A 53-y old lady with chronic pancreatitis underwent a Frey’s procedure and Lateral Pancreaticojejunostomy (LPJ) in 2016. However, four years after the surgery, she developed a lower Common Bile Duct (CBD) stricture and was on endotherapy for the same, with currently four plastic stents in situ.
Issue 8 (August)
A 29-year-old woman with no known medical history presented with a one-year-old pathological fracture of her left femur following a trivial fall at her residence. Initially treated with an intramedullary nail, she complained of difficulty in walking and multiple bony aches.
In this article, we aim to report a patient whom initially presented with initial symptoms suggestive of an underlying immunodeficiency, but diagnostic workups lead us towards suspecting an underlying hemato-oncologic disorder.
A 60-year-old woman with a long history of Crohn‘s disease and rheumatoid arthritis was admitted to the emergency department due to progressive severe cramping with abdominal pain (right upper quadrant), subfebrile temperature, and obstipation since 3 weeks.
58-year-old woman presented to the hospital with sudden onset right sided abdominal and chest pain. Coronary angiogram demonstrated calcified aneurysms (yellow arrows) at the bifurcation left main which were in communication with one another (green arrow).
Introduction: Although large randomized trials have not shown significant benefit of renal artery stent placement, stents continue to be placed in patients with Renal Artery Stenosis (RAS). These intravascular foreign bodies can cause cytokine expression that might result in longterm harm. We evaluated the possibility that they could have adverse effects that were both temporally and spatially distant from their insertion.
Pyoderma Gangrenosum (PG) is a very uncommon neutrophilic dermatosis that is not contagious. According to the clinical definition, it begins clinically as sterile pustules that quickly advance into painful ulcers of varying depth and size with weakened violaceous margins.
Moyamoya syndrome is a type of progressive cerebro vascular disorder characterised by progressive narrowing of arteries of the circle of Willis. Arteries get clogged because of growth of prominent small vessel due to which blood supply to the brain is reduced . A 31 years old male was a pre-diagnosed case of Moyamoya Disorder (MMD) with hemiplegia of right side.
This retrospective study compared different reconstructive strategies for through-and-through cheek defects arising from radical resection of buccal squamous cell carcinoma. Based on clinical data collected from March 2016 to September 2021, the study included 96 patients with buccal squamous cell carcinoma that underwent radical resections and subsequent reconstructions.
Cerebral vasospasm is a well-known phenomenon following aneurysmal subarachnoid hemorrhage and trauma. While cerebral vasospasm is observed following skull base tumor surgery, it remains a rare phenomenon and is a major cause of neurologic morbidity and mortality [1,2].
Parathyroid carcinoma is an extremely rare malignancy of the endocrine system with an incidence of 0.5 - 5% of patients with hyperparathyroidism worldwide. It typically presents with an indolent course, and manifestations of hyperparathyroidism usually appear well before local invasion.
Background: Blepharochalasis is an infrequent palpebral sickness. Few cases have been reported. Patients suffer from recurrent episodes of painless and nonpruritic eyelid edema that begins in childhood and ends up producing atrophy and periocular skin depigmentation, tissue relaxation and Ptosis in adolescence or adult age.
The diagnosis of endemic Burkitt lymphoma was made in this 16 year old Sudanese boy by kidney biopsy histopathology (Figure 1) and touch imprint (Figure 2) as the bone and bone marrow biopsies were unremarkable. He was given 7 cycles of R-COPADM1 chemotherapy according to LMB-89 protocol, and he became disease free by PET scan.
Rothia Mucilaginosa (RM) is a bacteria found in the flora of the upper respiratory tract that can cause lower respiratory tract infections in immunocompromised individuals or the presence of significant comorbidities. The number of cases reported as a cause of pneumonia in the literature is quite a few.
Multi-nodular goitre is very common in our environment. Our environment do covers some parts with lack of iodine. Multi-nodular goitre may develop as toxic or non-toxic depending on the thyroid functional status. This disorder has a predilection for females as compared to males due to their body needs that is more on the reproductive system.
Hepatocellular Carcinoma (HCC) is a poor prognosis cancer of liver which could be associated with venous thrombo-emboli but cardiovascular metastasis is rare; Here we present a case of HCC with tumor thrombosis and clot in transit who managed conservatively with anti- coagulation.
Spontaneous left Vertebral Artery Dissection (VAD) is an uncommon but very important etiology of acute posterior circulation stroke. We reported a case of a 43 years old man, who came with the complaint of chest pain with sudden onset, severe sweating, and dizziness. After 12 hours of the patient’s admission, he had tonic-colonic generalized seizure, generalized ataxia and new onset headache.
The diagnosis of anal tuberculosis is often challenging and requires systematic investigation, particularly in endemic countries and when there is a suggestive clinical context. Histological examination of fistulectomy specimens is crucial for diagnosis .
Various factors like diet, medications, beverages, and congenital conditions have been shown to have an effect on uric acid levels. Hyperuricemia (serum uric acid level > 6.8mg/dL) is detrimental to health and is an independent risk factor for all-cause cardiovascular mortality and ischemic stroke mortality.
Tuberculosis in India contributes to significant endemicity, morbidity and mortality. Rifampicin is the most potent bactericidal drug used as a first line agent in the Anti-Tubercular Treatment (ATT) in rifampicin sensitive cases. Adverse effects of the ATT add to morbidity and decreased treatment compliance.
From a citizens’ perspective, global health is an integrated approach of research and development of global actions that aims to give full meaning and implementation to a vision of health as a state of bio-psycho-social well-being and as a fundamental human right. Dealing with global health means preventing and reducing inequalities and fostering harmonious and sustainable development.
A 22-year-old female patient sought emergency medical services because she was complaining of asthenia, cough and haemoptysis for one month. She had a past medical history of a pulmonary tuberculosis four years ago while she was living abroad. The treatment was administered only for three months but isolates, antibiotic sensitivity and exact therapeutic regimen were not known.
Background: For women with early cervical cancer who wish to preserve their fertility, radical trachelectomy is the recommended procedure. More than 40% of all instances of cervical cancer occur in women of reproductive age, resulting in a major increase in the frequency of this surgery.
Introduction: Transient Global Amnesia (TGA) is a neurological condition characterized by a temporary dysfunction of the episodic memory system. In this short communication, we present the clinical and paraclinical features of TGA cases collected at the neurology emergency unit.
A partialy dependent 76-year-old female with medical history of rheumatoid arthritis treated with methotrexate 2.5 mg 3 pills once weekly, dyslipidemia treated with atorvastatin 10 mg QD, aortic stenosis, and bipolar disorder treated with sodium valproate 250 mg TID and bupropion 300 mg QD, presents to the geriatric appointment, where she’s being followed in order to manage her multiple comorbidities.
Fusarium species are emerging opportunistic pathogens responsible for life-threatening infection, especially in immunocompromised hosts. In this report, we present the case of invasive fusariosis in a term male neonate diagnosed with early-onset neonatal sepsis and post-renal Acute Kidney Injury (AKI).
A 79-year-old female patient with a complex medical history including coronary heart disease, old anterior descending artery infarction, left ventricular aneurysm, and atrial fibrillation, managed with anticoagulation therapy following an ischemic stroke, was admitted because of a sudden onset of delirium accompanied by elevated inflammatory markers.
As we contend with the global effects of the COVID-19 pandemic, nutrition has received a growing amount of attention. The relationship between our diet and immune response has become apparent, necessitating a greater focus on nutrition in public health strategies.
A 26-year-old patient, presented with a bilateral corneal clouding that had been slowly progressive over the last 2 years. He was a sports trainer having consumed protein for bodybuilding. Visual acuity was 6/10 in the Right Eye (RE) and 1/20 in the Left Eye (LE).
The Covid-19 pandemic has resulted in the rapid development and deployment of vaccination programs globally. While most adverse reactions are well-documented, rarer manifestations continue to be reported. Here, we present a detailed case of self-limiting pernio-like ‘Covid-Toe’ reaction in a 40-year-old female with a history of kidney/ pancreas transplant who received the Oxford-AstraZeneca Covid-19 vaccine.
Hyponatremia, defined as a serum sodium concentration <135 mmol/L, is associated with significant morbidity and mortality. Hyponatremia occurs in one third of preterm infants in the first week of life. The patient was a preterm infant born to a G2P0A1 mother at 25 weeks of gestation. The pregnancy was complicated by chlamydia infection and E-coli bacteriuria (both treated), as well as severe pre-eclampsia, for which labor was induced.
Cranial nerve palsies caused by herpes zoster are uncommon presentations of Herpes Zoster Ophthalmicus (HZO) for which third nerve involvement is relatively rare. In this paper we present a case of III cranial nerve palsy resulting from HZO. The first presentation of our case was cutaneous involvement which continued with complete ophthalmoplegia.
It has been argued that in helminth-endemic regions, the intensity of SARS-CoV-2 infection and the severity of the disease it produces (COVID-19) can be satisfactorily reduced, due to helminth-motivated modulation of the immune system, since that, it is pointed out that part of the host’s immune response against SARS-C0V.
Whispering dystonia, also known as DYT-TUBB4A, is characterized by laryngeal dystonia and is linked to upper limb dystonia, cervical dystonia, and frequent generalization. Mutations in the TUBB4 gene, which codes for a tubulin that is expressed in neurons, have been identified as the root cause of whispering dysphonia. Magnetic Resonance Imaging and genetic testing are used to diagnose diseases.
Kufor-Rakeb Syndrome (KRS) is an uncommon autosomal recessive neurological condition that frequently has clinical symptoms including supranuclear gaze palsy, dementia, and generalized brain atrophy. Patients with KRS have been shown to carry mutations in the PARK9 locus-related gene, ATP13A2. Here, we present the KRS cases of two Iranian brothers who also have a new mutation in ATP13A2 in addition to a pathogenic mutation.
Background: Craniosynostosis (CS) is defined as an early premature fusion of cranial sutures resulted to congenital skull deformity and affecting approximately 1 in 2500 children. Clinical assessment of CS may considered a difficult challenge due to the complex phenotype variability between cases. Phenotypically, CS classified into isolated (non-syndromic) or syndromic with frequent majority of 85% to the reported non-syndromic.
Melioidosis is a disease caused by gram negative bacteria called Burkholderia Pseudomallei. Development of Guillain Barre Syndrome (GBS) with this disease is very rare. We report a case of Melioidosis which got complicated with development of GBS. Laboratory detection of B. Pseudomallei by culture remains the mainstay to diagnosis.
Background: Iodine-125 seeds are used for brachytherapy of several tumors, which are considered to be relatively safe with rare complications. Here we report a case of acute myocardial infarction induced by Iodine-125 seeds migrating to right coronary artery. A 72-year-old male patient was diagnosed with colorectal cancer in 2019.
Proteomic and transcriptomic biomarkers have become valuable tools for the early detection and diagnosis of OSCC. The human saliva proteome, which was previously thought to contain a limited number of proteins, has now been found to consist of over 2000 proteins. We searched Pubmed and google scholar for research and review articles
64-year-old lady presented to emergency with dyspnoea, fever, cough and green sputum production for the previous week. She had tested positive for SARS-cov-2 two weeks prior to the onset of these symptoms. Investigations including a Chest X-Ray (CXR) (Figure 1a) confirmed a lower respiratory tract infection, likely a secondary complication to COVID-19 infection.
Introduction and objective: Genus Achromobacter is ubiquitous, opportunistic pathogen. Treating Achromobacter infections are a challenge as the bacterium is intrinsically resistant to several empirically used antibiotics. There is a dearth of data on this organism so; the present prospective study was undertaken to understand various aspects of this uncommon organism.
At present, cerebral infarction has become a serious disease that endangers human health, and one of the important reasons for cerebral infarction is carotid artery stenosis. Carotid Endarterectomy (CEA) is a surgical procedure to treat carotid artery stenosis, Its principle is to remove carotid plaque and relieve carotid artery stenosis, thereby increasing the distal cerebral blood supply and preventing cerebral infarction.
Colostomy is an artificial colo-cutaneous fistula which can be temporary or permanent, depending on the purpose for which it was created. The indications for colostomy include protection of a distal intestinal anastomosis, control of sepsis in open injury to the colon or rectum, to facilitate the operative treatment of a high anal fistula and to relieve a benign or malignant acute large bowel obstruction.
Local therapies such as ablation therapy and brachytherapy may play a role in the management of patients with metastatic sarcomas. Here, we report a case of retroperitoneal leiomyosarcoma in a 62-year-old male, who developed local recurrence and pulmonary, hepatic, renal, peritoneal, intramuscular, and subcutaneous metastases over the course of four years following surgical resection of the primary tumor.
Background: The implication of human Schistosoma mansoni (S. mansoni) infection in concomitance with other risk factors such as Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) in the development of Hepatocellular Carcinoma (HCC) is still under controversy.
The hypothesis defended here is that child abuse can change trajectories of certain conditions e.g. ADHD and histrionic personality disorder and negatively influence healthy individuals. Children regularly punished for impulsivity, hyperactivity, hysterical fits or supposed misbehavior would modify their conduct to prevent repeated trauma and/or to cope with it.
Turner’s syndrome is a chromosomal disorder characterized by complete or partial monosomy of the X chromosome. It is possible for Turner’s syndrome to be associated with autoimmune diseases such as rheumatoid arthritis.
Background: The Erector Spinae Plane (ESP) block has been shown to provide good perioperative analgesia for thoracic, chest wall, abdominal, spinal and hip surgeries. A recent case report had demonstrated its efficacy in post-operative analgesia for an above-knee amputation surgery.