Articles

Myeloschisis (rachischisis) is a rare congenital malformation linked to incomplete development of the spine and characterized by posterior opening of the vertebrae. It is spread over more than one floor or even the entire spine and incompatible with life. Its diagnosis is clinical, confirmed by ultrasound and cross-sectional imaging.

Pneumonia caused by unknown etiology occurred in December 2019 in Wuhan, Hubei Province, China, confirmed to be caused by a novel coronavirus. The Symptoms of SARS-Cov-2 depend on the patient’s age and underlying disease, as well as the state of the immune system.

The occipital encephalocele is a rare homozygous congenital malformation, linked to the C677T gene according to Molloy et al. In relation to a defect in the closure of the cranial part of the neural tube during intrauterine life, it is therefore defined such as a hernia of the nervous tissue (part of the cerebellum) and / or the meninges through a bone defect in the occipital region.

A 58-year-old man presented with numbness and muscle twitching in the lower limbs since 2.5 months and muscle twitching in the upper limbs since 2 days. In early April 2015, the patient noticed numbness and coolness in the toes of both his feet without any obvious cause, and occasional muscle twitching in the left calf.

We present a case of a 2 year old female with digital fibrous lesions, dysmorphic facial features, stridor, sensorineural hearing loss, and scoliosis. The patient surgical history included digital amputations at the interphalangeal joint line bilaterally on the middle, ring, and little finger.

A 16 year old female, recent refugee, presented to the clinic with the complaint of difficulty walking. The patient had been told she had osteoporosis as a child, though did not recollect a formal diagnosis. On physical exam, the patient had good range of motion of the hips, knees, ankles, and feet.

A 77-year-old woman has sudden loss of vision in the lower left eye due to non-arteritic anterior ischemic optic neuritis. Seven days later, she presented sudden loss of vision in the right eye due to non-arteritic anterior ischemic optic neuritis. The usual causes have been ruled out.

In this report, we describe three cases of rare oncologic metastases. The first patient was a 73-year-old male, diagnosed with metastatic male breast cancer after radiological investigation of suspected renal cell carcinoma. The other two male patients, a 69 and 73-year-old, were diagnosed with colon adenocarcinoma.

Disorders of Sex Development (DSD) refers to biological differences between phenotypic sex, gonad morphology and chromosomal material. A full-term infant was born with Hypoplastic Left Heart Syndrome (HLHS) and ambiguous genitalia. Karyotype revealed 46XX with no evidence of Y chromosome or SRY. Biopsy of both gonads revealed testicular tissue. Parents decided to rear the child as male.

The Coronavirus disease 2019 (COVID19) mass vaccination program in India began on January 16, 2021, with two vaccines: Covishield and Covaxin. One of the most important things to remember is that, while COVID-19 immunizations offer the highest protection, but do not stop us from catching the virus.

The iliopsoas muscle abscess is a rare condition that may occur by hematological/lymphatic dissemination or secondary to local infections, namely rare situations of kidney infection. Its early identification plays an essential role for an therapeutic and good prognosis. The authors present a rare complication of a very common pathology in the internist’s clinical practice.

Fistula between gall bladder and gastrointestinal tract occurs anywhere for example stomach, duodenum, and colon. Results of inflammatory reaction adhesion may be occur and between two organs and gall stone’s pressure may be contribute this process. Laparoscopic cholecystectomy has been the most widely accepted modality of treatment for patients with gall bladder disease.

We report a challenging diagnosis and the successful management of a rare case of intracranial dural chondroma in a 19-year-old student. He was admitted for secondary epilepsy with behavioral and mood disorder without neurological deficit. His past medical history was unremarkable.

A 12-years-old, Moroccan child with a history of skeletal deformities, gait disorder, Short stature, valvulopathy, facial dysmorphy, corneal opacity, umbilical hernia, and hepatomegaly. He has onset from birth, delayed first milestones (setting, gait, and language) and severe dysostosis multiplex.

Poisoning with opioid compounds is one of the dangerous and unfortunately common poisonings of children in our country. The patient in question is a 5-month-old infant who inadvertently suffered from methadone syrup poisoning and was referred to the hospital with severe drowsiness and decreased level of consciousness.

COVID-19 has been identified as one of the most urgent issues in health care systems worldwide. Identification of the prognostic-related characteristics in the patients with COVID-19 for timely diagnosis and treatment is the most important current priority of treatment systems. This study aimed to determine the clinical characteristics, laboratory and imaging profile of COVID-19 cases.

It is difficult to make a diagnosis for this case. A 38-year-old man suffered from mild cognitive dysfunction for 3 months and intermittent headache for 20 days, and his focal neurological signs were unconspicuous. Cerebrospinal fluid (CSF) showed normal biochemical and negative bacteriologic examinations.

We present the case of a 45-year-old man who underwent intracranial pressure monitoring for postural headaches. ICP results were unexpected with crescendo of overnight pressures and sudden drops. A diagnosis of sleep-disordered breathing, in the form of obstructive sleep apnoea was suspected. Sleep-disorderd breathing is known to cause rise in ICP.

Sarcomas are rare and characterised by an incidence of approximately 5 cases/100.000 people. Primary spindle cell sarcomas are a subclassification of soft tissue sarcomas, known as uncertain differentiation tumours, based on their unspecific line of differentiation. It might begin in layers of connective tissue under the skin, between muscles or surrounding organs.

Cephalic vein is a superficial vein of upper limb formed by dorsal venous arch on the radial side. It is used for catheterization, insertion of pacemaker and creating an Arteriovenous Fistula (AVF) in patients with Chronic Kidney Disease (CKD) for the purpose of hemodialysis. This is a case report of supraclavicular course of bilateral cephalic veins draining into external jugular veins on their respective sides.

HIS Bundle Pacing (HBP) is considered the most physiologic pacing technique as it generates a physiological activation of both ventricles through synchronous ventricular depolarization of His bundle–Purkinje conduction system. Permanent HBP and Atrioventricular Node (AVN) ablation in patients with heart failure.

Real-time three-dimensional spot tracking echocardiography (RT3D-STE) can be used to assess the prognosis of myocardial infarction (MI). Analyzing the correlation between miRNAs and RT3D-STE, especially miRNAs and Global Longitude Strain (GLS) and Global Circumferential Strain.

Gangrenous cholecystitis (GC) is the most severe form of cholecystitis and is associated with acute pancreatitis. Once GC diagnosis is established, urgent cholecystectomy is recommended. The preoperative diagnosis is challenging, and clinical judgment can be critical. We report a case of GC with acute pancreatitis diagnosed in the absence of definite laboratory or imaging evidence.

This paper discusses the treatment of ulcerative colitis with Traditional Chinese Medicine, and expounds the specific pathogenesis of ulcerative colitis. In addition, we put forward the application of some new technologies and methods for the scientific research on the treatment of ulcerative colitis, and summarizes the research hotspots of ulcerative colitis, hoping to provide reference for other scholars to study ulcerative colitis.

We present a case of congenital diaphragmatic hernia (CDH) diagnosed in the second trimester of pregnancy, with most of the stomach and part of the liver occupying half of the left hemithorax. Severe pulmonary hypoplasia is associated with reduced survival in patients with CDH.

Anal cancer is a rare malignancy and constitutes only 2.5% of all digestive system cancers in the USA. There is an uptrend in the incidence of anal cancers in the general population, which could be attributed to human papilloma virus and human immunodeficiency virus infections, increase in lifetime number of sexual partners.

Dolichoectasia is an abnormal condition of the blood vessels that arise due to architectural abnormalities in the weakened walls. This is a case of a 67-year-old woman being managed for chronic hypertension who initially presented with features of left hemispheric stroke.

We present a case of 38-year-old man who presented with persisted mild headache and occasional vision loss for four and half years. MRI of brain revealed tri-ventricular dilatation with uninvolved fourth ventricle. On the FIESTA-C and 3D-BRAVO MR sequences, two thin membranous webs were seen in the distal part of the aqueduct of sylvius.

Contrast cavography during removal of a vena cava filter in patients treated via thrombectomy for pulmonary embolism is a widely performed procedure, which may involve potentially serious complications if the human factor fails. Accidental injection of hydrogen peroxide (H2O2) after mistaking it for contrast material can have fatal consequences.

Left Ventricular Noncompaction (LVNC) is a cardiac disease characterized by a trabecular meshwork and deep intertrabecular myocardial recesses that communicate with the left ventricular cavity. MYH7 splicing mutations are very rare, and seem to be restricted to patients with myopathy of LVNC.

A 68-year-old woman with history of Laparoscopic Cholecystectomy (LC) for symptomatic gallstones 1 month ago, presented to the emergency department for mid abdominal pain since surgery. The pain is severe, continuous and unrelated to food. Her past medical history is significant for Diabetes Mellitus Type 2.

Congenital malignant neonatal tumors are rare and different from the tumors observed in older children and adults. Multimodal treatments such as surgery are required to remove these tumors. Neonates are the most vulnerable patients from anesthesiologists’ perspectives. We present a neonate with a massive malignant orbital round cell tumor.

Gallbladder cancer is an uncommon disease, comprising 1.2% of cancers in the world, with squamous cell pathology of the gallbladder being even more uncommon, making up 1-3% of those cases. When diagnosed, squamous cell carcinoma carries higher mortality when compared to all other pathologies in the gallbladder.

It’s a patient followed disorderly for high blood pressure for six months under ARB (Angiotensin II Receptor Blockers) and Calcium Antagonist with a recent elevation of his blood pressure in spite of association of a B-Adrenergic Blocker and a thiazide diuretic.

Congenital Adrenal Hypoplasia (AHC) first described in 1948, characterized by adrenal insufficiency, and hypo-gonadotropic hypogonadism. X linked AHC mainly affects males, it occur mainly due to mutation in NR0B1 gene. In this report, we present two cases of NR0B1 mutation from same family with dichotomous pubertal presentation.

We report a case of 6 years old girl with ovarian Steroid Cell Tumor, Not Otherwise Specific (SCT-NOS). She was admitted to the hospital with increased weight gain, hypertrichosis, and cushingoid facies in form of prominent cheecks, moon facies with dorsocervical fat pad, obese built, acanthosis nigricans on back of neck and marked hirsutism.

Oral malignancy is most common tumors in Pakistan. The age of the greater part of the patient’s reaches somewhere in the range of 50 and 70 years and old age is an indirect risk factor for malignant growths. It is challenging to treat the older patients with oral squamous cell carcinoma due to poor performance and the adjusted physiology.

To evaluate the therapeutic efficacy of Laparoscopic Gastric Sleeve Resection (LGSR) for patients with metabolic syndrome and Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS). Two patients with metabolic syndrome and OSAHS received LGSR in our hospital in 2015 and were postoperatively followed up for 3 months to observe relief of the symptoms of Acanthosis Nigricans (AN) and snoring.

Although the neonatal mortality rate has been diminished over time in Bangladesh, the rate is still very high. The day of birth is the most vulnerable period for newborns. This study assessed to predict and detect associated risk predictors of the first-day neonatal mortality through Machine Learning (ML) algorithm.

Kodamaea ohmeri, previously known as Yamadazyma ohmeri and Pichia ohmeri, is ascomycetous yeast that belongs to the Saccharomycetaceae family. It is a rare clinical isolate that has recently become known to cause various human infections. Here, we report the first case of co-infection with Sars-Cov2 and Kodamaea ohmeri in Tunisian patient without underlying disease.

[99mTc] Tc-HMPAO, developed for brain imaging, is taken up by the heart, but never used to study it. We aimed to compare cardiac images with [99mTc] Tc-HMPAO and [99mTc] Tc-Tetrofosmin, using imaging techniques. Cardiac gated SPECTs with [99mTc] Tc-HMPAO were compared with myocardial perfusion scintigraphies (MPS) with [99mTc] Tc-Tetrofosmin in three inpatients.

Angina pectoris, the main manifestation of coronary artery disease has an unfavorable impact on quality of life. The aim of this study was to assess Health-Related Quality Of Life (HRQoL) in patients with Stable Coronary Artery Disease (SCAD) and to explore possible relationships between HRQoL and the risk factors for ischaemic heart disease.

Delayed movement disorder is an involuntary movement syndrome after long-term use of antipsychotic drugs, and also a serious adverse drug reaction. The treatment of delayed movement disorder has been an important issue. How to carry out related prevention is directly related to the vital interests of patients.

We present a case of arteriovenous malformation with aneurysmatic dilatation of the drainage vein, presenting with obstructive hydrocephalus located in the tectum. A 59-year-old female patient was taken to the emergency department after complaining for 8 days of increasingly worsening headache, gait disturbance, sleepiness, blurred vision, and double vision, as well as gush vomiting.

Granulocytic sarcoma (GS) is a rare extramedullary solid tumor composed of immature myeloid cell that is associated with acute myeloid leukemia or myelodysplastic syndrome. Especially, the involvement of the breast as a pattern of relapse after allogeneic bone marrow transplantation (allo SCT) is extremely rare.

Geotrichum capitatum infection is a rare condition and it has only been reported in immune-compromised patients. The prognosis is poor, with a mortality rate between 50-90%. Here we report a case of Geotrichum capitatum septicemia in a neutropenic patient undergoing induction chemotherapy for acute myeloblastic leukemia.

Breast cancers have traditionally been classified based on histology. However, with the development in imaging modalities and available treatment options, it is imperative to also focus on the molecular classes of breast cancer. Molecular profile and gene expression are important predictors of treatment response and overall prognosis.

Proximal humeral reconstructive alternatives in orthopedic oncology are well described, but the literature regarding post-failure salvage is sparse. This report details a multiply failed humeral reconstruction that ultimately resulted in resection arthroplasty. Although initial tumor resection was treated with an intercalary reconstruction, this case is unique in that its sequelae are equally applicable to failures of proximal humeral reconstruction.

A 26-year-old woman, 21.6 weeks gestation, was diagnosed with hyperemesis gravidarum a month earlier. She continued with vomiting and started with weakness in extremities, unsteadiness and slurred speech. She was hospitalized, had hypokalemia (2 mEq/L), received intravenous potassium phosphate replacement, and was discharged. One week later, she started with dizziness and confusion.

A 79-year-old woman with pseudoexfoliation and zonular weakness underwent routine phacoemulsification with 5.5 mm capsulorhexis and implantation of posterior chamber intra-ocular hydrophobic lens (KSSPStaar®). Examination at one-week post-surgery was normal. One-month post-surgery, the vision had decreased to 20/200.

To analyze the clinical, pathological spectrum and prognosis of patients with Monoclonal Gammopathy of Renal Significance (MGRS). Patients with kidney biopsy-proven MGRS at Dr Lütfi Kırdar City Hospital between 2015 and 2019 were included, clinical data, kidney pathology type, treatment and prognosis were collected.

Osteogenesis Imperfecta (OI) is a skeletal dysplasia that affects the cross-linking of Type 1 collagen leading to a wide spectrum of manifestations including bony abnormalities, scleral abnormalities, dentinogenesis imperfecta, and hearing abnormalities. We present a case of Sillence Type III OI, diagnosed by genetic analysis at birth, with significant bony deformities.

Retrocaval Ureter (RCU) is a rare congenital anomaly that often presents with obstructive changes in the upper urinary tract which may or may not symptomatic. It arises as a result of an aberration in embryologic development of Inferior Vena Cava (IVC). Commonly occurs in isolation but can occur in association with other anomalies.

Globally, COVID-19 pandemic has immensely affected medical education including postgraduate medical education. This study used a qualitative approach to explore the psychological impact of the COVID-19 pandemic on Foundation Year Doctors (FYD). Ten semi-structured interviews were conducted.

Chronic Graft-Versus-Host Disease (GvHD) is one of the most common cause of poor quality of life after Hematopoietic Stem Cell Transplantation (HSCT). Chronic GVHD can present with vulvovaginal symptoms which is usually under reported. Only small series have been reported so far and its incidence, pathophysiology, clinical manifestations and management are not well understood.

Retroperitoneal sarcomas are a relatively rare disease that represent a challenge for the surgeon especially when the mass reaches remarkable size and causes anatomical subversion. Liposarcoma is one of the most common histological subtypes. It often grows asymptomatic till considerable dimensions.

A 77-year-old man with a history of Coronary artery disease, COPD, and pulmonary fibrosis on 5 L of oxygen at home presented to the emergency department with dizziness. Vital signs at presentation included temperature 37°C, pulse 160/min, blood pressure 86/60 mmHg, respiratory rate 24/min, oxygen saturation 96% on 5 L of oxygen.

We report a case of internal iliac pseudoaneurysm complicated by hydroureteronephrosis in a newly diabetic 76 year old woman with Salmonella enterica serovar Choleraesuis bacteremia. She was treated with endovascular coiling and levofloxacin and was discharged in stable condition.

Leptomeningeal carcinomatosis is an increasingly recognized phenomenon for metastatic spread of a wide variety of carcinomas to the Central Nervous System (CNS). We report a case of a 79 year-old man with perineural spread of locally invasive melanoma to the CNS along the brachial nerves and plexus.

A vanishing twin, or foetal resorption, is a foetus in a multi-gestation pregnancy which dies in-utero and is then partially or completely reabsorbed. Single foetal death in the second and third trimester is associated with a higher risk of maternal and foetal morbidity and mortality in the first trimester.

SARS-COV2 pandemic had a great impact on our life. Changes had been done to accommodate the current situation. Infection control measures in the endoscopy units had entirely changed. Also, prioritizations of different procedures had changed especially in the lockdown time. Peroral Endoscopic Myotomy (POEM) is considered a low priority endoscopic procedure.

A 39-year-old male with a 20-year history of cannabis and methamphetamine abuse presented to the ER with progressive shortness of breath, orthopnea, and bilateral leg swelling.Temperature 36.8°C, pulse 116/min, blood pressure 125/89 mmHg, respiratory rate 18/min, oxygen saturation 93% on room air.

To examine trends in respiratory diseases other than infectious diseases is important for public health issue during coronavirus disease 2019 (COVID-19) pandemic. This study aimed to examine the trends in patient consultations for asthma and Chronic Obstructive Pulmonary Disease (COPD) at Show a University Hospital in Japan during the COVID-19 declaration of the state of emergency.

Foreign body inhalation is a major problem in children and is one of the most serious accidents in early childhood. It is considered a common cause of childhood morbidity and mortality. We present a unique and unusual case of inhalation of a piece of tissue in a 10-month-old infant admitted to the Pediatric Emergency Department.

Axial Spondyloarthirtis (ax-SpA) includes a non-radiographic variant, called Non Radiographic Axial Spondyloararthrophy (nr-ax-SpA), which is a very rare type of arthritis of spine. Hansen disease or Leprosy is a chronic infectious disease with various clinical manifestations, which is endemic in India.

Renal Cell Carcinoma with Leiomyomatous Stroma (RCCLMS) is a rare renal cancer with indolent behavior and favorable prognosis. We present a case of rare renal cell carcinoma with leiomyomatous stroma in a 49-year-old male, with an incidental finding of a 1.6 cm renal nodule on MRI scan.

Infection with HIV and TB leads to inflammation. Markers of inflammation include TNF-α, IFN-γ, CD38 and HLA-DR. In HIV infection these markers create an environment which favours reactivation of latent TB to TB disease in patients on HAART. The markers TNF-α, IFN-γ, CD38, HLA-DR and CD4 cell count can be used to predict possible reactivation of latent TB to disease in HIV patients on HAART.

A 38-year-old Asian man was referred to our hospital due to a history of decompensated heart failure. Transthoracic echocardiography demonstrated a left ventricular ejection fraction of 29%. The chest radiograph demonstrated an increased cardiothoracic ratio.

Children infected with COVID-19 are often asymptomatic or with very mild symptoms. While the risk of vertical transmission has not been fully elucidated, it is less common for newborns to have serious infection. We report a case of a 9-day old with COVID-19 Pneumonia requiring mechanical respiratory support.

A 55-year-old lady female presents to the clinic complaining of hoarseness of voice, difficulty swallowing and breathlessness on exertion. This was associated with dryness and crusting in her nose. She underwent flexible nasoendoscopy, which was suggestive of supraglottic oedema with nodules over the back of the epiglottis.

Carotid stenting with the use of an embolic protection device has become a common procedure done routinely for carotid stenosis. The procedure is usually done in patients with transient ischemic attacks or minor strokes for preventing further strokes. Since it is done on patients who are asymptomatic or minimally symptomatic, the occurrence of complications should be kept as close to nil.

Melanoma is a relatively uncommon malignant neoplasm, either primary or secondary. We present a case of delayed metastatic melanoma to the pharyngeal tonsil. A 70-year-old Chinese male presented for half a year due to vague speech and snoring and then found tonsil enlargement.

The patient, a 28-year-old female, was aggravated by suspicion for more than a year, and the total course of the disease was unknown. She was sent to the outpatient clinic of our hospital by the staff of the rescue station on December 20, 2020. Outpatient clinic with “schizophrenia?” Admitted to hospital.

Unprotected sex in men who have sex with men is considered the main current mechanism of HIV infection in Western-culture countries. Chemsex refers to the use of different drugs and substances before or during sexual activities to enhance the sexual experience.

Intramedullary Nailing (IMN) has been the gold standard treatment for femoral shaft fractures. Earlier it was managed by Küntscher nail (K nail) fixation. However, in developing countries K nail may still be used as a low-cost fixation device. Heterotrophic Ossification (HO) is a rare complication following nailing in the treatment of femoral shaft fractures.

Acute Intermittent Porphyria, (AIP) is a rare disease caused by Hydroxymethylbilane Synthase (HMBS) deficiency. It is characterized by acute neurovisceral attacks, in which excessive heme production is induced following exposure to a trigger. One of the suggested triggers is low carbohydrate intake.

Uveal melanoma has a high metastasis rate. Following the initial diagnosis, up to 50% of patients are affected by late recurrence and gastrointestinal metastasis is found to be one of the least frequent. We report the case of a 47-year-old woman who underwent proton therapy for uveal melanoma.

Musculoskeletal disorders have a significant global burden, with tendinopathies of the lower limb having a high prevalence. Although the use of resistance training interventions as treatment for tendinopathies has become widespread, the reporting and description of these interventions is often poor, preventing translation to clinical practice.

Pachygyria is a component of a spectrum of malformation of cerebral neuronal migration. MRI is a fundamental neuroimaging tool for adequate description of cerebral structural pathology. As a component of lissencephaly-pachygyria spectrum, there are severe intertwined clinical and pathological manifestations, with/without other brain and systemic malformations.

In 1957, May and Thurner described the iliac vein compression syndrome. This is a disease entity with a variable anatomical state. It’s an anatomical variant that can be congenital or acquired. The mechanical obstruction prevents venous outflow from the LLE, resulting in persistent venous stasis and risk of thrombosis.

A 33 weeks preterm female weighting 1945 g was born to a 28-year-old gravida 2 para 1. Pregnancy was surveilled in Angola with two ultrasounds performed at 12 and 23 weeks reported as normal. Emergent cesarean section was performed due to severe fetal bradycardia in context of a maternal sepsis.

Pemetrexed is an antifolate agent which has shown activity on various tumors. But no result has been reported on the clinical efficacy and toxicity of pemetrexed combined with antiangiogenesis drug in patients with cervical cancer. Apatinib is an oral antiangiogenesis drug in cervical cancer, which has been reported efficacy and safety in cervical cancer.

In adults, brachial plexopathy due to clavicle fractures is rare and is most commonly caused by nonunion, mal-united fragments, hypertrophic callus, or pseudoaneurysm of the subclavian artery or vein. Conservative treatment of nondisplaced and displaced clavicle shaft fractures in adults usually produces satisfactory outcomes.

A 22-year-old female university student presented with hoarseness of voice for a few months. She had difficulty to project her voice and underwent initial voice assessment and stroboscopy, which mild–moderate dysphonia characterised by breathy husky quality with mild roughness on Grade of hoarseness; Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale.

Long QT Syndrome (LQTS) can present in the neonate with bradycardia and AV block and confers significant risk for life threatening ventricular arrhythmias. We report a case of a neonate presenting with complex bradyarrhythmias secondary to acquired LQTS after maternal overdose of QT-prolonging medications (haloperidol and sertraline).

Etanercept is a Tumor Necrosis Factor-Α (TNF-alpha) blocking agent used in Rheumatoid Arthritis (RA). It is a well-tolerated drug, but during treatment with it may occur increases in liver enzymes, the formation of autoantibodies and very rarely autoimmune hepatitis.

The MRI findings of a liver lesion in a patient with congenital heart disease are presented and the differences between the two types of MR contrast agents, i.e., extracellular and intracellular (hepatobiliary), and their role in characterizing the imaging features of hepatocellular carcinoma are discussed.

We present a report of a patient with desmin-related skeletal myopathy who underwent Cardiac MRI (CMR) following episodes of palpitations. Despite a recent normal echocardiogram, the CMR study revealed mild but unequivocal apical hypertrophy. These appearances were indistinguishable from those seen with sarcomeric apical hypertrophic cardiomyopathy.

X-linked myotubular myopathy, a rare disorder is part of a group of congenital myopathies that present in the neonatal period. While the clinical presentation in the antenatal period may be varied, the postnatal presentation is of a delayed cry, hypotonia and weakness resembling fetal hypoxia and acidosis.

A 78-year-old man with 24 years history of Rheumatoid Arthritis (RA) came with neck pain. He always refused any treatment except for NSAIDs. From 2 years ago, he was bedridden. He was chronic cigarette smoker. On examination, he had rheumatoid nodules, severe both hands deformity, elbows flexion contracture and knee joints limitation of motion.

Congenital hypothyroidism is the most common congenital endocrinopathy; it is also the leading cause of preventable mental retardation and has severe socioeconomical consequences. We report the case of a 10 year-old girl admitted for a typical clinical presentation of hypothyroidism with cretinism and dwarfism (height at 78 cm). Treatment was started immediately with levothyroxine.

Emotional neglects is the mostly widespread type of childhood experience which is believed to affect the overall psychological adjustment of the child as a result, victims may experience psychological distress with symptoms of low self-esteem, depression and anxiety. There is limited published data on this subject in Tanzania.

In situations like peritonitis due to bile-duct injuries drains insertion give an opportunity for healing. However in presented case the bile leakage from drains spontaneously stopped. Only constipation leads to icterus. A spontaneous choledoco-enteric fistula explains these conditions, discovered later. It could be the result of inflammation causing adhesion.

Real-Time Reverse Transcriptase Polymerase Chain Reaction (r RT-PCR) has been the main diagnostic tool for SARS-CoV-2 infection since the early stages of the COVID-19 pandemic and a positive test enables the clinicians and public health professionals to quickly isolate the patient and prevent spread of the disease.

Bronchoscopy poses distinct challenges for anaesthesia as the airway is shared by both the surgeon and anaesthetist. This difficulty increases manifold when the obstruction is present simultaneously in both the trachea and bronchi. The individualized anaesthetic approach is governed by the location and nature of obstruction along with airway size at the obstruction site.

Patients with severe COVID-19 pneumonia can develop acute respiratory distress syndrome, which triggers respiratory failure. Multiple Organ Support Therapies (MOST), such as Extra Corporeal Membrane Oxygenation (ECMO), Continuous Renal Replacement Therapy (CRRT) or plasmapheresis, can be used as part of adjunctive management in patients with refractory hypoxemia.