European Journal of Clinical and Experimental Medicine T.18, z. 1 (2020)

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  • Pozycja
    Effects of sensory integration therapy in a 7-year old child with epilepsy following craniocerebral trauma – a case study
    (Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Widelak, Maria; Wolan-Nieroda, Andżelina; Podgórska-Bednarz, Justyna; Guzik, Agnieszka
    Introduction. Post-traumatic epilepsy develops as a complication of a serious craniocerebral trauma, frequently an open head injury, resulting in neurological impairments. Aim. The study was designed to discuss problems associated with sensory integration dysfunction observed in a seven-year old girl with epilepsy which occurred as a result of craniocerebral injury. Description of the case. The case study is based on information gained from the girl’s medical records, an interview with her guardians and a sensory function questionnaire. Additional examinations assessed the girl’s balance control, and her functional performance according to Barthel scale. The girl received a three-week sensory integration therapy which included exercise involving tactile, vestibular and proprioceptive stimulation, as well as balance exercises and self-care training. Conclusions. In this particular case, application of sensory integration therapy produced beneficial results. The findings show improvement in balance, coordination as well as self-care.
  • Pozycja
    External ophthalmomyiasis by sheep botfly – a report from Sirmaur hills
    (Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Chauhan, Anubhav; Gautam, Neha
    Introduction. Myiasis is caused by larvae of flies infesting animal or human tissues and organs. Aim. In this report we present 2 cases of external ophthalmomyiasis by sheep botfly. Description of the cases. We report a case of two patients who presented with a history of foreign body sensation in the left and the right eye respectively. Slit lamp examination revealed larvae of Oestrus ovis (sheep botfly). In both cases, there was no contact history with sheep or goats. Signs of conjunctival inflammation and corneal involvement were absent in both cases. In most of the previous reports, corneal and conjunctival inflammation was present. Conclusion. Treatment for external ophthalmomyiasis is based on larvae removal and application of topical antibiotics and steroids.
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    Primary pure squamous cell carcinoma of the gall bladder – a case report of rare and aggressive entity with adverse prognosis
    (Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Bargotya, Mona; Mehta, Ankita; Das, Payel; Sachan, Ashish
    Introduction. The most common malignancy of the biliary tract is gall bladder carcinoma and the main subtype according to the histological classification is Adenocarcinoma. Pure squamous cell carcinoma of the gall bladder is very rare entity accounting for only 1.1-3.7% of the gall bladder carcinomas. It is highly malignant with poor prognosis due to high proliferative rate and local invasiveness to the adjacent organs. The patients are usually diagnosed at an advanced stage with a bulky tumor owing to its aggressive behavior. Aim. In this paper, we describe a female patient with primary pure squamous cell carcinoma of the gall bladder. Description of the case. A 42-year old female patient presented with chief complaints of pain in abdomen associated with nausea and vomiting and gradually progressive jaundice since 02 months. Contrast Enhancing Computed Tomography (CECT) abdomen showed an enhancing mass lesion in gall bladder involving adjacent organs for which she underwent extended cholecystectomy with pancreaticoduodenectomy. Conclusion. Diagnosis as well as the management of this exceptionally rare type of tumour is undoubtedly challenging because of non-specific clinical as well as imaging findings. This case report is an attempt to add to the literary evidence for better pathological as well as clinical understanding of this rare and aggressive entity thereby providing additional material for the early diagnosis as well as the development of effective targeted therapies which will certainly help in increasing the lifespan of these patients.
  • Pozycja
    Parotid pilomatrixoma: Diagnostic trap and management dilemma
    (Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Bhardwaj, Abhishek; Angral, Sumeet; Chandra, Sharath; Malhotra, Manu; Priya, Madhu; Varshney, Saurabh; Singh, Arpana; Raj, Ritu
    Introduction. Pilomatrixoma is a benign cutaneous adnexal neoplasm originating from the matrix cells of the hair follicles. Usually a slow growing and painless lesion, it must be considered in differential diagnosis of a preauricular swelling. Rapidly progressive lesion with skin fixity and missed subtle cytological features may lead to a misdiagnosis of parotid neoplasm resulting in management dilemma. Aim. This report emphasizes consideration of pilomatrixoma as a differential diagnosis in a similar clinical scenario, the role of frozen section during surgery and fascia lata interposition to prevent Frey’s syndrome. A brief review of literature is presented. Description of the case. We present a similar dilemmatic case of a 19 years old male with preauricular swelling. Based on cytology and image findings, a diagnosis of parotid neoplasm with possible malignancy was made. Surgical exploration revealed primarily a subcutaneous lesion with partial attachment to superficial surface of parotid. Lesion was excised with a cuff of normal parotid tissue. Frozen section confirmed it to be a nonmalignant lesion with possibility of pilomatrixoma. Fascia lata was interposed between parotid and thin skin flap to avoid gustatory sweating. Patient is on follow up for 6 months without recurrence or any complication. Conclusion. Pilomatrixomas can be misdiagnosed in case of lesions in subcutaneous plane in parotid region. In such cases, the differential diagnosis should include tumor and non-tumor lesions of skin and parotid gland. Importance of frozen section should also be kept in mind and the pathologist should be engaged at the time of surgical excision of the tumor. Interposition of soft tissue between parotid and thin skin flap helps prevent gustatory sweating in such cases. A high index of suspicion is needed for proper diagnosis and management of these lesions.
  • Pozycja
    Atypical extra nasopharyngeal angiofibroma in an unusual location: tonsil posterior pillar (oropharynx)
    (Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Mittal, Shweta; Priya, Madhu; Varshney, Saurabh; Angral, Sumeet; Xavier, Joyson; Malhotra, Manu; Bhardwaj, Abhishek; Kumar, Amit; Tyagi, Amit Kumar
    Introduction. Angiofibroma is a benign, locally aggressive highly vascular tumor that typically affects young adolescent males and has a pathognomonic epicenter of origin in the nasopharynx. The atypical angiofibromas share the same histological features as that of Juvenile nasopharyngeal angiofibroma, however they differ significantly in their clinical features. Aim. Here we are reporting a very rare case of atypical angiofibroma in an adult male presenting as a non-vascular mass in the oropharynx with posterior pillar as the subsite. Description of the case. A 26-years old male patient presented with chief complaints of foreign body sensation and mass in throat for one and a half months which was gradually progressive in size. Histopathological examination revealed a lesion with an intricate mixture of blood vessels, irregular fibrous stroma with loose edematous and fibrous area along with multinucleated stromal cells which was suggestive of angiofibroma. Conclusion. Oropharyngeal angiofibroma, being an atypical angiofibroma in terms of site and presenting complaints, presents a diagnostic challenge. Though rare, it should always be kept as a differential diagnosis in any oropharyngeal mass irrespective of its vascularity, typical age or sex of the patient.