Asploro Journal of Biomedical and Clinical Case Reports [ISSN: 2582-0370]

Covid-19 is an infectious disease that causes inflammation in the respiratory system, is contagious and spreads rapidly. The sequelae caused after infection and treatment of Covid-19 are not fully known. The study aims to evaluate the quality of life and respiratory capacity of individuals who have been contaminated by the Covid-19 virus. This study is characterized as descriptive, with a cross-sectional design and a quantitative-qualitative approach. The sample consisted of 54 participants, of both sexes, diagnosed with Covid-19, who were hospitalized or not. Data collection was carried out through a mixed online questionnaire, developed on the Google Docs^® platform. The results pointed to a worse quality of life in the domains Limitations due to physical aspects, Pain, Vitality, Limitations due to emotional aspects and a better quality of life for the domains Functional Capacity, General State of Health and Mental Health. And a worse quality of life assessed from the respiratory disease. It is concluded that the quality of life was affected and impaired after being affected by Covid-19 and that Physiotherapy helps to improve the sequelae and resumption of day-to-day activities, generating a good recovery.

The patient is an 83-year-old male, who smoked 20-40 cigarettes daily during 20-75 years and quit after that. In March 2021, he revealed normal chest X-P and was explained to take chest computed tomography (CT) next year. In April 2022, chest X-P was unremarkable, but CT showed a small solid abnormal shadow in the upper left lung region nearby aortic arch and abdominal aortic aneurysm (AAA) in the upper abdomen. Almost lung cancer cases are found in current smokers or ex-smokers. Using CT, lung cancer screening shows a 20-26% decrease in cancer death. Consequently, Low-Dose CT (LDCT) for smokers would be recommended.

A significant portion of all invasive fungal infections in solid organ transplants are due to cryptococcus. It can be a debilitating infection and affects the quality of life in transplant patients. We report a case of a 57-year-old male patient with recent kidney transplant, who presented with cryptococcal meningitis, after exposure to birds during a trip to Mexico 1 week ago. In addition to a two-day history of generalized weakness, dizziness, intermittent fever, and lightheadedness, the patient presented with on and off headaches, increased sinus pressure, neck stiffness, clogged ear sensation, confusion, and night sweats. The patient was initially treated empirically with fluconazole. Lumber punctuation showed elevated opening pressure, increased WBC, with neutrophil predominance. Cryptococcal antigen tests were positive in both serum and cerebrospinal fluid sources. After confirmation from CSF analysis, he was administered liposomal amphotericin B and flucytosine. Patient’s symptoms rapidly improved. Due to his immunocompromised state, the patient will require lifelong fluconazole maintenance therapy. Even though kidney transplant recipients have a positive outcome in terms of longevity, they are at increased risk of post-transplant infection, such as zoonotic infections. Therefore, in any recent kidney transplant patient with meningitis symptoms, cryptococcal meningitis should always be considered. We report the appropriate criteria, procedures, and tests that allow for a cryptococcal meningitis diagnosis in immunocompromised patients.

Background: Oral semaglutide (Rybelsus) has been in focus for type 2 diabetes (T2D).
Case Presentation: The patient is a 73-year-old male with T2D treated with metformin, Ipragliflozin, and rosuvastatin. He was diagnosed with depression by the Geriatric depression scale (GDS) with a stable condition by mirtazapine. His diabetic control was exacerbated to HbA1c 8.8% and weight 63.5kg in Feb 2022.
Results: He started to take Rybelsus, and then clinical improvement was found as HbA1c 6.9% and weight 57.5kg for 4 months.
Discussion: Remarkable effect of HbA1c and weight may be from longer fasting time after post-med, and regular lifestyle from the stable psychosomatic situation.

Mesenteric ischemia is a phenomenon that occurs when arteries supplying the gastrointestinal tract either become narrowed or obstructed, thus reducing or halting downstream perfusion. This case study will explore a case of mesenteric ischemia caused by SMA vasculitis, a nonatherosclerotic abdominal arterial vasculopathy (NAV), in which a 57 y/o woman with history of hyperlipidemia and GERD presented to the ER with chest and upper back pain. Initial work up for MI and PE were inconclusive and the patient was discharged. Patient then returned the next day complaining of chest and additional abdominal pain radiating to her back. An abdominal CTA, venous ultrasound, and MRI revealed findings highly suggestive of ischemia caused by vasculitis of the superior mesenteric artery, for which the patient was treated with tapering prednisone. Evaluation for mesenteric ischemia in patients presenting with nonspecific trunk pain will allow physicians to provide more prompt and catered care. Additionally, with the ubiquity of COVID-19 and its role in downstream inflammatory processes, atypical causes of mesenteric ischemia may be an increasingly important differential to consider.

Introduction: DPP-4 inhibitors are an integral part of the treatment of type 2 diabetes mellitus in Kenya. Most diabetics suffer from a lack of adherence due to a high pill burden due to multiple co-morbidities and the stigma of dependence on medication. Trelagliptin is a unique DPP-4 inhibitor due to its long biological half-life making it acceptable to be taken as a once-a-week dose. It was first accepted for use in Japan in 2015 and only got into the Kenyan market about 3 years ago. Here we have examined the effects of introducing this molecule into the regimen of a diabetic with extremely poor adherence due to a busy schedule and another diabetic who had multiple co-morbidities and subsequently a high pill load – with the benefits of its use in each case over a period of 6 months of observation.
Methods: These cases reported are the first of a 39-year-old female businessperson with a busy schedule and known to have mild hypothyroidism – yet always missing her medication. She was not confident in her consistency of medication uptake and always slacked in coming in for her tests because of the same. She is diagnosed to have diabetes with strong family history and thereafter she declined to add to her medication with daily metformin. She improved tremendously upon commencing trelaglyptin. The other is of an elderly woman who also had diabetes mellitus type 2, dyslipidemia, BPPV, and hypertension. She was unhappy about her results for diabetes and due to inconsistency in taking her medication but agreed to start on the trelaglyptin since it was once a week. Her outcomes were also very good from the same.
Conclusion: The use of trelaglyptin with the patients in Kenya could potentially lead to reduced stigma and inertia toward commencing medication and improved adherence to medication regimens in diabetes.

A 19-year-old man with a BMI of 23.8 kg/m² (5 ft 7 in; 152 lbs) presented with the concern of 3 years of progressively enlarging head leading to an increase in hat size. The patient fulfilled the criteria for macrocephaly as his head circumference was 62 cm, which was above the 97^th percentile for his age [1]. CT head revealed homogeneous bilateral hypertrophy of the temporalis, masseter, and medial pterygoid muscles with no evidence of a neoplastic process (Fig-1, Fig-2, and Fig-3). While genetic syndromes can be a cause of out-of-range head circumference, familial and environmental factors can contribute to variations [2,3]. In this case, the patient’s history revealed a history of bruxism since adolescence, however, no other physical or developmental abnormalities were noted. As a result, our case demonstrates bruxism and subsequent masticatory muscle hypertrophy as another possible cause of macrocephaly.

Falling is likely to occur in daily life and sports activities cause from right injury to severe injury in the upper extremity. The injuries from falls can range from contusion and sprain to fracture and dislocation. The injury occurs on the upper extremity more than on the lower extremity because people put their hands out to protect themselves from the body. Radiography (X-ray) can quickly diagnose a fracture because of the fracture line. In this case report, a 20-year-old woman slipped and put her hand to protect her body during ice-skating. The radius is a fine fracture line that could not be diagnosed by X-ray in this case even though magnetic resonance imaging (MRI) presented a fracture line.

Background: Intensive investigations have focused on the effect of propofol on the malignant behaviours of cancer cells. However, much is still unknown about the effect of propofol on non-small cell lung cancer (NSCLC). Here we aimed to investigate the effect of propofol on NSCLC with cancer stem-like cells (CSCs) A549.
Methods: CCK-8 assays, flow cytometry, and transwell assay were used to assess the changes in the proliferation, migration, and invasion in A549 treated with propofol. By detecting hallmarks of mesenchymal transition (EMT), the mechanism of the effect of propofol on A549 was assessed.
Results: In A549, propofol exposure promoted cell proliferation, while inhibiting migration and invasion. By activating EMT using TGF-β pretreatment, propofol treatment downregulated hallmarks of EMT and led to inactivation of EMT.
Conclusion: Modulation of self-renewal capacity of CSCs by anesthetics may affect cancer malignant behaviors following surgery. The employment of propofol not only exerts inhibitory effects on cancer cells but also on CSCs in non-small cell lung cancer.

In recent years, ultrasound-guided neuronal block had gradually become an indispensable skill for anesthesiologists in clinical work. Its visualization in operation makes the puncture more accuracy and anesthesia more effect, which effectively reduced the occurrence of related complications. However, it is not easy to master the ultrasound-guided neuronal block skill. Since the complexity of the knowledge system of ultrasound-guided nerve block, it makes the learning process cost more and learning period longer. So that the related teaching and training are facing great challenges. With the continuous innovation of teaching and training concepts and methods, a large number of teaching and training methods related to nerve block ultrasound-guided neuronal block had emerged, but there was still lacking a standardized, scientific and systematic teaching and training system in this field of medical education. Our review systematically summarized the current situation of ultrasound-guided nerve block training and reported the emergence of new forms and new methods in each link of teaching and training. We aimed to provide a sufficient and powerful reference for the reform and optimization of teaching system in this field.