IMPACT FACTOR: 2.1
Short Name: J Case Rep Clin Images
ISSN: 2639-9237
Publisher: MedDocs Publishers LLC
Lymphoepithelial parotid cysts are rare in HIV-negative patients and recurrence rate is very low when they occur. As of our knowledge, there is no similar reported case in the English literature. We present a case of a 42-year-old female Human retroviral infection (HIV) negative female patient who presented with recurrent parotid swelling.
The COVID-19 pandemic has led to an increase in secondary infections, including mucormycosis, particularly among immunocompromised patients. A 58-year-old male with uncontrolled diabetes and a history of right-sided stroke presented with continuous fever and severe dyspnea. Initial antibiotic therapy failed to resolve symptoms.
Scurvy, a condition resulting from vitamin C (ascorbic acid) deficiency, was previously thought to be rare in affluent countries, yet its prevalence has increased in recent years even in these regions.
A tumor originating from juxtaglomerular cells can produce renin, thus also called Reninoma, which leads to hypertension by secondary hyperaldosteronism. Here, we report the case of a 27-year-old female presenting with a 32mmx29mmx27mm centrally located, solid kidney tumor in the middle pole of the left kidney.
Postoperative complications are common and can occur in any individual ranging from postoperative nausea, vomiting, psychosis, haemorrhage, shock, surgical site infection, respiratory complications and death [1].
A 24-year-old male presented with a 2-year history of an insidiously expanding lesion to his left lateral thigh (Panel A) and widespread pink annular scaly plaques with central hypopigmentation to torso and extremities.
A male infant, delivered prematurely at 36 weeks and 2 days, received a prenatal diagnosis of a cardiac malformation, specifically a ventricular septal defect. He was admitted on the neonatal intensive care unit for monitoring and potential initiation of therapy. At birth, only transient alveolar recruitment was necessary.
Purpose: Of all cancers, Gastric Cancer (GC) is the third leading cause of cancer mortality and the fifth prevalent malign tumor to be diagnosed (except skin cancers) [1]. Adenocarcinomas, which develop from the glands of the stomach's mucosaor superficial layer, account for themajority of stomach cancer cases [2].
Purpose: Clinical prediction of survival (CPS) is based on the physician's opinion. Systematic reviews on the subject show that clinicians tend to more often overestimate than underestimate patients' survival. This study aimed to explore the Portuguese experience in prognostication in advanced cancer patients and assess if some clinician´s aspects or patient characteristics may have any impact on the process.
Background: Revascularization of the septal branch of the Left Anterior Descending artery is challenging due to its intramyocardial course. Percutaneous interventions, such as balloon angioplasty or stenting, are preferred in cases where traditional coronary artery bypass grafting is not feasible.
Moyamoya disease is an uncommon vascular cause of young onset stroke. We present a case of a 35-year-old Sri Lankan female with recurrent transient ischaemic attacks and migrainous type headache presenting with dense Middle Cerebral Artery (MCA) territory ischaemic infarct, who on extensive workup was diagnosed to have typical cerebral angiographic evidence of intracranial cerebrovascular occlusion and "puff of smoke", which are typical of Moyamoya disease
Cerebral Venous Sinus Thrombosis (CVST) is a potentially life-threatening condition associated with high mortality and morbidity. We present a unique case of a young man who presented with acute worsening headache ten days after a non-penetrating head injury, and subsequent neuroimaging revealed extensive CVST without underlying skull fractures.
Self-Healing Juvenile Cutaneous Mucinosis (SHJCM) is a rare, self-limiting disease with an unknown etiogenesis. Pediatric patients present with a variety of skin lesions that spontaneously resolve in a matter of weeks to months. We present a case of a 14-year-old Filipino boy with a 2-month history of recurrent well-defined, nontender nodules with surrounding halo-like ecchymoses on the trunk and extremities that spontaneously resolve in 10-14 days
Evans Syndrome (ES) is defined as the concomitant or sequential association of warm Autoimmune Hemolytic Anemia (AIHA) with Immune Thrombocytopenic Purpura (ITP), and less frequently autoimmune neutropenia. Its chronic course is characterized by recurrent relapses and remissions. The typical clinical course is chronic and relapsing, and therapy is generally progressive and of poor outcome. We present a case of evans syndrome who was doing well on treatment with azathioprine and steroids but deteriorated and succumbed to her illness due to non compliance.
Background: The ingestion of eggs of Taenia solium (also called pork tapeworm) determines infestation of the Central Nervous System (CNS) by the larval form of parasites with the formation of multiple cysts. The main diagnostic criteria for neurocysticercosis is the evidence of cystic lesions showing the presence of scolex on neuroimaging studies, typically MRI) or CT.
Background: Desmoid tumors are a rare type of soft tissue tumor that arise from connective tissue cells known as fibroblasts. They occur most commonly found in the abdominal wall. They are typically locally invasive and cause significant morbidity [1].
A Filipino female teenager with gross deformity of her right wrist, came as an outpatient for radiographic evaluation nonspecific pain and numbness after prolonged repetitive, active wrist movements like writing and clapping, are noted with no history of trauma, infection, or surgical intervention of the aforementioned wrist.
In this article I will be reviewing my personal experience with acne and the wide range of treatments I have received, which includes multiple antibiotics, spironolactone, numerous topical creams, holistic remedies, the contraceptive pill, Roaccutane and not to mention the numerous specialists I have seen. My acne journey has thus far lasted over three years and I believe it is the right time to share my experience to let people know they are not alone.
Several complications are reported after laparoscopic surgery. In this case, we underestimated small elevation of the right diaphragm in preoperative chest X-ray photograph, resulting in hypoxia due to atelectasis after laparoscopic surgery.
Filariasis is a rare disease which is a parasitic infection caused by Wuchereria Bancrofti. In 2006 there were 50 million people infected with or without symptoms. In 2005 95% of the cases in India were in Andhra Pradesh, Bihar, Gujarat, Kerala, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal [1].
Non-Bullous Congenital Ichthyosis (NBCI) is a rare genetic disorder that presents with dry, scaly skin due to impaired shedding of skin cells. We report a case of NBCI in a neonate born to consanguineous parents, who was diagnosed with a TGM1 gene mutation. The patient received treatment with oral retinoids, which were carefully monitored by clinical pharmacists to minimize the risk of adverse effects.
Nasopharyngeal Carcinoma (NPC) is one of the most common head and neck cancers. Positron emission tomography/computed tomography (PET/CT) combines biological metabolic information and anatomical images, and therefore, plays a crucial role in the diagnosis, treatment, and prognosis of NPCs.
We have entered 2023. Humans have the utmost staging and prognostic criterias for cancers. Yet we can never predict how a stage I breast tumour shockingly metastasizes to stage IV within a month in some cases. Or miraculously a patient on palliative care for recurrent carcinoma head and neck stabilizes and lives a long life on targeted therapy.
There is lack of accurate methods to diagnose Major Depressive Disorder (MDD), one of the most prevalent global psychiatric disorders. Possible pathophysiological effects could be used in assessment of depression, and for this purpose Electroencephalography (EEG) and Functional Magnetic Resonance Imaging (fMRI) are being studied. In addition, Functional Near-Infrared Spectroscopy (fNIRS) shows promising results as a method to assess MDD.
COVID-19 is nowadays understood as a systemic disease rather than an acute respiratory infection. Neurotrophic properties have been attributed to this virus, generating great concern due to its long-lasting consequences. Hereby we present the first case of rapid progression of cerebral atrophy associated with SARS-CoV-2 infection.
Airway loss during an operative procedure is potentially fatal. This is especially challenging in patients that are positioned non-supine as is the case in lateral decubitus positioning that is standard for the majority of lung resections. We present a novel approach that enabled rapid control of a lost airway during open thoracotomy and endotracheal tube exchange for such a patient.
Estimates on palliative care and mortality due to Non-Communicable Disease (NCD) for most nations are seemingly absent in the literature. An insightful data centric approach is a requisite need to fill in the void as a contribution to the existing body of knowledge.
Overall survival is directly correlated to melanoma thickness and definitive surgical excision. Spindle cell melanoma is a rare subtype of malignant melanoma and particularly difficult to diagnose. Identification of histopathological features and referral to specialists are essential.
We present a teen scooter rider who suffered from a major traffic accident. Multiple skull base fractures, subarachnoid hemorrhage (SAH), and a supraclinoid ICA pseudoaneurysm with transdural connection to the Cavernous Sinus (CS), forming Carotid-Cavernous Fistula (CCF), were diagnosed by brain computed tomography (CT) and angiography. Endovascular treatment was done 4 days later, and initial complete occlusion was achieved by combined transarterial and transvenous coil embolization.
Osteogenesis imperfecta (OI) is a group of disorders characterized by osteopenia, fractures, short statures, bone deformity, blue sclera and hyper laxity of ligaments and skin, with a prevalence 6-7 per 100 000 individuals. There are four main kinds of OI with type II being the most severe; it is inherited in an autosomal recessive pattern with prenatally lethally deforming OI with multiple congenital fractures, micromelia and severe lung disease.
A 74-year-old female patient under the care of the medical team was admitted as a failed discharge from Urology. The patient had undergone bilateral nephrostomy placement for obstructive nephropathy. The left-sided nephrostomy had previously been removed and the right-sided nephrostomy was on free drainage until follow-up Urology appointment 6 weeks from the point of review.
Splenic Flexure Volvulus (SFV) is rare and accounts for only 1-2% of all colonic volvulus, with approximately 50 cases being described in the literature. Patients typically present with non-specific symptoms of a large bowel obstruction such as abdominal pain, distension, obstipation, nausea or vomiting.
Median arcuate ligament syndrome (MALS) is defined by the clinical presentation and radiological findings of compression of the celiac trunk by the median arcuate ligament. The diagnosis is controversial, and generally one of exclusion due to poorly understood pathophysiological processes, variable clinical severity, and unpredictable response to treatment.
Dialysis-dependent stage 5 chronic kidney disease with renal osteodystrophy can lead to a rare and extreme form of cranial deformities called Sagliker syndrome, a condition driven by extreme parathyroid hormone production and characterized by disordered skeletal remodeling resulting in severe facial abnormalities, dental deformities, and possible psychological changes.
Bowel evisceration is a rare complication of hysterectomy with only 100 cases reported so far. The evisceration occurs through the vaginal cuff dehiscence, which is found in 0.24-0.39% of all hysterectomies. This is a surgical emergency where bowel injury and peritonitis can occur if not treated promptly. Some studies report increased rate of the vaginal cuff dehiscence associated with minimally invasive techniques of hysterectomy
Disseminated tuberculosis defined as concurrent involvement of at least two non-contiguous organ sites organ sites of the body or involvement of blood or bone marrow by tuberculosis process [1]. Disseminated tuberculosis continue to be a diagnostic problem even tuberculosis endemic areas. Its account less than 2% of all cases of tuberculosis [2]. Among extra pulmonary tuberculosis only 3-4% develop abdominal tuberculosis and in case abdominal tuberculosis perianal involvement is a rare phenomenon...
90% of Chronic Myeloid Leukemia (CML) patients having Philadelphia (Ph) chromosome or t(9;22)(q34;q11.2), and the remaining 5–8% of CML patients demonstrate variant translocations, with the involvement of third, fourth, or fifth chromosome other than 9;22. Though, in very rare cases, the fourth chromosome is involved. Here, we found a novel case of four-way translocation involving 46,XY,t(1;3;9;22)(p36;p14;q34;q11.2) in CML-chronic phase...
The case of a 58 year old, Caucasian man, presenting with homonymous hemianopia, in conjunction with previously undiagnosed diabetes, who attend the Emergency Department with an elevated haemoglobin A1c of 16.5% and a random serum glucose of 23.0 mmol/L, was published in your journal [1]. This case was identified as the first report of a ‘stroke mimic’, presenting with hemianopia in conjunction with diabetes, confirmed following full investigation, including repeated Magnetic Resonance Imaging (MRI)...
Purpose: Multiple primary neoplasms are defined as two or more synchronously or metachronously occurring tumors of separate origins in the same individual. Either cerebral oligodendroglioma or adrenal ganglioneuroma have been diagnosed as constituents of multiple primary neoplasms in several patients. However, there is no report of concurrent occurrence of these two tumors in a single patient.
A 77-year-old female, with background of refractory metastatic papillary thyroid cancer after a 2-stage thyroidectomy in 2016 and radioactive iodine ablation, presented with dyspnea and chest pain. She was COVID-19 positive. Computed tomography of thorax demonstrated marked progression in pleural soft tissue metastasis with pleural thickening and a large pleural effusion. She required chest drainage...
Bipolar Disorder (BPD) is a complex disorder and it is essential to understand the mechanisms underlying the disease stages. We present a case report of a 25-year-old male patient was diagnosed with type 1 BPD according to the DSM-5 and the SCID for DSM-5. He was referred to a private clinic because of complaints of persecutory delusions, mystical delirium, and hallucinations...
Highly Active Anti-Retroviral Therapy (HAART) may be related to Immune Restoration Inflammatory Syndrome (IRIS). Although rare, Graves’ disease may present as part of IRIS but usually presents 12-24 months after HAART initiation. We report a case of hyperthyroidism that developed 34 months after initiation of a new HAART regimen.
Focal neurological symptoms, in the context of non-ketotic hyperosomolar hyperglycaemic state (HHS), are a well-documented phenomenon. It is less clear whether focal neurological symptoms can be a manifestation of hyperglycaemia without evidence of ketosis or hyperosmolality. This report describes a case of a 58 year old Caucasian male who presented with a macula-sparing left homonymous hemianopia in the context of hyperglycaemia and a new diagnosis of type 2 diabetes mellitus without any radiological evidence of stroke on Computer Tomography (CT) or Magnetic Resonance Imaging (MRI) of the brain...
Central venous access in an intensive care unit is indicated for venous access, parenteral nourishment, inotrope infusion and blood transfusions. Central venous access can be obtained in multiple veins like the internal jugular, subclavian and femoral vein. It can be obtained via either ultrasound-guided or landmark-guided approach. Infection, catheter malpositioning, venous perforation, arterial puncture, hemothorax and pneumothorax are some of the associated complications...
Mucinous tubular and spindle cell carcinoma is a rare tumor described in the 2004 WHO classification as a new entity with a relatively indolent behavior. We report a case of 60 year old man with a large left upper pole tumor. The patient was treated by left radical nephrectomy. The histologic findings confirmed that it was a tubulo -mucinous carcinoma and spindle cell grade I Furhman contours with non-infiltrating hilar invasion...
A 30 year old female, with clinical suspicion of chronic myeloid leukaemia, was advised to have a Bone Marrow (BM) triphene biopsy to establish the diagnosis. The BM trephine biopsy was done from the right posterior superior iliac spine. 10-12 hours following the BM biopsy, she complained of severe abdominal pain and distension along with a few episodes of non-bilious vomiting...
Antiepileptic drugs frequently provoke Cutaneous Adverse Drug Reactions (cADRs). The management of these reactions often requires discontinuation of the therapy. Cross reactivity among the most common antiepileptics (phenytoin, carbamazepine, and oxcarbazepine) is reported.
End-stage temporomandibular joint diseases often cause pain in the area of joint, jaw opening limitation or facial deformity, and treatment of total joint reconstruction is recommended. However, the surgical procedures generally ignored the reconstruction of Lateral Pterygoid Muscle (LPM), leading to mouth opening deviation unilaterally or vanishment of lateral movement bilaterally...
Chemoports are implantable devices that provide central venous access for chemotherapy, parenteral nourishment, and blood transfusions, among other procedures. They have significantly reduced the morbidity associated with chemotherapy administered peripherally. Cephalic venous cut down technique is a well-known approach for central venous catheter implantation among the several proven procedures...
Immune checkpoint Inhibitor Therapy (ICI) represents a novel approach of modern oncology and has improved survival in metastatic melanoma, lung cancer and renal cancer. The main endocrine complications of ICI, usually irreversible, include thyroid dysfunctions and hypophysitis. The exact mechanisms by which ICI may induce a stimulated immune response leading eventually to Immune Related Adverse Events (irAEs) are still not fully understood...
Introduction: Stress fractures are common in athletes, accounting for 1-20% of all sports injuries attending sport clinics. Literature has reported few cases of femoral neck stress fractures (FNSF) which represent only 10% of all stress fractures.
To predict “extubation failure” is essential, as both delayed and failed extubation have detrimental consequences such as prolonged ventilation and long Intensive Care Unit (ICU) stay, need for tracheostomy, increased cost of treatment and mortality. However, it is not an easy task to predict which patients are to fail with the extubation process merely based on the conventional parameters of extubation for any critical patient in an ICU setting in general and neurocritical patient in particular...
A soft tissue ganglion presents as a localized cystic mass about a joint, usually at the wrist and ankle. An uncommon intraosseous ganglion resembling a geode may be seen in a bone adjoining a normal-appearing joint. A rare periosteal ganglion with variable cortical bone erosion occurs at surface of a bone...
The objective of this study is to summarize and review the literature data about Methamphetamines use during pregnancy, its effects on fetal and neonatal outcome. In the recent years, the increase of Methamphetamines abusers women has become an emerging problem. Very little data has been published regarding the effects of prenatal methamphetamines exposure. We reviewed articles reporting the Methamphetamines related toxicity both in the mothers and in the newborns...
Background: Renal malignancies in pregnancy are rare occurrences with a little over 100 cases described in literature. It is usually diagnosed and managed in the first trimester but we present the management of a third trimester pregnancy with renal mass
Case Presentation: A 27-year-old primigravida presented with a left sided intermittent pain at 32 weeks of pregnancy that on an ANC ultrasound revealed a renal mass...
Objective: The α and β Thalassaemias, a disorder of globin chain production, is an increasing global health problem. We performed a cross-sectional study of 384 undergraduates of the University of Sri Jayewardenepura to determine the prevalence and awareness of thalassaemia-minor among the students.
Coronavirus Disease (COVID-19) has presented significant challenges and burden to healthcare. Majority of patients have mild-moderate disease and are managed in a non-hospitalized home care setting by family physicians. COVID has pathological mechanisms that include endothelial injury and hypercoagulability due inflammatory mediators...
Background: Variations in biliary anatomy are frequently encountered. Of these, a Double Gallbladder (GB), with or without duplication of cystic duct is a very rare surgical encounter, with an incidence of approximately 1 in 4000-5000 population. There are multiple different subtypes of gallbladder duplication and knowledge of these is essential for diagnosis and operative management. We report a case of a previously unreported variant that lies outside of the current accepted classification.
Exertional Rhabdomyolysis (ER) finds itself an increasingly common cause of rhabdomyolysis as spin classes gain popularity amongst Singaporeans as a means to keep fit. We report 2 cases of ER, both of which were associated with recent attendance at spin classes. Both cases were treated with vigorous hydration and discharged with good renal function and mobility. This paper aims to raise the awareness of ER, which may be especially pertinent for general practitioners and emergency physicians...
Covid-19 has a worse prognosis on diabetic patients who can present with severe metabolic complications. We present a case of a new diagnosis likely type 1 diabetes in a middle age non-obese white female, who presented with severe Diabetic Ketoacidosis (DKA), which was resistant to treatment, and her management required slight deviation from the guidelines to improve her outcome...
There is a dangerous liaison between severe asthma with co-morbidities and COVID-19 disease. There are several factors, which have been associated with increased risk for COVID-19 severity and mortality. Severe allergic asthma with co-morbidities such as poor lung function, adrenal suppression, recurrent nasal polyposis, food and drug hypersensitivity reaction in addition to older age, endocrine-metabolic and cardiovascular disease, have increased risk of hospitalization and mortality...
Head neck region is a complex region with multiple structures close to each other. The maxilla is bounded by orbit superiorly, nasal cavity medially, the oral cavity inferiorly and the pterygomaxillary fissure posteriorly. Carcinomas arising in such a location with sarcomatoid histology tend to invade almost all the surrounding structures. Management of such a locally advanced cancer with such an unfavourable histology requires a bloc excision of the involved structures with a wide margin...
A 36 years old male presented with complaints of chest pain and palpitation for 5-7 days. He had similar complaints intermittently since last one year. He was examined in outdoor and his blood pressure was found as 172/96 mmHg with heart rate of 116 per minute. His ECG was done, which revealed ST segment depression in leads II, III, AVf, V5-V6 and peaking of T wave in V2 to V4...
A 35-year-old female with a history of migraine was admitted to the emergency department with severe headache with normal neurological exam. The patient evolved to convulsive crisis with identification of a non-pulsatile left cervical hematoma, chest wall hematoma and exuberant collateral venous circulation (observed in the images)...
Arterial stiffness is directly related to increased cardiovascular events [1-7]. Increased arterial stiffness, is a measure of the elasticity of arteries, has been shown to increase the risk of myocardial infarction and stroke.
European Society of Hypertension guidelines on the management of hypertension acknowledges that central pressures (measure of arterial stiffness) may be more predictive of cardiovascular events when compared to brachial pressures. This is due to different antihypertensive drugs potentially having different effects on peripheral pressures and central pressures...
In general, malignancies of spermatic cord are extremely rare. We herein reported a case of primary mucinous adenocarcinoma of the spermatic cord after radical inguinal orchiectomy with complete excision of the tumor. A mass located in inguinal area should always be considered as a malignant tumor and further general examination is necessary for distant metastatic lesions detection during the perioperative period...
Cocaine is a stimulant drug derived from coca plants and known for its addictive potential and toxicity, including cardiovascular complications. Complete heart block is a cardiovascular manifestation of cocaine toxicity, which can be life threatening. We present a case of a 49-year-old woman that presented with abdominal pain, diarrhea, and vomiting. With abnormal EKG readings, the patient was found to have a complete heart block from cocaine ingestion...
Primary hyperparathyroidism is a common endocrinological disorder. In rare circumstances, it is associated with familial syndromes, such as multiple endocrine neoplasia type 1. In this context, we report our case. The patient was a 48-year-old female with a hypocalcemia, which was discovered incidentally after total thyroidectomy. It was secondary to multiple parathyroid adenomas, which were mistakenly considered as nodular thyroid tissue both preoperatively, and peroperatively...
Patients with neuropathic pain, such as postherpetic neuralgia, complex regional pain syndrome, failed back surgery syndrome, and phantom limb pain rarely respond to traditional treatments and are more likely to develop chronic refractory pain. Even these patients do not respond to invasive treatment using implantable devices such as spinal cord stimulator and intrathecal morphine pump...
Primary hyperparathyroidism is a frequent endocrinological disorder. Rarely, it is associated with hereditary syndromes, such as multiple endocrine neoplasia type 1. In this context, we present the case of a woman with a giant cell epulis that was found to be the initial clinical manifestation of primary hyperparathyroidism...
The giant aortic aneurysm, defined as aortic dilatation with a maximum diameter greater than 10 cm [1], is the most frequent subtype of aortic aneurysm. However, its incidence is low and rarely described in the literature being a generally asymptomatic pathology and incidentally discovered in routine imaging exams as presented in this patient...
M, N a 3-year-old M boy, term born in hospital, the third of 3 siblings, from a consanguineous marriage, admitted for dysmorphic syndrome with mental retardation. The clinical examination showed severe failure to thrive (-4DS), facial dysmorphic included hirsutism, prominent and sloping forehead, dental abnormalities, retrognatism, well-defined, arched and confluent eyebrows, long eyelashes...
We report an elderly patient with massive splenomegaly in whom treatment with splenic irradiation and rituximab was successful, although the diagnosis was difficult to confirm. A 73-year-old male patient who had been followed for 6 years and who remained untreated for massive splenomegaly and cytopenia was hospitalized with severe abdominal pain. Abdominal Computed Tomography (CT) revealed worsening splenomegaly (maximum major axis diameter 38 cm) with multiple low-density areas suggestive of necrosis...
L A 05-year-old girl, from a non-consanguineous marriage, born by cesarean section with the use of forceps. She has a familial atopy: Allergic rhinitis in father and sister due to dust mites and pollen and a history of cervical poly lymphadenopathy 05 months before the onset of symptoms with spontaneous regression, the viral origin was suspected but no viral serology was done.
Lymphoblastic lymphomas are immature lymphoid malignancies accounting for approximately 30% of non Hodgkin lymphoma in children. Most of these neoplasms originate from T cell precursors while less than 25% of them originate from B lymphoblasts. On histology and immunohistochemistry, lymphoblasts in B Lymphoblastic Lymphoma (BLL) and B lymphoblastic leukaemia share the same features. However, they represent different diseases with distinct molecular alterations...
Both Mexico and United States share a border as well as Mexico being the country with the most American citizens living abroad and United States housing millions of individuals of Mexican descent, Covid 19 has impacted the world and both countries health system Mexico having to deal with the impact of a pandemic with a much lower budget and personnel compared to United States and as well United States having to deal with a pandemic occurring in a country with...
Suicidal depression is a growing problem in our modern society, especially among the young. Our world is complex and difficult to manage. For some, it ends in self destruction. Prevention should be paramount by having a well structured and balanced lifestyle.
A 55 year old male presented with nasal obstruction for 2 years. On examination a polypoidal growth was seen filling the right nasal cavity which oozed out blood. Computed tomography of the paranasal sinuses revealed a polypoidal lesion involving and mildly expanding the right nasal cavity and ethmoidal sinuses, displacing the nasal septum to the left side and having a large nasopharyngeal component. Polypectomy was done and a soft tissue mass measuring 1x1x1cm was received. Serial sections from the mass showed presence of a polyp lined by pseudostratified ciliated columnar epithelium.
A fifty-four year-old man was referred to the lung cancer clinic for the investigation of a left mid zone solitary pulmonary nodule seen on incidental chest radiography (Figure 1). A lifelong non-smoker, the history and clinical examination did not suggest lung cancer. The nodule was smooth, round and without calcification. Repeat radiography with skin and nipple markers had failed to clarify the diagnosis. CT scanning of the chest (Figure 2) showed atresia of the left upper lobe bronchus, predominantly affecting the anterior segment.
Objective: The aim of this study is to compare between two implant placement techniques, that is, Bone Graft Surgery (BGS) prior to freehand implant placement and Computer-Aided Implant Surgery (CAIS), in patients with maxillary atrophy.
Materials and methods: Patients with partial edentulous in the posterior atrophic maxilla were selected for a randomized controlled clinical trial, which was designed to compare implants in the posterior partially edentulous maxilla.
Cullen's and Grey turner signs are both dermatological manifestations of retroperitoneal or intraperitoneal haemorrhages. Cullen's sign is characterised by periumbilical ecchymosis while in Grey Turner sign there is involvement of the flanks. Cullen’s sign, first described in 1918 by Thomas Stephen Cullen a Gynaecologist, as a bluish discoloration of periumbilical skin in patients of ruptured ectopic pregnancy due to retroperitoneal blood that tracks along the gastrohepatic and falciform ligament to the umbilicus
A 75-year-old man presented with a soft, non-tender right subcostal mass of 6 months evolution. His medical history was remarkable for a non-penetrating thoracic trauma 30 years before. Physical exam revealed no pain or respiratory distress and vital signs were normal. A CT-scan showed protrusion of lung tissue (arrows) through a chest wall intercostal defect in axial (Figure 1A-B) and coronal (Figure 1C-D) views, images consistent with lung hernia.
A 75-year-old man presented with a soft, non-tender right subcostal mass of 6 months evolution. His medical history was remarkable for a non-penetrating thoracic trauma 30 years before. Physical exam revealed no pain or respiratory distress and vital signs were normal. A CT-scan showed protrusion of lung tissue (arrows) through a chest wall intercostal defect in axial (Figure 1A-B) and coronal (Figure 1C-D) views, images consistent with lung hernia.
Melorheostosis is a rare sclerosing bone dysplasia. We report a unique case of melorheostosis with involvements of femur, tibia, and patella, resulting in pain, limited range of motion and impingement between patella and tibia. An arthroscopic assisted open surgery approach was performed to debride the damaged cartilage, soft tissue, and removal of the lesion on patella. This procedure led to an improvement of knee function and remission of pain.
The risk of Amiodarone-associated TdP is not common but possible and often underestimated. We present a case of a patient who had a history of AF that was converted to sinus rhythm by Amiodarone. However, the patient developed TdP few days after loading and on maintenance Amiodarone treatment. We documented a sudden significant increase in QTc interval by 400 ms within 24 hours which led to the presentation of patient to Emergency Department (ED) with pulseless polymorphic ventricular tachycardia...
Background: Odontogenic myxoma (OM) is a benign intraosseous tumour of the jaw usually treated by surgery. Computer-aided design and manufacturing (CAD/CAM) technology may optimize preoperative planning of the resection and jaw reconstruction.
Case Report: A 29-year-old female was diagnosed with mandibular odontogenic myxoma. A large, benign but potentially infiltrating, and locally aggressive tumour required radical surgical treatment.
Studies in selected transgender populations demonstrate a high HIV-prevalence, but data on this subject in the Dutch transgender population are lacking. In this report we illustrate the importance of a timely HIV diagnosis to prevent complications. Routine HIV testing should be considered as part of the work-up for people attending Dutch gender-identity clinics.
A 15-year old, presented with five days of bilateral eyelid swelling, fatigue, cervical lymphadenopathy and fever. There was no associated pruritis, conjunctivitis or eye pain. There was mild pharyngitis on examination. C-Reactive Protein (CRP) was mildly elevated (24.3mg/L), full blood count and albumin were normal, transaminases were raised (AST 230 U/mL, ALT 218 U/mL), proteinuria was absent. Ebstein Barr Virus (EBV) serology was diagnostic of acute Infectious Mononucleosis (IM).
A 62-year-old Female with Beta-Thalassemia Major, complicated by transfusion dependence, hypocalcemia, and ironoverload requiring chelation therapy. Cat scan after skull injury, revealed multiple lytic lesions scattered throughout the calvarium some which demonstrated cortical disruption and concern for neoplasms such as multiple myeloma or metastatic disease. (Figure A).
Over the last two decades the incidence of syphilis has increased. Ocular syphilis can occur during any stage of syphilitic infection and Acute Syphilitic Posterior Placoid Chorioretinopathy (ASPPC) is a rare but pathognomonic manifestation of ocular syphilis. Key ophthalmologic findings of this disease can be demonstrated on dilated retinal exam and optical coherence tomography with supplemental findings seen on fundus auto fluorescence imaging and intravenous fluorescein angiography...
Myoepithelial carcinoma, also named malignant myoepithelioma or epithelial – myoepithelial carcinoma, is an unusual neoplasm arising from neoplastic myoepithelial cells. This tumor accounts for 0, 1–0, 45% of all salivary tumors; these neoplasms can involve both major and minor salivary glands. Myoepithelial carcinomas generally occur in adults or elderly. The described cases in literature have an average age of 52, 5 years, with a range from 7 to 81 years...
Background: The Coronavirus Disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has had a significant impact on healthcare provision, both in acute inpatient management of critically-ill COVID-19 patients and also in regard to health services which have been curtailed in an effort to maximise resources in tackling the virus. The clinical manifestations of COVID-19 are highly varied and those of syphilis are notoriously protean...
Background: In Metastatic Colorectal Cancer (mCRC) patients, mutational analysis of KRAS and NRAS genes is mandatory for therapeutic programming as in wild type patients anti-EGFR monoclonal antibodies (panitumumab/cetuximab) demonstrated clinical efficacy.
Case report: We report here-by a case of a 63-years-old woman, no smoker, with mCRC that involved lung, liver and abdominal lymphadenopathies. Molecular analysis revealed NRAS, KRAS and BRAF wild-type adenocarcinoma.
Nowadays the exact pathophysiological processes underlying Systemic Lupus Erythematosus (SLE) development remain unknown. Factors, which seem to contribute to disease onset is a strong genetic predisposition but also an environmental influence. Among environmental factors, viral infection may play an important role, leading to immune system dysfunction in several ways.
Treatment of patients with Gaucher disease type 1 with enzyme replacement therapy might be associated with development of anti-drug antibodies. As we know, the literature is lacking reports demonstrating the development of ADAs in patients with GD1 and association with a decreased efficacy, as was shown in other LSDs.
Rotator cuff injuries are common, especially in older individuals. These injuries can be partial or complete thickness tears and can require either therapy or surgical intervention and therapy. Three patients were treated with extracorporeal shock wave or FOCUS wave therapy to see if this would cause healing of supraspinatus tears.
Catheter Related Blood Stream Infection (CRBSI) is associated with significant morbidity and mortality in Hemodialysis patient, and it’s a leading cause of hospitalization. Gram-negative organism is increasingly reported as a cause of CRBSI in hemodialysis patients. Recently, primary and catheter related bacteremia caused by Chryseobacterium indologenes is identified more frequently.
The perineurioma is a rare nerve tumor. The etiology is unknown and only a small number of case reports can be found in the literature, which includes proposals of conservative as well as surgical means of treatment. The current objective is to present an effective therapeutic strategy in treating this disease, which led to complete recovery.
Extramammary Paget Disease (EMPD) is a rare cutaneous neoplasm that most frequently affects the vulva. Wide local excision remains the preferred treatment, which may need vulvar reconstruction. However, it is associated with high recurrence rates. Frequently women with Paget’s disease of the vulva who are elderly with associated co-morbidities and are not suitable for surgery.
A 9-year-old girl with history of sickle cell anemia presented to our hospital with severe low back pain with 8 days duration, not relieved with analgesics. She had previous episodes of vaso-occlusive crisis and a basal hemoglobin level of 4,9 mmol/L. Spinal magnetic resonance imaging revealed multiple recent bone infarcts in the lumbar vertebral bodies
Otogenic pneumocephalus describes intracranial free air as a consequence of mastoid effusion secondary to complicated otitis media. While the incidence of intracranial complications related to middle ear disease is low, the associated mortality rates remain particularly high. Clinical manifestations vary from asymptomatic to an acute neurosurgical emergency.
The Morel-Lavallée lesion is a traumatic soft tissue degloving injury [1]. The injury is characterized by a separation between the fascia and overlying hypodermis, and a collection of fluid often ensues in the created space. The soft tissue injury disrupts vascular or lymphatic flow in the area of local trauma resulting in a hemolymphatic fluid collection.
We reported a 60-year-old patient with porcelain gallbladder was performed abdominal CT scan which showed the calcification of gallbladder wall disappeared. The specimens showed the gallbladder mucosa was attached to white jelly-like substances which were not calcified. In our opinion, the while jelly-like substance may be a special manifestation of stones.
Pure Sensory Stroke (PSS) is a well-defined clinical entity in which hemisensory symptoms predominate without other major neurological signs. Pure sensory stroke without involving other features is uncommon. Most commonly it is caused by a lacunar syndrome, either infarction or hemorrhage. The literature rarely describes putaminal haemorrhage producing pure spinothalamic sensory deficit.
Hepatic hemangiomas are the commonest benign mesenchymal hepatic tumors. Majority of the cases are asymptomatic and do not need interventions. Few presents with wide variety of symptoms. Of these, spontaneous or traumatic rupture is rare but most dramatic complication. They may present with sudden abdominal pain, anemia and hemoperitoneum.
Duodenal duplication cyst is a rare congenital entity. The treatment has classically involved surgical resection.We report the case of a 61 year old women who presented with upper abdominal pain and vomiting related to a cystic duodenal duplication. She was treated with endoscopic marsupialization in the cyst roof. The patient remained asymptomatic during 4 years follow-up.
Mechanical ventilation is the main therapy used as the support live therapy performed in Intensive Care Units (ICU) for the patient swith COVID-19. The failure in weaning the patient from mechanical Ventilation (MV) can result in such air way manipulations as deep tracheal aspiration and tracheostomy, where there are the high risks of rein tubation and aerosol generation. It is the most important point to decide to weaning the mechanically-ventilated patients from the device at the right time.
The patient, male 50 years old, was admitted to hospital for 20 days due to headache and vomiting. The CT and MRI of the external hospital head suggest intracranial space occupying, considering the possibility of tumor. Admission examination: clear mind, no abnormal cranial nerve examination; no deformity of spine and limbs; normal muscle strength of limbs.
The periodontal ligament faces even greater occlusal forces within a limit, presenting with trauma changes from occlusion locally to the tooth where it operates. Subsequently, the whole pathology is followed at the level of articulation, to present there the distinct radiographic signs of occlusion trauma.
Background: CDH1 mutation is a rare autosomal dominant mutation in the gene encoding for E-cadherin, and a known familial cancer syndrome associated with hereditary diffuse gastric carcinoma and lobular breast carcinoma. Case: A 21 year old with a known CDH1 mutation and history of diffuse hereditary gastric cancer with a prior total gastrectomy presented seven years later with a pelvic mass. Pathology was consistent with a FIGO stage IA1 mucinous adenocarcinoma, (intestinal type, expansile pattern) of the left ovary.
Cyclosporine A (CyA) is the initial immunosupressive in Steroid Resistant Nephrotic Syndrome (SRNS). Hypertension is one of its adverse effects but Posterior Reversible Encephalopathy Syndrome (PRES) is rare. Nephrotic syndrome is a hypercoagulable state with thromboembolic events in 2-3% of the cases rarely involving cerebral vessels.
Here we discuss the case of a 37 year old gentleman found collapsed and unresponsive at home. He was subsequently diagnosed with a Cerebral Venous Thrombosis. Successful treatment with therapeutic Low Molecular Weight Heparin was achieved. Cerebral Venous Thromboses arise in the draining dural sinuses. Annual incidence is between 0.22 and 1.57 per 100,000 population
Here we discuss the case of a 37 year old gentleman found collapsed and unresponsive at home. He was subsequently diagnosed with a Cerebral Venous Thrombosis. Successful treatment with therapeutic Low Molecular Weight Heparin was achieved. Cerebral Venous Thromboses arise in the draining dural sinuses. Annual incidence is between 0.22 and 1.57 per 100,000 population
We performed a radiofrequency catheter ablation of atrial fibrillation by means of high-density electroanatomical mapping of the left atrium. During radiofrequency delivery into the Right Superior Pulmonary Vein (RSPV), we observed restoring of sinus rhythm. Post-ablation re-mapping of the left atrium in sinus rhythm evidenced isolated fibrillatory activity confined to the RSPV.
The aim of this paper was to present a case report in which prothombic or hypercoagulable states had caused a large mobilizing thrombus to developed in the Left Atrium (LA). This is perhaps due to delay in primary management. If it is not due to narrowing of the mitral valve as a result from mitral stenosis, the LA thrombus could have cause a catastrophic complications.
It is a case of giant cell arteritis diagnosed firstly by Combined MRA and High Resolution MRI (HRMRI), the lesion site and inflammatory degree can be easily evaluated by MRA and HRMRI. It can be predicted that temporal artery biopsy may be avoided in patients with typical features accompanied by characteristic HRMRI findings for GCA.
A 81-year-old, right-handed female presented with complete weakness of the left upper and lower extremities due to infarcts in the right anterior and middle cerebral artery territories. She was transferred to the rehabilitation department of a university hospital at 3 weeks after onset.
A 18 year old female presented with pain of insidious onset associated with swelling over the right wrist joint for 6 months. Swelling and pain gradually increased over the duration of 6 months. She came to the Orthopedician’s out-patient clinic when her symptoms affected her day to day activities.
Chlorhexidine contact vasculitis in a 72-year-old patient with cutaneous herpes (Figure 1) for whom he was put on local care with chlorhexidine, the evolution was marked by the installation of an erythematous and purpuric plaque at the level of the left flank (Figure 2) appeared 4 days after the application of chlorhexidine that the patient did not rinse with water after use. Dermoscopy showed an erythema that did not fade at the vitropression corresponding to purpura (Figure 3)...
Parathyroid carcinoma is a rare form of endocrine malignancy which occurs most commonly in patients with primary hyperparathyroidism. Here we report an unusual case of parathyroid carcinoma developing on secondary hyperparathyroidism in a 53-year-old man, with a chronic renal insufficiency on hemodialysis, operated 10 years ago of subtotal parathyroidectomy for secondary hyperparathyroidism with favorable outcome, was hospitalized for bone pain with hypercalcaemia and elevated serum Para Thyroid Hormone (PTH).
Dislocation of the fourth and fifth carpometacarpal (CMC) joint associated with a fracture of the hamate is a rare injury. Literature shows no consensus regarding optimal treatment of this injury. We present three cases that will discuss this specific injury and all have been treated according to the same philosophy; reconstruction of the hamate to get a stable joint.
Dislocation of the fourth and fifth carpometacarpal (CMC) joint associated with a fracture of the hamate is a rare injury. Literature shows no consensus regarding optimal treatment of this injury. We present three cases that will discuss this specific injury and all have been treated according to the same philosophy; reconstruction of the hamate to get a stable joint...
Desmoid tumors are rare benign tumors that tend to be locally invasive rather than metastatic, and have a high recurrence rate despite complete excision [1]. Intra-abdominal desmoids are sporadic in most cases with only 20% associated with familial syndromes, in particular Familial Adenomatous Polyposis (FAP). Sporadic cases seem to be less aggressive and associated with a lower mortality and recurrence rate than FAP-associated desmoids [2]. The etiology is unknown, however, a history of previous trauma is sometimes identified [3]...
Bevacizumab is a growing monoclonal antibody agent in oncology. Nasal septum perforation due to bevacizumab is rare. It is generally more common in patients receiving high doses of bevacizumab and who are using taxane. In the treatment of nasal septal perforation, bevacizumab treatment interruption, nasal hygiene, antibiotics, local irrigation or observation are recommended...
Malignant glomus tumors are a extremely rare soft tissue sarcomas, supposed originated from a benign glomus tumor. We report a case of glomus tumor of uncertain malignant potential occurring on the skin of volar area of arm of a 56-year-old woman...
Longitudinally Extensive Transverse Myelitis (LETM) is an inflammatory lesion of spinal cord that extending over three or more spinal segments. A number of conditions may be associated with LETM such as autoimmune central nervous system disease, infective, neoplastic, and connective tissue disorders...
Mucoceles are benign, pseudo-cystic, expansive tumors, due to an accumulation of mucus in a cavity whose orifice is obstructed. This accumulation may occur in the tear sac or sinus. Mucocele can be maxillary, sphenoidal, ethmoidal, frontal and ethmoido-frontal.
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Authors
Kyryll Chulak*; Faisal Awan
Department of General Surgery, Saint Luke’s Hospital, Kilkenny, Ireland
Received: Mar 14, 2018
Accepted: May 05, 2018
Published Online: May 10, 2018
Authors
Mudassir Wani
Associate professor, King Khalid University, Surgery, 132, Green Lane Hafiz Colony Peerbagh J&k India, Srinagar, Jammu & Kashmir 190014, India
Received: Mar 01, 2018
Accepted: May 07, 2018
Published Online: May 10, 2018
Authors
Lorna Ting, MBBS1 ; YT Liew, MS2
1 Department of Otorhinolaryngology, Queen Elizabeth Hospital, Sabah, Malaysia
2 Department of Otorhinolaryngology, Head & Neck Surgery, University Malaya Medical Centre, Malaysia
Received: May 30, 2018
Accepted: Jun 21, 2018
Published Online: Jun 22, 2018
Authors
Yuh Baba1 *; Yasumasa Kato2
1 Prof. of Department of General Clinical Medicine, Ohu University School of Dentistry, 31-1 Misumido, Tomita-machi, Koriyama City, Fukushima 963-8611, Japan
2 Prof. of Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, 31-1 Misumido, Tomita-machi, Koriyama City, Fukushima 963-8611, Japan
Received: June 26, 2018
Accepted: July 17, 2018
Published Online: July 20, 2018
Authors
Rakesh K Varma1 *; Andrew J Gunn1 ; Nathan W Ertel1 ; Ahmed Kamel Abdel Aal, MD, PhD, FSIR2
1 Assistant Professor, Section of Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, USA
2 Associate Professor, Division of Interventional Radiology, Medical Director, Heart and Vascular Center, University of Alabama at Birmingham (UAB), USA
Received: June 06, 2018
Accepted: July 18, 2018
Published Online: July 23, 2018
Authors
Lorna Ting, MBBS1 *, YT Liew, MS2
1 Otorhinolaryngology Department, Queen Elizabeth Hospital, 88300 Kota Kinabalu Sabah, Malaysia
2 Otorhinolaryngology Department, University Malaya Medical Centre, 46200, Kuala Lumpur, Malaysia
Received: May 31, 2018
Accepted: Sep 20, 2018
Published Online: Sep 25, 2018
Authors
Mina Sherif Soliman Georgy
Ain Shams University Hospitals, Group101 Block 6, Rehab City, New Cairo, Cairo, Egypt 11841
Received: Sep 11, 2018
Accepted: Oct 01, 2018
Published Online: Oct 08, 2018
Authors
Jan M Keppel Hesselink
Faculty of health, University of Witten-Herdecke, Germany
Received: Aug 31, 2018
Accepted: Oct 12, 2018
Published Online: Oct 19, 2018
Authors
Cláudia Nakandakari1 ; André Henrique de Almeida e Silva2 ; Ildeu Andrade Junior3 ; Vinícius César Barbosa de Menezes4*; Fabrício Rezende do Amaral4 ; João Roberto Gonçalves1
1 Araraquara School of Dentistry, Univ Estadual Paulista (UNESP), Rua Humaitá 1680, 14801-903, Araraquara/SP, Brazil
2 São Leopoldo Mandic Dental Research Center, R. Dr. José Rocha Junqueira 13, 13045-755, Campinas-SP, Brazil
3 The Pontifical Catholic University of Minas Gerais, Rua Dom José Gáspar 500, 30535-901, Belo Horizonte/MG, Brazil
4 Private Practice, Rua Araguari 1705, sl 801, 30190-111 Belo Horizonte/MG, Brazil
Received: Aug 17, 2018
Accepted: Oct 30, 2018
Published Online: Nov 05, 2018
Authors
Jan M keppel Hesselink
Faculty of health, University of Witten-Herdecke, Germany
Received: Aug 31, 2018
Accepted: Nov 12, 2018
Published Online: Nov 13, 2018
Authors
Yee-Huang Ku1 ; Huwi-Chun Chao2 ; Wen-Liang Yub3 *
1 Division of Infectious Disease, Department of Internal Medicine, Chi Mei Medical Center-Liouying, Taiwan
2 Department of Intensive Care Medicine, Chi Mei Medical Center, Taiwan
3 Department of Medicine, Taipei Medical University, Taiwan
Received: Nov 02, 2018
Accepted: Dec 20, 2018
Published Online: Dec 28, 2018
Authors
Farzad Tahmasebi Arashloo1 ; Mohsen Shahba2 ; Farnaz Fahimi Hanzaei1 ; Ghazaleh Amjad3 *
1 Department of Radiology, Kerman University of Medical Sciences, Iran
2 Department of Neurosurgery, Kerman University of Medical Sciences, Iran
3 Shahid Akbar Abadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
Received: Nov 24, 2018
Accepted: Dec 21, 2018
Published Online: Dec 28, 2018
Authors
Safa Fatima; Ahmad Muhammad; Juveria Khaleel
Deccan College of Medical Sciences, Hyderabad, India- 500028
Received: 20-May-19
Accepted: 10-Jun-19
Published Online: 12-Jun-19
Authors
Safa Fatima; Ahmad Muhammad; Juveria Khaleel
Deccan College of Medical Sciences, Hyderabad, India- 500028
Received: 21-Jun-19
Accepted: 22-Jul-19
Published Online: 25-Jul-19
