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peer reviewed open access journals 80




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Coffee-Induced Hypokalaemia     (15/Apr/2010)


Taking an excess amount of caffeine (e.g. overdrinking caffeinated beverages) sometimes causes hypokalaemia. Although the detailed mechanism has not been clarified yet, an increased loss of potassium via the urine stream caused by the diuretic action of caffeine is proposed as one of the possibilities. We report the case of...


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Hemorrhagic Cystitis in a Patient Receiving Docetaxel for Prostate Cancer     (15/Apr/2010)


A case is reported in which docetaxel was used to treat a patient with hormone refractory metastatic prostate cancer. The treatment was terminated at the third course of docetaxel following the development of hemorrhagic cystitis. This reaction was unexpected, as it is not a known reaction to docetaxel. Hemorrhagic cystitis...


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Co-existence of Ventricular Septal Defect and Bronchial Asthma in Two Nigerian Children     (14/Apr/2010)


Congenital heart diseases (CHD) often present with recurrent or chronic breathing difficulties, as do chronic airway diseases such as asthma. Both are relatively common, and may sometimes co-exist. However, there is a paucity of literature from developing countries to that effect. We present two children diagnosed with ventricular septal defect,...


Article: Juvenile Bow Hunter’s Stroke without Hemodynamic Changes
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Juvenile Bow Hunter’s Stroke without Hemodynamic Changes     (16/Mar/2010)


Bow hunter’s stroke (BHS) is a cerebrovascular disease caused by occlusion of the vertebral artery (VA) on head rotation. BHS is generally associated with hemodynamic changes, often leading to vertebrobasilar insufficiency symptoms, such as vertigo and faintness. Although artery-to-artery embolism has also been proposed as an underlying mechanism, it remains controversial. This report documents a case of BHS without hemodynamic changes. We describe a 26-year-old male patient who had VA occlusion on head rotation and...


Article: Intractable Chronic Low-Back Pain Caused by Ligamentopathia Treated Using a Spinous Process Plate (S-plate)
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Intractable Chronic Low-Back Pain Caused by Ligamentopathia Treated Using a Spinous Process Plate (S-plate)     (10/Mar/2010)


We report a case of intractable chronic low-back pain in a gymnast that was caused by ligamentopathia in the interspinous region of the lumbar vertebrae. Sprained interspinous ligaments are a common mechanical cause of acute low-back pain in athletes. Although conservative therapy is generally effective in such cases, in this case it was not. The patient experienced severe low-back pain during lumbar flexion with tension between the L5/S interspinous ligaments. We performed interspinous fixation by...


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The Use of Topical Tacrolimus 0.1% Skin Ointment for Anterior Segment Conditions: A Case Series     (23/Feb/2010)


Tacrolimus (FK 506) is a macrolactam derivative with immunomodulatory and anti-inflammatory activity. Topical tacrolimus 0.03% has been used for inflammatory conditions of the anterior segment. This article adds to the literature on the off-license application of tacrolimus ointment, by describing the safe and effective use of the higher strength of...


Article: Bilateral Basal Cell Adenocarcinoma of the Parotid Gland: In a Recipient of Kidney Transplant
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Bilateral Basal Cell Adenocarcinoma of the Parotid Gland: In a Recipient of Kidney Transplant     (18/Feb/2010)


We report a rare case of bilateral basal cell adenocarcinoma (BcAC) of the parotid gland in a male patient 30 years after kidney transplantation and continuous administration of immunosuppressive therapy. BcAC is a salivary gland malignancy first recognized as a distinct neoplastic entity in WHO classification of salivary gland tumours in 1991. Over 90% of BcACs are detected in the parotid gland. The most important differential diagnosis is basal cell adenoma. Infiltrative growth is the...


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Introductory Editorial     (10/Feb/2010)


Introductory Editorial by Dr Karna Dev Bardhan


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Quetiapine Induced Acute Dystonia in a Patient with History of Severe Head Injury     (03/Feb/2010)


A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups...


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Spectral Domain OCT Documented Resolution of Pseudophakic Cystoid Macular Edema after Intravitreal Triamcinolone     (03/Feb/2010)


Cystoid macular edema (CME) is an important cause of visual loss after cataract surgery. Treatment is usually with topical anti-inflammatory agents, with anti-vascular endothelial growth factor agents and steroids used intravitreally in resistant cases. Even though time-domain Stratus OCT can quantify the macular thickness, it cannot prognosticate visual outcomes due...


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Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms     (27/Jan/2010)


Background: Children with developmental disorders experience chronic gastrointestinal symptoms. Aims: To examine the nature of these gastrointestinal symptoms and histologic findings in children with autism spectrum/developmental disorders and ileocolonic disease. Methods: Chart review. 143 autism spectrum/developmental disorder patients, with chronic gastrointestinal symptoms, undergoing diagnostic ileocolonoscopy. Results: Diarrhea was present...


Article: A Case of Protruding Eyeballs and Diminishing Vision
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A Case of Protruding Eyeballs and Diminishing Vision     (20/Jan/2010)


This case report discusses issues related to a 56-year-old man from Bangalore who presented with complaints of a gradual protrusion of his eyeballs along with diminishing vision for the previous month. The approach to diagnosis and management issues around this unusual presentation is discussed.


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Triple Vessel Coronary Artery Bypass Grafting in a 14-year-old Child with Familial Hypercholesterolemia-A Rare Case Report     (13/Jan/2010)


Familial hypercholesterolemia is a genetic disorder caused by a mutation in the low density lipoprotein (LDL) receptor gene. The homozygous type of the disease is rare and causes tendon xanthomas and coronary artery disease during the early years of life. Premature coronary artery occlusive disease in familial homozygous hypercholesterolemia might...


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Acute Coronary Syndrome in Pregnancy     (08/Dec/2009)


Acute coronary syndrome (ACS) in pregnancy has traditionally been considered to be a rare event, but the combination of normal physiological changes of pregnancy and more prevalent cardiovascular risk factors are increasing its incidence in this population. The present report describes a 39 year-old woman that is seven weeks pregnant...


Article: Orbital Metastasis of Breast Carcinoma
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Orbital Metastasis of Breast Carcinoma     (02/Dec/2009)


We report a case of orbital metastasis in a previously diagnosed metastatic breast cancer in a 46-year old woman presenting with diplopia and proptosis of her left eye bulb. An orbital computed-tomography (CT) and a magnetic resonance imaging (MRI) both revealed an intra-orbital extra-bulbar mass of 1.5 × 3 cm in size, in the left orbit. The patient had been diagnosed with stage IV breast cancer 4 years before. She had received chemotherapy with docetaxel...


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Common Variable Immunodeficiency Associated with Inflammatory Bowel Disease and Type I Diabetes     (27/Nov/2009)


Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency disorders characterized by defective antibody production, low levels of serum immunoglobulins and increased susceptibility to infection. The patient was a 39-year-old male who was admitted to the gastroenterology department with a two week history of diarrhea, blunt abdominal pain...


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Osler-Weber-Rendu (OWR) Disease and Heart Failure     (25/Nov/2009)


OWR is a genetic disease, transmitted as an autosomal dominant disorder characterized by arteriovenous malformations pre-dominantly involving the mucocutaneous epithelium. One of the significant complications is the development of arteriovenous fistulas in different organs like the liver and brain. One of the rarest complications of this arteriovenous conduit is a...


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Doty’s Method (Two Sinus Reconstructions) of Supravalvular Aortic Stenosis in Williams’s Syndrome     (24/Nov/2009)


We experienced a successful surgical Williams’s syndrome case of extended aortoplasty by means of Doty’s method (two sinus reconstructions) for congenital supravalvular aortic stenosis. Case was 29-year-old woman, who had no complaint except heart murmur and dyspnea. The retrograde aortography and Digital Subtraction Angiography (DSA) demonstrated localized stenosis just above...


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A Case of Fahr’s Disease Presenting as Chorea Successfully Treated by the Use of Quetiapine     (22/Oct/2009)


We report a case of 30-year-old man presenting chorea in his legs. A brain computed tomography (CT) scan showed bilateral symmetric calcifications in the basal ganglia, thalamus, cerebellum and subcortical white matter. Laboratory studies showed no abnormalities of serum calcium, phosphate, PTH, lactic acid, pyruvic acid and cerebrospinal fluid. Under...


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Crossplasty: An Alternative Technique for Closing Double Defects     (22/Oct/2009)


Crossplasty is a modified O-T advancement flap. It is an alternative technique to close double surgical defects, which are arranged in a vertical line. It is useful to camouflage the scar in forehead parallel lines. Geometrically, it is an inverted T joined to a vertical linear defect. There are three...


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Intestinal Obstruction and Pheochromocytoma in a Patient Suffering from von Recklinghausen’s Disease     (13/Oct/2009)


GISTs are rare neoplasms, which were recently identified to be a distinct pathologic entity. They can develop in patients with neurofibromatosis type 1 (NF1) or may be sporadic. NF1 is one of the most common inherited diseases and is a complex disease, with patients having an increased prevalence of benign...


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Dysfunction of Corticomotoneurons in Guillain-Barré Syndrome (GBS)?     (01/Oct/2009)


Guillain-Barré syndrome (GBS) is characterized by acute and symmetric flaccid paraparesis and areflexia. Involvement of the central nervous system has been infrequently reported. In the current issue of Clinical Medicine: Case reports, an unusual case of GBS with asymmetric muscle weakness was reported. Corticomotoneuronal dysfunction was invoked as a possible...


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Metabolic Complications of Bypass Surgery for Morbid Obesity     (18/Sep/2009)


Postoperative complications resulting from bariatric surgery can lead to severe vitamin-deficiency states. A patient who underwent bariatric bypass surgery and later developed Wernicke’s encephalopathy prompted us to present her interesting case history for discussion. Although bariatric surgery is known to be a risk factor for Wernicke’s encephalopathy, this diagnosis is...


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Hemangioma of the Thyroid     (18/Sep/2009)


Introduction: Thyroid hemangioma is very rare, and only a few cases have previously been reported. We encountered a patient with thyroid hemangioma diagnosed after surgery. Case Report: A 71‑year‑old woman visited our hospital with a mass in the left thyroid region. A 5‑cm, elastic mass of the thyroid was palpable in...


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The Influence of Traditional Herbal Medicine (Kampo) on Anti-cyclic Citrullinated Peptide Antibody Levels     (17/Sep/2009)


We present three rheumatoid arthritis (RA) patients successfully treated with traditional herbal medicine (THM: Kampo). The treatment with THM resulted in a decrease in RA disease activity such as DAS28, as well as in the serum levels of anti-cyclic citrullinated peptide antibodies (anti-CCP) in 3 cases. These observations suggest that...


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Stress Cardiomyopathy (Takotsubo Cardiomyopathy)     (17/Sep/2009)


Background: Due to the rise in the number of reports of stress cardiomyopathy in the literature, awareness of this condition is increasing. Although different names have been used to describe this condition, the similarities in clinical, electrocardiographic, echocardiographic, and angiographic features suggest that they represent the same spectrum of diseases...


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Asymmetrical Weakness Associated with Central Nervous System Involvement in a Patient with Guillain-Barrè Syndrome     (03/Sep/2009)


Guillain-Barrè syndrome (GBS) is usually associated with symmetrical weakness, and therefore asymmetrical weakness may confuse diagnosis. We report on a patient with GBS subsequent to Campylobacter jejuni enteritis who had asymmetrical weakness with CNS involvement. The patient tested positive for anti-ganglioside antibodies, including anti-GM1 IgM, anti-GD1b IgG, and anti-GT1a IgG....


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New Advanced Technologies to Provide Decentralised  and Secure Access to Medical Records: Case Studies  in Oncology     (07/Aug/2009)


The main problem for health professionals and patients in accessing information is that this information is very often distributed over many medical records and locations. This problem is particularly acute in cancerology because patients may be treated for many years and undergo a variety of examinations. Recent advances in technology...


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Methotrexate-Induced  Acute Leukemia: Report of Three Cases and Review of the Literature     (31/Jul/2009)


For many years, methotrexate has been used in the treatment of certain chronic medical disorders e.g. rheumatoid arthritis and psoriasis as well as a number of malignant disorders e.g. acute lymphoblastic leukemia, certain types of lymphoma and breast carcinoma. Its use has been associated with various systemic toxicities and complications....


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Sarcomatoid Carcinoma of the Urinary Bladder Treated with Adjuvant Radiotherapy: A Case Report     (30/Jul/2009)


Sarcomatoid carcinoma is a rare tumor of the urinary bladder accounting for less than 0.5% of all primary urinary bladder tumors. Since the patients were presented with large tumor with extended stages, outcome was found to be poor. In order to improve local control, adjuvant local treatment may be practical....