Primary tracheal tumor is a disease with low morbidity and poor prognosis. Surgical resection is the main treatment. It is difficult to treat tracheal tumors, while involving tracheal reconstruction operations are more complicated. We report a case of tracheal tumor patient. The large tumor was located above the tracheal carina and the opening of the left main bronchus.
Issue 8 (Aug)
Noonan Syndrome (NS) is an autosomal dominant disorder in which parents with Noonan syndrome have a 50% chance of passing the mutation to their children, most commonly due to a mutation in the PTPN11 gene. In a clinical case, we identified a male child who showed clinical features such as short stature, congenital heart disease and a peculiar facial appearance, strongly suspecting Noonan syndrome.
Atypical caudal regression syndrome with lumbar agenesis, hypoplastic sacrum without sacro-iliac joints in the Eastern Democratic Republic of Congo: A case report
Lumbosacral agenesis is a rare and complex malformation characterized by a total or partial absence of the lumbosacral vertebrae. It is often associated with other congenital malformations. Its etiology is poorly understood but factors such as gestational diabetes, genetic abnormalities and environmental factors are incriminated.
Neuroblastoma (NB) and Wilms tumor (WT) are very common tumors of the pediatric patient and can be sometimes difficult to make a differential diagnosis based only on the imaging findings. We present the case of a little patient who presented to our department with an abdominal mass in the left abdominal region, where the lesion presented elements at imaging which led to the diagnosis of a WT in a context of negativity of the urinary catecholamines.
IgG4-Related Lung Disease (IgG4-RLD) is an unusual disease, having various clinical manifestations. Patients may have no respiratory symptoms and no abnormalities shown on chest images. Therefore, the diagnosis is challenging. Here we present an uncommon case of IgG4-RLD with multi-loci nodeson the center of the hilar and review the relevant literature.
Elevated serum Carbohydrate Antigen (CA) 19-9 level in a patient with uncontrolled diabetes mellitus
Around 40-year old male with previously controlled diabetes mellitus type II, presented for right upper quadrant abdominal pain. Workup showed elevation in HbA1c 15% and CA 19-9 of 445 U/ml (reference range <37). CT abdomen with IV contrast was negative for pancreatic tumor. CT chest showed peripheral ground glass infiltrates noted mainly at the right lungâ€™s lower base.
Myocardial Perfusion Imaging (MPI) is a non-invasive modality with proven diagnostic and prognostic utility in coronary artery disease. We present a case of Transthyretin Amyloid Cardiomyopathy (ATTR-CM) where MPI findings were vastly different from Transthoracic Echocardiogram (TTE) and Cardiac Magnetic Resonance Imaging (CMR). A 78-year-old gentleman presented with atypical chest pain to rule out ischemic heart disease.
Severe pulmonary mucorales superinfection in three influenzapatients with and without influenza-associated aspergillosis
Mucormycosisis an opportunistic fungal disease which affects immunocompromised hosts including patients with haematologic malignancies and poorly controlled diabetes mellitus. Mucorales grow invasively and are associated with high mortality even if promptly diagnosed. Viral infection like influenza can cause severe pneumonia and is associated with pulmonary aspergillosis.
Three-dimensional assessment of human enamel surfaces after adhesive resin removal using CLSM - an in vitro study
The aim of this study was to evaluate the effects of three different methods of adhesive resin removal on the enamel structure using a confocal laser scanning microscope (CLSM). Initially, the enamel roughness of 39 extracted molars was determined using CLSM and the surface roughness parameters Sa, Sq and Sz were obtained. Subsequently, self-ligating metal brackets were applied using the composite Transbond XT.
A case series of different courses of methotrexate-associated lymphoproliferative disease with pulmonary involvement
Lymphoproliferative Disorder (LPD) is a complication of Methotrexate (MTX) therapy. Several cases of Methotrexate-Associated Lymphoproliferative Disorder (MTX-LPD) have been reported. However, pulmonary lesions in MTX-LPD are rare. Image findings of MTX-LPD show various patterns. Pneumocystis pneumonia and interstitial pneumonia, which have complex courses, have been reported in MTX-treated patients with lung diseases other than MTX-LPD.
From the standpoint of fundamental physical optics, clinical images and medical cases of a number of human viral diseases are considered under the influence of the environment on a sick organism, namely: Solar-geomagnetic disturbances and modern anthropogenic background. Microwave emission of the terrestrial ionosphere disturbed by flares on the Sun and during periods of magnetic storms was determined to be the agent of such an impact.
Digital communication through COVID: A free NHS app for patients with type 1 diabetes improves accessibility and self-management
Self-management of chronic disease is increasingly being recognised as an essential tool in chronic disease management. During the pandemic, face-to-face diabetes clinics were suspended, and resources were focussed on delivery of urgent care only. A free NHS app was created to virtually deliver information on every aspect of type 1 diabetes management and to promote patient self-management.
The role of â€œsmart-flapâ€ of sternocleidomastoid muscle in cervical spine surgery: A proposal of a new surgical technique
In cervical spine surgery there are known risk of complications such as esophageal fistula and dural tear. Usually the gold standard in treatment is represented by surgery. The sternocleidomastoid flap is the most common used in the revision procedure. In this paper we propose a modified surgical technique of harvesting the SCM flap and we suggest its use as prevention in selected cases.
Biomechanical invasive reconstruction of the distal oblique band of the interosseous membrane with extensor carpi radialis longus in radioulnar instability: A new clinical therapy for athletes
Distal Radioulnar Joint (DRUJ) instability is a pathology without a clear reconstructive procedure. Throughout history, numerous techniques have been described whose objectives have been to increase stability as well as relieve pain. The main stabilizing element is the Triangular Fibrocartilage Complex (TFCC) and, there are also secondary stabilizers among where the Distal Oblique Bundle (DOB) is consistently located.
The impact of psycho-education on health knowledge of depression and adherence to treatment in depressed patients
Depression is a major public health problem associated with increased functional impairment and mortality. In the United States in 2010, the estimated annual direct and indirect medical costs of depression were more than $200 billion. Depression is very common worldwide and its prevalence has increased over time.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated pancytopenia and hypothyroidism are known but rare complications of COVID-19 syndrome that are not well described in literature, particularly when manifested simultaneously. Severe acute respiratory syndrome coronavirus 2 has shown the potential to affect any organ including the hematopoietic and endocrine system
Congenital toxoplasmosis results from vertical transmission of the Toxoplasma gondii parasite from mother to fetus after a primary maternal infection. The risk of fetal contamination is higher the later the term of maternal infection. Conversely, the risk of severe fetal infection decreases with term; third trimester infections are most often asymptomatic at birth.
The patient was a 62-years-old man that known case of hypertension for 15 years and had a history of cerebrovascular accident 10 days ago was admitted to our hospital due to chest pain and dyspnea, after evaluation and workups, coronary angiography revealed an absence of left circumflex artery with right coronary artery dominancy.
Binderâ€™s Syndrome or Maxillonasal dysplasia is an uncommon condition that presents as retrusion of the midface. This varies in severity, ranging from minor involvement of the nose to severe hypoplasia of the maxillary complex. Depending upon the severity, different types of procedures are required. In this paper we present our experience with managing such patients.
Neural tube defects are pathologies of the central nervous system occurring between the 23rd and 27th day of embryonic life. Classified into two groups: cephalic pole anomaly (anencephaly) and spinal pole anomaly (spina bifida), these are uncommon anomalies representing one case per 1000 births, often resulting in therapeutic termination of pregnancy.
Uterovaginal prolapse and concomitant primary vaginal carcinomas are extremely rare. We present a case of 70-year-old woman who had uterovaginal prolapse for 4 years and complained one episode of post-menopausal bleeding. There was a large cystocele, third degree uterovaginal prolapse with large fungating growth confined to the upper and mid vagina.
Airway bleeding during extracorporeal membrane oxygenation treatment of covid-19 pneumonia: A case report
COVID-19 virus disseminates throughout the body but the host response to this infection is variable. Inflammation and coagulation are essential host defense mechanisms that protect from infection. When unregulated these processes can lead to profound end organ injury. Anticoagulation remains a standard for Extracorporeal Membrane Oxygenation (ECMO) support.
Vitiligo is a multifactorial autoimmune disease characterized by depigmentation of the skin and mucous membranes. The etiology and pathogenesis of vitiligo are not yet fully understood. The establishment of suitable vitiligo models will facilitate studies of the pathogenesis and therapeutic treatments of vitiligo.
Emergence of extended-spectrum beta-lactamase CTX-M-27 in Shigella sonnei clinical isolate from croatia
The patient developed bacillary dysentery with frequent stools mixed with blood and mucus and was hospitalized in Sestre Milosrdnice Hospital in Zagreb, Croatia. Shigella sonnei was isolated from the stool specimen. The antibiotic susceptibility testing was performed by disk-diffusion and broth microdilution method.
We present a case of a 70-year-old man with recurrent abdominal pain for one month, which preceded the onset of erythematous tender nodules over bilateral lower limbs. After full history-taking and extensive investigations, he was subsequently found to have chronic pancreatitis with a pancreatic duct stone. Skin biopsy of the nodules showed lobular panniculitis and in the setting of high serum amylase.
Cutaneous sweat gland carcinoma is an extremely rare malignant skin cancer which may arise from the apocrine or eccrine types of sweat glands. It has a high mitotic index and malignant potential and usually occurs in the elderly people, without any gender predilection.
Penetrating neck trauma are defined as injuries deeper to the platysma, and is associated with serious complications because of its high density of vital structure contents. The fast establishment of a secure airway is the first priority of management, especially in patients with laryngotracheal insults that carries high risk of airway compromise.
Mitochondrial neurogastrointestinal encephalomyopathy syndrome mimicking Guillain-Barre syndrome: A case report and literature review
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is rare autosomal recessive multisystem disorder characterized by severe gastrointestinal dysmotility and leads to cachexia, ptosis, external ophthalmoplegia, peripheral neuropathy, and leukoencephalopathy. Due to its complex clinical findings and non-specific symptoms.
A dural arteriovenous fistula (DAVF) is defined as an anastomosis between meningeal arteries and dural venous sinuses or cortical veins. Intracranially, these pathological dural-based shunts account for 10-15% of all intracranial malformations. Complications associated with DAVFs include dural sinus thrombosis, venous hypertension, previous craniotomy, and trauma
Pityriasis rubra pilaris (PRP) is a papulosquamous disorder of unknown aetiology. We report the first case of PRP induced by the Moderna mRNA-1273 COVID-19 vaccine. A 63 year old male presented with a new onset papulosquamous eruption 2 weeks after his second dose of the Moderna COVID-19 vaccine. He underwent a skin biopsy which showed psoriasiform dermatitis but continued to progress despite topical corticosteroid treatment.
Breast cancer is one of the leading malignancies in women worldwide. Early detection of breast cancer could be the best strategy to hold on to cancer and save lives. Circulatory microRNAs are the most dominant method for diagnosis and monitoring cancers. Here in this study, we aimed to see the potential of miR-155 as a diagnostic biomarker for breast cancer early detection.
Extrinsic stain and black hairy tongue need to be considered in the differential diagnosis of discoloration of the tongue. Both are benign conditions, characterized by altered coloration of the dorsum of the tongue. However, they differ in the macro- and microscopic appearance, with black hairy tongue presenting with hypertrophy and elongation of the filiform papillae.
Lymph node tuberculosis before treatment, under treatment and post-treatment detected by 18F-FDG PET/CT
People infected with Mycobacterium Tuberculosis (TB) stay infected for a long time. Infected people may not develop tuberculosis disease and were asymptomatic. Once progressing to disease, it can affect most tissues and organs, but especially the lungs. We report a case of a 40-year-old woman who initially presented with dry cough for 3 months.
Nosocomial meningitis after spinal anaesthesia is a very rare event and it can be functionally or vitally life-threatening in the short term. Pseudomonas aeruginosa is responsible for severenosocomial infections including meningitis. Ceftazidime or cefepime are the reference treatments but none of these molecules are available in Madagascar.
Failure of bone fracture healing is quite common and between 5% and 10% of bone fractures are associated with delayed or nonunion. The aim of this case report is to draw attention to the management and the potential solutions of this problems. We report a case in which we successfully used low-intensity pulsed ultrasound (LIPUS) in a 40-year-old Caucasian woman with a delayed union of both bone forearm.
Tetraplegia is paralysis of all four limbs. It is due to a lesion, partial or complete, of the spinal cord, most often at the cervical level. We carried out a retroprospective study over a period of 55 months (4 years and 7 months), from June 01, 2017 to December 31, 2021 from the files of patients referred for assessment by magnetic resonance imaging (MRI) in a context of sensorimotor deficit of the four limbs.
A 67 year old lady presented with increasing lethargy and worsening of performance of activities of daily living. She was haemodynamically stable and investigations were unremarkable except for mild dehydration and high INR. She was admitted for further management. She remained well, until she was noticed to have deteriorated in GCS (responsive to pain).
Strategies and interventions (including behaviour modification) to reduce HIV transmission in the UK
Sexually transmitted infections (STIs) cause significant morbidity, and rates are increasing across the North West. Partner notification (PN) is a public health mainstay in the United Kingdom (UK) for preventing the spread of STIs. However, health services face several challenges when trying to implement PN.
Gravesâ€™ Disease (GD) is the most common cause of primary hyperthyroidism. It is an autoimmune disorder characterized by the presence of thyrotropin-related antibodies that stimulate thyroidal cells, resulting in an overproduction of thyroid hormones. It has been reported that cytokines might be involved in the GD pathogenesis.
Hemophilia is a rare X-linkated bleeding disorder which causes spontaneous or secondary bleeding. This disorder used to be treated with plasma or cryoprecipitate, but since clotting factor precipitates became available these have become standard of treatment. Unfortunately, in Romania, this treatment has been approved very late, and first only for on-demand treatment.
A rare case of dystrophic calcification in anterior aspect of C4-C5 vertebrae due to infection in hemodialysis catheter
A 42 year old female, known case of Lupus nephritis with post renal transplant status since 2 years was admitted with complaints of chronic neck, back and right shoulder pain, which was stabbing in nature. She had on and off pain for which she was being managed on OPD basis since 1 year.
Posterior Reversible Encephalopathy Syndrome (PRES) in a young woman with eclampsia: Focus on imaging findings
Posterior Reversible Encephalopathy Syndrome (PRES) is a rare complication of arterial hypertension, eclampsia or pre-eclampsia, chemotherapy regimens, immunosuppressant medications, chronic renal failure and dialysis and autoimmune diseases. Extremely rarely, PRES may occur in young women during puerperium.
SARS COV 2 infection causes lung lesions characterized by the appearance of ground glass opacities, and a significant percentage of patients present persistent symptoms and changes in CT scan represented by fibrotic lesions, traction bronchiectasis, persistence of ground glass images. Laser therapy has anti-inflammatory effects, stabilizes the vascular endothelium, has antifibrotic effects.
The imperforate hymen is the result of a failure in the canalization of the vaginal plate, with an incidence of 1 in 2000 live births of women. Imperforate hymen can complicate with hematocolpos or hematometrocolpos. Common clinical manifestation is a periodic and long-lasting abdominal pain, enduring months to years before diagnosis.
Sudomotor dysfunction and corneal nerve loss: An unusual presentation of syringomyelia and COVID-19 infection
To highlight unusual neurological findings in a patient with syringomyelia and COVID-19. Neurological examination, Vibration Perception Threshold (VPT), Magnetic Resonance Imaging (MRI) of the full neuroaxis, electrophysiologic studies, Corneal Confocal Microscopy (CCM) and Sudoscan were performed.
Nephrotic syndrome complicated with severe dengue infection and pediatric Multisystemic Inflammatory Syndrome (MIS-C)
Dengue infection is endemic in India and can be associated with other illnesses like nephrotic syndrome. Dengue and nephrotic syndrome share a common spectrum of presentation of plasma leakage leading to proteinemia and hypoalbuminemia further manifesting in form of generalized edema, pleural effusion, and ascites.