Articles

Hypertrophic cardiomyopathy is the most common form of cardiomyopathy. It is a heterogeneous genetic cardiac muscle disorder characterized by inappropriate left ventricular hypertrophy, malalignment of the myocardial fibers, and myocardial fibrosis.

The invasive airway approach, such as orotracheal intubation, laryngeal mask placement and suspension laryngoscopy for laryngeal microsurgery, may result in neurological complications in the postoperative period [1,2].

Sinusoidal Obstruction Syndrome (SOS) of the liver is a life-threatening disorder generally occurring as a complication of Hematopoietic Stem Cell Transplantation (HSCT). Here, we describe a case of a child with Hodgkin’s lymphoma and liver involvement who developed SOS during induction chemotherapy outside the transplant context, which is a very unusual presentation in pediatric patients.

Due to clinical suspicion of embolism, a 36-year-old gravida 5 para 4 patient was referred for CTPE five days after a normal vaginal delivery CTPE showed no pulmonary artery filling deficit. However, lung window measurements showed pneumoperitoneum.

Ulcerative Colitis (UC) is a chronic inflammatory bowel disease which is rare in the Nigerian populace. It is often misdiagnosed as most patients may not have ready access to endoscopy services which is key to diagnosis.

Screw Loosening (SL), called also “Implant Loosening: (IL), is a common complication after implant surgery when a screw (or screws are inserted in a bone since it was (mainly) broken, partially replaced, or cracked).

Acute mesenteric ischemia (AMI) is an uncommon life-threatening emergency in all acute surgical admissions with reported incidence rates of only 0.09-0.2% and a high mortality rate, ranging 30-90% [1,2].

Uterine adenosarcoma is rare and can be associated with pelvic radiation and tamoxifen therapy in postmenopausal women. Symptoms are nonspecific but a recurrent polypoid formation is a characteristic clinical feature.

Lichen Planus is a multifaceted mucocutaneous auto immune inflammatory disease of multiplex etiopathogenesis. Nail involvement is seen in up to 10-15% of patients. Most cases are mild, and serious consequences may occur due to swift progression of the disease, the high risk of scarring, and resulting in permanent damage to the nail architecture (4-12%).

Pulmonary actinomycosis is a rare chronic purulent granulomatous disease, which can be easily misdiagnosed as lung cancer, tuberculosis, and other diseases. However, diagnosis relies on histopathological evidence, and early diagnosis is conducive to the patient’s recovery.

Pancreas cancer with peritoneal involvement was found in a 64-year-old man for which he received 5-fluorouracile, folinic acid and oxaliplatin. One month later, the patient was referred to ICU for shock. Examination revealed intense abdominal and right scrotal pain. The patient received fluids, norepinephrine and intravenous piperacillin-tazobactam.

A 63-year-old man with right corona radiata infarct presented to our hospital with a history of abdominal distension, 500 cc melena, vital signs: Blood pressure 90 (systolic)/60 (diastolic), heart rate 90, total leukocyte count of 11500/cmm, hemoglobin 11.3 g/dl, platelet 414000/ μl, stool occult blood: Positive, a prothrombin time 15.5 sec.

Toxoplasma and Blastocystis sp. are two common single-celled parasites found worldwide. Although the pathogenesis of Blastocystis sp. is still unknown, it is frequently reported in immunocompromised patients. Toxoplasmosis is also becoming a primary health concern due to its high occurrence rate globally.

An 8-year-old Thai boy presented with a two-week history of anemia, abnormal purpura in both legs, and was diagnosed with B-cell acute lymphoblastic leukemia (B-cell ALL). Following Thai-POG guidelines, he underwent chemotherapy and received trimethoprim-sulfamethoxazole prophylaxis.

Hirschsprung Disease (HD) is a form of colonic aganglionosis with an incidence of 1 in 5000 liver births. It presents as constipation since birth with other intestinal and extraintestinal disorders. Here we present a case of a 22-year-old female who presented with constipation since birth and repeated episodes of melena requiring a total of eight units of blood transfusion for the last six years. There was a history of prolonged defecation and digital evacuation of stool.

Diagnosis of cancer is rare during pregnancy and renal cell carcinoma appears to be the most common urological neoplasm in gestation. We presented a 29-year-old pregnant woman who was treated with progestogen for secondary infertility and developed renal mass during pregnancy.

A 70-year-old male patient presented with bilateral lower limb weakness that progressively extended to the upper limbs. This weakness was accompanied by an inability to walk or stand, back pain, followed by paraparesis and paraplegia. He also experienced urine retention and no passage of stools or flatus, along with an episode of fever and weight loss.

When planning the management of a predicted difficult airway, it is important to determine which strategy will be followed. Using fiberoptic bronchoscopy is a major option in scenarios with factors suggesting difficult airway access.

It described the “ladder distribution” of Live Attenuated Influenza Vaccine (LAIV) reassortment between Vero cells adaption attenuated strain and wide type high virulent influenza virus strains by the reverse genetics approach.

Genitourinary tuberculosis is a rare manifestation of extrapulmonary tuberculosis in children with vague symptoms and clinical presentations. It may be complicated with obstruction, and urethral stricture, and may lead to chronic renal disease if not diagnosed and treated promptly.

Retrospective study aimed to investigate the anatomoclinical features of triple negative breast carcinoma and compare them with data in the literature. An exhaustive retrospective study of 50 cases of triple-negative breast cancer diagnosed in the Pathology Department at the Mohammed V Military Training Hospital in RABAT, for five years and 08 months from January 2018 to August 2023.

Scapulothoracic dissociation is rare but a limb-threating injury that usually occurs after high energy trauma. Our case was 2 year olds after low energy trauma with axillary mas and restricted movement of the right shoulder and radiographic finding showed that the scapula was displaced laterally.

Brown Adipose Tissue (BAT) activation with increased uptake on FDG-PET/CT studies is a well-known phenomenon. Activated BAT is usually seen in the supraclavicular region, but also in Para spinal and mediastinal locations, and rarely in perirenal sites. Here, we report a unique case of atypically intense, multilocular FDG uptake in activated BAT

Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors [1,2]. We present a rare case of a 52-year-old, without significant past medical history, initially reported intermittent right shoulder pain six years ago.

A 33-year-old female presented with four years of shortness of breath. She denied sputum production, fever, chills, chest pain or hemoptysis. She was diagnosed with pulmonary embolism four years prior, treated with anticoagulation for six months. Physical examination was remarkable for sinus tachycardia.

Chilaiditi syndrome is the colonic interposition to the liver reaching the under-surface of diaphragm with associated abdominal pain; it is one of the causes of pseudopneumoperitone- um. This clinical manifestation distinguishes chilaiditi syndrome from asymptomatic colonic interposition, which is termed as chilaiditi sign [1,2].

The patient had suffered from arthritis in both knees for several years. In discussions between the patient and the orthopaedic surgeon the decision was made to carry out a simultaneous bilateral complete knee replacement. Epidural anaesthesia was employed to remove feeling from the lower part of the body. The operation was completed successfully.

Sickle cell disease refers to a group of inherited disorders resulting from mutations in the gene encoding the haemoglobin subunit β. Main pathophysiological determinants of the disease’s course are vaso-occlusion, systemic inflammatory reaction and endothelial dysfunction.

We report the case of a 44-year-old-male presenting with hypertrophic cardiomyopathy and a biochemical analysis suggestive of a Fabry-disease but with a negative coding-regions sequencing of GLA gene (Next Generation Sequencing (NGS), Sanger sequencing and GLA large rearrangement assay).

In a 68-year-old male patient with long-term drinking, he appeared tongue tremor, hands shaking, hallucination, clarity of consciousness decline, disorientation at 12 days after stopping drinking, after discussion in our ward, his diagnosis was identified for delirium tremens. He was given the treatment by diazepam, high doses of B vitamins.

A 48-year-old female patient, with a medical history encompassing familial amyloidotic polyneuropathy and heart failure, became the focal point of a complex medical narrative. Admitted due to a symptomatic increase in right pleural effusion, accompanied by contralateral deviation of the mediastinum.

Snake envenomation is one of the important but neglected medical emergencies in countries like Nepal. Snake bite venom can cause hemotoxic, myotoxic and neurotoxic features. Russell’s Viper envenomation in known for its hemotoxic feature.

Synovial hemangioma is a rare benign tumor. This case report describes a 27-year-old woman who was admitted to the hospital with a 1-year history of pain in the popliteal fossa of the left knee and mobility limitation. According to the medical history and MRI examination, the patient was diagnosed as synovial hemangioma of the left knee.

A 4-year-old boy was admitted for polyuria and polydipsia syndrome for which the diagnosis of diabetes insipidus was retained after doing a hydrous restriction test with the Minirin test.

Osteonecrosis of the lunate bone or lunatomalacia, it is also known as Kienbok disease. The mechanisms by which this disorder develops are not fully understood, compromise of the bone vasculature is the most commonly proposed cause.

A 29-year-old man was referred by his primary care physician for hypertension resistant to antihypertensive drugs. For 1 year he had been suffering from bradypsychia, dizziness, asthenia, adynamia, muscle weakness and weight gain.

A gallstone may form within a duodenal diverticulum, entering the bowel without the presence of a biliary enteral fistula. This can result in a small bowel obstruction known as “gallstone ileus” but characterized by a normal gallbladder and no pneumobilia.

A 81-year-old man with previous history of arterial hypertension presented to the emergency department with sudden left chest pain and dyspnea, after having two episodes of non-bloody vomiting.

The objective was to investigate the correlation between early lactate levels and the early development of Intensive Care Unit-Acquired Weakness (ICU-AW) in patients with septic shock. Data from pneumonia-induced septic shock patients in our ICU were analyzed, dividing them into ICU-AW and non-ICU-AW groups based on ICU-AW development within 7 days.

Superior Mesenteric Artery (SMA) syndrome, also known as Wilkie’s syndrome, is a rare condition of duodenal obstruction due to extrinsic compression of the third portion of the duodenum by the superior mesenteric artery and the abdominal aorta.

Erythema Ab Igne (EAI) is a skin condition manifested by net-like darkening due to continuous exposure to moderate temperatures generated by various heat sources which predominantly appear in the calf area and distal region of the lower extremities. EAI diagnosis is clinical and treatment consists of removal of the heat source.

Frontal Fibrosing Alopecia (FFA) has been considered a variant of Lichen Planopilaris (LPP) in which characterized by gradual and progressive hair loss in frontal area of the scalp and facial papules.

Granulicatella elegans (G. elegans) is a Gram-positive facultative anaerobe and one type of Nutritionally Variant Streptococci (NVS) normally role as normal flora in human body, for example oral cavity. Rarely had this colony become infective compared to other Granulicatella.

Rituximab (RTX) is increasingly used to manage autoimmune diseases and haematological malignancies [1,2]. Contrary to the common adverse effect of hypersensitivity reactions and infection, late-onset complications of rituximab are rarely reported.

Urethral warts (condyloma acuminatum, CA) frequency is up to 12.5% of genital warts cases [1]. This case study reports a 78-year-old patient with a known history of penile shaft warts presenting with new onset haematuria. Flexible cystoscopy revealed papillary looking tumours in the bulbar urethra suspicious of primary urethral cancer.

A 56-year-old man was admitted to the hospital for acute decompensated heart failure and acute kidney injury. He had a history of smoking, hypertension, and obesity. He was diagnosed with acute myocardial infarction and received medical treatment.

Metastatic Pulmonary Calcification (MPC) is described as the deposition of calcium in normal lung parenchyma and is commonly associated with secondary hyperparathyroidism resulting from end-stage renal disease.

Non-recurrent laryngeal nerve is a rare anomaly which makes it prone to iatrogenic injury during thyroid surgeries. The aim of this article is to show the presence of non-recurrent laryngeal nerve in a patient being operated for thyroidectomy.

Hydatid disease, caused by encysted larvae of the dog tapeworm Echinococcus granulosus, results in the formation of proctoscoleces. The primary definitive host of the adult worm is the dog, while intermediate hosts for the larval stage include sheep and humans.

Thromboembolic events are severe but classic complications of chronic Inflammatory Bowel Disease (IBD). They are attributed to a pre-thrombotic state induced by the inflammatory activity of this disease. Most often, these are venous thrombosis of the limbs and pulmonary embolism.

A 58-year-old man with diabetes and human immunodeficiency virus presented to the emergency department in a state of acute catatonic rigidity, with the inability to speak, and the inability to relax his upper and lower limbs with gravity. Bedside glucometry revealed a blood sugar level of 29 milligrams per deciliter.

There is strong evidence that appropriate antibiotic medication is the cornerstone of effective severe sepsis, sepsis and septic shock treatment. It has been acknowledged that delaying the start of proper antibiotic medication increases the risk of death.

Extranodal tuberculosis is a rare pathology in ear nose and throat (ENT) sphere. It remains a worldwide health problem despite the development seen. We report 7 cases of extranodal localizations, collected at the ENT department of Farhat Hached Hospital Sousse, between 2008 and 2022.

Neonatal suppurative parotitis is a rare entity, its diagnosis is essentially clinical with a good prognosis usually. We report a case of a 21-day-old female whose been taken care of in our department for neonatal suppurative parotitis presenting with feverish, hard, red, tender swelling of the parotid loge.

A 35-year-old male reported to the emergency department after a road traffic accident with complaints of chest pain on the left side and breathing difficulty. On the primary survey, his GCS was full, his airway was patent, breathing spontaneously with a respiratory rate of 28/min with paradoxical movement.

A 60-year-old woman with a high-grade myxofibrosarcoma of her left forearm, submitted to surgical excision and postoperative radiotherapy, presented to the emergency department, after 3 years, with a 2-months history of progressive asthenia and shortness of breath.