International Journal of Medical Science and Clinical Research Studies

Tonsillar and Soft Palate Trauma Secondary to Difficult Intubation by Videolaryngoscopy: Case Report

Casasnovas Blanco Salma Guadalupe — 2025-04-03

Airway management is one of the activities that the anesthesiologist routinely performs in the operating room, and one of the greatest challenges they face is managing a difficult airway whether predicted or not.

The reported incidence rates are for difficult ventilation 1.4–5.0% and impossible 0.07–0.16%. For difficult intubation 5-8% and failed intubation 0.05-0.35%.

Videolaryngoscope has demonstrated a higher success rate for intubation compared to conventional laryngoscopy, but without proper training the risk of trauma and injury to the oropharynx increases.

In our case report, we present the injury to the right tonsil and soft palate caused by difficult intubation with videolaringoscope which required surgical intervention by otolaryngology for resolution.

Due to an increase in reported cases of injuries secondary to videolaryngoscopy, it is important to review the factors associated with complications in the institutions where it is used, whit the aim of reduce complications that can have serious or even fatal consequences.

Scarlet Enigma: A Case of Diffuse Neonatal Hemangiomatosis

María Pamela Contla Armengol — 2025-04-03

Infantile hemangioma is the most common vascular tumor in the neonatal stage, characterized by the proliferation of endothelial cells and generally exhibiting benign behavior. However, the presence of more than five skin lesions may indicate involvement of other organs, particularly the liver, where the prognosis can worsen due to associated cardiac, thyroid, and hematological complications. This study involves a case analysis and a review of current literature. The clinical case discusses a 39-day-old female infant with a history of NICU management, presenting with multiple generalized cutaneous hemangiomas from birth and an episode of gastrointestinal bleeding. Imaging revealed numerous hepatic hemangiomas and significant hepatomegaly, while laboratory tests showed coagulation abnormalities and thrombocytopenia. A diagnosis of diffuse neonatal hemangiomatosis (cutaneous and hepatic) was made, and treatment with propranolol was initiated. The prognosis for diffuse hemangiomatosis is severe due to the high risk of hemorrhagic complications if treatment is not promptly started. Therefore, we recommend initiating propranolol treatment upon evidence of such lesions, even before beginning the diagnostic protocol.

Contemporary Management of Adrenal Insufficiency: A Comprehensive Review of Diagnostic Strategies, Therapeutic Interventions, and Long-Term Monitoring

Elsa Itzel calderón Tapia — 2025-04-05

Adrenal insufficiency (AI) is a life-threatening endocrine disorder characterized by inadequate production or action of glucocorticoids, with or without deficiency in mineralocorticoids and adrenal androgens. The condition can be primary (due to adrenal gland dysfunction), secondary (due to pituitary dysfunction), or tertiary (due to hypothalamic dysfunction). The management of AI has evolved significantly over the past decade, with advancements in diagnostic modalities, glucocorticoid replacement therapies, and patient education. This article provides a comprehensive review of the current diagnostic approaches, including dynamic endocrine testing and imaging studies, as well as the latest therapeutic strategies, such as individualized glucocorticoid dosing, dual-release formulations, and the emerging role of circadian rhythm-based therapies. Additionally, the importance of patient education, self-management, and long-term monitoring to prevent adrenal crises and optimize quality of life is emphasized. The review also highlights the challenges in managing special populations, including pediatric patients, pregnant women, and those with concurrent comorbidities. By integrating the latest evidence-based practices, this article aims to guide clinicians in delivering optimal care for patients with adrenal insufficiency.

Reversibility of Grade 4 Hypertensive Retinopathy One Month After Living Donor Kidney Transplant in A 26-Year-Old Woman with IGA Nephropathy Induced End Stage Renal Disease: A Rare Case Report

Khin Phyu Pyar — 2025-04-05

The patient was a 26-year-old woman; she developed end stage renal disease (ESRD) due to IgA nephropathy. She was on maintenance hemodialysis for one year. Her blood pressure was 160/110 mmHg; barely controlled with 4 different anti-hypertensive drugs. It occasionally rose to 220/130 mmHg at the end of hemodialysis. Fundoscopy revealed Grade 4 Hypertensive Retinopathy and carotid intima media thickness was increased (1.0 mm). Her blood pressure decreased to 140/90 mmHg 3 days after living donor kidney transplant, requiring monotherapy. Fundoscopy one month after transplant showed Grade 2 Hypertensive Retinopathy.