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 %. Urine analysis showed trace protein (0.03g/24h). Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. Tests for HBsAg and HCV were negative. Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. Neither lymphadenopathy nor liver abnormality was present. A chest X-ray film disclosed bilateral pleural effusion. Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. Cultures for bacteria and mycobacteria gave no growth. Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. Echocardiogram and electrocardiogram were normal. Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. Pelvic examination was normal. Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. Histological examination of the peritoneum showed non specific chronic inflammation. Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. 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). 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). 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. The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission. Hydroxychloroquine 200 mg daily in combination with diuretics was initiated. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
|
EN100114
|
The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission.
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A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. 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. On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. 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 %. Urine analysis showed trace protein (0.03g/24h). Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. Tests for HBsAg and HCV were negative. Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. Neither lymphadenopathy nor liver abnormality was present. A chest X-ray film disclosed bilateral pleural effusion. Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. Cultures for bacteria and mycobacteria gave no growth. Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. Echocardiogram and electrocardiogram were normal. Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. Pelvic examination was normal. Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. Histological examination of the peritoneum showed non specific chronic inflammation. Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. 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). 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). 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. The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission. Hydroxychloroquine 200 mg daily in combination with diuretics was initiated. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
|
EN100114
|
Hydroxychloroquine 200 mg daily in combination with diuretics was initiated.
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A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. 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. On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. 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 %. Urine analysis showed trace protein (0.03g/24h). Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. Tests for HBsAg and HCV were negative. Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. Neither lymphadenopathy nor liver abnormality was present. A chest X-ray film disclosed bilateral pleural effusion. Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. Cultures for bacteria and mycobacteria gave no growth. Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. Echocardiogram and electrocardiogram were normal. Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. Pelvic examination was normal. Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. Histological examination of the peritoneum showed non specific chronic inflammation. Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. 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). 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). 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. The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission. Hydroxychloroquine 200 mg daily in combination with diuretics was initiated. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
|
EN100114
|
One month later, there was no detectable ascitic fluid and no pleural effusions.
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A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. 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. On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. 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 %. Urine analysis showed trace protein (0.03g/24h). Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. Tests for HBsAg and HCV were negative. Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. Neither lymphadenopathy nor liver abnormality was present. A chest X-ray film disclosed bilateral pleural effusion. Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. Cultures for bacteria and mycobacteria gave no growth. Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. Echocardiogram and electrocardiogram were normal. Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. Pelvic examination was normal. Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. Histological examination of the peritoneum showed non specific chronic inflammation. Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. 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). 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). 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. The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission. Hydroxychloroquine 200 mg daily in combination with diuretics was initiated. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
|
EN100114
|
Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
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A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. 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. On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. 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 %. Urine analysis showed trace protein (0.03g/24h). Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. Tests for HBsAg and HCV were negative. Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. Neither lymphadenopathy nor liver abnormality was present. A chest X-ray film disclosed bilateral pleural effusion. Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. Cultures for bacteria and mycobacteria gave no growth. Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. Echocardiogram and electrocardiogram were normal. Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. Pelvic examination was normal. Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. Histological examination of the peritoneum showed non specific chronic inflammation. Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. 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). 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). 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. The SLEDAI score according to Systemic Lupus Erythematosus Disease Activity Index was estimated to be 7 on admission. Hydroxychloroquine 200 mg daily in combination with diuretics was initiated. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take Hydroxychloroquine
|
EN100114
|
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.
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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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics.
|
[
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12
],
"role": "",
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"text": "swelling",
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{
"id": "8398",
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27
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"role": "",
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51
],
"role": "",
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},
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46,
51
],
"role": "",
"semantic_type_id": "C0015967",
"text": "fever",
"type": "CLINENTITY"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss.
|
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34
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"text": "vomiting",
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"text": "eyes",
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"text": "loss",
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],
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],
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],
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"semantic_type_id": "C0009806",
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},
{
"id": "9384",
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],
"role": "",
"semantic_type_id": "C0848416",
"text": "yellow eyes",
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},
{
"id": "9391",
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"role": "",
"semantic_type_id": "C1971624",
"text": "loss of appetite",
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},
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97,
108
],
"role": "",
"semantic_type_id": "C1262477",
"text": "weight loss",
"type": "CLINENTITY"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
{
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30
],
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},
{
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89,
104
],
"role": "",
"semantic_type_id": "",
"text": "in October 2012",
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}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
{
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"text": "his mother",
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191,
198
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"role": "",
"semantic_type_id": "",
"text": "in 2000",
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}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD).
|
[
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3
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"text": "She",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
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"text": "ingestion",
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40,
43
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"role": "OTHER",
"semantic_type_id": "",
"text": "she",
"type": "ACTOR"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
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"text": "her child",
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{
"id": "9694",
"offsets": [
137,
150
],
"role": "",
"semantic_type_id": "",
"text": "May 27th 2011",
"type": "TIMEX3"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin.
|
[
{
"id": "9613",
"offsets": [
0,
9
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "The child",
"type": "ACTOR"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
{
"id": "8728",
"offsets": [
4,
12
],
"role": "",
"semantic_type_id": "",
"text": "reported",
"type": "EVENT"
},
{
"id": "8743",
"offsets": [
76,
84
],
"role": "",
"semantic_type_id": "",
"text": "seizures",
"type": "EVENT"
},
{
"id": "8758",
"offsets": [
89,
96
],
"role": "",
"semantic_type_id": "",
"text": "nodding",
"type": "EVENT"
},
{
"id": "9419",
"offsets": [
76,
84
],
"role": "",
"semantic_type_id": "C0036572",
"text": "seizures",
"type": "CLINENTITY"
},
{
"id": "9426",
"offsets": [
89,
96
],
"role": "",
"semantic_type_id": "C3658353",
"text": "nodding",
"type": "CLINENTITY"
},
{
"id": "9620",
"offsets": [
0,
3
],
"role": "OTHER",
"semantic_type_id": "",
"text": "She",
"type": "ACTOR"
},
{
"id": "9627",
"offsets": [
48,
57
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "the child",
"type": "ACTOR"
},
{
"id": "9703",
"offsets": [
106,
117
],
"role": "",
"semantic_type_id": "",
"text": "twice a day",
"type": "TIMEX3"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
On general examination, he was dehydrated, febrile and moderately wasted.
|
[
{
"id": "8773",
"offsets": [
11,
22
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "8788",
"offsets": [
31,
41
],
"role": "",
"semantic_type_id": "",
"text": "dehydrated",
"type": "EVENT"
},
{
"id": "8803",
"offsets": [
43,
50
],
"role": "",
"semantic_type_id": "",
"text": "febrile",
"type": "EVENT"
},
{
"id": "8818",
"offsets": [
66,
72
],
"role": "",
"semantic_type_id": "",
"text": "wasted",
"type": "EVENT"
},
{
"id": "9433",
"offsets": [
31,
41
],
"role": "",
"semantic_type_id": "C0011175",
"text": "dehydrated",
"type": "CLINENTITY"
},
{
"id": "9440",
"offsets": [
43,
50
],
"role": "",
"semantic_type_id": "C0015967",
"text": "febrile",
"type": "CLINENTITY"
},
{
"id": "9634",
"offsets": [
24,
26
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "he",
"type": "ACTOR"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
There was a right lumbar region mass, tender, indurated and non-fluctuant.
|
[
{
"id": "9494",
"offsets": [
12,
36
],
"role": "",
"semantic_type_id": "",
"text": "right lumbar region mass",
"type": "BODYPART"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
The spleen and liver were not palpable.
|
[
{
"id": "8833",
"offsets": [
30,
38
],
"role": "",
"semantic_type_id": "",
"text": "palpable",
"type": "EVENT"
},
{
"id": "9500",
"offsets": [
0,
10
],
"role": "",
"semantic_type_id": "",
"text": "The spleen",
"type": "BODYPART"
},
{
"id": "9506",
"offsets": [
15,
20
],
"role": "",
"semantic_type_id": "",
"text": "liver",
"type": "BODYPART"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
There was no renal or supra-pubic tenderness.
|
[
{
"id": "8848",
"offsets": [
34,
44
],
"role": "",
"semantic_type_id": "",
"text": "tenderness",
"type": "EVENT"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
The rectum was full of faecal material which was of normal colour and consistency.
|
[
{
"id": "8863",
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15,
19
],
"role": "",
"semantic_type_id": "",
"text": "full",
"type": "EVENT"
},
{
"id": "9512",
"offsets": [
0,
10
],
"role": "",
"semantic_type_id": "",
"text": "The rectum",
"type": "BODYPART"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
The anal tone was normal and there was no blood on examining fingure.
|
[
{
"id": "8878",
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18,
24
],
"role": "",
"semantic_type_id": "",
"text": "normal",
"type": "EVENT"
},
{
"id": "8893",
"offsets": [
42,
47
],
"role": "",
"semantic_type_id": "",
"text": "blood",
"type": "EVENT"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia.
|
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"role": "",
"semantic_type_id": "C0151683",
"text": "neutrophilia",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
There were immature granulocytes and atypical lymphocytes seen on the peripheral film report.
|
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37,
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"role": "",
"semantic_type_id": "",
"text": "atypical lymphocytes",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
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"role": "",
"semantic_type_id": "",
"text": "tests",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall.
|
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"text": "internal and external oblique muscles of the anterior abdominal wall",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted.
|
[
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"text": "14 days",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
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"text": "from the time of intervention",
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] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life.
|
[
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],
"role": "",
"semantic_type_id": "",
"text": "seizures",
"type": "EVENT"
},
{
"id": "9238",
"offsets": [
74,
81
],
"role": "",
"semantic_type_id": "",
"text": "nodding",
"type": "EVENT"
},
{
"id": "9468",
"offsets": [
61,
69
],
"role": "",
"semantic_type_id": "C0036572",
"text": "seizures",
"type": "CLINENTITY"
},
{
"id": "9475",
"offsets": [
74,
81
],
"role": "",
"semantic_type_id": "C0679312",
"text": "nodding",
"type": "CLINENTITY"
},
{
"id": "9662",
"offsets": [
44,
53
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "the child",
"type": "ACTOR"
},
{
"id": "9669",
"offsets": [
86,
95
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "the child",
"type": "ACTOR"
},
{
"id": "9730",
"offsets": [
34,
43
],
"role": "",
"semantic_type_id": "",
"text": "one month",
"type": "TIMEX3"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
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.
|
[
{
"id": "9253",
"offsets": [
65,
73
],
"role": "",
"semantic_type_id": "",
"text": "findings",
"type": "EVENT"
},
{
"id": "9268",
"offsets": [
88,
94
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "9283",
"offsets": [
115,
120
],
"role": "",
"semantic_type_id": "",
"text": "tests",
"type": "EVENT"
},
{
"id": "9298",
"offsets": [
128,
140
],
"role": "",
"semantic_type_id": "",
"text": "electrolytes",
"type": "EVENT"
},
{
"id": "9313",
"offsets": [
178,
183
],
"role": "",
"semantic_type_id": "",
"text": "level",
"type": "EVENT"
},
{
"id": "9739",
"offsets": [
74,
87
],
"role": "",
"semantic_type_id": "",
"text": "2 weeks later",
"type": "TIMEX3"
}
] |
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. The swelling was associated with a high grade fever which was constant and only partially relieved by analgesics. These symptoms were not associated with vomiting, constipation, yellow eyes, loss of appetite or weight loss. 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. 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. She reported that there was an uneventful pregnancy which was carried to term and delivery by Spontaneous vaginal delivery (SVD). 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. 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. The child was enrolled in Atanga treatment centre and was being managed with Carbamazepine, multivitamins and Ivermectin. 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. On general examination, he was dehydrated, febrile and moderately wasted. There was a right lumbar region mass, tender, indurated and non-fluctuant. The spleen and liver were not palpable. There was no renal or supra-pubic tenderness. The rectum was full of faecal material which was of normal colour and consistency. The anal tone was normal and there was no blood on examining fingure. Haematological investigations were conducted and showed neutrophilia, lympocytosis, monocytosis, and eosinophilia. There were immature granulocytes and atypical lymphocytes seen on the peripheral film report. 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. Abdominal Ultrasound showed inflamed internal and external oblique muscles of the anterior abdominal wall. The patient underwent incision and drainage at Gulu Hospital and wound left open for 14 days and thereafter secondary wound closure was conducted. 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. 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. With these interventions for over one month the child had no seizures nor nodding and the child returned to normal life. 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.
|
EN100075
|
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic.
|
[
{
"id": "7642",
"offsets": [
51,
54
],
"role": "",
"semantic_type_id": "",
"text": "SWS",
"type": "EVENT"
},
{
"id": "7657",
"offsets": [
70,
79
],
"role": "",
"semantic_type_id": "",
"text": "headaches",
"type": "EVENT"
},
{
"id": "7672",
"offsets": [
80,
88
],
"role": "",
"semantic_type_id": "",
"text": "admitted",
"type": "EVENT"
},
{
"id": "9096",
"offsets": [
0,
28
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "A 21 year old female patient",
"type": "ACTOR"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
She had a 2 year history of frequent non-pulsating headaches.
|
[
{
"id": "7687",
"offsets": [
51,
60
],
"role": "",
"semantic_type_id": "",
"text": "headaches",
"type": "EVENT"
},
{
"id": "9580",
"offsets": [
51,
60
],
"role": "",
"semantic_type_id": "C0018681",
"text": "headaches",
"type": "CLINENTITY"
},
{
"id": "9103",
"offsets": [
0,
3
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "She",
"type": "ACTOR"
},
{
"id": "9236",
"offsets": [
10,
16
],
"role": "",
"semantic_type_id": "",
"text": "2 year",
"type": "TIMEX3"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity.
|
[
{
"id": "7702",
"offsets": [
4,
12
],
"role": "",
"semantic_type_id": "",
"text": "headache",
"type": "EVENT"
},
{
"id": "7717",
"offsets": [
17,
26
],
"role": "",
"semantic_type_id": "",
"text": "relieving",
"type": "EVENT"
},
{
"id": "7732",
"offsets": [
82,
91
],
"role": "",
"semantic_type_id": "",
"text": "worsening",
"type": "EVENT"
},
{
"id": "7747",
"offsets": [
106,
114
],
"role": "",
"semantic_type_id": "",
"text": "activity",
"type": "EVENT"
},
{
"id": "9581",
"offsets": [
4,
12
],
"role": "",
"semantic_type_id": "C0038505",
"text": "headache",
"type": "CLINENTITY"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
There was no nausea or aura like symptoms accompanying the headache.
|
[
{
"id": "7762",
"offsets": [
13,
19
],
"role": "",
"semantic_type_id": "",
"text": "nausea",
"type": "EVENT"
},
{
"id": "7777",
"offsets": [
33,
41
],
"role": "",
"semantic_type_id": "",
"text": "symptoms",
"type": "EVENT"
},
{
"id": "7792",
"offsets": [
59,
67
],
"role": "",
"semantic_type_id": "",
"text": "headache",
"type": "EVENT"
},
{
"id": "9582",
"offsets": [
13,
19
],
"role": "",
"semantic_type_id": "C0027497",
"text": "nausea",
"type": "CLINENTITY"
},
{
"id": "9583",
"offsets": [
23,
27
],
"role": "",
"semantic_type_id": "C0236018",
"text": "aura",
"type": "CLINENTITY"
},
{
"id": "9584",
"offsets": [
59,
67
],
"role": "",
"semantic_type_id": "C0038505",
"text": "headache",
"type": "CLINENTITY"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Headaches were lasting for hours.
|
[
{
"id": "7807",
"offsets": [
0,
9
],
"role": "",
"semantic_type_id": "",
"text": "Headaches",
"type": "EVENT"
},
{
"id": "9585",
"offsets": [
0,
9
],
"role": "",
"semantic_type_id": "C0018681",
"text": "Headaches",
"type": "CLINENTITY"
},
{
"id": "9245",
"offsets": [
27,
32
],
"role": "",
"semantic_type_id": "",
"text": "hours",
"type": "TIMEX3"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
The pain was bilateral, generalized and pressing in quality.
|
[
{
"id": "7822",
"offsets": [
4,
8
],
"role": "",
"semantic_type_id": "",
"text": "pain",
"type": "EVENT"
},
{
"id": "7837",
"offsets": [
13,
22
],
"role": "",
"semantic_type_id": "",
"text": "bilateral",
"type": "EVENT"
},
{
"id": "7852",
"offsets": [
24,
35
],
"role": "",
"semantic_type_id": "",
"text": "generalized",
"type": "EVENT"
},
{
"id": "7867",
"offsets": [
40,
48
],
"role": "",
"semantic_type_id": "",
"text": "pressing",
"type": "EVENT"
},
{
"id": "9586",
"offsets": [
4,
8
],
"role": "",
"semantic_type_id": "C0030193",
"text": "pain",
"type": "CLINENTITY"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
The family history for headache was negative.
|
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A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
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.
|
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"text": "the fifteenth day of life",
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] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
At the age of 6 she had a history of callosotomy to control her seizures.
|
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] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
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.
|
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] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then.
|
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] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
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.
|
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A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
There was nothing significant on her family history except for her elder sister's port wine stain on her face.
|
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}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
The elder sister had no feature of SWS and no researches were done regarding her stain.
|
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"role": "OTHER",
"semantic_type_id": "",
"text": "The elder sister",
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}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches.
|
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],
"role": "",
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"role": "",
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"text": "daily",
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}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
She was also inscribed NSAID drugs.
|
[
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22
],
"role": "",
"semantic_type_id": "",
"text": "inscribed",
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"offsets": [
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"role": "PATIENT",
"semantic_type_id": "",
"text": "She",
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}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same.
|
[
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"text": "frequency",
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{
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"text": "same",
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],
"role": "",
"semantic_type_id": "",
"text": "the first week",
"type": "TIMEX3"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
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.
|
[
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"text": "nevus",
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},
{
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78
],
"role": "",
"semantic_type_id": "",
"text": "angioma-on",
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},
{
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],
"role": "",
"semantic_type_id": "",
"text": "observed",
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{
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"role": "",
"semantic_type_id": "",
"text": "the right forehead",
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},
{
"id": "9302",
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"role": "",
"semantic_type_id": "",
"text": "right eyelid",
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},
{
"id": "9308",
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"role": "",
"semantic_type_id": "",
"text": "nasal wing",
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},
{
"id": "9314",
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128,
137
],
"role": "",
"semantic_type_id": "",
"text": "the cheek",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Intra oral examination showed a right sided overgrowth of gingiva.
|
[
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"text": "overgrowth",
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"text": "gingiva",
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] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement.
|
[
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"text": "overgrowth",
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{
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"text": "red",
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{
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"text": "blanching",
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"text": "pressure",
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"text": "suggesting",
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"role": "",
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"text": "enlargement",
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}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
On her extremities a mild asymmetry was visible.
|
[
{
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],
"role": "",
"semantic_type_id": "",
"text": "asymmetry",
"type": "EVENT"
},
{
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],
"role": "",
"semantic_type_id": "",
"text": "visible",
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},
{
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"offsets": [
3,
18
],
"role": "",
"semantic_type_id": "",
"text": "her extremities",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size.
|
[
{
"id": "8629",
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],
"role": "",
"semantic_type_id": "",
"text": "smaller",
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{
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"semantic_type_id": "",
"text": "hemiparesis",
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},
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"id": "9601",
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],
"role": "",
"semantic_type_id": "C0018989",
"text": "hemiparesis",
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},
{
"id": "9332",
"offsets": [
0,
12
],
"role": "",
"semantic_type_id": "",
"text": "Her left arm",
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},
{
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],
"role": "",
"semantic_type_id": "",
"text": "leg",
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},
{
"id": "9344",
"offsets": [
85,
116
],
"role": "",
"semantic_type_id": "",
"text": "the upper and lower extremities",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye.
|
[
{
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],
"role": "",
"semantic_type_id": "",
"text": "evaluation",
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},
{
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],
"role": "",
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"text": "diagnosed",
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},
{
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],
"role": "",
"semantic_type_id": "",
"text": "glaucoma",
"type": "EVENT"
},
{
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],
"role": "",
"semantic_type_id": "C2012198",
"text": "glaucoma of the right eye",
"type": "CLINENTITY"
},
{
"id": "9350",
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83
],
"role": "",
"semantic_type_id": "",
"text": "the right eye",
"type": "BODYPART"
},
{
"id": "9201",
"offsets": [
35,
38
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "she",
"type": "ACTOR"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
On her psychiatric examination she showed signs of anxiety disorder.
|
[
{
"id": "8704",
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19,
30
],
"role": "",
"semantic_type_id": "",
"text": "examination",
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},
{
"id": "8719",
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],
"role": "",
"semantic_type_id": "",
"text": "signs",
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},
{
"id": "8734",
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67
],
"role": "",
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"text": "disorder",
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{
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],
"role": "",
"semantic_type_id": "C0003469",
"text": "anxiety disorder",
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},
{
"id": "9208",
"offsets": [
31,
34
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "she",
"type": "ACTOR"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Her neurological examination was not remarkable except for her hemiparesis.
|
[
{
"id": "8749",
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17,
28
],
"role": "",
"semantic_type_id": "",
"text": "examination",
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},
{
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],
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"text": "hemiparesis",
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},
{
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"semantic_type_id": "C0018989",
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},
{
"id": "9428",
"offsets": [
33,
47
],
"role": "",
"semantic_type_id": "",
"text": "not remarkable",
"type": "RML"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area.
|
[
{
"id": "8779",
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11,
16
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"semantic_type_id": "",
"text": "scans",
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},
{
"id": "8794",
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23
],
"role": "",
"semantic_type_id": "",
"text": "showed",
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},
{
"id": "8809",
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32,
39
],
"role": "",
"semantic_type_id": "",
"text": "atrophy",
"type": "EVENT"
},
{
"id": "8824",
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],
"role": "",
"semantic_type_id": "",
"text": "calcifications",
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},
{
"id": "9356",
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63
],
"role": "",
"semantic_type_id": "",
"text": "the right hemisphere",
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},
{
"id": "9362",
"offsets": [
131,
155
],
"role": "",
"semantic_type_id": "",
"text": "the right occipital area",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side.
|
[
{
"id": "8839",
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29
],
"role": "",
"semantic_type_id": "",
"text": "MRI",
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},
{
"id": "8854",
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],
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"semantic_type_id": "",
"text": "revealed",
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{
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"role": "",
"semantic_type_id": "",
"text": "structures",
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{
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"text": "atrophy",
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},
{
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25
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"semantic_type_id": "",
"text": "brain",
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},
{
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91,
107
],
"role": "",
"semantic_type_id": "",
"text": "right hemisphere",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left.
|
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"text": "MRI",
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"text": "thickness",
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"role": "",
"semantic_type_id": "",
"text": "the left and right hemisphere",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
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.
|
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"text": "formations",
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"text": "formations",
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"text": "seen",
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"text": "corpus of right lateral ventricle",
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"text": "Gallen vein",
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"id": "9398",
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"role": "",
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"text": "perivascular space",
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"text": "third ventricle",
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"id": "9410",
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"text": "Willis polygon",
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"role": "",
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"text": "right temporooccipital area",
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308,
329
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"role": "",
"semantic_type_id": "",
"text": "quadrigeminal cistern",
"type": "BODYPART"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
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63,
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"text": "75 points",
"type": "RML"
}
] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
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"text": "75 points",
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] |
A 21 year old female patient with the diagnosis of SWS suffering from headaches admitted to our clinic. She had a 2 year history of frequent non-pulsating headaches. Her headache was relieving with non-steroidal anti-inflammatory drugs and was not worsening with physical activity. There was no nausea or aura like symptoms accompanying the headache. Headaches were lasting for hours. The pain was bilateral, generalized and pressing in quality. The family history for headache was negative. 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. At the age of 6 she had a history of callosotomy to control her seizures. 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. After that she was prescribed carbamazepine 400 mg at daily dose and never had a seizure since then. 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. There was nothing significant on her family history except for her elder sister's port wine stain on her face. The elder sister had no feature of SWS and no researches were done regarding her stain. She was inscribed daily doses of ketiapin 25 mg for anxiety disorder and venlafaxine 75 mg for both anxiety disorder and the chronic headaches. She was also inscribed NSAID drugs. After the first week of this treatment her headaches were slightly decreased by heaviness but the frequency was the same. 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. Intra oral examination showed a right sided overgrowth of gingiva. Gingival overgrowth was bright red in color and showed blanching on applying pressure suggesting angiomatous enlargement. On her extremities a mild asymmetry was visible. Her left arm and leg was slightly smaller in portions and showed hemiparesis both in the upper and lower extremities of the same size. On her ophthalmological evaluation she was diagnosed with glaucoma of the right eye. On her psychiatric examination she showed signs of anxiety disorder. Her neurological examination was not remarkable except for her hemiparesis. Cranial CT scans showed diffuse atrophy in the right hemisphere and irregular double-contoured gyriform cortical calcifications in the right occipital area. Gadolinium enhanced brain MRI revealed multiple dilated pial venous vascular structures on right hemisphere also with the diffuse atrophy on the same side. Axial T1 weighted cranial MRI shows right calvarial thickness compared to the left and right hemisphere is asymmetrically smaller than the left. 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. She was performed a proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded. Proteus intelligence test in which she had 75 points and accepted as mildly mentally retarded.
|
EN100129
|
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident.
|
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"text": "A 3 years old boy",
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] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
The delay to consult was 5 hours after the incident.
|
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"offsets": [
25,
32
],
"role": "",
"semantic_type_id": "",
"text": "5 hours",
"type": "TIMEX3"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
|
[
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"text": "left superior member",
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"text": "a right inferior member",
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252,
258
],
"role": "",
"semantic_type_id": "",
"text": "member",
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}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
|
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"text": "dislocated head of the right femur",
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"text": "pelvis",
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"text": "head of the right femur",
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{
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],
"role": "",
"semantic_type_id": "",
"text": "the head of the femur",
"type": "BODYPART"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
|
[
{
"id": "4160",
"offsets": [
13,
24
],
"role": "",
"semantic_type_id": "",
"text": "radiography",
"type": "EVENT"
},
{
"id": "4175",
"offsets": [
46,
52
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "4190",
"offsets": [
75,
85
],
"role": "",
"semantic_type_id": "",
"text": "separation",
"type": "EVENT"
},
{
"id": "4481",
"offsets": [
55,
100
],
"role": "",
"semantic_type_id": "",
"text": "Salter I epiphyseal separation of the humerus",
"type": "CLINENTITY"
},
{
"id": "4544",
"offsets": [
28,
45
],
"role": "",
"semantic_type_id": "",
"text": "the left shoulder",
"type": "BODYPART"
},
{
"id": "4550",
"offsets": [
93,
100
],
"role": "",
"semantic_type_id": "",
"text": "humerus",
"type": "BODYPART"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks.
|
[
{
"id": "4205",
"offsets": [
43,
52
],
"role": "",
"semantic_type_id": "",
"text": "reduction",
"type": "EVENT"
},
{
"id": "4220",
"offsets": [
103,
112
],
"role": "",
"semantic_type_id": "",
"text": "placement",
"type": "EVENT"
},
{
"id": "4488",
"offsets": [
60,
74
],
"role": "",
"semantic_type_id": "",
"text": "dislocated hip",
"type": "CLINENTITY"
},
{
"id": "4556",
"offsets": [
71,
74
],
"role": "",
"semantic_type_id": "",
"text": "hip",
"type": "BODYPART"
},
{
"id": "4615",
"offsets": [
6,
14
],
"role": "",
"semantic_type_id": "",
"text": "one hour",
"type": "TIMEX3"
},
{
"id": "4624",
"offsets": [
171,
182
],
"role": "",
"semantic_type_id": "",
"text": "three weeks",
"type": "TIMEX3"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy.
|
[
{
"id": "4235",
"offsets": [
17,
24
],
"role": "",
"semantic_type_id": "",
"text": "results",
"type": "EVENT"
},
{
"id": "4250",
"offsets": [
50,
58
],
"role": "",
"semantic_type_id": "",
"text": "restored",
"type": "EVENT"
},
{
"id": "4265",
"offsets": [
69,
77
],
"role": "",
"semantic_type_id": "",
"text": "symmetry",
"type": "EVENT"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
|
[
{
"id": "4280",
"offsets": [
13,
23
],
"role": "",
"semantic_type_id": "",
"text": "detachment",
"type": "EVENT"
},
{
"id": "4295",
"offsets": [
58,
65
],
"role": "",
"semantic_type_id": "",
"text": "reduced",
"type": "EVENT"
},
{
"id": "4310",
"offsets": [
71,
82
],
"role": "",
"semantic_type_id": "",
"text": "immobilized",
"type": "EVENT"
},
{
"id": "4562",
"offsets": [
31,
38
],
"role": "",
"semantic_type_id": "",
"text": "humerus",
"type": "BODYPART"
},
{
"id": "4633",
"offsets": [
128,
135
],
"role": "",
"semantic_type_id": "",
"text": "a month",
"type": "TIMEX3"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
The child has been discharged the next day.
|
[
{
"id": "4325",
"offsets": [
19,
29
],
"role": "",
"semantic_type_id": "",
"text": "discharged",
"type": "EVENT"
},
{
"id": "4599",
"offsets": [
0,
9
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "The child",
"type": "ACTOR"
},
{
"id": "4642",
"offsets": [
34,
42
],
"role": "",
"semantic_type_id": "",
"text": "next day",
"type": "TIMEX3"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
Revised after a month, showed a stable left hip on the clinical examination.
|
[
{
"id": "4340",
"offsets": [
0,
7
],
"role": "",
"semantic_type_id": "",
"text": "Revised",
"type": "EVENT"
},
{
"id": "4355",
"offsets": [
23,
29
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "4568",
"offsets": [
39,
47
],
"role": "",
"semantic_type_id": "",
"text": "left hip",
"type": "BODYPART"
},
{
"id": "4651",
"offsets": [
14,
21
],
"role": "",
"semantic_type_id": "",
"text": "a month",
"type": "TIMEX3"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
[
{
"id": "4370",
"offsets": [
38,
45
],
"role": "",
"semantic_type_id": "",
"text": "noticed",
"type": "EVENT"
},
{
"id": "4385",
"offsets": [
80,
87
],
"role": "",
"semantic_type_id": "",
"text": "results",
"type": "EVENT"
},
{
"id": "4400",
"offsets": [
106,
117
],
"role": "",
"semantic_type_id": "",
"text": "radiography",
"type": "EVENT"
},
{
"id": "4415",
"offsets": [
137,
142
],
"role": "",
"semantic_type_id": "",
"text": "signs",
"type": "EVENT"
},
{
"id": "4430",
"offsets": [
156,
164
],
"role": "",
"semantic_type_id": "",
"text": "necrosis",
"type": "EVENT"
},
{
"id": "4445",
"offsets": [
168,
175
],
"role": "",
"semantic_type_id": "",
"text": "changes",
"type": "EVENT"
},
{
"id": "4495",
"offsets": [
146,
164
],
"role": "",
"semantic_type_id": "C3887513",
"text": "avascular necrosis",
"type": "CLINENTITY"
},
{
"id": "4574",
"offsets": [
183,
196
],
"role": "",
"semantic_type_id": "",
"text": "head of femur",
"type": "BODYPART"
},
{
"id": "4580",
"offsets": [
201,
215
],
"role": "",
"semantic_type_id": "",
"text": "the acetabulum",
"type": "BODYPART"
},
{
"id": "4586",
"offsets": [
219,
234
],
"role": "",
"semantic_type_id": "",
"text": "the joint space",
"type": "BODYPART"
},
{
"id": "4660",
"offsets": [
18,
25
],
"role": "",
"semantic_type_id": "",
"text": "2 years",
"type": "TIMEX3"
}
] |
A 3 years old boy without any particular diseases history, admitted to the emergency room for a bipolar trauma with a left hemicorporal point of impact following a domestic accident. The delay to consult was 5 hours after the incident.
The clinical examination at admission had showed a deformed left superior member, painful on palpation with the presence of the humeral pulse and a right inferior member shortened and flexed, the thigh slightly in adduction, internal rotation with the member.
A radiological assessment was performed immediately; including a standard X-ray of the pelvis which showed a dislocated head of the right femur, completed secondarily by a CT Scan of the hip confirming the posterior type of the dislocation isolated from any fractures of the head of the femur.
The standard radiography of the left shoulder showed a Salter I epiphyseal separation of the humerus.
After one hour, we performed an orthopedic reduction of the dislocated hip monitored under scope, with placement of a pelvic splint for an analgesic aim to be kept during three weeks. The radiological results were satisfactory with a restored bilateral symmetry of the articular anatomy. The Salter I detachment of the humerus was orthopedically reduced then immobilized by a thoracoabdominal plaster be kept during a month.
The child has been discharged the next day. Revised after a month, showed a stable left hip on the clinical examination.
In the decline of 2 years, we haven't noticed any recidivism and the functional results were good; On the radiography we do not have any signs of avascular necrosis no changes of the head of femur, of the acetabulum or the joint space.
|
EN100315
|
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old).
|
[
{
"id": "6721",
"offsets": [
20,
24
],
"role": "",
"semantic_type_id": "",
"text": "came",
"type": "EVENT"
},
{
"id": "6736",
"offsets": [
120,
129
],
"role": "",
"semantic_type_id": "",
"text": "consulted",
"type": "EVENT"
},
{
"id": "6751",
"offsets": [
147,
158
],
"role": "",
"semantic_type_id": "",
"text": "menstruated",
"type": "EVENT"
},
{
"id": "7636",
"offsets": [
143,
158
],
"role": "",
"semantic_type_id": "C0497456",
"text": "not menstruated",
"type": "CLINENTITY"
},
{
"id": "7747",
"offsets": [
0,
19
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "A 33-year-old woman",
"type": "ACTOR"
},
{
"id": "7754",
"offsets": [
135,
138
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "she",
"type": "ACTOR"
},
{
"id": "7828",
"offsets": [
165,
176
],
"role": "",
"semantic_type_id": "",
"text": "5 years ago",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age.
|
[] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain.
|
[
{
"id": "6766",
"offsets": [
36,
42
],
"role": "",
"semantic_type_id": "",
"text": "period",
"type": "EVENT"
},
{
"id": "6781",
"offsets": [
60,
68
],
"role": "",
"semantic_type_id": "",
"text": "replaced",
"type": "EVENT"
},
{
"id": "6796",
"offsets": [
120,
124
],
"role": "",
"semantic_type_id": "",
"text": "pain",
"type": "EVENT"
},
{
"id": "7643",
"offsets": [
110,
124
],
"role": "",
"semantic_type_id": "C0013390",
"text": "menstrual pain",
"type": "CLINENTITY"
},
{
"id": "7761",
"offsets": [
0,
11
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "The patient",
"type": "ACTOR"
},
{
"id": "7768",
"offsets": [
56,
59
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "she",
"type": "ACTOR"
},
{
"id": "7837",
"offsets": [
46,
54
],
"role": "",
"semantic_type_id": "",
"text": "5-7 days",
"type": "TIMEX3"
},
{
"id": "7846",
"offsets": [
82,
97
],
"role": "",
"semantic_type_id": "",
"text": "2-3 times / day",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped.
|
[
{
"id": "6811",
"offsets": [
18,
25
],
"role": "",
"semantic_type_id": "",
"text": "history",
"type": "EVENT"
},
{
"id": "6826",
"offsets": [
109,
118
],
"role": "",
"semantic_type_id": "",
"text": "injection",
"type": "EVENT"
},
{
"id": "6841",
"offsets": [
124,
135
],
"role": "",
"semantic_type_id": "",
"text": "menstruated",
"type": "EVENT"
},
{
"id": "6856",
"offsets": [
163,
170
],
"role": "",
"semantic_type_id": "",
"text": "stopped",
"type": "EVENT"
},
{
"id": "7775",
"offsets": [
0,
11
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "The patient",
"type": "ACTOR"
},
{
"id": "7782",
"offsets": [
120,
123
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "she",
"type": "ACTOR"
},
{
"id": "7855",
"offsets": [
73,
85
],
"role": "",
"semantic_type_id": "",
"text": "once a month",
"type": "TIMEX3"
},
{
"id": "7864",
"offsets": [
86,
93
],
"role": "",
"semantic_type_id": "",
"text": "in 2010",
"type": "TIMEX3"
},
{
"id": "7873",
"offsets": [
140,
150
],
"role": "",
"semantic_type_id": "",
"text": "two months",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea.
|
[
{
"id": "6871",
"offsets": [
18,
29
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "6886",
"offsets": [
45,
56
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "6901",
"offsets": [
74,
83
],
"role": "",
"semantic_type_id": "",
"text": "diagnosed",
"type": "EVENT"
},
{
"id": "6916",
"offsets": [
99,
109
],
"role": "",
"semantic_type_id": "",
"text": "amenorrhea",
"type": "EVENT"
},
{
"id": "7650",
"offsets": [
89,
109
],
"role": "",
"semantic_type_id": "C0425957",
"text": "secondary amenorrhea",
"type": "CLINENTITY"
},
{
"id": "7789",
"offsets": [
58,
69
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "the patient",
"type": "ACTOR"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head.
|
[
{
"id": "6931",
"offsets": [
34,
49
],
"role": "",
"semantic_type_id": "",
"text": "ultrasonography",
"type": "EVENT"
},
{
"id": "6946",
"offsets": [
58,
63
],
"role": "",
"semantic_type_id": "",
"text": "X-ray",
"type": "EVENT"
},
{
"id": "6961",
"offsets": [
76,
80
],
"role": "",
"semantic_type_id": "",
"text": "Head",
"type": "EVENT"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion.
|
[
{
"id": "6976",
"offsets": [
0,
15
],
"role": "",
"semantic_type_id": "",
"text": "Ultrasonography",
"type": "EVENT"
},
{
"id": "6991",
"offsets": [
27,
32
],
"role": "",
"semantic_type_id": "",
"text": "X-Ray",
"type": "EVENT"
},
{
"id": "7006",
"offsets": [
33,
39
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7021",
"offsets": [
88,
96
],
"role": "",
"semantic_type_id": "",
"text": "effusion",
"type": "EVENT"
},
{
"id": "7657",
"offsets": [
74,
96
],
"role": "",
"semantic_type_id": "C2063366",
"text": "right pleural effusion",
"type": "CLINENTITY"
},
{
"id": "7796",
"offsets": [
45,
52
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "patient",
"type": "ACTOR"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits.
|
[
{
"id": "7036",
"offsets": [
8,
19
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "7051",
"offsets": [
20,
26
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7699",
"offsets": [
32,
61
],
"role": "",
"semantic_type_id": "",
"text": "bilateral ethmoidal sinusitis",
"type": "BODYPART"
},
{
"id": "7705",
"offsets": [
66,
81
],
"role": "",
"semantic_type_id": "",
"text": "pituitary gland",
"type": "BODYPART"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use.
|
[
{
"id": "7066",
"offsets": [
14,
18
],
"role": "",
"semantic_type_id": "",
"text": "plan",
"type": "EVENT"
},
{
"id": "7081",
"offsets": [
45,
52
],
"role": "",
"semantic_type_id": "",
"text": "therapy",
"type": "EVENT"
},
{
"id": "7096",
"offsets": [
92,
99
],
"role": "",
"semantic_type_id": "",
"text": "control",
"type": "EVENT"
},
{
"id": "7803",
"offsets": [
27,
34
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "patient",
"type": "ACTOR"
},
{
"id": "7882",
"offsets": [
75,
85
],
"role": "",
"semantic_type_id": "",
"text": "for 7 days",
"type": "TIMEX3"
},
{
"id": "7891",
"offsets": [
103,
110
],
"role": "",
"semantic_type_id": "",
"text": "2 weeks",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding.
|
[
{
"id": "7111",
"offsets": [
2,
6
],
"role": "",
"semantic_type_id": "",
"text": "test",
"type": "EVENT"
},
{
"id": "7126",
"offsets": [
7,
13
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7141",
"offsets": [
71,
82
],
"role": "",
"semantic_type_id": "",
"text": "consumption",
"type": "EVENT"
},
{
"id": "7156",
"offsets": [
103,
111
],
"role": "",
"semantic_type_id": "",
"text": "bleeding",
"type": "EVENT"
},
{
"id": "7900",
"offsets": [
47,
54
],
"role": "",
"semantic_type_id": "",
"text": "14 days",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out.
|
[
{
"id": "7171",
"offsets": [
4,
13
],
"role": "",
"semantic_type_id": "",
"text": "treatment",
"type": "EVENT"
},
{
"id": "7186",
"offsets": [
171,
178
],
"role": "",
"semantic_type_id": "",
"text": "control",
"type": "EVENT"
},
{
"id": "7201",
"offsets": [
217,
225
],
"role": "",
"semantic_type_id": "",
"text": "runs out",
"type": "EVENT"
},
{
"id": "7909",
"offsets": [
89,
100
],
"role": "",
"semantic_type_id": "",
"text": "for 21 days",
"type": "TIMEX3"
},
{
"id": "7918",
"offsets": [
144,
159
],
"role": "",
"semantic_type_id": "",
"text": "12th -21st days",
"type": "TIMEX3"
},
{
"id": "7927",
"offsets": [
193,
201
],
"role": "",
"semantic_type_id": "",
"text": "one week",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL.
|
[
{
"id": "7216",
"offsets": [
36,
43
],
"role": "",
"semantic_type_id": "",
"text": "results",
"type": "EVENT"
},
{
"id": "7231",
"offsets": [
49,
52
],
"role": "",
"semantic_type_id": "",
"text": "FSH",
"type": "EVENT"
},
{
"id": "7246",
"offsets": [
67,
69
],
"role": "",
"semantic_type_id": "",
"text": "LH",
"type": "EVENT"
},
{
"id": "7261",
"offsets": [
81,
90
],
"role": "",
"semantic_type_id": "",
"text": "Prolactin",
"type": "EVENT"
},
{
"id": "7810",
"offsets": [
54,
65
],
"role": "",
"semantic_type_id": "",
"text": "8.71 MIU/mL",
"type": "RML"
},
{
"id": "7816",
"offsets": [
71,
79
],
"role": "",
"semantic_type_id": "",
"text": "3.1 IU/L",
"type": "RML"
},
{
"id": "7822",
"offsets": [
92,
103
],
"role": "",
"semantic_type_id": "",
"text": "319.4 ng/mL",
"type": "RML"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation.
|
[
{
"id": "7276",
"offsets": [
8,
12
],
"role": "",
"semantic_type_id": "",
"text": "test",
"type": "EVENT"
},
{
"id": "7291",
"offsets": [
13,
19
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7306",
"offsets": [
31,
37
],
"role": "",
"semantic_type_id": "",
"text": "result",
"type": "EVENT"
},
{
"id": "7321",
"offsets": [
65,
77
],
"role": "",
"semantic_type_id": "",
"text": "hysteroscopy",
"type": "EVENT"
},
{
"id": "7336",
"offsets": [
82,
91
],
"role": "",
"semantic_type_id": "",
"text": "curettage",
"type": "EVENT"
},
{
"id": "7351",
"offsets": [
107,
117
],
"role": "",
"semantic_type_id": "",
"text": "evaluation",
"type": "EVENT"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department.
|
[
{
"id": "7366",
"offsets": [
13,
20
],
"role": "",
"semantic_type_id": "",
"text": "results",
"type": "EVENT"
},
{
"id": "7381",
"offsets": [
21,
27
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7396",
"offsets": [
52,
61
],
"role": "",
"semantic_type_id": "",
"text": "adhesions",
"type": "EVENT"
},
{
"id": "7411",
"offsets": [
187,
197
],
"role": "",
"semantic_type_id": "",
"text": "amenorrhea",
"type": "EVENT"
},
{
"id": "7426",
"offsets": [
219,
231
],
"role": "",
"semantic_type_id": "",
"text": "endometritis",
"type": "EVENT"
},
{
"id": "7664",
"offsets": [
52,
82
],
"role": "",
"semantic_type_id": "C0241593",
"text": "adhesions in the uterine cavum",
"type": "CLINENTITY"
},
{
"id": "7671",
"offsets": [
177,
197
],
"role": "",
"semantic_type_id": "C0425957",
"text": "secondary amenorrhea",
"type": "CLINENTITY"
},
{
"id": "7678",
"offsets": [
206,
231
],
"role": "",
"semantic_type_id": "C0275958",
"text": "tuberculosis endometritis",
"type": "CLINENTITY"
},
{
"id": "7711",
"offsets": [
65,
82
],
"role": "",
"semantic_type_id": "",
"text": "the uterine cavum",
"type": "BODYPART"
},
{
"id": "7717",
"offsets": [
104,
142
],
"role": "",
"semantic_type_id": "",
"text": "connective tissue in the uterine cavum",
"type": "BODYPART"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis.
|
[
{
"id": "7441",
"offsets": [
32,
44
],
"role": "",
"semantic_type_id": "",
"text": "hysteroscopy",
"type": "EVENT"
},
{
"id": "7456",
"offsets": [
45,
51
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7471",
"offsets": [
191,
201
],
"role": "",
"semantic_type_id": "",
"text": "malignancy",
"type": "EVENT"
},
{
"id": "7486",
"offsets": [
239,
245
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7501",
"offsets": [
284,
294
],
"role": "",
"semantic_type_id": "",
"text": "amenorrhea",
"type": "EVENT"
},
{
"id": "7516",
"offsets": [
318,
330
],
"role": "",
"semantic_type_id": "",
"text": "endometritis",
"type": "EVENT"
},
{
"id": "7685",
"offsets": [
274,
294
],
"role": "",
"semantic_type_id": "C0425967",
"text": "secondary amenorrhea",
"type": "CLINENTITY"
},
{
"id": "7692",
"offsets": [
305,
330
],
"role": "",
"semantic_type_id": "C0275958",
"text": "tuberculosis endometritis",
"type": "CLINENTITY"
},
{
"id": "7723",
"offsets": [
52,
183
],
"role": "",
"semantic_type_id": "",
"text": "endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells",
"type": "BODYPART"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months.
|
[
{
"id": "7531",
"offsets": [
47,
53
],
"role": "",
"semantic_type_id": "",
"text": "result",
"type": "EVENT"
},
{
"id": "7546",
"offsets": [
55,
64
],
"role": "",
"semantic_type_id": "",
"text": "treatment",
"type": "EVENT"
},
{
"id": "7936",
"offsets": [
131,
143
],
"role": "",
"semantic_type_id": "",
"text": "for 6 months",
"type": "TIMEX3"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
[
{
"id": "7561",
"offsets": [
21,
27
],
"role": "",
"semantic_type_id": "",
"text": "result",
"type": "EVENT"
},
{
"id": "7576",
"offsets": [
60,
66
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7591",
"offsets": [
180,
192
],
"role": "",
"semantic_type_id": "",
"text": "observations",
"type": "EVENT"
},
{
"id": "7606",
"offsets": [
193,
199
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "7621",
"offsets": [
339,
344
],
"role": "",
"semantic_type_id": "",
"text": "found",
"type": "EVENT"
},
{
"id": "7729",
"offsets": [
200,
220
],
"role": "",
"semantic_type_id": "",
"text": "fibromuscular tissue",
"type": "BODYPART"
},
{
"id": "7735",
"offsets": [
224,
251
],
"role": "",
"semantic_type_id": "",
"text": "high cylindrical epithelium",
"type": "BODYPART"
},
{
"id": "7741",
"offsets": [
285,
329
],
"role": "",
"semantic_type_id": "",
"text": "inflammatory granulomatic and aplastic cells",
"type": "BODYPART"
}
] |
A 33-year-old woman came to Department of Fertility, Endocrinology and Reproduction at Saiful Anwar public Hospital and consulted that she has not menstruated since 5 years ago (28 years old). Her initial menarche was at the age of 14 years and it is in accordance with the normal growth of a child at her age. The patient had a regular menstrual period of 5-7 days, she replaced the pads for 2-3 times / day, and had no menstrual pain. The patient has a history of injective contraceptive that was done every once a month in 2010, and after the injection, she menstruated for two months and then it stopped. Based on clinical examination and a physical examination, the patient was diagnosed with secondary amenorrhea. Investigations that were used are ultrasonography, thorax X-ray and CT Scan Head. Ultrasonography and thorax X-Ray showed that patient is suspected to have right pleural effusion. CT-Scan examination showed that bilateral ethmoidal sinusitis and pituitary gland was within normal limits. The treatment plan in this patient is P test therapy with Prothyra 1x10 mg for 7 days, with control on 2 weeks after the use. P test showed a negative result, because after 14 days of progesterone consumption the prothyra is not bleeding. The treatment is followed by a E+P test (Estrogen+Progesterone) with Estrogen 1x0.625 mg for 21 days and an addition of Progesterone 1x10 mg on 12th -21st days, while the control was performed one week after the drug runs out. Based on the E+P test, the obtained results were FSH: 8.71 MIU/mL, LH: 3.1 IU/L, Prolactin: 319.4 ng/mL. The E+P test showed a negative result, so it was necessary to do hysteroscopy and curettage for the uterus evaluation. Hysteroscopy results showed that there were grade 4 adhesions in the uterine cavum, with a pale colored connective tissue in the uterine cavum, which refers to the diagnosis of secondary amenorrhea suspect tuberculosis endometritis, while the result of tissue curettage was examined on the Anatomical Pathology department. Results of anatomical pathology hysteroscopy showed endometrial tissue with stromal looks granulomas with lymphocytes, histiocytes, epithelioid and Langhans multinucleated giant cells and no malignancy was found in this preparation, which showed that patient's diagnosis is secondary amenorrhea suspected tuberculosis endometritis. Based on the Anatomical Pathology hysteroscopy result, treatment was done by using anti-tuberculosis drug category I (FDC 1X3 tab) for 6 months. Anatomical pathology result through macroscopic observation showed visible network of approximately 0.3 cm and 0.4 cm in diameter with a grayish-white color, while the microscopic observations showed fibromuscular tissue at high cylindrical epithelium with polyps shaped vacuolar, and inflammatory granulomatic and aplastic cells were not found.
|
EN100275
|
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago.
|
[
{
"id": "8969",
"offsets": [
52,
60
],
"role": "",
"semantic_type_id": "",
"text": "diabetic",
"type": "EVENT"
},
{
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"text": "weaned",
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],
"role": "H-PROFESSIONAL",
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},
{
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"text": "10 years",
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},
{
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"role": "",
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"text": "5 years",
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},
{
"id": "10545",
"offsets": [
157,
168
],
"role": "",
"semantic_type_id": "",
"text": "4 years ago",
"type": "TIMEX3"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before.
|
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"text": "admitted",
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"semantic_type_id": "C0013362",
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"role": "",
"semantic_type_id": "",
"text": "48 hours",
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}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria.
|
[
{
"id": "9044",
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8,
18
],
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"semantic_type_id": "",
"text": "assessment",
"type": "EVENT"
},
{
"id": "9059",
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],
"role": "",
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"text": "score",
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},
{
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],
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"text": "opening",
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{
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},
{
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"text": "response",
"type": "EVENT"
},
{
"id": "9119",
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172,
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],
"role": "",
"semantic_type_id": "",
"text": "deficit",
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},
{
"id": "9134",
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],
"role": "",
"semantic_type_id": "",
"text": "reflexes",
"type": "EVENT"
},
{
"id": "9149",
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222,
231
],
"role": "",
"semantic_type_id": "",
"text": "polypneic",
"type": "EVENT"
},
{
"id": "9164",
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264,
274
],
"role": "",
"semantic_type_id": "",
"text": "saturation",
"type": "EVENT"
},
{
"id": "9179",
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313,
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],
"role": "",
"semantic_type_id": "",
"text": "tachycardic",
"type": "EVENT"
},
{
"id": "9194",
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340,
352
],
"role": "",
"semantic_type_id": "",
"text": "hypertensive",
"type": "EVENT"
},
{
"id": "9209",
"offsets": [
389,
396
],
"role": "",
"semantic_type_id": "",
"text": "glucose",
"type": "EVENT"
},
{
"id": "9224",
"offsets": [
460,
469
],
"role": "",
"semantic_type_id": "",
"text": "ketonuria",
"type": "EVENT"
},
{
"id": "10212",
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313,
324
],
"role": "",
"semantic_type_id": "C0039231",
"text": "tachycardic",
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},
{
"id": "10219",
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],
"role": "",
"semantic_type_id": "C0020538",
"text": "hypertensive",
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},
{
"id": "10296",
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],
"role": "",
"semantic_type_id": "",
"text": "pupils",
"type": "BODYPART"
},
{
"id": "10371",
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],
"role": "PATIENT",
"semantic_type_id": "",
"text": "he",
"type": "ACTOR"
},
{
"id": "10413",
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48,
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],
"role": "",
"semantic_type_id": "",
"text": "12/15",
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},
{
"id": "10419",
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],
"role": "",
"semantic_type_id": "",
"text": "5",
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},
{
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"semantic_type_id": "",
"text": "2",
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},
{
"id": "10431",
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],
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"semantic_type_id": "",
"text": "5",
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},
{
"id": "10437",
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235,
248
],
"role": "",
"semantic_type_id": "",
"text": "24 cycles/min",
"type": "RML"
},
{
"id": "10443",
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"semantic_type_id": "",
"text": "97%",
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},
{
"id": "10449",
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],
"role": "",
"semantic_type_id": "",
"text": "115 bpm",
"type": "RML"
},
{
"id": "10455",
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],
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"text": "160/95 mmHg",
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},
{
"id": "10461",
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400,
408
],
"role": "",
"semantic_type_id": "",
"text": "2.24 g/L",
"type": "RML"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
The patient was apyretic.
|
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16,
24
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"semantic_type_id": "",
"text": "apyretic",
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"text": "The patient",
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] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L.
|
[
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"text": "testing",
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},
{
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27
],
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"text": "showed",
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},
{
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{
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{
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"text": "lactatemia",
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},
{
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"semantic_type_id": "C0020621",
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{
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},
{
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130,
141
],
"role": "",
"semantic_type_id": "",
"text": "0.43 mmol/L",
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] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test.
|
[
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],
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"text": "decompensation",
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},
{
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65,
78
],
"role": "",
"semantic_type_id": "",
"text": "ketone bodies",
"type": "BODYPART"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition.
|
[
{
"id": "9359",
"offsets": [
81,
91
],
"role": "",
"semantic_type_id": "",
"text": "correction",
"type": "EVENT"
},
{
"id": "9374",
"offsets": [
104,
111
],
"role": "",
"semantic_type_id": "",
"text": "therapy",
"type": "EVENT"
},
{
"id": "9389",
"offsets": [
122,
130
],
"role": "",
"semantic_type_id": "",
"text": "referred",
"type": "EVENT"
},
{
"id": "9404",
"offsets": [
186,
201
],
"role": "",
"semantic_type_id": "",
"text": "non-improvement",
"type": "EVENT"
},
{
"id": "10385",
"offsets": [
20,
31
],
"role": "PATIENT",
"semantic_type_id": "",
"text": "the patient",
"type": "ACTOR"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities.
|
[
{
"id": "9419",
"offsets": [
8,
12
],
"role": "",
"semantic_type_id": "",
"text": "scan",
"type": "EVENT"
},
{
"id": "9434",
"offsets": [
79,
86
],
"role": "",
"semantic_type_id": "",
"text": "scanner",
"type": "EVENT"
},
{
"id": "9449",
"offsets": [
87,
93
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "9464",
"offsets": [
168,
179
],
"role": "",
"semantic_type_id": "",
"text": "pneumopathy",
"type": "EVENT"
},
{
"id": "9479",
"offsets": [
220,
230
],
"role": "",
"semantic_type_id": "",
"text": "ultrasound",
"type": "EVENT"
},
{
"id": "9494",
"offsets": [
239,
243
],
"role": "",
"semantic_type_id": "",
"text": "show",
"type": "EVENT"
},
{
"id": "9509",
"offsets": [
248,
261
],
"role": "",
"semantic_type_id": "",
"text": "abnormalities",
"type": "EVENT"
},
{
"id": "10314",
"offsets": [
49,
71
],
"role": "",
"semantic_type_id": "",
"text": "parietal ischemic foci",
"type": "BODYPART"
},
{
"id": "10320",
"offsets": [
73,
78
],
"role": "",
"semantic_type_id": "",
"text": "chest",
"type": "BODYPART"
},
{
"id": "10326",
"offsets": [
114,
151
],
"role": "",
"semantic_type_id": "",
"text": "septal and foci of bronchial dilation",
"type": "BODYPART"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks.
|
[
{
"id": "9524",
"offsets": [
3,
20
],
"role": "",
"semantic_type_id": "",
"text": "electrocardiogram",
"type": "EVENT"
},
{
"id": "9539",
"offsets": [
35,
42
],
"role": "",
"semantic_type_id": "",
"text": "showing",
"type": "EVENT"
},
{
"id": "9554",
"offsets": [
66,
78
],
"role": "",
"semantic_type_id": "",
"text": "hypokalaemia",
"type": "EVENT"
},
{
"id": "9569",
"offsets": [
97,
109
],
"role": "",
"semantic_type_id": "",
"text": "disturbances",
"type": "EVENT"
},
{
"id": "9584",
"offsets": [
125,
141
],
"role": "",
"semantic_type_id": "",
"text": "echocardiography",
"type": "EVENT"
},
{
"id": "9599",
"offsets": [
161,
171
],
"role": "",
"semantic_type_id": "",
"text": "ultrasound",
"type": "EVENT"
},
{
"id": "10233",
"offsets": [
66,
78
],
"role": "",
"semantic_type_id": "C0020621",
"text": "hypokalaemia",
"type": "CLINENTITY"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers.
|
[
{
"id": "9614",
"offsets": [
18,
24
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
"id": "9629",
"offsets": [
48,
55
],
"role": "",
"semantic_type_id": "",
"text": "protein",
"type": "EVENT"
},
{
"id": "9644",
"offsets": [
84,
97
],
"role": "",
"semantic_type_id": "",
"text": "procalcitonin",
"type": "EVENT"
},
{
"id": "9659",
"offsets": [
124,
129
],
"role": "",
"semantic_type_id": "",
"text": "cells",
"type": "EVENT"
},
{
"id": "9674",
"offsets": [
141,
144
],
"role": "",
"semantic_type_id": "",
"text": "PNN",
"type": "EVENT"
},
{
"id": "9689",
"offsets": [
164,
175
],
"role": "",
"semantic_type_id": "",
"text": "lymphocytes",
"type": "EVENT"
},
{
"id": "9704",
"offsets": [
189,
205
],
"role": "",
"semantic_type_id": "",
"text": "thrombocytopenia",
"type": "EVENT"
},
{
"id": "9719",
"offsets": [
214,
226
],
"role": "",
"semantic_type_id": "",
"text": "ferritinemia",
"type": "EVENT"
},
{
"id": "9734",
"offsets": [
239,
245
],
"role": "",
"semantic_type_id": "",
"text": "levels",
"type": "EVENT"
},
{
"id": "9749",
"offsets": [
276,
284
],
"role": "",
"semantic_type_id": "",
"text": "D-dimers",
"type": "EVENT"
},
{
"id": "10240",
"offsets": [
28,
55
],
"role": "",
"semantic_type_id": "C0742906",
"text": "elevated C-reactive protein",
"type": "CLINENTITY"
},
{
"id": "10247",
"offsets": [
189,
205
],
"role": "",
"semantic_type_id": "C0040034",
"text": "thrombocytopenia",
"type": "CLINENTITY"
},
{
"id": "10479",
"offsets": [
65,
69
],
"role": "",
"semantic_type_id": "",
"text": "45.5",
"type": "RML"
},
{
"id": "10485",
"offsets": [
99,
109
],
"role": "",
"semantic_type_id": "",
"text": "0.04 ng/ml",
"type": "RML"
},
{
"id": "10491",
"offsets": [
133,
139
],
"role": "",
"semantic_type_id": "",
"text": "12,500",
"type": "RML"
},
{
"id": "10497",
"offsets": [
148,
152
],
"role": "",
"semantic_type_id": "",
"text": "9280",
"type": "RML"
},
{
"id": "10503",
"offsets": [
179,
183
],
"role": "",
"semantic_type_id": "",
"text": "2140",
"type": "RML"
},
{
"id": "10509",
"offsets": [
258,
262
],
"role": "",
"semantic_type_id": "",
"text": "5.37",
"type": "RML"
}
] |
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago. He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before. Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria. The patient was apyretic. Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L. Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test. After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition. A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities. An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks. Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers. Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative. Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours. Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy. Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures. Anticonvulsant treatment was started with sodium valproate. The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset). A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions. Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2. Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6. The diagnosis of SARS-CoV-2 encephalopathy was retained. The patient is still in intensive care.
|
EN100705
|
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