Articles

Volume-3, 2022
Issue 10 (Oct)



A rare cause of chronic respiratory failure in adult

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease, characterized by ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy. A 64-year-old man, ex-smoker, with previous history of multiple myeloma and tetralogy of Fallot non surgically corrected. Admitted to the Pulmonology Department for worsening dyspnea in the last week.

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Large pyomyoma after an urgent uterine artery embolization (UAE)

Leiomyomas, or fibroids, are a common, benign tumor of the smooth muscle of the uterus, with a cumulative incidence of 70% in white women and 80% in black women by age 50. Suppurative leiomyoma, also referred to as pyomyoma, is a rare disorder of infarction with subsequent infection of a leiomyoma, which must be distinguished from other degenerative changes.

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Primary signet ring cell carcinoma of the lung: A case report

Signet Ring Cell Carcinoma (SRCC) also known as mucocellular carcinoma, it is a cancer cell with a lot of mucus. Primary lung SRCC is an extremely rare type of lung cancer malignancy. At present, there is no standard treatment scheme for primary pulmonary SRCC at home and abroad. We describe the clinical symptoms of a unique primary lung SRCC and the evaluation of its efficacy after targeted drug therapy.

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Dystrophic breast calcifications in a patient with dermatomyositis

We report the case of a 34-year-old woman with a history of dermatomyositis in its typical form. She was treated by corticosteroids and methotrexate with no further relapses. She also had universalis calcinosis. 24 years later, the patient suffered from breast abscesses. Mammograms showed irregular, bizarre and coarse calcifications involving bilateral breasts. She received antibiotics for the infection.

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Radiographic presentation of a multi-compartmental atypical giant lipoma of the lower extremity

A 61-year-old female with no significant past medical history presented with painless progressive left lower extremity weakness and foot drop resulting in altered gait over the course of two years prior to seeking care. Examination revealed a hypertrophied left lower extremity, steppage gait, and 1 out of 5 strength with left ankle dorsiflexion. Initial x-ray of the affected ankle was unremarkable.

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False occult hepatitis B virus infection with negative HBsAg while positive HBeAg & overt DNA levels: Case report and literature review

Occult Hepatitis B Infection (OBI) is characterized by the detection of Hepatitis B Virus (HBV) DNA in serum (usually HBV DNA <200 IU/ml) or liver but negativity for hepatitis B surface antigen. The diagnosis of OBI is based on the sensitivity of assays used in the detection of HBV DNA and HBsAg. HBsAg assays with inadequate sensitivity or inability to detect HBV S variants.

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The value of preoperative FDG PET/CT in detecting groin metastases in vulvar cancer patients

This retrospective study aimed to evaluate the diagnostic value of preoperative18F-Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in detecting groin Lymph Node (LN) metastases in newly diagnosed vulvar cancer patients. In the period 01.01.2014 to 31.12.2018, we retrospectively collected data by reviewing the medical record of 237 patients with diagnosed vulvar cancer referred to Aarhus University Hospital.

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Metatypical basal cell carcinoma invasion of the central nervous system

Metatypical basal cell carcinoma is a rare skin cancer. Compared to basal cell carcinoma, this tumor type is more aggressive and has higher incidence of metastasis. We present the case of a 45-year-old female with metatypical basal cell carcinoma of the scalp with invasion of the central nervous system.

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Implementation of an e-medical portal system for healthcare services in Calabar

This article is about the implementation of a web-based e-medical patient portal to facilitate the interaction between the hospital, the medical practitioners and the patients. The aim of this study is to develop a guideline that can be used to implement a web-based e-medical portal. An E-medical portal is an information system that provides to individuals the access to their personal health records and many other services related to healthcare.

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Corticospinal tract decussation alteration: A single case of a healthy woman presenting with left fronto-parietal intraparenchimal haemorrhage showing homolateral symptoms and signs

Alterations in crossing CST pathways are rare findings which may cause diagnostic confusion and in some cases pose a real challenge. Some of these patients have a known genetic or congenital syndrome which correlates with CST crossing pattern alterations, but in many others the diagnosis is less intuitive due to the absence of conditions related.

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Cutaneous plasmacytosis in a 30-year-old woman post COVID-19 vaccine

With the continuous spread of COVID-19 pandemic and no effective drugs for its treatment, getting vaccinated is the only effective method to defend against the COVID-19. However, few adverse events related to the vaccination of COVID-19 vaccine have been reported. Here, we report a case of cutaneous plasmacytosis after COVID-19 vaccination.

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Two cases of intracranial infection after percutaneous microballoon compression of trigeminal neuralgia

Trigeminal neuralgia is a common cranial nerve disease. Percutaneous Microballoon Compression (PBC) has a definite therapeutic effect, and postoperative intracranial infection is rarely reported. A total of 1051 patients with trigeminal neuralgia conducted PBC surgery in our hospital from October 2014 to December 2021, and 2 cases reported intracranial infection, which were cured and discharged after active and effective treatment.

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Benign fibroepithelial polyp of ureter masquerading as upper tract urothelial carcinoma: A management conundrum

Upper tract Urothelial Cell Carcinomas (UTUCs) account for only 5–7% of urothelial carcinomas. Of these only 25% are located in the ureter. The imaging characteristics of these tumors can mimic certain benign entities like fibroepithelial polyps. The gold standard treatment for invasive upper tract urothelial carcinomas, regardless of the tumor’s location in the UUT, is Radical Nephroureterectomy (RNU) with excision of a bladder cuff.

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Three cases of eruptive syringoma with dermoscopic features

Syringoma is a benign adnexal neoplasm originating from the intraepidermal eccrine duct. Eruptive Syringoma (ES) is a rare variant that is characterized by skin-colored to reddish-brown and shiny papules. Here we report three cases of ES, one of them initially misdiagnosed as Darier disease. Dermoscopy showed light brown pigment networks and dotted or linear vessels.

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Thrombotic thrombocytopenic purpura a new threat of a savior: A case report

Thrombotic thrombocytopenic purpura (TTP) is a potentially fatal consumptive coagulopathy that requires prompt diagnosis and treatment. It is characterized by microangiopathic hemolytic anemia and thrombocytopenia, with microthrombosis. COVID-19 vaccination is proven to reduce disease morbidity and mortality. Vaccines have been hypothesized to link to certain autoimmune diseases.

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Recurrent stroke associated with brain metastasis due to a cardioembolism secondary to left atrial Sarcoma: Case presentation and review of the literature

Primary cardiac tumours are rare; 75% of primaries are benign mesenchymal, mostly myxomas. Primary sarcomas are the second most frequent type. Only a few hundred primary cardiac sarcomas have been reported, most diagnosed by autopsy. Sarcomas of the intima are polypoid mesenchymal masses anchored to a vessel or the cardiac wall.

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False hypoperfusion detected by RAPID software due to status epilepticus

Automated CT Perfusion (CTP) has become an essential decision-making tool for treatment decision in the extended-time window of acute ischemic stroke. But its interpretation can be challenging. Making a correct diagnosis requires a good clinical examination, in conjunction with neuroimaging. We present a case of an 85-year-old patient who presented a seizure in the emergency room, followed by a left hemiplegia, language impairment and left gaze deviation.

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A rare case of multiple autoimmune syndrome after sars-cov2 infection

Mixed Connective Tissue Disease (MCTD) is a complex clinical entity, which includes features of Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), Systemic Sclerosis (SSc) and Polymyositis/Dermatomyositis (PM/DM), along with the presence of a distinctive antibody, anti-U1-Ribonucleoprotein (RNP). Autoimmune hepatitis is a chronic inflammatory disease of the liver.

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Non-Recurrent Laryngeal Nerve (NRLN) is a rare anatomical anomaly of the RLN

A 34-year young lady with a right-sided euthyroid nodule of 3 x 5 cm size for one year visited our clinic for surgery. FNAC was reported as colloid goiter. The right hemi- thyroidectomy surgery was planned. Intraoperatively while dissecting the right thyroid lobe, we could not find the right recurrent laryngeal nerve in its normal course, but we found a cord white-like structure running transversely & entering the larynx at the level of the cricothyroid muscle.

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A case series assessing relationship between active motions and stereognosis in cerebral palsy

Cerebral Palsy (CP) is an umbrella term used to describe a permanent disability resulting from non-progressive damage to the brain, specifically the corticospinal tract, of a developing fetus or infant. CP is believed to be caused by a malformation of the brain during its development and is a common pediatric disorder with about two to three cases occurring out of every thousand births.

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A case of Helcococcus kunzii infection

Helcococcus is a resident bacteria in human and animal skin. It is a rare opportunistic pathogen in humans. Helcococcus kunzii, which causes mainly skin infection, was first discovered by Collins in 1993 [1]. At present, there are few case reports of infection caused by Helcococcus kunzii. Here, we report a case of Helcococcus kunzii infection admitted to our department, to increase the understanding of its diagnosis and treatment in the clinic.

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The bile duct stenosis by a complete annular pancreas: A rare association

The annular pancreas is a rare congenital anomaly with retained ventral pancreas encircling the duodenum. It can be either complete or incomplete. The annular pancreas may manifest clinically in the neonate, but in the elderly it can mimic a wide range of clinical entities as a duodenal obstruction, rarely as a biliary tract obstruction making the diagnosis difficult.

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Calcific uremic arteriolopathy in a young man on intermittent hemodialysis

A 42‐year‐old man with ESKD who has been on intermittent hemodialysis for 7 years, presented with extremely painful inguinal ulcer and abdominal mass. The lesion was developed 2 weeks after repairing aneurysmal cubital AVF. At first, it was a small and painful red nodule but then its size increased and a large ulcer was developed.

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Perifissural pulmonary nodules in oncology patients – Always benign?

Pulmonary nodules are a frequent finding on chest CT. Many are Perifissural Pulmonary Nodules (PFN), which are shown to be benign on follow-up in lung cancer screening and routine care subjects and represent intrapulmonary lymph nodes. Since a growing number of patients that undergo CT have an oncology history, it is increasingly important to have knowledge on whether metastases can mimic PFN and whether these lesions should be treated with more suspicion in oncology patients.

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Incidence of surgery after gamma knife radiosurgery for parasagittal and parafalcine meningiomas is higher than meningiomas in other locations: A 10-year institutional analysis and review of the literature

Parasagittal and Parafalcine Meningiomas (PSPF) have a higher rate of recurrence, increased risk of postoperative morbidities, and less favorable outcomes after stereotactic radiosurgery compared to other ocations. Herein, we try to find factors associated with treatment failure after radiosurgery in patients with PSPF meningiomas. We retrospectively reviewed records of 104 patients with 130 Gamma Knife® Radiosurgery (GKRS) treatments for individual meningiomas at a single institution.

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Moyamoya disease incidentally discovered in head trauma

Moyamoya disease is a chronic cerebral vascular disease of undetermined origin, characterized by stenosis and progressive occlusion of the distal portion of the internal carotid arteries and the proximal portion of the middle and anterior cerebral arteries with resulting, abnormal vascular network development at the base of the skull, realizing a smoke volute appearance or moyamoya.

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Congenital growth disorder: Silver Russell syndrome - A case report

Silver Russell syndrome is a congenital growth disorder with features of craniofacial dysmorphia and asymmetrical limbs. This case highlights failure to thrive (height and weight are less than -2SD), hemi-hypertrophy of the left side of the body and dysmorphic facial profile in a 13 year old boy. The parents have been counselled regarding etiology of the disease and the child is being treated with growth hormone therapy.

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Small bowel bleeding due to angiodysplasia causing fetal death in utero

One of the known causes of GI bleeding is angiodysplasia, which usually causes bleeding over 70 years old patients. 30-40% of small bowel Angiodysplasia (AD) shows Gastrointestinal (GI) bleeding which occurs chronically and repeatedly. A 25-year-old patient in 27+6 weeks of pregnancy administered to our hospital with os bleeding.

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Could machine learning approach improve diagnosis accuracy for malignancy in imaging examinations? A mini-review

The early diagnosis of malignancy by ultrasound, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) is still limited. Therefore, the diagnostic efficacy could be improved from Machine Learning (ML), which mainly based on deep learning and convolutional neural networks. In this work, we reviewed ML-based imaging examinations ultrasound, CT and MRI could evaluate early diagnosis value of small size tumor.

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Metastatic triple negative breast adenocarcinoma presenting as a fungating chest wall mass

A 60-year-old female with no previous medical history presented with progressive left sided weakness. Examination demonstrated a large, fungating chest wall mass with mucopurulent drainage and necrotic odor. The patient stated this lesion was worsening for multiple years and was associated with a 90-pound weight loss; however, she was hesitant to seek medical care until the onset of weakness.

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CRPS after unicompartmental knee arthroplasty: A case report

A 59-year-old female presented with pain, warmth, erythema, and swelling over the medial aspect of her left knee that began after medial unicompartmental arthroplasty. Exam fulfilled the Budapest criteria for diagnosis of Complex Regional Pain Syndrome (CRPS) type 2. Topical compound cream and physical therapy were prescribed, and symptoms were improved at follow up visit.

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Clinical manifestations of diseases caused by Y.pseudotuberculosis and Y.enterocolitica (Yersinioses)

Yersinioses are typical representatives of zoonotic infectious diseases. Yersinioses are wide spread without clearly delimited endemic territories. Yersinias (except Y.pestis) have neither specific hosts nor specific vectors, they can survive and reproduce in an abiotic environment – soil, rotting plant remains, etc. (which allows some authors to attribute them to sapronoses).

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Unusual pediatric pleural effusions: A case series and a review of the literature

Point-of-care ultrasound is an effective tool for pediatric emergency physicians in addition to the physical examination for respiratory failure and suspected pleural effusion. We present a series of three unusual cases where point-of-care ultrasound was crucial as first diagnostic tool to identify pleural effusion and to allow further therapeutic choices.

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Possible sitafloxacin-induced dysglycemia: Case report

A 93-year-old diabetic patient was prescribed sitafloxacin (100 mg, bid, po) for 8 days to treat a pulmonary infection. Prior to the treatment with sitafloxacin, his blood sugar was well controlled, but during treatment, his blood sugar showed abnormal biphasic dysregulation, with a downward trend in the early stages of treatment (d1-3) and an upward trend in the late stages of treatment.

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Intrabronchial haemorrhage – the bronchoscopist’s nightmare: A case of major haemoptysis due to pulmonary Dieulafoy’s disease

Massive haemoptysis is a term used to describe a large amount of expectorated blood or rapid rate of bleeding (>100 ml blood in 24 h) and is associated with a serious risk of death. However, there is no clear consensus on its definition. In the present we report the case of a 39-year-old male, investigated for haemoptysis, quickly turning bad during diagnostic flexible bronchoscopy due to a rare condition.

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Association of chronic liver disease with resistive index of intra-renal artery

Cirrhosis of the liver is characterized by a profound disarrangement of the parenchyma and intrahepatic circulation, which leads to portal hypertension. Several vascular changes occur in the course of hepatic cirrhosis leading eventually to renal vascular changes with consequent renal function affection. Renal hemodynamic changes with intense intrarenal vasoconstriction begin early in the course of liver disease before changes in the level of serum urea and serum creatinine.

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Mastitis tuberculosis: About an uncommon case report

Mastitis tuberculosis is a very unusual form of extrapulmonary tuberculosis, even in endemic countries. The clinical and imaging features are not specific to this condition, which must be distinguished from other mammary pathologies, especially breast cancer, in order to avoid investigations and treatments that are sometimes mutilating.

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The use of temozolomide in a patient with chronic thrombocytopenia: A case report

Thrombocytopenia is commonly experienced with Temozolomide (TMZ) during treatment for Glioblastoma (GBM). With the increasing prevalence of obesity and associated Non-Alcoholic Steatohepatitis (NASH) worldwide, chronic thrombocytopenia is becoming increasingly common, and necessitates modifications in the standard of care treatment regimen for GBM.

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