Case Study and Case Report 2023; 13(2): 27 - 30.

Noren Q, Omren P. A case of cannabis-induced ST-Segment elevation myocardial infarction with possible coronary artery dissection. Case Study and Case Report 2023; 13(3): 27 - 30. ABSTRACT Acute coronary syndrome caused by spontaneous coronary artery dissection is an uncommon and sometimes misdiagnosed cause of the condition. We discuss the case of a 41-year-old male patient who had an acute start of left-sided chest pain, which was preceded by several hours of nausea and vomiting. Chronic marijuana usage and several episodes of nausea and vomiting necessitating multiple hospitalizations were noteworthy in the past medical history. A urine drug screen indicated only cannabis, and an electrocardiogram revealed an ST-segment elevation myocardial infarction. This was compounded by a ventricular fibrillation event that was successfully defibrillated and prompted cardiac catheterization, which revealed a coronary intraluminal filling defect and a segmental lesion, both of which suggested coronary dissection. The patient was stabilized after stent implantation and thrombectomy. As the use of cannabinoids becomes more legal and popular, this case seeks to raise physicians' awareness of potentially life-threatening consequences. Key words: Cannabis, myocardial, infarction

Case Study and Case Report 2023; 13(2): 21 - 26.

Noren Q, Omren P. A Case report of the incidental resolution of severe alcohol use disorder During esketamine treatment of major depressive disorder. Case Study and Case Report 2023; 13(2): 21 - 26. ABSTRACT Major depressive disorder (MDD) sufferers are particularly prone to alcohol use disorder (AUD), which is linked to greater rates of morbidity, mortality, disability, and suicide risk. 2019 saw the US FDA approve intranasal esketamine, which has been shown to be a secure and useful therapy choice for MDD that has resisted other therapies. The need for a Risk Evaluation and Mitigation Strategy program for its administration and worries about substance use disorders (SUD) as a potential contraindication or negative effect, however, have limited the availability of esketamine. In this example, a 63-year-old woman with a history of severe MDD that has resisted treatment and a severe alcohol use disorder (AUD) has expressed interest in using esketamine. She started out taking 56 mg of intranasal esketamine twice a week for 20 sessions before moving up to 5 weekly sessions and then 14 weekly sessions of 84 mg. Although PHQ-9 and HAM-D scores decreased and there was an immediate subjective improvement in mood, the dosage was raised to maintain the therapeutic benefit for the duration of the intertreatment period. She managed to get through these sessions without any issues. She also saw a decrease in impulsivity, a decrease in the desire to drink, and a full stop to drinking by the second week. She had one binge relapse while taking 56 mg, which was addressed with motivational therapy, and she hasn't had any alcohol since. This shows that esketamine use is safe and free from the possibility of developing or worsening SUD. Esketamine should not be disregarded as a treatment option for SUD patients because of this, and more study is required to clarify this. Key words: Major, depressive disorder, alcohol, treatment, esketamine

Case Study and Case Report 2023; 13(2): 17 - 20.

Dashtseren Y, Ranishen P. Isolated splenic peliosis: a case report. Case Study and Case Report 2023; 13(2): 17 - 20. ABSTRACT The liver is impacted by peliosis, an uncommon illness having anatomopathological traits. But splenic peliosis is even more unusual and uncommon. Most patients with this condition don't show any symptoms. Due to the significant likelihood of splenic rupture and shock, this disease is also fatal. Here, we describe the case of a 39-year-old Arab woman who presented to the hospital with acute upper abdominal pain that started one week prior to her admission and was accompanied by nausea, anorexia, a low-grade fever, and vomiting. She had no prior medical conditions or histories. A computed tomography scan with contrast revealed several hypodense splenic cysts as well as intraperitoneal free fluid. The result was an emergency exploratory laparotomy with splenectomy. If peliosis is shown to exist in one organ, such as the liver, additional testing is necessary to find out if it exists in any other probable organs that peliosis may impact. Splenic peliosis is incredibly uncommon. Furthermore, there is no proven management strategy for this condition. The only effective treatment is surgery. Splenic peliosis still has many unsolved features that will likely require further study in the near future. Key words: Peliosis, spleen, anatomy