Post traumatic epilepsy are frequent complications of moderate and severe head injuries, they are found in hemorrhagic contusions and hematomas. Several isolated or associated mechanisms are involved in the occurrence of these convulsions (increased inflammatory markers, neuronal cell death, altered blood-brain barrier, changes in astrocytes, and glucose metabolism dysregulation changes in synaptic abundance and function).The first attacks can occur more than 2 years after the head trauma or after cranial surgery. Preventive treatment does not change the course of the disease. Treatment with Valproate and levetiracetam were also compared to phenytoin and no benefit was found in recovery.
The particularity of our patient is the severe head trauma, with regressive frontal contusion with secular lesions, followed by the appearance at nearly three and a half months of the trauma of a fronto-parietal extradural hematoma with mass effect which resolved spontaneously. Two and three years after the trauma, he developed generalized epilepsy, suggesting post-traumatic epilepsy following the sequelae of the hemorrhagic contusion or the extradural hematoma, or the sequelae of these associated lesions. These seizures were treated with sodium valproate. This clinical case challenges clinicians to monitor in severe head injuries the occurrence of complications such as epilepsy that can occur beyond 2 years.
Background: Pituitary apoplexy is a clinical problem resulting from abrupt pituitary ischemia or hemorrhage. A small proportion of pituitary adenomas manifest as an apoplectic crisis, with pan hypopituitarism, vomiting, nausea, headache, ophthalmoplegia, and visual impairment being the most common symptoms.
Case Report: A 32-year-old diabetic Asian male presented to the emergency department with symptoms of polyuria, polydipsia, persistent vomiting, and diffused abdominal pain. He also reported a recent fever and severe headache, as well as self-limited episodes of blurring of vision and diplopia three months prior. Upon admission, his vitals were stable and he was fully conscious and oriented, though irritable and anxious. On examination, he was found to have third cranial nerve palsy and a dilated pupil with no light reflex. Laboratory tests revealed diabetic ketoacidosis (DKA). A CT scan of the brain revealed a possible invasive pituitary macro adenoma and the patient was referred for further evaluation. He also tested positive for COVID-19. Treatment for DKA was initiated and an MRI scan was scheduled for further evaluation. However, the patient's condition worsened and he was transferred to the ICU, where he was intubated and an MRI indicated a hemorrhagic mass in the pituitary gland. The patient was diagnosed with pituitary apoplexy, and he also received treatment with antibiotics and antiviral medication for suspected encephalitis.
Conclusion: Pituitary apoplexy is a serious condition that requires immediate evaluation and treatment. It can cause permanent damage or death if left untreated. Treatment options include surgery and conservative management with frequent monitoring.
Chukwuka Elendu, Chiagozie P. Ayabazu, Abasi-Okot A. Udoyen, Nnenna O. Kalu-Udeh, Olisa S. Okabekwa, Rachel E. Dada, Precious A. Ante, Emmanuel O. Egbunu, Michael C. Eze, Geraldine C. Okafor, Joy M. Enyong, Blessing N. Bassey, Joy H. Avong, Anietienteabasi O. Okongko
Alcohol withdrawal is a clinical state characterized by symptoms such as tremors, tachycardia, sweating, nausea and vomiting, headache, malaise, insomnia, grand mal convulsions amongst others. Patients typically present acutely with a history of recent cessation or reduction of heavy alcohol use after a long period of repeated, persistent use. It may feature perceptual disturbances such as illusions or hallucinations. It may present with delirium in a condition known as delirium tremens, which typically occurs after recent cessation or reduction of very heavy alcohol use in patients with a long-standing history of alcohol dependence syndrome, who may also have coexisting medical conditions. We herein report a case of a 40 year old man, with a 12-month history of persistent alcohol use, who presented with classical symptoms of alcohol withdrawal including inability to sleep, excessive sweating, tachycardia, vomiting, and hallucinations. There is no associated history of convulsions or co-morbid medical conditions. Features of this case are discussed, as well as evaluation and treatment of alcohol withdrawal.
Background: The world population has been greatly affected by the Sars-Cov-2 pandemic and the related financial, civil, psychological and mental health consequences. Considering the significance of QOL, it is imperative to consider the effects of the pandemic on the population. The study was designed to compare the psychological Impact of COVID-19 on healthcare and non- healthcare workers during COVID-19 pandemic.
Materials and Methods: A cross-sectional survey was conducted among healthcare and non-healthcare workers and a structured questionnaire was circulated in goggle forms via emails and social networking sites.
Results: The mean score for four QOL domains was 58.82 ±15.56, 56.45 ±15.52, 59.08 ±19.03 and 51.42 ±15.51, respectively. Among participants, (31.3%) had Minimal Depression,(33.4%) Mild depression, (24.7%) Moderate depression and (8.8%) had moderate-severe depression .Healthcare workers were found to be more depressed (34%) at a moderate level of depression and (11%) at severe depression while (11%) of non-Healthcare workers show moderate depression and 12 (5%) show moderately severe depression.
Conclusions: The study depicted the detrimental impact of the pandemic on the population, with healthcare workers being more affected by the pandemic and this study calls for use of appropriate psychological intervention to address the mental health needs of the population.
Global health attention is necessary to improve the prison population mental and physical health because limited public health ramifications and inmates’ psychological effects impose many strains on community preventive measures and prison rehabilitation. Though some prisoners are younger than the general population, the jail population often has the worse health. Many have considerable mental and physical health needs as a result of social and economic poverty. Since many prisoners have histories of tobacco use and alcohol or drugs, many of these risk patterns result in addictions that are tied to unhealthy lifestyles. Prior contact with mental health, substance use or medical services typically was very limited or absent due to lack of access to treatment, diminished resources, barriers for the uninsured and underserved, financial stability to afford care, stigma, or reluctance to focus on self-care. There are certain mental health disorders and infectious diseases that are prevalent in prisoners and should be addressed. Many prisoners have serious, debilitating mental and physical conditions that go untreated or undiagnosed while they are incarcerated. Prior to being incarcerated, If crime and incarceration are to be decreased and rehabilitative efforts are increased to deter re-incarceration, preventive measures are necessary that include community mental and medical services accessibility and affordability while availability of such services are provided in prison and coordination of care of evidence-based therapy and infection-control strategies are highly recommended before the inmate returns to the community. This review covers most common mental and physical health issues and their management for inmates because few research has explored how having a mental health disorder compound with a physical ailment affects an inmate’s behavior while advocating for human rights-informed strategies for the treatment of people in the criminal justice system.
