Myiasis in a Backyard Pig: A Case Report
Published on: 27th May, 2024
Background: Myiasis is a parasitic infestation of livestock animals caused by dipteran larvae. The presence of wounds, lack of hygiene on the farm, and temperate climatic conditions contribute to myiasis. Swine can be infested by myiasis if injured pigs are not treated properly and failure to treat myiasis in time may cause the culling or death of the pigs, resulting in huge economic loss to the farmers. But like humans and other farm animals, pigs also deserve to be treated and cured of any suffering or disease. Therefore, this study is documented on pig myiasis and its management because to date a few cases have been reported on it.Case presentation: This case report documented the successful management of neck myiasis in a male, 9-month-old, 12-kg-weighing backyard pig. The wound site was cleaned using antiseptics and maggots were removed. The site was treated with turpentine oil, and ivermectin at 0.2 mg/kg B.W. and S/C. A combination of streptomycin (12.5 mg/kg B.W.) and penicillin (20000 IU/kg B.W.) was used IM daily for 5 days to prevent secondary bacterial infection. The wound was dressed regularly on every alternate day until the complete removal of maggots and the formation of granulation tissue.Conclusion: Through proper therapeutic management, the backyard pig’s neck myiasis wound was successfully healed in 10 days without any complications.
Complications of External Otitis in Horses
Published on: 21st May, 2024
The physiological removal of foreign bodies in the horse’s external ear canal is best achieved by head-shaking. However, external otitis in the horse induces moderate to severe pain: therefore, the horse does not shake his head. The causes of external otitis are dust, water in the external ear canal, keratin, and ceruminous debris. The clinical symptoms are ear discharge, skittishness, facial nerve paresis, and/or head tilt. After the horse has been sedated, the most important diagnostic procedure is the endoscopy of the cartilaginous and osseous part of the external ear canal, including the evaluation of the transparency of the tympanic membrane. The clinical complications of external otitis are hearing loss, facial nerve paresis, head tilt, hypertrophy of the tympanostylohyoideum, and corneal ulcers. The most important treatment is soaking up the exudate in the osseous part of the external ear canal using small cotton balls which are held by the foreign body forceps of the endoscope. Based on the results of the culture of exudate and the antibiogram, an antibacterial drug must be administered orally for 3 to 4 weeks. At this time, an endoscopy of the external ear canals and guttural pouches also has to be done. Based on the outcome of the endoscopy, endoscopic and clinical investigations have to be performed six months later as well. Only 7/19 horses had a normal osseous part of the external ear canal with a transparent tympanic membrane, including normal hearing measured by the brainstem auditory-evoked response after one month of treatment.
Adalimumab in the Treatment of Complex Sarcoidosis-related Inflammatory Eye Disease: A Case Series
Published on: 21st May, 2024
Background: Sarcoidosis is a systemic granulomatous inflammatory disease that is associated with inflammatory eye manifestations such as uveitis, cystoid macular edema, and retinal vasculitis. Although Corticosteroids (CS) have traditionally been the mainstay of treatment, there is a clinical need and growing interest in exploring alternative therapeutic options for patients who are refractory to or intolerant of CS or require long-term steroid-sparing agents. Purpose: This case series aims to describe the effectiveness of adalimumab, an anti-tumor necrosis factor (TNF)-α monoclonal antibody, in the management of complex sarcoidosis-related inflammatory eye disease via reduction in CS dosage and ocular exam findings before and after initiation of adalimumab therapy.Method: A retrospective chart review of patients between 2010 and 2023 seen at our academic center’s rheumatology and eye clinics was conducted, with 5 patients meeting the inclusion criteria. Results: Most patients were able to lower, discontinue, or remain off oral CS, while all 5 patients demonstrated a reduction in uveitis activity, Cystoid Macular Edema (CME), and/or retinal vasculitis. Conclusion: These findings suggest a potential role for adalimumab as an effective and safe therapeutic option in the management of complex sarcoidosis-related inflammatory eye disease.
Hypercalcaemic Crisis Associated with Hyperthyroidism: A Rare and Challenging Presentation
Published on: 15th May, 2024
A 51-year-old female with a history of multinodular goitre presented with vomiting, abdominal discomfort, and generalized tiredness. Investigations revealed hypercalcemia (ionized calcium 1.41 mmol/L), hypokalaemia, suppressed parathyroid hormone, and significantly elevated free thyroxine (> 7.77 ng/dL) with a suppressed thyroid-stimulating hormone level consistent with hyperthyroidism. Further, the workup confirmed Graves’ disease as the underlying aetiology. Hyperthyroidism is occasionally associated with mild to moderate hypercalcemia, but severe hypercalcemia or hypercalcaemic crisis is an extremely rare complication. Prompt recognition and treatment are crucial to prevent life-threatening complications. The patient was treated with intravenous fluids, a low-calcium diet, zoledronic acid, carbimazole, and a beta-blocker, leading to improvement in her condition. This case highlights a rare occurrence of hypercalcaemic crisis in a patient with thyrotoxicosis due to Graves’ disease. Hyperthyroidism-induced hypercalcemia requires prompt recognition and multidisciplinary management involving endocrinologists, internists, and critical care specialists to prevent potentially life-threatening complications. Healthcare providers should consider the hypercalcaemic crisis in the differential diagnosis of hypercalcemia in the context of hyperthyroidism.
A Rare Consanguineous Case of Alazami Syndrome in a Jordanian Family: Clinical Presentation, Genetic Analysis, and Therapeutic Approaches - A Case Report
Published on: 7th May, 2024
Objective: Alazami syndrome (AS) is an infrequent genetic disorder inherited in an autosomal recessive pattern, characterized by the presence of multiple congenital abnormalities. This study explores a case of a 4-year-old girl with AS, examining symptoms, genetic factors, and treatment efficacy. Case report: A 4-year-old girl, born to consanguineous Jordanian parents, displayed dysmorphic features including low birth weight, microcephaly, hyperthyroidism, short stature, blue sclera, triangular-shaped face, deep-set eyes, narrow palpebral fissures, and a prominent forehead. Examination revealed height (92 cm) and weight (7.7 kg) below the 5th and 3rd percentiles respectively. Blood tests and renal ultrasound were normal. Whole exome sequencing (WES) identified a homozygous eight-base pair deletion within exon 5 of the LARP7 gene on chromosome 4q25, confirming the diagnosis of AS, an autosomal recessive disorder. This variant induces frameshift mutations leading to premature stop codons, suggesting a probable mechanism of illness via loss of function. Treatment involving growth monitoring and therapy led to significant improvements in height, weight, and communication skills within three months. Conclusion: We describe a rare autosomal recessive AS case due to consanguinity, with a frameshift mutation in the LARP7 gene found via WES. Our AS treatment program effectively alleviates symptoms and enhances developmental progress.
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