Articles

Anomalous Pulmonary venous connection is drainage of one or more pulmonary veins outside of left atrium. Anomalous Pulmonary Venous Connection is most common on Left side left upper pulmonary vein drains directly into left innominate vein to ultimately drain into right atrium. Right side Partial Anomalous venous drainage can be into Superior Vena Cava, Right Atrium, Innominate vein or rarely Inferior Vena Cava.

In this case report, we discuss the presentation, physical examination, imaging studies, and diagnosis of a rare vascular lymphatic malformation in the upper limb of a 3-year old child. Vascular lymphatic malformations are uncommon conditions, which can be misidentified as malignant tumours in children at first glance. The image study is essential to identify them and decide the best treatment strategy in each situation.

A 54-year-old man was admitted to the hematology department for exploration of splenomegaly. The blood count showed an isolated normochromic normocytic anemia (9.9 g/dL). Bone marrow aspiration showed a rich marrow with an estimated 35% plasma cell infiltration made up of dystrophic plasma cells (plasma cells with flamed cytoplasm, centered nuclei, multinuclearity), making the diagnosis of multiple myeloma.

Preconditioning (PC) is a concept now 36 years old, since first described in 1986 by Murry et al in KA Reimer’s laboratory. Over the years a huge number of experiments, reviews and meta- analyses have been produced. Pre- peri- and post conditioning have been described together with direct and remote application. Amazing insights dealing with functional, biochemical, molecular and genomic changes have emerged.

Subungual exostosis is a relatively uncommon, slow-growing benign bone tumor that most often affects the toes of young people and has a significant impact on quality of life. The treatment of which is essentially based on surgical excision with meticulous closure of the wound while avoiding the causes of nail dystrophy.

Warfarin therapy is known to participate in numerous drug-drug interactions that may cause substantial fluctuations in anticoagulation status. Rifampin is a commonly used antibiotic that also possesses the capability to interact with a multitude of medications, including warfarin, due to its strong induction capabilities on the CYP450 system, including CYP2C9, CYP3A4, CYP1A2, and CYP2C19.

Erythroderma is a life-threatening condition which presents with redness, pruritus, erosions and painful fissures. These lesions are much more prone to infection. Atopic dermatitis is a chronic inflammatory condition of the skin characterized by itching, recurrent lesions, family history and lichenification.

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.

Intracerebral hemorrhage is a complication of thrombolytic therapy in stroke patients. Furthermore, Cerebral Amyloid Angiopathy (CAA), which itself can cause hemorrhage, may be a risk factor for thrombolysis-related intracerebral hemorrhage. However, only few data are available on this setting. We describe a case of a thrombolysis-related intracerebral hemorrhage in a patient with a diagnosis of CAA and its radiological features, to help physicians in the decision-making process.

Transient osteoporosis of the hip is a self-limiting condition that is difficult to diagnose. It affects both men and pregnant women. The purpose of this article is to show two clinical cases that underwent two different treatments. Early diagnosis can indeed avoid surgical treatment.

A 27 year old male presented with downward displacement of the left globe and severe enophthalmous. He had a history of severe blunt trauma to the head during a traffic-road accident the previous weeks. Due to intracranial hemorrhage with increased intracranial pressure signs, craniotomy surgery was performed for him.

Tuberculoma is an unusual cause for seizures in pregnancy, which results in diagnostic dilemma due to its intriguing clinical picture mimicking toxemia of pregnancy and brain tumor. A 32 years primigravida presented at 37 weeks of gestation, with rupture of membranes. She gave history of two episodes of generalised tonic clonic convulsions three weeks earlier, which resolved with anticonvulsants.

The upper gastro-intestinal bleed is one of the most common indication for endoscopy. There are various reasons for the same and include gastric or duodenal ulcer, erosive gastritis or duodenitis, esophagitis, mallory weiss tear, gastric malignancy etc. Many prisoner feign to be having hematemesis but their history and clinical presentation does not match with it.

Autism Spectrum Disorder (ASD) is characterized by deficits in communication and social interaction, and restricted, repetitive movements and behavioural patterns. In this case report we would like to describe a worsening symptomatology of a patient affected by ASD following SARS-CoV-2 infection. We have thought that the virus may have affected a child and the caregivers and as so may have caused immune system dysregulation as already described by the scientific literature.

The pelvis and spine X-rays of a 64-year-old female patient complaining of habitual dislocation within in one year after total hip arthroplasty (a). The component angles were in Lewinnek safe zone, and no abnormality were found in femoral offset and leg length (b), which constitutes difficulty to find the truth. The lateral view of spine in standing and sitting positions unveil the hidden etiology of dislocation.

Corona Virus Disease-19 (COVID -19) is still a menacing pandemic, especially in vulnerable patients with co- morbidities as old age, Diabetes Mellitus, immunosuppression and kidney failure on dialysis. Vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) seems to offer protection in these patients by boosting both humoral and cellular immunity.

Cervical cancer is the fourth most common cancer among women worldwide. In Tanzania, it is the leading malignancy in women with 58% of deaths reported annually. Radical hysterectomy is the recommended treatment for early-stage cervical cancer, but this option only became available at Bugando Medical Centre (BMC) in 2014. The purpose of this study is to provide insight into the efficacy of gynecologic oncology surgery at BMC.

A 32-year-old nepalese woman presented with dyspnea and dry cough. She had a non-confirmed diagnosis of pulmonary tuberculosis (TB) and completed 6-months of antibacilar treatment 10 years ago. She had no occupational exposure, smoking habits or familiar history of respiratory diseases. Auscultation revealed bilateral decreased and rude respiratory sounds.

Cerebral Arterial Gas Embolism (CAGE) is a serious condition, which tends to occur as an iatrogenic complication of numerous invasive medical and surgical procedures performed in an esthesia and intensive care. Although air embolism due to right-to-left shunt is a well- known concept, positive pressure ventilation related arterial embolism is a frequently overlooked mechanism.

Hypernatremia is a relatively common electrolyte imbalance in hospitalized patients and is considered an independent predictor for increased mortality. Concomitant sepsis and thromboembolism are also common with severe hypernatremia and management of the fluid therapy is a challenging issue.

We have actually in our unit a 18 months old boy admitted for another episode of pyelonephritis. He was born at full term by vaginal delivery with cephalic presentation and normal Apgar. His weight at birth was 3070 g. His mother a 41-year-old Moroccan healthy women with 3 other normal children, had a poor antennal follow up in a tertiary care center.

Breast cancer is a frequent condition among Spanish women, being the number one in prevalence during 2018, representing 36.2% of all tumors affecting women, being one of the most frequent type of breast cancer the HR+/HER2- type. Endocrine therapy has been the standard treatment of hormone receptor positive/HER2-negative breast cancer.

Malakoplakia is an uncommon granulomatous disease that occurs in immunocompromised individuals. It's thought to be caused by macrophagic bactericidal defect. We report a rare case of breast malakoplakia in a pregnant 35 years-old woman that mimicked malignancy.

This report presents the case of a 20-year-old student girl with no medical history, no usual medications, no known allergies and living in a clean and sanitary environment. The patient was referred to the Emergency Department (ED) with a four week history of non-productive cough associated with right-sided back pain. She denied fever, dyspnea, night sweats, anorexia, or involuntary weight loss.

Renal Artery Stenosis (RAS) occupies a prominent place among the secondary causes of arterial hypertension (HTA), in particular resistant. It is mainly due to atherosclerotic disease, in connection with the aging of the population and the problem of generalized atherosclerosis. The imaging methods most commonly used for the evaluation of renal artery stenosis are echo-Doppler of the renal arteries and abdominal CT angiography.

Chronic diarrhea, juvenile cataracts, and tendon xanthomas, among other neurological and systemic disturbances, characterize Cerebrotendinous xanthomatosis, an autosomal recessive lipid storage disease. We report a 49-year-old Peruvian man, with no relevant family history, who experienced progressive gait disturbance and exhibited cognitive impairment. On examination, he presented cerebellar ataxia, slurred speech, and brisk tendon reflexes, enlarged Achilles's tendons with subcutaneous mass and bilateral cataracts.

Secretory Breast Carcinoma (SBC) is a rare and distinct type of breast cancer which accounts for less than 0.2% of all breast cancers. The modern breast imager should be aware of this rare entity as it can sometimes masquerade as a breast abscess as in the present case. This case underscores the importance of continued imaging follow up.

Ortner Syndrome (OS) is a disorder that presents with hoarseness due to compression of the Left Recurrent Laryngeal Nerve (LRLN) of vascular origin, such as cardiac pathology. We present the case of a 65-year-old patient with a history of double mitral injury after percutaneous mitral valvuloplasty operated 30 years ago, without current follow-up by Cardiology, who attends an ENT clinic due to progressive hoarseness of months of evolution.

Laryngeal leishmaniasis is a rare disease that should be considered in patients presenting with hoarseness or dyspnea having risk factors as immunodeficiency (systemic or local) and previous Leishmania infections. We report an adult patient with history of dysphonia, cough and episodes of nausea and vomiting due to laryngeal leishmaniasis. We explain its diagnosis and management, detailing complementary tests and final treatment.

A 52-year-old male patient was admitted to our emergency department with complaints of chest pain and back pain for one hour. The vital findings of the patient were normal except the blood pressure of between the arms. The right arm was of 170/110 mmHg and the left arm was of 140/90 mmHg. He was active smoker. The physical examination revealed diastolic murmur in the aortic area.

Tympanic Membrane Cholesteatoma (TMC) is a rare pathology of unknown etiology which occurs more frequently in pediatric population, being the presentation in adults exceptional. Resection of the lesion is usually the surgical treatment through a transcanal approach. We report two patients, one adult and one pediatric, presenting TMC with no previous otologic history. We explain diagnosis and management, detailing complementary tests and final treatment.

Acute traumatic maculopathy included a spectrum of disorders following blunt ocular trauma, such as traumatic pigment epitheliopathy, commotio retina, and choroidal rupture. Our patient was a 47-year-old male who came to the emergency department due to blurred vision in his left eye for the past two weeks following blunt ocular trauma. His best-corrected visual acuity was 10/10 in the unaffected right eye (OD) and 7/10 in the left eye.

A systemically healthy 35-year-old female has complained of blurry vision of the Right Eye (RE) over the past week. The best-corrected visual acuity was 6/120 in both eyes. Mild conjunctival injection, fine keratic precipitates, and 1+ cell in the anterior chamber without hypopyon was detected in the RE.

The purpose of this paper is to outline muscle damage and oxidative stress responses to high intensity exercise protocols. The information provided will be important for athletes, coaches, and the general population to provide information related to mechanisms and consequences of high intensity exercise performance.

A 5-year-old female child from a well-monitored, full-term pregnancy with no specific history of ataxia, hypotonia and global developmental delay. Joubert syndrome is an autosomal recessive malformation affecting the cerebellum and brainstem, with a pre- or neonatalon set and with out clear gender predominance. It is a molar malformation of the midbrain and hindbrain.

Takotsubo Cardiomyopathy (TTC) is known as a syndrome of transient and acute left ventricular dysfunction caused by emotional and physiological stressors. Due to a variety of complications in the acute phase, recently, there has been increased attention to TTC. Although an increasing emphasis is put on the value of multimodality imaging in TTC, the role of radionuclide myocardial imaging is rarely mentioned.

A 36-year-old Burmese male was found unresponsive at his place of work with possible seizure-like activity. The patient received naloxone by Emergency Medical Services with no response. Upon ED arrival, the patient was tachycardic, hypertensive, with a Glasgow Coma Score of 3, and sluggishly reactive but equal pupils of 4 mm.

We report the case of posterior mediastinal myxoid liposarcoma with right intra-pleural development operated through right thoracotomy. We observed a significant invasion of a segment of the descending aorta though there was no evidence of tumor infiltration in preoperative imaging. A replacement of the descending thoracic aorta was peroperatively decided in order to perform a complete resection.

Kaposi-Irgang disease is a rare chronic from of cutaneous lupus. We describe a case of 28 years who was admitted for atrophic scars on both cheeks. The diagnosis of systemic lupus with chronic lupus profound was retained based on immunological and biopsy results. She was treated with hydroxychloroquine and referred to plastic surgery for lopfilling.

Urothelial carcinoma of the bladder is common cancer. Despite advances in treatments and the introduction of immune checkpoint inhibitors in recent years, metastatic disease carries a poor prognosis. Fibroblast growth factor receptors (FGFR) family alterations are frequently implicated in the development of papillary urothelial carcinomas. FDA-approved FGFR inhibitors demonstrate good response in patients with locally advanced and metastatic urothelial carcinomas that harbor FGFR mutations.

Ventricular Tachycardia (VT) is a dangerous form of arrhythmia that often warrants immediate treatment. We report here a case of “intraoperative VT” as a result of Electrocardiograph (EKG) artifacts during a spine surgery. Differentiating EKG artifacts from real VT can be challenging for clinicians and we reviewed some practical strategies. Awareness to rule out artifacts is important to avoid unnecessary interventions, especially in the acute care setting of the operating room for anesthesia providers.

Good's Syndrome (GS) is a rare adult-onset combined immunodeficiency characterized by thymoma, hypogammaglobulinaemia and B- cell depletion. Patients with GS are predisposed to recurrent infections. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections have been scarcely reported in patients with GS.

The purpose of the paper is to consider the metabolic mechanisms contributing to high intensity exercise performance, recovery, and fatigue. A further purpose is also to consider the total stress response to exercise by outlining the catecholamine responses to exercise performance. Concentrations of Noradrenaline (NA), Adrenaline (A) and have been found to reach higher values during short duration high intensity performance compared to longer duration low intensity activities.