Hashimoto’s thyroiditis is a common autoimmune thyroid disease and often coexists with differentiated thyroid carcinomas, but the link between medullary thyroid carcinoma and Hashimoto’s thyroiditis is not established, so the cases of these diseases occurring simultaneously are rare in the literature. Here we report a case of spindle cell variant of the medullary thyroid carcinoma in underlying Hashimoto’s thyroiditis.
Issue 5 (May)
The trisomy 18 syndrome is a common chromosomal disorder due to the presence of an extra chromosome 18, either complete, mosaic trisomy or partial trisomy 18q. The mosaic trisomy 18 patients’ phenotype was extremely variable, from the absence of dysmorphic features to complete trisomy 18 syndrome.
A 76 year old male presented with a few month history of weight loss, abdominal pain, altered bowel habits and dyspepsia despite being on lansoprazole. He was referred for a Gastroscopy (OGD) under the 2 week wait cancer pathway. OGD showed a smooth pigmented mucosal lesion in the mid oesophagus of unknown aetiology. Laboratory investigations were unremarkable.
A 66-year-old man presented with a history of hypertension, benign prostatic hyperplasia (BPH), and urinary retention and multiple hospitalizations for gross hematuria with clots and clot urinary retention. A prostatic biopsy revealed localized amyloidosis of the seminal vesicles. The patient underwent transurethral resection of the prostate with postoperative clot urinary retention and gross hematuria.
Colonoscopy is an increasingly used diagnostic-therapeutic technique. Although it is a safe procedure, it is not exempt from complications, which are rare but potentially serious. We present the case of a 54-year-old woman who came to the emergency room for abdominal pain after a diagnostic colonoscopy, with anemia in blood test.
In patients with neurofibromatosis type 1 (NF1), cerebral vascular abnormalities can manifest in the form of stenosis, occlusions and aneurysms. In case of arterial obstructions, cerebral perfusion is made possible by the compensation mechanisms of collaterals at different levels.
We present the case, including imaging and histopathology findings, of a 62-year-old lady who presented with a short history of unilateral nasal symptoms and a unilateral nasal mass. Angiography and biopsy showed a vascular architecture akin to an angiofibroma. The tumour was therefore embolised before complete macroscopic surgical resection.
Coronavirus is a pathogen that caused fatal pneumonia cases in Wuhan province of China in December 2019. It was declared as a pandemic in March 2020 by the World Health Organization. The disease is a severe acute respiratory syndrome with multi-organ involvement, including the cardiovascular system, musculoskeletal system, gastrointestinal and neurological system.
Epilepsy is a chronic neurological disease characterized by spontaneous and repeative seizures resulting in abnormal and excessive electrical discharge in cortical neurons. In adults, epilepsy is the most common neurological disease after cerebrovascular diseases. It is important to be careful about the distinctive diagnosis of cases that are similar to clinical similarity but not epileptic feature.
Diarrheal disease forms one of the two major killer diseases in children under five years of age in the developing world. According to World Health Organization (2017), diarrhea related deaths in Nepal accounts for 4.83% of total deaths. Prevalence of diarrhea in children under five in Nepal was reported to be 9.7 % in 2016.
Salivary gland neoplasms are infrequent, with a worldwide annual incidence of 1.0–6.5 cases per 100,000 people. Although pleomorphic adenoma (PA) is the commonest amongst the benign salivary gland tumors and makes half of all salivary gland tumors. Its presence on the lip is quite rare. Here, we present a case of 39 years old gentleman who presented with a complaint of right upper lip gradual swelling for last two years.
Synovial Sarcoma (SS) is a rare type of highly aggressive sarcomatoid neoplasm, that commonly affects the extremities. Primary pulmonary and intra-abdominal SS are extremely rare. However, metastasis to lungs from other sites is far more common. Diagnosis usually depends on histopathological evaluation (HPE) and immunohistochemistry (IHC) analysis
Intestinal obstruction is one of the most common cause for acute abdomen. However redundant cecum whose incidence is 10% causing intestinal obstruction is very rare. This is case of a female who presented to us with the complaints of on and off pain in the abdomen since 2-3 months which aggravated in 15 days.
Schwanomma is a soft tissue tumor derived from Schwann cells of the peripheral nerves system. Schwannoma of the oral and maxillofacial regions primarily appears in soft tissue with tongue being the common site. Schwannoma arising within the bone are rare and commonly involve the mandible compared to maxilla.
The suspicion and diagnosis of urothelial neoplasm are considered a rare commodity in the pediatric age group presenting with hematuria. A 10 years old patient presented to out-patient department with lower pain abdomen and hematuria for 2 months. Routine examination and ultrasonography, followed by urethrocystoscopy, revealed a solitary intravesical lesion in close approximation to the right ureteric orifice.
The spore-forming probiotic Bacillus subtilis DG101 have proven to be an effective adjuvant intervention in the treatment of type 2 diabetes mellitus originally refractory to conventional therapy with metformin. Since the COVID-19 is able to trigger type 1 and type 2 diabetes mellitus which may not respond to medication and / or insulin levels.
Corona Virus 2 (SARS-CoV 2), a recent coronavirus was first discovered in Wuhan, China in December 2019 . Previous coronavirus infections, namely Middle-East Respiratory Syndrome (MERS-CoV ) and SARS-CoV have been reported to damage the respiratory system and cause serious outbreaks . Major complaints are shortness of breath, cough, fever, and diarrhea.
Sinopharm vaccine is in fact an inactivated form of SARS-CoV-2. This vaccine is one of the agents that are frequently utilized worldwide. The most frequent adverse effects of this vaccine have been local irritation, fever, and fatigue. The case is a 34-year-old male without any previous medical conditions who presented with pleuritic chest pain 48 hours after the inoculation of Sinopharm vaccine.
Diabetic peripheral neuropathy (DPN) is a frequent complication of DM. Advanced DPN can lead to major problems such as diabetic foot ulcers. Early identification of DPN cases will benefit early therapy and motivate patients to participate in their care actively. Early diagnosis is critical to improving prognosis and quality of life for people with DPN.
Inflammatory myofibroblastic tumors (IMTs) represent a heterogeneous group of mesenchymal benign neoplastic lesions, with a wide spectrum of histological presentations. IMT´s are most often located at the lungs. In the head and neck region, the most affected areas are the paranasal sinuses and orbits. Laryngeal involvement is extremely rare and occurs more frequently in the true vocal folds.
Ossification of posterior longitudinal ligament (OPLL) and ossification of ligamentum flavum (OLF) are common clinical heterotopic ossification diseases and are the main causes of cervicothoracic spinal stenosis and spinal cord damage. However, the incidence of cervical OPLL combined with thoracic OLF is unclear, this clinical condition is difficult to treat, and the surgical approach is not fully established.
Fibromuscular dysplasia (FMD) is a rare, medium-sized arteriopathy affecting less than 7% of the population. It affects predominantly young women of childbearing age. Stroke caused by fibromuscular dysplasia of the carotid artery is uncommon and reported to range between 0.6% by angiography and 1.1% by autopsy.
Since the beginning of 2020, the COVID-19 pandemic has intensely influenced different clinical specialty lines . Nonetheless, a number of medical practitioners such as different types of oral health care providers are more susceptible to COVID-19 infection than others. The nature of the dental procedures (including the potential of aerosol generation.
Focal segmental glomerulosclerosis (FSGS) is the main glomerular nephropathy secondary to malformative uropathies. The latter can be included in the poly malformative syndromes in the pediatric population. However, other glomerular impairments may rarely be associated with some polymalformative syndromes as reported in this rare case of a minimal change disease (MCD) associated with Rubinstein Taybi syndrome (RSTS).
Neuronal brain activity is assumed to be reflected by blood level oxygenation levels, also known as BOLD signal, measured with fMRI. A scan of the literature points to both oxygen and carbon dioxide blood levels effects on BOLD fMRI. The roles of oxygen (O2; hypoxia/hypoxemia, hyperoxia) and carbon dioxide (CO2; hypocapnia, hypercapnia) in neuronal activity and BOLD signal are complex and still under investigation.
Early detection of simple steatosis and differentiating it from NASH is an important turning point for evaluation and management. Liver biopsy is the gold standard method, but it is unpractical for many reasons and not accepted by most patients. So, many noninvasive methods have been used including microRNAs and fibrosis score (Fib-4).
One of the most common causes of chronic abdominal pain is ‘Chronic Abdominal Wall Pain, “CAWP”, which frequently goes undiagnosed. CAWP accounts for 10-30% of patients in surgical, gynecological, and gastrointestinal clinics who have a primary complaint of persistent abdominal pain. CAWP, on the other hand, may be treated quickly and efficiently using a neuro intervention approach.
People living with HIV aged 50 years and over (P50+) represent a growing population in HIV care units in Cameroon. The objective of this study was to determine the epidemiological profile of this population in order to better target their management in HIV care units in Cameroon. It was found that the prevalence of P50+ was 13.3% and the median age was 58 [52-61] years.
Accidental infection by Trypanosoma cruzi (T. cruzi) usually occurs through accident with a sharp instrument during handling of infected animals in research laboratories. This case report describes the evolution of a case of accidentally acquired acute Chagas disease (CD). A 46-year-old female with suspicious symptoms of acute CD received medical care after reported a sharp puncture accident, during a laboratory procedure with an animal contaminated with T. cruzi.
Typical spinal tuberculosis affects the continuous vertebral levels and causes narrowing of the adjacent disc space and bone destruction. However, atypical form of spinal tuberculosis is difficult to distinguish from malignancy, leading to misdiagnosis and delay in treatment. Tuberculous spondylitis is a curable disease if permanent neurologic damage were avoided by early diagnosis and prompt treatment.
Uncommon neurological diseases make for roughly half of all rare diseases. As one of the key players in the diagnostic process, neurologists require guidelines on the types of screening tests that can be done. In this sense, biomarker research has been very active. By minimizing the chance of misdiagnosis and improper therapy, diagnostic biomarkers may help reduce the risk of disease progression.
Pseudoexfoliation syndrome (PEX) is a systemic disorder of the extracellular matrix that presents primarily via its characteristic ocular manifestations. Typically, white fibrillary residue on the anterior lens capsule and pupillary margin is observed, as are pupillary transillumination defects and pigmentation of the trabecular meshwork. Zonular weakness can be attributed to the deposition of pseudoexfoliative material on the zonular fibers and ciliary processes
Toxic epidermal necrolysis (TEN) is a rare but serious dermatological emergency characterized by diffuse exfoliation of the skin and mucous membranes, the epidermal loss is due to massive keratinocyte apoptosis and/or necroptosis. TEN is often caused by a drug mediating a specific TCR?HLA interaction via the (pro)hapten, Frequently, the eyes and mucous membranes are affected.
The patient is 42 years of age, female presenting to the COPD department with acute pneumonia and shortness of breath. She had a history of granulomatous tubular formation (tuberculosis) in the lungs 10 years back. Then she has admitted in a hospital. After CT scan of the chest with contrast, the impression was, suggestive of bilateral pulmonary inflammatory lesions and left sided pleural effusion with thickening.
It is known that mRNA vaccines against COVID-19 infection are effective in reducing symptoms, mortality and hospitalization of the patients suffering from COVID-19. In fact, these can cause some complications, as fever, headache, dizziness and, rarely, can induce some cardiac involvement, such as the inflammatory reaction of myocardium and/or pericardium.
Oral health is a fundamental right for the individual regardless of age or living environment. Given the repercussions that the alteration of oral health could make in the daily life of an individual. It was a question in this work of determining the oral state of the patients of the dental unit in the District hospital of Mbanga.
Apert syndrome is autosomal dominant disease characterized by multiple craniofacial and limb deformities like syndactyly of feet and hands. There are many factors that challenging for anesthesiologists. In our case, a patient who has Apert syndrome came for syndactyly operation. We aim to highlight anesthetic considerations for Apert syndrome and how to maintain anesthesia during the operation.
In this case report, we present a patient with a low velocity fall resulting in thoracoabdominal blunt trauma made occult by the absence of reported history or external physical signs and symptoms. Delayed grade 3 renal laceration and concomitant grade 2 hepatic laceration was the result in this patient that was being treated for septicemia in the setting of urinary tract infection.
Craniofacial clefts, estimated to be between 1.4 and 4.9 per 100,000 live births, are extremely rare congenital malformations. Apart from functional, psychosocial, and aesthetic effects on a patient’s life, these anomalies pose a great challenge to anesthesiologists in managing the airway of patients. We here describe the case report of successful management of Tessier cleft with left encephalocele.
A 71 year old man presented with a 24 hour history of a pruritic rash on his bilateral lower extremities, petechiae and purpura. 3 days prior he saw an Ophthalmologist for eye dryness and pain. He was prescribed eye drops and Meloxicam. After taking Meloxicam, he developed petechiae and purpura in both lower extremities prompting him to seek medical care.
The malignant pleural mesothelioma (MPM) originates from the mesothelial tissue of the pleura and is associated with exposure to asbestos in majority of cases. Genetic susceptibility and potential synergy with an infection with the Simian Virus 40 are discussed for the pathogenesis of MPM.
A 54-year-old myopic female presented with sudden flashes/floaters in her left eye. Visual acuity was 20/20 and 20/80 in the right and left eye, respectively. Dilated exam of the left eye revealed posterior vitreous detachment (PVD), a retinal tear at 10 o’clock with an actively-bleeding bridging vessel, and a mild vitreous hemorrhage (VH).
Sinonasal melanoma is a rare type of melanoma that originates from the mucous membranes of the nasal and paranasal sinuses. It has a poor prognosis with an estimated 5-year overall survival rate of 10-30%. The most common locations of metastasis include lymph nodes, liver and lungs. Currently, there are several therapeutic options for advanced mucosal melanoma.
Ewing sarcoma (ES) and peripheral primitive neuroectodermal tumor (PNET) comprise the same spectrum of neoplastic diseases known as the Ewing sarcoma family of tumors (EFT). Ewing sarcoma is the most common bone sarcoma typically arising from bone and is one of the most common pediatric solid tumors. It mostly affects the bones of the lower parts of the body.
Classical bladder exstrophy results from a defective lower abdominal wall with open bladder and urethra, and anteriorly opened bony pelvis. Families with low socioeconomic status, lack of education and limited access to health care in developing countries often neglect treatment of such cases.
A six-year-old Brazilian boy was born to non-consanguineous and healthy parents at 40 weeks of gestation via cesarean delivery. The family history is unremarkable. He had diagnosis of hydrocephalus since prenatal period and the treatment was the placement of a shunt at the first week of life.
Endoscopic Retrograde Cholangiopancreatography (ERCP) leading to arterial vascular complication is exceedingly rare. This case report describes a life threatening hemobilia, from a pseudoaneurysm of the pancreaticoduodenal artery, which occurred post ERCP. The pseudoaneurysm was diagnosed by selective angiography of the superior mesenteric artery, and successfully treated with polyvinyl alcohol particle embolization.