Hyperhomocysteinemia (HHcy) has been recognized as a risk factor of several chronic disease. It is noteworthy that HHcy prevalence appeared to be rising in recent years. Many patients have good curative effect after treatment, but some HHcy caused by gene mutations remains difficult to treat. Here, we present a case of hyperhomocysteinemia type II with poor effect of conventional treatment. We report it in order to provide a basis for follow-up studies.
Issue 9 (Sep)
En plaque meningioma is a type of tumor that causes infiltrates into the bony tissue and forms a lamellar structure. The symptoms and prognosis are significantly related to the severity of bone involvement and involved areas. Given the limited information from the basic knowledge of these patients, we aimed to determine the characteristics and post-surgical outcomes of patients operated via pterional approach surgery.
A 25- year-old systemically healthy female patient reported with an aesthetic complaint due to a growth in the corner of right upper lip present for 2 months. Clinical examination revealed a solitary spherical-shaped bright red fibrous overgrowth measuring 4 x 4 mm involving the mucocutaneous line of upper lip. On palpation, it was non tender, smooth in texture, and soft in consistency.
Since May 2022, there is an ongoing Monkeypox (MPX) outbreak that has been declared as a public health emergency of international concern by WHO. Most of the cases are men who have sex with men, frequently presenting to the clinic with one or more Sexually Transmitted Diseases (STDs). We present one of the first cases admitted to our hospital ward with a clinical image of multiple painful peri anal lesions.
Femoral hernias account for 10% of all groin hernias. Females have a 4:1 incidence of abdominal hernias, while males have a 5% incidence. A spontaneous enterocutaneous fistula is rare due to a small bowel loop perforation in an incarcerated femoral hernia. Patients’ ignorance and late presentation cause these fistulas. This case report discusses the presentation of spontaneous enterocutaneous fistula due to femoral hernia, as very little literature describes this phenomenon.
Covid-19 influence on QT prolongation is mainly caused by antiviral medications. However, there is some evidence of independent effect of disease on QT interval in association with cardiac injury and on the other hand as previously demonstrated, acquired long QT has potential negative impact on the outcome of Covid-19 infection. We are presenting a case of QT prolongation in an ambulatory patient with a pre-existing borderline QT interval who was on no antiviral medications.
Dasatinib, a second-generation tyrosine kinas inhibitoris effective against most cases of imatinib-resistant Chronic Myelogenous Leukemia (CML), and this drug has also shown significant glucose-lowering effects. Here, we report two diabetes patients with sudden onset of CML. In Case 1, dasatinib produced mild but clear improvement of hyperglycemia with the same anti-diabetic regimen together with rapid control of CML.
Pseudoaneurysms are a well described complication of peripheral arteries. They often develop post-traumatically and/or iatrogenically. Prompt recognition with appropriate management is paramount in preventing limb-threatening complications. Surgeons must maintain a high index of suspicion for pseudoaneurysms of peripheral arteries in patients with recent history of trauma and/or surgery of the area.
Thyroid nodules are one of the frequently seen presentations in the clinic. Thyroid nodules are present in almost 5% of females and 1% males in iodine-sufficient regions. On the other hand it can incidentally be found in as high as 67% of the patients on ultrasound neck. Among all the thyroid nodules, 5-15% come out to be malignant on final histopathology.
Bronchial atresia is a rare congenital lung abnormality characterized by the focal obliteration of the bronchial lumen, on a lobar, segmental or subsegmental level, usually associated with peripheral mucus impaction (bronchocele or mucocele). It presents with adjacent segmental or subsegmental hyperinflation, and reduction of vascularization of the involved segment or lobe.
Aesthetics is a major concern for patients suffering from cleft lip-palate, and equally challenging to a dentist when approached at a later stage for rehabilitation. Regenerative procedure involving use of bone grafts is advocated at a younger age, due to higher regenerative capacity and greater acceptance rate.
Mammary Analogue Secretory Carcinomas (MASCs) are rare slow growing salivary gland tumors that mimic the histological and genetic features of secretory carcinoma, a rare tumor of the breast. In this article, we present the case of a 24-year-old woman diagnosed as a case of mammary analogue secretory carcinoma.
Cervical lymphadenopathy usually represents lymphomas or metastasis from head and neck primary tumors, but it can also occasionally be a manifestation of a remote primary site. PET-CT has improved identification of the location of such unknown primaries, particularly when they are distant in location.
Apical or periapical cysts are the most common type of cyst, affecting the local and systemic health of patients. This pathology can manifest as an inflammatory condition in periodontal tissues due to the stimulation and proliferation of the epithelial cell rests of Malassez and it can be identified in clinical visits and imaging exams of routine. Apical cysts do not cause facial pain and/or swelling and appear as a well-defined radiolucent region when analyzed radiographically.
Spontaneous Intracranial Hypotension (SIH) results from a decrease in cerebrospinal fluid volume without any iatrogenic cause and presents most commonly with orthostatic headache. Cervical dural tears are an uncommon cause of SIH. Cervical epidural blood patch has been successfully used in many developed countries for the treatment of spontaneous intracranial hypotension after failure of conservative management.
Postpartum hemorrhage is the leading world cause of maternal mortality in low-and-middle income countries. Puerperal hematomas are auncommon cause of postpartum hemorrhage. Their adequate management requires a particular skill and technical platform to surgically assure hemostasis. This case allows us to draw the attention of practitioners to the seriousness and singularity of this highly morbid pathology.
Residents are the backbone of every large medical center that aims to strengthen and nourish the upcoming crop of medical personal. The professional prospect of a resident is largely based on their core subject knowledge, the tenacity to practice these core principles and their ability to add to it by academic activities and didactic thinking.
Cervical lymphadenopathy is a common finding in the everyday life of an ORL physician. The diagnostic steps range from laboratory and microbiological examinations to removing lymph nodes for histopathological processing. The differential diagnoses include infectious, chronic and malignant diseases. In rare cases, lymph node biopsy may diag-nose a chronic lung disease like sarcoidosis or silicosis.
The effect of aspirin therapy in patients with nonobstructive Coronary Artery Disease (CAD) remains controversial. This study aimed to investigate the association between aspirin therapy and prognosis in nonobstructive CAD. We searched for observational cohort studies on Pubmed, Embase, the Cochrane Library and Web of Science. Studies were included that compared the endpoint differences in patients with nonobstructive CAD who were treated with aspirin or not.
The study of aerosol deposition and bronchial tube flows in the human respiratory system can assistance improve an understanding of the damaging or beneficial effects of the inhalation of lung aerosols. In this study, we propose a strategy for segmenting the decomposition of particles inside the respiratory system.
Glucocorticoids are among the most commonly prescribed medications owing to their generic anti-inflammatory and immunosuppressive effects. Adrenal insufficiency and adrenal crisis are among the major serious adverse effects of long course glucocorticoid treatment. Patient education on sick day rules and the use of steroid treatment identifiers are some of the strategies.
Langerhans cell histiocytosis is a group of diseases characterized by an inflammatory neoplasia of myeloid precursor cells driven by mutations in the mitogen-activated protein kinase pathway leading to the proliferation and accumulation of Langerhans cells. Clinical manifestations range from isolated disease to multifocal lesions and systemic involvement with a worse prognosis
At present, the treatment of internal carotid artery stenosis has been extensively modified, passing from endarterectomy to balloon plasty and stent placement, generating a significant reduction in surgical risk. In-stent stenosis is reported in up to 30% of cases and patients generally present with a transient ischemic attack or stroke.
Various studies have suggested a correlation between Fas Cell Surface Death Receptor/Fas Ligand (FAS/FASL) variants and multiple types of cancers. The present study aimed to investigate the association between FAS-670A/G and FASL-844C/T and the synergistic effects of both variants on the risk of Gastric Cancer (GC) in the Kurdish population of West of Iran.
A 41-year-old female presented to emergency with complaints of recurrent vomiting, pain abdomen since last 24 hours. She is known case of diabetes, non-compliant to her medication. On examination, she was confused, GCS 11/15, and vitals were pulse rate 102/min, blood pressure 130/70 mmHg, respiratory rate 26/min, and random blood sugar 439 mg/dl.
Sub-Saharan Africa is currently having a dual burden of HIV and Non-communicable diseases. HIV is regarded as a chronic condition regardless of HIV being infectious, due to the absence of a cure. However, these patients have achieved a substantial increase in survival after receiving Antiretroviral Therapy (ART). An increase in survival puts HIV patients at risk of developing Non-Communicable Diseases (NCD).
A middle-aged male, coming from a remote hilly village of Northern India, presented to the outpatient department for optimization of his anti-diabetic medications. On routine general examination innumerable soft to firm, asymptomatic subcutaneous nodular swellings were noted over his trunk and limbs which varied from 1-4 cm in size.
A 21 year female patient reported with the chief complaint of pain and difficulty while eating and swallowing food from past 15-20 days. Her mother complained about her silent mode most of the time. Patient revealed that she is having pain while speaking, therefore she avoid speaking from past few days. Patient was systemically healthy.
A 24-year-old immune-competent man, with no significant past medical history, presented a Streptococcus viridans Infective Endocarditis (IE). Work-up for IE showed on post-contrast brain CT-scan a ring- enhancing lesion suggesting a cerebral abscess, with a contiguous nodular enhancing lesion. Given this radiological aspect, and because immediate cardiac surgery was indicated, a cerebral angiography was performed.
DIVC may play a role as a confounding factor in imaging diagnostic tests and also may represent a hazard for inadvertent injury and bleeding during surgery. Careful interpretation Radiological investigations help to define such anomalies and avoid significant morbidity during surgical exploration. We present a case of renal cell carcinoma involving Right kidney with tumor thrombus extending into both venae cava.
To describe our experience with TSCPC with diode laser for refractory glaucoma in a single centre in southern Italy. This retrospective descriptive study included 134 eyes with refractory glaucoma. Patients underwent TSCPC using a Cyclo-G6 laser method with a G-probe delivery system. Intraocular Pressure (IOP) and the number of Antiglaucoma Medications (AGM) were recorded at baseline and at 1-, 7-, 30-, 60-, 90- and 180-days post-treatment.
We present a case of a radiocarpal fracture dislocation. The injury of the distal radioulnar joint was initially underestimated and only fixed with screws and a K-wire without addressing the radiocarpal instability. In the further course, the patient developed a painful radiocarpal dislocation and an impaired Range Of Motion (ROM) of the affected wrist.
Libman Sacks Endocarditis is rare, nonbacterial vegetation of the heart valves. Most commonly seen in association with solid cancers and autoimmune diseases. A 64-year-old male came in with sudden onset left upper arm numbness, pain and pallor which worsened with movement. On examination, he had feeble pulses of the left upper extremity and an aortic diastolic murmur of the heart.
Aneurysmal bone cysts are primarily benign neoplastic lesions, often occurring in childhood and adolescent age group. A 27 year old male with neoplastic lesion arising from the posterior end of right third rib, underwent resection without thoracotomy or use of thoracoscopy. In this technique we used posterior midline transpedicular approach and resected with the help of neuronavigation system.
A 19-year-old man presented to the emergency department with 3 weeks of history of abdominal pain and constipation. He had nausea and vomiting 48 hours ago. Previously, he was in good health and did not have any relevant medical history. The heart rate was 87 beats per minute, with blood pressure at 100/70 mm Hg.
IgE-mediated food allergies can cause life-threatening anaphylaxis. Management of these allergies is based on a strict avoidance diet in relation to foods that may contain the allergen. The European regulations issued by the INCO (consumer information) provide a list of 14 allergens subject to mandatory declaration.
Pneumonia is common in neurocritical care patients. Non-bronchoscopic bronchoalveolar lavage (NB-BAL) is a generally safe, well-tolerated procedure with similar sensitivity to bronchoscopic bronchoalveolar lavage. This procedure is most often performed by non-physicians, particularly nursing and respiratory therapy, often without advanced training regarding the procedure.