Authors: Ragini Shrivastava, Shweta Mishra, Ruchi Singh...

Owing to stress, sedentary lifestyle and changes in diet pattern, there is an increase in the surge of lifestyle and metabolic disorders. Polycystic ovarian syndrome (PCOS) affects 8-13% of reproductive-aged women. PCOS is characterised by menstrual irregularity, hyperandrogenism and polycystic ovarian morphology (PCOM). The efficacy of yoga as a therapy to tackle the direct and indirect cause of ailment in the management of PCOS is to be documented. This is the case study of a female patient age 25 years, a diagnosed case of PCOS was registered at the Ayurveda, Yoga, Unani,Siddha,Homeopathy (AYUSH), yoga OPD, with complaints of irregular menstruation, treated successfully by Yoga and Naturopathy (Y and N), i.e., yoga, diet and lifestyle modification. This is evident from the reduction in weight, regularisation of the menstrual cycle along with morphological changes in the ovary after a follow-up of 6 months.

PubMed: 35516692
DOI: 10.4103/jfmpc.jfmpc_651_21

Authors: Keith Baar

Patellar tendinopathy is one of the most common afflictions in jumping sports. This case study outlines the rehabilitation of a professional basketball player diagnosed by magnetic resonance imaging (MRI) with a central core patellar tendinopathy within the proximal enthesis. The player undertook a nutrition and strength-based rehabilitation program combining gelatin ingestion and heavy isometric loading of the patellar tendon designed to produce significant stress relaxation as part of their competition schedule and a whole-body training plan. On follow-up one and a half years into the program an independent orthopedic surgeon declared the tendon normal on MRI. Importantly, the improved MRI results were associated with a decrease in pain and improved performance. This case study provides evidence that a nutritional intervention combined with a rehabilitation program that uses stress relaxation can improve clinical outcomes in elite athletes.

Topics: Athletes; Basketball; Gelatin; Humans; Male; Patellar Ligament; Rehabilitation; Sports Nutritional Physiological Phenomena; Tendinopathy; Young Adult

PubMed: 30299199
DOI: 10.1123/ijsnem.2018-0231

Authors: Daniel Davey, Shane Malone, Brendan Egan...

Vegan diets are increasingly of interest to athletes, but require a well-planned approach in order to mitigate the risk of potential adverse effects on nutrient intakes, and consequently performance. This case study reports the process of an elite male Gaelic football player (age 25 years; height, 1.88 m; body mass, 87.8 kg; lean body mass, 73.26 kg; body fat, 11.3%) transitioning from an omnivorous diet to a vegan diet at the beginning of a competitive season. The report encompasses key considerations in the planning and provision of nutrition support in this context, in addition to iterations needed based on challenges presented by the athlete. Analysis of nutrient intake (Nutritics Dietary Analysis Software), body composition (dual X-ray absorptiometry; Lunar iDXA, GE Healthcare), and running performance during match-play (global positioning system-based tracking; STATSports Apex) each indicated that with adequate knowledge and education, and appropriate planning, commitment and iterative feedback, the athlete was able to meet nutrition targets on a vegan diet without compromising key performance indicators compared to the omnivorous diet of the previous season. We anticipate that this case study will assist practitioners to recognize the key considerations to address when working with athletes transitioning to a vegan diet.

PubMed: 33466231
DOI: 10.3390/sports9010006

Authors: Cade Arries, Patricia Ferrieri

BACKGROUND

There are few reports of bacteremia caused by   in the literature. We present a review of the literature in addition to a case study.

METHOD

We describe the case of an 82-year-old patient who underwent gastrointestinal surgery and subsequently presented with dehydration, nausea, and hyperkalemia secondary to diarrhea. Further clinical work included blood cultures, and the patient was started empirically on piperacillin/tazobactam.

RESULTS

After five days, the blood culture bottle showed growth of a gram-variable, curved rod-shaped organism. After culture under anaerobic conditions on sheep blood agar, the organism was identified as   by MALDI-TOF mass spectrometry and enzymatic technology. A review of the literature reveals five additional cases of   bacteremia.

CONCLUSIONS

This is the sixth case in the literature describing species bacteremia. This organism is rarely identified in blood culture and is most often thought of in the context of bacterial vaginosis. However, the reported cases of bacteremia show gastrointestinal symptoms and presumed gastrointestinal source of infection. The pathogenesis of infection of this organism requires further investigation.

PubMed: 35076503
DOI: 10.3390/idr14010009

Authors: Andrew P Smith

BACKGROUND

There has been extensive research showing that upper respiratory tract infections (URTIs), such as the common cold and influenza, can impair mental performance. Much of this research has involved studies of experimentally induced URTIs or laboratory studies of naturally occurring illnesses. The results from this research have implications for performance at work and in education.

AIMS

The present article presents a case study of the association between URTIs and academic performance and reports the use of such information as an extenuating circumstance for poor performance.

METHODS

The paper describes the poor performance of a primary school student taking the 11+ examination, which determines the choice of the future secondary school. Evidence suggested that it was plausible that the student was incubating an URTI at the time of the examination. Other possible infections, such as COVID, were ruled out. An appeal was made based on the possible association between incubating an URTI and unusually poor examination performance.

RESULTS

The appeal was supported by the adjudicating committee and the student was allowed a place in the preferred secondary school.

CONCLUSIONS

This case study shows that information about the association between URTIs and mental performance can be used as an extenuating circumstance that can plausibly account for poor academic performance. This can form the basis of the future appeals and recommendations for the type of evidence needed to make such claims are made.

RELEVANCE FOR PATIENTS

URTIs are frequent, common, and a cause of absence from education and work. They may also impair performance, with effects not being restricted to the time the person is symptomatic. They may also increase susceptibility to the negative effects of stress and fatigue.

PubMed: 35475269
DOI: No ID Found

Review

Authors: Jeffrey S Litt

Advances in the management of burn patients have contributed to significant improvements in morbidity and mortality over the last century. The physiologic insult from this injury pattern, however, still requires extensive surgical intervention, resuscitation and multidisciplinary care. This paper will review the standard of care of these patients in the context of a recent case study from our institution.

Topics: Airway Management; Burns; Debridement; Explosions; Female; Humans; Middle Aged; Skin Transplantation

PubMed: 30385993
DOI: No ID Found

Authors: Megha Mulchandani, Agatha Conrad

BACKGROUND

The seven tiered behavioural and psychological symptoms of dementia (BPSD) model of service delivery has been used by inpatient units. The classification of each tier is broadly defined and not always agreed upon by clinicians. The case study uses novel approach by combining the BPSD classification criteria with clinical presentation to identify the clinical characteristics of the case and match these characteristics against the BPSD classification. This process was enhanced by using case specific measures such as the Neuropsychiatric Inventory (NPI) and Cohen Mansfield Agitation Inventory (CMAI) scales and key clinical data.

CASE PRESENTATION

A case study of 76 year old male diagnosed with mixed Alzheimer's and Vascular dementia. The clinical presentation of the symptomatology was deemed to be extreme, thus fitting into the seventh tier (Extreme) of the BPSD model of service delivery. The case is considered to fit into the Extreme BPSD category given the high levels of aggression, which were consistently reflected in high scores on NPI and CMAI, as well as long length of inpatient stay (over 3 years). The average number of Pro re nata (PRN) psychotropics medications per month was 56 and seclusion episodes of 6 times per month, with each episode lasting on average 132 min shows severity of behaviours. His level of aggression had resulted in environmental damage and staff injuries.

CONCLUSION

We recommend patient clinical characteristics, relevant hospital data and specific measures should be used to develop consensus around defining and classifying cases into Extreme BPSD.

Topics: Humans; Male; Aged; Aggression; Dementia, Vascular; Alzheimer Disease; Dementia; Behavioral Symptoms; Psychiatric Status Rating Scales

PubMed: 38730300
DOI: 10.1186/s12888-024-05785-1

Authors: Joel M Santiaguel, Mithi Kalayaan S Zamora

OBJECTIVE

This single-subject case study was done to evaluate the presence and evaluate the risk factors for the development of Work-Related Musculoskeletal Disorders (WMSDs) among the staff performing bronchoscopy in the bronchoscopy suite.

METHODS

A single-subject case study to describe the ergonomic issues in bronchoscopy including identifying multiple factors that can potentially, either singly or in combination, affect physical work capacity. The study focused on the evaluation and control of occupational factors during bronchoscopy to improve awareness of ergonomic issues in bronchoscopy using the following data collection tools: 1) hierarchical task analysis, 2) activity sampling, 3) direct observation of the procedure (walk-around), 5) structured interview of the subject, and 5) utilization of checklists.

RESULTS

During the process of bronchoscopy, identified factors that can cause pain in the wrists, fingers, and shoulders include repetitive movement and awkward positions of the hands and wrists coming from the need to move the directional controls and position the bronchoscope. For the back, prolonged standing with awkward postures is a concern. For the neck, the need to look at the monitor which is situated at the side of the patient and frequent shifting of the eyes and head from the monitor to the patient can cause neck pain and stiffness. Aside from the above, other factors would include job stress from the workload, inadequate time for rest and recovery, and the possibility of an uncomfortable environment due to poor air quality. Chronic exposure and repeated injury followed by inflammation and repair lead to structural and biochemical changes in the tissues affected by Cumulative Trauma Disorders (CTDs) leading to the development of WMSDs.

CONCLUSION

Although CTDs do not account for work-related deaths, they do account for a significant amount of human suffering, loss of productivity, and economic burden on the compensation system. Thus, ergonomic concerns must be addressed early to prevent WMSDs/CTDs.

PubMed: 39484193
DOI: 10.47895/amp.vi0.5437

Authors: Marianne Magnesdotter Helleseth, Andrew Athan McAleavey, Christian Moltu...

BACKGROUND

While routine outcome monitoring and clinical feedback may improve outcomes after psychotherapy, results from efficiency studies have been mixed. Moreover, how clinical feedback is implemented influences how it works for patients and clinicians, and working mechanisms are hitherto not thoroughly explored. Researchers have argued that inviting and using feedback from patients is best conceived of as a clinical skill. In this paper, we use case study methodology to explore and describe feedback's functions within three clinical skill themes: actualizing alliance work, concretizing change and stagnation and verbalizing the non-verbal.

CASE PRESENTATION

Sonja is a young adult patient with a trauma background. She has a history of serious suicide attempts and distrust in relationships. She attended psychotherapy for eight months. Harald is a middle-aged man with a stable family. Traumatic events in his past has made him conceal own needs and developing depression. He attended psychotherapy for 19 months. Case material include the patient's clinical feedback over a range of life areas, medical health notes and the therapist's process notes.

CONCLUSION

Clinical feedback can be a positive supplement to the therapeutic work and process. The importance of making this as a joint tool between the client and the therapist is significant.

PubMed: 38152559
DOI: 10.3389/fpsyg.2023.1199431

Authors: Gyula Molnár, V Anna Gyarmathy, Noémi Zádori...

The prevalence of familial hypercholesterolemia (FH) is about 1 in 200-500 in the general population, but approximately less than 1% of those affected are actually diagnosed. One of the most promising approaches to treat FH is utilizing human monoclonal antibodies. This is a case study describing a 47-year-old male patient who presented to the Emergency Department with acute abdominal pain caused by severe hypertriglyceridemia (HTG)-induced acute pancreatitis (AP). We report the steps necessary for establishing the right diagnosis and the management of HTG-induced AP, which are inevitable for the reduction of severity and mortality. This case study shows that hypercholesterolemia is an underdiagnosed and potentially lethal disease. Once diagnosed, all measures should be considered to control blood cholesterol and lipid levels. The decision to administer PCSK9 inhibitors should not be solely based on economical calculation, but rather individual factors should also be considered to weigh the risk/benefit ratio.

PubMed: 33790708
DOI: 10.1159/000511017