Tunneled Dialysis Catheters (TDC) remain a common modality of vascular access and often malfunction because of a myriad of reasons including thrombosis and fibrin sheath formation. A common practice is to use thrombolysis for TDC malfunctional with decreased blood flow. While this approach could work, it is prudent to obtain imaging of the TDC (cathetergram) to confirm its position and integrity.
Peripheral Smear (PS) examination still remains a cornerstone and first step towards diagnostic work-up of patients. However, presence of artefacts in PS can sometimes prove perplexing for the pathologists . In one such experience, early morning blood sample in K2-EDTA vial of a 23-year-old female was sent to hematology lab.
The chemotherapy-induced peripheral neuropathy treatment with novel systemic ozone therapy method: A case report
Cancer is one of the leading causes of death in the world today. Chemotherapy is promising to overcome it, but chemotherapy accompanies with side effects. Among these side effects can be pointed to Chemotherapy-Induced Peripheral Neuropathy (CIPN). CIPN decreases the quality of life of sufferers and increases the cost of care. This report mentions a new method based on systemic ozone therapy for the treatment of pain caused by CIPN.
A 64-year-old man complaint about low vision of the right eye long time ago, presented to change his glasses. The best corrected visual acuity was 5/10 OD, and 10/10 OS. On examination, we found a central triangle-shaped cataract in his right eye that is better shown by retro illumination. The rest of the exam is unremarkable.
Hens egg allergy is common food allergy in infant, there are various clinical presentations which anaphylaxis is the most serious reaction, it could be life threatening event and need to manage urgently. Major rout of allergenes delivery in food allergy is oral rout although it could be occured by skin or respiratory system.
Monkeypox is Atypical zoonotic Orthopoxvirus infection and is classified in the same viral subfamily as smallpox. Monkeypox is transmitted to humans by direct contact between humans and bush animals like rodents. In this article we are discussing the course of transmission, symptoms and sign along with treatment and prevention of the disease, what appropriate measures can be taken to overcome the new outbreak.
Dr Jekyll and Mr Hyde’ of exocrine gland carcinomas: Breast adenoid cystic carcinoma - A rare entity
Primary Adenoid Cystic Carcinoma of Breast (bACC) is an extremely rare salivary gland-like tumor accounting for less than 0.1% of all breast tumors with excellent prognosis. These tumors are generally triple-negative. There is limited data on optimal treatment and management. We herein report a patient who underwent a Modified Radical Mastectomy for carcinoma of the left breast, and the post-operative histopathology revealed bACC.
From thoracic mass to the diagnosis of esophageal neoplasm: A case of bizarre metastasis in the chest wall
Non-smoker 57-years-old male, with a history of bariatric surgery (gastric banding), was observed due to a right infraaxillary tumefaction, with progressive dimensional increase, anorexia, asthenia, and unquantified weight loss over the past 2 months. He also referred dyspnoea for small efforts and chest pain in orthostatism. No complaints of dysphagia or other gastrointestinal symptoms.
Hemorrhagic stroke in the context of pre-eclampsia on pregnancy of 28 weeks of gestation: A case report and review of the literature
Strokes are rare but serious accidents during pregnancy, they are responsible for high mortality and morbidity, preeclampsia and stroke are significantly linked. Endothelial dysfunction, impaired cerebral self-regulation, and severe high blood pressure are, probably, the cause of many strokes in pregnant women.
The incidence and prevalence of anxiety and depression is increasing with time and more number of patients are reporting for consultation for the same. Still a large group of patients due to inhibition and social stigma associated with anxiety and depressive illness, either do not report or get delayed consultation when severity of symptoms has increased, then they seek consultation from the specialist.
Tuberculosis is one of the leading causes of morbidity and mortality throughout the world which can have both pulmonary and extrapulmonary manifestations. Among the myriad extra pulmonary manifestations of tuberculosis, Deep Vein Thrombosis is rare. We present a case of middle-aged lady who presented with progressive painful swelling of the left upper limb associated with intermittent low-grade fever spikes.
Mucormycosis is an opportunistic deep-fungal infection requiring urgent intervention. Because of the rapidly and destructively progress, delayed initiation of treatment is associated with increased mortality. We reported the survived case of Rhino-Orbital-Cerebral Mucormycosis (ROCM) after taking liposomal amphotericin B.
Burns are serious health problems that are associated with high mortality and morbidity in developing countries. Suicide by burning is among the most dramatic of all forms of suicide. The results of treatment of 218 patients with suicide hospitalized in Samarkand Branch of RSCUMA were analyzed during the period from 2005 to 2018.
Immunogenicity of COVID-19 vaccine among multiple myeloma patients post autologous stem cell transplant
The safety and efficacy of mRNA vaccines against SARS-CoV-2 have proven widely among all age groups but not well studied among cancer patients who received Autologous Stem Cell Transplant (ASCT). Multiple Myeloma (MM), a clonal plasma cell disease shown to have poor vaccine response by weakening host immunity due to the disease and anti-MM therapy.
Pneumothorax is defined as the accumulation of air in the pleural cavity and typically presents as sudden chest pain and dyspnea. It is a complication of pulmonary emphysema and the likelihood of occurrence correlates with the severity of the underlying disease. It may present atypically, leading to delays in diagnosis and treatment.
CNV and RNA analysis reveal a germline pathogenic duplication of MSH2 exon 15 in a family with Lynch syndrome: A case report
MSH2 germ line pathogenic variants are a well-recognised cause of Lynch syndrome, predisposing individuals to a variety of malignancies, most usually colorectal and endometrial cancer. Partial duplications of MSH2 gene, due to their position in the genome and frequently unclear mechanisms of pathogenicity, are often classified as Variants of Uncertain Significance (VUS).
Teratomas are the most common ovarian germ cell tumors. Growing teratoma syndrome is a rare condition that entails the appearance of extragonadal teratomas during or after chemotherapy treatment of non-seminomatous germ cell tumors. We present the case of a 15-year-old patient with recurrent dermoid cysts in the lungs and contralateral ovary after receiving chemotherapy for an immature teratoma in the left ovary.
Insulinoma is a rare variety of endocrine neoplasm and is usually benign, solitary, and small in size. It is responsible of endogenous insulin secretion resulting in development of symptoms of hypoglycemia. Diagnosis of insulinomas can be challenging. We report 4 cases of insulinoma that were diagnosed and managed in the year 2022. Three women and one man, with a mean age of 61.5 years.
Median incisional hernia and double parastomal hernia repair with retromuscular prosthetic biomaterial mesh using SMART technique (Stapled Mesh Stoma Reinforcement Technique) after pelvic exenteration due to cancer
Patient aged 64 with parastomal hernia on a terminal colostomy and a Bricker ileal conduit following pelvic exenteration in the context of a locally advanced low rectal adenocarcinoma. Underwent in 2021 a first median incisional hernia using an intraperitoneal biomaterial mesh, reoperated one year later, when appeared a symptomatic parastomal hernia at stomial sites and next to the median laparotomy scar.
During the COVID-19 (SARS-CoV-2) pandemic, cancer patients have represented a high-risk population. We aimed to describe the clinical characteristics of patients with cancer and COVID-19 in the cities of Santa Fe and Buenos Aires, Argentina, and to compare the clinical evolution of cancer and non-cancer patients with severe COVID-19. We conducted a retrospective, hospital-based study involving 79 patients with laboratory-confirmed SARS-CoV-2 infection and pathological diagnosis of a malignant tumor.
Evaluation of fetal cardiac anomalies and their outcomes in isolated cardiac anomalies and non-isolated groups and based on minor and major abnormalities
This study was aimed to evaluate the characteristics and outcomes of isolated CHD and non-isolated CHD and also compare with major and minor cardiac anomalies. This prospective observational study was performed on 135 cases of CHD from September 2018 to December 2021.
Pigmentation of oral mucosa is caused by pigments leading to change in colour of tissues. It can be endogenous or exogenous. Melanin, haemoglobin, hemosiderin, and beta-carotene are responsible for endogenous pigmentations. The majority of brownish pigmentation is physiological, however occasionally it might be a sign of serious disorders.
COVID-19 is currently a major health problem, leading to respiratory, cardiovascular and neurological complications, with additional morbidity and mortality. Spinal infections are rare, representing around 1% of all bone infections and comprising less than 2 per 10,000 of all hospitalizations in tertiary care centers. Spondylodiscitis is a complex disease, with challenging diagnosis and management.
Peripheral Neuropathy: A review of mechanism-based treatments with a focus on metformin as a possible choice
Despite the troublesome nature of Peripheral Neuropathy (PN) and the possibility of irreversible complications, there is still no approved strategy for the treatment of PN. However, some atypical analgesic agents such as gabapentin, pregabalin, and duloxetine have beneficial effects. Metformin is an anti-hyperglycemic agent which is widely used for the treatment of type 2 Diabetes Mellitus (DM).
Occult type Ib endoleak not identified on imaging study as a cause of sac expansion refractory to treatment for recurrent type II endoleak
We report a case of serial occurrence of different type II endoleak from inferior mesenteric artery and lumbar artery. Despite repeated interventions, gradually expanding aneurysmal sac was eventually followed by impending rupture. In the end, the patient required open repair that revealed the type Ib endoleak which is not identified in CT scan or ultrasonography previously. The patient has been without any specific findings for 5 years without recurrence.
A 28-year-old patient was followed up for unilateral anterior synechial uveitis of the right eye, with an inconclusive etiological work-up. Multiple relapses resulted in posterior synechiae formation around the pupil with a tomato iris appearance (Figure 1). The intraocular pressure was 45 mmHg. After preparation of the patient with intravenous mannitol infusion and hypotonic and corticosteroid eye drops, Peripheral Iridotomy (PI) with Yag laser was performed.
The history of studying the problem of inhalation injury has several decades. I.I. Dzhanelidze wrote about changes in the lungs of victims of a fire. Janelidze back in 1941. Already in the 60s, it became clear to researchers that damage to the respiratory tract is one of the main causes of death in burn victims. The most severe lesions of the respiratory tract develop under the action of chemical compounds inhaled along with smoke. It is undeniable that the prognosis for life with a combination of skin burns with inhalation injury is unfavorable.
The Killian polyp or antrochoanal polyp, represents 4% to 6% of nasal polyps and is more common in children and young adults. This benign lesion grows from the mucosa of the maxillary sinus and extends to the choana. A 7 year-old patient consulted for increasing nasal obstruction. Computed tomography demonstrated a well-defined, hypodense mass in the left maxillary sinus extending to nasopharynx and oropharynx. An excisional biopsy was performed, and histopathology confirmed the diagnosis of a Killian polyp.
Larsen syndrome is a rare genetic disorder of osteochondrodysplasia manifested by distinctive facial features, multiple joint dislocations, and spinal abnormalities. Joint dislocations described in Larsen syndrome include the hip, knee, shoulder and elbow. However, atypical dislocations such as perilunate may also occur in Larsen syndrome. In this report, we present a 28-year-old adult male who presented with a nontraumatic perilunate dislocation.
Analyzing coronary bifurcation structures: Towards personalized balloon angioplasty and stent deployment
Treating coronary artery disease in bifurcation lesions presents many practical challenges. Developing bifurcation-specific devices and procedures may improve results. In order to further understand angiographic bifurcation features, a set of healthy coronary artery bifurcations were measured and evaluated in order to develop models to predict carina diameter and tapering length for a new balloon forming system.
Heterotopic pregnancy (HP) is a rare condition, with an incidence of 1/30,000 after spontaneous conception, which increases to 1/1,000-1/100 following assisted reproduction technology (ART), but potentially life-threatening, since the rupture of EP may lead to major internal bleeding, hemoperitoneum and hypovolemic shock. The early and accurate diagnosis of HP is critical to prevent such complications.
Spinal acute subdural hematoma following cerebrospinal fluid drainage during thoracoabdominal aortic aneurysm repair: Case report
During repair of abdominal aortic aneurysms, the risk of acute spinal cord injury secondary to decreased spinal perfusion rises up to 20%, that`s why the lumbar cerebrospinal fluid drain has been used as a form of intra-spinal pressure control and monitoring medullary perfusion pressure; the positioning of a lumbar drain carries some risks such as cerebrospinal fluid fistula.
Neurological tumors, such as gliomas and meningiomas are rarely presented by movement disorders. Early detection of neurological tumors, both basal ganglia-arising tumors and basal ganglia-sparing ones, presenting with movement disorders is crucial to prevent any further deficits. In this review, we focus on neurological tumors-induced movement disorders, such as hemiballismus, hemichorea, myoclonus, Parkinsonism, and dystonia.
IIntussusception in adults is quite rare. Among the leading causes, tumor comes first. A 49-year-old male admitted for acute bowel obstruction due to left colo-colic intussusception. The patient underwent laparotomy. Intraoperatively: there was a hard mass palped within the intussuscepted bowel. We performed a left colectomy with double barrel colostomy.
To report an unusual case of severe anterior segment inflammation with nodular iris infiltration 2 weeks after an uncomplicated Pars Plana Vitrectomy (ppvit) masquerading as endophthalmitis. A 43-year-old man came to the clinic with severe pain, redness, and vision decrement in his right eye two weeks after uncomplicated pars plana vitrectomy with silicone oil tamponde for rhegmatogenous retinal detachment.
Accuracy of subjective and objective physical activity measurement methods for prediction of possible sarcopenia
Early detection and prevention of sarcopenia arecritical. There is a close association between sarcopenia and physical activity levels. Possible sarcopenia is a precursor to sarcopenia, which can accurately predict sarcopenia. According to the tertiary prevention system, the diagnosis of possible sarcopenia has significant implications for the early detection of sarcopenia and the reduction of its prevalence.
Study on the application value of high intensity focused ultrasound in the treatment of gynecological diseases
Along with the advancement of science and technology and the ongoing development of adjuvant therapies, the treatment options for common or difficult diseases related to gynecology have become more diversified. At the same time, due to the increasing health awareness and the development of minimally invasive treatments, the majority of female patients are more in pursuit of swift and non-invasive treatments.
Percutaneous renal biopsy was an incidental discovery when physicians obtained renal tissue accidentally while performing intended liver biopsies. Subsequently, Iversen and Brun in Copenhagen described their results using cutting and aspiration techniques in 1951. However, the success was inconsistent and operator-dependent.
Adventitial Cystic Disease (ACD) is a rare vascular disease which is characterized by the accumulation of mucinous components histologically similar to ganglia in the adventitia of a blood vessel. ACD can compress the lumen of blood vessels extrinsically. With respect to ACD, the arterial system is more frequently involved than venous system.