Depression as a civilization-deformed adaptation and defence mechanism
Published on: 2nd March, 2020
OCLC Number/Unique Identifier: 8544395440
Depression is currently one of the main barriers to further civilizational development. Despite intensive efforts, it is a growing health, social and economic problem. We still lack clarity regarding the ethology of depression and treatment is still mainly symptomatic. The authors postulate that depression has similarities with anxiety and from an evolutionary perspective is an archaic defence mechanism. Formerly, through the agency of complex psychological, biological and social mechanisms, healing was facilitated in conditions of an intense, short-term nature. Adverse civilizational and environmental changes have caused pathological changes in both the mechanism of depression and corresponding defence mechanisms such as the induction of an anxiety state. Related to depression is the mechanism of thanatosis, concerning chronic biological and psychosocial dysfunctions. It is a mechanism for activating self-eliminating processes to free the community from the burden of a dysfunctional individual.
Actinomycosis of the appendix
Published on: 17th October, 2018
OCLC Number/Unique Identifier: 7906092415
A 40 year old woman presented to the emergency department with acute on chronic abdominal pain in her right iliac fossa. On history her pain had been present for over 6 months and had previously been investigated with ultrasound, CT and a diagnostic laparoscopy several months prior to presentation. Her pain had acutely worsened over the preceding two weeks. This was associated with two days of diarrhoea but nil other systemic symptoms. Her medical history was significant for immunosuppression with tacrolimus, azathioprine and prednisone post renal transplant for IgA nephropathy [1]. Her abdominal examination was unremarkable other than tenderness in her right iliac fossa and a palpable non-tender renal transplant. Her inflammatory markers, electrolytes and urine microscopy were unremarkable. She was further investigated with an ultrasound which demonstrated nil complications with her transplant and a non-contrast CT (due to contrast allergy). Her CT demonstrated a faecolith within the appendiceal lumen but no signs of acute appendicitis (Figure 1). Due to ongoing pain and CT finding of faecolith she was taken for a diagnostic laparoscopy with appendicectomy.
Figure 1: Non-contrast CT demonstrating faecolith.
Intraoperatively she had a macroscopically normal appendix and no other cause for the patients symptoms could be identified. A laparoscopic appendicectomy was performed with no complications. Her pain persisted postoperatively and she was discharged post operative day two with analgesia. Histology subsequently revealed actinomyces-like organisms consistent with actinomycosis of the appendix (Figure 2). Her case was discussed with the Infectious diseases team and she was started on an extended course of oral amoxicillin [2].
Figure 2: High Powered H&E stain & gram stain of actinomyces like organisms
Impact of Christian meditation and biofeedback on the mental health of graduate students in seminary: A pilot study
Published on: 9th March, 2020
OCLC Number/Unique Identifier: 8552069109
With increasing awareness of the mental health issues among the clergy and seminary students, it is important to explore possible interventions to help address their mental health concerns. This pilot study examined the impact of Christian meditation and biofeedback on levels of stress, anxiety, and depression of seminary students. Participants of this study included 20 theology students from two seminary campuses. Participants were of various ethnic backgrounds and had an average age of 31. At the beginning of the study, participants were randomly assigned to practice either Christian meditation or biofeedback for 4 weeks, three times per day, and to keep a log of their practice times. The results from the paired samples t-tests indicated that both Christian meditation and biofeedback significantly reduced the levels of stress, anxiety, and depression experienced by the participants. ANCOVA indicated that neither intervention was more effective than the other. Seminaries, churches, and pastoral care groups should look into these interventions as a good source to help their clergy cope with stress, anxiety and depression.
Therapeutic application of herbal essential oil and its bioactive compounds as complementary and alternative medicine in cardiovascular-associated diseases
Published on: 10th March, 2020
OCLC Number/Unique Identifier: 8586050480
Background: Herbal essential oil contains pharmacological benefits for intervention treatment of various diseases. Studies have demonstrated its antimicrobial, antioxidant, and anti-inflammatory effect involving in vitro cell culture and preclinical animal models. It has been also traditionally used to reduce anxiety and hypertension in human. However, scientific studies elucidating its mechanism of action and pharmacological targets, as well as its effectiveness and safety as phytotherapeutic compounds are still progressing. Recent studies showed its promising effect in depression-cardiovascular disease intervention. However, comprehensive evaluations to enlighten latest advancement and potential of herbal essential oil are still lacking.
Objective: In this systematic review, the depression-cardiovascular effects of herbal essential oil on lipid profile, biochemical and physiological parameters (e.g haemodynamic) are presented. The route of delivery and mechanism of action as well as main bioactive compounds present in respective essential oil are discussed.
Methods: Article searches are made using NCBI PubMed, PubMed Health, SCOPUS, Wiley Online, tandfonline, ScienceDirect and Espacenet for relevant studies and intellectual properties related to essential oil, depression and cardiovascular disease.
Results: In experimentation involving in vitro, in vivo and clinical trials, herbal essential oil showed its effectiveness in reducing coronary artery disease (narrowing of the arteries), heart attack, abnormal heart rhythms, or arrhythmias, heart failure, heart valve disease, congenital heart disease, heart muscle disease (cardiomyopathy), pericardial disease, aorta disease, Marfan syndrome and vascular (blood vessel) disease.
Conclusion: This review gives a valuable insight on the potential of essential oil in the intervention of depression associated with cardiovascular diseases. Studies showed that herbal essential oil could act as vasodepressor, calcium channel blocker, antihyperlipidemia, anticoagulant, antiatherogenesis and antithrombotic. It can be proposed as an interventional therapy for depression-cardiovascular disease to reduce doses and long-term side-effect of current pharmacological approach.
Anatomical Distribution of Intramuscular Lipomas
Published on: 19th April, 2017
OCLC Number/Unique Identifier: 7286426158
Lipomas are the most common type of soft tissue tumor occurring in the subcutaneous tissue. Rarely, lipomas present in the deep soft tissue such as intermuscular, intramuscular, and parosteal sites. When they occur within a skeletal muscle they are called intramuscular lipomas. Intramuscular lipomas may involve both children and adults. They are benign, nontender, deep located, circumscribed but unencapsulated lesions. Intramuscular lipomas account less than 1% of all lipomas. Most are located within a single muscle (solitary), while cases involving two or more muscles are very rare. They present with typical histological features. They may be divided into the infiltrative, the well-circumscribed and the mixed type. Differential diagnosis of the infiltrative type from liposarcoma is very difficult. Local recurrence may be evident if the surgical margin is not clear. They can occur in almost any anatomical site [1-15].
Problems shared in psychiatry helpline of a teaching hospital in eastern Nepal during COVID-19 pandemic lockdown
Published on: 27th April, 2020
OCLC Number/Unique Identifier: 8586054474
COVID-19 pandemic soon apparently proved to be havoc and a great stressor. During such a stressful time, mental health is in threat. Here, we intend to review the presenting problems/ symptoms as shared in psychiatry helpline of a Teaching Hospital in eastern Nepal during the second week of lockdown and to reflect on to emotional, including mood problems.
It is an institute based period observation noted for all psychiatry helpline calls during 1 week of lockdown days of COVID-19. Their concerns and problems were listened and symptoms clarified by a consultant psychiatrist to help them as far as possible through the telephonic conversation. Maintaining the confidentiality, basic information were noted down in a semi-structured proforma to record certain socio-demographic and clinical information (including mood and other emotional symptoms).
We received 102 helpline calls of 60 clients for psychiatry in 1 week, from 14 districts. More patients being discussed were males (35/60), average age being 34.15 (15 - 70) years. More patients were regular follow-up cases with some new issues (24/60) and 18/60 each were new clients and regular follow-up cases. Majority had exacerbated symptoms in the wake of COVID-19 as: emotional (47/60; mood 24/60, anxiety/worry 23/60) symptoms along with disturbed sleep (32/60); treatment/service issues (31/60) and changed routines. Most common mental problems were Bipolar affective disorder, Psychosis, Anxiety and Depression and advices included Antipsychotics, Benzodiazepines, Antidepressants, along with some Psycho-education. Most common concerns were about OPD service, worsening symptoms and local unavailability of medicines. Many had mood and emotional symptoms in this stressful time, both simple amenable to telephonic advices and severe requiring to be called to emergency service.
Emergency laparoscopic left sided colonic resection with primary anastomosis: Feasibility and Safety
Published on: 20th November, 2018
OCLC Number/Unique Identifier: 7943252570
Patients undergoing laparoscopic surgery had a lower incidence of major complications, such as anastomotic leak, intra-abdominal bleeding, abscess, and evisceration. Controversies about the operative management of left colonic emergencies are decreasing. Nowadays there is worldwide shifting towards primary resection, on table lavage and primary anastomosis. The aim of this study is to record the safety of laparoscopic primary anastomosis in left-sided colonic emergencies.
Patients: The study was carried out at Beni-Suef University Hospital, in the period between January 2016 and July 2017. Twenty-six patients were included in this study, twelve with left colon cancer, twelve with left colonic complicated diverticulitis and two cases with sigmoid volvulus. Patients presented clinically with either obstruction or perforation. All patients were subjected to laparoscopic resection, on table lavage and primary anastomosis.
Method: Decompression was done prior to starting the intervention, followed by resection and on table lavage then colorectal anastomosis using the circular stapler. The study was approved by the ethical committee in the faculty.
Results: Mean operative time: 185 min (160- 245).
LOS: 12 (10- 18).
Leak: one in obstruction group and two in perforation group.
Redo one in perforation group.
Conclusion: Emergency laparoscopic left-sided colonic resection and primary anastomosis can be performed with low morbidity, however with caution if there was free perforation with peritonitis
Comparison of Vitreous Protein Profiles of Rabbits subjected to Acute Carbon Monoxide poisoning and normal animal after death
Published on: 6th June, 2017
OCLC Number/Unique Identifier: 7286357384
Acute carbon monoxide (CO) poisoning is caused by the inhalation of large quantity of CO within short time leading to morbidity and mortality. In this study, a total of eighteen (18) rabbits were divided into three (3) groups of six (6) animals each. The first group first group was poisoned with CO and labelled carbon monoxide death (CD). The second group of animals was killed prior to exposure to CO and labelled disguised death (DD), while the third was the control group (CG). The vitreous humour samples were collected from all the animals using standard methodologies. The vitreous humour total protein and albumin were estimated while its globulin content and albumin/globulin ratio were derived mathematically. Pearson correlation analyses were used to establish relationships between vitreous protein profile components and the acute graded carbon monoxide concentrations. Results indicated a significant increase (P<0.05) in vitreous total protein and globulin of the studied groups. This observation was more pronounced in the CD group of animals. Therefore the marked elevation of vitreous total protein and globulin may serve as a useful tool in the confirmation of death due to carbon monoxide poisoning.
Socio-demographic characteristics and other factors associated with depressive illness among medical students at the University of Port Harcourt
Published on: 14th May, 2020
OCLC Number/Unique Identifier: 8691259611
Background: The burden of depression as a mental disorder has continued to increase and constituting an enormous public health concern among all age groups. A number of socio-demographic, and other factors including a stressful and rigorous academic programme or curriculum such as the one run in most medical schools could contribute to the occurrence of depression among medical students.
AIM: To determine the socio-demographic and other factors associated with depression among medical students in the University of Port Harcourt.
Methodology: This study was a descriptive cross-sectional study. Appropriate sample size was calculated and the stratified random sampling method was used to select the subjects. A well-structured open ended self-administered socio-demographic questionnaire was administered to the students. The Zung Self-Rated Depression Scale was used to assess the depression status of each respondent. The data were analyzed via descriptive and analytical methods.
Results: The prevalence of depression among the medical students was 5.3%. Fourteen students (4.6%) were mildly depressed while only two respondents had moderate depression. Year 3 had the highest prevalence with 10.5% followed by final year with 5.3%, while the only 2 cases of moderate depression were found among students in year 2 of their medical programme. Two hundred and seventy-one respondents (88.8%) were found to have good knowledge of depression, 32 (10.5%) were found to have average knowledge of depression and 2(0.7%) had poor knowledge of depression.
Conclusion: Depression does occur among medical students at the University of Port Harcourt albeit low, and was associated with a number of socio-demographic and other factors. The present medical curriculum and programme should be sustained and more efforts at making it less stressful and academically friendly, be made to further reduce the current rate of psychological stress and depression among the students.
The Effect of Cement and wrapping on the Decomposition rate of the Rabbit Carcasses
Published on: 16th August, 2017
OCLC Number/Unique Identifier: 7286357028
Taphonomic study was first time conducted in Kuala Lumpur, capital city of Malaysia. In this research model, male Oryctolagus cunicullus weighed 1.8-2.6 kg each were killed by Dolethal intravenously at the ear region. In Phase 1 study, eight subjects were wrapped in a sack and cemented within a container to be compared with the other four controls at each location labelled A (ground) and B (manmade freshwater pond). Phase 2 involved duplicating set of 15 cemented samples comparable to 1 control made up to total of 32 subjects which were all put into a compact polytank containing freshwater to simulate a case study. Taphonomic changes were observed and scored using TBS system incorporating of fresh stage, early decomposition stage, advanced decomposition stage and skeletonisation stage. The ambient temperature of surroundings with 28.81C±4.21°C and 29.21°C±4.57°C (mean±S.D.) while relative humidity of air with 74.49 %±14.61% and 79.15%±16.32% (mean±S.D.) were recorded for Phase 1 and Phase 2 study respectively. Time taken for ground control exposed and wrapped carcasses to reach first sign of skeletonised stage were four days and five days respectively. Whilst freshwater controls reached initial skeletonised stage within one week for exposed carcass and two weeks for wrapped carcass. Within the control and cemented sample carcasses, TBS scores increased from initial stages of decomposition and become plateau after advanced decomposition. The cementing factor have superseded the wrapping factor due to its stronger physical barrier effect to slow down the decomposition more than half compared to controls based on Multiple way ANOVA test. Phase 2 study has demonstrated more accurately on the decomposition rate of the cemented samples. It showed that wrapping and cementing factors have delayed the decomposition process of the rabbit carcasses about 4 times to reach the initial stage of skeletonisation compared to the control carcasses. There was absence of insect activity within the cemented samples, hence the microorganism activity would be the only contributor to the decaying process within the cemented samples at slower rate comparing to the exposed or wrapped controls.
“Iliosacral bridging” - A new alternative minimal invasive fixation of unstable pelvic ring fractures
Published on: 20th November, 2018
Introduction: Fractures of both the anterior and posterior pelvic ring are common injuries in polytrauma and the elderly that extend beyond those of simple low-impact trauma. While conventional X-rays predominantly show the ventral aspect of the injury, computed tomography often detect additional fractures of the sacrum. A large number of these fractures are B-injuries by AO, mainly compression fractures at an advanced age. In addition, the prevalence of pelvic insufficiency fractures caused by osteoporosis rather than subsequent to an obvious trauma is increasing, with such an injury often associated with pain that impairs mobilization. The standard sacroiliac screw fixation is often characterized by loosening and thus failure of the osteosynthesis especially in osteoporotic bone of elderly patients.
Method: A new alternative surgical minimal invasive technique, the “iliosacral bridging”, stabilizes the fractures of the sacrum with an internal fixation from S1 pedicle of the uninjured side to the ilium on the affected side. The combination of this internal fixation with the standard single sacroiliac screw on the injured side allows an immediate full weight bearing and pain free mobilization. We present a case series of 8 patients.
Results: The clinical and radiological analysis analogous to the pelvic-outcome-score brought forward that 2 patients showed an excellent and 2 patient a good result. The other 4 patients achieved sufficient results.
Conclusions: The “iliosacral bridging” we have introduced in the present study provides evidence of an expected increased stability of the pelvis after B-injuries
Potter Syndrome: A case study
Published on: 31st August, 2017
OCLC Number/Unique Identifier: 7286353788
Potter syndrome (PS) is a term used to describe a typical physical appearance, which is the result of dramatically decreased amniotic fluid volume secondary to renal diseases such as bilateral renal agenesis (BRA). Other causes are abstraction of the urinary tract, autosomal recessive polycystic kidney disease (ARPKD), autosomal dominant polycystic kidney disease (ADPKD) and renal hypoplasia. In 1946, Dr Edith Potter characterized this prenatal renal failure/renal agenesis and the resulting physical characteristics of the fetus/infant that result from oligohydramnios as well as the complete absence of amniotic fluid (anhydramnios). Oligohydramnios and anhydramnios can also be due to the result of leakage of amniotic fluid from rupturing of the amniotic membranes. The case reported below, concerns of stillborn boy with potter syndrome.
Iarogenic Bile Duct Injuries: Repairs Feasibility
Published on: 14th January, 2019
OCLC Number/Unique Identifier: 7985946066
Due to laparoscopic cholecystectomy there is increase in the bile duct injuries. It was 0.2% to 0.4% during open opposed to 0.6% to 0.8% during laparoscopic. Included in the study were 22 patients, 19 patients with two redo operated upon. Between Feb. 1999 to Nov2017 and 3 referral cases. The treatment options were end to end anastomosis and hepaticojejunostomy. Regarding the injuries, according to Stresberg there were 2A .4D injuries with injury in the lateral aspect of the ducts, 8 E1, with hepatic stump > 2cm., 5 E2 with hepatic stump < 2cm. The three referral cases were choledochodoudonostomy E1, and E2. They were treated with si ligation of cystic in two cases, anastomosis in seven cases. The remaining fifteen cases with hepaticojejunostomy .Conclusions: The risk is more proximally. After complex injuries diversion is the best while with simple end to end was acceptable. The insertion of stents has to be individualized according to the situations of each patients and the experience of each surgeon.
Unrecognized myocardial infarction in the elderly
Published on: 22nd September, 2017
OCLC Number/Unique Identifier: 7286428021
This study presents the frequency of old myocardial infarctions (OMI), and the frequency of unrecognized myocardial infarction (UMI) in elderly people in a forensic material. It was also examined if predisposing factors of UMI could be identified. Of special interest was also to investigate the value of the police’s records as a source for medical information in a forensic setting. The study is based upon medico-legal autopsies of persons above the age of 60 at the time of death during the period 1999-2003. The study included 325 cardiovascular deaths. Of these, 166 died from OMI. UMI accounted for 123 of these (74%). Most UMI were located in the interventricular myocardial septum and left anterior wall (>60%), but no significant differences could be found between UMI and recognized MIs (RMI). No obvious reason could be found as to why the UMI remained unrecognized. Police records were inferior to the hospitals records, regarding medical information to the pathologist, with information about cardiac disease in about 60%, and with information about OMI in 11-17%. Hospital records supplying information about OMI were found in half the cases. It is concluded that unrecognized myocardial infarction is not uncommon among elderly persons, and with a high risk of sudden death. More emphasis should be put in recognizing OMI in ECGs to attempt to reduce the risk of sudden cardiac death.
The relationship of cell phone use and aggression among young adults with moderating roles of gender and marital status
Published on: 26th August, 2020
OCLC Number/Unique Identifier: 8691260155
The use of cell phones has remarkably increased in the last two decades with several pros and cons. The negative consequences of cell phones on mental health have not been studied widely. Aggression, in this regard was a completely neglected area. The present study, therefore, was carried out to investigate the relationship between cell phone use and aggression and to further identify the moderating roles of gender and marital status between cell phone use and aggression. The inquiry included 500 young adults from Rawalpindi, Pakistan. Buss and Perry Aggression Questionnaire was administered. It was hypothesized that there would be a strong positive relationship between cell phone use and aggression. It was further hypothesized that gender and marital status would be significant moderators between cell phone use and aggression. The results supported the hypotheses on significant differences and made a significant contribution in the existing scientific literature.
Prevalence and measurement of anxiety and depression in nurses during COVID pandemic in Nepal
Published on: 28th September, 2020
OCLC Number/Unique Identifier: 8674562360
Background: Anxiety and depression are under reported, underdiagnosed mental illness in health worker in Nepal especially during COVID pandemic. The study was carried out as an observational study on nurses in Nepal. In this study we attempted to assess the incidence and impact of depression and anxiety in nurses who are working upfront in different hospitals during this crisis.
Objective: The purpose of the study is to assess the prevalence of anxiety and depression among nurses in Nepal during COVID pandemic who are working in various hospitals.
Method: A cross-sectional non-probability purposive sampling with observational analysis was carried out and the sample was collected from nurses working in different hospitals. Prevalence of anxiety and depression was assessed using a structured and validated questionnaire. Anxiety was assessed with the Hamilton Anxiety Scale (HAM-A), General Anxiety Disorder Questionnaires (GAD) with a cut-off score for various levels of anxiety while Hamilton Depression Rating Scale (HAM-D) was used to assess depression.
Result: The analysis of these different scales revealed that disabling anxiety prevailed at highest (43.6%) in nursing staff according to HAM-A scale. Moderate anxiety also seemed to be higher (> 20%) in GAD questionnaire.
Conclusion: This is the first study carried out in Nepal that investigates the mental health of nurses who are working in the frontline in this COVID pandemic situation. The study revealed that our nurses who have given their life in the line are suffering from serious mental health problems.
Trans Abdominal Pre-Peritoneal (TAPP) mesh for Inguinal Hernia Repair with External Fixation [Abdelhamid Technique], Outcome Assessment
Published on: 24th January, 2019
OCLC Number/Unique Identifier: 7985919127
Purpose: To compare the outcomes of Abdelhamid technique in treatment of inguinal hernia to conventional TAPP with mesh stapling, Prolene hernia system (PHS) and Lichtenstein repair.
Background: the mesh is applied and fixed externally aiding in decreasing port size and cost. There is controversy concerning the necessity of securing the mesh during laparoscopic TAPP repair.
Patients: The study was carried out at the faculty of medicine – Beni Suef University, Egypt from September 2008 to April 2018. 672 patients with unilateral inguinal hernia participated in the study. 432 were treated using Abdelhamid Technique, 382 of which were unilateral primary inguinal hernia and 50 were unilateral recurrent. 50 patients were treated using Prolene Hernia System (PHS). 50 patients with recurrent hernias were treated using Lichtenstein repair and 140 patients went TAPP with mesh stapling.
Results: Abdelhamid technique showed more cost effectiveness than stapling (1800$ vs 3000$) , pronounced less recurrence rate in comparison with Liechtenstein and PHS (2% vs 4%), same LOS compared to other techniques and mean operative time of 76 minutes which is longer than stapling (60 mins), Liechtenstein (65 mins) and PHS (55 mins).
Conclusion: Abdelhamid technique was a more lengthy operation costing more than open surgery but less than mesh stapling. The recurrence rate is considerably reduced with shorter recovery period. The technique is done with smaller port size that leads to cost reduction
Hormones and depression in women
Published on: 15th October, 2020
OCLC Number/Unique Identifier: 8691260689
It is well known that depression is more common in women than in men with more prescriptions for antidepressants, hospital admissions for depression and suicide attempts. However another aspect to be considered is that depression is different in women than men because women have depressive episodes at times of hormonal shift which is a physiological phenomenon not encountered in men. This is why hormone therapy is so important.
Suicidal behaviors as a risk factor among heroin addicts with comorbid depression: A comparative study
Published on: 19th January, 2021
OCLC Number/Unique Identifier: 9026724523
The main purpose of the present study was to find out the differences on suicidal ideation, hostility, hopelessness and negative self-evaluation among heroin addicts with comorbid depression. After reviewing the literature, it was hypothesized that heroin addicts with high depression may have high scores on variable of suicidal ideation, hostility, hopelessness, and negative self-evaluation as compared to those with low depression. The sample was consisted of 60 males from Low-socioeconomic status (SES) (34 of them were screened as having high scores on the variable of depression and 26 were screened as low scorers). Siddiqui Shah Depression Scale (Siddiqui & Shah, 1997) and Urdu version of Suicide Probability Scale (Cull & Gill, 1982) was administered. To compare heroin addicts with high and low depression on various variables, t - test was applied. The research findings showed that heroin addicts with mean age of 30 years (range 20 to 40) having the mean duration of heroin dependence of 10 years with high depression were significantly high on the variable of suicidal ideation, hostility and hopelessness ((p < .05) as compared to those with low depression. And there was no significant difference on the variable of negative self-evaluation for both groups (p > .05). So it was concluded that services for patients with Heroin addiction should include periodic screening for suicidal behavior along with psychiatric treatment and psychosocial support.
Squamous cell carcinoma developed on neglected, mistreated and delayed diagnosed chronic venous leg ulcer
Published on: 4th February, 2019
OCLC Number/Unique Identifier: 8022276860
Chronic venous leg ulcers (VLU), especially long-lasting non-healing ulcers, are among the risk factors for squamous cell carcinoma (SCC) with particularly aggressive behaviour. We present a case of a 71-year-old female patient with a relevant personal history of multiple SCC and basal cell carcinoma (BCC) excision and chronic venous insufficiency showing for about three years a ulcerated lesion located on the anteromedial distal third of the left leg non-responsive to specific treatment, which subsequently increased their size and merged. Biopsy sample was taken. Histopathology revealed a G2 SCC in all biopsy samples. After the staging, a left inguino-femoral lymphadenectomy and the excision were done. The treatment of bone exposure with a soleus muscle flap in the upper half of the defect and skin graft for all the defect and a specific oncologic treatment were proposed as possible curative solutions. Patients with chronic venous leg ulcers and clinically suspicious lesions should be evaluated for malignant transformation of the venous lesion. When diagnosed, malignancy complicating a chronic venous leg ulcer requires a resolute treatment as it may be fatal.
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