Co-occurrence of patent foramen ovale and Chiari network in a diabetic patient.

INTRODUCTION: The coexistence of congenital cardiovascular anomalies provides valuable insights into the intricate nature of human cardiac anatomy and its potential interactions with underlying health conditions. This case report presents an autopsy analysis of a diabetic patient manifesting both a patent foramen ovale and a Chiari network. CASE PRESENTATION: A 26-year-old male with a history of type 2 diabetes mellitus was admitted with post cardiac arrest. He died despite resuscitative efforts. Autopsy revealed notable findings including a patent foramen ovale and a Chiari network. Post-mortem biochemical markers indicated elevated HbA1c level and hyperglycaemia. The absence of cryptogenic strokes or paradoxical embolism prompted exploration into potential relationships between these anomalies and metabolic disturbances, and prompts a discussion about whether the observed anatomical variations could potentially serve as risk factors contributing to the patient's death due to complications of diabetes. CONCLUSION: The co-occurrence of a patent foramen ovale and a Chiari network within a diabetic patient, accompanied by elevated HbA1c level and hyperglycaemia, offers a unique perspective on the convergence of congenital cardiovascular variation and metabolic health. The juxtaposition of these anomalies with biochemical markers underscores the intricate interplay between cardiac morphology and metabolic conditions.

Acute methotrexate toxicity in a patient with psoriasis: a case report.

Aside from rheumatoid arthritis, methotrexate is also used to treat cancer, psoriasis, and other diseases. Side effects with methotrexate are possible, as they are with any medication. This drug is extremely potent and has the potential to produce serious adverse effects. Those who use this medication need to be tracked often. We provide a case of a patient with psoriasis vulgaris who died due to methotrexate administration without proper dosage verification. A female patient in her forties had a history of psoriasis vulgaris of the lower limbs. Under treatment, she developed acute methotrexate toxicity. This drug was taken as an intramuscular injection per day in an infirmary without checking that the dose regimen prescribed was per week. She developed extensive bullous and pustular lesions associated with digestive signs related to generalized toxiderma. But at that point, she had septic shock, which led to her death a few weeks after the methotrexate injection. The medical responsibilities of the doctor, pharmacist, and nurse were discussed. To conclude, methotrexate is not a killer drug in most cases, but it can be extremely harmful if it's overused. Acute toxicity is a potentially fatal condition, and a deeper understanding of its potential toxicity is still necessary.

Postoperative rhabdomyolysis following otoplasty: an autopsy case report.

Postoperative rhabdomyolysis is a significant complication that can arise from prolonged surgery, causing potential harm to the kidneys and leading to acute renal failure. Despite its importance, the incidence of rhabdomyolysis following ear reconstruction surgery remains undocumented in the literature. In this report, we present a case study of a male patient in his forties who underwent otoplasty for ear reconstruction after the amputation of his right ear due to a physical assault. The surgery lasted for 8 h under general anesthesia, and unfortunately, the patient developed postoperative rhabdomyolysis, which resulted in severe renal failure and ultimately an unrecoverable cardiac arrest, leading to his death. The autopsy findings indicated no identifiable lesions except for organ congestion, while histopathology revealed acute tubular necrosis of the kidney and muscle rhabdomyolysis. Previous literature has explored the association between surgical duration, location, and rhabdomyolysis, underscoring that this condition is an infrequent yet preventable consequence of prolonged surgery. The co-occurrence of rhabdomyolysis and acute renal injury in this case suggests the presence of comorbidity, emphasizing the need for prompt action to mitigate the negative consequences of rhabdomyolysis. Awareness and early intervention are crucial in preventing and managing this condition effectively.

Unexpected death of an infant suffocated in the course of breastfeeding when the mother fell asleep.

Death following accidental suffocation due to overlaying is often overlooked, and still attributed to Sudden Infant Death Syndrome (SIDS). We report a case of sudden infant death following accidental suffocation due to breast overlaying during breastfeeding. We report the death of a two-month-old male baby, without medical history, who was found lifeless wedged under his mother's breast. The mother subsequently admitted that she had fallen asleep while breastfeeding and awoke a few minutes later to find him wedged under her breast and not breathing. External examination of the infant's body revealed right frontal congestion with reddish-purple colour of the right frontal skin corresponding to where the mother's breast had overlaid his face with bilateral conjunctival petechiae with no signs of external injury. Internal examination revealed congestion with petechiae marks of the internal side of the right frontal scalp, with moderate congestion and few petechiae marks at the level of the lungs. The histopathological examination showed non-specific passive congestion, with no abnormalities. The cause of death was attributed to accidental suffocation following obstruction of external airways by the mother's breast during breastfeeding. Accidental asphyxia cases require extensive investigation of the circumstances surrounding death, reconstruction of events, and careful documentation of the findings observed at autopsy with full histological examination which may become relevant in a specific case in later stages of the investigation.

Death in Children After Atractylis gummifera L. Poisoning in Morocco-Report of Three Cases and Review of Literature.

BACKGROUND: Atractylis gummifera L. is a poisonous thistle plant that grows in the Mediterranean regions especially in northern Africa like Morocco and southern Europe. It has been used frequently to treat some diseases in traditional medicine, and its ingestion is a common cause of fatal poisoning. Here, we report 3 death cases in children after accidental ingestion of the Atractylis gummifer L. CASES REPORTS: We report 3 cases of death in children after accidental ingestion of the poisonous plant Atractylis gummifer L. The poisoned children were admitted to hospital in deteriorated general state with clinical symptoms, such as nausea, vomiting, epigastric, and abdominal pain, diarrhea, followed by coma. However, they died a few hours later. The postmortem investigations were performed, and the diagnosis of Atractylis gummifer L. poisoning was confirmed by toxicological examination (chromatography), the latter showed the presence of atractyloside (potassium atractylate), a toxic compound of the plant Atractylis gummifera L.Atractylis gummifer L. poisoning was discussed with review through the literature. CONCLUSIONS: Through the presented cases, we show that Atractylis gummifera L. poisoning remains a health problem that involves children in Morocco, where the plant grows spontaneously. Thus, teaching children to recognize dangerous plants will be helpful to prevent accidental ingestion.