Articles

Volume-3, 2022
Issue 1 (Jan)



Extended spinal dysraphism: Rachischisis or myeloschisis

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.

PDF HTML

What can reveal occipital growth in newborns? Meningo-encephalocele

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.

PDF HTML

A case report of neuromyotonia (Isaacs syndrome)

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.

PDF HTML

Skeletal deformities in a case of digitocutaneous dysplasia

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.

PDF HTML

Severe polyostotic fibrous dysplasia presenting as a leg length discrepancy

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.

PDF HTML

Causeless? A new interrogation!

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.

PDF HTML

Rare oncological metastasis; Colorectal and male breast cancer

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.

PDF HTML

46XX testicular DSD SRY-Negative in a child with hypoplastic left heart syndrome

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.

PDF HTML

Breakthrough infection in covid 19: Indian scenario

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.

PDF HTML

A rare complication of a common disease?

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.

PDF HTML

Laparoscopic management of cholecystoduodenal fistula: A case report

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.

PDF HTML

Radio clinico histological presentation of intracranial dural chondroma

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.

PDF HTML

A novel nonsense MPS VI mutation in a south Moroccan patient

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.

PDF HTML

Case report: Unusual infant methadone poisoning

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.

PDF HTML

Clinical characteristics, laboratory profile and imaging results in COVID-19 cases

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.

PDF HTML

Encephaloma, neurocysticercosis, angiocavernoma or others: A case report

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.

PDF HTML

Intracranial pressure monitoring: An unexpected diagnosis of obstructive sleep apnoea

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.

PDF HTML

Metastatic spindle cell sarcoma: A rare type of undifferentiated soft tissue neoplasm

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.

PDF HTML

Cephalic vein draining directly into external jugular vein: A rare entity

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.

PDF HTML

Acute pancreatitis associated with gangrenous cholecystitis in the absence of definitive laboratory or imaging evidence: Case report and literature review

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.

PDF HTML

Traditional Chinese medicine treatment of ulcerative colitis

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.

PDF HTML

Membranous web in aqueduct of sylvius on FIESTA-C and 3D-BRAVO MR sequence in an adult

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.

PDF HTML

Cavography with hydrogen peroxide. Accidental injection of hydrogen peroxide into the inferior vena cava

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.

PDF HTML

Retained gallstones: A forgotten complication after laparoscopic cholecystectomy

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.

PDF HTML

Congenital orbital malignant tumor in a neonate: Anesthetic management

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.

PDF HTML

Middle - aortic syndrome with a thrombus in the renal artery

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.

PDF HTML

Rare case series of congenital adrenal insufficiency in two brothers with NROB1 mutation, presenting with dichotomous pubertal presentation

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.

PDF HTML

Ovarian steroid cell tumor, not otherwise specific, causes Cushing syndrome in 6 years old girl: A case report

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.

PDF HTML

Association of age with depth of invasion and extra capsular spread in patients with oral squamous cell carcinoma: A retrospective study

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.

PDF HTML

Laparoscopic gastric sleeve resection for metabolic syndrome (MS) with obstructive sleep apnea-hypopnea syndrome (OSAHS): Report of two cases

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.

PDF HTML

Risk predictors selection and predict for the first-day neonatal mortality in Bangladesh using machine learning techniques

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.

PDF HTML

Coinfection with Sars-Cov2 and Kodamaea ohmeri: A case report from Tunisia

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.

PDF HTML

Imaging myocardial perfusion with [99mTc] Tc-HMPAO: Fiction or reality? – Preliminary results

[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.

PDF HTML

Patients’ perception of health status and ischaemic burden in stable coronary artery disease

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.

PDF HTML

Progress in diagnosis and treatment of delayed movement disorder

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.

PDF HTML

A case of unruptured tectal located AVM presenting with obstructive hydrocephalus

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.

PDF HTML

Granulocytic sarcoma with unusual localizations (breast and stomach) without bone marrow involvement after the allogeneic transplantation

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.

PDF HTML

Case of Geotrichum capitatum septicemia successfully resolved by the use of liposomal amphotericin B in a patient with acute myeloid leukemia

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.

PDF HTML

Imaging thumbprint of molecular subtypes of breast cancer

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.

PDF HTML

Resection arthroplasty of the proximal humerus following chondrosarcoma removal and reconstructive failure: A case report with 22 year follow-up

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.

PDF HTML

Young pregnant woman with hyperemesis gravidarum and cognitive alterations

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.

PDF HTML

Complete anterior capsule phimosis after routine cataract surgery

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.

PDF HTML

Bony deformities in a child with untreated osteogenesis imperfecta type III

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.

PDF HTML

Hematometrocolpos in chronic vulvovaginal GVHD

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.

PDF HTML

Perineural spread of melanoma to the central nervous system

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.

PDF HTML

Per oral endoscopic myotomy (POEM) in a COVID-19 patient

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.

PDF HTML

Impact of the COVID-19 declaration of the state of emergency on weekly trends in the care of asthma and COPD in Japan: A retrospective and descriptive study

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.

PDF HTML

Unusual inhalation of a tissue piece in an infant

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.

PDF HTML

Non radiographic axial spondyloarthropathy in tuberculoid leprosy

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.

PDF HTML

Renal cell carcinoma with leiomyomatous stroma: A case report and a review of the literature of a provisional entity distinct from conventional renal cell carcinoma

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.

PDF HTML

Inflammatory cytokines and cell activation markers in HIV and HIV/TB co-infected patients attending AMPATH clinic at MTRH-Eldoret, Kenya

Infection with HIV and TB leads to inflammation. Markers of inflammation include TNF-?, IFN-?, 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-?, IFN-?, CD38, HLA-DR and CD4 cell count can be used to predict possible reactivation of latent TB to disease in HIV patients on HAART.

PDF HTML

Right circumflex aorta: An extremely rare aortic arch anomalies

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.

PDF HTML

Rare case of COVID-19 pneumonia in a neonate

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.

PDF HTML

Carotid angioplasty and stenting-Device related complication: Embolic protection filter-wire retention

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.

PDF HTML

Delayed metastatic melanoma to the pharyngeal tonsil in a Chinese male

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.

PDF HTML

Callus cap over a Küntscher nail: A case report and literature review for heterotrophic ossification

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.

PDF HTML

Acute hepatic porphyria attack following mini gastric bypass surgery

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.

PDF HTML

Reporting of exercise descriptors and variables in resistance training interventions for lower limb tendinopathy: Protocol for a scoping review applying the consensus on exercise reporting template and Toigo and Boutellier framework

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.

PDF HTML

Pachygyria in a Saudi preteen female: A case report and review of literature

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.

PDF HTML

May-Thurner syndrome: An uncommon vascular disorder

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.

PDF HTML

Amniotic band sequence

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.

PDF HTML

Pemetrexed-cisplatin combined with antiangiogenesis drug in recurrent and metastatic cervical carcinoma: A case report and literature review

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.

PDF HTML

Brachial plexopathy due to subclavian artery pseudoaneurysm secondary to comminuted clavicle shaft fracture: A case report

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.

PDF HTML

A classical case of recurrent respiratory papillomatosis in an adult

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.

PDF HTML

A neonate with acquired long QT from placental transfer of medications

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).

PDF HTML

Desminopathy with early cardiac involvement mimicking apical hypertrophic cardiomyopathy: Demonstration by cardiovascular magnetic resonance

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.

PDF HTML

Amidst the chaos of late rheumatoid arthritis with no treatment

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.

PDF HTML

Cretinism: Case report

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.

PDF HTML

Childhood emotional neglect experiences as a risk factor for psychological distress among adolescents in Dar es Salaam, Tanzania: A community-based cross sectional study

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.

PDF HTML

Spontaneous choledoco-enteric fistula formation after bile duct injury due to laparoscopic cholecystectomy: A case report

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.

PDF HTML

Fluctuating RT-PCR CT values: A case series

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.

PDF HTML

Prolonged bronchoscopy in a case of multiple level central airway obstruction: A case report

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.

PDF HTML

Successful sequential extracorporeal multiple organ support therapy in COVID-19 pneumonia: A case report

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.

PDF HTML