Latest Articles

Volume-3, 2022
Issue 9 (Sep)



American Thyroid Association guidelines for evaluation of thyroid nodule: Our experience of patients presenting to AKUH

Thyroid nodules are one of the frequently seen presentations in the clinic. Thyroid nodules are present in almost 5% of females and 1% males in iodine-sufficient regions. On the other hand it can incidentally be found in as high as 67% of the patients on ultrasound neck. Among all the thyroid nodules, 5-15% come out to be malignant on final histopathology.

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Bronchial atresia presenting with two bronchoceles

Bronchial atresia is a rare congenital lung abnormality characterized by the focal obliteration of the bronchial lumen, on a lobar, segmental or subsegmental level, usually associated with peripheral mucus impaction (bronchocele or mucocele). It presents with adjacent segmental or subsegmental hyperinflation, and reduction of vascularization of the involved segment or lobe.

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Giant apical cyst in anterior maxilla: A case report

Apical or periapical cysts are the most common type of cyst, affecting the local and systemic health of patients. This pathology can manifest as an inflammatory condition in periodontal tissues due to the stimulation and proliferation of the epithelial cell rests of Malassez and it can be identified in clinical visits and imaging exams of routine. Apical cysts do not cause facial pain and/or swelling and appear as a well-defined radiolucent region when analyzed radiographically.

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Cervical epidural blood patch in spontaneous intracranial hypotension: A case report

Spontaneous Intracranial Hypotension (SIH) results from a decrease in cerebrospinal fluid volume without any iatrogenic cause and presents most commonly with orthostatic headache. Cervical dural tears are an uncommon cause of SIH. Cervical epidural blood patch has been successfully used in many developed countries for the treatment of spontaneous intracranial hypotension after failure of conservative management.

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Postpartum vulvar expansive hematoma: An uncommon case report

Postpartum hemorrhage is the leading world cause of maternal mortality in low-and-middle income countries. Puerperal hematomas are auncommon cause of postpartum hemorrhage. Their adequate management requires a particular skill and technical platform to surgically assure hemostasis. This case allows us to draw the attention of practitioners to the seriousness and singularity of this highly morbid pathology.

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When the dust has settled…An occupational disease with swelling of the cervical lymph nodes

Cervical lymphadenopathy is a common finding in the everyday life of an ORL physician. The diagnostic steps range from laboratory and microbiological examinations to removing lymph nodes for histopathological processing. The differential diagnoses include infectious, chronic and malignant diseases. In rare cases, lymph node biopsy may diag-nose a chronic lung disease like sarcoidosis or silicosis.

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Association of aspirin therapy with prognosis in patients with non obstructive coronary artery disease: A systematic review and meta-analysis

The effect of aspirin therapy in patients with nonobstructive Coronary Artery Disease (CAD) remains controversial. This study aimed to investigate the association between aspirin therapy and prognosis in nonobstructive CAD. We searched for observational cohort studies on Pubmed, Embase, the Cochrane Library and Web of Science. Studies were included that compared the endpoint differences in patients with nonobstructive CAD who were treated with aspirin or not.

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Awareness of sick day rules and use of steroid cards among patients taking long term synthetic oral glucocorticoids for immunosuppression and adrenal hormone replacement at a tertiary hospital in Ethiopia: A cross-sectional study

Glucocorticoids are among the most commonly prescribed medications owing to their generic anti-inflammatory and immunosuppressive effects. Adrenal insufficiency and adrenal crisis are among the major serious adverse effects of long course glucocorticoid treatment. Patient education on sick day rules and the use of steroid treatment identifiers are some of the strategies.

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Extensive cranial langerhans cell histiocytosis revealed by acute mastoiditis

Langerhans cell histiocytosis is a group of diseases characterized by an inflammatory neoplasia of myeloid precursor cells driven by mutations in the mitogen-activated protein kinase pathway leading to the proliferation and accumulation of Langerhans cells. Clinical manifestations range from isolated disease to multifocal lesions and systemic involvement with a worse prognosis

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In-stent stenosis of the internal carotid artery

At present, the treatment of internal carotid artery stenosis has been extensively modified, passing from endarterectomy to balloon plasty and stent placement, generating a significant reduction in surgical risk. In-stent stenosis is reported in up to 30% of cases and patients generally present with a transient ischemic attack or stroke.

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Potential cost and benefits of integrating health care services for managing multiple chronic conditions in sub-Saharan Africa: A critical short review and commentary

Sub-Saharan Africa is currently having a dual burden of HIV and Non-communicable diseases. HIV is regarded as a chronic condition regardless of HIV being infectious, due to the absence of a cure. However, these patients have achieved a substantial increase in survival after receiving Antiretroviral Therapy (ART). An increase in survival puts HIV patients at risk of developing Non-Communicable Diseases (NCD).

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Asymptomatic disseminated cysticercosis: A rare incidental finding

A middle-aged male, coming from a remote hilly village of Northern India, presented to the outpatient department for optimization of his anti-diabetic medications. On routine general examination innumerable soft to firm, asymptomatic subcutaneous nodular swellings were noted over his trunk and limbs which varied from 1-4 cm in size.

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Dental calculus contributing to impaired speech and deglutition: A rare case

A 21 year female patient reported with the chief complaint of pain and difficulty while eating and swallowing food from past 15-20 days. Her mother complained about her silent mode most of the time. Patient revealed that she is having pain while speaking, therefore she avoid speaking from past few days. Patient was systemically healthy.

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In infectious endocarditis, a lesion can hide another one

A 24-year-old immune-competent man, with no significant past medical history, presented a Streptococcus viridans Infective Endocarditis (IE). Work-up for IE showed on post-contrast brain CT-scan a ring- enhancing lesion suggesting a cerebral abscess, with a contiguous nodular enhancing lesion. Given this radiological aspect, and because immediate cardiac surgery was indicated, a cerebral angiography was performed.

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Renal cell carcinoma with tumour thrombus extending in duplicated inferior vena cava: A rarity with management conundrum

DIVC may play a role as a confounding factor in imaging diagnostic tests and also may represent a hazard for inadvertent injury and bleeding during surgery. Careful interpretation Radiological investigations help to define such anomalies and avoid significant morbidity during surgical exploration. We present a case of renal cell carcinoma involving Right kidney with tumor thrombus extending into both venae cava.

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Is transscleral cyclophotocoagulation with diode laser (TSCPC) still a valid option for refractory glaucoma? A real-world single-centre Italian experience

To describe our experience with TSCPC with diode laser for refractory glaucoma in a single centre in southern Italy. This retrospective descriptive study included 134 eyes with refractory glaucoma. Patients underwent TSCPC using a Cyclo-G6 laser method with a G-probe delivery system. Intraocular Pressure (IOP) and the number of Antiglaucoma Medications (AGM) were recorded at baseline and at 1-, 7-, 30-, 60-, 90- and 180-days post-treatment.

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Autoimmune disease with libman sacks endocarditis presenting with acute limb ischemia

Libman Sacks Endocarditis is rare, nonbacterial vegetation of the heart valves. Most commonly seen in association with solid cancers and autoimmune diseases. A 64-year-old male came in with sudden onset left upper arm numbness, pain and pallor which worsened with movement. On examination, he had feeble pulses of the left upper extremity and an aortic diastolic murmur of the heart.

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Posterior midline transpedicular approach for third rib neoplasm

Aneurysmal bone cysts are primarily benign neoplastic lesions, often occurring in childhood and adolescent age group. A 27 year old male with neoplastic lesion arising from the posterior end of right third rib, underwent resection without thoracotomy or use of thoracoscopy. In this technique we used posterior midline transpedicular approach and resected with the help of neuronavigation system.

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Ascaris lumbricoides causing 3 weeks abdominal pain: A case report

A 19-year-old man presented to the emergency department with 3 weeks of history of abdominal pain and constipation. He had nausea and vomiting 48 hours ago. Previously, he was in good health and did not have any relevant medical history. The heart rate was 87 beats per minute, with blood pressure at 100/70 mm Hg.

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Cardiac arrest following non-bronchoscopic bronchoalveolar lavage: A case report

Pneumonia is common in neurocritical care patients. Non-bronchoscopic bronchoalveolar lavage (NB-BAL) is a generally safe, well-tolerated procedure with similar sensitivity to bronchoscopic bronchoalveolar lavage. This procedure is most often performed by non-physicians, particularly nursing and respiratory therapy, often without advanced training regarding the procedure.

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