Articles

Volume-3, 2022
Issue 3 (Mar)



Pleural plaques

A 55-year-old male, with past history of COPD, presented with progressive shortness of breath of five days duration, associated with cough and increased sputum production. He had a 30 pack year smoking history and worked as a clerk in a plumbing store for two decades.

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Necrotizing fasciitis of the neck: A rare diagnostic emergency

A 76-year-old male, with no prior medical history, was referred to our hospital due to odynophagia and fever with 3 days, sudden worsening with dyspnea, drooling, edema and anterior neck pain. Physical examination revealed tachypnea, trismus, halitosis, bulging of the pharyngeal lateral walls and salivary stasis.

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Anxiety as neuropsychological symptom of aphasia

Aphasia causes a significant limitation on the person who suffers it since communication is essential for the human being. Among the behavioural changes observed in people with aphasia, we can highlight impulsive responses, rejection and states of intense anxiety.

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A case report and review of the literature on Von Recklinghausen’s disease complicated with cervicofacial plexiform neurofibromas

Neurofibromatosis type I, also known as Von Recklinghausen disease, is an autosomal dominant genodermatosis caused by a mutation in the NF1 gene on chromosome 17q11.2. It is characterized by a wide range of clinical signs and symptoms comprising macules of café-au-lait and tumours of the nerve sheath. Neurofibromas make up 90% of all instances and plexiform tumors are less common.

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Intraosseous hydatid cyst

Hydatidosis is a parasitic disease caused by Echinococcus granulosus or echinococcal tænia, preferentially localized in the lung (20 to 30%) and in the liver (60 to 70%). Intraosseous localization is extremely rare. Imaging features takes a very important place for the diagnosis and therapeutic management such as ultrasound, CT and MRI.

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Rare case of Marchiafava Bignami Disease (MBD)

We report a case of a 45-year-old patient with a history of severe alcoholism who presented to the emergency department an impaired unconscious and weakness with upper and lower limbs. The patient was referred to our department for an MRI investigation. MRI showed abnormalities signal in the corpus callosum.

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“Milking” the way to diagnosis

A 43-year-old non-smoker man presented to the emergency department with exertional dyspnoea and left pleuritic pain for 3 days. He denied fever or cough. He had history of pulmonary embolism, deep venous thrombosis and multiple opportunistic infections. At presentation, his oxygen saturation was 94% with venturi mask at 31% and lung auscultation showed basal crackles.

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Numerous opium packets retention in the stomach

Body packers are smugglers who swallow packets of illicit drugs as a trick of transporting illegal drugs. The main medical hazards for a body packer are the potential possibility of acute drug poisoning due to torn packets, gastrointestinal tract obstruction, and perforation. Here, we report a 36-year-old male who presented to the Emergency Department (ED) with abdominal pain, nausea.

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Unusual cause of dyspnea and hemoptysis in a healthy female

Rare congenital malformation can lead to the aberrant communication between systemic arterial circulation with pulmonary venous circulation which can range from sequestration to arteriovenous fistulas. We describe a 24 year old female with no significant medical history presenting with dyspnea and hemoptysis.

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Anton syndrome due to bilateral posterior cerebral artery stroke with polyneuropathy in a patient with uncontrolled diabetes mellitus

Anton syndrome comprises of visual loss from cortical damage with patients not perceiving their own blindness in the absence of psychiatric illness or underlying cognitive impairment. Most commonly it results from bilateral posterior cerebral artery stroke. In 1920, Meyer first reported occipital lobe infarction and postulated compression of branches of the posterior cerebral artery as the causal factor for Anton syndrome.

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Congenital CMV induced neonatal cholestasis: A case report

Cholestatic jaundice in the neonatal period becomes difficult to diagnose because of complex and diverse etiology. The Index case was severe IUGR (intrauterine growth restriction), with a maternal history of infection and leaking per vaginum. The baby cried immediately at birth but was very low birth weight and short for gestation. Soon after birth, the baby developed respiratory distress and had poor activity.

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Correlation analysis of TCM syndrome characteristics and high risk factors of patients with colorectal polyps in Shenzhen: A case retrospective study

To analyze the characteristics of Traditional Chinese Medicine (TCM) asthenia- and sthenia-syndrome and its correlation with high-risk factors in patients with colorectal polyps in Shenzhen through case retrospective study. 296 eligible patients hospitalized were collected in the Department of TCM in People’s Hospital of Shenzhen Baoan District from January 2016 to June 2021, and diagnosed with intestinal polyps.

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Appendicitis in a drain-site hernia

A 73 year old woman underwent a Hartmann’s procedure for stricturing ulcerative colitis of the sigmoid colon. Following the procedure, she developed a tender, ruborous lump in the right lower quadrant, at the site of a recently removed silicone (Blake) abdominal drain. Computed tomographic images revealed herniation of the vermiform appendix in to the tract created by the abdominal drain.

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Spiderweb omentum – A previously unknown surgical finding in ovarian cancer

Carcinoma of the ovaries is one of the most common gynecological malignancies and also a leading cause of death. Most ovarian cancers are generally high-grade serous carcinomas and present at an advanced stage (IIIC) in a majority of patients. The response of chemotherapy in patients is variable and the surgical finding of the state of omentum following chemotherapy has not been described specifically in literature.

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Analysis of clinical characteristics of subacute combined degeneration on three cases of delayed diagnosis

Subacute Combined Degeneration (SCD) is a kind of neurodegenerative diseases which is easy to be misdiagnosed because of some promiscuous symptoms and atypical laboratory test results. The prognosis would be poor if patients had clinical symptoms of myelopathy for a long time. Therefore, doctors should combine pre-existing conditions, clinical symptoms and correlated laboratory examinations to make definite diagnosis quickly and accurately.

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Severe lymphedema mass of the right forearm

Lymphedema can be divided into primary and secondary lymphedema depending on the underlying cause. It is a common instance often seen after breast surgery with resulting lymphedema of the adjacent upper extremity. Here we present an astonishing case of 56 year old women who presented with a massive lymphedema mass in the right forearm.

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Role of magnetic resonance imaging in the pre?surgical planning of perianal hidradenitis suppurativa, complicated by anal fistulae: A case report and review of the literature

Hidradenitis Suppurativa (HS) is a chronic inflammatory disease of the skin starting from the apocrine glands and mainly involving the axilla, perineum and perianal area. It is clinically defined by the onset of painful subcutaneous nodularities, associated with signs of local inflammation, whose progression proceeds towards the definition of true subcutaneous abscess collections from which fistulous pathways branch off.

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A rare bird spotted: Inferior vena cava-calyceal fistula on pelvic kidney following on iatrogenic injury during a retrograde intrarenal surgery

We report the case of an 18-year old woman presenting an inferior vena cava-calyceal fistula on a pelvic kidney revealed by chronic pelvic pain and recurrent pyelonephritis 6 months following an iatrogenic renal injury during an ureterscopy for renal stone. Retrograde ureteropyelography imaging showed a fistula between the upper calix and the inferior vena cava.

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Roseomonas gilardii bacteremia: A case report and literature review

Bacteremia is a known complication of long-term central venous catheters and one of the most common reasons for removal. Usually, the infection happens after contamination from the skin during handling and rarely from the environmental organism. Roseomonas gilardii is a non-fermentative, oxidative Gram-negative coccobacillus.

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A case of accidental dental prosthesis ingestion

sixty years old patient was admitted to our intensive rehabilitation department after a right nucleo-capsular hemorrhagic stroke. He was affected by hypertension, paroxysmal atrial fibrillation, recent infective pneumonia. The day after admission missing of upper fixed dental prosthesis was noticed during neurological evaluation.

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Thoracoscopic removal of a posterior mediastinal parathyroid adenoma

Ectopic Parathyroid Adenomas (EPA) can occur in many anatomical locations and the most frequent one was the mediastinum region. Traditionally, the adenoma resection has been performed through conventional thoracotomy or sternotomy. Recently, a few cases of thoracoscopic excision of mediastinal adenoma were reported.

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Unclassified testicular sex cord-stromal tumors in children

We report a case of 12-year-old boy diagnosed with an unclassified sex cord stromal testicular tumor after a mild testicular trauma and the unclear ultrasound finding of a testicular mass. Physical examination was significant for a mass in the right testis. Scrotal magnetic resonance revealed an 8 millimeters nodular lesion suggestive of a Leydig cell tumor. Tumor markers were negative.

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Analysis of characteristics of workers with occupational benzene poisoning in Jiangsu province, 2006-2018

To investigate the characteristics of workers with occupational benzene poisoning in Jiangsu Province during 2006-2018, find out the susceptible population of occupational benzene poisoning and provide some evidence for establishing some exposure standards for workers. Questionnaire is the tool that we adopt to collect basic information of workers. Benzene detector is applied to detect the concentration of benzene in the working environments.

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A case of Mounier-Kuhn syndrome in a geriatric patient

Mounier-Kuhn syndrome, or tracheobronchomegaly, is a rare clinical and radiologic condition characterized by marked tracheobronchial dilation and recurrent lower respiratory tract infections. The syndrome was first described by Mounier-Kuhn in 1932, and few cases have been reported in the medical literature.

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Iatrogenic aortocaval shunt treated by stent graft placement into the inferior vena cava

Fifty six year old male sustained an injury to the abdominal aorta during his 1992 lumbar disc surgery with subsequent aortocaval shunt formation. In order to close the shunt, his abdominal aorta and both common iliac arteries were ligated and bilateral aortoiliac bypass was implanted. Postoperatively the patient remained asymptomatic for several years.

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Increased skin autofluorescence of advanced glycation end-products (AGEs) in Tunisian hemodialysis patients with heart failure

Cardiovascular disease (CVD) is the main reason for morbidity and mortality of patients in hemodialyis. Skin autofluorescence (SAF), a noninvasive measurement method, reflects tissue accumulation of advanced glycation end products (AGEs) that has been implicated in CVD as a strong marker. The aim of this study was to evaluate SAF profile in hemodialysis patients and to assess the association between SAF and heart failure.

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Remodelled multiple linear regression equation for stent size calculations of left anterior descending artery (LAD-proximal) dimensions with single vessel disease

To validate the Multiple Linear Regression Equation (MLR) of predicted dimensions of left anterior descending coronary artery (LAD-o, p) and left circumflex artery (LCx-o, p) by remodelling the equation based on the percentage of stenosis present in the artery segments. This helped us to go forward with an objective to explore the possibility of explaining the relationship with a MLR formula.

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Psychological effects of burnout among health workers

Stress and burnout among human service professionals have been considered by researchers as an endemic affecting the quality-of-service delivery within the profession. A cross-sectional survey research method through a quantitative approach was used in exploring the psychological effects of burnout among health professionals.

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Twin-Twin Transfusion Syndrome (TTTS) in dichorionic-diamnionic twin pregnancy: A case report

Twin-to-Twin Transfusion Syndrome (TTTS) is a serious complication of twin pregnancy, which develops in approximately 10 to 15 percent of monochorionic twin pregnancies while it is very rare in dichorionic pregnancies. At present, fetal laser surgery has become the preferred treatment for stage II to IV TTTS. It has been reported that fetal laser therapy after early diagnosis of TTTS can improve neonatal outcome.

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Acute motor weakness of lower extremity after a novel balloon-inflatable catheter for percutaneous epidural adhesiolysis and decompression: A case report

As our population ages and the rate of spine surgery continues to rise, the use of epidural lysis of adhesions has emerged as a popular treatment for spinal stenosis and disc herniation. Percutaneous Epidural Adhesiolysis (PEA) causes pain by preventing the release of increased spinal nerve movement and nerve sensitivity due to nerve compression.

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Full mouth rehabilitation with immediate loading implants

Implant-supported fixed prosthodontics are successful treatment modalities that can be used for full mouth rehabilitation. According to the patient’s wishes, great concern was given to the esthetic and function. The purpose of this study is to report the clinical outcomes of full-mouth rehabilitation using flapless implant placement and immediate loading prosthesis in patients.

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A rare coexistence of ankylosing spondylitis and SCD: Pitfalls and challenges during THA

The co-existence of Ankylosing Spondylitis (AS) and Sickle Cell Disease (SCD) is extremely rare, and the case of such a patient undergoing Total Hip Arthroplasty (THA) has never been reported. We present a case report of a 39-year-old male with co-existing AS and SCD who underwent staged bilateral THA with good clinical and radiographic outcomes at 5 years follow-up.

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The SARS-CoV-2 manifestations within the oral cavity

The COVID-19 pandemic that began on 31 December 2019 is considered as the world’s most deadly infectious disease of the century. COVID-19 is predominantly a respiratory disease, but it can really affect any organ in the body. This capability depends on several factors such as the method that is utilised by the virus for cell entry.

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Trastuzumab-related sarcoidosis in patient with breast adenocarcinoma: Case report and review of the literature

Sarcoidosis is a complex systemic granulomatous disease of unknown etiology, characterized by the formation of non-caseous granulomas. It has a biphasic age pattern, with higher incidence in young adults as well as in older people. Trastuzumab is a monoclonal antibody that inhibits the Human Epidermal Growth Factor Receptor (HER2) and there are few reports in the literature.

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Periodontal wound healing: An absolute literature review

Periodontal healing is a complex process requiring coordinated responses involving gingival epithelium and connective tissue, periodontal ligament, cementum and alveolar bone. The understanding of this process is necessary to visualize the outcome of different periodontal procedures which inhibits the further progression of periodontal disease and restore the lost periodontal structures.

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Right ventricular myxoma: An incidental finding on CT chest lung screen

With the rise in screening modalities, incidental findings increase. We present a case of a computed tomography (CT) chest lung cancer screen that resulted in the diagnosis of a right ventricular (RV) myxoma. Echocardiogram and cardiac magnetic resonance imaging (CMR) led to this diagnosis.

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Isolated tricuspid valve disease in antiphospholipid syndrome

We report the case of a 27-year-old male, presenting with dyspnea and chest pain. Radiographic and echocardiographic evaluations revealed bilateral segmental pulmonary embolism, left lower extremity deep vein thrombosis, and isolated tricuspid valve endocarditis. Microbiologic and serologic tests ruled out an infectious etiology and supported a diagnosis of nonbacterial thrombotic endocarditis.

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An unusual case of empyema with septicaemia secondary to eggerthella lenta

Eggerthella lenta is an anaerobic, non-spore-forming, nonmotile, gram-positive bacillus commensal in human intestine. It causes genitourinary tract infection, abscess, and wound infection but can lead to disseminated life-threatening septicemia. Risk factors to develop infection secondary to E. Lenta are immunocompromised and elderly patients with pre-existing co-morbidities such as cancer and diabetes mellitus.

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An uncommon association of L-asparaginase with gastrointestinal vascular congestion

A 71-year-old Chinese female was admitted with nasal symptoms and biopsy of her right nasal mass confirmed extra-nodal Natural Killer/T (NK/T) cell lymphoma. She was commenced on combination chemotherapy regime consisting of Prednisolone, Vincristine and L-asparaginase. Six days after initiation of chemotherapy, she developed an acute onset of generalized 2 abdominal distension with large amount of ascites.

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Indirect inguinal hernia of the urinary bladder

An 83-year-old man was diagnosed with stage IIIA follicular small cleaved cell lymphoma in June 2021. Treatment with rituximab x4 weekly was initiated. Routine CT scanning was obtained in August 2021 to determine response to treatment. A right-sided indirect inguinal hernia was encountered at this time which had not been present upon prior examinations.

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Evaluation of IL-1? and TNF-? level in endometrial flush in patients with recurrent implantation failure

Infertility is defined as the inability to conceive within a year of regular unprotected intercourse affecting one in six couples. The most common causes of infertility are ovulatory dysfunction, male factor infertility, and tubal disease. Unexplained Infertility (UI) and Recurrent Implantation Failure (RIF) are diagnoses based on failed pregnancy attempts with current infertility treatment options.

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Renal cell carcinoma, MiTF/TFE3 family translocation-associated subtype

A 20-year old male presented with right flank pain and hematuria. Initial workup for nephrolithiasis by CT imaging revealed a right renal lower pole mass. Biopsy of the renal mass revealed “clusters of spindle cells and mature fat” with no malignant cells found. Subsequent MRI imaging confirmed the presence of the mass, with concern for an infiltrative process.

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Unmasking hereditary hemochromatosis with CFTR modulator therapy

Cystic Fibrosis (CF) is a genetic condition affecting the ability to excrete chloride, resulting in multi-system organ damage. Liver disease is one co-morbidity that affects 20-40% of people with CF. This case describes a 16-year-old male with CF (F508Del and Q493X mutations) who was started one lexacaftor/tezacaftor/ifacaftortriple CF Transmembrane Regulator (CFTR) modulator therapy.

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Ulcerative colitis and cerebral venous thrombosis: A case report with literature review

Cerebral Venous Thrombosis is a rare complication of Inflammatory Bowel Disease and the pathogenesis underlying its incidence remains enigmatic. We present a case of a child with a history of ulcerative colitis complicated with Cerebral venous thrombosis, and through the search engine ‘Pubmed’ we performed literature review to select similar cases in Pediatric population.

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Chronic venus ulcer pain reduction and full recovery by an autologous blood clot: A case study

Venous Leg Ulcers (VLU) can be associated with severe pain, having a tremendous effect on the ulcer treatment and eventually the patient’s quality of life. Dressing removal and procedures are the main cause for VLU pain, however, background pain is common in chronic wounds, with numerous patients needing analgesics to manage the pain. ActiGraft is an autologous whole blood clot, created by the patient’s own peripheral blood.

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Art and pediatric orthopaedics: Pieter Bruegel and children’s games

Pieter Bruegel’s “The Children’s Games” demonstrates a wide age range of children participating in a known therapeutic and preventative measure --outdoor play. An interpretation of captivating oil-on-wood masterpiece in the context of recent pediatric and pediatric orthopedic literature is given.

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Emphysematous cystitis in a renal transplant recipient

Emphysematous cystitis is a rare entity characterized by gas inside the bladder and in its wall on CT, the gold standard to establish the diagnosis. Few renal transplant recipients have reported few cases, and none of them had associated diabetes over the last ten years. We report the case of a 64-year-old female who had a history of type 2 diabetes mellitus and who presented emphysematous cystitis

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Two cases of anomalous origin of left coronary artery from the pulmonary artery

Coronary artery originating from pulmonary artery is a rare congenital vascular malformation, which generally presents corresponding clinical symptoms with the growth of patients’ age. Coronary CTA and angiography are important methods for diagnosis of this disease, and provide evidence for treatment strategies of patients.

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COVID-19 treatment of pediatric cases: Advantages vs disadvantages

COVID-19 became the most challenging health, economic, and social problem of the entire world from the beginning of 2020. Despite the first insight about COVID-19 in children, more critical involvement of children was observed. However, World Health Organization has not approved any preventive drug or curative antibiotic for COVID-19 infection.

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Is that a berry?

A 55-year-old male, smoker, with no other comorbidities, was referred to our hospital with signs and symptoms of acute left lower limb ischemia, which was not salvageable. He underwent an Above Knee Amputation [AKA] to avoid sepsis and relieve pain. He was discharged on therapeutic dose of Rivaroxaban as he had a past history of unprovoked venous thrombo-embolism.

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Nonpuerperal mastitis associated with prolactinoma: Case report

Nonpuerperal mastitis (NPM) is characterized by chronic nonspecific inflammation, complex pathological types, and unclear causes. Prolactin seems to play an important role in the occurrence and development of NPM. This study reports two cases of mastitis with prolactinoma. While treating mastitis, active treatment of prolactinoma and reduction of prolactin levels have achieved good curative effects.

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HE4 elevated levels correlated with breast cancer progression

Despite several, there were many Breast Cancer (BC)-related deaths around the world. Searching for new analytical tools for BC detection at early stages is widely demanded. We aimed to evaluate Human Epididymal Protein 4 (HE4) clinical value in BC development and progression. HE4 serum levels were determined by ELISA in females with BC (n=120), benign breast disease (n=40) and healthy women (n=40).

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Case report on typhoid fever

An Eight-year-old boy with high grade fever, abdominal pain and vomiting suspected for typhoid and diagnose by serological test (rapid card test), urine analysis and blood culture were also performed. Rapid card test is very helpful for the detection of IgG and IgM antibodies present in the body in 15-30 minutes of time.

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Surgical outcome of septorhinoplasty using spreader graft in patients with nasal obstruction: An institutional study

Nasal obstruction is one of the most common complaints of patients in the ENT OPD. The most common causes of nasal obstruction include septal deviation, turbinate hypertrophy, nasal masses and nasal valve narrowing. The nasal valve pathology is often overlooked and attributed wrongly to other factors such as a deviated septum or hypertrophy of turbinates even at the level of tertiary facility

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Epstein-Barr virus-associated lymphoproliferative disorder of donor origin after heart transplantation

Post-Transplant Lymphoproliferative Disorder (PTLD) represents a group of lymphomas, which may develop after solid organ transplantation and decrease the survival of transplant recipients. The main challenge of treatment is to achieve disease remission by avoiding the risk of allograft rejection. This report describes a successful treatment of PTLD in an adult patient who underwent allogeneic stem cell transplantation as a child and cardiac transplantation as a young adult.

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Autoimmune response and myocarditis associated with COVID-19 vaccination

Recently, there have been numerous reports of suspected myocarditis cases following vaccination against Corona Virus Disease 2019 (COVID-19), although the exact mechanism behind it is still unclear. Shaw KE and colleagues reported four cases of acute myocarditis that were temporally related to the receiving of COVID-19 vaccine based on their Cardiac Magnetic Resonance (CMR) imaging findings.

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Sporadic Burkitt’s lymphoma presenting as intussusceptions in a 12-year-old Chinese boy

Intussusception is a condition in which one segment of bowel telescopes into an adjacent segment. Intussusception is more common among children than adults, in children it is one of the most common acute abdomen. Intussusception is usually seen at five months of life, peaks at four to nine months, and then gradually declines at around 18 months.

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Emphysematous cystitis: A rare cause for urosepsis

An 89 year old female with diabetes mellitus, dyslipidemia, hypertension and ischemic heart disease admitted to orthopedic department following intra-capsular neck of femur fracture. While awaiting Austin Moore Hemiarthroplasty (AMH), she developed lower abdominal pain, fever, features of acute cystitis, hematuria and pneumaturia.

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