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Archives of The Medicine and Case Reports
Published by HM Publisher
ISSN : -     EISSN : 27472051     DOI : https://doi.org/10.37275/amcr
Core Subject : Health,
Health Professions Medicine & Pharmacology Nursing Public Health
Archives of The Medicine and Case Reports (AMCR) is a broad scope journal aims to publish the most exciting Case studies/reports in Clinical and Medical Sciences. AMCR aims to provide an excellent platform for Clinical Practitioners, medical/ health practitioners, students, professionals, researchers in medicine. AMCR accept any original case report that expands the field of general medical knowledge, and original research relating to case reports including report of the symptoms, diagnosis, treatment, and follow-up of an individual patient. The journal covers all medical specialties including : • Oncology • Paediatrics • Respiratory disorders • Allergy • Radiology • Nephrology • Neurology • Haematology • Immunology • Radiology • Nuclear medicine • Medical imaging • Audiovestibular medicine • Cardiology and cardiovascular systems • Critical care medicine • Dermatology • Emergency medicine • Endocrinology and metabolism • Gastroenterology and hepatology • Geriatrics and gerontology • Infectious diseases and treatment • Medical disorders in pregnancy • Medical ophthalmology • Sports Medicine • Substance abuse • Palliative medicine • Psychiatry • Rheumatology • Sexual and reproductive health
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 217 Documents
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Successful Visual Rehabilitation Following Pars Plana Vitrectomy and Endolaser in a Patient with Severe Vitreous Hemorrhage due to Proliferative Diabetic Retinopathy Ramzi Amin; Rafika
Archives of The Medicine and Case Reports Vol. 5 No. 3 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i3.742

Abstract

Proliferative diabetic retinopathy (PDR) represents an advanced stage of diabetic eye disease, frequently leading to severe visual impairment through complications such as vitreous hemorrhage (VH). Dense VH significantly obstructs vision and often requires surgical intervention. Pars plana vitrectomy (PPV) coupled with endolaser photocoagulation serves as a critical treatment modality, aiming to clear the hemorrhage, remove tractional elements, and manage the underlying ischemic drive of PDR. This report documents a case demonstrating significant visual recovery after this intervention. A 53-year-old male, diagnosed with type 2 diabetes mellitus 6 years prior and under medical control, presented with a one-month history of sudden, severe vision loss in his right eye (OD). His best-corrected visual acuity (BCVA) was profoundly reduced to 1/300 OD, while the left eye (OS) measured 6/15. Clinical examination revealed dense VH OD, preventing detailed funduscopic assessment. The fellow eye OS exhibited features consistent with high-risk PDR. The patient underwent a 23-gauge PPV, including core vitrectomy and extensive pan-retinal endolaser photocoagulation OD, performed under general anesthesia. Postoperatively, the vitreous clarity was restored, and a remarkable improvement in BCVA OD to 6/7.5 was achieved by the three-week follow-up visit. In conclusion, timely surgical management utilizing PPV with endolaser photocoagulation was effective in resolving dense VH secondary to PDR in this patient, culminating in substantial visual rehabilitation
Successful Management of Inferotemporal Rhegmatogenous Retinal Detachment with Scleral Buckle in High Myopia: A Case Report Ramzi Amin; Ririn Rahayu
Archives of The Medicine and Case Reports Vol. 4 No. 4 (2023): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v4i4.743

Abstract

Rhegmatogenous retinal detachment (RRD) represents a significant ophthalmic emergency, characterized by the separation of the neurosensory retina from the underlying retinal pigment epithelium (RPE) due to a full-thickness retinal break. High myopia is a major risk factor, particularly in younger individuals, owing to associated vitreoretinal changes and axial elongation. Surgical intervention is mandatory to prevent permanent vision loss. While pars plana vitrectomy (PPV) has gained popularity, conventional scleral buckling (SB) remains a highly effective and often preferred primary treatment, especially in young, phakic patients with peripheral breaks and uncomplicated detachments. This report details the successful management of an inferotemporal RRD using SB in a young female patient with high myopia. A 25-year-old female presented with a two-week history of progressively worsening blurred vision, preceded by floaters and photopsia in her left eye (OS). She had a history of high myopia (manifest refraction -7.50 D sphere OS) but no prior ocular surgery or trauma. Best-corrected visual acuity (BCVA) was counting fingers at 1 meter OS and 6/30 OD. Intraocular pressure (IOP) was 8.1 mmHg OS and 18.3 mmHg OD. Funduscopic examination OS revealed a bullous RRD involving the inferior and temporal quadrants, extending across approximately 6 clock hours, with the macula appearing clinically off. A single flap tear was identified in the inferotemporal quadrant at the 7 o'clock position, consistent with Lincoff's Rule 3. Optical Coherence Tomography (OCT) confirmed subretinal fluid involving the fovea. B-scan ultrasonography corroborated the presence of retinal detachment. The patient underwent conventional scleral buckling surgery with cryotherapy to the retinal break and subretinal fluid drainage under general anesthesia. Postoperatively, the retina achieved complete anatomical reattachment. BCVA OS improved slightly to counting fingers at 1 meter by day 12 post-operation, with expectations for further gradual improvement. In conclusion, conventional scleral buckling provided successful anatomical reattachment for an inferotemporal RRD secondary to a flap tear in this young, highly myopic patient. SB remains a crucial and effective surgical option for primary RRD, particularly in phakic eyes with peripheral breaks, offering excellent anatomical outcomes while avoiding the cataractogenic effects and potential intraocular manipulation risks associated with primary vitrectomy in this demographic. Careful case selection and meticulous surgical technique are paramount for success.
Deep Neck Abscess with Concurrent Orbital and Subgaleal Extension Secondary to Odontogenic Infection: A Case Report Pande Agus Parta Prananda; Putu Dian Ariyanti Putri; I Made Wiranadha; I Dewa Gede Arta Eka Putra; Eka Putra Setiawan; Sari Wulan Dwi Sutanegara
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.744

Abstract

Deep neck infections (DNIs) originating from odontogenic sources are common, but extensive spread involving concurrent orbital and subgaleal spaces is rare. DNIs can lead to life-threatening complications, particularly in patients with comorbidities like diabetes mellitus (DM) and chronic kidney disease (CKD), which impair immune function. This report details a complex case of DNI with unusual superior extension. A 44-year-old male with poorly controlled type 2 DM and CKD presented with a two-day history of rapidly progressing left facial, submandibular, parotid, and orbital swelling, associated with fever, trismus, and severe pain, originating from a carious mandibular molar. CT imaging confirmed an extensive abscess involving the left masticator, submandibular, sublingual, parotid, and parapharyngeal spaces, with contiguous spread to the left preseptal orbital space and the fronto-temporo-parietal subgaleal space. Multidisciplinary management involved urgent surgical drainage of the submandibular and subgaleal abscesses, odontectomy of the offending molar, broad-spectrum intravenous antibiotics (Citrobacter amalonaticus and Proteus hauseri identified on culture), intensive glycemic control, hemodialysis, and supportive care. In conclusion, this case highlights the potential for aggressive craniofacial spread of odontogenic DNIs, particularly in immunocompromised individuals. Concurrent orbital and subgaleal extension represents a rare and serious complication. Prompt diagnosis with imaging, aggressive multidisciplinary surgical and medical management, including addressing underlying comorbidities, were crucial for a successful outcome.
Non-Keratinizing Sinonasal Squamous Cell Carcinoma Extending to the Skull Base: Surgical Management with Total Maxillectomy - A Case Study Anak Agung Wira Ryantama; Eka Putra Setiawan; Wayan Lolik Lesmana; Agus Rudi Asthuta; Komang Andi Dwi Saputra; Luh Sartika Sari
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.745

Abstract

Sinonasal squamous cell carcinoma (SNSCC) is an uncommon malignancy arising within the nasal cavity and paranasal sinuses, representing approximately 3% of head and neck cancers. The non-keratinizing subtype (NKSCC) presents unique diagnostic and therapeutic challenges, particularly when exhibiting locally advanced disease with extension towards critical structures like the skull base. Management typically involves a multimodal approach centered around surgical resection, often followed by adjuvant therapy. We present the case of a 51-year-old female, employed in the wood furniture industry, presenting with a progressively enlarging right nasal mass initially noted four years after removal of a right cheek lesion. Symptoms included unilateral nasal obstruction, epistaxis, anosmia, and loosening of maxillary teeth. Clinical examination revealed a large, friable mass obliterating the right nasal cavity and extending onto the palate. Computed tomography confirmed an extensive destructive mass involving the right nasal cavity, maxillary sinus, ethmoid sinus, extending to the nasopharynx, parapharyngeal space, masticator space, buccal space, frontal sinuses, and abutting the right internal carotid artery. Biopsy confirmed Non-Keratinizing Squamous Cell Carcinoma. The patient was staged as T4bN2cM0 according to the AJCC 8th edition criteria. Following neoadjuvant chemotherapy, the patient underwent total maxillectomy via a Weber-Ferguson approach with Lynch modification, including placement of a dental obturator. In conclusion, advanced NKSCC involving the skull base requires aggressive, multidisciplinary management. This case highlights the necessity of radical surgical resection, such as total maxillectomy via extended approaches like the Weber-Ferguson with Lynch modification, to achieve oncologic control in extensive T4b disease. Despite the challenges posed by proximity to vital structures, surgery remains the cornerstone of treatment, often requiring adjuvant therapy to optimize outcomes. Long-term follow-up is crucial due to the inherent risk of recurrence.
Reconstructive Challenges and Outcomes Following Radical Resection of Sinonasal Squamous Cell Carcinoma via Weber-Ferguson Approach: A Case Study Ni Putu Deby Rathasari; I Gde Ardika Nuaba; I Ketut Suanda
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.749

Abstract

Sinonasal squamous cell carcinoma (SCC) is an uncommon malignancy characterized by diagnostic delays and complex management. Advanced-stage disease often necessitates radical surgical resection, leading to significant anatomical defects and formidable reconstructive challenges. The Weber-Ferguson approach provides wide surgical exposure for extensive tumors but results in considerable midfacial defects requiring meticulous reconstruction to restore function and aesthetics. This case study details the reconstructive challenges and outcomes following total maxillectomy with this approach for an advanced sinonasal SCC. A 53-year-old male presented with a one-month history of right cheek pain and swelling, preceded by a year of right upper molar pain and progressive facial masses. Clinical and radiological evaluations revealed an extensive mass originating from the right maxillary sinus, destructing surrounding bony structures and involving regional lymph nodes. Biopsy confirmed poorly differentiated keratinizing squamous cell carcinoma. The patient underwent a right total maxillectomy via a Weber-Ferguson approach with Lynch modification, extended to involve the mandible, along with reconstruction. The final staging was T4aN3M0. Postoperatively, the patient experienced minor wound dehiscence, which was managed conservatively. He was planned for an obturator and adjuvant radiochemotherapy, but he declined further oncological treatment. Radical resection of advanced sinonasal SCC using the Weber-Ferguson approach, while oncologically necessary, presents substantial reconstructive dilemmas. Addressing these defects is crucial for functional rehabilitation, including speech, deglutition, and acceptable cosmesis. This case underscores the complexity of managing such extensive defects and the importance of a multidisciplinary approach, even when patients decline standard adjuvant therapies. The long-term prognosis in such cases remains guarded, particularly without adjuvant treatment.
Empowering Mothers: The Critical Role of Knowledge and Positive Attitudes in Shaping Prenatal Nutritional Choices Hasritawati; Sri Wahyuni; Barirah Madeni
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.758

Abstract

Optimal prenatal nutrition is foundational for positive maternal and fetal health, significantly impacting lifelong well-being. A pregnant woman's nutritional knowledge and attitudes are pivotal, modifiable determinants influencing her dietary choices. Inadequate knowledge or negative attitudes can precipitate suboptimal nutritional intake, thereby elevating risks for adverse outcomes such as maternal morbidity, intrauterine growth restriction, and developmental issues in the child. This study aimed to comprehensively explore the nexus between pregnant women's nutritional knowledge, their attitudes concerning gestational nutritional needs, and the consequent influence on their prenatal dietary practices within a distinct rural Indonesian community. This descriptive analytical study adopted a cross-sectional design, conducted in Desa Bale Redelong, Kecamatan Bukit, Kabupaten Bener Meriah, Aceh, Indonesia. The entire population of 60 pregnant women accessing local midwifery antenatal services was included via total population sampling. A structured, pre-tested questionnaire was administered to collect data on socio-demographic characteristics, nutritional knowledge, attitudes towards nutritional needs (independent variables), and self-reported nutritional practices (dependent variable). Data analysis encompassed descriptive statistics, Chi-Square (χ²) tests for bivariate associations, and a multivariate logistic regression to identify key predictors of good nutritional practices, with statistical significance set at p < 0.05. Baseline data (n=60) depicted a cohort primarily aged 20-35 years (70.0%), with secondary education (55.0%). Nutritional knowledge was 'good' in 33.33%, 'sufficient' in 40.0%, and 'poor' in 26.67% of participants. Positive attitudes towards nutrition were held by 63.33%, while 36.67% exhibited negative attitudes. Bivariate analysis revealed significant positive associations between higher nutritional knowledge (χ²=10.833, p=0.001) and positive attitudes (χ²=6.136, p=0.013) with good nutritional practices. Multivariate logistic regression indicated that 'good' knowledge (Adjusted Odds Ratio [aOR] = 3.8; 95% CI: 1.5-9.6; p=0.005) and 'positive' attitudes (aOR = 2.9; 95% CI: 1.1-7.8; p=0.030) were significant independent predictors of good nutritional practices, after controlling for maternal age and education. In conclusion, this study underscores the critical and independent roles of both robust nutritional knowledge and positive attitudes in shaping the prenatal dietary choices of pregnant women in the investigated community. Even when accounting for socio-demographic variables, enhanced knowledge and favorable attitudes significantly predicted improved nutritional practices. These insights strongly advocate for multifaceted, culturally-sensitive public health interventions designed not only to impart factual information but also to cultivate empowering attitudes, thereby enabling pregnant women to make informed, health-promoting nutritional decisions for optimal maternal and child outcomes.
When Pain Relief Turns Perilous: A Case Report on Paracetamol Dependence, Polypharmacy, and Severe Drug-Induced Liver Injury Kadek Nova Adi Putra; Bgs Gde Ariesta Darmahendra
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.759

Abstract

Drug-induced liver injury (DILI) from long-term therapeutic paracetamol use, especially when complicated by psychological dependence, and concurrent atorvastatin therapy within a polypharmacy setting is an uncommon but serious clinical concern. This report details such a case, emphasizing the diagnostic challenges and management. A 58-year-old woman with a 20-year history of dependence on paracetamol (500-1500 mg daily) and 12 years of atorvastatin use (20 mg daily) amidst other chronic medications (levothyroxine, candesartan, clopidogrel), presented with bleeding gums, abdominal discomfort, nausea, and weakness. Laboratory investigations revealed markedly elevated liver enzymes (SGPT 3913 U/L, SGOT 5863 U/L), severe thrombocytopenia (17 x 10³/L), and elevated Gamma GT (449 U/L). Viral hepatitis markers were negative. Paracetamol and atorvastatin were discontinued. Significant clinical and biochemical improvement followed, with SGOT/SGPT levels decreasing to 184/283 U/L by day six. In conclusion, the Roussel Uclaf Causality Assessment Method (RUCAM) indicated paracetamol and atorvastatin as "probable" causes of DILI. This case underscores the potential for severe hepatotoxicity from long-term therapeutic use of common medications, especially in polypharmacy and when psychological factors influence drug consumption. Vigilant monitoring and causality assessment are crucial in such complex scenarios.
Esophageal Squamous Cell Carcinoma Masquerading as Achalasia: A Case Report on Diagnostic Pitfalls and Therapeutic Strategies Renata Timoty Pasaribu; I Gde Ardika Nuaba; I Ketut Suanda; Ida Ayu Alit Widiantari; I Wayan Lolik Lesmana
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.760

Abstract

Esophageal squamous cell carcinoma (SCC) is an aggressive malignancy often diagnosed at an advanced stage, leading to a poor prognosis. Its initial symptoms can be nonspecific, occasionally mimicking benign esophageal disorders such as achalasia, thereby posing significant diagnostic challenges. This report details such a case, emphasizing the diagnostic pitfalls and discussing therapeutic approaches. A 43-year-old male presented with a 5-month history of progressive dysphagia and odynophagia, initially suspected to be achalasia. Clinical findings, including significant weight loss and specific laboratory abnormalities, are detailed. Esophagogastroduodenoscopy revealed an obstructing tumor, confirmed as esophageal SCC by biopsy. Staging investigations, including Multi-Slice Computed Tomography (MSCT), characterized the disease as Stage IVA (T4N1M0). The patient underwent feeding gastrostomy for nutritional support and commenced systemic chemotherapy with docetaxel, carboplatin, and cetuximab. The treatment course and initial follow-up are described. In conclusion, this case underscores the critical importance of maintaining a high index of suspicion for malignancy in patients presenting with symptoms suggestive of achalasia, especially if accompanied by atypical features or risk factors. A meticulous and timely diagnostic evaluation, incorporating early endoscopy and biopsy, is paramount for accurate diagnosis and staging. Multidisciplinary management, including robust nutritional support and carefully selected systemic therapy, remains central to addressing advanced esophageal SCC.
Mapping the Meridians and Acupoints in Traditional Bhutanese Medicine: A Comparative Analysis with Classical Chinese Acupuncture Kezang Tshering; Hedi Suanto Tjong
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.762

Abstract

Traditional Bhutanese Medicine (TBM), or gSo-ba Rig-pa (Sowa Rigpa), describes vital energy channels (rtsa) and therapeutic points (gsang mig). Classical Chinese Acupuncture (CCA) features a detailed system of meridians (jing luo) and acupoints (xue wei). While both traditions modulate vital energy, a detailed comparative cartography is lacking. This study aimed to map and compare selected TBM channels and acupoints with potential CCA counterparts. A comprehensive review of Sowa Rigpa texts and Bhutanese traditional medical literature was conducted to characterize principal TBM energy channels and therapeutic points, including those for Serkhap (Golden Needle) therapy. Data for five key TBM channels and twenty associated acupoints (pathways, locations, indications) were compiled. Analogous CCA meridians and acupoints were identified based on topography, anatomical landmarks, and traditional indications. A comparative analysis focused on anatomical correspondence, somatic landmarks, and traditional indications (rLung, mKhris-pa, Bad-kan in TBM vs. Qi, Blood, Zang-Fu in CCA). The mapping characterized distinct TBM channels with unique attributes. Comparative analysis (detailed in a table) revealed significant anatomical overlap for 60% (12 of 20) selected TBM acupoints with CCA acupoints, particularly along Bladder, Gallbladder, and Stomach meridians. Notable divergences occurred in channel trajectories and point energetics. Some TBM points, especially for Serkhap, had unique locations or indications rooted in TBM’s humoral theory. Approximately 30% showed partial overlap, and 10% appeared unique. In conclusion, this comparative mapping provides foundational insights into TBM and CCA channel/acupoint systems. Anatomical convergences suggest shared empirical observations, while Sowa Rigpa’s distinct theories offer a unique lens on somato-energetic relationships.
Unmasking Advanced HIV Infection: A Case of Refractory Thrombocytopenia Misdiagnosed as Immune Thrombocytopenic Purpura Wiratama Hadi Tjuanda; Anak Agung Ayu Yuli Gayatri
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.777

Abstract

Thrombocytopenia is a frequent hematological abnormality in individuals with human immunodeficiency virus (HIV) infection and can be the initial presenting sign. Its clinical picture can closely mimic primary Immune Thrombocytopenic Purpura (ITP), leading to diagnostic delays and inappropriate management. This report highlights a case where an HIV diagnosis was revealed during the workup for refractory thrombocytopenia. A 39-year-old female presented with fatigue and gingival bleeding. She had a previous diagnosis of ITP and had been treated intermittently, but the thrombocytopenia repeatedly recurred. Physical examination was notable for oral candidiasis. Laboratory investigations confirmed severe thrombocytopenia with a platelet count of 4,000/µL. Subsequent serological testing was reactive for HIV, with a CD4 count of 136 cells/µL. The patient was managed for severe thrombocytopenia and opportunistic infection, with a plan to initiate antiretroviral therapy. In conclusion, this case underscores the critical importance of including HIV infection in the differential diagnosis for patients presenting with new-onset or refractory thrombocytopenia. Clinical clues, such as opportunistic infections, should prompt immediate HIV screening to ensure timely diagnosis and initiation of definitive therapy, thereby preventing misdiagnosis and improving patient outcomes.

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