Articles

Volume-4, 2023
Issue 6 (June)



Amyopathic dermatomyositis induced by the COVID-19 vaccination

Covid 19 vaccination have been employed to control the ongoing SARSCoV-2 pandemic and reduce the number of subsequent COVID-19 cases. Cutaneous reactions after SARS-CoV-2 vaccination are heterogeneous such as Immune-Mediated Diseases (IMD) that can flares or appeared after SARS-CoV2-vaccination. We report the first case, to the best of our knowledge, of amyopathic dermatomyositis secondary to COVID-19 Vaccine.

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An unusual instance of acquired intraoral cavernous lymphangioma

Lymphangiomas refers to hamartoma group and can be defined as rare congenital deformities caused by aberrant lymphatic vessel development, typically appear in infancy and the early years of childhood. They are rarely detected in the oral cavity and are typically found in the head and neck. Clinically, lymphangiomas can appear as localized or widespread growths that can expand to generate macroglossia of the tongue, which can cause speech impairment, mastication issues, airway obstruction, and other probable maxillofacial structure defects.

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Rheumatoid arthritis presenting as vasculitis and neuropathy: A case report and review

Rheumatoid vasculitis is a rare condition that causes inflammation of small or medium sized blood vessels. It most often affects vessels of skin, fingers, toes, nerves, eyes and heart. Neuropathy is also a rare extra articular complication of rheumatoid arthritis which is associated with vasculitis in most cases. We present a long standing untreated case of rheumatoid arthritis who presented with vasculitis and neuropathy.

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Scorpion sting complicated by ischemic stroke in a child

Scorpionic envenomations (SE) are a public health problem, especially in Morocco where they rank first, causing high morbidity and mortality. The presence of neurological signs marks the seriousness of this envenomation especially in the pediatric population, which remains more vulnerable to these intoxications. We present the rare observation of a child hospitalized in July 2022 in the pediatric department A of the CHU Mohammed VI of Marrakech, Morocco, for a stroke complicating a scorpion sting.

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Role of superior mesenteric artery doppler and maternal pancreatic size for prediction of gestational diabetes mellitus

Gestational Diabetes (GDM) is a glucose tolerance disorder that occurs or is diagnosed during pregnancy with no prior history of the disorder. Contemporary studies have reported that GDM affects 1%-14% of all pregnancies, and the incidence has been steadily rising. The mechanism of GDM is defined as insufficient/dysfunction of β-cell, which regulate the diabetogenic conditions by overcoming the antagonism created by the anti-insulin hormone of pregnancy.

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Optic nerve head and macular neurovasculature in psychosis

Studying the neurovasculature of the retina can provide invaluable information regarding Central Nervous System. This is mainly because the retina shares a common embryological origin with the brain. The neurosensory retina can be regarded as an extension of the brain itself.

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Moyamoya disease: A case report in a 10 years old Sudanese girl

Moyamoya Disease (MMD) is a rare pathology caused by a progressive unilateral or bilateral stenosis of the terminal portion of the internal carotid artery, leading to the development of collateral vessels. We report a rare case of a 10 years old girl presented with sudden onset of left side weakness not associated with headache or vomiting.

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34-year-old female with acute onset quadriparesis and recurrent carpopedal spasm

Gitelman syndrome is an autosomal recessive condition also characterized by hypokalemic metabolic alkalosis, with hypocalciuria and hypomagnesemia. The similarity between the features of Gitelman syndrome and those caused by thiazide administration originally suggested that the defect might be in the distal convoluted tubule.

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How team work makes the dream work: Successful management of internal carotid artery lesion during routine Functional Endoscopic Sinus Surgery (FESS)

We present the case of a 60-year-old male patient with a history of chronic rhinosinusitis with nasal polyps grade III who suffered an injury to the Internal Carotid Artery (ICA) during a scheduled Functional Endoscopic Sinus Surgery (FESS). After careful analysis of the case, all parties involved decided that an arterial reconstruction strategy with placement of a flow diverter stenting was the best approach for the patient. Finally, an optimal outcome was attained for the patient.

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The ‘Zebra Spleen’: CT enhancement pattern of the spleen

Zebra spleen, also referred to as psychedelic spleen is a radiological sign reflecting the transient heterogeneous parenchymal enhancement of the spleen during the arterial or early portal venous phases of contrast enhancement in CT, MRI, or ultrasound imaging.

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Apocrine cancer: Clinical image

The incidence of apocrine carcinoma, a rare subtype of breast cancer, ranges from 0.3 to 4%. Currently, its prognosis and treatment are the same as those of other ductal carcinomas without apocrine disruption. However, the management of patients may be affected by its recognition.

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A case of complicated falciparum malaria from coming back from Myanmar-India border presenting with cerebral malaria, black water fever, acute kidney injury, metabolic acidosis, hypocalcemia, severe anemia, thrombocytopenia and hepatitis having early para

A-39-year-old migrant worker coming back from Palatwa (Sagaing Division) and Myanmar-India border area (Rakhine State) developed cerebral malaria, acute kidney injury and metabolic acidosis. He was treated with intravenous artemisinine followed by ACT (artemisinine combination therapy); Dihydroartemisinine- piperaquine, hemodialysis, fresh blood transfusion.

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Comparison of the patient demographics, high resolution computed tomography (HRCT) features of the pulmonary ground-glass opacity (GGO) and its diagnostic value analysis

Pulmonary Ground-Glass Opacity (GGO) on Computed Tomography (CT) is considered a diagnostic feature of lung adenocarcinoma. However, a significant radiological predictive sign remain controversial. We retrospectively analyzed 206 patients with GGO to developing a correlation analysis model between CT images and diagnosis of GGO nodules.

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Bald vulture appearence

Mr. X, a 32 year old man (Figure 1) presented in clinic with breathlessness since 1 year despite being on a dual agent inhaler therapy and Ms. Y, a 68 year old lady (Figure 2) was received in emergency in a state of respiratory failure and was intubated. Both patients had a history of pulmonary tuberculosis in past.

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UHRF1: A diagnostic and prognostic marker of cancer

There are many members of the UHRF family including UHRF1, UHRF2, UHRF3, and UHRF4 having different functions. In this review, we mainly study the activity of UHRF1. It is a multi-domain protein associated with epigenetic mechanisms of cell regulation and proliferation. UHRF1 stands for Ubiquitin-like PHD Ring finger 1 having a location in the chromosomal region 19p13.3.

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Otologic presentation of nasal rhinosporidiosis: A clinical picture

25 year, male, pilot by profession presented with complaints of blockage and pain in (R) ear for 2 weeks. Otoendoscopic examination revealed fluid menisci behind (R) Tympanic membrane. On Diagnostic nasal endoscopy, a bluish-grey mass arising near (R) inferior meatus was seen extending posteriorly over the nasal floor with a pinkish hue with multiple white spots (classical strawberry appearance) over the surface.

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Peritonitis after rosemary infusion: Is it possible?

We report a case of a 65-year-old-woman, with no pathological history. The patient developed acute onset of perpetual widespread abdominal pain and intermittent episodes of postprandial vomiting. She presented to the emergency department 24 hours after the beginning of symptoms. A physical examination revealed haemodynamically stable patient with generalized abdominal defense.

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A rare presentation of idiopathic distal radial artery aneurysm in anatomical snuff box in a 40 year old male

True non- traumatic radial artery aneurysms (RAAs) are uncommon; just a small number of cases have been reported. The majority are iatrogenic pseudo-aneurysms caused by arterial cannulation and have traumatic origins. There have also been reports of other uncommon causes include vascular tumors, connective tissue disorders, and industrial injuries.

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Monostotic paget’s bone disease of the pelvis

Paget’s disease is a metabolic disorder of the elderly characterized by an excessive bone resorption followed by an excessive and anarchic bone formation responsible for a bone remodeling. It is often asymptomatic of fortuitous discovery. Conventional radiology and CT scans often allow the diagnosis to be made with certainty. Alkaline phosphatases mark activity and therapeutic response.

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Studies on the mutagenic and tumor-promoting effects of TRF2 protein in the mechanism of tumor formation

In recent years, the gene mutation hypothesis related to tumor formation has been deeply studied, and some scholars have put forward some new views on the basis of the original theory. The view that tumor formation begins with the genetic material variation of somatic cells has been confirmed and universally recognized by the academic community.

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Diagnostic value of 15 days fever history for screening of kala-azar with rK39 test kit: A hospital-based observational study

Visceral Leishmaniasis (VL), also known as kala-azar, is a neglected vector-borne disease and a major public health problem in Bihar, India. The disease is targeted for elimination (reducing incidence to less than one per 10,000 populations at the PHC level) by 2020. Despite the main strategy, early detection of KA cases is still posing a greater challenge to KA elimination from the Indian subcontinent.

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Imatinib associated generalized exfoliation and scaly cutaneous lesions with facial predominance

We report the case of a 62-year-old female patient who presented to us with complaints of low grade fever, fatigue and left upper abdomen discomfort. Her routine physical examination was unremarkable except for splenomegaly 5 cm below costal margin. Her blood profile showed a WBC count of 122,740/mm3 with left shift and 1% blast, hemoglobin was 11.3 gm/dL, hematocrit was 34.1% and platelet count was 163,000/ mm3.

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The magnitude of maternal near-miss cases in public hospitals of Hadiya zone, southern Ethiopia

Reducing the maternal mortality ratio below 70 per 100,000 live births for all countries by the year 2030 is one of the targets of the UN’s sustainable development goals. Hence, knowing the magnitude of maternal near-miss would tell us the scope of planning to accelerate the achievement of this target as women who survive severe obstetric complications have many characteristics in common with maternal death events.

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The serpent or snake sign in liver hydatid cyst

The liver hydatid cyst is becoming a worldwide parasitic disease due to the immigrants from pandemic countries [1]. In some cases, the diagnosis is challenging and debatable and the imaging features are helpful. For this reason, the different radiological specific signs should be well known.

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Insulin therapy combined or not with metformin is associated to a reduced bone mineral density and content in type 2 diabetic postmenopausal women

Anti-diabetic drugs may have negative, positive or neutral effect on bone health. The aim of this study was to compare the effect of combined treatment of metformin and insulin, metformin monotherapy and insulin monotherapy on Bone Mineral Density (BMD), Bone Mineral Content (BMC) and bone markers in postmenopausal women. In this cross-sectional study, a total of 81 postmenopausal women aged 50 years or older were recruited.

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The distribution of curative care expenditure on gender, age and disease system among patients with noncommunicable diseases based on SHA 2011: A cross-sectional study in 2016-2018, Beijing

To analyze the distribution of curative care expenditure on gender, age and disease system of patients with Noncommunicable Diseases (NCDs) in different level of medical institutions, thus providing reference for the Hierarchical Medical System (HMS). A multistage stratified cluster sampling survey was used for hospital sampling. System of Health Accounts 2011 (SHA2011) was used to account the Curative Care Expenditure (CCE).

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Tropical paradise turns into a nightmare. A rare case of evisceration caused by the misuse of over-the-counter proparacaine and dexamethasone eye drops

The abuse of topical anesthetics and steroids is not uncommon. However, having an eye eviscerated is rare due to complications from abusing both topical eyedrops. We report a case of Left Eye (LE) severe corneal ulcer with panophthalmitis secondary to over-the-counter topical proparacaine and topical dexamethasone abuse. His vision was No Perception of Light (NPL).

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Clinico-social case report of lepromatous leprosy in a rural area of Central India

Leprosy is a well-known disease (Hansen’s Disease) since the days of Sushruta and Charkas and is caused by Mycobacterium leprae. In Vedic reference, it is mentioned as “Kusht Rog” [1]. It is one of the important causes of permanent physical deformity and the social stigma attached to it grossly increases the level of stress.

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Oropharyngeal Kaposi’s sarcoma in a non-immunosuppressed patient

Kaposi’s sarcoma is a malignant tumor caused by the HHV-8. It usually occurs in people with weakened immune systems, due to HIV/AIDS. We expose the diagnostic-therapeutic process of a 71-year-old man with an oropharyngeal Kaposi’s sarcoma due to infection with human herpes virus 8 without alteration of the immune system.

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A rare case of an inclusion cyst mimicking carcinoma unknown primary with secondary in the neck

Squamous cell carcinomas of Head and Neck are at a rising trend since recent years. Southeast Asia (especially the Indian subcontinent) is a high-risk region for these cancers. More than 200,000 new such cases are reported each year in India. Patients usually present with a neck mass without any other known primary tumour. The differential diagnosis includes both benign and malignant growth, of which malignant can be either primary tumours or metastases.

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Characterization of oral-derived neural crest-derived stem cell populations (oNCSCs) in the teeth: Therapeutic potential for bone tissue engineering

Oral Neural Crest-Derived Stem Cells (oNCSCs) are a type of adult stem cell that can be isolated from the oral cavity. These stem cells have the ability to differentiate into various cell types, including neurons, glial cells, and adipocytes. oNCSCs have been shown to play a crucial role in the regeneration and repair of damaged tissues in the oral cavity, making them a promising candidate for use in regenerative medicine.

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Squamous cell carcinoma of the face with a focus of myiasis

An 87-year-old woman was admitted to a public hospital in São Paulo, Brazil, with an extensive, ulcerated, infected lesion with bleeding on her face, along with a focus of myiasis. The lesion had appeared 15 years ago on the right malar region, but the patient had never sought treatment. In the past year, the lesion had progressed more rapidly, involving the entire right hemiface and orbit region.

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Cases of severe hypotension caused by prone position in patients with scoliosis: A case report

We hope to provide useful experience for clinical workers about the solutions to the critical situation of severe hypotension in scoliosis surgery. Hypotension was prevented by using Kocher’s forceps to lift the exposed vertebral body and then rotating the staple to relieve body pressure on the stent, thereby relieving right ventricular outflow tract obstruction and ensuring a safe blood pressure level.

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Naevo-cellular nevus of pregnancy mimicking melanoma

It is a common opinion that expansion and darkening in melanocytic nevi may occur during pregnancy. The main problem is that whether is an usual finding, or it is a condition that requires suspicion about melanoma. We report the story of a patient with a pigmented lesion of the abdomen that changed in size and color during pregnancy mimicking melanoma.

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The dangerous safety pin: Melioidosis

Melioidosis, although endemic, is often misdiagnosed and underreported in India. This is a case report of a 36 year old male patient, who was thought to have a head injury and aspiration pneumonia, and was ultimately diagnosed to have melioidosis, based on peculiar clinical, radiological and microbiological characteristics.

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Inflammasomes in health and disease

Inflammation is a complex process that helps the body to eliminate invading pathogens or damaged cells, and initiates the repair process. The inflammasomes are a class of cytosolic large protein complexes that are responsible for the activation of inflammatory responses and inducing programmed cell death. Inflammasome activation has been implicated in the pathogenesis of various diseases, including infectious, autoimmune, and metabolic disorders.

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Frontal swelling of the forehead in a teenager

A 16-year-old male was admitted to the pediatric emergency department with headache, frontal swelling and fever. Physical examination revealed a prominent frontal swelling, painful on palpation. Analytical evaluation showed a rise in inflammatory markers (leukocytes 15100 cells/μL, 84.3% neutrophils and C-reactive protein 17.19 mg/dL).

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Adnexal cyst masquerading as a distended urinary bladder

A 45 year old female with Diabetes presented with bloating, abdominal distension and urinary urgency for past 3 months. On examination, there was suprapubic tenderness with a large palpable mass in the location of the urinary bladder that was seen extending to the umbilicus. A provisional diagnosis of urinary retention was made for which a foley catheter was inserted.

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A therapeutic challenge in an elderly woman and spectacular clinical response to an unusual left supra-clavicular metastasis of ovarian adenocarcinoma

Ovarian carcinomas with a single left supraclavicular metastasis in the node of Virchow are rare. We report a case of an 80-year-old woman with a large painful left supraclavicular adenopathy. Immunohistochemical study of the lymph node biopsy and pelvic magnetic resonance imaging revealed adenocarcinoma of ovarian origin. After three courses of full-dose carboplatin-based chemotherapy.

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Diagnosis of congenital bronchobiliary fistula in children by bilirubin crystallization in the bronchoalveolar lavage fluid: A case report and literature review

Congenital Bronchobiliary Fistula (CBBF) is a rare disease with abnormal connection between the biliary tract and the bronchus. The misdiagnosis rate of CBBF is high, delayed surgery may induce poor outcome. We reported a girl with CBBF who was confirmed via bronchoscopy and chest Computed Tomography (CT).

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