COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, led to an increase in intensive care admission for massive interstitial pneumonia. Many patients underwent long periods of endotracheal intubation for mechanical ventilation and subsequent tracheostomy. The most common complications related to these maneuvers are known: laryngotracheal granulomas, webs, stenosis and malacia.
Issue 4 (Apr)
Transcatheter tricuspid valve-in-ring (TVIR) implantation using balloon-expandable valve was an alternative technic to high-risk redo surgery for patients with tricuspid valve (TV) ring repair and symptomatic severe tricuspid regurgitation. In this case, we report a case of unsuccessful transfemoral TVIR implantation with a severe paravalvular leak (PVL) treated successfully with Amplatzer vascular plug.
A 79-year-old woman was transferred to our service with a complaint of hematemesis associated with hypotension. There was no history of trauma. She was hemodynamically stable, but developed melena and anemia during hospitalization. She underwent abdominal ultrasound which showed an expansive oval formation in the gastroduodenal transition, determining compression of the intestinal lumen and liquid dilatation of the gastric chamber.
A 47-year old Chinese woman presented with a 2-year history of multiple small flammulated papilloma-liked lesions on her tongue. She has noted an increase of the size and number of lesions within the past month, with significant harsh feeling, but the taste sensation is normal.
We admitted five patients (0.16%) with firearm-related eye injuries during the period from January 01, 2010 to January 01, 2022. All our patients were male. The average age was 33.2 years with extremes between 21 and 55 years. The circumstances of occurrence were dominated by attacks with lead as the main traumatic agent in all our patients.
Neurofibromatosis causes various types of benign or malignant tumors of the central or peripheral nerves and often causes pigmented macules of the skin and sometimes other manifestations. We present a case of 29 years old patient diagnosed by neurofibromatosis manifested by breast lesion, at the beginning, the diagnosis was not clear, but after the anatomopalogist report von Recklinghausen disease was suspected and the patient was having all the criteria to confirm that.
A 90-year old male diagnosed with stage III non-Hodgkin's peripheral T-cell lymphoma under palliative treatment was admitted due to a feeling of food impaction and vomiting. He underwent upper digestive endoscopy which revealed an extensively necrotic esophageal mucosa with complete esophagus obstruction where two impacted pills were seen (Figure 1) and fragmented.
We present a case of a 64-year-old male with a patent foramen ovale who suffered severe complications from a massive air embolism while accessing a tunneled CVC. Air embolism may occur in conjunction with trauma, diving accidents, hemodialysis, cardiopulmonary bypass surgery, neurosurgery, thoracic biopsies, or transpulmonary passage from barotrauma
Adherence to a guideline and evidence-based practice is a crucial factor defining quality of care and more precise on treatment, demands and targets impose challenges. The approach in this direction has been termed precision medicine then involved become precision healthcare where patient preference, patient-oriented, evidence-based care, interprofessional collaboration, and self-management are core elements.
A 68-year-old man presented to the emergency department with a 2-week history of fever, shivering and general malaise. Physical examination was otherwise unremarkable. Laboratory findings showed elevation of C-reactive protein (33 mg/dL), aspartate and alanine aminotransferase (89 and 120 U/L, respectively).
Lipoprotein glomerulopathy is an unusual kidney disease with clinical presentation of proteinuria and renal insuffciency. The diagnosis is based on histological examination, featuring lipoprotein thrombi in glomerular capillaries. We present here an unusual case of lipoprotein glomerulopathy detected during pre-employment checkup. Histopathology examination confirmed the diagnosis, and subsequent genetic test revealed ApoE Kyoto mutation.
Follow-up management of patients with acromegaly after pituitary surgery is performed by biochemical assessment of Growth Hormone (GH) and Insulin-Like Growth Factor-1 (IGF1). There is increasing recognition of patients who show discordance results between GH and IGF1.
Paraplegia due to involvement of a long segment of the spinal cord: A rare presentation of chronic myeloid leukemia in blast crises
Chronic myeloid leukemia is the most common myeloproliferative neoplasm and very rarely presents upfront with involvement of central nervous system. Here we present a peculiar case of a 34 year old male who presented with complaints of rapidly progressive weakness of both the lower limbs of 2 week duration.
Gaucher disease (GD) is a rare autosomal recessive metabolic disorder caused by the deficiency of the enzyme glucocerebrosidase, required for the degradation of glycosphingolipids. This leads to the accumulation of glucosylceramide and glucosylsphingosine in lysosomal macrophages (Gaucher cells).
Papillarycarcinoma thyroid is the prevalent histological subtype of well-differentiated thyroid cancer (WDTC). Patients are treated with thyroidectomy followed by radioactive iodine (RAI) therapy. Follow-up is done with a low-dose whole-body scan (WBS), serum thyroglobulin (sTg), and neck ultrasonography depending upon the stage. Elevated serum sTg despite a negative WBS scan is termed the TENIS.
The majority of eye cancers develop from metastasis of other organs metastasis to the eye. Although it is thought to be quite rare, its frequency has reported to have increased in recent years. Breast cancer in women is more often responsible for intraocular metastases than lung cancer in men.
Assessment of knowledge, atitude and practice towards legalization of abortion among child bearing age women, in Chichu Dilla Zuria Woreda, SNNPR Gedeo zone, South Ethiopia, 2020
Septic abortion is the most common cause of maternal morbidity and mortality, especially in developing countries, even if safe methods are available. This research is expected to solve the problems of women's knowledge, attitudes and practice, and add some knowledge to make better use of services.
Explaining urban-rural disparity in prevalence of stunting and wealth related inequality in Ethiopia: A decomposition analysis
Stunting is a global health concern. It has consequences on child survival, growth, and development. The absolute level of stunting has been decreasing in Ethiopia although the prevalence is still high varying across socioeconomic determinants and geographical location with a larger burden among the disadvantaged group and the rural areas.
5-alpha-Reductase deficiency is one of the causes involving disorders of sex development 46, XY. Mutations in SRD5A2 gene lead to a wide clinical manifestation, sometimes not giving a clear outlook for a clinical diagnosis, making molecular diagnosis an important diagnostic pillar of these conditions. Here, we show the importance of molecular and pedigree analysis for diagnosis and adequate genetic counseling.
Two depressed young patients with angina pectoris induced by microvascular dysfunction detected by stress perfusion cardiac magnetic resonance
Recent evidence indicates a link between depression and microvascular dysfunction, which may affect therapy options and prognosis. We described two young depressed patients with angina. No obstructive coronary heart disease was detected by computed tomography coronary angiography or invasive coronary angiography. Determined by stress perfusion cardiac MRI, these two patients were diagnosed with microvascular angina.
30-year-old female with a history of papillary thyroid carcinoma, status post thyroidectomy and radioactive iodine ablation presented for a routine follow up visit for management of hypothyroidism. Patient was noted to have a congenital branchial cleft cyst in the right superolateral cervical area.
Acute Lymphoblastic Leukemia (ALL) is the most common cancer of childhood. While some 5 to 8% of ALL cases will have neurological involvement at initial presentation, up to 30% of relapses have neurological manifestations. We present the case of a pediatric ALL with meningo-radiculoneuropathy revealing a relapse while on maintenance therapy, mimicking Guillain-BarrÃ© syndrome.
PD-1/PD-L1 inhibitors combined with chemotherapy in the treatment of thymic carcinoma metastasis to the liver
Epithelial neoplasms of the thymus is a relatively rare malignancy. In this report, we present a case of thymic carcinoma of a 68-year-old man with hepatic metastasis, which with the severe hypokalemia, hypoproteinemia, and fatigue of concomitant symptom. After positive symptomatic treatment such as correction of electrolyte disorder, supplementation of albumin and nutritional support, the patient's general condition recovered and improved.
Still a hospital hazard: Varicella-Zoster virus infection in a health-care worker after exposure to Herpes Zoster
Varicella-Zoster Virus (VZV), a highly contagious herpesvirus, remains a hospital hazard and nosocomial transmission of VZV, despite vaccine availability, is well documented. Although World Health Organization (WHO) recommends immunization for all health-care providers, cases of in-hospital VZV transmission are still reported and summarized here, indicating the existence of susceptible individuals.
Knowledge, attitude and practice of contraception among female students of Dilla secondary and preparatory school, Dilla town, Gedeo zone, Ethiopia, 2019
Family planning is recognized not only as an important intervention to improve the health of women and children, but also as a human right. The basis of action in family planning should allow individuals to freely and responsibly adhere to and determine the number and spacing of their children. The use of modern family planning depends on the place of residence and region.
Roth's spots are retinal hemorrhages with white or pale centers, which can be seen in numerous conditions. Ocular disorders have been described in 39.3% of patients with diagnosis of leukemia. Incidences of intraocular manifestations are 7.7% in patients of chronic leukemia. Mechanism of retinal hemorrhages is related to hyperviscosity syndrome caused by leukocytosisor direct infiltration.
Accidental discovery of appendiceal carcinoma in gynecological surgery: A case report and literature review
To introduce the common diagnosis and treatment of appendix cancer. The discovery process and treatment plan of a patient with mucinous adenocarcinoma of appendix accidentally found in gynecological surgery in the Affiliated Hospital of Jining Medical College in May 2021 were summarized.
Superior mesenteric artery thrombosis in a female patient with most probable cause COVID-19 vaccination: Case report
Superior mesenteric artery thrombosis is a rare incident with high mortality rate. Herein we present the case of a 65-year-old woman of Spanish origin who attended the Emergency department two days after COVID-19 vaccination with symptoms and signs of mesenteric ischemia.
Total paralysis of all or near all unilateral cranial nerves indicates Garcin syndrome. Garcin syndrome caused by Rhino-Orbito-Cerebral Mucormycosis (ROCM) complicating with cerebral infarction has been reported rarely. ROCM is an opportunistic fungal infection with high morbidity and mortality rates despite treatment due to acute angioinvasive infections.
Atypical parathyroid adenomas as a rare cause of primary hyperparathyroidism: In an academic institution experience
Primary Hyperparathyroidism (pHPT) is caused by benign and malignant conditions. Most commonly by Typical Adenoma/single gland disease (PA) - this is 80-85% cases of pHPT. Parathyroid hyperplasia or multiple gland disease accounts for 10-15% of cases of PHPT. Atypical Parathyroid Adenoma (APA) and Carcinoma (PC) - very rare conditions - are both responsible for pHPT in approximately 0,5 - 1,5% of cases.
Evaluating plasma assisted noninvasive surgery (PANIS) as a new method for pterygium removal; a clinical case series
A clinical case series study was carried out in 6 patients. Six eyes with grade 2 or 3 of primary pterygium were operated. The pterygium head was detached from the corneal surface. Then, the free conjunctival edges were attached near the limbus using the plasma spots [generated by Plexr device (GMV, Rocca Priora, RM, Italy)].
The use of 18F-2-Fluoro-2-Desoxy-D-Glucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) has become an integral part of patient management in many lymphoid malignancies. However, the diagnostic accuracy of FDG-PET/CT in some indolent lymphoid malignancies with commonly low FDG-avidity, including Chronic Lymphocytic Leukaemia (CLL) can still be challenging in clinical routine.
Assisted reproductive cycles have been associated with deficient luteal phase which was extensively researched. Progestogens can be given IM, SC, orally, rectally, transdermal or vaginally. Although progesterone supplementation represents the most preferable drugs for luteal phase support in fresh cycles, there is still debate which is the best time, dose and route for administration.
The effect of shexiang tongxin dropping pill on coronary microvascular dysfunction assessed by stress perfusion cardiac magnetic resonance: A case report
Although Coronary Microvascular Dysfunction (CMVD) is clinically prevalent, its therapeutic efficacy data remains uncertain. We report a 62-year-old female CMVD patients whose condition improved after Shexiang Tongxin dropping pill treatment, as confirmed by stress perfusion cardiac MRI. This case emphasizes that Shexiang Tongxin dropping pill is typically effective in the treatment of CMVD.
Non-Hodgkin's lymphomas in HIV patients are generally B-cell lymphomas. The coexistence of HIV-1 infection with Cutaneous T-Cell Lymphoma (CTCL) is an infrequent occurrence, particularly in the classic variety of Mycosis Fungoides (MF). This case demonstrates that in an HIV-1 positive patient, CTCL can manifest as MF with features comparable to those reported in the general population.
Bilateral wallerian degeneration of middle cerebellar peduncles following unilateral pontine infarction
Bilateral lesions of medial cerebellar peduncles are rare and are most frequently observed in acute cerebral infarction due to large-artery atherosclerosis, wallerian degeneration, neurodegenerative diseases (i.e. multiple system atrophy), inflammatory diseases (i.e. neuromyelitis optica, acute demyelinating encephalomyelitis), toxic encephalopathies (i.e. heroin abuse) and primary central nervous system lymphomas.
Horizontal root fractures involve cementum, dentin and pulp tissues, comprising between 0.5 and 7% of trauma cases that affect the permanent dentition. This paper aimed to report a case of horizontal root fracture, without immediate care, resulting from a car accident. Patient presented tooth 11 with darkening, coronary fracture and mobility grade two, in addition to negative responses to cold sensitivity tests and vertical and horizontal percussion tests.
Relationship between nutritional status and periodontal disease among pregnant women attending Abakpa Nike health center, Enugu, Enugu state, Nigeria
Pregnancy is a period during which one or more offspring develop inside the womb of a woman. It lasts for a period of nine months comprising of three trimesters. Obesity has been proven to have an adverse influence on the effect of pregnancy hormones on the periodontal tissue. It produces inflammatory cytokines which aggregates the systemic inflammatory conditions exacerbated by pregnancy hormones which predisposes the periodontuim to periodontal disease.
Could the association of sunitinib and stereotactic ablative radiotherapy lead to abscopal effect in metastatic renal cell carcinoma?
Simultaneous prescription of systemic targeted therapy and Stereotactic Ablative Radiotherapy (SABR) is being used increasingly in various histological types of oligometastatic/oligoprogressive tumors. The underlying mechanisms of the synergistic effect are not yet well known. This case report concerns the interaction between a tyrosine kinase inhibitor and SABR in a patient affected by oligoprogressive metastatic renal cell carcinoma.
Is there disparate provision of biologic therapies for chronic inflammatory conditions in New Zealand?
Biologic therapy is approved for the treatment of rheumatoid arthritis, inflammatory bowel disease and psoriasis in New Zealand. In order to qualify for subsidy for infliximab or adalimumab, treatment must be initiated by a relevant specialist. However, there is a clear role for family practitioners in ensuring that appropriate patients are offered these treatments regardless of ethnicity or levels of social deprivation.
Management of spastic diplegic cerebral palsy and periventricular leukomalacia in a preterm 2-year-old: A case report and review of the literature
Periventricular Leukomalacia (PVL) is the most frequent brain injury to be associated with Cerebral Palsy (CP), especially in preterm infants. Spastic diplegia, a movement disorder commonly seen in CP, is characterized by increased muscle tone and spasticity in the lower extremities. The authors present a case of a 2-year-old child with mild PVL and spastic diplegia CP.
Fibroepithelial of polyp and epidermal inclusion cyst are common benign skin lesions but they arise rarely on nipple. This paper reports rare manifestations of these common lesions. The first patient manifested with huge polypoid mass on nipple that microscopic examination proved fibroepithelial of polyp. The second patient had a smooth papule on her nipple that was diagnosed as Epidermal inclusion cyst.
Osteomyelitis of the hand is uncommon, but if not adequately and promptly treated the detrimentally effects can be devastating. This is particularly important for hand infections caused by anaerobic bacteria that are more frequently recognised in recent years due to improvements in bacterial isolation.