Articles

Overt hyperthyroidism during pregnancy is uncommon, occurring in only 0.7% to 0.9% of pregnancies. The grave disease is the most common cause, accounting for 90–95% of cases. It is characterized by low Thyroid Stimulating Hormone (TSH) and Elevated Levels of Free Thyroxine (T4) and Triiodothyronine (T3). Due to the normal changes in a woman’s body during pregnancy and the different levels of thyroid-stimulating hormones in each trimester, overt hyperthyroidism is difficult to diagnose.

A 40-year-old female, previously healthy, started 2 months earlier with skin lesions characterized by blisters of 3 to 4 cm on the trunk and extremities that, when broken, left denuded areas, excoriations, and painful and pruritic meliceric crusts with serohematic secretion: with involvement of the gingival mucosa, palate, and oropharynx.

Screening of fetal chromosomal abnormalities is an essential part of antenatal care. Effective first trimester screening involves PAPP-A (pregnancy associated plasma protein A) and free HCG (human chorionic gonadotropin) levels in the maternal serum along with ultrasound examination. The objective of this study is to investigate whether the measurement of PLGF (Placental Growth Factor) can improve the performance of first trimester combined screening for Trisomy 21, 18 and 13.

The consumption of medicinal herbs has increased in recent years. There is little evidence with regards to their real benefits and a small number of scientific papers about adverse effects. A case of a 55-year-old woman is presented, with recent diagnosis of luminal A de novo metastatic breast cancer. She starts first-line treatment with Ribociclib in combination with letrozole.

A 71 year old male, diabetic; had cough, low-grade fever with significant weight loss. A lesion along the mediastinal surface of the lung was seen. CT guided biopsy showed acute suppurative inflammation. Tuberculosis, Melioidosis, Mould infection, Nocardia & Actinomycosis were in the differential diagnosis and was treated with Doxycycline. However, 2 months later, abdominal discomfort with fever developed and a new necrotic lesion had developed in the right adrenal gland.

Gastric mucormycosis is a rare but an often fatal form of mucormycosis. Immunocompromised patients are at a risk of this form of mucormycosis. This is a case report of a 53 year old liver transplant patient who developed gastric mucormycosis, possibly due to tacrolimus related thrombotic microangiopathy which led to mucosal damage of the lining of the stomach.

Chest Radiography (CXR) is typically the first-line imaging modality used for patients with suspected respiratory tract infections, including COVID-19. CXRs may be normal in early or mild disease. Of patients with COVID-19 requiring hospitalization one study has demonstrated that 69% had an abnormal CXR at the initial time of admission, and 80% had radiographic abnormalities sometime during hospitalization.

A relapsing and remitting illness that may affect any organ system, systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory condition. Autoantibodies and immune complex development are its defining features. The heart is one of the organs that it might impact. In patients with SLE, the immune system's response to dying cells is aberrant. The diagnosis of SLE is made on the basis of distinctive clinical findings in the skin, joints, kidneys, and central nervous system.

A man in his late 70's visited to a hospital with one day history of fever and cough. Eight years before, he underwent a left upper lobectomy due to stage IB lung cancer. He had taken follow-up Computed Tomography (CT) exams annually and no abnormality was detected 9 months earlier. Laboratory data showed elevated C-reactive protein, 9.7 mg/dL and D-dimer, 2.5 g/mL with normal white blood cell counts.

Left atrial thrombi with a hollow core are sometimes detected in patients with Atrial Fibrillation (AF) and Flutter (AFL) by Transesophageal Echocardiography (TEE). In previous studies, this finding at the initial assessment denotes relatively fresh and acute growing thrombus with inner liquefaction. However, its significance during anticoagulation treatment is unknown.

GRID radiotherapy is a form of spatially fractionated radiotherapy that allows delivery of high radiation doses to bulky tumours. A grid splits the beam into multiple beamlets to give a heterogenous dose to the tumour, while stimulating the immune system to improve tumour response through the abscopal effect. However, this has fallen out of favour in recent times due to the presence of more modern techniques.

Traumatic Brain Injury (TBI) is one of the most major causes of disability, especially cognitive problems and mortality in worldwide. Present study aims are the effect of cognitive rehabilitation for improving cognitive function in patients with traumatic brain injury. This study was reviewed by using a search of keywords including Cognitive Rehabilitation, Traumatic Brain Injury (TBI) in google scholar, pubmed, Elsevier databases. Approximately 30 articles were selected that were fully reviewed.

Isolated physeal fractures in the pediatric distal ulna are relatively uncommon. While the skeletally immature patient generally has higher remodeling potential than adults, special considerations should be given to the pediatric wrist. We report the case of a 15-year-old male with an isolated Salter-Harris (SH) type IV distal ulna fracture.

Ischemic stroke is the third cause of mortality in the world even though it decreased over the last decade, it remains a major etiology of a lifelong handicap. In fact, approximately one third of the patients will experience aphasia, a devastating impairment for the patient and his family. The language rehabilitation enable variant degrees of recovery and mild improvement occurs within the first six months but results still less efficient than desired.

Radiomics features are used to identify disease types and predict therapy outcomes. However, how the radiomics features are different among different anatomical structures has never been investigated. Hence, we analyzed the radiomics features of 22 anatomical structures in the head and neck area in CT images. Furthermore, we studied whether CT radiomics can classify anatomical structures of the head and neck using unsupervised machine-learning techniques.

Duplication of the ureter and renal pelvis is one of the most common anomalies of the upper tracts with incidence reported to be approximately 2% [1]. An increased incidence of uretero-renal pathology has been documented with duplication anomalies. Here we present a case report of a 27-year-old married male who presented with a bilateral complete duplex system with ectopic insertion into the prostatic urethra.

A 71-year-old woman with multiple myeloma complaining of sudden onset low back pain, associated with functional impotence of both lower limbs. The clinical examination found paraparesis of the lower limbs. An MRI was performed 72 hours after onset of symptoms. Epiduritis corresponds to extensive or localized inflammation in the epidural space, it can be of infectious, tumoral, inflammatory or traumatic origin, etc.

Open Reduction and Internal Fixation (ORIF) with various implants is one of the most commonly used techniques for management of Mason type III radial head fracture; however on-table reconstruction can also be an option where fractures are not amenable to classical ORIF. We present a case of 35 years female with Mason type III radial head fracture who underwent ex-situ radial head reconstruction and fixation with K-wire.

Pancreatic Lymphoepithelial Cysts (PLECs) are very rare and benign lesions of the pancreas. They are commonly detected incidentally during radiological examinations. Proper diagnosis of Pancreatic Cystic Lesions (PCLs) is very important, and physicians should be aware of the different types of cystic lesions and their characteristics before the treatment choice.

Urinary Bladder Hamartoma (UBH) is one of the rarest entities reported in Urology, with, as far as we know, only fourteen cases reported in the literature. Otherwise, similar in presentation, imaging findings and macroscopic appearance as other bladder lesions, such as urothelial bladder carcinoma, UBH can solely be distinguished by histopathological examination. Therefore, we report an additional case of this rare tumour and provide a brief review of the current literature.

Conventional complete denture is the best treatment for edentulous arches. There is resorbption of bone in both maxilla and mandible. There is more bone resorption in mandible than maxilla, due to which mandibular dentures loose retention and stability. Neutral zone implies that the forces applied by the muscles are in harmony with the denture, therefore providing the denture optimum stability and retention.

Tobacco cigarette contents are associated with inflammatory conditions. To our knowledge, this is the first case reporting of electronic cigarette-induced panuveitis. A 41-year-old gentleman with no known comorbid presented with a two-day history of sudden blurring of vision in the left eye, associated with mild photophobia. He was well, with no similar episodes prior.

Mesonephric Adenocarcinoma (MNA) is a rare malignant tumor to arise from mesonephric remnants occurring in the uterine cervix and, less likely the corpus. Only about 30 cases of MNA arising from uterine corpus had been reported in the literature and its clinical symptoms, treatment method were not known very well. So we reported our case, MNA of uterine corpus, and reviewed clinical symptoms of it.

Recent epidemiological studies have reported that hypercoagulopathy is a well-documented symptom of SARS-CoV-2 infection, particularly in more severe cases requiring admission to the critical care unit. We report here the clinical and imaging features of three patients with SARS-CoV-2 infection who developed acute thrombosis of the abdominal aorta, the superior mesenteric artery and cerebral arteries, respectively.

A 74-year-old white gentleman with a history of colon polyps presented for surveillance colonoscopy. On digital rectal examination he had dark perianal lesions noted. Upon insertion of colonoscope images of perianal lesions and normal appearing anus were taken. Colonoscopy was completed without difficulty and showed normal.

A 52 year old woman having bronchiectasis, presented to us with worsening cough which was productive with profuse, foul smelling sputum of a week's duration. A clinical diagnosis of infective exacerbation of bronchiectasis was made. She was started on antibiotics based on her previous sputum culture sensitivity reports.

As the COVID-19 pandemic continues, the number of patients presenting to dermatology clinics with hair loss is increasing. Little is known about the specifics of telogen effluvium affecting this patient population. We aimed to discover patterns in patient characteristics and clinical course in those with telogen effluvium secondary to COVID-19 infection.

Intramedullary Osteosclerosis (IMOS) is a rare idiopathic dysplasia of the long bones shafts. IMOS remain an un known diagnosis because of its rarity and the absence of specific features. Indeed, the diagnosis of IMOS can be confirmed only after excluding other differential diagnosis of osteosclerotic lesions. We report here a case of IMOS of the tibia shafts, diagnosed in a 53-year-old man.

A standard CBCT image lacks localization accuracy in the complex registration of a moving target. The 4D Cone Beam Computed Tomography (4D CBCT) is a useful tool for treating moveable tumors because it allows us to precisely pinpoint the location of the tumors during treatment and provide a guide during adaptive treatment strategy. This study evaluates the accuracy of 4D CBCT over a wide range of target motion scenarios.

ROHHAD is an acronym for rapid-onset obesity with hypoventilation, hypothalamic, and autonomic dysregulation. It is a rare disorder that presents with rapidly onset obesity with multiorgan disorders during early childhood. There are less than 100 cases reported. In this paper, we aimed to present a case of ROHHAD syndrome with rare neurologic symptoms. We also discuss our treatment regimen for this specific patient.

Bullous hemorrhagic dermatosis is a rare and benign adverse effect happening on days 5-21 of treatment with heparin and Enoxaparin. It can be localized or generalized and occur in places adjacent to and distant from the subcutaneous injection site. It is mostly happening in the extremities, followed by the trunk and abdomen, and is very rare on the head and neck. Our reported case had lesions on the forehead, neck, trunk, abdomen, and extremities.

R.R.M., female, 40 years old, presenting with severe symptoms of Temporomandibular Joint disorder, underwent Head Computed Tomography (CT) during its investigation. It revealed an incidental finding of asymptomatic pedunculated bone lesion of approximately 0,51 x 0,55 mm, originating in the inferior portion of the right Internal Auditory Canal (IAC), adjacent to the cerebellopontine angle.

A 32-year old woman, gravida 1 para 0, was referred to Seoul St. Mary’s Hospital for fetal cardiac mass by ultrasound at 38 weeks of gestation from a local obstetric office. Detailed fetal echocardiogram was performed and the presence of multiple cardiac tumors was observed, suggesting rhabdomyoma. After birth, fetal echocardiography and genetic screening were performed.

Fungal sinusitis, with passage of time, has become one of the common entities among a long list of inflammatory diseases involving mucosa of the sinonasal tract. By definition, AFS is a collection of cellular debris and mucus in result of an allergic response to fungal colonization in sinus mucosa.

A 23 years old lady presented with lower abdominal vague pain and fullness for 6 months. Physical examination revealed a lump in the left lumbar region extending into the pelvis. The upper border was palpable, but the lower limit was not palpable. Computerized tomography of the abdomen revealed a multiloculated cystic lesion with minimal enhancement probably arising from the left adnexa.

Cancer associated thrombosis is well known in patients with cancer. Following proximal DVT, post thrombotic syndrome is prevalent. Our patient with history of colon cancer presented with proximal DVT with extreme swelling of the leg and treated successfully with Angio Jet Zelante DVT catheter, a procedure which is safe and effective.

Endocarditis is an entity witch severity and outcome are time related. Sometimes its presentation is linear, such as the one we present on this image, and the echocardiogram is not needed to do the diagnosis. However sometimes this isn’t possible. With this image we pretend to show some typical findings of objective exam and CT scans, so if this appears on emergency department, endocarditis diagnosis is assumed, and prompt treatment is started in order to achieve a good outcome.

Supplemental over-the-counter high-dose curcumin preparations are in widespread use for inflammatory conditions. We describe a case of a 74-years old male that presented to the emergency department complaining on left thigh pain and spontaneous large hematoma. His medical history was notable for hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, ischemic heart disease, status post renal transplantation, and benign prostatic hyperplasia.

Each year, about 6 million cataract surgeries with Intraocular Lens (IOL) implantation are accomplished; IOL implantation into the human eye during this surgery has been an enormously successful procedure. IOL opacification is a rare condition, it could happen intraoperatively or postoperatively. Up to now, IOL opacifications are described in different IOL materials and designs such as silicone, poly-methyl-methacrylate, hydrophilic acrylic.

Brucellosis is an endemic infection in Iran, affecting different parts of human body. However, less attention has been paid to accidental injuries among rural inhabitants. Here, we report a rare case of Brucella melitensis infection on a left leg wound following a tibia surgery caused by an accident over 13 years. Therefore, in brucellosis endemic countries, Brucella spp. should be considered as one of the possible causes of further infections as accident consequences.

Vasa praevia is an uncommon but very serious condition that is characterized by the presence of vessels belonging to the fetal circulation in the amniotic membranes surrounding the internal cervical os below the fetal presenting part. These vessels are at risk of rupture in active labor, or when the membranes spontaneously or artificially rupture, which can result in an acute fetal exsanguination and death.

Cardiac gunshot wounds, despite being rare, have a high mortality rate, and their proper management and prompt decision-making are critical.Here we present a case of cardiac gunshot woundin a young male who was shot at close range in the left shoulder from behind. The patient admitted at hospital with stable vital signs, but after a while, shortness of breath was begun and pneumothorax was diagnosed.

We present a case report of a middle aged post menopausal female with a huge pelvic mass for last 15 years that was previously misdiagnosed as chronic dermatitis. Based on its uncanny appearance, it was decided to do complete excision of the vulval mass to rule out any soft tissue tumour. The histopathology came out to be a rare benign lesion i.e, angiomyofibroblastoma with the immunohistochemistry report favouring the diagnosis.

Hypertrophic Olivary Degeneration (HOD) is a rare degenerative disease that causes hypertrophy rather than atrophy. The classical presentation of HOD is palatal myoclonus but HOD may also present with tremor, and stiffness in the extremities. In this paper, case report 1 was a man aged 46 years with HOD and Holmes tremor spreading to the head, trunk and bilateral upper and lower extremities after pontine hemorrhage.

A Left Ventricular Pseudoaneurysm (LVP) forms when cardiac rupture is contained by pericardium or scar tissue [1]. Ventricular pseudoaneurysms differ from true aneurysms since they do not contain the endocardium or myocardium. LVPs can result from myocardial infarction, cardiac surgery, infection, or trauma.

Intussusception is the most common cause of bowel obstruction in the children. However, it is rare in the adults, accounting for only 5% of all cases of bowel obstruction. In Adult Intussusception (AI), an underlying pathology can be demonstrated in majority of the cases. Malignancy is the most common cause of colonic intussusception. We present a case of colonic intussusception due to an underlying primary malignancy in a young female.

The limited efficacy of first-line treatment of Posttraumatic Stress Disorder (PTSD) with selective serotonergic reuptake inhibitors commonly leads to the use of multiple medications that still fail to achieve symptomatic remission. VA/DOD guidelines identify trauma-focused psychotherapies as the evidence-based treatment for PTSD, but overall effectiveness is limited by reduced levels of patient engagement.