Academics - Interesting Cases

Chhindwara Institute of Medical Sciences, Chhindwara has been in a process of up gradation of previous district hospital into a teaching hospital and already has 485 sanctioned beds. The Hospital has all major departments already working. Dermatology, Radiotherapy and Physical Medical Rehabilitation (PMR) are the new additional departments.

 

Here are few special/ difficult / complicated cases diagnosed and treated / managed successfully after April, 2018 by the faculties of this hospital which earlier required referrals to higher centers.

 

Department of General Medicine

 

Case No.: 1

Snakebite (Cobra bite) with Neurotoxicity with unconsciousness with Respiratory Failure .

Outcome - Patient went home in stable condition after 6 days of active medical management.

 

Case No.: 2

Acute Coronary Ischemic Episode with left Bundle Branch Block (LBBB) with uncontrolled Diabetes Mellitus with Hypertension .

Outcome – All ischemic changes in ECG got reversed. Patient stabilized and improved symptomatically. Patient was then referred to cardiology OPD for further needful.

 

Department of General Surgery

 

Case No.: 1

Large Hepatic Hydatid Cyst

Outcome - Uneventful Intra-operative and post-operative period. Patient was discharged in stable condition.

 

Case No. -2

17 yr Female with Sickle Cell Disease with Massive spleenomegaly with repeated crisis.

Outcome - Patient suffering from massive crisis requiring blood transfusions twice a month operated by Surgeon for Splenectomy. Intra-operative and post-operative were uneventful and patient went home in stable condition.

 

Case No.: 3

42 years old male patient with rectal prolapse since 4 years.

Outcome- After Laparoscopic Rectopexy under GA, Patient was discharged with full relief in symptoms.

 

Case No.: 4

Large thyroid swelling in a 25 years old female. Follicular nodular carcinoma .

Outcome - After Total Thyroidectomy under GA, Patient relieved of symptoms and cancerous lump and is under further follow up with radiotherapy department.

 

Department of Obstetrics and Gynecology

 

Case No.: 1

35 years old Elderly Primigravida with precious pregnancy with rupture of posterior uterine wall (post myomectomy rent) with labor pains.

Outcome- After Emergency exploration for acute abdomen with cesarean extraction of live term male baby with manual removal of placenta with closure of rent at old myomectomy scar over posterior uterine wall with 3 intra-operative blood transfusions and NICU care for baby post-operative period was stable for both mother and baby and were discharged on 15th day after birth of baby.

 

Case No.: 2

Chronic inversion of uterus

Outcome- After surgical removal of inverted uterus along with ovaries, tubes and appendages patient remained stable and went home relieved of her agony tolerated for about 8-10 years.

 

Case No.: 3

Diagnosis - A rapidly increasing uterine fibroid of about 28 – 30 weeks size with huge fibroid polyp filling vagina with suspicion of sarcomatous degeneration within lump with anemia and Hypertension.

Outcome - After Surgical removal - Myomectomy, Total Hysterectomy and extraction with removal of cervical fibroid polyp, patient went home in totally cured status with histopathology ruling out any malignant transformation.

 

Department of Pediatrics

 

Case No.: 1

Dengue fever (confirmed by IgM ELISA) with moderate thrombocytopenia.

Outcome - After active medical management in PICU and ward patient improved and went home afebrile with normal platelet counts within  one week.

 

Case No.: 2

3 month old baby with congenital heath disease with? VSD (Ventricular Septal Defect) with CCF (Congestive Cardiac Failure) with pneumonia.

Outcome - After active medical management in PICU and ward patient responded in 5 days and was discharged after 15 days on oral medications and was referred to Cardiology unit for further evaluation.

 

Department of ENT

 

Case No.: 1

Ranula in oral cavity with complaints of difficulty in deglutition, respiratory distress in sleep and difficulty in conversation since 10 months.

Outcome - After Surgical removal of Ranula with excision of associated salivary gland under short general anesthesia patient remained stable without any complication and came for follow up with no evidence of recurrence of Ranula.

 

Department of Anesthesia

 

Case No.: 1

Chronic Burger’s Disease with severe neuropathic pain (Severe burning) requiring amputation of fingers of left hand with history of right hand fingers amputation done in past for same reason.

Outcome- After Left Stellate ganglion block under fluoroscopic control Patient got excellent relief from pain and amputation was avoided. Patient is pain free till date.

 

Department of Radiotherapy

 

Case No.: 1

Bilateral solid huge Ovarian tumors with suspicion of malignancy.

Outcome- Surgically the diseases is totally removed and with chemotherapy now patient is at home with negative CECT scan and normal CA – 125. Patient is under appropriate follow-up.

 

Case No.: 2

Carcinoma Breast stage III-A.

Outcome - With multiple modalities of treatment used, pre and post operative patient is stable and diseases free till today.

 

Department of Dermatology

 

Case No.: 1

28 yrs Male with Pemphigus Vulgaris -  intractable type.

Outcome - After active medical management, all lesions cleared by 13 - 15 days. Now patient is in total remission.  Patient is under regular follow up.