Latest Articles

Volume-5, 2024
Issue 10 (October)



Nevus of ota with pigmentation of buccal mucosa and lips

Nevus of ota or oculodermal melanocytosis, is a benign condition characterized by blue or gray-brown hyperpigmentation, primarily distributed along the divisions of the trigeminal nerve. The pigmentation typically affects both the skin and ocular structures. In this report, we present a rare case of a female patient with oculodermal melanocytosis involving not only the skin and eye but also the buccal mucosa and lips.

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Usefulness of electron urography for physiotherapeutic management of Bell’s palsy - 7 case series

Bell’s palsy or Idiopathic Facial Palsy (IFP) is the most common form of acute spontaneous peripheral facial paralysis and can present as unilateral weakness or paralysis of the face. The initial degree of facial paralysis has been regarded as one of the most important prognostic factors for recovery . In clinical practice, the degree of initial facial paralysis is determined by the House-Brackmann (H-B) grade or Sunny brook scale of Facial grading.

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A case of neuropsychiatric lupus in a patient presenting with sepsis

Systemic Lupus Erythematosus (SLE) refers to an autoimmune condition of multifactorial origin. While SLE most commonly causes constitutional symptoms, complications involving the cardiorenal and nervous systems may also occur. The case presented in this report is of a 34-year-old female with a history of hypertension and iron deficiency anemia who presented to the Emergency Department with a cough.

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Prevalence of tooth transpositions and associated dental anomalies: A CBCT study

The aim of this study is to evaluate the frequency and type of dental transposition and its relationship with other dental anomalies and pathologies using Cone Beam Computed Tomography (CBCT). Images of patients who had CBCT taken for various reasons between 2012 and 2023 were evaluated for the presence of dental transposition. The demographic data of the patients, the presence of transposed teeth, their number, location, unilateral or bilateral nature, dental transposition classifications defined in the literature, other adjacent dental anomalies and pathologies were examined.

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Clinical significance of Sphingomonas species in urethritis - Case series in 6 patients

The role of Sphingomonas spp. as aetiological agents in patients with urethritis is unclear. Therefore, we conducted an observational, retrospective study in six male patients, who presented with complaints of acute urethritis between January 2023 and July 2023 in our outpatient urological medical office. Microbiological cultures from urethral swabs were carried out on different culture media and Sphingomonas spp.

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The relationship of postural asymmetry to inspiratory and expiratory pressure of young women

Breathing mechanic is determined by tonus and flexibility, correct contraction amplitude of the thoracic diaphragm, relaxation, and the activity of auxiliary muscles. Respiratory muscle strength is evaluated by measuring the static Maximal Inspiratory (MIP) and Expiratory (MEP) pressures. The aim of this research was to determine the relationship between MIP and MEP and body posture in female soccer players.

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Autoimmune hepatitis complicated by bone marrow aplasia: A case report

Post-Hepatitis Bone Marrow Aplasia (BMA) is a rare disease characterized by secondary damage to the primary bone marrow cell compartment. Severe bone marrow aplasia associated with autoimmune hepatitis is a well-described form of AM, occurring within 6 months of an increase in Alanine Aminotransferase (ALAT) of at least five times the upper limit of reference values, and is generally negative for known hepatic viruses (A,B,C).

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Intracranial solitary fibrous tumor: A rare case report and literature review

Solitary Fibrous Tumors (SFT) are very rare, particularly those of the Central Nervous System (CNS), and they have mesenchymal origin. Here, we present the case of a 46-year-old man who, a year after suffering a head injury, lost consciousness for an hour. He had therapy after developing paralysis in his left arm and left foot after three months.

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Adalimumab triumphs: Psoriatic arthritis case report

This case report highlights the successful treatment of a patient with psoriatic Arthritis (PsA) using Adalimumab, a monoclonal antibody targeting tumour necrosis factor-alpha. The patient, diagnosed with PsA concurrent with skin psoriasis, exhibited significant joint pain, swelling, and disability. There was an incomplete response to conventional treatment with Disease Modifying Anti-Rheumatic Drugs.

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Case report of a spigelian hernia following robotic pyeloplasty

Spigelian hernia is a rare ventral hernia that accounts for 0.12% of abdominal wall hernias. It is a protrusion seen through the spigelian aponeurosis which is limited laterally by Linea semilunaris and medially by lateral border of rectus abdominis. This hernia arises due to a weakness in the spigelian aponeurosis which might be iatrogenic, traumatic or due to increased intraabdominal pressure.

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Silent trauma leading to necrotizing fasciitis in a diabetic patient: A case report

Necrotizing Fasciitis (NF) is a severe, rapidly spreading infection of deep soft tissues that can result in significant morbidity and mortality if not treated promptly. This condition is more common in men and primarily affects the lower limbs. Diabetes is a significant risk factor for lower limb ischemia. This case report describes a 60-year-old diabetic male who developed NF in his left foot as a result of a minor, unnoticed trauma, which was exacerbated by his habit of walking barefoot.

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A rare case report of perineal hernia after abdominal perineal resection

This report describes a case of a 65-year-old man with a perineal hernia after an abdominal perineal resection for low rectal cancer. A contrast-enhanced computed tomography scan revealed significant prolapse of digestive loops at the level of the posterior pelvic floor. Surgery via perineal access using a synthetic mesh was performed.

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Ictal asystole as primary presentation of seizure: A case report

Ictal Asystole (IA) is a rare but serious condition associated with epilepsy, characterized by a cessation of ventricular complexes for more than 4 seconds during a seizure. This case report highlights the importance of considering IA in patients presenting with unexplained syncope and seizure-like activity.

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A strange case of a large abdominal mass

Male, 78 years old, with a history of hypertension, anemia, diabetes, and hip arthroplasty. He was referred to the emergency department due to an increase in abdominal circumference, asthenia, anorexia and constipation which had been going on for two weeks, not associated with abdominal pain, urinary complaints, or reference to altered urine output.

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Iatrogenic tracheal rupture following elective endotracheal intubation in the emergency department

Iatrogenic tracheal rupture following endotracheal intubation is a rare but serious complication. This condition may be associated with widespread subcutaneous emphysema, pneumothorax, respiratory failure, and even mortality. Therefore, early diagnosis and treatment play a crucial role. In this report, we provide a case study of a 49-year-old male patient who experienced an iatrogenic tracheal rupture subsequent to elective endotracheal intubation.

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Gastric outlet obstruction secondary to giant traumatic pancreatic pseudocyst

Traumatic pancreatic injury is rare due to its retroperitoneal location and relative protection to the organ. Pancreatic pseudocyst formation may occur following pancreatic trauma, but giant pseudocyst rarely develops. Early management is recommended for giant pancreatic pseudocysts before clinical deterioration. We presented a case report with gastric outlet obstruction symptoms in the casualty department.

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Vitamin B12 deficiency mimicking AIDP: A case report

Acute inflammatory demyelinating polyneuropathy typically presents with progressive weakness and numbness in the lower extremities, along with gait abnormalities. However, other conditions can mimic these symptoms, potentially delaying diagnosis and appropriate treatment. We present the case of a 67-year-old man, who did not smoke, drink alcohol, or have diabetes or hypertension, who developed acute progressive weakness and numbness in his lower extremities over five days, along with oscillopsia and unsteady gait.

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Congenital hydrocephalus: A case report

Hydrocephalus is the accumulation of excessive quantities of cerebrospinal fluid, causing dilation of the cerebral ventricles and/or an increase in intracranial pressure. Manifestations may include an enlarged head, bulging fontanelle, irritability, lethargy, vomiting and convulsions. Diagnosis is based on ultrasonography in newborns and young children with a permeable fontanel, and on brain scans or MRI in older children.

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Leser-Trelat syndrome and mycosis fungoides: A rare association

Leser-Trelat syndrome is one of the multiple cutaneous manifestations of paraneoplastic syndromes occurring in patients presenting solid cancers. We report the rare case of a patient with Leser-Trelat syndrome associated with mycosis fungoides. Case presentation A 76-year-old patient, with a history of type II diabetes, presented to the dermatology department for red and scaly lesions on his arms and chest.

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A rare case of purple pleural effusion

30 years old male from Lalitpur district, presented to our tertiary care centre with complaints of pleuritic chest pain in the left subcostal region for three days, and shortness of breath of MMRC gradeII aggravated by lying on left lateral decubitus for one day. Examination revealed decreased chest expansion on left side, stony dull note on percussion on left inframammary, infra axillary area and decreased intensity of vesicular breath sounds on the same areas on auscultation.

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Marfan syndrome and multiple myeloma: A coincidence or tendency?

Marfan Syndrome (MFS) is an autosomal dominant connective tissue disorder characterized by musculoskeletal, ocular, and cardiovascular abnormalities. It results from a mutation in the fibrillin-1 gene, leading to its deficiency and often causing overactivation of the TGF-β signaling pathway, which may contribute to cancer development. Numerous case reports and a case-control study have noted the coexistence of MFS with solid and hematologic malignancies.

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Clot on top of chaos: A case of fungal endocarditis with superior vena cava thrombosis

Fungal endocarditis is a rare but serious complication. It accounts for 1-3% of all infective endocarditis cases, a mortality rate exceeding 70% [1,2]. Fungal endocarditis is a medical challenge not only in terms of diagnosis but management and source control. Candida and Aspergillus species are the most common fungal culprits [3], often evading detection in blood cultures. Echocardiography plays an important role in identification of vegetations on the heart valve.

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Giant epidermal cyst involving ischiorectal fossa: Clinical images with MRI demonstration

The ischiorectal fossa is the largest space among the perirectal spaces. The benign neoplasms that develop in the ischiorectal originate from different components that vary from benign to malignant lesion. Epidermal cysts occur as a result of the migration of epidermal cells into the dermis. Usually lesion being small, solitary, and slowgrowing, located on the trunk, face, scalp and neck, [1] with uncommon case of larger masse reported in the ischiorectal fossa.

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Impact of manual physiotherapy technics with ultra sound therapy on treatment of chronic PLID patient: A clinical case study of Ashulia Women and Children Hospital

Low Back Pain (LBP) is a common complaint in Bangladesh and has many possible causes. Multiple Physical therapy interventions, including electrotherapy, traction, and lumbar stabilization exercises such as bridging and planking variations, have been shown to be very effective in reducing LBP. The purpose of this case study is to examine the Impact of Manual Physiotherapy Technics with Ultra Sound Therapy on Treatment of Chronic PLID Patient.

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Historical cutaneous squamous cell carcinoma with pulmonary metastasis

Squamous cell carcinoma is the second most common form of skin cancer. We report the case of a patient with a history of untreated HPV who presented with a historical and metastatic form of squamous cell carcinoma. Mr RS, aged 69, presented with a pubic ulcerating mass that had been evolving for over 30 years. The history of the disease dates to 1989, with the appearance of a small nodular lesion measuring a few millimeters above the pubic bone

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Bottleneck emergency: A case of penile strangulation

This case report describes a 60-year-old male who was referred to our hospital due to penile strangulation by a plastic bottle neck with marked oedema and ischemia. The patient diagnosed with Bipolar affective disorder which is characterized by impulsivity and episodes of mania registered himself at the emergency department after being in pain and suffering from urinary retention for 12 hours.

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Imaging of a giant ascending aorta aneurysm in a marfan patient

A 39-year-old male patient presented to the cardiology OPD with complaints of chest pain, palpitations and dyspnoea on exertion for the past five months. On physical examination, the patient was found to have marfanoid features, water hammer pulse and positive Corrigan’s sign. Chest X-ray was performed, and it showed an increased cardiothoracic ratio with the apex shifted down and out suggestive of left ventricular dilatation.

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An haemocholecyst associated with an anticoagulant therapy

Hemocholecyst is an extremely rare pathology defined as hemorrhage into the gallbladder. It may be associated with the use of anticoagulant therapy and may be complicated by spontaneous rupture and hemorrhagic shock. Some cases have been reported in the literature [1-5]. In this article, we describe a case of hemocholecyst related to anticoagulant therapy, complicated by hemorrhagic shock.

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Afebrile intracranial hypertension revealing varicella meningitis

The varicella and shingles virus VZV is a strictly human virus which belongs to the family of herpesviridia which is transmitted by air or in contact with skin lesions rich in virus, it is a virus with dermo-neurological tropism whose primary infection corresponds to chicken pox and reactivation after stagnation in the sensory ganglia, caused by shingles during a drop in immunity.

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“Release and Revive”! Optimizing pediatric tongue tie care with oromyofunctional therapy: A case series

Ankyloglossia, commonly known as tongue-tie, whether partial or complete, can cause significant issues such as speech abnormalities, malocclusion, and swallowing difficulties, impacting daily routine activities. Various techniques, including scalpel, laser, electro-surgery. This novel research has shown that the atmospheric plasma is a minimally invasive method, successfully used for frenectom.

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Adrenocortical tumor in children: About three pediatric cases

Adrenocortical tumor is a malignant and rare tumor in children, and are sometimes integrated within the framework of predisposition syndromes such as Li and Fraumeni or Beckwith-Wiedemann syndromes. Their diagnosis is often made on a bundle of clinical, biological, radiological and anatomopathological arguments.

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Seizure induced by tramadol injection in a female patient with epigastric pain

Tramadol is a weak mu (μ)-opioid receptor agonist with additional serotonin and norepinephrine reuptake inhibition properties. It undergoes extensive hepatic metabolism and is commonly used for managing moderate to moderately severe pain. However, tramadol can induce seizures, a side effect not always linked to overdose or preexisting seizure disorders.

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Cardiogenic shock in a 29 weeks pregnant woman: A case report

Cardiogenic shock in pregnancy represents a rare clinical condition associated with high mortality. Its diagnosis and management pose a challenge for the medical team due to the hemodynamic changes induced physiologically by pregnancy, which contribute to a potentially rapidly evolving clinical course.

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Congenital lenticular pigmentation: Epicapsular stars

A 26-year-old female with no relevant past medical history presented for comprehensive eye exam and was observed on slit lamp to have pigment deposits on the anterior capsule of the crystalline lens in the right eye. The pigment was brown, opaque, star-shaped, and clustered in the center, superior region of the anterior lens capsule (Figure 1).

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