Traumatic Optic Neuropathy and Central Retinal Artery Occlusion Following Blunt Ocular Trauma

We present a case as a rare sign of traumatic optic neuropathy and central retinal artery occlusion following blunt ocular trauma. A 10-year-old child suffered complete loss of the vision of one eye following a blunt ocular injury. He sustained an occlusion of the central retinal artery and traumatic optic neurupathy of the affected eye. Isolated cases of central retinal vessel occlusions and traumatic optic neurapathy following ocular blunt trauma are rare conditions. Clinicians to be aware of the potential for blunt ocular trauma to cause optic nerve damage and retinal vessel occlusions

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Role of Conventional and Diffusion-Weighted Magnetic Resonance Imaging of Spinal Treatment Protocol for Hydatid Disease

Objective: To demonstrate the role of magnetic resonance imaging (MRI) in determining the treatment protocol for hydatid disease of the spine

Partial Modification of the Yamada Technique in Myopic Strabismus Fixus Treatment: Case Presentation

A 41-year-old female presented with a history of gradually increasing esotropia (ET) for 23 years. The best corrected visual acuity was 20/63 in both eyes. Refraction values were -18.50 (-1.00*55) in the right eye and -13.25 (-3.00*105) in the left eye. The axial length was measured as 29.35 mm for the right eye and 28.36 mm for the left eye. The patient's ocular motility was very restricted in the left eye with values of (-4) for abduction from the midline, (-3) for elevation and (-4) for elevation in adduction. The patient's left eye had 80 prism diopters (PD) ET and 16 PD hypotropia with the prism cover test. During surgery, an 8 mm recession was first performed to the left eye medial rectus (MR). The SR and LR muscles were then divided into two for 15 mm from their insertions. The temporal half of the SR muscle and the superior half of the LR muscle were sutured together with 6/0 spatulated suture 7 mm away from the limbus at the exact midpoint of the two muscles, at the 1:30 o'clock position (Yamada procedure). A posterior fixation suture was placed on the sclera 7 mm behind the combined end of the two muscles (14 mm from the limbus) with 5/0 Ethibond suture (our modification of the Yamada procedure). Post-operative 1st day, 1st month and 6th month follow-ups were performed. On the 6th month follow-up, there was a marked decrease in the restriction of the patient&#8217;s left eye movements compared to the pre-operative period and there was 20 PD ET and 8 PD hypotropia in the primary position. Left eye movements were (+4) on abduction, (-2) on elevation and (-2) on elevation at adduction. We determined that we had achieved partial success in such cases with our partial modification of the Yamada procedure. [Med-Science 2015; 4(3.000): 2564-9

Deep Vein Thrombosis Associated with Protein C and Protein S Deficiency: An Unusual Cause of Acute Abdomen

Deep venous thrombosis is an extremely rare cause of acute abdomen and is often difficult to diagnose. Protein C and protein S deficiencies are rare genetic abnormalities that predispose the patient to thrombophilia and lead to thrombosis. We report the case of a previously healthy 7-year-old boy with iliofemoral thrombosis due to protein C and protein S deficiencies mimicking acute abdomen. (C) 2010 Wiley Periodicals, Inc. J Clin Ultrasound 39:287-289, 2011; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/jcu.2077

Unusual complications during endoscopic retrograde cholangiopancreatography (ERCP): Electrical burn in the liver

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard technique for the diagnosis of biliary obstruction. ERCP is also used for therapeutic purposes. During these procedures (diagnostic and therapeutic), complications such as pancreatitis, infection, hemorrhage, perforation and cardiopulmonary problems may arise. Some of these complications occur frequently, while others are extremely rare, as in the case presented here. In this case report, we present a woman who suffered an electrical burn in the liver during therapeutic ERCP. To our knowledge, this is the first case ever reported, which was caused by a monopolar cutter during ERCP and diagnosed by magnetic resonance imaging (MRI). (C) 2011 Elsevier Masson SAS. All rights reserved

Management and treatment of splenic trauma in children

AIM: To assess types of splenic traumas, accompanying injuries, their management and results

Infra-renal abdominal aorta hypoplasia in a case of Down syndrome depicted by multidetector computed tomography angiography

We report the case of a 3-day-old newborn with Down syndrome suffering from congenital infra-renal aortic hypoplasia. To our knowledge, this is the first report of a Down syndrome case with infra-renal abdominal aorta hypoplasia depicted by multidetector computed tomography angiography. In cases with no palpable pulsations in the lower extremities, multidetector computed tomography angiography is a fast and reliable diagnostic tool for the evaluation of distal aortic lesions. J Cardiovasc Med 10:276-278 (C) 2009 Italian Federation of Cardiology