Multiple Myeloma (MM) is the 2nd most frequently diagnosed hematologic malignancy and accounts for 10-15% of all blood cancers and 1–1.8% of all cancers. Approximately 1% plasma cell myelomas are non-secretory (NSMM) and 15% of latter are non-producers (NSNPMM) where no cytoplasmic immunoglobulin (lg) synthesis is detected.
Issue 7 (July)
This is a retro illumination image of right eye under 10x magnification of a 12-year-old girl with bilateral microspherophakia without any systemic association. You can see a clear crystalline natural lens in globular or spherical shape with intact and stretched zonules attached to the equator of the lens all around visible after full mydriasis.
Marchiafava-Bignami disease (MBD) is a very rare demyelinating/ necrotic disorder of the corpus callosum and nearby subcortical white matter, seen mostly in chronic alcoholics. We present here the magnetic resonance imaging findings of Machiafava-Bignami disease in a 75-year-old man with a history of untreated diabetes mellitus who presented with a sudden onset of alteration in speech and multiple falls in a few days.
Objective: Patients infected with different virus strains have different clinical characteristics. This study had observed the clinical indicators of COVID-19 patients infected with early virus strains, and the aim was to supplement the data of patients with early virus infection internationally, and reflect the thinking process of researchers and the strategy of clinical monitoring at the beginning of the epidemic.
Familial Mediterranean Fever (FMF) is a rare hereditary autoinflammatory disease. In particular, the onset is rare in the elderly, and the symptoms are atypical, making diagnosis difficult. A 61-year-old man was referred to our hospital due to recurrent fever and weight loss 3 months ago.
Omentum infarction occurs when the omentum is torsioned around its long axial axis and compresses the vascular structure. Although omentum infarction is rare, it is an important pathology that should be considered in acute abdomen. The insidence is 2 times higher in men than in women.
The acrofacial dysostoses are a genetically heterogeneous group of inherited disorders characterized by craniofacial and limb abnormalities. Nager and Rodriguez syndromes, posited as distinct subtypes, have recently been described as a phenotypic spectrum associated with haploinsufficiency of the SF3B4 gene.
Ivermectin is an antiparasitic drug that has been used as an alternative for prophylaxis and treatment of COVID-19 infection. The adverse effects from supratherapeutic doses of Ivermectin can include non-neurological and neurological symptoms. In this study, we report the case of a 52-year old Filipino male with newly diagnosed diabetes mellitus who developed a subacute history of fever, cough and generalized weakness, causing him to self-medicate with supratherapeutic doses of Ivermectin and thereafter subsequently developed decrease in sensorium, restlessness and complex visual hallucinations.
Coronary artery anomalies are found in 0.6%-1.55% of patients who undergo coronary angiography. The anomalous origin of the Right Coronary Artery (RCA) as a branch from the Left Anterior Descending artery (LAD) is a very rare variation of the single coronary artery anomaly.
As Hypoglycemic disorders are rare in patients without Diabetes Mellitus, a thorough evaluation should be performed only in individuals presenting with Whipple’s Triad (Symptoms or signs consistent with hypoglycaemia, a low reliably measured plasma glucose concentration and resolution of these symptoms after plasma glucose is raised).
Primary intrathoracic goiter is a very rare entity representing only 1% of all intrathoracic goiters. It arises from mediastinal ectopic thyroid, without tissue connection with cervical thyroid and its blood supply is entirely derived from intrathoracic vessels. Secondary intrathoracic goiter is a much more common condition.
Background: Enteric fever usually leads to hepato-cellular necrosis, a likely cause of alteration in liver biochemical markers in the serum. Further, the emergence of multidrug-resistant Salmonella to common antibiotics, has complicated the treatment and management of this infection.
Brain tumors are the commonest tumors (20-22%) in children after leukemia’s (30%) and have a number of specific features compared to adults. To study the incidence & distribution of cerebral hemispheric tumors, its various clinical presentation, imaging characteristics, pathological features and outcome after advocated treatment.
A 73-year-old Caucasian woman presented with a week’s history of vague post-prandial right upper quadrant and flank pain. She reported that the pain felt similar to her cholecystitis over 40 years ago for which she received a laparoscopic cholecystectomy (LC)
Uterine prolapse is the herniation of the uterus into or beyond the vagina as a result of the failure of ligamentous and fascial supports. It is almost always accurately diagnosed by clinical examination but maybe sometimes confused with its differential diagnoses.
A 65-year-old multiparous patient presented to our hospital with vague abdominal pain for 2 months. Physical examination revealed normal bowel sounds in all four quadrants, with a soft and non-tender abdomen. Distension and dullness in percussion were noted.
Background: Multicystic encephalomalacia is a condition of cerebral necrosis followed by the formation of cystic lesions of varying sized starting from the periventricular area and may extending to the cerebral cortex.
A 12-year-old female patient came to our outpatient department with complaints of low vision in both eyes since childhood. There was no significant history of ocular trauma or family history of similar disease. Her parents also give no significant medical or surgical history in the past.
Obturator hernia is a rare disease that affects thin, elderly women. Non-incarcerated hernias are often particularly difficult to diagnose. We present a case of a non-incarcerated obturator hernia diagnosed based on patient history and Computed Tomography (CT) findings.
A 47-year-old female with a documented history of allergies to medicine ingested a 1 gram tablet of amoxicillin for supposed dental pain. After 10 minutes, she began experiencing tongue swelling, throat congestion, shortness of breath, and eventually faints. The emergency medical service that arrived at the site found the patient with no vital signs and started resuscitation. They were able to stabilize the patient, and she was transported to the hospital and admitted to the intensive care unit.
A 73-year-old male was admitted to the neurology department complaining of right hemiparesis lasting for 19 hours. At admission, Magnetic Resonance Imaging (MRI) showed acute ischemia in the left cerebral hemisphere, but brain MR angiography and ultrasonography of the carotid artery were unremarkable.
A man in his mid-forties presented with a two-day history of sudden onset right upper quadrant pain and coffee-ground vomiting. Eight months previously, he underwent successful endoscopic retrograde cholangiopancreatography (ERCP) with biliary stenting for cholangitis and severe gallstone pancreatitis.
Arterial Tortuosity Syndrome (ATS) is a very rare autosomal recessive disorder, that affects the connective tissue. The incidence of ATS is not well known and to date only 106 patients have been described in literature.
A middle-aged female presented with vague abdominal symptoms that after diagnostic and staging work up was revealed to be an advanced case of combined hepatocellular and cholangiocarcinoma (cHCC-CCA). She was started on systemic chemotherapy inspite of which experienced disease progression. cHCC-CCA is a rare histopathalogical entity making it a diagnostic challenge. Treatment for advanced disease is not well established and prognosis is poor.
Objective: Cervical Vertigo is a controversial entity. Here we present an un reported case of Isolated Atlanto Occipital Joint effusion as a cause of Vertigo. Case report: A 45-year-old male presented with imbalance, ataxia, swaying, quick spins, and oscillopsia, especially when turning his head. There were no oculomotor findings on videonystagmography.
The gut microbiota can influence the brain function through a variety of ways, but its role in the etiology of Bipolar Disorder (BD) is yet unknown. The brain and the gut are linked through a communication pathway called the Microbiota-Gut-Brain Axis (MGBA). The current review aims to summarize the gut microbiota, neuroimaging endophenotype and its correlation in BD patients.
Metabolic syndrome (MetS) is an important risk factor for diabetes and CVD, but there is no standard definition, particularly in pediatrics, and this is further complicated because of the effects of puberty and growth stage.
Background: Extrapulmonary tuberculosis is detected more frequently in children than adults since the risk of lymphohematogen spread is high in young children. Tuberculosis may attack any organ in the body, including the lymph nodes and the central nervous system. In children, it is difficult to detect tuberculosis since most signs and symptoms are not easily detected in young children.
Although foreign body ingestion and food bolus obstruction are frequently encountered gastrointestinal emergencies, the management of sharp objects in the oesophagus remains highly challenging due to the risk of perforation. We present the case of a 44-year-old patient with an impacted chicken bone penetrating into the aortic arch. The importance of a swift and effective multidisciplinary approach involving interventional radiology, vascular surgery, upper gastrointestinal surgery and endoscopy was illustrated.
A 45- year- old male from an urban community, laborer, heavy alcohol consumer, exclusively on rice diet presented to outpatient department in primary health care centre with chronic diarrhea for three months. He was treated multiple times with antibiotics with no improvement.
A 46 yr female with long-standing disabling low backache with pain radiating to the right lower limb, pain at tail bone not allowing her to sit, sleep and stand for the last 3 months with acute exacerbation since 3 days were diagnosed as degenerative lumbar disc disease with right L5/S1 radiculopathy and coccydynia not responding to medical management and treated with minimally invasive procedures-CT guided ganglion impar block.
A 16-year-old male was brought to the Dermatology OPD with complaints of generalized progressive thickening of the skin since one year of life and development of blisters after trauma. There was a history of difficulty in swallowing, protrusion of tongue, hoarseness of voice, and diffuse loss of hair.
These are the nine images taken in Unani research OPDs related to skin disease as Unani System of medicine has significant result in skin and cosmetics fields. Patients who had taken treatment from the specialist did not cure moved to Unani treatment. Here the purpose is only to present the cases of skin diseases with special peculiarities met in the Unani Research Centre.
We present a case of Fungus ball or aspergilloma in a 13- years-old girl with sinonasal mass that mimicking bony septal destruction. Fungal colonization inside affected sinuses showed High density opacities due to its concentration. Endoscopic findings demonstrated a huge amount of viscous greenish-brown fungal tangle with cottage cheese consistency which has the same principles as fungus ball.
This report presents a rare case of a 47-year-old male patient with ocular cicatricial pemphigoid and bullous pemphigoid, five months after receiving the first dose of COVID-19 vaccine. The patient presented with redness, burning sensation, and photophobia in the scalp and oral cavity.
Background: Tuberculosis continues to be endemic in developing countries. Despite genitourinary tuberculosis being common, reports of isolated ovarian tuberculosis are rare, further its presentation can mimic that of ovarian cancer. Challenge arises when evaluating patients who lack usual clinical symptoms and laboratory evidence required for correct diagnosis.
Introduction: Endometrial ossification is a rare condition in which its actual etiology and pathogenesis is controversial and debatable however, the condition is usually related to secondary infertility after abortion and endometritis.
A 36-year old female underwent elective parathyroidectomy at a Swiss tertiary teaching hospital for primary hyperparathyroid-ism. Induction, surgery and extubation were uneventful. During transfer to the post-anaesthetic care unit, some retching was interpreted as vomiting. At arrival, she was apnoeic and unresponsive but with palpable pulse.