Diabetes in patients with cirrhosis is common. SGLT-2 inhibitors are newer class of antidiabetic drugs with pleiotropic effects. Its safety and efficacy has not been evaluated in patients with advanced cirrhosis and diabetes.
Issue 11 (November)
This case report focuses on a woman in her late thirties (gravida three para three) referred from Neurology to Physical Medicine & Rehabilitation department due to pain, lower limb weakness, walking difficulties, and dependence in daily activities.
Early oral functional therapy in toddlers with Down Syndrome was first described by Castillo Morales in the 1970s. Management of facial manifestations remains essential to gain social integration of these children. Oral functional therapy by palatal plates is a complement to the early multidisciplinary management by speech therapists
Waldenström’s Macroglobulinemia (WM) is a rare lymphoma characterized by monoclonal Immunoglobulin M (IgM) production and can remain asymptomatic for extended periods. Cryoglobulinemia is a known manifestation of WM, but cryoglobulinemic vasculitis.
Kurt Schwitters (born June 20, 1887 in Hannover, † January 8, 1948 in Kendal, Cumbria, England) was a multitalented German artist. Schwitters´ life was marked by various health problems that never have been discussed in all their biographical and medical aspects according to contemporary medical knowledge.
A 22-year-old newly diagnosed HIV male, homosexual, presented with rash and thin scaly peeling on bilateral knees and elbows. There were multiple orange-brown scaly plaques on the extensor surfaces of his extremities.
Mycosis Fungoides (MF) and Sezary Syndrome are the most common subtypes of cutaneous T cell lymphoma. MF is a mature T cell non-Hodgkin lymphoma with initial involvement of the skin, but as the disease progresses can involve lymph nodes.
Left-sided infective endocarditis is a recognized but less common cause of cerebral embolism. When the causative organism is Methicillin- resistant Staphylococcus aureus, the rate of embolic phenomena increases. In such cases, surgical interventions should be considered when indicated.
Amyloidosis is a rare condition characterized by the accumulation of amyloids in various tissues. These amyloid proteins are usually misfolded and form insoluble fibrils that deposit in the extracellular spaces of tissues, disrupting their normal structure and function.
In this case 8 year old boy presented with a complaint of fever for 4 days 8-10 episodes of seizure in 2 days, and semiconscious. The parents brought the patient in with these complaints, during the examination the physician noticed the flexion at the elbow and lower extremity in extension and hypotonia in all limbs.
A 90-year-old multipathological female patient presented at the emergency department with right hypochondrial abdominal pain. Physical examination revealed a positive Murphy’s sign.
Congenital hyperextension of the knee, also known as congenital genu recurvatum, is a rare medical condition with an incidence of 1:100,000 deliveries. It is typically diagnosed clinically at birth, aided by radiological findings.
Tachy and bradyarrhythmias are reported complications of COVID19 infection. We report two adults with COVID19 infection induced complete heart block, with previously documented normal electrocardiogram.
Rhinocerebral Mucormycosis (RCM) has been challenging infection specially occurring in diabetic and immunocompromised patients. Its clinical manifestation varies from mild cases to very severe fatal infection with toxemia and septicemia.
The Sister Mary Joseph nodule is a rare umbilical metastasis of abdominopelvic cancer, easily accessible on clinical examination, and often correlated with a poor prognosis. Its recognition as a secondary lesion allows early diagnosis and treatment.
Systemic onset Juvenile Idiopathic Arthritis (SJIA) is defined as a systemic inflammatory disease. Innate immune system dysregulation and systemic inflammation are the autoinflammatory pathogenesis of this disease. The clinical manifestations are fever, arthritis, lymphadenopathy, rash, and serositis.
Dendriform pulmonary ossification is an uncommon entity in which there is metaplastic bone formation in the lungs. Cicatricial organizing pneumonia has been described as one of its causes. We present the case of four patients who developed dendriform pulmonary ossification after having severe SARS-CoV-2 pneumonia.
A 47-year-old female patient with a history of umbilical endometriosis and iron deficiency anemia presented to the gastroenterology department with a year-long complaint of abdominal pain, rectal pain, and hematochezia during menstruation.
People living with HIV/AIDS (PLHIV), like everyone else want and intend to have children. Although the fertility impact of HIV is already well acknowledged, women’s fertility behaviors could also largely be influenced by the level of their viral loads.
Cutaneous Squamous Cell Carcinoma (SCC) with Osteoclast-Like Giant Cells (OLGCs) is a rare finding, with only 11 previous cases reported in the literature. The origin of the OLGC within carcinomas has been debated, and there are two prevailing theories regarding the cell origin.
Patient is a 53 year-old black woman with a history of type 2 DM, HTN, R knee total arthroplasty, and significant obesity. She has been suffering with chronic lymphedema for several years and is presenting today with papillomatosis cutis lymphostatica with overlying cellulitis to the right lower extremity.
A 16-year-old girl presented to the emergency department with a several days history of insect bite to the dorsal aspect of the left hand. Initially the swelling was localized to the dorsal hand, over the following four days the swelling became more diffuse involving the whole left forearm.
The Antisynthetase Syndrome (ASS) is a rare autoimmune disease considered as a subset of idiopathic inflammatory myopathies. This syndrome is associated with antisynthetase antibodies.
Hydatid cysts are parasitic infections caused by ecchinococcus granulosus. They usually infect the liver and the lungs in 90% of cases, while the abdominal aortic localization is extremely rare.
Recurrent acute ischemic stroke due to large vessel occlusion is a rare condition that primarily affects patients with cardioembolic risk factors. This condition is more frequent in patients who lack sufficient anticoagulation therapy.
Spontaneous lens dislocation is a result of disruption of the ciliary body zonules and may develop because of damage of the zonule fibers that holds the lens in place. Lens luxation may occur spontaneously in association with ocular or systemic disease or can follow trauma.
A 81-year-old female presented with two weeks of fatigue, dysuria, abdominal pain, and weight loss. Vital signs and physical exam were normal except for abdominal tenderness and dry oral mucosa. Complete Blood Count (CBC) was normal; blood glucose was elevated.
A 89-year-old man with left basal ganglia internal capsule post limb infarct to our hospital with a history of sputum, fever (37.8oC), dyspnea combined with nasal cannula oxygen therapy, vital signs.
This is a case involving a 27-year-old Filipino female who presented with a chief complaint of progressive weakness in all extremities. The initial assessment of the patient’s clinical history and the neurologic examination revealed the presence of a motor neuron disease.
Patients with antisynthetase antibody syndrome require long-term oral corticosteroids combined with immunosuppressants, which are prone to immune abnormalities and secondary infections. Varicellazoster virus is a neurotropic virus that has long been latent in the posterior root of the spinal cord or the trigeminal ganglion.
Placenta Accreta Spectrum (PAS) is a broad term that includes placenta accreta, placenta increta, and placenta percreta. The major risk factor is a scarred uterus commonly as a result of prior cesarean delivery, myomectomy, or uterine instrumentation. We report a case of placenta increta in the absence of identifiable risk factors.
A 13-year-old female presented to our clinic with a pruritic, progressive, 5 centimeters long cutaneous linear erythema on the left foot. The patient informed us that the lesion appeared progressively 2 weeks before. She spent hours in contact with seawater and sand without protection due to beach holidays.
Cutaneous melanoacanthoma is a rare benign epithelial lesion that typically presents as a solitary black plaque or nodule in elderly people. We present a case in a 90-year-old man with a peculiar lesion on the back with conflicting clinical and dermoscopic characteristics simulating a malignant skin tumor.
Myocarditis can mimic takotsubo cardiomyopathy and via versa. We present a 70-year-old woman with known systemic lupus erythematous who presented to the emergency department twice during the last 2 years with chest pain, dyspnea and transient LV dysfunction. We also discuss the difficulties in differential diagnosis between lupus myocarditis and takotsubo cardiomyopathy.
Esophageal Atresia (EA) is an uncommon but serious surgical emergency that typically presents at birth. It can be managed initially with gastrostomy tube placement and a delayed repair, unlike EA with TEF which is typically corrected in the newborn phase.
Ectopic posterior pituitary is one of the leading causes of pituitary dwarfism related to a growth hormone deficiency. It can be either isolated or associated to other abnormalities, the most widely known being the pituitary stalk interruption syndrome .
Capgras syndrome is a rare psychiatric disorder characterized by the delusional belief that a person or people close to the affected individual have been replaced by identical impostors. This case report presents the unique clinical presentation and management of a 52-year- old male patient who exhibited classic symptoms of capgras syndrome.
The case involved a 32-year-old male patient who experienced delayed puberty until the age of 18. He exhibited low levels of LH, FSH, and testosterone. Chromosome karyotyping revealed a 46XY genotype, while whole exon sequencing identified a missense mutation (c.337T>C) in the PROKR2 gene.
A 72-year-old man with normal pressure hydrocephalus to our hospital with a history of productive cough, sputum, fever, dyspnea combined with nasal cannula oxygen therapy, chest radiography, vital signs.
To report a rare atypical case of ocular toxoplasmosis presenting as choroidal granuloma in a young adult. A 16-year-old male presented with sudden diminution of vision in the right eye. The visual acuity was 6/12p in the right eye. The anterior segment examination was normal.
To find out the effect of a single dose botulinum toxin injection. This study is an observational case series. Data of patients with infantile esotropia who received a single dose of botulinum toxin in 6th-9th month of their age were retrospectively reviewed during the period from February 2013 to January 2015.
To evaluate the effects of cardiopulmonary rehabilitation on the functional capacity of post-COVID-19 individuals. Clinical trial, 7 patients participated in the study who tested positive for COVID-19. Participants underwent a 30-session rehabilitation program.
Post burns neck contracture is always considered a difficult airway and requires meticulous planning for proper management. Awake fiberoptic intubation (AFOI) have been gold standard for managing difficult airways .
A 75-year-old female patient with hypertension, obesity, and dyslipidemia is being followed up in primary health care. She was referred to the hospital due to the finding on transthoracic echocardiography of a 55x30 mm dense, oval image at the level of the right atrium in relation to the interauricular septum.