Articles

Volume-4, 2023
Issue 3(Mar)



An unusual failed reverse shoulder arthroplasty: Case report

Shoulder arthroplasty is a surgical method used to relieve pain and restore functionality in cases of primary and secondary degenerative joint diseases and post-traumatic proximal humeral fractures [1]. It is especially preferred in cases such as irreparable rotator cuff injuries, pseudoparalysis, multi-part proximal humerus fractures and degeneration secondary to rheumatoid arthritis

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Rowell’s syndrome: A paediatric case

Rowell’s syndrome is a rare disease, combining Lupus Erythematosus (LE) and Erythema Multiforme (EM)-like lesions with a characteristic immunological pattern, including a speckled pattern of Antinuclear Antibodies (ANA), positive anti-Ro/SSA or anti-La/SSB antibodies and positive Rheumatoid Factor (RF).

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Malignant ascites with irreducible pelvic organ prolapse

Two women with gastrointestinal malignancies leading to increased abdominal pressure from their copious ascites presented with irreducible pelvic organ prolapse. The first patient is a 62-year-old para 2 with a diagnosis of low-grade mucinous adenocarcinoma suspected to be arising from the appendix who was referred to urogynecology service for worsening pelvic organ prolapse.

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Benefit of inpatient rehabilitation care in management of acute demyelinating syndrome in children

Guillian Barre Syndrome (GBS) is the most common cause of minor flaccid paralysis in the world and post-polio eradication is the most common cause on the Indian subcontinent as well. It affects 0.6-4 people per 1 lakh people per year. Guillian-Barre syndrome should be distinguished by a variation associated with inflammation of the cortical area of brain of chronic inflammatory polyneuropathy predicting prognosis and clinical course.

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Surgical treatment of solitary axillary schwannoma

Solitary axillary schwannomas are very rare lesions, with just over 20 cases previously reported in the literature. Here we describe a patient with a symptomatic solitary axillary schwannoma. Total removal was successful, without complication. In patients with increasingly symptomatic axillary schwannoma, early surgical removal is recommended to avoid further neurological deficit, and to achieve the best results.

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Mastoid adenocarcinoma revealed by chronic otitis media

The diagnosis of primary carcinoma in the mastoid bone is usually made while performing a mastoidectomy in an effort to control presumed chronic mastoiditis. The chronic infection, purulent otorrhea, and severe otalgia, are the main warning signs of carcinoma of the middle ear or external auditory canal. If the amount of bony mastoid destruction is out of proportion, malignancy should be strongly suspected.

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Rare association of a patient with multiple ischemic strokes with thrombotic thrombocytopenic purpura and systemic lupus erythematosus: A case report

The Trial of ORG 10172 in Acute Stroke Treatment categorizes stroke etiology into large-artery atherosclerosis, small vessel occlusion, cardio-embolism, stroke of undetermined etiology, and stroke of other determined etiology with patients with hematological, and hypercoagulable states falling under the last category. Cases of Thrombotic Thrombocytopenic Purpura with stroke manifestations have been described mostly as large vessel occlusion.

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Let’s know systemic lupus erythematosus

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a wide spectrum of disease expression, with aberrant host innate and adaptive immune response, and chronic inflammation. It is a chronic autoimmune inflammatory disease with a spectrum of clinical and serological manifestations caused by autoantibody production, complement activation, and immune complex deposition.

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Inflammatory fibroid polyp presenting as intussusception

Inflammatory fibroid polyp is a benign mesenchymal tumor most commonly arising in the stomach and ileum. It needs to be distinguished from other mesenchymal tumors of the GIT which is done with the help of morphological features and with the help of IHC. Here in, we describe the case of a 58 year old female who presented with complaints of abdominal pain.

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Clinical outcomes of stapled hemorrhoidopexy using a novel three-row stapler for grade III/IV hemorrhoids: A single-center experience with literature review

Stapled hemorrhoidopexy is recognized as one of the transformative minimally invasive treatments for grade III/IV hemorrhoids, refractory to conservative management. The current evidence on the clinical use of the novel circular hemorrhoidopexy stapler is sparse. Moreover, the efficacy of the stapler in terms of long-term prevention of rectal prolapse, recurrence of hemorrhoids, and risks of anorectal fistula has not been evaluated

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Cardioverter defibrillator placement in a young woman with Brugada syndrome: A case report and review

Brugada Syndrome (BS) is a hereditary disorder characterized by a primary electrical abnormality, absence of structural heart disease, an elevated risk of sudden death, polymorphous ventricular tachycardia, and ventricular fibrillation, which mainly affects young men. The heterogeneous clinical presentation of this syndrome in contrast to an asymptomatic presence, reinforces the interest in the documentation of management and proper treatment of this syndrome.

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Erythematous candidiasis white patches on tongue: A rare clinical image

We are presenting a case of an 35 years old male; He came to the department of oral medicine with chief complaint of burning sensation in the mouth from last 1 month, white patch on tongue and lips and loss of taste. On intraoral examination, there was a lesion on erythematous region without elevation seen on the hard and soft palate. Lesions measure approximately 5 x 4 cm in the size and present all over the tongue.

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The effect of dyssynchrony on hemodynamics after pacemaker implantation

We analyzed the correlation between Left Ventricular (LV) contraction and right ventricular pacing position via longitudinal strain on 2-dimensional speckle-tracking echocardiography in a patient underwent permanent pacemaker implantation and developed pacemaker induced cardiomyopathy. Furthermore, the effect of dyssynchrony was quantitatively assessed by LV pressure-strain loop based on systemic blood pressure and LV longitudinal strain.

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The problem of COVID-19: Yesterday, today and tomorrow

The article analyzes the dynamics of the development of the Covid-19 problem in the world. The most contagious viral strain “Delta” currently poses the greatest danger. It has already penetrated almost all countries and is gradually replacing its less dangerous variants of COVID-19. Are officially confirmed cases enough to study the dynamics of the COVID-19 pandemic?

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A complex case of metastatic pituitary lesions with unusual presentation

Metastases to the pituitary gland and hypothalamus commonly occur with breast cancer in women. It is unusual and rare if these metastases are discovered late (10 or more years of primary tumor diagnosis), follow an indolent course and have radiological features suggestive of the inflammatory process. We report a case of a 71 years old female who presented with collapse, which was suspected secondary to adrenal crises, and gradual deterioration of visual acuity on the background of treated breast cancer.

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OX-LDL promotes insufficient autophagy and apoptosis of ovarian granulosa cells through regulation ROS-mediated PI3K/Akt/mTOR pathway

The purpose of this study was to determine the role of Oxidized Low-Density Lipoprotein (OX-LDL) promotes insufficient autophagy and apoptosis of ovarian granulosa cells through regulation Reactive Oxygen Species (ROS)-mediated PI3K/Akt/mTOR pathway. In vivo studies, we established mouse models of OX-LDL induced ovarian dysfunction and tested the changes of follicle-stimulating hormone (FSH) and estradiol (E2) under OX-LDL.

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Right ventricular dysfunction in cancer patients; Is it real or dilemma? A narrative review

Cardiotoxicity is one of the challenges of treating a cancer patient. With the advancement of treatment methods and the production of new drugs, the life expectancy of cancer patients improved significantly. As a result, cardiovascular diseases that may occur due to cancer treatment need special attention. In most studies, only the function of the left ventricle is evaluated to investigate cardiotoxicity, while the right ventricle can also be affected by anticancer treatments.

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Hypothyroidism presenting with left sided Brown’s syndrome

An 11-year-old female presents with a 6-week history of double and blurred vision associated with headaches and neck swelling. Thyroid function tests demonstrated antibody negative hypothyroidism. In addition, connective tissue disorder screening was negative. The patient was commenced on thyroid hormone replacement (levothyroxine).

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Embolization of giant hepatic hemangioma: A case report

Hepatic hemangiomas (HH) are the most common benign tumors of the liver and consist of vascular malformations or hamartomas of congenital origin that increase due to ectasia. The declared giant hepatic hemangiomas (GHH) embody from 10 cm (most commonly) to 20 or more cm. In general, most patients are asymptomatic and the diagnosis is usually made accidentally by imaging tests.

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Toxic Megacolon leading to bowel perforation: A rare adverse effect of bortezomib

Bortezomib is a chemotherapeutic drug used in the treatment of multiple myeloma and amyloidosis. The major dose-limiting adverse effect is neuropathy. Although rare, autonomic involvement of the gastrointestinal tract, can present with ileus. We report a compelling case highlighting the association between Bortezomib initiation and development of life-threatening toxic megacolon.

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A case of rhino-orbital cerebral mucormycosis presenting with spontaneous cerebrospinal fluid rhinorrhoea

Rhino-orbital cerebral mucormycosis has increased in the recent second wave of post-COVID-19 illness, mainly in tropical countries like India. The burden of diabetes mellitus and rampant use of corticosteroid, environmental factors, post-COVID-19 immunological derangement might be contributory factors to the development of extensive outbreak of ROCM. Cerebrospinal fluid rhinorrhea is rarely documented with such fungal infection in literature.

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A case report of tracheobronchopathia osteochondroplastica

Tracheobronchopathia Osteochondroplastica (TO) is a benign disease of low incidence that is characterized by multiple submucosal cartilaginous and bony tracheobronchial nodules. There is still no unified standard or guideline for the diagnosis and treatment of TO worldwide. This case report may help reduce clinical misdiagnosis and missed diagnosis while providing accurate diagnosis and treatment for this disease.

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Extramammary Paget’s disease of the inframammary fold

Extramammary Paget’s disease is a rare malignancy of the skin. We present the case of a 62-year-old woman with a well-defined erythematous lesion of the left inframammary fold, without flaking, erosion or crust. Skin biopsy showed presence of Paget’s Disease. Physical examination and imaging showed no relation to the nipple-areola complex or breast glandular tissue.

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Ustekinumab to treat Crohn’s colitis complicated by colonic stricture

A 28 year old male was diagnosed with moderate-severe colonic and perianal Crohn’s disease and commenced on combination therapy with adalimumab and azathioprine. After six years, the patient developed secondary loss of response, with severe distal colitis and recurrent perianal fistulae and was switched the intravenous infliximab.

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Squamous cell carcinoma of scrotum- A confounding entity amongst benign lesions: A case report

Squamous cell carcinoma of the scrotum is a rare entity, the current incidence being 1 per million males/year. It was among the first occupational malignancies identified. A 45- year- old man with multiple sebaceous cysts of the scrotum, presented with a nodular ulcerated lesion over the right hemi-scrotum for 2 months, which appeared after incision and drainage of an abscess at the same site.

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An echocardiographic study of cardiac hypertrophy changes in hypothyroidism and response to treatment

A-73-year-old Japanese woman visited our hospital due to a 1-month history dyspnea and systemic edema. Echocardiography showed marked left ventricular symmetric hypertrophy. Laboratory findings indicated hypothyroidism. As the thyroid hormone levels were normal, her left ventricular hypertrophy was also normalized. Physicians should raise awareness regarding hypothyroidism when cardiomegaly is diagnosed based on echocardiography.

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Extranodal NK/T-Cell lymphoma with Behcet’s syndrome: A case report

Behcet’s Syndrome (BS), also known as Behcet’s disease, is a systemic immune system disease with vasculitis as its basic pathological manifestation, which can affect joints, blood vessels, heart, nerves, and other systems, mainly manifested as oral and perineal ulcers, erythema nodules of lower limbs, eye iritis, esophageal ulcers, small intestine or colon ulcers, joint swelling and pain, etc.

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A rare case of multiple deformities with idiopathic cause

A 26-year-old female patient came to physiotherapy OPD with multiple deformities in upper and lower limb. Patient is full term normal delivery, cried after birth weight was 2.5 kg. Patient has history of high-grade fever at the age of 7 to 8 month, after that she was normal. She started walking at the age of one and half year, but parents identify that walking is abnormal. Minimal weakness of upper and lower extremity was there but activities of daily living was normal.

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A comparative study on the prevalence of intestinal helminths in dewormed and non-dewormed healthy persons in Ghana

Helminthic infection is a significant public health concern in most developing countries. This study determined the prevalence of intestinal helminths in dewormed and non-dewormed health persons in Ghana. A cross-sectional descriptive study was conducted from January, 2021 to August, 2021. A total of 336 students and adult participants within the Accra metropolis were recruited after informed consent was obtained.

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Glypican-3 (GPC-3) for early diagnosis and target therapy

Liver cancer is one of the highest causes of cancer-related deaths worldwide, and China accounts for more than half of the new cases and deaths. It’s highly malignant and progresses rapidly. Once diagnosed, it is often in the late stage of the disease with limited treatment options and bad prognosis.

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Patients with different cancer types are reliably stratified by CBC data

Searching for informative indices indicating cancer type and cause of the disease is of great importance. Here we tried to identify those indices from the data of complete blood analysis, only. We studied the inhomogeneity in the mutual distribution of a number of oncology patients with various types of tumors in the space of qualitative data provided by the complete blood count.

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Clinical evaluation of preoperative skin preparation with aqueous povidone iodine only and in combination with alcoholic chlorhexidine in patients undergoing clean elective surgeries

Surgical site infections (SSIs) is a dangerous condition posing a heavy burden on the patient and social health system. Adequate pre-operative skin preparation helps in reducing the SSIs and this study is undertaken to compare the efficacy of povidone-iodine alone and in combination with chlorhexidine.

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Congenital giant progressive parotid hemangioma in an infant treated successfully with propranolol and steroids

An otherwise healthy baby girl was born normally and a small birth mark like spot on her right parotid area appeared around two weeks of age. This spot went on growing gradually with growth of the body in infancy. However, the patient presented with cosmetically ugly giant mass pushing the right ear lobule up and compressing the right external ear canal with secondary changes started coming up with superficial ulceration and bleeding.

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Congenital duodenal windsock deformity simulating midgut volvulus and treated with innovative minimal invasive technique and duodenoplasty

We present a 3200 gm female term neonate born by spontaneous vaginal delivery with uneventful antenatal scans and perinatal period who had passed normal meconium, breast fed for 6 days and presented with bilious vomiting simulating neonatal midgut volvulus. The baby was found to have double bubble in the upper abdomen and scattered gas bubble in the right lower abdomen.

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Successful treatment of advanced prostate cancer patient with moderate to severe COVID-19 infection: A case report and review of the literature

A novel coronavirus known as severe acute respiratory syndrome coronavirus2 (SARS-CoV2) discovered in late December 2019 in China and spread across the world rapidly. Cancer patients are among the more vulnerable population to severe COVID-19 infection. Immunosuppression caused by cytotoxic agents, comorbidities and aging may be the reason of their susceptibility to COVID-19.

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Erdheim-Chester disease with a late onset cardiovascular manifestations: A case report

Erdheim-Chester disease (ECD) is an uncommon non-Langerhans cell histiocytosis. Bilateral symmetric sclerosis of the long bones and probable multiorgan involvement are the main manifestations of this condition. Here, we report a case of ECD showing diffuse thickening of the aorta’s entire wall and pericardial effusion. We represent the case of a 50-year-old man with a diagnosis of ECD who was admitted because of dyspnea.

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Metastatic hip fracture in a patient with severe coronavirus disease 2019: Case report

During the 1st Alarm State in Spain due to the Coronavirus Disease 2019 pandemic the screening for cancer was suspended and in the following months the routine diagnosis suffered delays, which is supposed to hold up the final diagnosis and probably affect overall survival. We present a clinical case in which the diagnosis of suspicion thanks to a complete physical examination during an intensive care unit hospitalization because a severe Coronavirus Disease 2019 allowed an early diagnosis and treatment of the oncological process.

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Prediction of nomophobia based on shyness, loneliness and anxiety in Shiraz teenagers

Various factors can be associated with nomophobia in teenagers due to their sensitive age during puberty. Establishing effective communication and social relations is one of the most important concerns for teenagers and young people. The present applied study is conducted to predict nomophobia based on shyness, loneliness and anxiety among teenagers in Shiraz.

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Massive jugular foramen schwanoma revealed by the hypogloss paralysis

Jugular foramen schwannomas are a rare event with an estimated 200 cases reported in the literature. These tumors represent only 2.9% to 4% of all intracranial schwannomas and less than 1% of all temporal bone lesions. In addition to the rarity of these tumors, their variable presentation, varying degrees of cranial nerve involvement, and multiple treatment options make each case unique.

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Sickle cell disease - Impact of delayed diagnosis and non compliance to treatment

Sickle cell disease is an autosomal recessive hematological disorder resulting from a missense point mutation in the beta chain of the haemoglobin molecule. This article reports a case of homozygous sickle cell disease in an adult patient with long-standing history of non-healing ulcer. Subsequently, it calls for the need for detailed and careful investigation of inherited disorders in people of rural background and highlights the need for doctors to better convince people of low socio-economic status on compliance towards long term treatment.

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Giant pulmonary arterial saccular aneurysms in Behçet syndrome

A 28-year-old non-smoker male with Behçet syndrome presented with recurrent oral/genital ulcers and erythema nodosum, giant pulmonary arterial saccular aneurysms (Figure 1 A-D) with recurrent hemoptysis and a pulmonary nodule with biopsy suggestive of necrotizing vasculitis. The patient was initially treated with methylprednisolone and cyclophosphamide with no clinical or imaging response.

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Case report: Delayed onset of Guillain-Barré syndrome following SARS-CoV-2 infection

To date, little is known about the rare complications of SARS-CoV-2 infection. Here, we report a case of delayed onset of Guillain-Barre Syndrome (GBS) after such infection in a 40-year-old who was presented to the emergency department with fever and shortness of breath with no previous chronic condition. On a following visit, he was presented with bilateral lower extremity weakness. A final diagnosis of GBS was made after spinal fluid analysis.

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Varicella zoster virus cerebral vasculopathy without rash accompanied by mucous and bloody diarrhea successfully treated with intravenous acyclovir: A case report

In recent years it has become evident that Varicella Zoster Virus (VZV) reactivation can present as ischemic and hemorrhagic stroke or Gastrointestinal (GI) symptoms in immunocompetent and immunocompromised patients. Both VZV cerebrovascular and visceral manifestations may appear in the absence of a cutaneous rash. We present a 49-year-old male patient who presented with recurrent hemorrhagic strokes accompanied by abdominal pain and bloody and mucous in diarrhea.

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Conjunctival inclusion cyst emerging from a pterygium

A 35 year-old female presented with a painless swelling of the left eye, with foreign body sensation, and an aesthetic concern. There was no history of trauma or inflammatory episode. Ocular movements were normal. The blood vessels in the pterygium could be observed over the cyst, which is at the level of the body of the pterygium.

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Gardasil 9 vaccine for the treatment of recalcitrant plantar warts in an immunocompromised patient

Plantar warts (verruca plantaris) are benign epithelial tumors caused by HPV-1 (myrmecia) and HPV-2,-27 or,-57 (mosaic). They may be difficult to treat with many failures or recurrences after multiple treatments, especially in immunosuppressed patients. Small series have reported the interest of two HPV vaccines, Gardasil 4 (a quadrivalent vaccine targeting HPVs 6/11/16/18), and Cervarix (a bivalent vaccine targeting serotypes 16/18) in the treatment of cutaneous warts.

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