Case Report: Priapism as The Clinical Presenting Feature of Chronic Myeloid Leukemia: Case Report and 20-Year Literature Review

Priapism in chronic myeloid leukemia (CML) appears to be an infrequent manifestation as well as a crucial emergency. Here, we report an 18-year-old male presenting with a persistent erection of the penis for 20 days. We evaluated and compared the reported cases within 20 years discussing the management of priapism in CML. Cytoreductive therapy followed by leukapheresis, the administration of tyrosine kinase inhibitor, and intra-cavernosal blood aspiration may resolve the symptoms of priapism. Early intervention for cytoreduction and aspiration are the pivotal keys to successfully impeding the complications.

Main causes of cattle slaughter condemnation under the state sanitary inspection in Bahia, Brazil

Slaughter condemnations are important sources of information on cattle health and handling. The aim of this study was to evaluate the main causes of condemnation of cattle slaughter under the state sanitary inspection by the Diretoria de Inspeção de Produtos de Origem Agropecuária (DIPA) of Agência de Defesa Agropecuária da Bahia (ADAB), in Bahia, Brazil. A retrospective data of all cattle slaughtered from 2012 to 2019 was obtained from DIPA – ADAB. During this period, 4,635,615 cattle were slaughtered and 1,452,472 (31.33%) condemnations were registered to have occurred at varying levels in all regions of the state. The more condemned organs were kidneys and lungs; and the main causes of condemnation were nephritis (11.79%), congestion (11.20%), emphysema (10.72%), blood aspiration (8.36%), renal cysts (5.75%), and abscesses (5.71%). However, other condemnation causes such as cysticercosis, fasciolosis, and tuberculosis were observed at lower rates. Results showed that the main causes of condemnation of cattle slaughter were not related to zoonotic diseases instead were more involved in partial condemnation of organs.

MULTIPLE VACUUM SYRINGE BLOOD ASPIRATION PROCEDURE (MVSBAP): A NEW HORIZON OF RAKTAMOKSHANA PROCEDURE IN PANCHAKARMA THERAPY OF AYURVEDA

Panchakarma is a specialized branch of Ayurveda that primarily deals with the body's purification (Shodhana) of doshas. As we know, the word Panchakarma refers to five special therapeutic procedures like Vamana, Virechana, Vasti, Nasya and Raktamokshana. Raktamokshana is an effective bloodletting therapy. Classically it is described as of six types, i.e. (1) Shringa, (2) Jalauka, (3) Alabu, (4) Shiravedha, (5) Prachchhana and (6) Ghatiyantra. In the present study, a clinical trial has been done, especially in the disease of Gridhrasi, with particular reference to Sciatica by combining Parchchhana and Ghatiyantra, a modified form of Raktamokshana therapy, called Multiple Vacuum Syringe Blood Aspiration Procedure (MVSBAP). Sciatica is painful neuralgia of the Sciatic Nerve in which pain starts from the gluteal region and buttock and comes down through the back of thigh, knee, calf and outer border of the foot. Sixty patients were selected for the clinical trial using a simple random sampling method from the OPD and IPD of Government Ayurveda College and Hospital, Varanasi, Uttar Pradesh, India. Two groups are made like Group-A and Group-B, each consisting of 30 patients. Patients of Group-A are treated with only traditional Ayurvedic medicines, and patients of Group-B are treated with MVSBAP and traditional Ayurvedic medication. After one month of final treatment, assessment is done on statistical parameters, which show pretty better results in Group-B patients. The application of MVSBAP in the disease of Gridhrasi draws a new horizon to the ailing humanities.

ENDOSCOPIC CORRECTION OF IATROGENIC TRACHEA INJURIES IN SMALL PETS

Today, the veterinarian is increasingly in veterinary practice began to use new modern technologies for the treatment of small pets, using modern equipment for medical manipulations. At present, a modern operating room can no longer be imagined without a ventilator and a device for giving inhalation anesthesia. But, even new modern equipment and modern drugs for performing anesthesia cannot protect against medical errors. One of the most important manipulations is the ability to correctly place the endotracheal tube to perform resuscitation or give inhalation anesthesia. The percentage of iatrogenic injuries during this procedure reaches 2.5 % and is complicated by bleeding and blood aspiration, which requires emergency assistance, primarily with the use of endosoepic technologies.

Case Report: Priapism as the clinical presentation of chronic myeloid leukemia in accordance with reports created during last twenty years: a case report and literature review

Priapism in chronic myeloid leukemia (CML) appears to be an infrequent manifestation as well as a crucial emergency. Here, we report an 18-year-old male presenting with a persistent erection of penis for 20 days. We evaluate and compare the reported cases during the past 20 years discussing the management of CML patients experiencing priapism. Cytoreductive therapy followed by leukapheresis, the administration of tyrosine kinase inhibitor, and intra-cavernosal blood aspiration may resolve the symptoms of priapism. Early intervention for cytoreduction and aspiration are the pivotal keys to successfully impeding the complications.

SARS-CoV-2 Infection as a Determining Factor to the Precipitation of Ischemic Priapism in a Young Patient with Asymptomatic COVID-19

COVID-19 is a disease characterized by respiratory distress, systemic inflammation, multiple organ dysfunction and coagulation disorders, chiefly pulmonary embolism, and deep venous thrombosis. In this case report, we discuss a peculiar case of ischemic priapism in a 36-year-old patient with asymptomatic COVID-19 and no other plausible causes of thrombophilia and/or alternative causes of priapism, as well as discussing possible explanations for such remarkable findings and comparing them to analogous cases recorded in literature. The patient was unsuccessfully treated via cavernous blood aspiration and required several shunting procedures, with no further recurrences and negative testing for pulmonary embolism, deep venous thrombosis, and other causes of thrombophilia.

Opinion-related difficulties related to severe injuries of the facial and cerebral parts of the skull resulting from punching

Aim: Comparison of injuries to the facial and cerebral parts of the skull causing death and grievous bodily harm, resulting solely from punches to the facial area of the skull. Assessment and confrontation of both groups in terms of the final criminal-legal classification of the perpetrator’s acts. Review of reasons for court judgements with a focus on the subjective elements of the prohibited act. Attempt to verify the hypothesis assuming that death or grievous bodily harm can be caused by a single punch to the facial part of the skull. Material and methods: Final judgements passed by criminal divisions of common courts of law in cases where death or grievous bodily harm was caused by injuries to the facial and cerebral parts of the skull resulting solely from punches to the facial area of the skull. Assessment of individual cases within each group to determine similarities and differences. Comparative analysis of both groups. Results: The cause of death in cases involving injuries to the facial part of the skull was rapid suffocation following blood aspiration into the respiratory tract. However, the criminal-legal classification of the perpetrators’ actions in these cases was varied. In one case, death resulted from injuries to the cerebral part of the skull, which are extremely rare as a result of a punch to the facial area within the skull. Grievous bodily harm was due to the loss of vision in the eye, typically due to eyeball rupture. Conclusions: Even though the circumstances of the injuries were similar, different mechanisms were responsible for causing death and grievous bodily harm in the victims. The most severe consequences (death and grievous bodily harm) were not caused by injuries of the same type in any of the cases studied. A single punch to the facial part of the skull may be enough to lead to either grievous bodily harm or death, but the criminal-legal assessment of punching to the face can vary greatly.

Continuous PENG block for hip fracture: a case series

IntroductionThe pericapsular nerve group (PENG) block is a novel regional technique indicated for analgesia for hip joint pain. We administered PENG blocks and performed catheter insertion for continuous infusions in patients with femur fractures on hospital admission. In this case series, we describe our initial experience of pain management in 10 patients with continuous infusion and its associated adverse events.Case seriesThe PENG block was administered with an introducer needle. The catheter was then inserted 3 cm beyond the needle tip. In three patients, blood aspiration through the catheter occurred. In each patient, the catheter was repositioned 0.5–1.0 cm more medially. No blood aspiration or visible hematoma occurred subsequently. The presence of any vascular structure deep to the iliopsoas muscle was excluded postoperatively based on a Doppler color flow scan.DiscussionOverall, eight patients had femoral neck fractures, and two patients had intertrochanteric fractures. All 10 patients reported good pain relief. The median (IQR) Numerical Rating Scale (NRS) score decreased from 7 (6–7) before the block to 2 (2–2.75) 20 min after PENG catheter placement. The median (IQR) NRS score after 12, 24 and 48 hours were 2 (2–3), 2 (2–3), and 2 (0.25–2), respectively. Patients underwent surgery 24–48 hours following catheter placement. Catheters were removed by an Acute Pain Service nurse 72 hours postinsertion. We want to highlight the potential for intravascular catheter placement in this anatomical region. Further studies are required to confirm if this is a technical error or an associated complication of continuous PENG blocks.