Clinical Medical Reviews and Case Reports (CMRCR) is an open access monthly journal publishing Cases, Reviews and Images to elaborate the importance of solving case challenges. The Journal allows clinical and medical reviews among elaborated fields such as Angiology/Vascular Medicine, Cardiology, Critical care medicine, Otolaryngology, Rhinology, Tumor Science, Ophthalmology, Dentistry, Endocrinology, Gastroenterology, Geriatrics, Hematology, Hepatology, Infectious diseases, Nephrology, Neurology, Oncology, Pathology, Pediatrics, Gynecology, Cytology, Andrology, Pulmonology, Rheumatology, etc. from scholarly open accessed attributes. This Journal focus upon building a thorough network among the doctors to understand the cases and provide improvised medical care and discuss further advancements in treating the challenging cases.

We are open to invite experts in the field to share their challenging skills in improving health care via CMRCR. It also includes original empirical, theoretical research and trends to enable policy makers to make informed decisions, as well as to identify health care trends. The Journal publishes novel research work conducted on various cases in the medical field on various types of diseases, covering their respective clinical and diagnosis issues. CMRCR assures enriched scientific documentation of a clinical and medical observations pooled together in our issues.

Journal Information

Title: Clinical Medical Reviews and Case Reports

ISSN: 2378-3656

Editor-in-chief: Wei Wang

NLM title abbreviation: Clin Med Rev Case Rep

ICV: 91.40

ISO abbreviation: Clin Med Rev Case Rep

Other titles: CMRCR

Category: Clinical/Medical

DOI: 10.23937/2378-3656

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email:

Articles Search by   Keyword   |   Journal title   |   Author name   |   DOI


 Open Access DOI:10.23937/2378-3656/1410448

Bacteroides fragilis Pneumonia and Empyema in a Child with Down Syndrome

John Kelly Smith

Article Type: Case Report | First Published: 2024/04/27

A 10-year-old female with Down syndrome was admitted with a 5-day history of fever, rigors, and progressive dyspnea. Admitting assessment revealed the presence of a right-sided Bacteroides fragilis pneumonia and empyema. Shortly after admission, the child’s respiratory condition deteriorated when she drained an unsuspected right lung abscess into the opposing lung. She was placed on assisted ventilation and intravenous clindamycin with gradual improvement in her clinical condition....

 Open Access DOI:10.23937/2378-3656/1410447

Primary Cutaneous CD4-Positive Small/Medium T-Cell Lymphoproliferative Disorder: Report of a Case with Spontaneous Regression after Biopsy

E El bakali, H Ammari, F El guennouni, H Kerrouch, I Anouar, T Hanafi1, J Azhari, M Azzakhmam, Y Zemmez, R Frikh1 and N Hjira

Article Type: Case Report | First Published: 2024/03/28

Primary cutaneous CD4- positive small/medium T-cell lymphoproliferative disorder (PCSM-TCLD) is a low-grade cutaneous T-cell disorder, previously classified as a provisional entity [1] of primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoma until 2016, when the terminology was changed during the revision of the classification of lymphomas by the World Health Organisation and the European Organisation for Research and Treatment of Cancer due to its uncertain malignant potential [1,2]. ...

 Open Access DOI:10.23937/2378-3656/1410446

A Rare, Severe Complication of Delayed Surgical Treatment for Rectal Prolapse

Rachel Masia, DO and Amanda Ayers, MD

Article Type: Case Report | First Published: 2024/03/18

Transanal small bowel evisceration is a very rare presentation. However, it is associated with significant morbidity and mortality. Our case report describes an 84-year-old female with known rectal prolapse, who presented to the emergency room in sepsis with transanal small bowel evisceration after cancelation of her elective surgical repair. Due to her acutely ill presentation, she required a damage control operation, additional surgery, intensive care management, prolonged hospital stay, and a...

 Open Access DOI:10.23937/2378-3656/1410445

De Winter Syndrome Secondary to a Blunt Chest Trauma

Omar Al-assaf, MD, Lara Abumuaileq, MD, Ena Skikic, MD and Shibu Bahuleyan, MD

Article Type: Case Report | First Published: 2024/02/29

Dewinter's syndrome is a life-threating electrocardiographic (ECG) diagnosis, indicates a proximal left anterior descending artery (LAD) disease. It is rarely reported finding post blunt chest trauma and it requires an abruptly intervention. We report a young gentleman previously healthy that developed an anterior myocardial infarction following a blunt chest trauma and ECG was showing de winter syndrome....

 Open Access DOI:10.23937/2378-3656/1410444

Delirium Improving Symptoms of Chronic Schizophrenia in Elderly: A Case Series

Prerak Kumar, Shailendra Mohan Tripathi, Richa Shukla and Roshni Basu

Article Type: Case Series | First Published: 2024/02/29

Delirium is an acute medical emergency, consisting of fluctuations in attention, cognition and consciousness disturbance found more commonly in elderly in clinical settings because of multiple comorbidities and etiologies. In the clinical setting of Geriatric Mental Health (GMH) we found delirium improved psychotic symptoms in elderly having Schizophrenia as their prime diagnosis from almost 30 years, delirium episode made them antipsychotic free, in ward both patients were treated without antip...

 Open Access DOI:10.23937/2378-3656/1410443

Giant Acquired Fibrokeratoma of the Big Toe: A Case Report

El bakali, M Khalidi, I Anouar, T Hanafi, T Aaboudech, Y Zemmez, R Frikh and N Hjira

Article Type: Case Report | First Published: 2024/01/31

The patient is a 21-year-old Moroccan, without any notable pathological history. He consulted for a painless swelling of the lateral border of the left big toe, evolving for 2 years. Examination revealed a polypoid and poly-lobed mass, flesh-coloured, measuring 3 cm in long axis, of elastic consistency, mobile in relation to the deep plane (Figure 1). Histological examination showed epidermal acanthosis and hyperkeratosis, associated with dermal fibrosis, confirming an acquired acral fibrokerato...

 Open Access DOI:10.23937/2378-3656/1410442

Atypical Hemolytic Uremic Syndrome: A Therapeutic Challenge When Eculizumab is Not Available

C. Chaccour, C. Doueihi, S. Karaa and A. Germanos

Article Type: Case Report | First Published: 2024/01/10

Atypical hemolytic uremic syndrome (aHUS) can be triggered by pregnancy and may lead to both irreversible and severe consequences. We herein present the case of a woman who will develop postpartum aHUS, with the consequent diagnostic and therapeutic challenges that followed....

 Open Access DOI:10.23937/2378-3656/1410441

Intraventricular Metastasis of Adenocarcinoma: A Rare Case Report

Juvencio Angelo P Pereche III and Leo Anthony Acedillo

Article Type: Case Report | First Published: 2023/12/30

A 56-year-old female came into our institution due to dull, non-radiating, 8/10 pain scale, persistent bifrontal headache. Associated with drowsiness, nausea, and 3 episodes of non-projectile vomiting. Work up revealed a frond-like mass with small enhancing bands within the distal body extending to the right atrium of the right lateral ventricle. It was measured to be 4.5 × 2.2 × 2.6 cm. Patient underwent posterior parietal approach craniotomy, excision of tumor with ventriculostomy tube place...

 Open Access DOI:10.23937/2378-3656/1410440

Diabetes Remission with Plant-Based Diet Restoring Integrity of an Advanced Charcot's Neuroarthropathic Foot & Ankle: Factors Contributing to Functional Recovery

Gunadhar Panigrahi, MD, FACC, DipABLM, FACLM

Article Type: Case Report And Clinical Review | First Published: 2023/12/09

Diabetes mellitus is the most common cause of Charcot's Neuroarthropathy (CN). It is a devastating complication of longstanding uncontrolled hyperglycemia. When present, it leads to cascades of interrelated and compounding pathophysiological abnormalities resulting in distal peripheral neuropathy, vasculopathy, inflammation, and arthropathy. If diagnosed early, it responds to conservative medical management with diabetes control, non-weight bearing (offloading), and immobilization;...

 Open Access DOI:10.23937/2378-3656/1410439

QuantiFERON in the Diagnosis of Tuberculosis

Hamida Amer and Amal Ouhida

Article Type: Original Article | First Published: 2023/11/29

The study include (n = 254 cases), (58 sample 22.8%) show positive results by Quantiferon test while (196 sample 77.1%) show negative test. Females constituted 118 (46.4%) of the total cases, while the males constituted 136 (53.6%). The age (31-40 years) for the negative includes (35 cases 13.7%) while (41-50 years and (61-70 years) for positive include (11 cases 4.3%)....

 Open Access DOI:10.23937/2378-3656/1410438

Follicular Cholecystitis: A Case Report of Uncommon Morphological Spectrum of Gallbladder Lesions

Lili Ananta Saputra

Article Type: Case Report | First Published: 2023/11/20

A very uncommon subtype of chronic cholecystitis is follicular cholecystitis (FC). Hyperplastic lymphoid follicles and noticeable germinal centers are its defining features. About 2% of standard cholecystectomies involve it. A very uncommon form of chronic cholecystitis is follicular cholecystitis. At least three lymphoid follicles per cent of the gall bladder tissue and an inflammatory infiltrate that is almost entirely made up of dispersed, well-formed lymphoid follicles define it. ...

 Open Access DOI:10.23937/2378-3656/1410437

Incidental Diagnosis of Coarctation of the Aorta in a Pregnant Patient with Severe Hypertension and Respiratory Distress

Ajit Kumar Thakur, Rajnikant Prasad, Richa Tiwari and Sandeep Kumar

Article Type: Case Report | First Published: 2023/10/14

A 30-year-old primigravid at 31 weeks of gestation with ARDS and severe PIH was initially diagnosed at an external facility. Despite aggressive management, her blood pressure remained high. An incidental chest CT scan revealed overlooked coarctation of the aorta. Other secondary causes, like pheochromocytoma and renovascular hypertension, were explored....

 Open Access DOI:10.23937/2378-3656/1410436

Traumatic Splenic Rupture Unmasking Necrotizing Histoplasmosis in a Sickle Cell Anemia Patient: The Mystery behind Recurrent Abdominal Pain

Ogechi Agogbuo, MD, Priscilla Ozueh, MD, Yashashree Vegi, MD, Celestine Ishiekwene, MD, Michael O. Agogbuo, MD and Kavita Nirmal MD

Article Type: Case Report | First Published: 2023/10/12

Sickle cell anemia is the most common abnormality of the red cell. The clinical manifestations of SCD are mostly related to hemolytic anemia, hypersplenism, and Vaso-occlusion, which can lead to acute and chronic pain and tissue ischemia or infarction. Disseminative or primary invasive infections such as histoplasmosis can masquerade in splenomegaly resulting in multiple hospital visits for acute splenic crises, causing increased morbidity and mortality. ...

 Open Access DOI:10.23937/2378-3656/1410435

Cyclopia, A Rare Congenital Malformation: A Case Report in a Resource-Limited Setting in Sub-Saharan Africa

Therence N. Dingana, Carlson Sama, Nuh T. Zeh, Herbert Fonteh, Achuasah M. Tah-Atam and Gloria Ashuntantang

Article Type: Case Report | First Published: 2023/09/30

Cyclopia is a rare and severe form of holoprosencephaly, a condition in which the forebrain fails to divide into two hemispheres during embryonic development. It is poorly reported in sub-Saharan Africa. We report the case of a 21-years-old G2P1001 lady who was referred to our service for better management of preterm labor. She was 29 weeks pregnant, and her cervix was 4 cm dilated on arrival. ...

 Open Access DOI:10.23937/2378-3656/1410434

Painless Stanford A Aortic Dissection: A Case Report

Gabin Kenfack, Julien Guihaire, Yamen Lababidi, Kamal Benaoudia, Ahmed Guesmi and Abdenacer Cheikh

Article Type: Case Report | First Published: 2023/09/30

We describe the case of a 58-year-old black male smoker patient with untreated hypertension admitted to the emergency room without symptoms, having presented a few hours earlier, moderate chest pain with transient sweating. The clinical examination found blood pressure asymmetry and a weaker radial pulse on the right arm. The ECG showed nonspecific abnormalities....

 Open Access DOI:10.23937/2378-3656/1410432

A Case Report on Solitary Pulmonary Cryptococcoma: Synergistic Approach towards this Rare and Highly Misdiagnosed Entity

Adarsh G, MS, DNB, Haritha Biju and Narendra KL, MD

Article Type: Case Report | First Published: 2023/08/31

Solitary Pulmonary Cryptococcoma without diffuse infiltration of the lung is an extremely rare manifestation of cryptococcosis, even in immunosuppressed individuals. This report presents an immunocompetent elderly man with a large solitary right lung mass, preoperatively diagnosed as inflammatory lesion with granuloma on CT guided biopsy, later proved to be Cryptococcoma on histopathological examination after Right Postero-lateral Exploratory Thoracotomy and Excision of the Mass....

 Open Access DOI:10.23937/2378-3656/1410431

Deep Vein Thrombosis with Concomitant Cellulitis in a 47-Year-Old Filipino Female

Lea Fatima B Hingpit, MD and Lalaine R Visitation, MD, FPDS

Article Type: Case Report | First Published: 2023/07/31

Deep Vein Thrombosis (DVT) occurs when there are clots in the deep veins of the body, accounting for the majority of venous thromboembolism (VTE) cases. Half of the cases may report symptoms of pain, swelling, warmth and discoloration or redness which may be similar to cellulitis. Here we report a 47-year-old Filipino female who presented with bullae on her left leg, associated with pain, swelling and erythema which improved with anticoagulants and antibiotics....

 Open Access DOI:10.23937/2378-3656/1410430

A Rare Case of Acute Ischemic Stroke Following Russell's Viper Snake Bite

Addepalli Naga Sowmya, Addepalli Yamini and M Nagarjuna

Article Type: Case Report | First Published: 2023/07/31

Ischemic stroke following a snakebite is a rare complication. We report a case of a 49-years-old male who developed weakness of right upper and lower limb slurring of speech with facial asymmetry following Russell's viper bite. Magnetic resonance imaging of brain revealed infarct in the left middle cerebral artery territory. The possible mechanisms for cerebral infarction in this scenario are discussed, which were hypotension causing watershed infarcts due to hypovolemia....

 Open Access DOI:10.23937/2378-3656/1410429

An Unusual Case of Atypical Meningioma Mimicking as High-Grade Astrocytoma: A Case Report

Putri Rossyana Dewi, I Wayan Niryana, Nyoman Golden, I Made Gotra and I Putu Eka Widyadharma

Article Type: Case Report | First Published: 2023/06/30

Meningiomas are the most common non-glial primary tumors of the central nervous system and extra-axial neoplasms. The annual incidence of meningioma is around 1,28 and 7,8 of 100.000 based on the worldwide data registries. Meningiomas vary based on the clinical findings, imaging, and histopathology from benign to malignant types....

 Open Access DOI:10.23937/2378-3656/1410428

Two Abnormal Presentations of Celiac Disease in Obese, Premenopausal Women

Rachel Pray, BS and Sanjiv Amin, DO

Article Type: Case Report | First Published: 2023/05/31

Celiac Disease is a malabsorptive disorder of the small intestine that often presents with diarrhea as the most common symptom. Confirmatory diagnostic testing includes endoscopy, serologic testing, and biopsy of the small intestine. These two cases of Celiac Disease are unique because two women, mid-thirties and medically obese, presented with non-classic symptoms of CD. Patient A complained of recurrent upper abdominal discomfort and pain, while Patient B complained of persistent daily symptom...

 Open Access DOI:10.23937/2378-3656/1410427

Polyarticulark Arthritis in a 17-Year-Old Boy: Poncet's Disease or a Masquerader?

Adwoa Afrakoma Agyei-Nkansah, Louis Adoko Enchill, Shaibu Ibrahim, Jane Afriyie-Mensah and Alfred Doku

Article Type: Case Report | First Published: 2023/05/31

Poncet's disease is a rare form of reactive arthritis described in people with active Tuberculosis (TB). We report a case of Poncet's disease in a 17-year-old boy who posed a diagnostic challenge because of the presence of purulent effusion from affected joints. His arthritis preceded pulmonary symptoms which were in fact mild and largely subclinical. Clinical remission occurred within 10 days of anti-Tuberculous therapy and the diagnosis of Poncet's disease was established....

 Open Access DOI:10.23937/2378-3656/1410426

Hepatosplenic Melioidosis: A Common Misdiagnosed Entity

Lalkrishna U, Ramu M, Gaurav Khatana, Sandesh K, Saji Sebastian and Deni Joseph

Article Type: Case Report | First Published: 2023/05/31

Burkholderia pseudomallei is a commonly misdiagnosed pathogen. It can cause clinical features like pneumoniae, septicaemia, arthritis, abscess etc. Cases have been mainly reported from Southeast Asia. In India, few cases have been reported from the southern part of the country. Our patient was a 53-year-old diabetic, who presented with low grade fever, right hypochondrial pain, weight loss, for 2 months. Treated at local hospitals with various antibiotics, on further evaluation the patient was d...

 Open Access DOI:10.23937/2378-3656/1410425

Lung Ultrasound: A Reliable Tool for a Better Estimation of Dry Weight in Chronic Haemodialysis Patients

Mahamoud M Houssein, Lafrid Maria, A Bahadi, W Arache and D El Kabbaj

Article Type: Case Report | First Published: 2023/04/30

Volume overload, whether overt or sub-clinical, is associated with increased cardiovascular mortality in chronic haemodialysis patients. The assessment of dry weight remains a challenge and relies on clinical and paraclinical methods. Pulmonary ultrasound could thus prove useful as an additional tool in improving the management of haemodialysis patients, possibly in addition to bioimpedance metry data....

 Open Access DOI:10.23937/2378-3656/1410424

Invasive Candida auris Complicating Influenza H1N1 in North Sharqiy-Oman

Yassir Hamadalnil, Abhijit Sukumaran Nair, Waheed Mohamed Alawady, Faisal alsawafi and Manal Abdelaziz

Article Type: Case Report | First Published: 2023/04/30

Candida auris remain a major healthcare problem in intensive care units (ICU) as it is multidrug resistant and complicates an immunocompromised patient Our case is a 56-year-old gentleman admitted for H1N1 pneumonia and intubated, with prolonged antibiotics and imunocompromised status the patient develops Candida auris in blood and treated with anidulafungin....

 Open Access DOI:10.23937/2378-3656/1410423

Gorlin Goltz Syndrome: A Clinical Case Report

Zakaria ARKOUBI, Razika BENCHEIKH, Anas BENBOUZID, Abdelilah OUJILAL and Leila Essakalli

Article Type: Case Report | First Published: March 31, 2023

Like most syndromic diseases, it is responsible for systemic damage. Nevertheless, the main and feared type of affection is dermatological lesions of basal cell carcinoma type. The genetic expression lies in the mutation of the PTCH gene, a tumor suppressor, located on the long arm of chromosome 9....

 Open Access DOI:10.23937/2378-3656/1410422

Displaced Laryngeal Fracture on Blunt Traumatism: About One Case

Zakaria ARKOUBI, Razika BENCHEIKH, Anas BENBOUZID, Abdelilah OUJILAL and Leila Essakalli

Article Type: Case Report | First Published: March 31, 2023

The blunt laryngotracheal traumatism can be frequently ignored by the patient itself due to the scarcity of symptoms related to this form of injury within the first hours. The importance of the damage can be not proportional to the rarity of clinical signs. In this article we are about to present a serious form of laryngeal damage in a patient with no vital signs....

 Open Access DOI:10.23937/2378-3656/1410421

The Neuroanatomical Basis of Unfamiliar Presentations of Herpes Zoster: A Review and A Case Report

Maher N Ghabriel and Mounir N Ghabriel

Article Type: Review Article | First Published: March 31, 2023

Herpes zoster (HZ, shingles) is caused by reactivated varicella zoster virus, that travels along the peripheral branches from its dormant location in neurons of spinal and cranial sensory ganglia. HZ is well known for its skin vesicular eruptions and severe sensory neuropathy. Over the years, reports have described the occurrence of segmental paresis of skeletal muscles and the involvement of the large and small intestine, clinically resembling intestinal obstruction....

 Open Access DOI:10.23937/2378-3656/1410420

The Perceived Effect of Cannabis Use on Penile Growth in Humans

C. Tamayo, D. Martínez, M. Thawani, C. Adell, A. Arias, N. Vidal, W.T. Gerbil, R.T. Gerbil, C.D.S. Daime and F. Cervera

Article Type: Research Article | First Published: February 28, 2023

The use of cannabis has become increasingly popular in recent years, and there is ongoing debate and research on its potential effects on human health. While some studies have suggested that cannabis use can have negative effects on sexual function and fertility, there has been little research on its potential effects on penile growth. The aim of this study is to investigate the perceived relationship between cannabis use and penile growth in human males....

 Open Access DOI:10.23937/2378-3656/1410419

A Case of Extramammary Inguinal Paget’s Disease in a Male Patient

Najoua AMMAR, Zineb ZEGGWAGH, Mariame MEZIANE and Karima SENOUCI

Article Type: Case Report | First Published: February 28, 2023

Extramammary Paget’s disease (EMPD) is a rare intraepithelial cancer. It is more common in women and usually develops in apocrine gland-bearing areas, Less frequenly, EMPD can affect males in the anogenital area. EMPD may present with a focal, multifocal, or an ectopic lesion. We report a case of a 56-year-old male with extra- mammary Paget’s disease....

 Open Access DOI:10.23937/2378-3656/1410418

Suspected Mycotic Aneurysm of the Aortic Arch in the Setting of Group B Strep Bacteremia

Angelina Liddy, MD, Sanjay Desai, DO, Brian Jordan, DO, William Pace, MD, Lindsay Jablonski, DO and Kameron Durante OSM-IV

Article Type: Case Report | First Published: January 31, 2023

Mycotic Aneurysms are aneurysms (or pseudoaneurysms) which result from an infectious etiology. Group-B Strep (GBS) associated mycotic aneurysms are exceedingly rare and current literature varies on presentation and diagnostic criteria. This case is a rare presentation of a likely mycotic aortic arch pseudoaneurysm induced from GBS Bacteremia and cervical osteomyelitis in a 60-year-old male....

 Open Access DOI:10.23937/2378-3656/1410417

Importance of Test Battery Approach for the Diagnosis of Auditory Neuropathy Spectrum Disorder during Corona Pandemic: A Case Study

Ayishath Ruwaidha PV, Aswathy R Nair, Apoorva Gogiyan, Ansila Raslan, Vikas MD and Chandni Jain

Article Type: Case Report | First Published: January 31, 2023

The COVID-19 pandemic has adversely affected health care services worldwide, including India. A test battery approach is required to effectively diagnose various audiological conditions, and utilizing a test battery was challenging during COVID-19. The audiological practice has been modified during COVID 19 and the test is decided based on the client’s urgent need. The present case study highlights the importance of the test battery approach for the effective diagnosis of Auditory Neuropathy S...

 Open Access DOI:10.23937/2378-3656/1410416

Yellow Ligament Ossification of Cervical Spine-Must Know for a Clinician

Sharat Agarwal

Article Type: Letter to Editor | First Published: January 26, 2023

I read with great interest, the case report entitled “Unusual site of yellow ligament ossification-cervical spine” with citation details as Mahmoodkhani M, Askariardehjani N (2022) Unusual site of yellow ligament ossification cervical spine. Clin Med Rev Case Rep 9:397., published in your esteemed journal recently....

 Open Access DOI:10.23937/2378-3656/1410415

Early Imaging to Detect Bone Metastatic Disease of a 54-Year-Old Woman with History of Breast Cancer: A Case Report

I Made Bayu Suya Dana and I Nyoman Teri Atmaja

Article Type: Case Report | First Published: December 31, 2022

The World Health Organization (WHO) has predicted a global amount of 19 million cancer case in 2025. After the lungs and liver, bone is the third most common site of tumour spread. The bone is a dynamic tissue that plays a critical role not only in structural support and movement, a reservoir for minerals and energy, but also houses of the bone marrow, which is the main site of postnatal hematopoiesis. A 54-year-old Indonesian woman presented to orthopaedist with complaints of sudden left hip pa...

 Open Access DOI:10.23937/2378-3656/1410414

Massive Liver, and Kidney Cysts Excision: A Case Report

Cagla Yazar, MD, Mesher Ensarioglu, MD and Nedim Cekmen, PhD

Article Type: Case Report | First Published: December 30, 2022

Polycystic kidney disease is a multisystemic familial inherited disease. A symptomatic treatment approach is the standard modality for autosomal dominant polycystic kidney disease (ADPKD) complications and life-long 50% chronic renal failure risk, as renal transplantation is the only definitive treatment. We aimed to explain the anesthesia management of our patient who had an 18 kg cyst removed. There are various complications that; include hypertension, urinary tract infections, hematuria, pain...

 Open Access DOI:10.23937/2378-3656/1410413

Atypical Presentation of Classic Kaposi’s Disease: About a New Observation

Najoua Ammar, Mariame Meziane, Laila Benzekri and Karima Senouci

Article Type: Case Report | First Published: November 30, 2022

Kaposi’s disease (KD) is a multifocal, vascular lesion of low- grade malignant potential that presents most frequently in mucocutaneous sites. KD also commonly involves lymph nodes and visceral organs. This case intend to describe multifocal atypical kaposian manifestations in HIV negative patient....

 Open Access DOI:10.23937/2378-3656/1410412

Online Learning on Students during the COVID-19 Pandemic

Hamida Amer and Amal Ouhida

Article Type: Review Article | First Published: November 30, 2022

In this Covid-19 pandemic phase, all teaching and learning process is done by online learning. The COVID-19 pandemic has created the largest disruption of education systems in human history, affecting nearly 1.6 billion learners in more than 200 countries. Closures of schools, institutions and other learning spaces have impacted more than 94% of the world’s student population. There is a fear of losing 2020 academic year or even more in the coming future....

 Open Access DOI:10.23937/2378-3656/1410411

ADM-Assisted Implant Based Breast Reconstruction vs. Free Tissue Transfer Breast Reconstruction

Mohammad Mohammad

Article Type: Original Article | First Published: November 22, 2022

Despite in the recent decade, the free tissue transfer has been the gold standard for breast reconstruction and evolving of DIEP, TUG flaps toe the most common used breast reconstruction approach at present time, however the complexity of the procedure, long operative time, donor site comorbidities, long learning curve and subsequently increased cost were always present as downside of this approach...

 Open Access DOI:10.23937/2378-3656/1410410

Unusual Variant of Cutaneous Amelanotic Melanoma of the Cheek

Mohamed Amine Haouane, Issam Rharrassi, Abouchadi Abdeljalil, Ahmed Bouhamidi and Mohamed Amine Azami

Article Type: Original Article | First Published: October 31, 2022

Amelanotic melanoma is a type of cutaneous melanoma characterized by the absence of pigment. The rhabdoid features are an uncommon histological variant of malignant melanoma. Only a handful of primary rhabdoid melanoma cases have been reported in the literature. We describe here an additional case of a 60-year-old man with a primary pure dermal amelanotic melanoma with rhabdoid features and review the clinicopathological features of the previously reported cases of this rare entity....

 Open Access DOI:10.23937/2378-3656/1410409

Laryngeal and Pharyngeal Reconstruction: A Worldwide Review of the Current Guidelines and Standards of Practice. Does a Universal Reconstruction Algorithm Exist?

Mohammad Mohammad, Giannis Dimovelis, Ashraf Mostafa and Aenone Harper Machin

Article Type: Original Article | First Published: October 31, 2022

The reconstruction of hypopharynx and larynx post ablative surgery has been always a demanding challenge. Not only the restoration of the anatomy and achieving robust wound healing, but also the complexity of function in the area for the airway and upper digestive tract not to be compromised. Moreover, the age of this group of patients and perioperative radiotherapy adds to the existing obstacles in reconstruction. The evolution of microsurgery and free tissue transfer replacing the previous gol...

 Open Access DOI:10.23937/2378-3656/1410408

Registration of the First Case Study in Cyprus of a Critically Ill Patient with Tuberculosis and Simultaneous Infection with Mycobacterium Soft Tissue on the Medial Surface of the Thighs

Andria Syka, RN, BSc, MSc and Lakis Palazis, MD, EDIC, MP

Article Type: Case Study | First Published: October 21, 2022

The first critically ill case with medial soft tissue tuberculosis is recorded for the first time in Cyprus. She is a young patient with a rich medical history. Tuberculosis was detected in the soft tissues of the medial degree in the Intensive Care Unit of the Nicosia General Hospital. The purpose of this specific study is to record and analyze the first clinical case in Cyprus of a critically ill patient with tuberculosis and simultaneous infection with Mycobacterium soft tissue on the medial ...

 Open Access DOI:10.23937/2378-3656/1410407

Gastric Schwannoma, Rare Presentation of a Gastric Mass, with an Excellent Outcome

Fadwa Oudad, Samira Benayad, Zineb Bouchbika, Nadia Benchakroun, Nezha Tawfiq, Hassan Jouhadi, Souha Sahraoui and Abdellatif Benider

Article Type: Case Report | First Published: September 30, 2022

Schwannoma is a benign tumor, that mainly occurs in the nerve endings of the head and neck, and more rarely in the gastrointestinal tract. In the latter case, it appears as a submucosal tumor (SMT), which elective site is the stomach. Gastric schwannoma (GS) accounts for 0.2% of all gastric tumors and is mostly benign slow-growing, and very often asymptomatic. Its diagnosis can only be confirmed by a histopathological examination, which allows the distinction between a GS and other SMTs, particu...

 Open Access DOI:10.23937/2378-3656/1410406

Anesthetic Management of a Patient with Epidermolysis Bullosa for Esophageal Dilatation: A Case Report

Ersin Kandemir, Begüm Gökdemir, Deniz Kaya, Figen Leblebici and Nedim Çekmen

Article Type: Case Report | First Published: September 30, 2022

Epidermolysis bullosa (EB) is a mucocutaneous disorder characterized by fragility of skin and mucosal membranes to the mechanical stress resulting formation of blisters, erosions and scarring. Their vulnerability needs certain attention and anesthetic management plan to perform anesthesia requiring procedures and surgeries without complications. In our case, a patient with EB had undergone an esophageal dilatation procedure....

 Open Access DOI:10.23937/2378-3656/1410405

Multi-Drug Resistant Tuberculous Meningitis in a Pregnant Woman

Batuhan Erdir, Burcu Ileri Fikri, Irem Ezgi Demirhisar and Guldem Turan

Article Type: Case Report | First Published: September 30, 2022

Tuberculous meningitis (TBM) is the most fatal form of the Mycobacterium tuberculosis infection. Its diagnosis remains difficult due to poor suspicion of the disease especially in the case of pregnancy. We bring to your attention a 27-year-old pregnant woman who came to the emergency department with headache and nausea. With high clinical suspicion and early treatment with Meropenem 3x2 gram, Levofloxacin 2 x 500 mg, Amoxicillin Clavulanate 3 x 1 gram, Ethambutol 1 x 25 mg/kg body weight, Pyrazi...

 Open Access DOI:10.23937/2378-3656/1410404

Merkel Cell Carcinoma of the Upper Eyelid: A Case Report and Review of the Literature

K Coulibaly, S Anajar, E Othman, Amal Hajjij and F Slimani

Article Type: Case Report | First Published: September 30, 2022

Merkel cell carcinoma of the upper eyelid is a rare and aggressive tumor. It develops from Merkel cells present in areas with glabrous skin. It touches females more than males. A 42 years old female patient presented with a nodular painless and purplish lesion of the left upper eyelid. The diagnosis of Merkel cell carcinoma was made on histopathological examination and immunohistochemical analysis....

 Open Access DOI:10.23937/2378-3656/1410403

Pyoderma Gangrenosum of the Breast: A Rare Location of Neutrophilic Dermatoses

Sophia AI, Aboudouraib M, Amal S and Hocar O

Article Type: Case Report | First Published: August 31, 2022

Pyoderma gangrenosum (PG) is a rare entity belonging to the neutrophilic dermatoses. It is an inflammatory dermatosis with a chronic evolution by relapses, often revealing an associated underlying disease. The location to the breast represents is unusual, poorly documented in the literature and whose diagnosis remains difficult to establish....

 Open Access DOI:10.23937/2378-3656/1410402

Rapid Progression of Sternocostoclavicular Hyperostosis (SCCH) Observed after Anti-TNF-a Therapy for Polyarthritis: A Case Report

Atsushi Kitagawa, Mitsuhiko Takahashi, Tomoko Nakamura and Yasushi Hashimoto

Article Type: Case Report | First Published: August 31, 2022

Sternocostoclavicular hyperostosis (SCCH) is a chronic osssifying diathesis affecting mostly juxtasternal structures and the inflammatory osteitis is mostly part of the synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. we presented a case of 62-year-old woman with polyarthritis in bilateral hands, who had experienced swelling of anterior chest wall sinse she was 30 years old....

 Open Access DOI:10.23937/2378-3656/1410401

Perspectives in the Treatment of Crohn’s Disease by a Physician of Family Medicine: A Clinical Case Presentation

Luka Vučkič, Eva Zadravec, Igor Rakuša and Mateja Rakuša

Article Type: Case Report | First Published: August 19, 2022

Crohn’s disease is a rare disease with a chronic relapsing course. Usually begins at a young age influenced by environmental, genetic, and immunological factors. Patients mostly have only intestinal changes. In addition to the gut, other organs, such as skin, joints, liver, and kidneys can be affected. The type of treatment and choice of drugs depends on the type and severity of the disease....

 Open Access DOI:10.23937/2378-3656/1410400

Periprosthetic Fractures and Acetabular Loosening after Surgical Treatment of Bilateral Femoral Neck Pathological Fractures Secondary to Hypocalcemic Seizure with Chronic Renal Failure: A Case Report and Review of the Literature

Weihua Li, Zehui Zou, Xuqiang Liu and Xiaofeng Li

Article Type: Case Report | First Published: July 31, 2022

Long-term hemodialysis treatment of chronic kidney disease (CKD) can lead to disorder of calcium and phosphorus regulation and abnormal parathyroid function. Most patients with renal failure often have secondary hyperparathyroidism, at which time the parathyroid glands can release large amounts of parathyroid hormone (PTH), which activate osteoclast activity to increase serum calcium levels, resulting in severe skeletal diseases, including osteoporosis, pathological fractures, bone pain....

 Open Access DOI:10.23937/2643-3885/1710069

Irreducible First Metatarsophalangeal Joint Dislocation Secondary to Entrapment Through Flexor Hallucis Brevis: A Case Report

Kelly Tomasevich, Colin Pavano, Jacob Silver and Jill Putnam

Article Type: Case Report | First Published: July 30, 2022

This case report highlights a unique soft tissue entrapment in an open Metatarsophalangeal joint dislocation requiring operative reduction....

 Open Access DOI:10.23937/2378-3656/1410399

The Pharmacology of Curaderm in the Treatment of Basal Cell Carcinoma

B E Cham

Article Type: Research Article | First Published: July 31, 2022

Skin cancer is the most common form of cancer in the United States of America and in Australia. Basal cell carcinoma (BCC), the most prominent skin cancer, is curable, but can be disfiguring and costly to treat....

 Open Access DOI:10.23937/2378-3656/1410398

Colorectal Cancer in Adolescence: A Report of Two Cases


Article Type: Case Series | First Published: July 30, 2022

Colorectal cancer is very rare in children. Therefore, the diagnosis is generally established at advanced disease. This is a presentation of two cases of colorectal treated at Habib Bourguiba Hospital University....

 Open Access DOI:10.23937/2378-3656/1410396

Susac Syndrome: Collaboration is Required for a Diagnosis

Claudia Candale-Radu, Akintomide Femi Akindotun, Reza Hosseini, Sibi Thirunavukkarasu, Unn Ljostad and Ase Mygland

Article Type: Case Report | First Published: June 30, 2022

Susac Syndrome is a rare auto-immune endotheliopathy that rarely presents with the full triad of branched retinal artery occlusion, encephalopathy and sensorineural hearing loss. The diagnosis of Susac can be a challenge due to the variability in presentation, course and severity of disease....

 Open Access DOI:10.23937/2378-3656/1410397

Unusual site of yellow ligament ossification- cervical spine

Mehdi Mahmoodkhani and Navid Askariardehjani

Article Type: Case Report | First Published: June 30, 2022

The yellow ligament, or Ligamentum flavum, is the ligament that connects the lamina arches of two adjacent vertebrae in the spine. This ligament is yellow and has elasticity. Ligamentum flavum ossification is an uncommon cause of pressure on the cervical cord....

 Open Access DOI:10.23937/2378-3656/1410395

Methotrexate Induced Stevens-Johnson Syndrome: Two Cases Reports

I. Masmoudi, F. Baklouti, N. Siala, YO. Yaye, A. Masmoudi and A. khanfir

Article Type: Case Report | First Published: June 23, 2022

Methotrexate induced Stevens-Johnson syndrome (SJS) is rare but life-threatening cutaneous reaction. This is a case report of two 14-year-old girls with methotrexate (MTX)-induced Stevens-Johnson syndrome (SJS). Both girls received chemotherapy with MTX in the treatment of osteosarcoma and then developed SJS....

 Open Access DOI:10.23937/2378-3656/1410394

Adult-Onset Atypical Coeliac Disease Presenting with Severe Anaemia and Hidradenitis Suppurativa: A Case Report

Udani Dassanayake and Saroj Jayasinghe

Article Type: Case Report | First Published: June 04, 2022

A 23-year-old female presented with a history of an acute febrile illness associated with cough for about 24 hours. She gave a background history of altered bowel habits for 2 years. A mixed deficiency anaemia was detected, and endoscopy, serology and histological tests confirmed a diagnosis of coeliac disease. She was successfully treated with a gluten free diet. She also had hidradenitis suppurativa which subsided with a gluten-free diet....

 Open Access DOI:10.23937/2378-3656/1410393

Superficial Temporal Artery Aneurysm

Hafedh DALY, Cyrine MNASSRI, Farhat CHALBI and Amira HORCHANI

Article Type: Case Report | First Published: May 29, 2022

The superficial temporal artery aneurysm is a rare pathology. We report the case of a 7-year-old child who consulted for a beating mass on the left forehead. The doppler ultrasound and The CT angiography confirmed the diagnosis of a superficial temporal artery aneurysm. The treatment was surgical and the postoperative course was simple....

 Open Access DOI:10.23937/2378-3656/1410392

Pleomorphic Adenoma of External Auditory Canal: First Case Report from Ethiopia with Relevant Literature Review

Yonas Girma Shumiye, MD, Fatuma Yassin Bushra, BSc, MPH, Ruth Abera Alemayehu, MD and Muluken Bekele Wondimagegnehu, MD

Article Type: Original Article | First Published: May 28, 2022

Ceruminous Pleomorphic Adenoma is a very rare, benign neoplasm originating from the ceruminal glands in the external auditory canal. Clinical manifestations are nonspecific. Meticulous preoperative clinical, pathologic, and radiologic evaluations are crucial in effective management of patients....

 Open Access DOI:10.23937/2378-3656/1410391

A Case of Parkinsonism and Encephalopathy with Combined Lithium-Risperidone Therapy: Treatment with Pramipexole

Enes Tarık İnci and Tahir Kurtuluş Yoldaş

Article Type: Case Report | First Published: April 30, 2022

Lithium is a drug that has been used in the treatment of bipolar disorder for many years. Due to its narrow therapeutic range, systemic side effects can be seen frequently. Serious side effects can occur even in non-toxic doses. We present a case of parkinsonism and encephalopathy developed in a patient with normal lithium blood level who used lithium and risperidone combination therapy for bipolar disease. Lithium is a drug that has been used to treat bipolar disorder for over 60 years. Due to ...

 Open Access DOI:10.23937/2378-3656/1410390

Risk of Pulmonary Toxicity and Benefits of Bleomycin Containing Regimen in Early-Stage Hodgkin’s Lymphoma - A Case Report and Insights from Literature Review

Adebola Adetiloye, Farhana Alladin, Kuldeep Ghosh, Julio Valencia-Manrique, Rasha Alaameri, Ana Maria Victoria, John Cosico and Andrea Popescu-Martinez

Article Type: Case Report | First Published: April 30, 2022

Bleomycin is chemotherapeutic agent that has been used for cancer treatment for several years. However, potentially life-threatening lung toxicity is a major concern limiting its use. This is a case of a 64-year-old male presenting sub acutely with gradual onset of exertional shortness of breath and cough after completing 4 cycles of ABVD regimen for Stage 2b Hodgkin’s lymphoma. CT scan showed extensive bibasilar reticular opacities with honey combing suggestive of pulmonary fibrosis with Usua...

 Open Access DOI:10.23937/2378-3656/1410389

Prolonged Recovery of Neuromuscular Transmission during General Anaesthesia after Mivacurium Administration - Case Report

Paweł Radkowski, PhD, Katarzyna Podhorodecka and Mariusz Kęska

Article Type: Case Report | First Published: April 29, 2022

Mivacurium is the shortest-acting nondepolarizing relaxant, used for brief procedures, such as those performed in the ambulatory setting. The recommended intubating dose of 0.2 mg/kg usually provides a clinically effective neuromuscular block for approximately 15 to 20 minutes and spontaneous recovery is 95% complete within about 25 to 30 minutes. 71-years-old woman was admitted for an elective laparotomy surgery with an intraoperative examination. Standard monitoring and TOF Scan (both the addu...

 Open Access DOI:10.23937/2378-3656/1410388

A Double-Edged Sword - Multiorgan Dysfunction as a Rare Complication of Dual Checkpoint Immunotherapy

Matthew Boykow, Ami K Patel1, Neil Sondhi, Eli Wercberger, Asif Mohammed, Devarajan Iyengar, Antonios Tsompanidis and John Dedousis

Article Type: Case Report | First Published: March 31, 2022

There are many immune checkpoints in the body which serve different functions. Some Immune checkpoints are molecules involved in the maintenance of immunologic homeostasis, and therefore help to maintain peripheral tolerance to self-molecules. Other immune checkpoints such as CTLA-4 and PD- 1, are important for augmenting or inhibiting the immune response. Yervoy (Ipilimumab) and Opdivo (Nivolumab) are monoclonal antibodies developed to target CTLA-4 and PD-1 respectively to augment the immune s...

 Open Access DOI:10.23937/2378-3656/1410387

A Spontaneous Tracheal Breach and a Pneumomediastinum in an 18-Month-Old Child: An Extremely Rare Case Report

Othmane Benhoummad, Sara Rochd, Zineb Sarda, Youssef Rochdi and Abdelaziz Raji

Article Type: Case Report | First Published: March 31, 2022

Spontaneous pneumomediastinum (SPM) in children was first defined by Hamman in 1939, Its Association to a posterior tracheal tear is even more uncommon. We report the case of an 18-month-child that presented a SPM associated to a posterior tracheal tear. The patient had no medical history and presented two days before her admission a dry cough and a shortness of breath. The radiological investigation showed a pneumomediastinum with an extensive subcutaneous emphysema and a posterior tear in the ...

 Open Access DOI:10.23937/2378-3656/1410386

The Role of Dermatoscopy to Differentiate Vestibular Papillae from Condyloma Acuminate in a Pregnant Woman

Fatima Zahra Agharbi and A. Kelati and S. Chiheb

Article Type: Case Report | First Published: March 14, 2022

The vestibular papillae (VP) represent an anatomical variant of the normal genital epithelium and are probably the female equivalent of pearly penile papules. It is thought that they are present in 1% of women, and this low percentage may be due to their lack of knowledge by practitioners since their diagnosis are often wrongly spotted as condyloma acuminates warts and this can lead to aggressive investigations, therapy, and anxiety in patients hence the role of dermoscopy. Here, we present a ca...

 Open Access DOI:10.23937/2378-3656/1410385

Spontaneous Rupture of Renal Pelvis Secondary to Extrinsic Compression of Sigmoid Volvulus

Kasturi Rangan Sarathy, Arun Jain and Abdus Samee

Article Type: Case Report | First Published: February 28, 2022

Spontaneous rupture of the renal pelvis is one of the rare complications and is commonly known to occur secondary to obstructed distal ureteric calculus. Malignant ureteric obstruction and bladder outlet obstruction are few other causes that could like to rupture of renal pelvis secondary to the back pressure changes. Pregnancy is one of the non-renal extraluminal causes of the spontaneous renal fornix rupture. However, blowout of renal pelvis secondary to an obstructing bowel has not been repor...

 Open Access DOI:10.23937/2378-3656/1410384

Blue Laser Imaging and Magnification Endoscopy as a Tool for the Detection of Helicobacter pylori Infected Mucosa

Ulises Leal-Quiroga, MD, Abigail Sara Kane, MD, Eduardo Mendoza-Fuerte, MD, Omar David Borjas-Almaguer, MD, Eugenia Leal, MS and Rafael Castañeda-Sepúlveda, MD

Article Type: Original Article | First Published: February 28, 2022

There are multiple diagnostic methods for the detection of H. pylori; however, because most are not cost-effective and have low sensibility and specificity, gastric biopsy remains the gold standard for diagnosis. H. pylori’s patchy distribution in the gastric mucosa requires multiple biopsy samples to accurately diagnose infection. This study’s objective is to identify the diagnostic value of using BLI-Bright with magnification endoscopy as a tool for guided biopsy sampling in patients with ...

 Open Access DOI:10.23937/2378-3656/1410383

Patients with Pelvic Inflammatory Disease vs. Tuboovarian Abscess: Comparison of Follow-Up and Treatment Processes

Busra Kanyildiz, MD

Article Type: Original Research | First Published: February 24, 2022

Pelvic inflammatory disease (PID) is an infection of the upper vaginal tract in women that can be subclinical or severe, affecting any or all of the uterus, fallopian tubes, and ovaries. Tuboovarian abscess (TOA) is a common consequence of PID. The purpose of this study is to compare the demographic features, symptoms, clinical findings, and treatment techniques of patients hospitalized with the diagnosis of PID and TOA, to assess their response to treatment protocols and therapy, and to evaluat...

 Open Access DOI:10.23937/2378-3656/1410382

Trendelenburg Gait Improved by Trigger Point and Scar Tissue Lidocaine Injections: A Case Report

Alexander King, DO, Rosie Wenrich, BS, Rachel Patel, BS and Joseph LaFontaine, BS

Article Type: Case Report | First Published: January 31, 2022

This case report describes a 74-year-old Caucasian female patient who presented with bilateral gluteus muscle trigger point pain, decreased gluteus medius strength, a substantial transverse abdominal scar, and a history of knee replacement culminating in a Trendelenburg gait and chronic pain. Treatment of the patients’ symptoms with lidocaine solution injections, known as neural therapy, into the bilateral gluteus muscle trigger points and along scar tissue facial planes yielded markedly impro...

 Open Access DOI:10.23937/2378-3656/1410381

Regression of Diabetic Macular Edema by Remission of Type 2 Diabetes with Plant-Based Diet: A Case Report and Review

Gunadhar Panigrahi, MD, FACC, FACP, DipABLM

Article Type: Case Report and Literature Review | First Published: January 31, 2022

Diabetic retinopathy (DR) is one of the major neurovascular complications of diabetes and is a leading cause of blindness in adults of working age group, 20- 74 years. From 1990-2010, DR ranked as the fifth most common cause of preventable blindness and fifth most common cause of moderate to severe visual impairment. In 2018, the estimated prevalence of diabetes among adults in the United States was 10.2% (26.8 million cases). In 2019, the disease was responsible for 4.2 million deaths worldwide...

 Open Access DOI:10.23937/2378-3656/1410380

Huge Peri Renal Extra Adrenal Myelolipoma

M Souissi, A Ben Fatma, Y Lahouel, C Kerkeni and S Jerbi

Article Type: Case Report | First Published: January 30, 2022

Extra-adrenal myelolipomas are a group of mesenchymal tumors which consist of a mixture of mature adipose tissue with hematopoietic cells. This intriguing tumor most commonly occurs within the adrenal gland; however, it has been occasionally found within the pelvis, thorax, retroperitoneal space, and various other sites throughout the body. The physiopathology is not yet clearly explained, Amin, et al. suggest that there may be a relationship between the re-activation of primitive peritoneal foc...

 Open Access DOI:10.23937/2378-3656/1410379

Integrated Management Strategies (Diagnosis, Treatment, and Wound Care Management) for Improved Clinical Outcomes of Buruli Ulcer in Ghana: A Retrospective Case Report in the Ga West Municipal Hospital, Amasaman

Gideon Atinga Akolgo, Anthony Ablordey, Janet Pereko, Joseph Tuffour, Nana Konama Kotey, Albert Paintsil, Gladys Adwapa, Akosua Agyapomaa Croffie, Samuel Kwarteng Donkoh and Richard Amewu

Article Type: Case Report | First Published: January 30, 2022

Buruli ulcer is a necrotizing skin infection caused by Mycobacterium ulcerans. BU lesions may start with characteristic painlessness but most often, the typical presentations of the disease are characterized by large ulcers with undermined edges. If left untreated, BU lesions may result in extensive ulceration that can cover 15% of the body. Even though public sensitization and education have resulted in sufficient and improved knowledge about the etiology of the disease in Ghana, patients still...

 Open Access DOI:10.23937/2378-3656/1410378

One Head Trauma, Three ENT Manifestations

Pedro Santos, MD, Ângela Rego, MD, Isabel Carvalho, MD and Luís Meireles, MD

Article Type: Case Report | First Published: December 31, 2021

It is well known that head trauma (HT) can cause hypoacusis; as well as benign positional paroxysmal vertigo (BPPV) and anosmia, which are frequently referred as sequelae of HY. However, the post-HT triad of BPPV, hypoacusis and anosmia is extremely rare to occur in the same patient, with only two cases reported in the literature. With this case report we wish to describe a clinical case of HT that caused hypoacusis, BPPV and anosmia as sequelae, and to review the importance of ENT evaluation in...

 Open Access DOI:10.23937/2378-3656/1410377

Acute Limb Ischemia as an Unusual Presentation of Spontaneous Coronary Artery Dissection

Basel Musmar and Alaa Gabi

Article Type: Case Report | First Published: December 31, 2021

Spontaneous coronary artery dissection (SCAD) is a rare, though, important cause of acute coronary syndrome that is more commonly seen in young and middle-aged women without risk factors for, or a history of, coronary artery disease. Acute embolization of left ventricular (LV) thrombus is an uncommon but known cause of acute limb ischemia. In this case, we present a rare case of SCAD that led to acute limb ischemia due to embolization of LV thrombus. A 53-year-old female with a past medical his...

 Open Access DOI:10.23937/2378-3656/1410376

Bilateral Lung Transplantation Due to Sjögren’s Syndrome in a Patient with Klinefelter Syndrome

Beauperthuy Levy Thais, MD, Anguera de Francisco Gabriel, MD, Fonfría Esparcia Carles, MD and Mancheño Franch N, MD

Article Type: Case Report | First Published: December 24, 2021

Klinefelter syndrome is one of the most frequent congenital chromosome disorders. Autoimmune diseases are not uncommon in patients with Klinefelter syndrome and associations between them have long been described. However, there is a paucity of literature regarding the effect of hypogonadism on respiratory system in these patients. Herein, we described a 28-year-old patient who presented with a constellation of unexplained respiratory signs and symptoms, such as tachypnea, hypoxemia, crackles rec...

 Open Access DOI:10.23937/2378-3656/1410375

An Unusual Complication of Mesenteric-Portal Axis Thrombosis and Septic Shock in a Patient with Mesangial Proliferative Glomerulonephritis

Sicharam Vijaya Luxmi, Sun Yue, Chen Xing Qing, Cao Fang Fang, Swalay Fedally and Du Xiao Gang

Article Type: Case Report | First Published: December 18, 2021

Thromboembolic events contribute to the most serious outcomes in patients with nephrotic syndrome. We report a case of a young male patient with mesangial proliferative glomerulonephritis presenting with nephrotic syndrome, which rapidly progressed to mesenteric and portal veins thrombosis and septic shock, ultimately leading to death. A 19-years-old, male patient was admitted due to bilateral lower extremity edema and abdominal distension. The abdominal distension appeared 2 months ago with acc...

 Open Access DOI:10.23937/2378-3656/1410374

Acute Wound with Varicose Vein in Rural Setting: The Challenge and Importance of Comorbidity Management

Agustini Song, MD, Kevin Leonard Suryadinata, MD and Nabila Viera Yovita, MD

Article Type: Case Report | First Published: November 30, 2021

Acute wound healing with comorbidities, such as a varicose vein, may be impaired and result in prolonged healing and unsightly scar if comorbidity identification and management are not done properly. We aimed to present the alternative comorbidity diagnosis and treatment for better outcome in rural setting. A 59-year-old woman was admitted to the ED with an open wound on the dorsolateral side of her left foot with comorbidity of uncontrolled hypertension and varicose vein. After wound closure wi...

 Open Access DOI:10.23937/2378-3656/1410373

Short Review of the Covid-19 Pandemic

Hamida Amer and Amal Ouhida

Article Type: Review Article | First Published: November 30, 2021

There is a dangerous virus spread across the globe since the end of 2019. The virus’s name is Coronavirus disease (Covid-19). Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. COVID-19 is caused by one virus, called severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2. An epidemic of Coronavirus disease 2019 (COVID-19) outbroke in December 2019 in China, Wuhan, which is becoming a Public Health Emergency of International Concern. As thi...

 Open Access DOI:10.23937/2378-3656/1410372

Factitious Disorder: A Paradox Case with Recurrent Symptomatic Hypoglycemia

Dana Hassneiah, MD, Seyma Sevinc, MD, Kendyl Stewart, MD, Charlotte Chaiklin, MD and Marcia Williams, MD, FACP

Article Type: Case Report | First Published: November 28, 2021

The patient was hospitalized and started on a Dextrose intravenous infusion. She underwent primary adrenal insufficiency testing with a normal co-syntropin stimulation test. She had normal glucose levels throughout her hospitalization. She was discharged home with instruction to discontinue use of oral hypoglycemic medications. A week after discharge the patient was found unresponsive and was brought to the emergency department for further evaluation. En route to the hospital, the patient was no...

 Open Access DOI:10.23937/2378-3656/1410371

Painless Cervical Lymphadenopathy in an Elderly Patient - A Rare Case of Rosai-Dorfman Disease and Hodgkin’s Lymphoma

Shi Ying Tan, MB, BCh, BAO, Pemasiri Upali Telisinghe, MBBS and Justin Fook Siong Keasberry, MB ChB, FRACP

Article Type: Case Report | First Published: November 22, 2021

Rosai-Dorfman disease is a rare, benign disease presenting with extensive lymphadenopathy. In this case, an 81-yearold gentleman with previous pulmonary tuberculosis, presented with painless cervical lymphadenopathy associated with generalized weakness, loss of appetite, and cough. The causes of cervical lymphadenopathy in elderly are comprehensive; hence thorough history taking, examination, and appropriate investigations are vital in diagnosing diseases. If blood investigations and imaging are...

 Open Access DOI:10.23937/2378-3656/1410370

Delayed Splenic Abscess Post Splenic Arterial Embolization for Trauma in a Patient with Previous Sleeve Gastrectomy

Thomas Vu, Charles Pilgrim, Warren Clements and Ee Jun Ban

Article Type: Case Report | First Published: November 20, 2021

In haemodynamically stable patients with blunt splenic injuries, non-operative management (NOM) including the use of selective splenic artery embolization have been shown to be an effective treatment option. Proximal splenic arterial embolization reduces bleeding by decreasing pulse pressure to the spleen, hence lowering intra-splenic arterial blood pressure and promoting thrombosis of injures vessels. Splenic tissue perfusion is still achieved through a collateral arterial network, deriving fro...

 Open Access DOI:10.23937/2378-3656/1410369

Systemic Quinolones and Risk of Retinal Detachment II: Systematic Review of Clinical Trials

Mohamed Kadry Taher, Mohamed Habsah, Lise M Bjerre, Franco Momoli, Donald Mattison and Daniel Krewski

Article Type: Review Article | First Published: October 31, 2021

Quinolones represent a popular group of antibiotics that is favored by physicians due to their potency, broad-spectrum, unique mechanism of action, and reasonable safety. Concerns have been raised about a possible association between quinolones and retinal detachment (RD). Despite the emergence of resistance and availability of other treatment alternatives, quinolones remain a popular choice among physicians worldwide. This systematic review examined all original clinical trials in which a quino...

 Open Access DOI:10.23937/2378-3656/1410368

Laparoscopic Resection of a Gastric Lipoma: A Case Report

Mohammed Najih and Aziz Zentar

Article Type: Images | First Published: October 30, 2021

Lipomas are slow growing benign tumors that develop in fat tissues. Gastric lipomas account for only 5% of all gastrointestinal lipomas. Although they are usually asymptomatic and detected incidentally. We report a new case on a 54-year-old male patient admitted to our clinical complaints of a vague lump in the upper abdomen, regarding a feeling of fullness in the stomach and early satiety for 10 months, no pathological finding was made. The Gastrointestinal Endoscopy showed the existence of a m...

 Open Access DOI:10.23937/2378-3656/1410367

Rhabdomyolysis Associated Acute Kidney Injury Following a Physical Violence

Yalini Thivaharan and Indira Deepthi Gamage Kitulwatte

Article Type: Case Report | First Published: October 30, 2021

Physical violence can lead to serious and, rarely, fatal injuries. In addition to head injury, which is the leading cause of death and long-term disability, injuries of the musculoskeletal system and internal organs are important cause of assault-related morbidity. This paper discusses such rare complication of an interpersonal violence - rhabdomyolyis associated with Acute Kidney Injury (AKI). A 37-year-old man who claims to be assaulted by a group of people, presented with focal contusions and...

 Open Access DOI:10.23937/2378-3656/1410366

Severe Malaria with Acute Kidney Injury and Post-Dialysis Hypocalcaemia and Hypertension: A Case Report of a Young Patient Managed in a Resource Limited Setting

Wafula Innocent, MBChB

Article Type: Case Report | First Published: September 29, 2021

Malaria is a leading cause of paediatric morbidity and mortality in Africa. Plasmodium falciparum species is commonly associated with severe complications of malaria including severe anaemia, prostration, altered consciousness, hypoglycaemia, pulmonary oedema, haemoglobinuria, and acute kidney injury (AKI). In patients with these complications, the cornerstone of treatment is prompt administration of antimalarials and the provision of appropriate supportive care. AKI is an established independen...

 Open Access DOI:10.23937/2378-3656/1410365

Preventing Progression of Chronic Kidney Disease with Plant-Based Diet

Gunadhar Panigrahi, MD, FACC, FACP, DipABLM

Article Type: Case Report | First Published: September 29, 2021

A 72-year-old female has long standing history of coronary artery disease (CAD), hypertension, hyperlipidemia, and obesity. In 1987, at the age of 39 years, she had sustained an anterior wall myocardial infarction. She had cardiac catheterization and received a stent to the left anterior descending coronary artery (LAD), the infarct related artery. In 2007, she had sustained a second heart attack at the age of 59 years, and this time she was treated with simple balloon angioplasty to the LAD. In...

 Open Access DOI:10.23937/2378-3656/1410364

Complete Perioral Reconstruction for High Power Electrical Burn

Abiel Kwok, BSc and Colin Hong, MD, FRCP

Article Type: Case Report | First Published: September 20, 2021

Facial reconstructive procedures aim to restore function and appearance to a section of the face affected by trauma, surgery or illness. Lip reconstructions are common procedures due to the mouth’s role in numerous key functions, such as speech, chewing and displaying emotion, as well as its contributions to the overall aesthetic of the face. Lip and perioral reconstruction for the purpose of restoring function is more complicated. Selecting the best source of the skin flap used to cover the a...

 Open Access DOI:10.23937/2378-3656/1410362

Cauliflower Outgrowths on an Amputation Stump

Farah El Hadadi, Line Mezni, Kaoutar Znati, Meriem Meziane, Leila Benzekri and Karima Senouci

Article Type: Case Report | First Published: August 30, 2021

Pseudo-epitheliomatous hyperplasia (PEH) is a histopathological reaction due to various stimuli, which includes trauma, infection, inflammation, neoplasia. We report a case of a patient with cauliflower outgrowths on an amputation stump simulating a squamous cell carcinoma. 62-year-old patient, diabetic on insulin therapy for 20 years, complicated by arteriopathy and diabetic neuropathy; who benefited from a trans-tibial amputation with prosthesis wear for 6 years. He consults in dermatology for...

 Open Access DOI:10.23937/2378-3656/1410363

High Level of Suspicion Based on Detailed Medical History and Focused Physical Examination: Important Tool to Diagnose Acute Myocarditis

Lahoud Patrick

Article Type: Case Report | First Published: August 30, 2021

The present study describes the case of a 39-year-old man who had acute retrosternal pain, history of upper tract infection and low-grade fever 3 days prior to presentation, elevated cardiac markers and electrocardiographic ST-T changes, which led to an original suspicion of acute myocarditis. The patient underwent coronary angiography after 36 hours to rule out coronary artery disease, which revealed normal coronary arteries. Finally, the diagnosis of viral myocarditis was confirmed on consider...

 Open Access DOI:10.23937/2378-3656/1410361

Systemic Quinolones and Risk of Acute Liver Failure II: Systematic Review of Clinical Trials

Mohamed Kadry Taher, Mohamed Habsah, Lise Bjerre, Franco Momoli, Donald Mattison and Daniel Krewski

Article Type: Review Article | First Published: August 30, 2021

Quinolones are a class with four generations of synthetic antibiotics characterized by a unique mechanism of action, broad spectrum, potent pharmacologic properties and reasonable safety profile. Their global and growing popularity has been accompanied by an increase in the emergence of antimicrobial resistance and occurrence of unexpected adverse reactions. Nevertheless, physicians continue to prescribe these drugs on an increasing scale, irrespective of the availability of other treatment alte...

 Open Access DOI:10.23937/2378-3656/1410360

A Case Report on Primary Neuroendocrine Cancer of Vagina

Kumari Puja, Ashok Kumar Arya, Arun Yadav and Durgesh

Article Type: Case Report | First Published: July 31, 2021

Neuroendocrine tumors of the gynaecologic tract are rare, and pose a significant clinical challenge because of the tumor heterogeneity and lack of standardized guidelines for treatment. Primary neuroendocrine tumor of vagina is extremely rare and only 26 cases have been reported so far in literature. Most, but not all, neuroendocrine tumors of the gynaecologic tract have an aggressive clinical course and clinically share similarities with small cell lung cancer. Cumulative data supports a multi-...

 Open Access DOI:10.23937/2378-3656/1410359

The Heart Shape-Sign in Bilateral Medial Medullary Infarction; Complicated with Quadriparesis and Respiratory Failure

Liaquat Ali, Numan Amir, Naveed Akhtar, Osama Elalamy, Mohammed Alhatou, Gholam Adeli and Ambreen Iqrar

Article Type: Case Report | First Published: July 31, 2021

20% of ischemic strokes involve posterior circulation. The most common causes of posterior circulation large artery ischemia are atherosclerosis, embolism, and dissection. The most common location of atherosclerotic occlusive disease within the posterior circulation is the proximal portion of the vertebral artery in the neck within the first inches. Basilar artery occlusive disease most often presents as ischemia in the pons. Occlusion of the rostral portion of the basilar artery can cause ische...

 Open Access DOI:10.23937/2378-3656/1410358

A Case of COVID-19 Infection Associated with Severe Cold Agglutinin Autoimmune Haemolytic Anaemia

Prabhashini Kumarihamy, Sujeewa Gunaratne, Ashani Ratnayake, Hiranya Abeysinghe, Sahan Perera, Vishaka Rajapaksha and Navoda Wickramasinghe

Article Type: Case Report | First Published: July 31, 2021

COVID-19 is known to cause systemic disease with multiple organ dysfunctions. COVID-19 associated immune-mediated phenomena such as autoimmune haemolytic anaemia has been identified previously with rare incidence. However, the association between COVID-19 infection and autoimmune haemolytic anaemia is not fully evaluated. Here, we present a case of a previously well patient who developed severe cold agglutinin hemolytic anemia during the course of COVID-19 infection. Although there were no throm...

 Open Access DOI:10.23937/2378-3656/1410357

Acute Lymphoblastic Leukemia Mimicking Bilateral Wilms Tumour: A Radiologic Review

Adebola-Yusuf AO, Adefalujo AP, Oyelese AT, Ilori OJ, Ajiboye OF, Oyegunle AO and Emmanuel EE

Article Type: Case Report | First Published: July 31, 2021

Acute leukemia, the commonest cancer in children, accounts for approximately 30% of all childhood malignancies approximately 75% of which are Acute Lymphoblastic Leukemia (ALL) affects children of any age, commoner in ages 1-4 years, boys more than girls. The kidneys are sites of extra medullary leukemic involvement usually seen late in the course of the disease. ALL with renal involvement may mimic Wilms’s tumor due to overlap of their clinical and radiological findings. These include malaise...

 Open Access DOI:10.23937/2378-3656/1410356

Case Report: A Rare Case of Biatrial Thrombus in the Absence of Interatrial Shunt

Paul Elias, MD, Jonatan D Nunez Berton, MD, Marian T Calfa, MD and Azar Radfar, MD, PhD

Article Type: Case Report | First Published: July 31, 2021

In this rare case we describe a 56-year-old woman who presented with an acute pulmonary embolism (PE) complicated by right heart strain indicating the need for catheter-directed mechanical thrombectomy. Pre-operative two dimensional (2D) transthoracic echocardiogram (TTE) showed no evidence of intracardiac thrombi. Subsequently, post-operative 2D TTE indicated large biatrial thrombi with no evidence of PFO, or other intracardiac shunt. Here, we describe this rare and unique presentation and disc...

 Open Access DOI:10.23937/2378-3656/1410355

New Diagnostic Algorithm to Asymptomatic Coronary Artery Disease in Patients with Lower Peripheral Artery Disease

Yasemin Saglam, MD and Ersin Saricam, MD

Article Type: Original Article | First Published: June 30, 2021

To suggest a risk index to prediction of coronary artery disease severity by examining lower extremity arterial regions in the patients with lower extremity peripheral artery disease. We retrospectively examined 4255 patients who experienced coronary angiography between September 2015 and January 2020. Medicana International Ankara Hospital Ethics Committee accepted the study schedule [Numbered: 2017/1]. Of the patients, 400 patients underwent both coronary angiography and lower extremity angiog...

 Open Access DOI:10.23937/2378-3656/1410354

Cyclophosphamide Induced Posterior Reversible Encephalopathy Syndrome (PRES) in a Patient with Lupus Nephritis

Chandan Buttar, MD, Sofia Lakhdar, MD, Francisco Cuevas Castillo, MD and Adriana Abrudescu

Article Type: Case Report | First Published: June 30, 2021

Immunosuppressant agent cyclophosphamide is a therapeutic option for treatment of systemic lupus erythematosus (SLE). Cyclophosphamide use is a predisposing factor to development of posterior reversible encephalopathy syndrome (PRES). PRES is a clinical syndrome of headache, altered mental status, changes in vision and seizures. Precipitating factors for PRES are multifactorial and include cytotoxic medications, changes in blood pressure, metabolic derangements and autoregulatory failure. We rep...

 Open Access DOI:10.23937/2378-3656/1410353

Biclonal Gammopathy of Iga Kappa Variant in a Patient with Systemic Lupus Erythematosus: A Case Report

Hicham Esselmani, Asmaa Yassine, Boutaina Akhatar, Otmane Touzani and Abderrazak Lfakir

Article Type: Case Report | First Published: June 30, 2021

The association of systemic lupus erythematosus and multiple myeloma is an uncommon event. Biclonal gammopathy is a rare case, which accounts for only 1.5% of all myelomas but biclonal gammopathy of IgA kappa variant is extremely rare. We report this unusual case in which the simultaneous diagnosis of biclonal gammopathy of IgA kappa variants and systemic lupus erythematosus was made. A 56-year-old man has a past medical history of renal failure (secondary to type 2 diabetes diagnosed 11 years b...

 Open Access DOI:10.23937/2378-3656/1410352

Another Great Pretender: A Case of Tuberculous Peritonitis Mistaken for Malignancy

Lauren Belak, Jane Fazio, Nicole Treadway and Iris Castro-Revoredo

Article Type: Case Report | First Published: June 28, 2021

A 34-year-old female with a history of anemia, low grade cervical dysplasia, and high-risk HPV presented with a 7-day history of worsening abdominal distension, following one month of progressive fatigue, anorexia, weight loss, and subjective fevers. She denied respiratory symptoms, night sweats or changes in bladder or bowel function. The patient immigrated from Mexico 15 years prior, and briefly lived with her father and brother who were both treated for TB decades before. Her aunt and grandmo...

 Open Access DOI:10.23937/2378-3656/1410351

A Rare Case of Adamantinoma in an 11-Year-Old

Pouyan Kheirkhah, Bartlomiej Radzik, Kyle Sonnabend, Grace Guzman and Steven Garzon

Article Type: Case Report | First Published: June 28, 2021

Adamantinoma is a low-grade malignant lesion most frequently arising in the tibial cortex. Approximately 27% of adamantinomas present with multifocal lesions in the same bone and 10% of cases involve the ipsilateral fibula. We describe an 11-year-old male with no significant past medical history who presented to the clinic with a 2-year history of abnormal gait. Two years after the onset of symptoms, a painful mass was noticed on his left shin. Patient biopsy showed a nest of epithelial-like ce...

 Open Access DOI:10.23937/2378-3656/1410350

Bilateral Hydronephrosis as a Consequence of Vesicoureteral Reflux in a 6-Year-Old Male Patient

Enrique Konstat-Korzenny and Raquel Cohen-Shaooli

Article Type: Case Report | First Published: May 31, 2021

Vesicoureteral reflux (VUR) is the most common urologic pathology in the pediatric population. VUR is defined as primary when the intravesical portion of the ureters is short and produces an incompetent ureterovesical junction. Secondary VUR is caused by anatomical or functional obstruction to bladder emptying, which in turn increases the bladder internal pressure, therefore overcoming the ureterovesical junction and causing reflux. Current guidelines reflect on whether patients of a certain age...

 Open Access DOI:10.23937/2378-3656/1410349

The Effect of Remdesivir and Convalescent Plasma in Severe COVID-19 in Pregnancy

Ahmed Elantably, MD, Dina Elantably, MD and Usman Ashraf, MD

Article Type: Case Report | First Published: May 31, 2021

32-year-old female, 27-week 6-day intrauterine pregnancy as confirmed by ultrasound, hairdresser by profession presented with 5-day history of shortness of breath, persistent cough, low-grade fever. Vital signs temperature 100.2, heart rate 106, respiratory rate 20, BP 108/55, she was requiring 6 L of oxygen to maintain an oxygen saturation of 92%. On presentation, labs showed WBCs 5, neutrophil 69%, lymphocyte 13%, bands 14%. Manual differential showed absolute neutrophils 3.5, absolute lymphoc...

 Open Access DOI:10.23937/2378-3656/1410348

Postoperative Bronchospasm in a Child with Coffin-Siris Syndrome Following Administration of Sugammadex

Nurcan Kutluer Karaca and Serhat Karaca

Article Type: Case Report | First Published: May 31, 2021

A 13-year-old boy with Coffin-Siris syndrome was scheduled to undergo dental surgery for dental treatment with general anesthesia. Mental retardation, finger anomalies and coarse facies features were recorded in preoperative assessment. Propofol, Fentanyl and Rocuronium were given for anesthesia induction. Sevoflurane was used as an inhalation anesthetic drug in anesthesia maintenance. At the end of the operation, the patient was extubated using sugammadex as a neuromuscular reversal drug. After...

 Open Access DOI:10.23937/2378-3656/1410347

Tongue Abscess: Delayed Diagnosis of a Foreign Body in the Tongue

Chyau Hong Wong and Shiun Chuen Chew

Article Type: Case Report | First Published: May 31, 2021

Tongue abscess is rare but can be life-threatening especially if the cause of it is not removed promptly. It usually results from trauma, foreign body, lingual tonsils pathology, thyroglossal duct remnants or dental diseases. The etiology of the disease can be found out by obtaining a detailed history from the patient and physical examination with the assistance of lab investigation, laryngoscope, imaging tools such as Computed tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasonograph...

 Open Access DOI:10.23937/2378-3656/1410346

Cracking Crabs Leading to Vibrio Necrotizing Fasciitis in a Male with Undiagnosed Adrenal Insufficiency

Ahmad Al-Abdouh, MD, Eileen McDonnell, MD, Divya Mamootil, Anas Bizanti, MD and Ammer Bekele, MD

Article Type: Case Report | First Published: May 31, 2021

Necrotizing fasciitis caused by Vibrio vulnificus is a fatal systemic infection affecting mainly immunocompromised patients. A high index of suspicion is required to start the treatment immediately, including resuscitation, systemic antibiotics, and surgical debridement. We present a case of a 72-year-old male who presented after a syncopal episode due to hypotension. He was diagnosed with Vibrio vulnificus bacteremia and necrotizing fasciitis of the right arm. During his hospitalization, he was...

 Open Access DOI:10.23937/2378-3656/1410345

Characterization of Patients with Inguinal Hernia Ambulatory Surgical Treatment

Pedro Rolando Lòpez Rodrìguez, Olga Caridad Leòn Gonzalez, Jorge Satorre Rocha, Eduardo Castillo Garcia, Luis Marrero Quiala, M Elisa Puentes Rizo and Lais Angelica Ceruto Ortiz

Article Type: Original Article | First Published: April 30, 2021

The surgical treatment of inguinal hernia has increased in the last decade and its prevalence is not known. Objective: Characterization of patients with inguinal hernia ambulatory surgical treatment. An observational, descriptive and prospective study of 972 patients with the diagnosis of inguinal hernia was performed, which were operated on an outpatient basis in the General Teaching Hospital “Enrique Cabrera” since January 2009 to December 2020. Emergency operated patients were excluded. ...

 Open Access DOI:10.23937/2378-3656/1410344

The Rare Finding of Posteromedial Papillary Muscle Hypertrophy in Chronic Rheumatic Mitral Valve Disease

Ros Lavery, MB, BCh, BAO, MRCPI and David Kerins, FACC, FAHA, FESC, FASE

Article Type: Case Report | First Published: April 30, 2021

A scarcity of literature exists on papillary muscle hypertrophy. The reported incidence of 0.4% is based on a single study of 6731 patient echos that were reported in 1990. The importance of this condition is substantial as patients are often asymptomatic and it has been postulated as a potential cause of sudden cardiac death. A 43-year-old lady presented to our care that had an incidental finding of papillary muscle hypertrophy in the context of chronic rheumatic mitral valve disease. The clini...

 Open Access DOI:10.23937/2378-3656/1410343

Acute Pericarditis in Chronic Dialysis Patients in Military Hospital of Morocco: About 8 Cases

Dina Ibrahim Montasser, Younes Skri, Kawtar El Hassani, Abdelali Bahadi, Taoufiq Aatif and Driss El Kabbaj

Article Type: Case Report | First Published: March 31, 2021

Uremic pericarditis was described by R. Bright in 1836, several factors were incriminated in the occurrence of this complication in this population in particular an inadequate kidney substitution treatment. It is a retrospective study of the clinico-biological and ultrasound characteristics as well as predictive factors for surgical drainage of the pericardium, performed on 8 chronic hemodialysis patients followed in our nephrology-dialysis unit. Optimization of quality of dialysis and Drainage ...

 Open Access DOI:10.23937/2378-3656/1410342

Recurrent Anal Abscess in a Young Male Patient with Autosomal- Dominant Hyper IgE Syndrome

Federico Lovisetto, Andrea Guala and Zonta Sandro

Article Type: Case Report | First Published: March 31, 2021

Here we present the case of a 17-year-old male patient affected by autosomal-dominant Hyper IgE Syndrome (ADHIES) who underwent to incision and drainage of recurrent anterior anal abscess. To our knowledge, this is the first reported case about recurrent perianal infection in autosomal- dominant Hyper IgE Syndrome. Hyper IgE Syndromes (HIES) are a rare primary immunodeficiencies characterized by elevated serum IgE, with an estimated incidence of 1 in 500000 to 1000000 individuals. The HIES are c...

 Open Access DOI:10.23937/2378-3656/1410341

Immunoglobulin D-Lambda Multiple Myeloma, and a Review of the Literature


Article Type: Case Report | First Published: March 27, 2021

IgD multiple myeloma (MM) is a rare plasma cell neoplasm, considered to have a poor prognosis compared to the other isotypes. Many studies reported an advanced stage at the presentation. In contrast to these studies, we report a case of rare IgD-Lambda MM at the early stage. The laboratory data showed no hypercalcemia, without any renal impairment, or monoclonal spike (M-spike or paraprotein) at the Serum protein electrophoresis (SEP) but only a hypogammaglobulinemia. IF is performed with antise...

 Open Access DOI:10.23937/2378-3656/1410340

Management of Actinic Keratoses

Lauren Schwartzberg, BS, Sonya Zarkhin, DO, Sarah Stano DO and Cindy Hoffman, DO

Article Type: Commentary | First Published: February 28, 2021

Chronic sun exposure causes the development and progression of AKs. This is due to the cumulative ultraviolet (UV) radiation from the sun which causes neoplastic effects in keratinocytes. Ultraviolet radiation exists in three wavelengths: UVA at 315-400 nm, UVB at 280-315 nm, and UVC at 100-280 nm. Generally, only UVA and UVB make it through the ozone layer. The long wavelength of UVA allows it to penetrate the skin as deep as the basal layer. This causes melanocytes within the basal layer to re...

 Open Access DOI:10.23937/2378-3656/1410339

Vancomycin Induced Thrombocytopenia from Impregnated Cement Beads

Vede Ramdass, Henry Fraimow and Kamyar Nader

Article Type: Case Report | First Published: February 25, 2021

Vancomycin is frequently used to treat Methicillin-resistant Staphylococcus aureus infections and has a rare side effect of thrombocytopenia. Currently, it is predominantly used in the intravenous form but other formulations are frequently used depending on the clinical scenario such as oral form and drug eluting beads. In this case report, we present a patient who developed persistent thrombocytopenia caused by vancomycin-impregnated cement beads. This patient had a hip replacement that was com...

 Open Access DOI:10.23937/2378-3656/1410338

MPhotoplethysmogram’s Amplitude is Well Correlated with Beat-By-Beat Changes in Arterial Blood Pressure

Gerardo Tusman, MD, Adriana Scandurra, Eng PhD, Cecilia M. Acosta, MD, Silvana Puca, MD, Jorge Martinez Arca, Eng, Matías Madorno, Eng PhD, Fernando Suarez Sipmann, PhD and Stephan H. Böhm, MD

Article Type: Original Article | First Published: February 25, 2021

To describe the association of the amplitude of the photoplethysmographic waveform (PPG) with arterial pulse pressure (PP) and surrogates of vascular tone. In 26 anesthetized patients PPG amplitude, invasive arterial blood pressure, estimated vascular compliance (Cvasc) and Doppler resistive index (RI)/mean flow velocity (Vm) were recorded during changes in arterial blood pressure. These variables were analyzed as: 1) Group-averaged analysis: 20 beats were selected at different arterial pressur...

 Open Access DOI:10.23937/2378-3656/1410337

Myoclonus-Opsoclonus-Ataxia Syndrome Secondary to Advanced HIV Infection: A Rare and Atypical Case with Management Considerations

Ashley Ryan Vidad, OMS-III, Ahjay Bhatia, OMS-III, Himadri Shah, OMS-III, Divy Mehra, OMS-III, Shrinand Shah, OMS-I and Olu Ogunjemilusi, PGY-I

Article Type: Case Report | First Published: February 17, 2021

Opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare but serious neurologic disorder that commonly presents with both spontaneous multidirectional saccades (opsoclonus) and involuntary shock-like muscular contractions (myoclonus), but may or may not present with ataxia. This disorder has an incidence of 0.18 cases per million in the total population but has a higher incidence of 0.27-0.40 per million in children due to its link to specific pathologies. OMAS is mostly idiopathic or associated wi...

 Open Access DOI:10.23937/2378-3656/1410336

Distal RTA with Hypokalemic Quadriparesis as the Initial Presentation of Primary Sjogren’s Syndrome

Tejaswee Banavathu, MBBS, Swapnil Tripathi, MBBS, Pankaj Sukhadiya, MBBS, Mahesh Kumar Barodia, MD and Gopal Krishna Bohra, MD

Article Type: Case Report | First Published: January 30, 2021

Sjogren syndrome (SS) is a multisystemic autoimmune disorder with predominant exocrine gland involvement leading to sicca symptoms. Among extraglandular manifestations, renal involvement is commonly seen. Renal involvement can be either tubulointerstitial (TIN) or glomerular, the former being more common. Distal RTA is the most common manifestation of TIN presenting as mild hypokalaemia, metabolic acidosis and rarely with hypokalaemic periodic paralysis. We report a case of a 70-year-old female ...

 Open Access DOI:10.23937/2378-3656/1410335

High-Dose Intravenous Hydroxocobalamin for Persistent Vasoplegic Syndrome after Cardiac Surgery

Mohamed Ben-Omran, MD, Ellen Huang, PharmD, Vijay S. Patel, MD, Nadine Odo, BA, CCRC, Taylor Glenn MD and Vaibhav Bora, MD

Article Type: Case Report | First Published: January 30, 2021

Vasoplegic syndrome is a vasodilatory shock characterized by significant hypotension, normal or high cardiac output, and increased requirement for intravenous fluid resuscitation and vasopressors. It is a relatively common complication following cardiac surgery. We describe the case of a 77-year-old man who developed prolonged vasoplegic syndrome which was refractory to high doses of conventional vasopressors following coronary artery bypass graft surgery. Given the possible increased risk of se...

 Open Access DOI:10.23937/2378-3656/1410334

Successful Medical and Surgical Management of Massive Hemoperitoneum in Early Pregnancy

Giovanna Rosica, Daniela Bucari, Giovanni Pastore, Angela Musella, Maria Pia Giorno, Valeria Ebano and Vincenzo Spina

Article Type: Case Report | First Published: January 09, 2021

There are several cases reported in literature about management of adnexal masses and hemoperitoneum during pregnancy, however there is still no clear and standardized treatment. Through this manuscript we want to report our experience about the successfully treatment of massive hemoperitoneum due to corpus luteum rupture during first trimester of pregnancy. A Caucasian young patient, pregnant at early gestational age, referred to our Department because of acute pelvic and abdominal pain due to ...

 Open Access DOI:10.23937/2378-3656/1410333

Chronic Neuropathic Pain after Umbilical Herniorrhaphy: A Case Report

María Eugenia Zuluaga Ruiz, Luz Miriam Leiva Pemberthy, Catalina Baena Alvarez and Daniel F. Gallego

Article Type: Case Report | First Published: December 31, 2020

We present the case of a 55-year-old female who recurrently consulted with intense pain in the right periumbilical region. The abdominal cutaneous nerve of root T10 was determined as the affected somatosensory structure and the patient was diagnosed with probable neuropathic pain. A complete history revealed umbilical herniorrhaphy procedure performed 2 years previously and that shortly anteceded the onset of pain....

 Open Access DOI:10.23937/2378-3656/1410332

Medication-Related Osteonecrosis of the Jaw by Concomitant Nivolumab and Denosumab Treatment

Gianfilippo Nifosì, Lorenzo Nifosì and Antonio Fabrizio Nifosì

Article Type: Case Report | First Published: December 31, 2020

Medication-related osteonecrosis of the jaw is a multifactorial disease described in association with antiresorptive drugs, such as bisphosphonates and denosumab. More recently, cases due to non-antiresorptive medications, particularly, some cases by immune checkpoint inhibitors, have also been reported. Dentists and oral surgeons in the coming years will see an increasing number of patients who are receiving treatment potentially toxic to bone. We reported a case of a cancer patient treated wit...

 Open Access DOI:10.23937/2378-3656/1410331

A Malrotated, Incarcerated Appendix within an Epigastric Hernia

Patrick E. McGovern, MD, Leandra Krowsoski, MD and Joseph F. Rappold, MD, FACS

Article Type: Case Report | First Published: December 16, 2020

A 40-year-old male who presented with non-reducible ventral abdominal mass that was tender to palpation on physical examination. He was found to have appendiceal incarceration within an epigastric ventral hernia defect secondary to congenital malrotation of the bowel, as initially identified on computed tomography. The patient was taken to the operating room emergently, where reduction of the hernia sac, appendectomy, and proper rotation of the colon was performed. Pathologic findings were consi...

 Open Access DOI:10.23937/2378-3656/1410330

Scrofuloderma: A Rare Case Report on Cutaneous Tuberculosis

Taksande Amar, MD, FIAE, Zeeshan Patel, MBBS and Meshram Rewat, MD

Article Type: Case Report | First Published: December 04, 2020

Globally, India has one of the highest burdens of tuberculosis (TB). The diagnosis of tuberculosis is challenging, particularly in young children due to a high rate of extra-pulmonary and meningeal disease. Scrofuloderma is cutaneous tuberculosis, accounting for approximately 1.5% of extra-pulmonary cases. Mycobacterium tuberculosis is the main etiological agent and, rarely, by Mycobacterium bovis. The cutaneous variants of tuberculosis have a variable clinical appearance, significance and progn...

 Open Access DOI:10.23937/2378-3656/1410329

Hemolysis and Venous Thrombosis: Which Link?

A. Rkiouak, PH.D, I El Kassimi, MD, N Sahel, MD, M Zaizaa, MD and Y Sekkach, PhD

Article Type: Original Research | First Published: November 25, 2020

Hemolytic anemia is defined by the premature destruction of red blood cells (RBCs). Hemolytic anemia may be acute or chronic and life-threatening, and it should be considered in all patients with a normocytic or macrocytic anemia that is unexplained. Premature destruction of RBCs can be intravascular or extravascular in the monocyte-macrophage system of the spleen and liver; extravascular destruction is more common. The mechanism of antibody-mediated hemolysis is via phagocytosis or complement-m...

 Open Access DOI:10.23937/2378-3656/1410328

Can Coconut Oil Promote Non-Alcoholic Steatohepatitis and Metabolic Syndrome? A Timely Review

Sheila CL Sanches, Fernando S Ramalho, Marlei J Augusto, Deyse M Silva and Leandra NZ Ramalho

Article Type: Review Article | First Published: Sanches SCL, Ramalho FS, Augusto MJ, Silva DM, Ram

Metabolic syndrome (MS) and non-alcoholic steatohepatitis (NASH) have been associated with bad eating habits. Supplementation with coconut oil (CO) has been proposed to control these conditions, as some authors suggest that CO provides weight loss and cardiovascular protective effects. However, the effectiveness and safety of emerging diets, such as CO, remain uncertain. This review focuses on the utilization of CO in the control of MS and NASH, besides in addition to describing this cardiovascu...

 Open Access DOI:10.23937/2378-3656/1410327

Diabetic Cherioarthropathy, a Clue for Uncontrolled Diabetes: Case Report and Review of the Literature

Amr Edrees, MD, FACP, FACR

Article Type: Case Report | First Published: November 14, 2020

Diabetes mellitus is associated with a wide variety of musculoskeletal manifestations which can significantly affect a patient’s quality of life. One of these manifestations is Limited joint mobility syndrome (LJMS) also known as diabetic cheiroarthropathy (DCA) which affects the hands. Herein is a case of a 50-year-old female patient with type 2 diabetes mellitus who was diagnosed with DCA after complaining of limited movements of all joints in her hands and tightening of the skin. Her diabet...

 Open Access DOI:10.23937/2378-3656/1410326

Recurrent Takotsubo Syndrome with Variant Ballooning Pattern

Pedro Llerena, MD, Francisco Besoain, MD, José Luis Winter, MD and Christian Dauvergne, MD

Article Type: Case Report | First Published: November 05, 2020

Takotsubo Syndrome usually presents with normal coronary arteries and the typical pattern of apical ballooning on the left ventricle. This entity can recur but very infrequently it presents with a different pattern of left ventricle wall motion abnormality. We describe the case of a 58-year-old woman presenting with recurrent TTS, associated with two different wall motion patterns in a period of nine years, triggered by a similar stressor factor. According to the modified Mayo Criteria, the diag...

 Open Access DOI:10.23937/2378-3656/1410325

Analysis of Transmission Rates in Asymptomatic COVID-19 Patients in a Community Hospital Setting

Casey A. Hughes, Thomas Boeding, Sanjay Desai, Katherine Westbrook, Constance Christian, Akash Patel, Ti Hoang and Raul Magadia

Article Type: Research Article | First Published: October 29, 2020

This study was conducted at the Regional Medical Center, a community hospital in Anniston, AL. We examined the outcomes of healthcare workers that were in contact with two patients that were asymptomatic during their stay, but were subsequently found to be positive upon discharge. The results of this study provide a better understanding of the risks of SARS-CoV-2 spread in asymptomatic patients with a focus on transmission to healthcare workers. The RMC Human Resources Department released a list...

 Open Access DOI:10.23937/2378-3656/1410324

Congenital Methemoglobinemia with Multiple Limb Anomalies in an 11-Year-Old Boy

Sheetal Agarwal, MD, Dhirendra Singh, MD, Ankur Agarwal, MS, Ridhima Sharma, MD and Savitri Singh, MD

Article Type: Case Report | First Published: October 21, 2020

An adolescent male presenting with multiple congenital limb defects planned for corrective surgery was incidentally detected to have low oxygen saturation on room air at rest. The child was not on any medication. After a pediatric cardiologist opinion a 2D Echocardiography and ECG were done which turned out to be normal. Proper history, detailed examination and simple bedside test carried out by the pediatricians proposed the possibility of methemoglobinemia. Since the child was not on any medic...

 Open Access DOI:10.23937/2378-3656/1410323

Knowing When Not to Operate: Extravasation-Induced Necrosis in the Neonate

Maxim Geeroms, MD, Fabrice Rogge, MD, Rani Kronenberger, Bob De Frene, MD, Daan De Cock, MD, Luc Cornette, MD and Bob Casaer, MD

Article Type: Case Report | First Published: October 09, 2020

Extravasation of infusion fluids is a frequent complication in the neonatal patient population. The authors report the case of a newborn infant who had a necrotic soft tissue lesion due to extravasation in the lower arm, and discuss the therapeutic options from a surgical point of view. Extravasation is the accidental leakage of infusion fluids in the subcutaneous tissues. Intravenous therapy can be required for a long period of time in premature infants and the intravenous access is hard to ach...

 Open Access DOI:10.23937/2378-3656/1410322

Mesothelial Cells in Lymph Nodes Associated with Massive Pericardial and Bilateral Pleural Effusion, a Diagnostic Dilemma: Report of a Case

Mohammadali Boroumand, MD, Mina Ghorbanpour Landy, MD and Narges Shahbazi, MD

Article Type: Case Report | First Published: October 07, 2020

Malignant pleural mesothelioma is a rare neoplasm that mostly occurs in elderly men. Recurrent unilateral pleural effusion is the most typical presentation and it is very rare to find extra-thoracic lymphadenopathy before the primary tumor, even in advanced cases. Herein, we report a challenging case of a young man presenting with unresolved fever, sore throat, and dysphagia associated with massive pleural effusion, cardiac tamponade, and multiple cervical lymphadenopathy with mesothelial cells ...

 Open Access DOI:10.23937/2378-3656/1410321

Unilateral Blindness: Exceptional Complication of Anti-Vitamin K about a Case

Salmi A

Article Type: Original Article | First Published: September 30, 2020

We report the case of a patient hospitalized for management of orbital hematoma on overdose with oral anticoagulants. With the increase of the hematoma and protrusion of the eyeball, the patient came to ICU, including CT scan of the eye had objectified hemorrhagic infiltration of the orbit, head of exophthalmos. Laboratory tests, found a INR greater than 9. The treatment consisted of a vitamin K antagonist by the associated PFC in default of prothrombin complex concentrate. Ophthalmological, evo...

 Open Access DOI:10.23937/2378-3656/1410320

A Case Arthrogryposis Multiplex Congenita with Renal Affection at Older Age

Abeer Awad Abdellatif, Mervat Essam Behiry and Asmaa Ezzat

Article Type: Case Report | First Published: September 30, 2020

Report on a known case of female patient, 58-years-old, deaf since birth with skeletal deformity presenting with acute kidney injury. These features are consistent with diagnosis of arthrogryposis multiplex congenita. A congenital disease presenting with multiple joint contractures and deformity with deafness and may be renal affection. The second point is that, up to our knowledge, we are the first authors to take into consideration that the arthrogryposis multiplex congenital may be presented ...

 Open Access DOI:10.23937/2378-3656/1410319

Sigmoid Volvulus in Second Trimester is Challenge to Obstetric and Surgical Departments at St. Francis Referal Hospital, Kilombero, Tanzania

Theresia A. Karuhanga MD, MMED and Joseph M. Lulengo, MD, MMED

Article Type: Case Report | First Published: September 19, 2020

A 25 years Gravida 4, para 3, with 2 living at gestation age of 20 weeks who presented at St Francis Hospital with three days of colicky abdominal pain, associated with abdominal distension and constipation. Abdominal X-ray revealed a dilated large bowel and coffee bean sign while abdominal ultrasound showed a single living intrauterine fetus. Emergency laparotomy was done in which the findings revealed a gangrenous and twisted sigmoid at its mesenteric axis by 360 degrees. End to end anastomosi...

 Open Access DOI:10.23937/2378-3656/1410318

Duodenal Malt Lymphoma Developed in 1 Year

Ferdane Sapmaz, MD, Evrim Kahramanoğlu Aksoy, MD, Muhammed Yener Akpınar, MD, Ayşegül Erdem Metin Uzman, MD, and Yusuf Sedar Sakin

Article Type: Case Report | First Published: September 19, 2020

Intestinal MALT lymphoma is a very rare neoplasm and there is limited data about clinical and pathological characteristics. They can become visible in a very short time. A 47-year-old woman was referred to our department because of epigastric pain. Gastroduodenoscopy revealed an irregular mucosal nodular lesion with ulceration extending from the bulb to the second portion of the duodenum. Endoscopic findings were normal about one year ago. The pathology spesiemens show that; duodenal biopsy reve...

 Open Access DOI:10.23937/2378-3656/1410317

Acute Upper Limb Ischemia in a Patient with COVID-19 Pneumonia

Roaa Alosaimi, MD, Ahood A Albajri, MD and Roaa M Albalwi, MD

Article Type: Case Report | First Published: August 31, 2020

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is an enveloped RNA beta coronavirus. It is a novel coronavirus responsible for the current global pandemic and poses a critical threat to global health worldwide. While SARS-CoV-2 is known to cause significant pulmonary disease, including pneumonia and acute respiratory distress syndrome (ARDS), clinicians have observed many extrapulmonary manifestations of COVID-19 particularly thrombosis...

 Open Access DOI:10.23937/2378-3656/1410316

Bruxism Management: A Comprehensive Review

Luis Gabriel Ladino, Melissa Vargas, Johana Rodriguez and Efrain López

Article Type: Review Article | First Published: August 31, 2020

The physiological predisposing factors of bruxism cannot be individualized, since this is the result of a combination of causes which produce a pathogenic, repetitive, and often unconscious action. Whenever bruxism is discussed in adults or children, the presence of dental contacts should be verified and established. Additionally, establishing a specific etiology for bruxism is impossible, since there are causes and factors associated with its presence, which may or may not be...

 Open Access DOI:10.23937/2378-3656/1410315

Pregnancy with Preexisting Total Uterine Prolapse

Adeviye Elçi Atılgan and Şükriye Leyla Altuntaş

Article Type: Case Report | First Published: July 31, 2020

Management of pregnancy with uterine prolapse is challenging. Physician may encounter scenario which endanger both mother and baby during pregnancy, at labor and also after birth. Here, we present conservative management of a pregnancy with preexisting total uterine prolapse up to term. We performed cesarean section due to previous delivery by cesarean section. Interestingly, prolapse did not recur after delivery at two years follow up period. Further reports are needed to conclude as pre-existe...

 Open Access DOI:10.23937/2378-3656/1410314

Immune-Mediated Necrotizing Myopathy with Anti-SRP Autoantibodies and Typical Clinical Presentation

Desislava Kalinova, Alexander Kopchev, Zlatimir Kolarov and Rasho Rashkov

Article Type: Case Report | First Published: July 27, 2020

Immune-mediated necrotizing myopathy (IMNM) is a relatively new disease, described for the first time in 2004. IMNM is a form of myositis since it is an inflammatory myopathy with strict involvement of the skeletal muscles albeit lymphocytic infiltration is sparse or absent. The clinical picture, pathological features and autoantibodies (Abs) of IMNM differ markedly from those of antisynthetase syndrome and non-specific myositis. Anti-HMGCR and anti-SRP Abs are strongly specific for IMNM, but th...

 Open Access DOI:10.23937/2378-3656/1410313

Multiple Cerebral and Cerebellar Infarctions following Russell’s Viper (Daboia Russelii) Envenomation - A Case Report

UDN Prasad, JMRP Bandara and HMS Senanayake

Article Type: Case Report | First Published: June 13, 2020

Ischemic stroke is a rare neurological complication following SriLankan Russell’s viper envenomation. We report a case of a 44-year-old person, who developed multiple cerebral and cerebellar infarctions following SriLankan Russell’s viper envenomation. The patient developed both local and systemic envenomation and was treated with Snake Venom Anti-Serum I.P. (VinsBioproducts Ltd). On day six, this patient developed left-sided hemiparesis. CT scan of the brain showed bilateral cerebellar, bil...

 Open Access DOI:10.23937/2378-3656/1410312

Case Series of Tetanus Diagnosis and Management in Hargeisa City

Hassan Abdi, Ibrahim Caqli, MD, Mustafe Mumin, MD, Jama Osman, MD, Gregory Fricchione, MD, MPH and Zeina Chemali, MD, MPH

Article Type: Case Series | First Published: June 10, 2020

Tetanus is a global infectious disease caused by tetanospasmin toxin produced by the anaerobic clostridium tetani. It affects the brain stem and spinal cord and leads to high morbidity and mortality if untreated. East Africa reports the highest number of cases and the highest fatalities. The objective of this study is to report on five inpatient clinical cases at Hargeisa Group Hospital in Hargeisa City with lessons learned for our team, a way to educate others and advocate for a new governmenta...

 Open Access DOI:10.23937/2378-3656/1410311

Bosma Arhinia Microphthalmia and Cardiac Abnormalities: A Case Report

Aakash Trivedi, OMS-III, Tyler Bean, OMS-III, Kayla Brown, M.S., OMS-III and Carolyn Cain, M.D

Article Type: Case Report | First Published: May 25, 2020

Bosma arhinia microphthalmia (BAM) syndrome is a rare condition with less than 100 patients reported. The suggested criteria for BAM syndrome diagnosis include congenital arhinia, hypoplastic maxilla, hypogonadotropic hypogonadism, and normal cognition in males. Our patient presented with unique symptomatology of cardiac abnormalities not otherwise described in literature relating to BAM syndrome. Anatomically, our patient had a patent ductus arteriosus and questionable aortic coarctation, a pat...

 Open Access DOI:10.23937/2378-3656/1410310

Pulmonary Embolism Mimicking Pneumonia, Acute Heart Failure and Myocardial Infarction: A Case Report

Hayatu Umar, Augie Ibrahim, Akintomide F. Akindotun, Muhammed E. Hadiza, Aminu M. Sakajiki, Maiyaki S. Abubakar, Balarabe A. Salisu, Mehmet S. Ulgen, Enver Erbilen, Mustafa Kirman

Article Type: Case Report | First Published: May 23, 2020

Venous thromboembolism (VTE) is a common medical condition encountered in emergency departments and is a major contributor to global disease burden. It’s often misdiagnosed in critically ill patients despite being common and diagnosis a times is at autopsy. This disease spectrum may present either as asymptomatic deep venous thrombosis (DVT) or acute pulmonary embolism (PE) leading to death. When established PE occurs without any evidence of DVT, this is known as de-novo pulmonary embolism...

 Open Access DOI:10.23937/2378-3656/1410309

Outcomes of Cardiopulmonary Resuscitation and its Predictors in Hospitalized Patients

Meisam Moezzi, Golshan Afshari, Fakher Rahim, Meysam Alavian, Maryam Banitorfi, Saeed Hesam and Nasrin Fatemi

Article Type: Research Article | First Published: May 13, 2020

Cardiopulmonary resuscitation (CPR) has been a frequently performed medical intervention that increases the chance of survival of a person strickenby cardiac arrest, and there is a great value of diversity in the rate of successful rehabilitation in societies. There was no significant difference in the success rate of CPR between men and women. The comparison of age groups revealed a significant difference between the success rates of CPR in the age of 14-64 with the group above 64. The analysis...

 Open Access DOI:10.23937/2378-3656/1410308

Septic Shock from Pyelonephritis in Pregnancy

Adam Rindfleisch, MD, Hannah Do, MD, Tove M Goldson, MD, PhD and Samuel N Forjuoh, MD, MPH, DrPH

Article Type: Case Report | First Published: May 06, 2020

Pyelonephritis is a relatively common infection in pregnancy. We report a case of a 20-year-old pregnant woman with limited prenatal care and history of untreated asymptomatic bacteriuria who presented to labor and delivery triage with signs and symptoms suggestive of sepsis. The initial management, although primarily driven by the patient’s chief complaints, history, and vital signs, was confounded by a relatively unremarkable urinalysis and physical exam. The patient subsequently developed s...

 Open Access DOI:10.23937/2378-3656/1410307

Descriptive Evaluation of National and International Hypertension Treatment Guidelines: The Guideline Quality and Comprehensiveness to provide Care to Adult with Hypertension

Mende Mensa Sorato, Majid Davari and Akbar AbdollahiAsl

Article Type: Review Article | First Published: May 04, 2020

We selected national guidelines of five countries (USA of America, Canada, Europe, Australia and Ethiopia) and one international guideline.We used clinical guideline appraisal tool to evaluate the quality of guidelines, and comprehensiveness of the guidelines was evaluated by using a tool developed reach team. National adult hypertension treatment guideline of Ethiopia addressed only 22 (64.7%) of quality appraisal tool components. The guideline is least comprehensive 15 (51.7%). Major problems ...

 Open Access DOI:10.23937/2378-3656/1410306

The Management of an Early COVID-19 Case with Severe Acute Respiratory Distress Syndrome in a Community Hospital in Ontario, Canada

Maham Khalid, BMSc, Han-Oh Chung, MD, MSc HS Ed, Dimitra Fleming, BSc Phm, George Farjou, MD and Jennifer LY Tsang, MD, PhD

Article Type: Case Report | First Published: April 23, 2020

We reported an early COVID-19 case in a young patient in a Canadian community intensive care unit (ICU) with severe acute respiratory syndrome (ARDS). We discussed the management according to the recently published Surviving Sepsis Guidelines on COVID-19. This will provide critical care physicians important and timely information on the management of severe COVID-19 using a real case when critical care physicians are facing a surge in COVID-19 cases. Many of the recommendations regarding ARDS ar...

 Open Access DOI:10.23937/2378-3656/1410305

Thoracopagus Conjoined Twins: Early Diagnosis by Ultrasound, A Case Report

Giovanna Rosica, Daniela Bucari, Giovanni Pastore and Angela Musella

Article Type: Case Report | First Published: April 23, 2020

A tempestive diagnosis of conjoined twins pregnancy is highly important to lead to the best the rapeutic option. Thoracopagus conjoined twins account for more than 40% of conjoined twins pregnancies, and the prognosis is very poor because in most of cases a single heart and/ or liver is present. In our case, the premature diagnosis has given the family a chance to choose for pregnancy termination reducing as far as possible the already heavy emotional impact of that condition....

 Open Access DOI:10.23937/2378-3656/1410304

Remifentanil: Pharmacokinetics, Pharmacodynamics, and Current Clinical Applications

Marco A Maurtua, MD, Amanda Pursell, MD, Kyle Damron, MD and Patel Sonal, MD

Article Type: Review Article | First Published: April 15, 2020

Remifentanil is a mu-receptor agonist chemically related to fentanyl, alfentanil, and sufentanil that was approved for use in general anesthesia in 1996 by the US Food and Drug Administration. It is a piperidine derivative, a 3-(4-methoxycarbonyl-4-[(L-oxopropyl)- phenylamino]-L-piperidine) propanoic acid, methyl ester. The introduction of the methyl ester group onto the N-acyl side chain of the piperidine ring is what makes remifentanil structurally unique among the currently available opioids....

 Open Access DOI:10.23937/2378-3656/1410303

Subnormal Thyroid Makes the Heart Skip a Beat

Supraja Thunuguntla, MD, Rizwan Mohammed, MBBS, Lauren Muenchow, MS and Jose Campo Maldonado, MD, FACP

Article Type: Case Report | First Published: April 11, 2020

A 72-year-old Hispanic male with an unconfirmed history of alcohol-related cirrhosis presented to the hospital for rectal bleeding and dark stool for two days. Vitals included a heart rate of 90-120 bpm, blood pressure 90-140 over 50-60 mmHg. A left thyroid nodule was appreciated on physical exam. His pertinent labs included TSH, free T3 and T4 levels that were 0.033 mU/L (low), 3.33 mU/L and 1.33 mU/L (both within normal limits) respectively. A TSH done 3 days later was low (0.024). Thyroid per...

 Open Access DOI:10.23937/2378-3656/1410302

Trench Fever in Texas

E Jane Gibson, MD, Tuyet T Pham, MD, Tove M Goldson, MD, PhD and Samuel N Forjuoh, MD, MPH, DrPH

Article Type: Case Report | First Published: March 30, 2020

Trench Fever is caused by Bartonella quintana, a small fastidious gram-negative rod organism carried by the body louse. We report a case of a 62-year-old woman who was admitted to a hospital in central Texas for a two-week history of fever and malaise. She was initially treated for Q fever which is usually caused by inhaling dust particles contaminated by infected animals, given that she was regularly around farm animals, but when her extensive infectious disease panel came back negative, the se...

 Open Access DOI:10.23937/2378-3656/1410301

Explantation of Silicone Breast Implants Ameliorates Gel Bleed Related Health Complaints in Women with Breast Implant Illness

Rita M Kappel, MD, PhD and Ger JM Pruijn, PhD

Article Type: Original Article | First Published: March 24, 2020

During the last decade the international debate on adverse health effects of silicone breast implants has intensified and recently the related disorder has been termed Breast Implant Illness (BII). This study aimed to explore the effects of explantation of silicone implants. In a retrospective study, women with silicone breast implants, who consulted plastic surgeons for a variety of reasons, were requested to fill out a questionnaire, which was aimed at an evaluation of health complaints. In to...

 Open Access DOI:10.23937/2378-3656/1410300

The Infectious Headache- A Case of Neurocysticercosis

Supraja Thunuguntla, MD, Obinna Echeruo, MD and Jose Campo Maldonado, MD

Article Type: Case Report | First Published: March 05, 2020

A 50-year-old Hispanic female presented to her primary care physician with a progressively worsening headache over a week, associated with visual disturbances, prosopagnosia and episodes of disorientation. Outpatient workup with head CT showed abnormality in the ventral aspect of the left thalamus showing 1.2 × 1 cm low density cyst with approximately 2-3 mm right-left midline shift locally. Left basal ganglia showed multiple well-defined foci of low density measuring up to 3 mm reflecting edem...

 Open Access DOI:10.23937/2378-3656/1410299

Successful Management of Hyperosmolar Hyperglycaemic State with Oral Hypoglycaemics in a Rural Setting - A Case Report

Jeremy Kay Hock Lee, Aaron Kwun Hang Ho and Lin Ho Wong

Article Type: Case Report | First Published: February 29, 2020

Hyperosmolar Hyperglycaemic State (HHS) is a diabetic emergency which requires prompt restoration of haemodynamic stability due to high early mortality. There is currently no study which recommends the use of oral hypoglycaemics to lower blood glucose levels, due to the high efficacy of parenteral Insulin. We report a case of our management of HHS using oral hypoglycaemics (Metformin and Gliclazide) due to the absence of parenteral Insulin in a rural setting, with remission of symptoms, stabiliz...

 Open Access DOI:10.23937/2378-3656/1410298

Cannabinoid Use and Depression: Comparison of Natural and Synthetic Cannabinoids

Serap Akdeniz Gorgulu, MD and Can Sait Sevindik, MD

Article Type: Original Article | First Published: February 29, 2020

Patients who predominantly used marijuana (natural cannabis) and patients who predominantly used synthetic cannabinoids in their history were evaluated as two separate groups in our study which aimed to compare the sociodemographic characteristics and depressive symptoms of these two groups. The sample of our study consisted of those patients who referred to the Polyclinic of Psychiatry at Ardahan State Hospital and were diagnosed with substance addiction. 30 polyclinic patients who defined pred...

 Open Access DOI:10.23937/2378-3656/1410297

Acute Simultaneous Renal and Ovarian Vein Thrombosis Mimicking Renal Colic and Associated with Factor V Leiden: Case Report and Review of Literature

Chahid Farah, Sabine Imad, Rachelle Abboud, Fady Nader, Rahil Zeaiter, Boutros Youssef, Karen Nicolas, Mireille Rizkallah, Alain Khalaf and Tony El Murr

Article Type: Case Report | First Published: February 14, 2020

Severe flank pain is a frequent complaint at the emergency department (ED). It is usually associated to other clinical symptoms like fever, dysuria, vomiting, diarrhea or radiation to the groin. Hereby, it may raise a lot of probable differential diagnosis that should be ruled out first depending on laboratory tests and imaging results. However, when flank pain is isolated and radiating to the groin without evidence of urolithiasis on abdominal CT scan, more rare diagnosis should be suggested su...

 Open Access DOI:10.23937/2378-3656/1410296

Mixed Zone between Drug-Induced Hyperpigmentation and Generalized Fixed Pigmented Erythema

Tarik Hanafi, Amine Essaoudi, Hicham Titou, Hasna Kerrouch, Rachid Frikh, Naoufal Hjira and Mohammed Boui

Article Type: Case Report | First Published: January 31, 2020

We report a particular case of fixed drug eruption (FDE), in its erythematous and pigmented form, as a fixed pigmented erythema (FPE), which manifests in a generalized form, evolving for three years, and discuss the imputability to piroxicam and the Ramipril/Hydrochlorothiazide combination. Indeed, chronological, semiological, bibliographic criteria, were imprecise and non-discriminatory. We ended up retaining the diagnosis of fixed pigmented erythema (FPE) of particular diffuse presentation ind...

 Open Access DOI:10.23937/2378-3656/1410295

Squamous Cell Carcinoma Complicating Hidradenitis Suppurativa in an HIV-Positive Patient

Tarik Hanafi, Hicham Titou, Hasna Kerrouch, Rachid Frikh, Naoufal Hjira and Mohammed Boui

Article Type: Case Report | First Published: January 27, 2020

Hidradenitis Suppurativa (HS), also called Acne inversa, is a Chronic inflammatory, suppurative, fistulizing disease, with a risk of malignant degeneration to squamous cell carcinoma (SCC). We report an intriguing case of a patient who developed an aggressive form of HS within a very short time of nine years, indeed, the patient was infected with the human immunodeficiency virus (HIV) and human papilloma virus (HPV). We believe that the oncogenic role of HPV was increased, given the very fast de...

 Open Access DOI:10.23937/2378-3656/1410294

Non-Typhoidal Salmonella Meningitis in an Adult Patient with HIV Infection: The Hostage-Taking Situation. Is There Any Solution?

Tarik Hanafi, Hicham Titou, Hasna Kerrouch, Rachid Frikh, Naoufal Hjira and Mohammed Boui

Article Type: Case Report | First Published: January 25, 2020

We report a case of Non-Typhoidal Salmonella meningitis (NTS) in adult HIV patient with many relapses despite well-conducted treatment, we compare this situation to a hostage-taking situation, perpetrated by NTS, taking the body of HIV patient as a hostage who cannot get rid of this germ. This is a clinical alert to discuss the efficiency of prolonged oral administration of Trimethoprim/Sulfamethoxazole in preventing relapse and a whistleblower for the urgency of developing a vaccine....

 Open Access DOI:10.23937/2378-3656/1410293

A Rare Case Report: Pancreatic IPMN and Lung Adenocarcinoma with Elevation of CA 19-9 in an Asymptomatic Individual

Dorovinis P, Roumpou A and Dimitroulis D

Article Type: Case Report | First Published: December 30, 2019

An 85-year-old man presented to our hospital because of an elevated value of CA 19-9 of 2000 U/ml, free of any symptoms. CT scan of the thorax and abdomen revealed a lesion in the upper lobe of the right lung and a cystic lesion located in the tail of the pancreas, comprised with dilation of the pancreatic duct, being indicative of peripheral pancreatic Intraductal Papillary Mucinous Neoplasm (IPMN). The pulmonary lesion was examined histologically through EBUS and had no specific signs of atypi...

 Open Access DOI:10.23937/2378-3656/1410291

Phase Change Biological Switch: A New Hypothesis on the Mechanism of Cancer Formation

G Di Donna, MD, PhD and R. Di Muro, MD

Article Type: Research Article | First Published: November 25, 2019

The Authors hypothesize that, when in the presence of a chronic inflammatory process, the organism, while attempting to solve it, goes through a mechanism that the Authors define as Phase Change Biological Switch: the cell line regression, which differentiated in that organ with the purpose of reprogramming to overcome the chronic inflammatory process, but regression involves loss of connections with the surrounding tissues and provokes the cancerous degeneration....

 Open Access DOI:10.23937/2378-3656/1410290

Percutaneous Coronary Intervention in a Cancer Patient with Dextrocardia and Situs Inversus

Patrick Lahoud

Article Type: Case Report | First Published: October 25, 2019

Although dextrocardia occurs rarely, the incidence of coronary artery disease is similar to the general population. Few cases of coronary angiography and percutaneous coronary intervention (PCI) in patients with dextrocardia have been reported. Because of unfamiliarity with performing catheterization, transradial coronary angiography has seldom been performed in a patient with dextrocardia. To the best of our knowledge, this is the first report of successful coronary angiography and ad hoc coron...

 Open Access DOI:10.23937/2378-3656/1410289

Disseminated Nocardiosis in an Immunosuppressed Patient with Sarcoidosis

Zachary Koehler, OMS IV, MPH, Jun Park, MD and Nicholas Jenkins, MD

Article Type: Case Report | First Published: October 07, 2019

Nocardiosis is a relatively rare disease with an incidence of 3 cases per 1,000,000 each year in the United States. The infection is caused by the Nocardia spp., which are aerobic, gram-positive, branching, weakly acid-fast bacilli found primarily in soil, water and decaying vegetation. Nocardiosis can be localized to a single organ, such as the skin or lung, or disseminated. Immunocompetent patients who are affected typically experience a chronic course involving one organ, most commonly the lu...

 Open Access DOI:10.23937/2378-3656/1410288

An Unusual Case of Palpitations: Pectus Excavatum

Zulfiqar Ali Sandhu, Sharjeel Shaikh and Aidan Buckley

Article Type: Case Report | First Published: October 04, 2019

Pectus excavatum is a congenital deformation of the chest, presenting as a funnel-shaped impression in the median frontal chest between the fourth and the seventh rib. Asymmetric presentation occurs, and the extent of deformation may vary from slight to serious. Exact numbers about prevalence are difficult to obtain, as the deformation is often not noted or-when noted-is not mentioned in the medical reports. Pectus excavatum is found in Europe in at least one in every 1000 births, mainly in men ...

 Open Access DOI:10.23937/2378-3656/1410287

No doubts left in Gastric Tumors. Gastric Adenomyoma Detected by EUS

Ulises Leal Quiroga, Erik Antonio Mier Escurra and Eduardo Mendoza Fuerte

Article Type: Case Report | First Published: October 03, 2019

Endoscopic ultrasound is important to assess gastric tumors in pediatric age. However, at present there is little information about its indications, applications and risks, as well as difficulty in obtaining adequate training. A 5-year-old male patient with a gastric tumor under study, in the endoscopy, an umbilicated tumor suggestive of ectopic pancreas is observed, the endoscopic ultrasound reveals that it is dependent on the muscular layer, pathology diagnosed Gastric adenomyoma....

 Open Access DOI:10.23937/2378-3656/1410286

What are the Factors and the Method Used for the Formation of Nasal Septal Perforations due to Septoplasty?


Article Type: Original Article | First Published: September 14, 2019

There were 280 male and 120 female patients. 378 patients had no postoperative septal perforation. 22 had perforation after surgery. Of the patients in the perforated group, 19 male and 3 female were female. 21 of these patients smoked, 1 patient did not drink. 11 of these patients were drinking alcohol and 10 of them did not drink alcohol. Transseptal suturation + nasal saturation splint was used in 14 patients to stabilize the septum while perforation rate was 22/400 (1.3%). Male sex ratio was...

 Open Access DOI:10.23937/2378-3656/1410285

Effect of Chemical Irrigants on the Bond Strength of a Universal Adhesive System to Dentin-Enamel Junction and Different Dentin Regions

Alper KAPTAN, DDS, PhD., Vahti Kilic, DDS, PhD., Feridun HURMUZLU, DDS, PhD., Ahmet Serper, DDS, PhD. and Arife KAPTAN, DDS, PhD.

Article Type: Research Article | First Published: September 11, 2019

The purpose of this in vitro study was to evaluate the influence of different irrigation solutions on the microshear bond strength of a universal adhesive system applied in etch & rinse mode and self-etch mode to dentin- enamel junction (DEJ), coronal dentin, pulp chamber dentin, and floor of the pulp. As well as a highly adequate apical seal, an effective coronal seal, is one of the primary goals of a successful endodontic dental treatment. Recently, a large number of adhesive systems have been...

 Open Access DOI:10.23937/2378-3656/1410284

Atypical Presentation of Viral Myocarditis in a Young Adult

Mandeep Kaur, Prema Bezwada and Ayala Rodriguez Cesar

Article Type: Case Report | First Published: September 09, 2019

Convulsive Syncope can be difficult to distinguish from seizures at times. We present a young adult with cardiogenic convulsive syncope that mimic seizures. Continuous cardiac monitoring revealed various arrythmias during seizure like activity. She had a viral prodrome. Cardiac MRI was diagnostic for myocarditis. More detailed studies for the role of a noninvasive cardiac testing such as Cardiac MRI (CMR) and newer treatment modalities such as anti-thymocyte immunoglobulin are required for the m...

 Open Access DOI:10.23937/2378-3656/1410283

Facial Nerve Palsy, When Should We be Alarmed: A Case Report of Facial Nerve Paralysis Caused by Occult Malignancy and Review of the Literature

Mohammed Alghamdi, Tobias Strenger, Ruben Thoelken, Tina Schaller and Johannes Zenk

Article Type: Case Report | First Published: September 06, 2019

Facial Nerve Palsy is mostly idiopathic in nature. Every patient with a facial nerve Paralysis needs to go under through investigation, most importantly imaging to exclude other causes such as neoplasms. In very rare cases, the normal imaging results may be misleading and occult tumor or perineural spread along the nerve may not be detectable. Luckily these cases may present with alarming signs such as progressiveness nature associated with pain, complete Paralysis with no recovery and most impo...

 Open Access DOI:10.23937/2378-3656/1410282

Chronic Wound Formation on an Old Burn Scar after Surgical Incision and Hyperbaric Oxygen Therapy: Case Report

Kubra Ozgok-Kangal, Iclal Karatop-Cesur, Cesur Ustunel and Kemal Simsek

Article Type: Case Report | First Published: September 04, 2019

Chronic wounds fail to progress through the phases of wound healing; inflammation-proliferation-remodelling which are usually the result of persistent infection, malperfusion due to periwound hypoxia, cellular failure, and unrelieved pressure or repetitive trauma. In this report, we present a different rare cause of a chronic wound; a surgical incision on a post-burn scar during the surgery of transurethral resection of the prostate (TUR-P) because of urethral stricture. After six weeks, the sur...

 Open Access DOI:10.23937/2378-3656/1410281

A Novel Use of Liraglutide: Induction of Partial Remission in Ulcerative Colitis and Ankylosing Spondylitis

Jeffrey Lourie

Article Type: Case Report | First Published: August 29, 2019

Ulcerative colitis and ankylosing spondylitis treatment options are limited to a few classes of medications at this time. Those options provide improvement for some patients, but leaves many with ongoing, unremitting symptoms. We report a case of ulcerative colitis (UC) with comorbid ankylosing spondylitis (AS), in which administration of a daily subcutaneous liraglutide, an exogenous Glucagon-like Peptide-1 receptor agonist (GLP-1RA), led to symptomatic remission of UC and significant improveme...

 Open Access DOI:10.23937/2378-3656/1410279

The Impulsivity of the Elderly - Genital Self-mutilation Case Caused from an Argument with his Wife

Michiho Sodenaga, M.D., Ph.D., Koji Hori, M.D., Ph.D., Chiaki Hashimoto, M.D., Kyoko Katsumura, M.D., Ikuko Katsumura, M.D., Masananori Tadokoro, Ph.D. and Sachiko Tsukahara, PhD

Article Type: Case Report | First Published: August 26, 2019

Suicide rate in Japan is also high. The suicide cases were above 30,000 in 1998, which increased to 34,427 in 2003. Then it gradually decreased to 21,897 in 2016 but the suicide rate at the age of more than 60 years is the highest, accounting for about 40%. Morbidity of depression is said as a risk factor of suicide by elderly people. In this case, we have discussed about a 77 year old man, who was in depressed mood. His wife was also unaware with his depression; he often had quarrels and at las...

 Open Access DOI:10.23937/2378-3656/1410278

Surviving a Single Ventricle and a Single Atrium with a Situs Inversus Viscerum

Randa Tabbah, MD, Rachoin Rachoin, MD, Bassam Harb, MD and Kabalan Saroufim, MD

Article Type: Case Report | First Published: August 24, 2019

We report a rare case of an 18-years-old female surviving a single ventricle malformation associated with a single atrium and a situs inversus viscerum. She was misdiagnosed in utero and at birth and lost to follow up since her early age when diagnosed at 4-years-old and didn't undergo any palliative surgeries after then due to financial issues. Patient was admitted for heart failure decompensation with hepatic congestion, supraventricular arrhythmias and bilateral pleural effusion and was treat...

 Open Access DOI:10.23937/2378-3656/1410277

Tracheal Bronchus: Rare Cause of Recurrent Pneumonia and Worsening Bronchiectasis in Adults

Asma Jamil MD, Ayesha Jamil MD, Rajesh Gulati MD, Alina Popa MD and Hiba Ismail

Article Type: Case Report | First Published: August 14, 2019

True tracheal bronchus is an aberrant bronchus arising above 2-6 cm from carina, from the lateral wall of trachea and directed towards the upper lung lobe. Frequently located on the right side, it can be further described as supernumerary if there is an anatomic right bronchus with normal segmental apical, anterior and posterior bronchi. It is considered displaced if it's accompanied by an absence of anatomic segmental bronchi. Tracheal bronchus can supply the entirety or part of the upper lung ...

 Open Access DOI:10.23937/2378-3656/1410276

Assessment of Knowledge, Attitude and Practice (KAP) on Prevention of Malaria at Gode Lalo Kebele (010), Anchar Woreda, West Haraarge Zone, Oromia, Ethiopia: A Community Based Descriptive Cross-Sectional Study Methods

Rahel Miliyon Mokonen, BSc, Maleda Tefera Iffa, BSc, MSc and Masresha Leta Serbesa, BSc, MSc

Article Type: Case Report | First Published: July 31, 2019

Malaria is a major public health problem in worldwide and causes high morbidity and mortality, despite global efforts to eradicate the disease. While the disease is easily preventable, curable and treatable, it remains a big health threat to many communities all over the world; most especially in Sub-Saharan Africa. Malaria affects about 5% the world’s population. It is the leading cause of death in children under 5 years in sub Saharan Africa still among the ten top leading causes of morbidit...

 Open Access DOI:10.23937/2378-3656/1410275

Progressive Medullary Congestion Resulting in Life-Threatening Condition Caused by Lower Cervical Dural Arteriovenous Fistula Successfully Treated with Endovascular Treatment: A Case Report and Literature Review

Prasert Iampreechakul, Punjama Lertbutsayanukul, Yodkhwan Wattanasen and Somkiet Siriwimonmas

Article Type: Case Report | First Published: July 25, 2019

The authors describe a patient with lower cervical dural arteriovenous fistula (DAVF), subsequently developing brainstem dysfunction following progressive myelopathy caused by extension of venous congestion from the cervicothoracic cord to the medulla oblongata. A 34-year-old woman suffered from progressive paraparesis with bowel/bladder dysfunction for 2 months. Before transferring to our institute, she obtained magnetic resonance imaging (MRI) of the neck, showing abnormal hyperintensity on T2...

 Open Access DOI:10.23937/2378-3656/1410274

The Performance of Novel Wavelet for Lung Image Analysis

Donia Ben Hassen and Sihem Ben Zakour

Article Type: Research Article | First Published: July 03, 2019

Even the advancement in the medical image, chest radiography still the most common used and cheapest method in detecting lung diseases. The generated image allows physicians to screen the normal, benign and malignant tissues in the lung. In order to better classify and reduce noise in the image's information, the employ of preprocessing methods is unavoidable. A novel scheme for lesions classification in chest radiographs is presented in this paper by combining discrete wavelet analysis (WA), FC...

 Open Access DOI:10.23937/2378-3656/1410273

Preterm Vaginal Delivery of Breech Presentation

Hanne Christensen

Article Type: Short Note | First Published: June 22, 2019

Very early preterm delivery is defined as delivery in week 23-28 GA. The incidence of preterm delivery in Denmark is about 5.6%. The incidence of breech presentation at date of delivery is 3-4% and there is an increase of breech presentation in lower gestational age. The few cases of extreme premature delivery have not been subjects to randomized controlled studies. In recent years retrospective multicentre studies comparing vaginal delivery versus cesarean section in breech presentation have no...

 Open Access DOI:10.23937/2378-3656/1410272

Basal-Like Breast Cancer: Main Features of a Very Particular Entity of Breast Cancer

Haddad S, Zemni I, Bettaieb I, Adouni O, Saadallah F, Slimane M, Chargui R and Rahal K

Article Type: Case Series | First Published: June 14, 2019

Molecular classification of breast cancer identified the basal like subtype, characterized by high heterogeneity and a very poor prognosis. These tumors are mainly triple negative, characterized by the expression of basal markers: CK5/6 and EGFR. In this study, we sought to investigate the features, outcome and therapeutic modalities of basal-like breast cancers (BLBC)....

 Open Access DOI:10.23937/2378-3656/1410271

Case Report: Necrotizing Fasciitis due to Cryptococcus Infection in Non-HIV Non-Organ Transplant

Rbab Taha, Mohamed Alama, Hessa Aljhdali, Ayaz khan and Reham Kaki

Article Type: Case Report | First Published: June 12, 2019

We are presenting 67-year-old female, known to have diabetes for 10 years, not compliance to medication. Presented with 3 weeks history of isolated right lower limb and left thigh pain. Then she started to develop redness and swelling in same areas. She had also History of dry cough for one week. Admitted as a case of necrotizing fasciitis based on clinical laboratory and radiological features. She was treated empirically with vancomycin and meropenem and went for debridement twice. Histopatholo...

 Open Access DOI:10.23937/2378-3656/1410270

Of Philosophy, Ethics and Moral about Euthanasia: The Discomfort between Modernity and Postmodernity

Euler Renato Westphal, Woryk Schoeder Nowak and Caciano Vinicius Krenchinski

Article Type: Research Article | First Published: June 10, 2019

To define euthanasia, as well as orthanasia, misthanasia and dysthanasia, to start from this, to discuss the different philosophical, ethical and moral visions that surround the subject. Exploratory qualitative study which defined from the existing literature the pertinent concepts and from them brought discussions about euthanasia....

 Open Access DOI:10.23937/2378-3656/1410269

General Surgery Approach to Neurofibromatosis Cases

Ethem Bilgic and Eyup Murat Yilmaz

Article Type: Mini Review | First Published: May 31, 2019

Neurofibromatosis is one of the most common autosomal dominant tumor syndromes with 1: 3000 birth incidence and 1: 4000 prevalence. Neurofibromatosis has three main forms, clinical and genetic. Von Recklinghausen disease or Neurofibromatosis is the most common known as type 1 (NF-1). Neurofibromatosis type 2 (NF-2) and Schwannomatosis are two other forms....

 Open Access DOI:10.23937/2378-3656/1410268

Diagnosing Genitourinary Tuberculosis: A Case Report

Chitsimran Mann, Gina Maki, DO, Marcus Zervos, MD and Nidhi Ravishankar

Article Type: Case Report | First Published: May 30, 2019

Genitourinary Tuberculosis (GUTB) is a common manifestation of tuberculosis and usually results from the reactivation of old, dormant tuberculous diseases by pathogens of the Mycobacterium tuberculosis complex. Most often, GUTB has a varied presentation ranging from irritative voiding symptoms to renal failure. Due to this varied presentation, diagnosis of GUTB is often very difficult. We present a case of a reproductive-age female with asymptomatic infertility. Many diagnostic measures failed t...

 Open Access DOI:10.23937/2378-3656/1410267

Cardiac Lipoma: Diagnosis after Cardiac Arrest

Elaine dos Reis Coutinho, Jose de Arimatea Francisco, Daniele Orrico, Mauricio Lopes Marson, Cleydicion Eloy da Costa, Gustavo Calado de Aguiar Ribeiro, Jose Humberto Pucci de Mesquita Filho, Aloisio Marchi da Rocha and Jose Francisco Kerr Saraiva

Article Type: Case Report | First Published: May 29, 2019

A 24-year-old female patient was admitted to the emergency room with palpitations associated with precordial pain and dyspnea. She was pale, sweating, with the heart rate 220 bpm and blood pressure 80 × 40 mmHg. The ECG demonstrated a sustained ventricular tachycardia rhythm evolving to a ventricular fibrillation rhythm. Four defibrillation attempts were performed with 360 J until obtained to sinus rhythm. ...

 Open Access DOI:10.23937/2378-3656/1410266

Mucosa-Associated Lymphoid Tissue Lymphoma of Thyroid: A Case Report

Youn Joo Jung, Dong-il Kim, Hyun-june Paik, Jeong Hee Lee and Hyun Yul Kim

Article Type: Case Report | First Published: May 29, 2019

Mucosa-associated lymphoid tissue lymphomas are a relatively recently recognized subset of B-cell non-Hodgkin's lymphomas. Generally, mucosa-associated lymphoid tissue lymphomas in the thyroid gland are known to have good prognosis, but recurrence and metastasis have also been reported....

 Open Access DOI:10.23937/2378-3656/1410265

What is New with Bordetella?

Shamsuddin Anwar MD, Allison Glaser MD and Mahreen Anwar

Article Type: Case Report | First Published: April 29, 2019

A 27-year-old HIV-1 positive male was admitted in September 2018 for sudden onset of vomiting and diarrhea and was conservatively managed for positive Norovirus on a Gastrointestinal PCR panel. It was anticipated to start him on ibalizumab intravenous infusions and enfuvirtide upon discharge and a PICC line was placed in the right internal jugular vein. On the third day of line placement, he developed a fever with mild respiratory symptoms. His respiratory PCR panel for Rhino/Enterovirus was pos...

 Open Access DOI:10.23937/2378-3656/1410264

Chronic Eosinophilic Pneumonia: A Pediatric Case

Irene Rutigliano, MD, Sara Gorgoglione, MD, Anna Pacilio, MD, Carmela De Meco, MD and Michele Carmine Sacco, MD

Article Type: Case Report | First Published: April 20, 2019

A 12-year-old nonsmoking asthmatic girl was admitted for general malaise and dry fatiguing cough. Diagnostic course reveled marked hypereosinophilia and chest radiography indicated multifocal and circumscribed bilateral pulmonary areas of consolidation. Bronchoscopy excluded the presence of neoplastic cells but marked hypereosinophilia was found in bronchoalveolar lavage. The increased number of eosinophils in blood and in bronchoalveolar lavage, the radiological findings were suggestive of Chro...

 Open Access DOI:10.23937/2378-3656/1410263

Staphylococcemia due to Cosmetic Doping: An Important Etiology of Fever of Undetermined Origin

Ronisie Duarte de Oliveira, Raquel Rodrigues Ferreira Rocha de Alencar, Bruno Vianei Real Antonio, Andre Luiz Tiuba Mendonca and Aryadine Allinne Machado de Miranda

Article Type: Case Report | First Published: April 13, 2019

A new problem, called cosmetic doping, has been inserted globally for some decades, and has grown in importance in Brazil in recent years, affecting athletes and non-athletes. The cosmetic doping consists in the use of oily substances by the intramuscular route to increase volumetrically the muscle, which can lead to the formation of oil deposits in the muscle, called oleomas, necrosis, physical deformities and even death. We present a 31-year-old male patient who sought the emergency room with ...

 Open Access DOI:10.23937/2378-3656/1410262

Frank-Ter Haar Syndrome, Report of a Case with a Novel Mutation from Iran

Z Hadipour, F Hadipour, H van Bokhoven, R Hennekam and Y Shafeghati

Article Type: Case Report | First Published: April 10, 2019

Frank-ter Haar syndrome is a genetic disease that is transmitted by autosomal recessive pattern with characteristic features such as megalocornea or glaucoma, a developmental delay and multiple congenital anomalies. It was first recognized as a separate entity by Frank, et al. and subsequently confirmed by ter Haar, et al. The main characteristics are brachycephaly, wide fontanels, prominent forehead, hypertelorism, prominent eyes, megalocornea with or without glaucoma, full cheeks, small chin, ...

 Open Access DOI:10.23937/2378-3656/1410261

Efficacy and Tolerability of the Nasal Airway Stent in the Treatment of Snoring

Takao Miyoshi, MSc, Ikumi Sasaki, MT, Fumika Koike, MSc, Saki Oyama, MT, Wakaba Furuie, MT, Miho Akaza, MD, PhD, Tetsuo Sasano, MD, PhD, Meiyo Tamaoka, MD, PhD, Yasunari Miyazaki, MD, PhD, Naohiko Inase, MD, PhD and Yuki Sumi, MD, PhD

Article Type: Brief Report | First Published: March 30, 2019

The nastent classic, a nasal airway stent (NAS), is a tube-shaped medical device that is positioned from the nose to the soft palate near the uvula. It is expected to reduce snoring by preventing the narrowing and obstruction of the airway and reduce apnea/hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Out of 23 subjects recruited, 18 completed the study. Most of the subjects showed improvements of snoring measured as the percentage of snoring time in their total sleep time...

 Open Access DOI:10.23937/2378-3656/1410260

Shear Wave Elastography: A New Assistant Modality in the Diagnosis of Hamartoma

Aysegul Altunkeser and Fatma Zeynep Arslan

Article Type: Case Report | First Published: March 27, 2019

Shear wave elastography(SWE) is a relatively new, promising modality which enables detailed information about tissues mechanical properties. Hamartomas are relatively rare, soft benign breast lesions comprised of glandulary and stromal components. The importance of radiological imaging methods increases especially in cases who do not have the typical appearance of hamartomas. Mammography and sonography are effective methods in evaluating morphological features of lesions. However, typical hamart...

 Open Access DOI:10.23937/2378-3656/1410259

Shear Wave Elastography as an Early Indicator of Breast Cancer in a Breastfeeding Patient: A Case Report and Literature Review

Aysegul Altunkeser and Fatma Zeynep Arslan

Article Type: Case Report | First Published: March 25, 2019

Shear wave elastography (SWE) is a relatively new and highly effective method to reveal mechanical features of tissue by demonstrating quantitative elasticity value. The morphological features including margin of the lesion, orientation, shape and border are considered in differentiation of breast lesions on USG. It is a known fact that malignant lesions are usually palpated as a hard mass in the physical examination. A qualitative broad information can obtain about the tissue elasticity by inte...

 Open Access DOI:10.23937/2378-3656/1410258

An Unexpected Lower Urinary Tract Symptom of Multiple Sclerosis: Valsalva Induced Urge Incontinence

Murat Akgul, MD, CenkYazıici, MD, NildaTurgut, MD, Arzu Malak and Mehmet Fatih Sahin, MD

Article Type: CASE REPORT | First Published: February 28, 2019

A 46-years-old male with the history of multiple sclerosis applied to urology outpatient clinic with frequency, urgency, incontinence, and nocturia. Urodynamic evaluation presented Valsalva-induced urge incontinence, which was an unusual finding for an MS patient. Here we present an MS patient with the urodynamic finding of Valsalva-induced urge incontinence. Multiple sclerosis (MS) is a chronic progressive demyelinating disease of the central nervous system, mostly affecting the people between ...

 Open Access DOI:10.23937/2378-3656/1410257

Management of Non-Classic Congenital Adrenal Hyperplasia in Pregnant Woman - Non-Referral Center Experience- Case Report

Zoran Gluvic, Milena Lackovic, Vladimir Samardzic, Bojan Mitrovic, Violeta Mladenovic, Milan Obradovic, Danimir Jevremovic and Esma R Isenovic

Article Type: Case Report | First Published: February 22, 2019

Congenital adrenal hyperplasia (CAH) is a rare autosomal recessive disorder with mutations in genes involved in cortisol and aldosterone production. Based on overall 21-OHase activity, CAH is divided into classic (C-CAH) and non-classic (NC-CAH). Females who suffered from NC-CAH have had increased infertility rates and higher miscarriage susceptibility. The treatment of CAH in pregnancy is still debatable. We present 22 years old pregnant female (seventh week of gestation), who is currently unde...

 Open Access DOI:10.23937/2378-3656/1410256

High Focused Ultrasound in a Case of Previously Untreated Breast Cancer

Hans-Christian Kolberg, MD, PhD and Cornelia Kolberg-Liedtke, MD, PhD

Article Type: Case Report | First Published: February 20, 2019

High focused ultrasound is a non-invasive treatment used for destroying benign and potentially also malignant tumors. Recent data have suggested that the generation of large volumes of tumor debris by high focused ultrasound may initiate an adaptive antitumor immune response by the release of tumor antigens and damage associated molecular patterns. The patient, a 48-year-old woman who was diagnosed with hormone receptor positive HER2 negative breast cancer 17 months before presentation had repea...

 Open Access DOI:10.23937/2378-3656/1410255

Soluble ST2 - A Potential Biomarker of Rheumatic Heart Disease

Ramona Januska, MD, Alexander von Meyer, MD, Martin Fleck, MD and Andreas Luchner, MD

Article Type: Case Report | First Published: February 18, 2019

Soluble ST2 might be a sensitive marker of rheumatic (peri-)carditis before and during antirheumatic treatment. We describe a case of rheumatic heart disease with pericarditis and mild left ventricular dysfunction which was successfully treated by immunosuppression. An interesting pattern of activation of the cardiac marker ST2 was observed at detection and during treatment. It suggests ST2 as biomarker for diagnosis and monitoring of disease activity in rheumatic heart disease. Rheumatic disord...

 Open Access DOI:10.23937/2378-3656/1410254

Intensification of Weight Loss with the Ketogenic Diet during the Management of a Super Obese: Case Study

Jamile Nobrega Zeraik Abdalla, Livia Lugarinho Correa, Priscilla Gil, Silvia de Freitas, Ignacio Sajoux, German Guzman and Walmir Coutinho

Article Type: Case Report | First Published: January 12, 2019

Obesity is a chronic disease referred to as a world epidemic. Superobesus management is challenging and requires multidisciplinary follow-up. In this case report, the patient had an initial body mass index (BMI) of 110 kg/m² associated with comorbidities such as type 2 diabetes (T2DM). Initial clinical management was performed with changes in lifestyle, through hypocaloric and ketogenic diet, associated with several antiobesity drugs and the introduction of light physical activity. After a tota...

 Open Access DOI:10.23937/2378-3656/1410253

Juvenile Huntington' Disease: A Case of Paternal Transmission with an Uncommon CAG Expansion

Luciana de Andrade Agostinho, Luiz Felipe Vasconcellos, Victor Calil da Silveira, Thays Apolinario, Michele da Silva Gonçalves, Mariana Spitz and Carmen Lucia Antao Paiva

Article Type: Brief Report | First Published: January 04, 2019

We report a patient with paternally inherited JHD caused by a large (74 CAG) expansion. The patient was prescribed olanzapine 2.5 mg q.d., oxcarbazepine 300 mg bid and underwent botulinum toxin treatment, with partial improvement of aggressiveness and chorea and partial resolution of torticollis. The MRI revealed bilateral caudate and putamen atrophy. JHD is rarer than adulthood HD, with an average prevalence rate of 5%. UHDRS has limited efficacy in evaluating JHD patients independence and func...

 Open Access DOI:10.23937/2378-3656/1410252

Effects of Hematocrit on Cardiac Parameters for Shock Patients

Rabindra Nath Das and Youngjo Lee

Article Type: Short Research Article | First Published: January 04, 2019

The hematocrit known as erythrocyte volume fraction (EVF) or packed cell volume (PCV), is the volume percentage of red blood cells in blood. The present report examines the association between hematocrit (HCT) and anyone of seven cardiac parameters such as shock type (SHOCKT), heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), systolic blood pressure (SBP), mean central venous pressure (MCVP), diastolic blood pressure (DBP) for shock patients. It is reported herein that that mean...

 Open Access DOI:10.23937/2378-3656/1410251

A Case Report of an Intestinal Helminth Infection of Human Hymenolepiasis in Rural Gambia

Usman N Ikumapayi, Chilel Sanyang and Dora IA Pereira

Article Type: Case Report | First Published: January 04, 2019

Hymenolepis nana, also called dwarf tapeworm infection, is an intestinal helminth not previously reported in The Gambia and only very rarely reported in West Africa. We report a case of H. nana infection in a 29-month old child living in a rural community of the north bank of the Upper River Region (URR) in The Gambia. The child presented with mild iron deficiency anaemia and granulocytosis but was otherwise mostly asymptomatic despite the moderate-intensity of infection....

 Open Access DOI:10.23937/2378-3656/1410250

A Case of Secondary Aortoduodenal Fistula Diagnosed by Esophagogastroduodenoscopy

Kyosuke Goda, Masanori Kawaguchi and Akiko Shiotani

Article Type: Case Report | First Published: January 03, 2019

A 64-year-old man underwent vascular graft surgery for an abdominal aortic aneurysm one year previously. Using esophagogastroduodenoscopy (EGD), he was definitively diagnosed as having an aortoenteric fistula (AEF) and underwent an urgent surgical procedure for treatment. Generally, the prognosis in cases of AEF after vascular graft operation remains poor, and the survival rate in cases of AEF that require surgery is low. We report this case of AEF because EGD played a significant role in its ea...

 Open Access DOI:10.23937/2378-3656/1410249

Case Report and Review of Literature: An Overlap Syndrome of Autoimmune Hepatitis and Systemic Lupus Erythematous

Charelle Salem, Elie Makhoul and Tony El Murr

Article Type: Case Report | First Published: January 03, 2019

Autoimmune Hepatitis (AIH) is a chronic necroinflammatory liver disease of unknown etiology associated with circulating autoantibodies and high serum globulin level. Systemic lupus erythematous (SLE) is a disease of unknown etiology in which tissues and cells are damaged by pathogenic autoantibodies and immune complex, affecting multiple organs including the liver, kidney, and CNS. AIH has been considered to occur infrequently in SLE. We report a 42-year-old female patient with an overlap syndro...

 Open Access DOI:10.23937/2378-3656/1410248

Progressive Cervical Myelopathy Caused by Bilateral Spontaneous High-Flow Vertebro-Vertebral Arteriovenous Fistulas Associated with Fibromuscular Dysplasia Successfully Treated by Endovascular V2 Segments Sacrifice Using Fibered Coils: A Case Report

Prasert Iampreechakul, Anusak Liengudom, Korrapakc Wangtanaphat, Punjama Lertbutsayanukul, Yodkhwan Wattanasen and Somkiet Siriwimonmas

Article Type: Case Report | First Published: December 19, 2018

The authors reported an extremely rare case of bilateral spontaneous vertebro-vertebral arteriovenous fistulas (VVAVFs) associated with fibromuscular dysplasia (FMD). A 53-year-old hypertensive woman has been placed on antiplatelet drug following diagnosis of supratentorial ischemic stroke for 2 years. Few months before hospitalization, she developed bilateral audible bruits and progressive spastic quadriparesis. Magnetic resonance imaging (MRI) of the cervical spine showed bilateral dilated epi...

 Open Access DOI:10.23937/2378-3656/1410247

Asymptomatic Benign Pleural Plaque Due to Asbestos Exposure in Former TB Patient: A Case Report

Agus Dwi Susanto and Steven Jonathan

Article Type: Case Report | First Published: December 14, 2018

Asbestos fibres, inhaled and displaced by various means to lung tissue, may cause a spectrum of diseases from benign diseases to malignancies. Pleural plaques (PPs) are usually asymptomatic and cause slight impairment of lung function only when they are extended in size. The cause of pleural plaques is exposure to asbestos fibres, most commonly in an occupational setting. Relationships between the dose-response and prevalence of asbestos-related diseases are complex. We present a case of asympto...

 Open Access DOI:10.23937/2378-3656/1410246

Visual Snow Syndrome: A Case Report and New Treatment Option

Shauna Wentzell and Mary Ryan

Article Type: Case Report | First Published: December 10, 2018

We present the case of a 47-year-old male who was diagnosed with Visual Snow Syndrome following extensive specialist consults and medical testing. With an unknown pathogenesis, Visual Snow Syndrome is very difficult to treat and there is no one treatment suited for all patients. The patient in this case report was successfully treated with Amitriptyline based on the hypothesis that Visual Snow Syndrome is a form of peripheral neuropathy and pituitary fatigue. With nearly 200 documented cases of ...

 Open Access DOI:10.23937/2378-3656/1410245

Iatrogenic Bilateral Lower Extremity Subcutaneous Emphysema after Robotic-Assisted Laparoscopic Hysterectomy with Bilateral Salpingo-Oophorectomy and Sacrocolpopexy

Bilal Farhan, Ahmed Aziz, Dina Saba and Gamal Ghoniem

Article Type: Case Report | First Published: December 03, 2018

As minimally invasive surgery becomes more prevalent, it is important to keep in mind the unique complications that can be associated with the use of carbon dioxide insufflation. Postoperative patients presenting with lower extremity pain and swelling should have the diagnosis of iatrogenic subcutaneous emphysema on the differential, alongside deep venous thrombosis and necrotizing fasciitis. A careful history and physical examination can help guide the appropriate management and avoid unnecessa...

 Open Access DOI:10.23937/2378-3656/1410244

A Welcome Seizure

Juan-Ignacio Perez-Calvo

Article Type: Case Report | First Published: November 28, 2018

Clinical diagnosis is one of the most demanding tasks, even for experienced physicians. In daily clinical practice, common diseases may require, developed skills. Not only by the intrinsic difficulties of the disease itself, but also because some of them may threaten patients' life and demands a prompt and safe attention. As examples of that are sudden dyspnoea, chest pain or syncope....

 Open Access DOI:10.23937/2378-3656/1410243

The Pathogenesis and Clinical Significance of Gastrointestinal Xanthelasma: A Case Report and Review of Literature

Marianna G Mavilia and George Y Wu

Article Type: Case Report | First Published: November 26, 2018

Xanthelasmas are lesions containing lipid-filled histiocytes, which can be found on the skin or in the gastrointestinal tract. Gastrointestinal xanthelasmas (GX) are rare lesions typically found incidentally on esophagogastroduodenoscopy. Several risk factors have been identified for development of GX including dyslipidemia, fatty liver, radiotherapy, Helicobacter pylori infection, and immunosuppression. We present a case of a gastroesophageal xanthelasma in a 78-year-old male without risk facto...

 Open Access DOI:10.23937/2378-3656/1410242

Efficacy and Safety of GLP-1 Agonists in Chronic Kidney Disease: A Case Series

Awdishu L and Morello CM

Article Type: Case Series | First Published: November 17, 2018

Tight glycemic control has been demonstrated to reduce the incidence of microvascular complications in type 1 and 2 diabetes. However, tight control comes at a risk of hypoglycemia, which is further increased in advanced diabetic kidney disease. GLP-1 agonists significantly lower HgA1c and have added benefits of early satiety and weight loss. However, the safety and efficacy of these agents has not been well documented in CKD stage 3-4....

 Open Access DOI:10.23937/2378-3656/1410241

Hyponatraemia Workup Leading to a Diagnosis of Primary Empty Sella Syndrome: A Case Report

Guillermo Ropero Luis, Sonia Santamaria Fernandez, Jesica Martín Carmona and Ricardo Gomez Huelgas

Article Type: Case Report | First Published: November 16, 2018

A 61-year-old woman was admitted to our ward - after her third visit to the Emergency Department in two months - because of progressive lethargy, weakness, and persistent euvolaemic hyponatraemia. Based on the results of the first diagnostic workup (complete blood count, serum and urinary biochemistry), a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was established. A comprehensive second diagnostic workup was performed, leading to the diagnosis of anterior hypop...

 Open Access DOI:10.23937/2378-3656/1410240

A Case of Necrolytic Migratory Erythema (NME) Initially Misdiagnosed as Subacute Cutaneous Lupus Erythematosus (SCLE)

Alexis C Gushiken, Adegbenga A Bankole, Jeff S Croteau and Douglas J Grider

Article Type: Case Report | First Published: October 31, 2018

When there are multiple vague positive findings and a plethora of possible answers, as well as multiple possible consultants with whom to work, it can sometimes be difficult to decide on the right course of action. A full and through history becomes especially more important in cases like this to help direct work up and therapy. Our case report illustrates that a consult that adds obtains more history and rules out a disease process adds helpful information in patient management. The input of co...

 Open Access DOI:10.23937/2378-3656/1410239

Paucisymptomatic Migrated Intrauterine Contraceptive Device to the Sigmoid Colon: A Case Report

Abdelwahed Yahmadi, Hakim Zenaidi, Najeh Hsayaoui, Saber Rebii, Choaouki Mbarki, Hajer Bettaieb, Hedhili Oueslati and Ayoub Zoghlami

Article Type: Case Report | First Published: October 31, 2018

Migration of intrauterine contraceptive device (IUCD) to adjacent organs is rare but the most serious complication. Withdrawal of any migrated IUCD is advisable even if asymptomatic and Laparoscopic removal remain the gold standard, however sometimes finding the device intra-operatively is challenging for the surgeon. We report a case of laparoscopic removal of migrated IUCD to the sigmoid colon. Computed tomography (CT) precisely located the migrated device embedded in the sigmoid colon. After ...

 Open Access DOI:10.23937/2378-3656/1410238

Prevention and Treatment of CMV Retinitis Related Blindness in Resource-Limited Settings, Myanmar

Ni Ni Tun, Thida Yamin Pyone, Yee Yee Aung and Frank Smithuis

Article Type: Case Report | First Published: October 21, 2018

In south-east Asia, cytomegalovirus (CMV) retinitis is a neglected disease [1], with no defined strategy for management. This is despite evidence that CMV retinitis is a common cause of HIV-associated blindness in this region and the second most common opportunistic infection to emerge during initiation of antiretroviral therapy (ART) and that CMV viremia is a strong predictor of mortality. The emerging body of data from resource-limited settings closely mirrors what was learned several decades ...

 Open Access DOI:10.23937/2378-3656/1410237

Low Saturation Readings in a Patient with Congenital Methemoglobinemia Exposed to Patent Blue Dye: A Case Report

Claudia Jong Chie TIEN and Priscilla Hui Yi PHOON

Article Type: CASE REPORT | First Published: September 29, 2018

Pulse oximetry is widely used perioperatively to detect respiratory events. Abnormal haemoglobins such as methemoglobin can result in inaccurate readings. Here we present the clinical challenges of managing a patient with congenital methemoglobinemia who went for surgery involving injection of patent blue dye and subsequently had a prolonged duration of poor saturation readings post-operatively. Differentials include desaturation due to respiratory causes, worsening of methemoglobinemia and dela...

 Open Access DOI:10.23937/2378-3656/1410236

Transfer Factor Revisited: Treatment of Chronic Mucocutaneous Candidiasis in a Child with Autoimmune Polyendocrinopathy Syndrome Type-1

J Kelly Smith

Article Type: CASE REPORT | First Published: September 15, 2018

A 5-year-old boy was diagnosed as having chronic mucocutaneous candidiasis at the age of three months. He showed no improvement despite treatment with two courses of intravenous amphotericin B, 2½ years of oral 5-fluorocytosine, and daily treatment with topical Mycostatin. An immune assessment revealed that he was anergic and had low levels of circulating FCγR+ monocytes. Buccal smears revealed numerous candida and no inflammatory response. On treatment with transfer factor his FCγR+ monocyte...

 Open Access DOI:10.23937/2378-3656/1410235

Painless Thyroiditis Induced by Immune Checkpoint Inhibitors in a Patient with Small Cell Lung Cancer

Maria Jose Burches Feliciano, Antonia Perez Lazaro and Juan Francisco Merino Torres

Article Type: CASE REPORT | First Published: September 14, 2018

New antineoplastic agents consisting of specific monoclonal antibodies which enhance the host's immune response against the tumoral cells are becoming more common in clinical practice. Ipilimumab, an antibody that blocks the cytotoxic T-lymphocyte antigen 4 (CTLA-4), and nivolumab, a programmed cell death 1 (PD-1) inhibitor are now approved for several advanced neoplasias such as melanoma, non-small cell lung cancer and renal cell carcinoma....

 Open Access DOI:10.23937/2378-3656/1410234

Fatal Side Effect of Treprostinil - Hypoglycemia: A Case Report

Dongling Luo, Caojin Zhang and Yigao Huang

Article Type: CASE REPORT | First Published: September 12, 2018

Treprostinil is generally safe and efficacious prostacyclin analog that is recommended for patients with NYHA class III/IV pulmonary hypertension. The reported side effects of standard dosing of treprostinil include fatigue, facial flush, headache, chest pain, dyspnea, right ventricular heart failure and pallor. Other side effects include abdominal cramping, diarrhea, jaw pain, edema, vasodilation and nausea [1]. Hypoglycemia as a side effect of treprostinil is extremely rare. We report the firs...

 Open Access DOI:10.23937/2378-3656/1410233

Consecutive Successful Pregnancies after Conservative Management of Early Stage Endometrial Carcinoma

Chia-Chi Yen, Chieh-Yi Kang, Hsing-Chun Tsai, Ming-Ting Chung, Meng-Chen Tsai and Yung-Chieh Tsai

Article Type: Case Report | First Published: September 06, 2018

Endometrial cancer is one of the most frequent gynecological cancers in women. According to a recent national survey, endometrial cancer has increased rapidly in the past 30 years in Taiwan and the incidence of endometrioid adenocarcinoma has increased more and more quickly in younger age. Although total hysterectomy is usually recommended to eradicate the malignant lesion, this procedure may not be suitable for a young nulliparous woman, especially when the endometrial cancer is early stage. We...

 Open Access DOI:10.23937/2378-3656/1410232

Laparoscopic TEP Inguinal Hernia Repair - Are We Overdoing It? A Comprehensive Study of 25 Cases of TEP Inguinal Hernia Repair Done Without the Use of Electrocautery and Without Any Mesh Fixation

Kaundinya Kiran Bharatam

Article Type: Research Article | First Published: August 17, 2018

As one of the most effective and accepted minimally invasive techniques for inguinal hernia repair Laparoscopic Totally Extra Peritoneal (TEP) repair is met with a learning curve and caution towards injury of major vessels/nerves and mesh migration. Less experienced surgeon may tend to use excessive cautery and overzealous mesh fixation. Such practices in surgery can be avoided without any changes in immediate or late outcomes of the procedure....

 Open Access DOI:10.23937/2378-3656/1410230

A Chronic Precipitant for Acute Intermittent Porphyria

Nick Li

Article Type: Case Report | First Published: August 15, 2018

Acute intermittent porphyria (AIP) is a rare inherited disorder of heme metabolism caused by a heterozygous, loss-of-function mutation affecting the enzyme porphobilinogen deaminase (PBGD). The remaining enzymatic activity is sufficient to avoid accumulation of intermediate metabolites until hepatic heme production is further activated, i.e. by a precipitant....

 Open Access DOI:10.23937/2378-3656/1410229

An Unspoken Threat Hiding behind the Gall Bladder in Laparoscopic Cholecystectomy - The Middle Hepatic Vein

Kaundinya Kiran Bharatam

Article Type: Case Report | First Published: August 10, 2018

Laparoscopic cholecystectomy is guided by working knowledge of bilio-vascular anomalies to prevent common bile duct injuries and bleeding during surgery. Less importance is given to the dissection of the gall bladder from the gall bladder bed where the middle hepatic vein or its large branch can be encountered. The lack of awareness of this presence can result in uncontrolled bleeding and result in significant morbidity or mortality in a seemingly uneventful procedure....

 Open Access DOI:10.23937/2378-3656/1410228

A Review on Separation Techniques of Graphene Oxide (GO)/Base on Hybrid Polymer Membranes for Eradication of Dyes and Oil Compounds: Recent Progress in Graphene Oxide (GO)/Base on Polymer Membranes-Related Nanotechnologies

Elahe Dadvar and Alireza Heidari

Article Type: Review Article | First Published: August 10, 2018

Nowadays, obtaining drink water for saving health of humans is very important. There have been various investigations about the cost effective and environmental friendly methods of water treatment. The purpose of the current study is reviewing the application of hybrid polymeric membranes Graphene Oxide (GO) as new techniques for separation of pollutants (Figures 1 and Figure 2)....

 Open Access DOI:10.23937/2378-3656/1410227

Borderline Personality Disorder with Psychopathic Traits: A Critical Review

Lopez-Villatoro JM, Palomares N, Diaz-Marsa M and Carrasco JL

Article Type: Research Article | First Published: August 04, 2018

Borderline Personality Disorder (BPD) is described as a severe mental condition characterized by high affective instability, impulsive behaviors, autolytic attempts, or unstable interpersonal relationships. Previous literature on BPD has focused mainly on symptoms of mood and anxiety and self-injurious behavior but relatively little is known about the association between borderline personality disorder and psychopathic traits....

 Open Access DOI:10.23937/2378-3656/1410226

Diagnosis of Tardive Dyskinesia in an Oral Surgical Office

Shamit S Prabhu, Sameh Almousa, Kevin Fortier and Uday N Reebye

Article Type: Case Report | First Published: August 03, 2018

Tardive dyskinesia (TD) presents as uncontrolled, repetitive movements of the body, typically beginning with orofacial structures, due to antipsychotic medications. The two classes of antipsychotics, atypical and typical, are mainly distinguished by their likelihood of producing extrapyramidal side effects (EPS), with atypical producing lower rates. Our case discusses a patient who presented at our clinic for dental extractions. Pre-operative consultation presented the rapid, repetitive tongue, ...

 Open Access DOI:10.23937/2378-3656/1410225

Placenta Increta at 14 Weeks with Subsequent Hysterectomy: A Case Report

Abigail E Collett, Jean Payer and Xuezhi Jiang

Article Type: Case Report | First Published: July 26, 2018

Abnormal placental implantation (API) is an uncommon obstetrical complication that is associated with significant maternal morbidity. Typically, the diagnosis of API is made at the time of delivery in the third trimester. Less commonly there are reports of API presenting in the second trimester, and rarely in the first trimester. Cesarean Scar Pregnancy (CSP) is another entity that can present similarly to API and is associated with previous cesarean deliveries. Unlike early API, which can rarel...

 Open Access DOI:10.23937/2378-3656/1410224

A Case of Rhizopus Keratitis

pradeep Kumar Mada, Gabriel Castano, Marithe G Gutierrez-Roberts and Andrew Stevenson Joel Chandranesan

Article Type: Case Report | First Published: July 25, 2018

Mycotic keratitis has been reported from many different parts of the world, with a worldwide incidence varying from 17% to 36% in various studies. It is particularly common in tropical areas, where the incidence ranges between 14%-40% of all ocular mycoses. Early diagnosis is highly important in every patient with the corneal lesion because infectious keratitis caused by various organisms such as bacteria, viruses, fungi, or Acanthamoeba the leading cause of monocular blindness....

 Open Access DOI:10.23937/2378-3656/1410223

Giant Aneurysm of Ascending Aorta Caused by Chronic Stanford Type A Aortic Dissection with Bicuspid Aortic Valve

Umit Arslan, Eyupserhat Calik and Bilgehan Erkut

Article Type: Case Report | First Published: July 21, 2018

An 82-year-old male patient was admitted to our clinic because of shortness of breath and chest pain. A grade 4/6 diastolic murmur was heard on auscultation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. There was a diagnosis of acute Stanford Type A ascending aortic dissection in the history of the patient. The patient had refused emergency surgical intervention three years ago. Computed tomography revealed chronic Stanford Type A dissection and ...

 Open Access DOI:10.23937/2378-3656/1410222

A Rare Case of Symptomatic Factor XII Deficiency Manifesting as Intraventricular Haemorrhage and Hydrocephalus in a Term Neonate

Jayant Kumar Muduli and Meenakshi Mitra

Article Type: Case Report | First Published: July 04, 2018

Factor XII (FXII) deficiency, which is also known as Hageman factor deficiency, was first described in the medical literature by Dr. Oscar Ratnoff and Dr. Jane Colopy in 1955. It has an Autosomal Recessive inheritance. The precise incidence of the disorder in the common population is still unknown, but it is found approximately one in a million....

 Open Access DOI:10.23937/2378-3656/1410221

Primary Pleiomorphic Liposarcoma of the Colon: A Case Report and Review of Literature

Mormont M, Gero D, Moulin-Stephan C, Worreth M and Morel P

Article Type: Case Report | First Published: June 22, 2018

Liposarcoma is the most common soft tissues sarcoma in adults. Pleiomorphic liposarcoma (PLS) is a rare subtype of liposarcoma with the highest malignancy rate. In this paper we present a rare case of pleiomorphic liposarcoma of the colon and the management of the disease....

 Open Access DOI:10.23937/2378-3656/1410220

Corpus Cavernosum Atypical Metastasis of Renal Cell Carcinoma: Presurgical Therapy and Complete Surgical Resection. Case Report and Review of the Literature

Sacca A, Roscigno M, Nicolai M, Manica M, La Croce G, Bettini A, Chirco A, Bonomi L and Da Pozzo L

Article Type: Case Report | First Published: June 18, 2018

We describe the case of a 71-years-old male, who was submitted to a left laparoscopic radical nephrectomy for Clear Renal Cell Carcinoma (CRCC). After a 14-year follow-up, MRI scan showed a 5-cm solid lesion of the perineum, that originates from the right corpus cavernosum. A percutaneous trans-perineal biopsy revealed an atypical metastasis of CRCC. To reduce surgical risk during the exeresis of the mass, the patient received 4 cycles of pazopanib as presurgical treatment, with a shrinking of t...

 Open Access DOI:10.23937/2378-3656/1410219

Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) - A Case Report of Successful SSA Therapy after Failure of Systemic Corticosteroids

Maja Badovinac, Matevz Harlander, Branislava Rankovic and Marjeta Tercelj

Article Type: Case Report | First Published: June 15, 2018

Treatment of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) has not been established yet. The majority of patients is treated with glucocorticoids. This article presents a case when such treatment was inefficient. When switched to somatostatin analogues treatment, patient's clinical condition and radiologic findings improved. Nonetheless, we were not able to prove the expression of somatostatin receptors in the lung nodules....

 Open Access DOI:10.23937/2378-3656/1410218

Refractory Vasodilatory Shock Induced by Irbesartan's Acute Intoxication

Romain Jouffroy, Antoine Pegat-Toquet, Alexandre Bourdiault, Pascal Philippe, Pierre Carli and Benoit Vivien

Article Type: Case Report | First Published: June 13, 2018

Angiotensin II (AII) is a strong physiological vasopressor hormone. Sartans act as antagonists of AT1 receptors of AII, inducing a vasodilatation via an upregulation of AT2 receptors. In July 2017, in the New England Journal of Medicine, efficiency of AII to increase blood pressure and reduce conventional vasopressors's dose in severe vasodilatory shock refractory to high-dose vasopressors were observed....

 Open Access DOI:10.23937/2378-3656/1410217

Prover Induced Cerebral Sinus Thrombosis in a SLE Patient

Shafira Mohamad Sha

Article Type: Case Report | First Published: May 31, 2018

Cerebral vein and sinuses thrombosis (CVST) is a rare condition and accounts of 0.5-1% of all stroke. It is more common in women compared to men. Usage of oral contraceptive pill (OCP) has been recognised to increase the risk of developing CVST. We report a case of 46 Chinese lady with underlying systemic lupus erythematous (SLE) who presented with a second episode of sudden onset severe headache which secondary to CVST within 5 years....

 Open Access DOI:10.23937/2378-3656/1410216

An Important Differential Diagnosis with Elevated D-Dimer: Acute Pulmonary Embolism or Aortic Dissection

Ekrem Sahan and Suzan Sahan

Article Type: Case Report | First Published: May 28, 2018

Acute pulmonary embolism (APE) or acute aortic dissection is one of the most serious clinical presentations at emergency department. Chest pain and elevated serum D-dimer level can be found in both APE and AAD. Echocardiography can be used as first line imaging modality for differential diagnosis. Computed tomography angiography is the main diagnostic test for APE and AAD. We aimed to emphasize differential diagnosis of chest pain with this case report....

 Open Access DOI:10.23937/2378-3656/1410215

Silver Nitrate in the Sphenoid Sinus following Nasal Cauterization

James Jordan Johnston, Dev Tandon, Tary Yin and Paul Simcock

Article Type: Case Report | First Published: May 28, 2018

A 68-year-old female who underwent bilateral Functional Endoscopic Sinus Surgery (FESS) in 2000 for chronic rhinosinusitis, presented with a one year history of recurrent headaches. The headaches were located particularly around the eyes, occurred weekly and improved with paracetamol. She also complained of anosmia and purulent rhinorrhea bilaterally....

 Open Access DOI:10.23937/2378-3656/1410214

Aortic Mycotic Aneurysm - A Rare Cause, A Common Clinical Presentation

Nidia Pereira, Marta Pereira, Liliana Carneiro, Luis Miguel Afonso, Ana veloso and M Catarina Tavares

Article Type: Case Report | First Published: May 28, 2018

Infected (mycotic) aneurysms (MA) are uncommon, and the aorta is the main vessel involved, with gram-positive bacteria being the most frequent causative agent. Their morbidity and mortality are important and an early diagnosis is challenging owing to their unspecified manifestations....

 Open Access DOI:10.23937/2378-3656/1410213

Gallbladder Volvulus: An Uncommon Phenomenon: A Case Report and Review of the Literature

Padmike Dayananda, Ramsh Dhamodaran Praba and Mohommed Rafaideen Balal

Article Type: Case Report | First Published: May 26, 2018

Gallbladder volvulus (GV) is an uncommon cause for abdominal pain and occurs due to rotation of gall bladder on its mesentery along the axis of the cystic duct and the cystic artery. Although it is often misdiagnosed as acute cholecystitis (AC) before surgery, critical constellation of presenting signs and symptoms which guide the emergency physician and surgeon to accurate and timely diagnosis of GV before surgical intervention....

 Open Access DOI:10.23937/2378-3656/1410212

Introduction of a Glove-Finger Extraction Option for Laparoscopic Appendectomy

Padmike Dayananda, Jacinta Drew and Jacinta Cover

Article Type: Case Report | First Published: April 25, 2018

The cost of the procedure of laparoscopic appendectomy is significantly higher than that of open surgery. Costing includes instruments, duration of surgery, and the potential for requiring conversion to open. Reducing procedure costs in simple ways will better enable laparoscopic appendectomy to be cost-effective in Regional Hospitals....

 Open Access DOI:10.23937/2378-3656/1410211

Arrhythmogenic Right Ventricular Dysplasia with Phasic Elevation in Troponin Levels

Apinya Bharmanee, Deemah Mahadin and Harinder R Singh

Article Type: Case Report | First Published: April 19, 2018

Arrhythmogenic right ventricular dysplasia (ARVD) is an inherited cardiomyopathy characterized by right ventricular structural abnormalities, dysfunction and ventricular tachycardia (VT) secondary to fibrofatty replacement of the myocardium. We report a male teenager with negative family history, presenting with sustained VT after sports practice....

 Open Access DOI:10.23937/2378-3656/1410210

A Case of Human Metapneumovirus Associated with Acute Haemorrhagic Oedema of Infancy

Padmike Dayananda, Sabrina Barrett and Sathiyaseelan Nair

Article Type: Case Report | First Published: April 11, 2018

Acute Haemorrhagic oedema of infancy (AHOI) is a cutaneous leukocytoclastic vasculitis, clinically characterized by the acute development of peripheral oedema and targetoid purpuric lesions on the face and extremities. It is commonly associated with Pneumococcal Bacteremia, CMV infection and Rotavirus infection....

 Open Access DOI:10.23937/2378-3656/1410209

Pulmonary Hyalinizing Granuloma in the Differential Diagnosis of Pulmonary Carcinoma

Fatih Uzer, I. Hicran Ozbudak, omer Ozbudak and Aykut Cilli

Article Type: Case Report | First Published: April 05, 2018

Pulmonary hyalinizing granuloma (PHG) which should be considered in the differential diagnosis of pulmonary nodules of unknown origin is a distinct fibrosing lesion of lung that occurs in middle-aged patients. It has been usually reported as case reports in the literature. Patients are usually symptomatic. We present the case which recognized during operation and determined rarely....

 Open Access DOI:10.23937/2378-3656/1410208

Sunitinib Induced Cytopenia in Metastatic RCC

Aykut Bahceci, M Metin Seker, Turgut Kacan, Nalan Akgul Babacan, Birsen Yucel and M Asım Gedikli

Article Type: Case Report | First Published: March 30, 2018

Most malignant kidney tumors are renal tubular epithelium derived adenocarcinomas and referred to as renal cell carcinoma (RCC). Kidney cancer accounts for 3-4% of adult cancers and one third of the overall cases of RCC are diagnosed at the advanced stages of the disease. RCC is a chemo-radioresistant cancer. Therefore, immunomodulatory agents and tyrosine kinase inhibitors (TKI) are commonly used in the treatment of mRCC....

 Open Access DOI:10.23937/2378-3656/1410207

Rhino-Orbito-Cerebral Mucormycosis in Immunocompetent Young Patient: Case Report

Rabab Taha, Talal Almteri, Nizar bahabri and Hani Almoallim

Article Type: Case Report | First Published: March 22, 2018

Mucormycosis is an invasive infection in immunocompromised host. It can lead to a devastating rhino-orbital-cerebral involvement with detrimental consequences. This disease is mainly caused by member of the family Mucoraceae that include Rhizopus, Rhizomucor, Mucor and Lichtheimia (formerly Absdia). This infection classically affects immunocompromised patients. The most common site of this infection in immunocompromised patients related to the pattern of the associated disease. In patients with ...

 Open Access DOI:10.23937/2378-3656/1410206

Painful Hand Swelling after a Roller Coaster Ride

Felicitas Stoll, Britta Vogel, Boris Radeleff, Hugo A Katus and Oliver J Müller

Article Type: Case Report | First Published: March 16, 2018

We present a case report on the Achenbach's syndrome, a condition characterized by a painful hematoma and swelling of the palmar side of the hand and/or fingers with a sudden onset. Symptoms are typically triggered by everyday activities like carrying a bag or pressing down a door handle. Achenbach's syndrome being rather unknown, its impressive clinical presentation might unsettle both patients and physicians and entail elaborate diagnostic measures despite its in fact benign and self-limiting ...

 Open Access DOI:10.23937/2378-3656/1410205

Current Microbiological, Clinical and Therapeutic Aspects of Impetigo

Lior Zusmanovich, Lior Charach and Gideon Charach

Article Type: Case Report | First Published: March 09, 2018

Impetigo is a highly contagious infection of the epidermis, seen especially among children, and transmitted through direct contact. Two bacteria are associated with impetigo: S. aureus and GAS. Over 140 million people are suffering from impetigo at each time point, over 100 million are children. Two forms of impetigo exist, namely impetigo contagiosa, known as the non-bullous form and the second one being bullous impetigo which presents with large and fragile bullae. Treatment options for impeti...

 Open Access DOI:10.23937/2378-3656/1410204

Culotte PCI through Arteria Lusoria

Tomislav Krcmar, Kristijan Dula, Branimir Culo, Ivan Zeljkovic, Nikola Bulj and Vito Mustapic

Article Type: Case Report | First Published: February 28, 2018

Aberrant right subclavian artery (ARSA) or arteria lusoria is one of the most common congenital aortic arch anomaly with prevalence ranging from 1-2%. However, it is mostly asymptomatic and consequently often found sporadically during various diagnostic procedures with prevalence of 0.45% during coronary angiography....

 Open Access DOI:10.23937/2378-3656/1410203

Urothelial Carcinoma with Intracranial Lesion: Metastasis or Abscess?

Tania Jain, Siddharth Gupta, Natasha Robinette, Dongping Shi and Ulka N Vaishampayan

Article Type: Case Report | First Published: February 21, 2018

Isolated central nervous system and dural metastasis from urothelial cancer are exceedingly rare. We describe 2 unique cases of intracranial lesions in patients with urothelial carcinoma-one with isolated brain and dural brain metastasis, and another with Nocardia brain abscess....

 Open Access DOI:10.23937/2378-3656/1410202

Necrotizing Neck Mass in a Young Female

Pradeep Kumar Mada, Gabriel Castano and Andrew Stevenson Joel Chandranesan

Article Type: Case Report | First Published: February 14, 2018

Mycobacterium tuberculosis is one of the most common diseases in the world, with a prevalence of approximately one-third of the global population and nine million new cases per year globally. In the USA, it is more common in immune suppressed conditions such as HIV or if there is a significant history of travel to tuberculosis-endemic regions. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Mycobacterial cervical lymphadenitis, also known as scrofula refers...

 Open Access DOI:10.23937/2378-3656/1410201

Adsorption Isotherms and Kinetics of Multi-Walled Carbon Nanotubes (MWCNTs), Boron Nitride Nanotubes (BNNTs), Amorphous Boron Nitride Nanotubes (a-BNNTs) and Hexagonal Boron Nitride Nanotubes (h-BNNTs) for Eliminating Carcinoma, Sarcoma, Lymphoma, Leukemia, Germ Cell Tumor and Blastoma Cancer Cells and Tissues

Alireza Heidari

Article Type: Research Article | First Published: January 31, 2018

Hydron, Transhumanism, H (S-train), Humanity+ (Humanity Plus), electron hole and Evolved High Speed Packet Access (or HSPA+ or HSPA (Plus) or HSPAP) from environment into human blood causes human blood cancer cells and tissues. Diagnosis and treatment of such human blood cancer before it is discharged into the human blood is essential. The present study investigated Hydron, Transhumanism, H (S-train), Humanity+ (Humanity Plus), electron hole and Evolved High Speed Packet Access (or HSPA+ or HSPA...

 Open Access DOI:10.23937/2378-3656/1410200

Scalp Arteriovenous Fistula following Hair Transplantation: A Case Report and Review of the Literature

Jason I Liounakos, Timur Urakov, Brian Snelling and Eric C Peterson

Article Type: Case Report | First Published: January 24, 2018

Scalp arteriovenous fistulae, as a result of hair transplantation, are exceedingly rare, with the current literature largely limited to few single case reports. Open surgical and endovascular treatments have been described with good results. We describe a case of scalp arteriovenous fistula following hair transplantation that was successfully treated by direct puncture embolization with n-butyl cyanoacrylate glue....

 Open Access DOI:10.23937/2378-3656/1410199

Disseminated Intravascular Coagulation due to Amniotic Fluid Embolism in an Early Molar Pregnancy

Veronika A Levin, John Villeneuve and Xuezhi Jiang

Article Type: Case Report | First Published: January 17, 2018

Disseminated intravascular coagulation (DIC) is a disruption of hemostasis and imbalance between thrombosis and thrombolysis. DIC can result in life-threatening bleeding, clot formation, and multi-system end organ damage. Although the prevalence of DIC in pregnancy is low, ranging from 0.03-0.35%, the prevalence increases in pregnancies complicated by comorbidities such as placental abruption, postpartum hemorrhage, pre-eclampsia, hemolysis elevated liver enzymes and low platelets (HELLP syndrom...

 Open Access DOI:10.23937/2378-3656/1410198

Vesicular Monoamine Transporter Type 2 (VMAT2) Inhibitors in the Management of Tardive Dyskinesia

Lillian L Smith Mosley, Juan F Mosley II, Jessica R Fleischfresser and Tiffani Reed

Article Type: Review Article | First Published: December 30, 2017

Neuroleptic medications are prescribed for the management of mental, gastrointestinal, and neurological disorders. These disorders occur via over-excitation of dopamine in the brain. When neuroleptics are used, dopamine receptors are blocked reducing the excitation. Thus, the disorder becomes controlled. The long-term use of neuroleptics can result in a misfire of the neurons of the brain causing tardive dyskinesia (TD), an irreversible chronic condition of spontaneous movements....

 Open Access DOI:10.23937/2378-3656/1410197

Diagnostic Dilemma of a Mature Parapharyngeal Teratoma in an Infant

Maria Cui Ying Pang and Tan Kun Kiaang

Article Type: Case Report | First Published: December 23, 2017

Cervical and parapharyngeal teratomas are rare but possible causes for respiratory distress in neonates. They can also present as cystic masses in the neck and can be clinically indistinguishable from lymphatic malformations. Physicians must be cognizant of teratoma as an alternate diagnosis when faced with a cystic neck lesion that responds poorly to injection sclerotherapy. We present a case of a parapharyngeal teratoma which was initially diagnosed and treated as a lymphatic malformation....

 Open Access DOI:10.23937/2378-3656/1410196

Management of Congenital Afibrinogenemia: Report of Two Cases

I Alharbi, A Algethami and T Almteri

Article Type: Case Report | First Published: December 22, 2017

Fibrinogen (Factor I) is an essential factor in the coagulation cascade. The activation of prothrombin to thrombin by Factor X is followed by the activation of fibrinogen. In turn, thrombin converts fibrinogen to fibrin, which is the end target of both extrinsic and intrinsic pathways. A deficiency in fibrinogen results in the tendency to bleed....

 Open Access DOI:10.23937/2378-3656/1410195

Methemoglobinemia after Local Anesthesia with Prilocaine in a Newborn after Aortic Coarctation Repair: A Case Report

Dilek Altun, Adnan Yüksek, Ahmet Arnaz, Yusuf Kenan Yalçınbaş and Tayyar Sarıoğlu

Article Type: Case Report | First Published: November 17, 2017

Prilocaine, widely used local anesthetic, can cause methemoglobinemia in pediatric patients even in therapeutic doses. Although complications related to local anesthesia are rare, it may occur especially in pediatric population when used in large doses exceeding the safe limits. Local anesthetic agent oxidizes hemoglobin and may cause methemoglobinemia....

 Open Access DOI:10.23937/2378-3656/1410194

Tetanus after Application of Traditional Topical on Severe Burn

Irie bi GS, Asse KV, Pete Y, Kadiane NJ, Nda-koffi C, Ogondon B, Kouadio S, Kouame KE, Boua N and Yapo Brouh

Article Type: Case Report | First Published: November 16, 2017

The possibility of the occurrence of tetanus after application of a traditional topical for the treatment of a severe burn is a reality in tropical environment. This is true for this case....

 Open Access DOI:10.23937/2378-3656/1410193

Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Daniel G Eichberg, Timur Urakov and Steven Vanni

Article Type: Case Report | First Published: November 16, 2017

To provide an overview of head, neck, and spine Desmoid Tumor (DT), to describe the case of a patient who underwent aggressive surgical resection of a large invasive cervical DT, and to analyze the DT literature. We discuss the importance of aggressive surgical margins in decreasing recurrence risk in head, neck, and spine DTs....

 Open Access DOI:10.23937/2378-3656/1410192

Panhypopituitarism in a Case of Newly Diagnosed Lung Cancer with a Concurrent Pituitary Mass

Jo Y, Zalikha A, Watford D, Khramov I and Williams M

Article Type: Case Report | First Published: October 30, 2017

A 65-year-old homeless African American man with a past medical history significant for hypertension, Chronic Obstructive Pulmonary Disease (COPD), diabetes mellitus type II, multiple substance abuse disorder, major depression, and successful treatment of tuberculosis presented to the Miami VA emergency department with depressed mood, fatigue, and suicidal ideation....

 Open Access DOI:10.23937/2378-3656/1410191

First Report of Geniospasm in a Five-Generation Brazilian Family: Clinical Features, Electromyography Findings and Botulinum Toxin Treatment

Carvalho LB, Rampim DB and Chung TM

Article Type: Case Report | First Published: October 28, 2017

Geniospasm is a rare movement disorder characterized by spontaneous, involuntary, irregular trembling of the chin and the lower lip with accompanying involuntary contractions of the mentalis muscle. It is thought to be an autosomal-dominant inherited condition with high penetrance, which typically manifests in early life and is triggered....

 Open Access DOI:10.23937/2378-3656/1410190

Hypnosis and Transversus Abdominis Plane Block for Brugada Syndrome Anesthesia: A Case Report

Pauline dos Santos, Loic Cailleau, Yveline Coscoy, Antoine Strzelecki, Benjamin Le Gaillard, Christophe Pelletier, Mireille Houadec, Celine Guerrini and Edmundo Pereira de Souza Neto

Article Type: Case Report | First Published: October 27, 2017

Brugada syndrome is a distinct form of an arrhythmic disease affecting ionic channels of the heart. We report the anesthetic management of a patient with Brugada syndrome for inguinal hernia repair which was managed satisfactorily with combined light anesthesia, hypnosis with indirect suggestions and transversus abdominis plane block....

 Open Access DOI:10.23937/2378-3656/1410189

Brief Comment on the Challenge and Opportunities for Effective Containment of the Type 2 Diabetes Mellitus Epidemic that Affects the World Population

Maria Eugenia Velasco-Contreras

Article Type: Commentary | First Published: October 25, 2017

It is a chronic disease associated with multiple health problems: Cardio-cerebrovascular, cancer, behavioral disorders, depression or anxiety, localized or generalized neuropathy problems due to irritation or destruction of the myelin layer, non-traumatic lower limb amputation, blindness, terminal renal damage, the leading cause of death in many countries....

 Open Access DOI:10.23937/2378-3656/1410188

T-Cell Large Granular Lymphocyte Leukemia Diagnosis in a Patient with Felty Syndrome

Nathan Catolino, Michel de Oliveira, Igor Age Kos, Maicon Piana Lopes and Valderilio Azevendo

Article Type: Case Report | First Published: October 05, 2017

T-Cell Large Granular Lymphocyte Leukemia (T-LGL Leukemia) is a lymphoproliferative disease that usually presents with an indolent behavior, even though in some cases it is complicated by cytopenias and recurrent infections. Felty Syndrome (FS) is a subtype of Rheumatoid Arthritis (RA) characterized by the association of RA, neutropenia and splenomegaly....

 Open Access DOI:10.23937/2378-3656/1410187

The Role of Fat Soluble Vitamins in Clinical Lipidology

Lauren Williams, Catherine McNeal and Don P Wilson

Article Type: Case Report | First Published: September 29, 2017

Fat Soluble Vitamins (FSV) is essential for the normal growth and development of children. Many genetic and acquired conditions have the potential of interfering with FSV absorption and transport. Understanding the physiology of these conditions is imperative in providing effective treatment, including prevention of FSV deficiency....

 Open Access DOI:10.23937/2378-3656/1410186

Claudication: A Teachable Moment or Missed Opportunity!

Ayad Jindeel

Article Type: Case Report | First Published: September 23, 2017

Claudication is a common manifestation of Peripheral Arterial Disease (PAD) and atherosclerosis. Patients with claudication are at increased risk of cardiovascular events and limb-related complications. Optimal medical therapy is effective in relieving patient's symptoms and reducing their risk of cardiovascular events....

 Open Access DOI:10.23937/2378-3656/1410185

An Asymptomatic Case of Hamartoma Located in the Trachea

Fatih Üzer, Levent Dertsiz and Aykut Çilli

Article Type: Case Report | First Published: September 11, 2017

Primary tumors of trachea are usually malignant (90%). Hamartomas are the most frequently seen benign lung tumors. Hamartomas are usually located peripherally but they can be present as endobronchial localization in 8-10% of cases....

 Open Access DOI:10.23937/2378-3656/1410184

A Case of Refractory Dysphagia in the Context of Polymyositis Treated with Subcutaneous Immunoglobulin and Review of the Literature

Vacchi C, Sebastiani M, Manfredi A and Ferri C

Article Type: CASE REPORT | First Published: September 04, 2017

Polymyositis (PM) is a systemic inflammatory disease affecting muscles and several other organs, including gastrointestinal system, in which the main symptom is dysphagia....

 Open Access DOI:10.23937/2378-3656/1410183

The Unpredictably Deadly Twist: A Case of Acute Mesenteric Ischaemia after Successful Gastrectomy

Salvatore Marchese, Yassar Ahmed Qureshi and Ashish Rohatgi

Article Type: Case Report | First Published: August 31, 2017

A 73-year-old woman underwent total gastrectomy for cancer. Postoperative course was uneventful until day five when she felt unwell, showing distended and tender abdomen. Developed acute kidney injury and metabolic acidosis with a lactate level of 13.5 mmol/L....

 Open Access DOI:10.23937/2378-3656/1410182

Brown Adipose Tissue and Disease: New Insights from Historical Data

Peter Aldiss, Patricia Burton, Shalini Ojha, Helen Budge and Michael E Symonds

Article Type: Research Article | First Published: August 26, 2017

At birth Perirenal Adipose Tissue (PrAT) exhibits a brown-like phenotype and then becomes phenotypically white with ageing and obesity, potentially contributing to the onset of chronic disease. Little is known about the composition of PrAT in the later years of life and whether it is modulated by different types of disease....

 Open Access DOI:10.23937/2378-3656/1410181

Accidental Ingestion of a Dental Bridge

Salvatore Marchese, Rosario Vecchio and Eva Intagliata

Article Type: Clinical Image | First Published: August 26, 2017

A 44-year-old female presented at the accident and emergency service for having swallowed a dental bridge few hours before during dinner. At the time of the visit, she was completely asymptomatic and no abdominal discomfort was reported. She had no background of mental disorder or misuse of alcohol or other drugs....

 Open Access DOI:10.23937/2378-3656/1410180

Cervical Subcutaneous Emphysema, Pneumomediastinum, Pneumoperitoneum and Pneumoretroperitoneum after Therapeutic Colonoscopy without Obvious Colon Perforation - A Case Report

Emese Ivany, Mark Philip Marcus and Tamas Molnar

Article Type: Case Report | First Published: August 23, 2017

We present a case of a 68-year-old man who underwent control colonoscopy 10 years after sigmoid resection due to a previous adenocarcinoma. An ascending colon polypectomy was performed by endoscopic mucosa resection and a sessile polyp was resected from the sigmoid colon....

 Open Access DOI:10.23937/2378-3656/1410179

Endovascular Treatment of Blunt Traumatic Injury to the Brachial Artery: Case Report and Review of the Literature

RR Smeets, A Ryckx, AG Krasznai, CJJM Sikkink and LH Bouwman

Article Type: Case Report | First Published: August 21, 2017

Blunt traumatic injury to the subclavian, axillary or brachial artery is uncommon and could have devastating consequences. Historically open repair is performed however reports of successful endovascular treatments are increasing. A case is described of a seventy one-year-old patient with a blunt injury to his right arm after being crushed in a closing hydraulic door of a truck....

 Open Access DOI:10.23937/2378-3656/1410178

Burkitt's Lymphoma Presenting as Endobronchial Lesion

Fatih Uzer, Levent Dertsiz and Aykut Cilli

Article Type: Case Report | First Published: July 29, 2017

Primary endobronchial tumor is seen rarely in young adults. Benign neoplasms such as hamartoma, hemangioma, papilloma, leiomyoma are seen more often whereas maling conditions are infrequent. Lymphoma is quite rare in children. ...

 Open Access DOI:10.23937/2378-3656/1410177

Severe ANCA Associated Vasculitis in the Setting of Cocaine Abuse: A Case Report

Ana Ramirez Berlioz, Orlando Garner, Eliana Wiesner, Alfredo Iardino Scarano and Kalpana Bhairavarasu

Article Type: Case Report | First Published: July 27, 2017

A 41-year-old Hispanic female with known medical history significant for bronchial asthma presents to the Emergency Department (ED) in February 2010, complaining of a 3-week long history of an erythematous tender rash with irregular margins on the tip of her nose, upper and lower extremities (Figure 1) accompanied by bilateral elbow, knee and ankle pain. ...

 Open Access DOI:10.23937/2378-3656/1410176

Evaluation of the Functional and Clinical Outcome of Intramedullary Osteosynthesis with Gamma Nail in Treatment of Unstable Peritrochanteric Fractures

Hatim Mohammed A ALShareef, Hossam Mohammed Aref, Ahmed H AlHasan, Amer Mohammed A ALShreef and Mohammed Abdul Wahab Al Juhani1

Article Type: Review Article | First Published: July 24, 2017

Peritrochanteric fractures of the femur rank among the most severe fractures in elderly people. The Gamma Nail is one of the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures....

 Open Access DOI:10.23937/2378-3656/1410175

Gaisbock's Syndrome: A Case Study

J Kelly Smith

Article Type: Case Study | First Published: July 24, 2017

A 57-year-old hypertensive, obese woman presented with several weeks of a febrile flu-like illness, facial and extremity flushing, and laboratory findings of polycythemia. A workup revealed no evidence of polycythemia rubra vera or a secondary cause of her polycythemia (her erythropoietin level was normal, she had no splenomegaly, and a test for JAK2 v617F mutation was negative)....

 Open Access DOI:10.23937/2378-3656/1410174

Progression from Acute Psychosis to Seizures and Autonomic Instability in an Adolescent with Ovarian Mass

Andy Y Wen Jason Ziplow, Benjamin Wadowski and Tanya Chadha

Article Type: Case Study | First Published: June 30, 2017

Anti-N-Methyl-D-Aspartate Receptor Encephalitis (NMDARE) is a complex clinical entity that is both diagnostically and therapeutically challenging. A 17-year-old girl presented to the emergency room with worsening anxiety, confusion, and acute psychosis. While in an inpatient psychiatric unit, she developed progressive catatonia with decreased responsiveness. ...

 Open Access DOI:10.23937/2378-3656/1410173

Radicular Cysts in Primary Dentition with Different Clinical and Radiographic Characteristics

Fernanda Mafei Felix da Silva, Andrea Laudares Marques, Thais Rodrigues Campos Soares, Carla Martins and Gloria Fernanda Castro

Article Type: Case Study | First Published: June 30, 2017

Radicular cysts are considered rare in primary dentition. The aim of this article was to present two cases of radicular cysts associated to primary molars with different characteristics. Two children sought care at a dental clinic with complaints of a painless swelling and the absence of a premolar, respectively....

 Open Access DOI:10.23937/2378-3656/1410172

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

Cassone G, Citriniti G, Sebastiani M, Manfredi A, Cesinaro AM and Ferri C

Article Type: Case Report | First Published: June 30, 2017

Tumor Necrosis Factor (TNF)-α blockers have been shown to be highly effective in the treatment of arthritis not responsive to traditional therapy. In parallel, there are an increasing number of reports about the development of cutaneous side effects after the administration of anti-TNF-α agents....

 Open Access DOI:10.23937/2378-3656/1410171

Reactive Arthritis Due to Subcutaneous Abscess: A Possible Correlation?

Viviane de Carvalho, Jessica Ferreira Saldanha, Jozyel Castro Claudio and Guilherme Augusto Pivoto Joao

Article Type: Case Report | First Published: June 27, 2017

Reactive arthritis is the specific entity of aseptic inflammatory arthritis and follows the previous infection in other parts of the body. The association of soft tissue infections with this disease is rare. A 63-year-old male patient after blunt trauma to the left knee progressively evolved with inflammatory signals and loss of joint function, followed by additive polyarthritis of large joints....

 Open Access DOI:10.23937/2378-3656/1410170

A 54-Year-Old Woman with a Myeloid Neoplasm Associated with Eosinophilia and t(5;12)(q33;p13)/PDFRFB Rearrangement: Case Report and Mini-review of the Literature

Delefortrie Quentin, Lambert Frederic, Bulliard Genevieve, Jurdan Maryvonne, Toffoli Sebastien, Sartenaer Daniel, Theate Ivan, de Prophetis Stephanie, Pranger Delphine, Konreich Anne and Mineur Philippe

Article Type: Case Report and Mini Review | First Published: May 31, 2017

The upper limit of normal range of eosinophils in the peripheral blood is an absolute eosinophil count of 350-500/mm3. Hypereosinophilia can further be classified as mild, moderate or severe according to absolute eosinophils counts (up to 1500/mm3, 1500-5000/mm3 and superior to 5000/mm3 respectively)....

 Open Access DOI:10.23937/2378-3656/1410169

Shaft Rupture of Ultra-High Pressure Balloons

Raoul Stahrenberg, Wolfgang Schillinger and Claudius Jacobshagen

Article Type: Case Report | First Published: May 31, 2017

The first patient, a 65-year-old male, presented to our emergency department with unstable angina without troponin elevation for the first time in January 2015. A calcified culprit lesion in the Right Coronary Artery (RCA) was managed by stenting....

 Open Access DOI:10.23937/2378-3656/1410168

A Case of Mumps Orchitis without Parotitis in a Vaccinated Post Pubertal Male

Ahmed Elantably and Vinit V Oommen

Article Type: Case Report | First Published: May 29, 2017

Mumps is a viral infection of the salivary glands that commonly present as unilateral or bilateral parotitis usually during childhood. Serious complications of mumps include meningitis/encephalitis, as well as orchitis in adolescent boys and adult men. We report a case of a 29-year-old male patient with mumps associated bilateral epididymo-orchitis without signs of parotitis....

 Open Access DOI:10.23937/2378-3656/1410167

Secondary Adrenocortical Insufficiency as a Result of Chronic Fentanyl Treatment: A Case Report

Eduardo Esteban-Zubero, Isabel Torres-Courchoud, Alvaro Flamarique-Pascual, Moises Alejandro Alatorre-Jimenez, Sara Anabel Alonso-Barragan and Fernando Jose Ruiz-Laglesia

Article Type: Case Report | First Published: May 29, 2017

Hypothalamus-Pituitary-Adrenal (HPA) may be disturbed by drugs, including opioids. In fact, opioids are a well-recognized cause of hypogonadotropic hypogonadism due to its effects in the hypothalamic-pituitary-gonads axis. Nevertheless, these results are not observed in all the studies and there are numerous contradictions in the literature....

 Open Access DOI:10.23937/2378-3656/1410166

Infectious Diseases Mimicking Ovarian Carcinomatosis

Sara M Drayer and Jessica J Shank

Article Type: Case Series | First Published: April 28, 2017

Two Filopina women presented with abdominal distension and had evaluations suggestive of advanced gynecologic malignancy. The first patient underwent surgery and was found to have peritoneal tuberculosis. Intra-operative pathology from the second case revealed ovarian carcinoma with schistosomal granulomas of the intestines....

 Open Access DOI:10.23937/2378-3656/1410165

Successful Resolution of Uremic Tumoral Calcinosis with Conventional Hemodialysis Using a Low-Calcium Containing Dialysate

Saul Pampa-Saico, Maite Rivera-Gorrin, Estefania Yerovi-Leon, Victor Burguera, Milagros Fernandez-Lucas and Jose L Teruel-Briones

Article Type: Case Series | First Published: April 26, 2017

A 40-year-old Caucasian man with end-stage renal disease (ERSD) due unknown cause had been on continuous ambulatory peritoneal dialysis (CAPD) since 2009 with 3.5 meq/l calcium dialysate....

 Open Access DOI:10.23937/2378-3656/1410164

Anti-HMGCR Necrotizing Autoimmune Myopathy Leading to Identification of Cancer Relapse

Oceane Landon-Cardinal , Yves Allenbach and Olivier Benveniste

Article Type: Case Series | First Published: April 22, 2017

In 2004, a 57-years-old female received rosuvastatin for secondary prevention of stroke. In 2010, an asymptomatic CK elevation around 900 IU/L is noticed on a routine workup and persisted despite statin discontinuation. A rise in CK level is progressively observed (up to 2,400 IU/L) and the patient referred in Neurology for consultation in March 2011....

 Open Access DOI:10.23937/2378-3656/1410163

Continuous Bilateral Brachial Plexus Blockade for Acute Pain Control in Patients with Bilateral Upper Extremity Traumatic Injuries: A Review of Five Cases

Sudipta Sen, Michael E Franklin, Veerandra Babu Koyyalamudi, Elyse M Cornett and Charles J Fox

Article Type: Case Series | First Published: April 20, 2017

In this study we discuss five case scenarios where we felt bilateral brachial plexus blocks were appropriate and, if performed with caution, the benefits would outweigh the risks. Each of these patients suffered severe bilateral upper-extremity traumatic injuries, requiring multiple surgical procedures and debridement's while inpatient on the trauma service....

 Open Access DOI:10.23937/2378-3656/1410162

Blue Fingernails during Treatment with Cyclophosphamide for Minimal Change Disease: A Very Rare Side Effect

Rollino Cristiana, Giulietta Beltrame, Roberta Fenoglio, Michela Ferro, Paola Mesiano, Giacomo Quattrocchio and Dario Roccatello

Article Type: Case Report | First Published: March 30, 2017

We present the case of a 52-year-old lady affected with cortico dependent minimal change disease who developed a blue pigmentation of her fingernails during a 3-months treatment with cyclophosphamide for cortico dependent minimal change disease. The typical manifestation of onset of Minimal Change Disease (MCD) is a pure nephrotic syndrome....

 Open Access DOI:10.23937/2378-3656/1410161

Extubation Airway Emergency after Spinal Fusion Using Bone Morphogenetic Protein

Bradley J Scherer, Brian D Benneyworth, Mara E Nitu and Brian D Lelan

Article Type: Case Report | First Published: March 30, 2017

An 11-year-old female who was admitted to the pediatric intensive care unit (PICU) intubated and mechanically ventilated with severe traumatic brain injury and occipito-cervical dislocation following a high speed motor vehicle collision, underwent both posterior arthrodesis from occiput to C3 and open reduction of cranio-cervical dislocation on hospital day 7....

 Open Access DOI:10.23937/2378-3656/1410160

Two Cases of Pseudomalabsorption Treated Successfully with Parenteral Levothyroxine

Seher Cetinkaya Altuntas, Mehtap Evran, Murat Sert and Tamer Tetiker

Article Type: Case Report | First Published: March 29, 2017

Hypothyroidism is a frequently seen endocrine disorder which may be managed by levothyroxine (LT4) replacement in most of the patients. Some patients with hypothyroidism do not respond and are refractory to oral LT4 therapy. The most encountered causes of unresponsiveness to oral LT4 replacement comprise non-compliance with therapy and malabsorption....

 Open Access DOI:10.23937/2378-3656/1410159

Anesthetic Management of Traumatic Brain Injury

Hashim Qureshi, Hussain Mithaiwala, Jacob Ezell and Marco Maurtua

Article Type: Original Review | First Published: March 27, 2017

Worldwide, Traumatic Brain Injury (TBI) is a leading cause of morbidity and mortality. It is the third most common cause of injury related death with direct and indirect costs totaling an estimated 60 billion dollars annually in the United States. Management of a TBI patient is guided by recommendations made by the Brain Trauma Foundation (BTF)....

 Open Access DOI:10.23937/2378-3656/1410158

Mobility Scooter Accidents - Need for Preventative Action?

Emilie S Baekgaard, Lars Christensen, Roar B Medici and Hans-Henrik Bulow

Article Type: Short Review | First Published: February 28, 2017

Mobility scooters are three- or four-wheeled vehicles, powered by an electric engine. Often acquired by the elderly population, they neither require a drivers' license, nor an assessment of operator skills prior to use. Other vehicles used primarily by older people are powered wheelchairs and electric bicycles. ...

 Open Access DOI:10.23937/2378-3656/1410157

Acute Liver Failure Secondary to AL Amyloidosis

Brian J Horner, Ryan Craig, Estelle S Harris, Tibor Kovacsovics and Juan F Gallegos-Orozco

Article Type: Case Report | First Published: February 28, 2017

AL amyloidosis, the most common form of amyloidosis, involves the extracellular deposition of immunoglobulin light chain protein fibrils, usually in the setting of a plasma cell dyscrasia. Amyloid deposition can occur in any organ system, including the gastrointestinal tract and liver....

 Open Access DOI:10.23937/2378-3656/1410156

Ocular, Nasal and Aural Myiasis in an Intoxicated Patient: A Case Report

Giorgio Berlot and Cristina Calderan

Article Type: Case Report | First Published: February 25, 2017

The authors describe a case of myiasis occurred in a self-intoxicated patient lying outdoor in a reduced state of consciousness for more than two days. The causes and the favoring circumstances of the infestation are described and discussed. The word Myiasis indicates the infestation of alive vertebrates, including humans, by larvae of different species of Diptera....

 Open Access DOI:10.23937/2378-3656/1410155

A Missed Diagnosis

Avinash Aujayeb

Article Type: Case Report | First Published: February 14, 2017

Her past medical history included squamous cell carcinoma of lung origin T2BN0M0 treated in 2012 with a right lower lobectomy via video assisted thoracoscopy with a wound infection preventing adjuvant chemotherapy. She then developed local chest wall recurrence in 2014 which was resected. In June 2016, there was further recurrence on the chest wall, which was confirmed on PET scan. She had received one cycle of chemotherapy and presented as above....

 Open Access DOI:10.23937/2378-3656/1410154

A Dangerous Triad: Sertraline, Mirtazapine and Methadone

Juan F Martin-Lazaro, Justin Hayde-West, Stelios Chatzimichael and Simon Kirwin

Article Type: Case Report | First Published: January 31, 2017

Serotonin syndrome is a potentially life-threatening complication of using serotonergic agents. Mirtazapine is a relatively safe antidepressant and has a comparatively low incidence of side effects but can induce serotonin syndrome in combination with other serotonergic agents such as methadone and sertraline. We describe a 41-year-old man with a history of heroin misuse and depression....

 Open Access DOI:10.23937/2378-3656/1410153

Misdiagnosis of Neurobehavoral Disorders Associated with Fetal Alcohol Exposure in Adults

Carl C Bell and Rochelle Gaudet

Article Type: Case Report | First Published: January 31, 2017

his case report addresses the misdiagnosis of Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) in adults. The American Psychiatric Association's (APA's) Diagnostic and Statistical Manual - Fifth Edition (DSM-5) has proposed Fetal Alcohol Spectrum Disorders (FASD) be designated as ND-PAE. ND-PAE is prevalent in some contexts and populations, and is the cause of significant morbidity and mortality....

 Open Access DOI:10.23937/2378-3656/1410152

Cement Powder Ingestion: Case Report and Review of the Literature

Kim Lewis, Christopher Sheasgreen and Waleed Alhazzani

Article Type: Case Report | First Published: January 30, 2017

Alkaline material ingestions can cause a wide variety of injuries, ranging from mild to fatal. Cement is an alkaline agent and can lead to abrasions, allergic dermatitis, and chemical burns. There are very few case reports of cement ingestion in the literature. The gold standard for assessing the extent of injury after cement ingestionis via an esophagogastroduodenoscopy (EGD) within 12-24h....

 Open Access DOI:10.23937/2378-3656/1410151

Significance of Antiphospholipid Antibodies in Essential Cryoglobulinemia: A Case Report and Review of Literature

Rama Atluri and Mian Muhammad Rizwan

Article Type: Case Report | First Published: January 13, 2017

Cryoglobulinemia is a rare immune-complex-mediated small vessel vasculitis that has a smoldering clinical course and can potentially involve multiple organ systems. The discovery of its relationship with hepatitis C infection shows the striking association between a viral infection, an autoimmune disease and lymphoproliferative disorders....

 Open Access DOI:10.23937/2378-3656/1410150

Dapagliflozin- Induced Severe Ketoacidosis Requiring Hemodialysis

Ossama Maadarani, Zouheir Bitar and Rashed Alhamdan

Article Type: Case Report | First Published: December 26, 2016

The availability of novel classes of medication for the treatment of type 2 Diabetes mellitus (type 2 DM) provides doctors with options to choose individualized treatments based on patient and agent characteristics beyond metformin therapy, as per current guidelines. Independent of impaired beta-cell function and insulin resistance, sodium glucose cotransporter type 2 (SGLT2) inhibitors represent a different treatment strategy for reducing plasma glucose levels and glycosylated hemoglobin concen...

 Open Access DOI:10.23937/2378-3656/1410149

Isolated Limb Infusion in a Pregnant Patient with Sarcoma of the Upper Extremity: A Case Report with Literature Review

Milovanov V, Wodago FM, Sittig M and Gushchin V

Article Type: Case Report | First Published: December 19, 2016

Several scientific publications have shown Isolated Limb Infusion (ILI) as a promising treatment option for patients with soft tissue sarcomas. This minimally invasive technique has a high complete response rate (42-90%) and could serve as a neo-adjuvant treatment for limb sparing sarcoma surgical treatment to increase the likelihood of R0 resection. ILI technique has low levels of systemic leak (< 1%) and systemic toxicity rate, which makes this treatment potentially relevant in pregnant patien...

 Open Access DOI:10.23937/2378-3656/1410148

An İncidental Findings of Polysplenia Syndrome in an Adult Patient with Multiple Anomalies

Mehmet Sedat Durmaz, Ali Cengiz, Serdar Arslan, Hasan Erdogan, Ismet Tolu and Arzu Cengiz

Article Type: Case Report | First Published: December 16, 2016

Polysplenia syndrome is a rare congenital subtype of heterotaxy syndrome associated with various visceral and vasculer anomalies. Polysplenia syndrome is characterized by presence of two or more spleens and anomalies of other asymetric organs. It is reported incidence of 1 per 250.000 and more common in females. Here, we report the case of a 53-year-old woman who presented with polysplenia syndrome....

 Open Access DOI:10.23937/2378-3656/1410147

The Use of Macitentan in the Treatment of Out-of-Proportion Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease: Case Report

Luca Fallavollita, Paolo Spinaci and Pietro Scendoni

Article Type: Case Report | First Published: December 14, 2016

Pulmonary hypertension (PH) is an important complication of chronic pulmonary disease, especially of chronic obstructive lung disease (COPD). The exact prevalence of PH in COPD is unknown. PH is defined as an increase in mean pulmonary arterial pressure (PAPm) > 25 mmHg at rest as assessed by right heart catheterization. In most cases, PH in COPD patients is usually mild to moderate. Only a small proportion of this cohort may present with severe pulmonary hypertension....

 Open Access DOI:10.23937/2378-3656/1410146

A Case of Pyonephrosis of an Obstructed Atrophic Kidney

Fareeha Khan, Rasha Nakhleh and Theodore Suh

Article Type: Case Report | First Published: December 12, 2016

This case is of a 67-year-old male who presented to the office with multiple symptoms and was treated for a variety of infections before the correct diagnosis of pyonephrosis in the setting of chronic ureteropelvic junction (UPJ) obstruction was made....

 Open Access DOI:10.23937/2378-3656/1410145

Outcome of Some of the Many Aedes Albopictus (Skuse, 1895) Mosquito Encounters with Man

Daniel Benharroch and Yane-Bianca Benharroch

Article Type: Review Article | First Published: December 03, 2016

Aedes albopictus, the Asian tiger mosquito, has lately become prominent, globally, while showing a marked "migratory" capacity. We have scrutinized the many consequences of the encounters between the Asian tiger mosquito and humans, and have chosen to review several of them. It seems inevitable that this mosquito be more and more present in our lives. It is a tremendous nuisance to man through its bite. However, several arboviral infections are the main consequences of these confrontations, enco...

 Open Access DOI:10.23937/2378-3656/1410144

Adult Rasmussen's Encephalitis

Campanille Veronica, De Aguirre Ines, Crespo Jose, Gonzalez Macarena, Lopez Juan Ignacio, Lucero Carolina, Perez Garcia Jorgelina and Knorre Eduardo

Article Type: Case Report | First Published: December 01, 2016

Rasmussen's Encephalitis (RE) is defined by the presence of partial seizures associated to focal progressive cortical atrophy and in advanced stages hemiparesis, hemianopia and cognitive impairment, though it may appear focal neurological deficits at onset; and it's more prevalent in childhood. Approximately, 10% presents at adulthood. Because of its immunologic physiopathology, RE is considered autoimmune epilepsy. Treatment is focused on antiepileptic drugs (AEDs), steroids, intravenous immuno...

 Open Access DOI:10.23937/2378-3656/1410143

Acute Disseminated Encephalomyelitis (ADEM) Secondary to Neurosyphilis

Ryan Kahn, Christopher Dermarkarian, Elizabeth Crocco, Gabrielle Yeaney and Marcia Williams

Article Type: Review Article | First Published: November 25, 2016

Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune demyelinating disease of the central nervous system. For our case presentation, a 52-year-old Hispanic male presented with altered mental status and focal neurological defects. MRI showed multiple lesions scattered throughout the brain. VDRL and FTA-ABS was positive in the CSF. Brain biopsy demonstrated foamy macrophages, loss of myelin, and perivascular T cells. The diagnosis was acute disseminated encephalomyelitis secondary to n...

 Open Access DOI:10.23937/2378-3656/1410142

Neonatal Polycythemia: A Review

S Umit Sarici, Murat Ozcan and Demet Altun

Article Type: Review Article | First Published: November 23, 2016

Polycythemia in the newborn is defined as either venous hematocrit or hemoglobin levels above 65% and 22 g/dl, respectively. Its incidence is reported between 1 to 5%. In this article definition and epidemiology of polycythemia, physiological changes in postnatal hematocrit levels, relationship between polycythemia and hyperviscosity, pathophysiology and diagnosis of polycythemia, etiology, clinical signs and complications of polycythemia with a special emphasis on treatment algorithms and long-...

 Open Access DOI:10.23937/2378-3656/1410141

Thyroid Metastasis from Colorectal Cancer: A Case Report and Review of Literature

Mennet A, De Blasi V, Simone G, Mormont M and Morel P

Article Type: Case Report | First Published: November 21, 2016

A 68-year-old man with sigmoid carcinoma was initially treated by surgical resection and adjuvant chemotherapy. Two years later, he was admitted to the hospital for recurrence of his disease with iliac parietal nodules and nodules in the recto-vesical pouch. Follow-up imaging with 18-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography (18-FDG PET) showed a focal increased uptake in the left side of the neck at the level of the thyroid gland and the absence of lung or liver metastases....

 Open Access DOI:10.23937/2378-3656/1410140

An Ileal Perforation Associated with Extended Spectrum β-Lactamases-Producing Escherichia Coli: Medical Case Report

Michael Owusu, Augustina Annan, Nimako Sarpong, Ellis Owusu-Dabo, Yaw Adu-Sarkodie, Kwadwo Sarfo Marfo, Isaac Osei and Kofi Tawiah Mensah

Article Type: Case Report | First Published: November 16, 2016

Intestinal perforation is one of the leading fatal causes of death among individuals mostly in developing countries. Although many reports have associated perforations with typhoid infections, reports on the role of other bacterial pathogens especially resistant strains in causing ileal perforations are limited. We report a rare case of ileal perforation associated with extended-spectrum beta-lactamase (ESBL) - producing Escherichia coli (E. coli) in Ghana....

 Open Access DOI:10.23937/2378-3656/1410139

Transcatheter Closure Combined with Antibiotic Therapies for Patients with Infective Endocarditis and Congenital Heart Disease

Boli Ran, Minfeng Li, Yeqing Li, Yang Lin, Weimin Liu, Qiulin Luo, Yongxin Fu, Qianmei Tang, Ya Yang and Yunfei Pu

Article Type: Case Report | First Published: November 12, 2016

The experience of transcatheter closure combined with antibiotic therapies at our cardiovascular center was retrospectively analyzed in 5 cases of infective endocarditis with congenital heart disease. Transcatheter closure was performed at least 7 to 10 days after the patient's body temperature had recovered normal following effective antibiotic therapies, and after cardiac vegetations were not detected by echocardiography....

 Open Access DOI:10.23937/2378-3656/1410138

Percutaneous Coronary Intervention for Single Coronary Artery: Two Case Studies

Yang Zhuo, Yu-qi Fan, Zhao-fang Yin, Li Fan, Zhi-hua Han, Chang-qian Wang and Zuo-jun Xu

Article Type: Case Series | First Published: November 09, 2016

Single coronary artery (SCA), a congenital and rare anomaly, is defined as a coronary artery arising from the sinus of valsalva and supplying the entire heart. According to modified Lipton's classification criteria, L-1 subtype is the rarest type of SCA. Here we present two L-I subtype cases. In case one, one of the side branches from the first septal artery proceeded as the right coronary artery (RCA). In case two, the distal septal artery and distal circumflex artery together served as the RCA...

 Open Access DOI:10.23937/2378-3656/1410137

Unresolved Issues concerning Inadequate Immune Response after Rabies Post-Exposure Prophylaxis in an Immunocompromised Patient

Rana Shibli and Shmuel Rishpon

Article Type: Case Report | First Published: November 05, 2016

We present an immunocompromised patient with inadequate immune response to the rabies post exposure prophylaxis (PEP), and our management strategy after this inadequate response. Currently, evidence based strategy for action after failure of PEP is partial. Since the prevalence of immunocompromised patients is increasing, further studies and guidelines are necessary....

 Open Access DOI:10.23937/2378-3656/1410136

Equivalence of Boosted Atazanavir Based Regimens and Currently Effective HAART Regimens with Other PI's/NNRTI's in HIV + Children and Adolescents with Elevated Lipid Levels

Janice Piatt, Jeff Foti, Kimberley Bickes, Deborah Frusciano and Laura Clarke-Steffen

Article Type: Research Article | First Published: October 31, 2016

A frequent side-effect of antiretroviral therapy is elevation of plasma lipids and cholesterol. Atazanavir has been shown in adults to have a smaller elevation in plasma lipids in relation to other protease inhibitors. The purpose of this study was to determine the efficacy of Atazanavir in pediatric patients switching to Atazanavir from other HAART regimens and to compare the lipid levels after the switch....

 Open Access DOI:10.23937/2378-3656/1410135

Aortoenteric Fistula in Patient with Infected Aortic Endovascular Stent

Giuseppe Grande, Helga Bertani, Angelo Caruso and Rita Conigliaro

Article Type: Case Report | First Published: October 12, 2016

A 70-years-old man was admitted at the emergency room for onset of fever, malaise and discharge of melena. At the admission, his vital signs were: blood pressure 135/70 mmHg, heart rate 92 bpm, O2 saturation 95%. Blood sample showed mild normocyitc anaemia (Hb 12.1 g/dL), leucocytosis (White blood cells count 12.300/mmc, Neutrophil 77%), rise of C-reactive protein (7.3 mg/dL, normal value < 0.5 mg/L), normal kidney function (creatinine 1.0 mg/dL). Clinical examination was remarkable for mild epi...

 Open Access DOI:10.23937/2378-3656/1410134

Right Superior Vena Cava Draining into the Left Atrium

Songul Usalp, Ali Rıza Karaci, Kevser Gulcihan Balci, Volkan Yazicioglu, Murat Baskurt and Nurcan Arat Koc

Article Type: Case Report | First Published: October 06, 2016

Anomalous systemic venous connection with the left atrium (LA) is an unusual congenital cause of a right-to-left shunt. The most common variant is persistent left superior vena cava (SVC), which is estimated to occur among 2.1% to 4.3% of the people with congenital hearts defects. Much less frequently, an anomalous right superior vena cava (SVC) connects to the LA....

 Open Access DOI:10.23937/2378-3656/1410133

Erythromelalgia in an Infant Caused by Adenovirus Gastroenteritis

Gulsum Alkan, Melike Keser Emiroglu and Huseyin Tokgoz

Article Type: Case Report | First Published: October 04, 2016

Reactive thrombocytosis (RT) is typically a result of bacterial infections in children. RT due to viruses is rarely seen and is most often secondary to a respiratory tract infection. Erythromelalgia (EM) is a rare condition caused by arteriovenous shunting and reduced capillary perfusion. Thrombocytosis can cause microvascular thrombi and can result in EM....

 Open Access DOI:10.23937/2378-3656/1410132

Cytotoxic Effect of Snake (Echis Carinatus) Venom on Human Embryonic Kidney Cells (HEK 293)

Mahboobeh Balali Bahadorani and Abbas Zare Mirakabadi

Article Type: Original Article | First Published: September 26, 2016

Background: The venom of snake (Echis carinatus) induces hemorrhage and necrosis locally at the bite site as well as acute renal failure (ARF) as a consequence of morphological and functional alterations in glomerular and tubular cells. Objectives: It is not clear that ARF results from a direct cytotoxic effect on renal epithelia or from a renal ischemia due to systemic hemodynamic disturbances. This work investigated the in vitro effect of Echis Carinatus crude venom, using cultured Human embry...

 Open Access DOI:10.23937/2378-3656/1410131

Advances in the Management of Skin Wounds with Synthetic Dressings

Fletes-Vargas Gabriela, Leon-Mancilla Benjamin and Esquivel-Solis Hugo

Article Type: Review Article | First Published: September 16, 2016

Treating wounds under normal wound healing processes often require little or no intervention, consisting primarily of debridement, as during the inflammatory stage the cells clear the wound to healing. However wound care professionals face many challenges in treating acute wounds with impairment on healing such as burn injuries or chronic wounds like diabetic, vascular and pressure ulcers. Wound healing is a complex process of several stages that requires being free of complications....

 Open Access DOI:10.23937/2378-3656/1410130

A Young Man with Joints Effusion without Trauma: It is a Rheumatic Disease

Cinzia Casu, Francesco Benazzo, Eleonora Bruschi, Franco Combi and Oscar Massimiliano Epis

Article Type: Case Report | First Published: September 14, 2016

The problem of swollen joints in athletes represents a typical risk following a sports injury, but this is not the only cause, although it is the most frequent one. Indeed inflammatory arthritis may also be a source of joint effusion. We report the case of a 21-year-old professional football player who suffered from pain and swelling in his joints after a mild sprain. He first underwent arthroscopy, followed by intra-articular steroid injections at a later stage....

 Open Access DOI:10.23937/2378-3656/1410129

Pseudoxanthoma Elasticum: An Unusual Cause of Hypertension in Child. About Three Cases Reports

A Dibi, M ElFahime, N Mouane, R Dafiri and A Bentahila

Article Type: Case Series | First Published: September 10, 2016

A 11-years-old boy was hospitalized for haematemesis. Clinical examination found a high blood pressure ranging at 170/90 mmHg. Renin activity was very high at 1825 mIU/l. The genetic study has identified 2 ABCC6 mutations in the composite state, what has allowed to confirm the diagnosis of PXE....

 Open Access DOI:10.23937/2378-3656/1410128

A Case of Spontaneous Regression of High-Grade Hepatocellular Carcinoma

Ghufran A, Agni R, Winslow E, Dalvie P and Agarwal PD

Article Type: Case Report | First Published: September 08, 2016

A 70-year-old South African male with a history of type 2 diabetes mellitus presented with vague abdominal discomfort of 2 months' duration. This was associated with anorexia and 15-pound weight loss over the preceding 6 months....

 Open Access DOI:10.23937/2378-3656/1410127

Malignant Peritoneal Mesothelioma in a Clerk: A Diagnostic Dilemma

Victoria Achaval Rodriguez, Patricia Moreira, Maria Camara, Pilar Rondon, Maria Garrido, Ricardo Hitt and Maria Jose Echarri

Article Type: Case Report | First Published: September 05, 2016

Diffuse malignant peritoneal mesothelioma (DMPM) represents one-fourth of all mesotheliomas. Association of asbestos exposure with DMPM has been observed, especially in males. Incidence is increasing worldwide and is not expected to peak for another 5 to 20 years. The majority of patients present with abdominal pain and distension, caused by accumulation of tumors and ascitic fluid....

 Open Access DOI:10.23937/2378-3656/1410126

HIV-Infected Patient with Refractory Giardiasis and Lingua Villosa Nigra: A Case Report

Nina Yancheva, Nina Tsvetkova, Maria Nikolova, Ivo Alexiev and Tatyana Tchervenyakova

Article Type: Case Report | First Published: August 22, 2016

Giardia lamblia is a protozoan parasite that can cause diarrhea in both HIV-positive and HIV-negative patients. The most frequent complaints associated with Giardia infection are loose, bulky, frothy and/or greasy stool with the absence of blood or mucus, flatulence, bloating, anorexia, cramps and foul belching. We report the case of a 34-year-old HIV-infected male patient with refractory giardiasis. He had two relapses of giardiasis with nausea, loss of appetite, diarrhea, bloating, foul belchi...

 Open Access DOI:10.23937/2378-3656/1410125

Hypothesizing that a Pro-Dopaminergic Regulator (KB220z TM Liquid Variant) can Induce 'Dopamine Homeostasis' and Provide Adjunctive Detoxification Benefits in Opiate/Opioid Dependence

Kenneth Blum, Debra Whitney, Lye Fried, Marcelo Febo, Roger L Waite, Eric R Braverman, Kristina Dushaj, Mona Li, John Giordano, Zsolt Demetrovics and Rajendra D Badgaiyan

Article Type: Case Series | First Published: August 16, 2016

In order to explore the initiation of detoxification of addictive patients to opiates/opioids (along with some other anti-withdrawal agents), we developed a protocol to be utilized in treatment centers particularly with heavily dependent opiate/opioid subjects. Out of 17 subjects, only three received Buprenorphine/Naloxone (Bup/nx) along with KB220Z. In this pilot, we first used a dose of KB220Z of 2 oz twice daily before meals along with clonidine and benzodiazepines and other anti-nausea and s...

 Open Access DOI:10.23937/2378-3656/1410124

A Patient with Rare Heterogenic Histopathological Presentation and Atypical Sites of Metastases in Oropharyngeal/Hard Palate Cancer: A Case Report

Aleksandra Danieluk, Aleksandra Filimoniuk, Joanna Mandziuk, Anna Marczuk, Marek Z Wojtukiewicz and Ewa Sierko

Article Type: Case Report | First Published: August 10, 2016

A case of a 45-year-old Caucasian female oropharyngeal cancer patient, who developed rare metastases to the skin and pleura, is presented. The tumour was characterised by four different histological types of cancer (mucoepidermoid carcinoma, squamous cell carcinoma, undifferentiated carcinoma and adenoid cystic carcinoma). The patient was first diagnosed with locoregionally advanced mucoepidermoid carcinoma (T3N0M0). She was primarily treated with radical surgery. Histopathological report identi...

 Open Access DOI:10.23937/2378-3656/1410123

Recovery of an Under-Deployed Renal Artery Stent Responsible for a Complication of Renal Artery Stenosis

Husain Alturkistani, Youri Kaitoukov, Patrick Gilbert and Vincent Oliva

Article Type: Case Report | First Published: August 08, 2016

A 74-year-old male patient presented to our emergency room (ER) with recurring episodes of flash pulmonary edema (dyspnea worsened by lying down) and hypertension resistant to medical treatment. He had a history of left nephrectomy for renal cell carcinoma (RCC) and right renal artery angioplasty. We hereby report a case of a complication of renal artery stenosis in a patient with a single kidney secondary to an under-deployed renal artery stent that was retrieved....

 Open Access DOI:10.23937/2378-3656/1410122

Non-Puerperal Uterine Inversion in a Young Woman: A Case Report, Brief Surgical Review, and Clinical Insights

Leeya F Pinder, Kennedy O Ouma and Brett D Nelson

Article Type: Case Report | First Published: August 06, 2016

Uterine inversion is usually encountered in the puerperal period and is considered a life-threatening event. The incidence of puerperal uterine inversion is 1 in 3500 deliveries; however, the incidence of non-puerperal uterine inversion is largely unknown. With few more than 100 cases reported in the literature, the management of this condition poses many challenges....

 Open Access DOI:10.23937/2378-3656/1410121

A Rare Case of Primary Mucosal Melanoma of the Palate

Elzbieta Sierko, Aleksander Nobis, Dominika Hempel, Marek Z Wojtukiewicz and Ewa Sierko

Article Type: Case Report | First Published: August 03, 2016

Melanoma usually occurs on the skin. Only 1% of all melanomas affect mucosal membrane of the head and neck with 1951 cases reported from 1945 to 2011 in the world. The article describes the case of the 65-year-old patient suffered from the palate melanoma that was irradiated on tumor area. The other therapeutic options for melanoma patients were discussed....

 Open Access DOI:10.23937/2378-3656/1410120

An Underdiagnosed ARVC Case until the Age of 67-Years with Two Large Aneurysms in the Right Ventricle

Kevser G Balci, Mustafa M Balci, Samet Yilmaz and Ramazan Akdemir

Article Type: Case Report | First Published: August 01, 2016

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy that manifests with ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). Hence immediate intervention is necessary for this type of presentation. A 67-year-old man was admitted to our emergency department with palpitation. Electrocardiogram (ECG) showed VT. Despite amiodarone and lidocaine administration VT persisted....

 Open Access DOI:10.23937/2378-3656/1410119

Bilateral Clavicle Fracture: A Rare Presentation of a Common Form of Orthopedic Birth Injury

Joana Oliveira, Andreia Abrantes, Raque Gouveia and Graca Oliveira

Article Type: Case Report | First Published: July 14, 2016

A female newborn presented at day-1 with isolated right clavicle crepitus after vaginal delivery by certified nurse midwives. Shoulder dystocia was suspected at birth but delivery was successful with the sole aid of suprapubic pressure. The adequate weight-for-gestational-age female newborn (3605 gr. at 39 Wk.) was vigorous at birth and no resuscitation was needed. Bilateral clavicle fracture was later confirmed by radiographic studies and associated birth injuries like brachial plexus paralysis...

 Open Access DOI:10.23937/2378-3656/1410118

Pulmonary Alveolar Hemorrhage While on Dual Antiplatelet Therapy

Brian Grondahl

Article Type: Case Report | First Published: July 11, 2016

Prasugrel is an anti-platelet agent in the thienopyridine class of adenosine diphosphate receptor inhibitors. It is commonly used in combination with low-dose aspirin as dual antiplatelet therapy (DAPT) in patients who have undergone percutaneous coronary intervention with stent placement. Prasugrel's use is associated with an overall low risk of bleeding (2.4% risk of major hemorrhage), but is avoided in the elderly and those with a low body mass index....

 Open Access DOI:10.23937/2378-3656/1410117

Sequential, Multimodal Treatment of a Refractory Adult-Onset Still's Disease Complicated by Reactive Hemophagocytic Lymphohistiocytosis

Sarah Rosset-Zufferey, Karim Gariani and Carlo Chizzolini

Article Type: Case Report | First Published: July 08, 2016

We report the case of a patient with severe adult-onset Still's disease not responding to treatment with high-dose corticosteroids and intravenous immunoglobulins. Partial remission was obtained under therapy associating anakinra and leflunomide but subsequently she developed acute hepatitis and disseminated intravascular coagulation consistent with a reactive hemophagocytic lymphohistiocytosis. The patient was successfully treated with a combination of tocilizumab, cyclosporine and corticostero...

 Open Access DOI:10.23937/2378-3656/1410116

Abrupt Increase in Glucose Intolerance after Smoking Cessation Therapy: A Case Report

Maki Komiyama, Sayaka Shimada, Yuko Takahashi and Koji Hasegawa

Article Type: Case Report | First Published: July 06, 2016

Komiyama M, Shimada S, Takahashi Y, Hasegawa K (2016) Abrupt Increase in Glucose Intolerance after Smoking Cessation Therapy: A Case Report. Clin Med Rev Case Rep 3:116....

 Open Access DOI:10.23937/2378-3656/1410115

A Preterm Neonate with Coxsackievirus Infection, Supraventricular Arrhythmia and Cerebral Sinus Venous Thrombosis

Friederike Sophie Weber, Antje Heilmann, Gabriele Hahn, Mario Rudiger and Jurgen Dinger

Article Type: Case Report | First Published: July 04, 2016

We report a preterm infant with coxsackievirus B3 (CVB 3) infection accompanied by supraventricular arrhythmia and cerebral sinus venous thrombosis. CVB 3 belongs to the Picornaviridae family and usually causes mild respiratory and gastrointestinal symptoms. Newborns, especially preterm infants, are at higher risk of severe infection involving the cerebral and cardiovascular system....

 Open Access DOI:10.23937/2378-3656/1410114

Acute Diarrhea Secondary to Pseudomembranous Colitis in the Adulthood, a Diagnostic Challenge: Case Report

Freddy A. Rodriguez-Hernandez, Giselle Blanco-Lamont, Cinthia Patricia Vargas-Chavez, Maria Valeria Jimenez-Baez, Cristian Alejandro Aguirre-Alva, Luis Sandoval-Jurado and Luis A. Medina-Andrade

Article Type: Case Report | First Published: June 30, 2016

An 84 years-old female presented at emergency room with abdominal pain and diarrhea. Pathological background include arterial hypertension treated with losartan 100 mg/24h, cardiac arrhythmia treated with propafenona 75 mg/24h, osteoarthritis treated with non-steroidal anti-inflammatories (COX-2) and chronic diarrhea for the last three months treated with quinolones....

 Open Access DOI:10.23937/2378-3656/1410113

Three-Vessel Spontaneous Coronary Artery Dissection in an Old Woman

Huseyin Bozbas, Tugba Kayhan Altuner, Ezgi Polat Ocakli, Mehmet Sanser Ates, Murat Kurtoglu and Mehmet Emin Korkmaz

Article Type: Case Report | First Published: June 27, 2016

Spontaneous coronary artery dissection (SCAD) is one of the rare causes of acute coronary syndrome. Regarding the etiology, it is classified broadly into 2 groups: atherosclerotic and non-atherosclerotic. It is more common in females and left anterior descending coronary artery is the most commonly involved artery. Optimal therapy for SCAD is not well-defined. Treatment options include a conservative approach, percutaneous intervention, and bypass grafting surgery. We present an old woman with t...

 Open Access DOI:10.23937/2378-3656/1410112

Successful Treatment of Insomnia with Melatonin in a Patient with Malignant Glioma after Radiotherapy-Involving the Pineal Gland

Andrea Reim, David Strobl, Gerda Saletu-Zyhlarz, Matthias Preusser, Maria Theresia Schmook, Karin Dieckmann, Christoph C Zielinski and Christine Marosi

Article Type: Case Report | First Published: June 25, 2016

A recent survey reported on conspicuous prevalence and severity of sleep disorders in patients with cancer. Insomnia is defined as difficulty falling asleep, difficulty staying asleep - with wake episodes of more than half an hour, unintended early awakening and/or non restorative sleep. This symptom complex qualifies as insomnia when it occurs at least three times a week, results in distress and impairs day time functioning. In cancer patients, especially in patients complaining about fatigue, ...

 Open Access DOI:10.23937/2378-3656/1410111

Variant Angina Induced Life-Threatening Ventricular Arrhythmias: does Dual Calcium Channel Blocker Eliminates the Indication for Implantable Cardioverter Defibrillator?

Maroun Matar, Elie Chammas and Samer Nasr

Article Type: Case Report | First Published: June 24, 2016

A 49-year-old white female tailor that works for a subcontractor at Clemenceau medical center, had in 25/10/2010, a severe substernal chest pain with left shoulder and bilateral arm pain, followed by near collapse. Nursing staff at the hospital who is very well acquainted with her, since she is an extremely gentle person, rushed and connected her to a monitor that showed a polymorphic ventricular tachycardia followed by ventricular fibrillation....

 Open Access DOI:10.23937/2378-3656/1410110

Primary Epiploic Appendagitis

Neha Gupta, Tony A Abdel Maseeh, Leyden Standish-Parkin and Yekaterina Sitnitskaya

Article Type: Case Report | First Published: June 10, 2016

Epiploic appendagitis is a rare diagnosis in pediatric population. It is a benign, self-limiting condition caused by infarction, torsion or thrombosis of the fatty appendages on the serosal surface of the colon. It can be a diagnostic dilemma as it can mimic acute appendicitis or diverticulitis, depending on its location. We report a case of a teenage girl who presented with right lower quadrant abdominal pain without any associated vomiting, fever, and diarrhea. Laboratory work up was non-contr...

 Open Access DOI:10.23937/2378-3656/1410109

The Biliary Sinus: A Rare Late-Stage Complication of Cholecystectomy

Ihsan Yildiz, Yavuz Savas Koca and Ibrahim Barut

Article Type: Case Report | First Published: June 03, 2016

A 53-year-old female patient who had undergone open cholecystectomy due to cholelithiasis 6 years earlier was admitted to hepatobiliary surgery unit with a painful mass in the right upper quadrant and fever. Ultrasonography showed that a 3-cm fluid-filled mass in the right upper quadrant subcutaneously, in computed tomography a fluid-filled tubular lesion extending from the right lobe of liver to right upper quadrant, and percutaneous cholangiography showed that a radio-opaque density communicat...

 Open Access DOI:10.23937/2378-3656/1410108

Left Atrial Appendage Occluder with Recurrent Thrombus Formation Visualized by Three-Dimensional Transesophageal Echocardiography

Sebastian Greiner and Hugo A Katus

Article Type: Case Report | First Published: May 31, 2016

A 78-year-old Caucasian female with newly diagnosed atrial fibrillation was put on anticoagulation with phenprocoumon. Two months later she developed an intracranial hemorrhage localized in the brainstem. Neurological findings were paresis and paraesthesia of the left body side. The treatment was conservative and symptoms resolved within three months....

 Open Access DOI:10.23937/2378-3656/1410107

Chemotherapeutic Agents for Brain Metastases in Non-Small Cell Lung Cancer: A Case Report with Eribulin Mesylate and Review of the Literature

Alejandra C Fuentes, Reordan O De Jesus and David N Reisman

Article Type: Case Report | First Published: May 30, 2016

Lung cancer accounts for the majority of cases of brain metastases, resulting in higher morbidity and mortality. Surgery and radiation are the current standard of care for the treatment of brain metastases. However, when brain metastases recur despite these treatments, the management options are limited, especially when recurrent metastatic events occur. The role of systemic chemotherapy for brain metastases remains undefined, with advances in drug delivery and ongoing studies using targeted age...

 Open Access DOI:10.23937/2378-3656/1410106

The Use of the Gallbladder Wall for Reconstruction of the Extrahepatic Bile Ducts in a Case of Agenesis of the Common Bile Duct: A Case Report

Maher N Ghabriel

Article Type: Case Report | First Published: May 16, 2016

Unexpected anomalies of the extrahepatic biliary ducts were found intraoperatively during open cholecystectomy in a 49-year-old male, with calcular obstructive jaundice. The patient had congenital absence of the common bile duct that appears to have been replaced by the cystic duct, which opened directly into the duodenum. The right and left hepatic ducts drained into the posterior wall of the gallbladder by a short common hepatic duct. Intraoperatively the gallbladder wall (with uncompromised n...

 Open Access DOI:10.23937/2378-3656/1410105

The Spread of Melanoma to the Adrenal Glands: Historical Cases

Wilson I B Onuigbo

Article Type: Review Article | First Published: May 12, 2016

Personal interest in cancer metastasis to the adrenal glands began in 1957 and matured in a Doctorate Thesis in 1961. Part of its eminence lay in cases in which it was the only soil selected for attack. What of the melanoma? The available historical account did not contain this answer. Therefore, this paper aims to determine the situation in the classical Transactions of the Pathological Society of London, which began to publish during the 1846 - 1848 period....

 Open Access DOI:10.23937/2378-3656/1410104

Neurobiology of KB220Z-Glutaminergic-Dopaminergic Optimization Complex [GDOC] as a Liquid Nano: Clinical Activation of Brain in a Highly Functional Clinician Improving Focus, Motivation and Overall Sensory Input Following Chronic Intake

Lucien L Duquette, Frank Mattiace, Kenneth Blum, Roger L Waite, Teresa Boland,Thomas McLaughlin1, Kristina Dushaj, Marcelo Febo and Rajendra D Badgaiyan

Article Type: Case Report | First Published: May 11, 2016

With neurogenetic and epigenetic tools utilized in research and neuroimaging, we are unraveling the mysteries of brain function, especially as it relates to Reward Deficiency Syndrome (RDS). We encourage the development of pharmaceuticals or nutraceuticals that promote a reduction in dopamine resistance and balance brain neurochemistry, leading to dopamine homeostasis. We disclose self-assessment of a highly functional professional under work-related stress following KB220Z use, a liquid (aqua) ...

 Open Access DOI:10.23937/2378-3656/1410103

Giant Mucinous Cystadenoma of the Ovary Mimicking Ascites: A Case Report

Marco Rossato, Marta Burei and Roberto Vettor

Article Type: Case Report | First Published: April 30, 2016

In the present case report we describe a 67 years old woman with clinically apparent ascites and no systemic causes for it and a giant mucinous cystadenoma of the right ovary diagnosed utilizing the CT scan and confirmed by the histological findings. Ascites consists in the accumulation of fluid within the peritoneal cavity and is a common finding with a wide range of causes. Although at least 80% of patients with ascites are found to have liver cirrhosis other pathologies as well as heart failu...

 Open Access DOI:10.23937/2378-3656/1410102

Does Breast Feeding Protect from Development of Breast Disease?

Muna M Baslaim, Forough Farrokhyar, Shefaa A Al-Amoudi, Arwa A Ashoor and Oussamah M Saidam

Article Type: Original Article | First Published: April 20, 2016

We retrospectively analyzed the data base of the breast unit at King Fahd Hospital from January 2000 till May 2012. We calculated proportions with 95% confidence intervals (CI) and used Logistic regression analysis to explore the predictors. Odds ratios with 95% CI were reported and p value of 0.05 was considered for significance. Breast feeding data were available for 1970 parous women of which 1856 (94.3%; 95% CI: 93.1%-95.2%) breast fed their babies....

 Open Access DOI:10.23937/2378-3656/1410101

Endometrioma Complicated by a Rare Bleeding Disorder Mimicking Ovarian Cancer

Mitchell Hoffman, Odette Daly and John Bomalaski

Article Type: Case Report | First Published: April 18, 2016

Hemophilia A is a congenital X-linked recessive bleeding disorder due to factor VIII deficiency. It is exceedingly rare in females. The association of the most common bleeding disorder (Von Willebrand Disease) and hemoperitoneum secondary to a hemorrhagic corpus luteum is well known. Most women with Hemophilia A are asymptomatic but scattered moderate and severe cases have been described....

 Open Access DOI:10.23937/2378-3656/1410100

Rx for Disaster: When Medication Non-adherence becomes an Emergency

Lindsay S. Leech, Nicole G. Tasker and Julie L. Welch

Article Type: Case Report | First Published: April 13, 2016

This case report describes a 35-year-old woman who presented to the Emergency Department (ED) after a seizure. Her evaluation revealed a rare cause of her seizures, confounded by medication non-adherence. She was emergently treated and admitted for further management. With standard patient education, social services, and outpatient follow-up, she did well for three years, however had two subsequent admissions for recurrent seizures from non-adherence. This case demonstrates a rare but treated ca...

 Open Access DOI:10.23937/2378-3656/1410099

Pulmonary Lymphangitic Carcinomatosis due to Metastatic Adenocarcinoma of the Lung: A Case Report

Somaya AM Albhaisi and Neama Luqman

Article Type: Case Report | First Published: March 31, 2016

Pulmonary lymphangitic carcinomatosis (PLC) is part of the spectrum of metastatic disease. Most cases result from dissemination of adenocarcinomas. Micro hematogenous spread to the periphery of the lung, with subsequent retrograde, centripetal lymphatic extension toward the hilar region, is the responsible mechanism in approximately 75% of patients. The remaining cases are due to retrograde extension from a hilar tumor or from an ipsilateral lung or breast carcinoma. In the latter settings, the ...

 Open Access DOI:10.23937/2378-3656/1410098

Topical Cream Curadermbec5 Treats a Recalcitrant Basal Cell Carcinoma

Batsev AF, Dobrokhotova VZ and Cham BE

Article Type: Case Report | First Published: March 28, 2016

Solasodine rhamnosides, solamargine and solasonine, are antineoplastics with high affinity, high efficacy and low toxicity as shown in cell culture, animal and human studies. The mode of action is by apoptosis and is accompanied by a high order of specificity. This specificity towards cancer cells is ideal for treating skin cancers. Previous studies show that solasodine rhamnosides in a topical cream formulation CuradermBEC5 is a highly regarded therapy for nonmelanoma skin cancers....

 Open Access DOI:10.23937/2378-3656/1410097

Prevention, Detection and Diagnosis of Expressive Oral Language Disorders in Premature Infants

Charollais Aude

Article Type: Short Note | First Published: March 23, 2016

To prevent language disorders in a vulnerable population we must understand that the language development is a multisensory and above-modal integration with specific neurodevelopmental period, some of which remain to study. The oral language development is done according to time of neuro developmental time for which information was recently confirmed in children born preterm....

 Open Access DOI:10.23937/2378-3656/1410096

Spontaneous Spleen Rupture: An Unusual Involvement of the Spleen in Systemic Lupus Erythematosus

Maria do Socorro Teixeira Moreira Almeida, Amanda Gualberto Carvalho, Lina Gomes dos Santos, Eliton Carlos Batista de Sousa and Gabriela Lustosa Said

Article Type: Case Report | First Published: March 14, 2016

The involvement of the reticuloendothelial system in systemic lupus erythematosus (SLE) concomitant to the disease activity is highly variable, and well-recognised but spontaneous splenic rupture is an unusual occurrence. We report a 35-year-old woman with SLE who had spontaneous splenic rupture during the course of her illness. The spleen rupture was evident on histophatological analysis. A brief review of spontaneous splenic rupture in systemic lupus erythematosus (SLE) is also presented....

 Open Access DOI:10.23937/2378-3656/1410095

Socket Reconstruction after Firework Explosion Injury

Reili Rebane, Mari Tamsalu and Artur Klett

Article Type: Case Report | First Published: March 14, 2016

We report a challenging case of orbital socket reconstruction. A 49- year-old man presented two weeks after fireworks exploded in his face. He had multiple orbital bone fractures on the right and the globe was enucleated because of severe damage. No primary orbital implant was used due to infection risk. One month after the trauma he suffered from infection of the conjunctival sac and periorbital skin despite initial intravenous and oral antibiotics. Because of inability to wear a cover shell ey...

 Open Access DOI:10.23937/2378-3656/1410094

Atypical Presentation of Madelung Disease

Maisel Lotan Adi, Retchkiman Meir and Gronovich Yoav

Article Type: Case Report | First Published: March 09, 2016

We present a unique case of a sixty two year old woman with symmetric lipomatosis of the lower back, similar to cup C female breast. Lipoma is the most common type of soft tissue mesenchymal tumor. Lipoma is commonly found in the upper back, neck, shoulder and abdomen, and rarely in the face, hands or feet. When lipomatosis is symmetrical it is often termed Multiple Symmetrical Lipomatosis (MSL), also known as Madelung disease, a rare syndrome of unknown etiology....

 Open Access DOI:10.23937/2378-3656/1410092

Coronary Artery Imaging in Patients with Congenital Heart Disease: Improved Image Quality Using an Intravascular Contrast Agent and Specific Magnetic Resonance Sequence Design

Nathalie Dedieu, Dirk Lossnitzer, Marcus R Makowski, Miguel Silva Nodgueira Vieira, Tarique Hussain, James Wong, Reza Razavi, Rene M Botnar and Gerald F Greil

Article Type: Original Research | First Published: February 29, 2016

In patients with congenital heart disease (CHD) imaging of coronary artery origin and course can be crucial for preoperative planning. A novel intravascular contrast agent Gadofosveset trisodium (GdT) has demonstrated to be superior for angiography due to improved intravascular contrast compared to the currently used extravascular contrast agent Gadopentetate dimeglumine (GdD)....

 Open Access DOI:10.23937/2378-3656/1410093

A Case of Macrovascular Complications after Treatment with DPP-4 Inhibitor, Sitagliptin, in a Patient with Type 2 Diabetes Mellitus

Kyuzi Kamoi and Hideo Sasaki

Article Type: Case Report | First Published: February 29, 2016

Our case involved a 72-year-old woman [height, 1.47 m; body mass index (BMI), 19.9 kg/m2] with T2DM and cardiovascular disturbance. She had been diagnosed with non-obese T2DM (BMI, 20 kg/m2; anti-GAD antibody, negative) during examination for coldness of the lower extremities attributed to cerebral ischemic attack or transient ischemic attack (TIA) in June 2008 (at 65 years old)....

 Open Access DOI:10.23937/2378-3656/1410091

Multiple Myeloma and Amyloidosis Presenting as a Restrictive Lung Disease with Respiratory Failure

Marta Pereira, Luis Afonso, Goncalo Fernandes and Rui Araujo

Article Type: Case Report | First Published: February 20, 2016

Amyloidosis refers to the extracellular tissue deposition of fibrils resulting from abnormal folding of proteins. It may affect multiple organs, causing a broad range of symptoms, thus making the diagnosis particularly challenging. Polyneuropathy is one of the recognized manifestations of Amyloid Light-chain (AL) amyloidosis....

 Open Access DOI:10.23937/2378-3656/1410090

Tetanus: A Case Report following an Upper Extremity Injury

John D. Hill, Eric Wombwell, Jelyn Miller and Gina M. Rochetti

Article Type: Case Report | First Published: February 20, 2016

Clostridium tetani is a spore-forming, toxin-producing, anaerobic, gram-positive bacillus which enters the CNS causing painful muscle contractions within the host. These painful spasms and stiffness typically manifest initially in the form of trismus, or lockjaw. According to the CDC, tetanus treatment includes the administration of Tetanus Immune Globulin (TIG), a tetanus toxoid booster, agents to control muscle spasms (benzodiazepines), and antibiotics (metronidazole)....

 Open Access DOI:10.23937/2378-3656/1410089

Aeroportia - A Rare Finding for a Frequent Disease

Marta Pereira, Luis Miguel Afonso, Sofia Patrao and Rui Araujo

Article Type: Case Report | First Published: February 13, 2016

A 69-year-old female was admitted to our hospital with complaints of abdominal pain and diarrhea for the last 2 weeks. She was obese, diabetic, and had peripheral arterial disease, but no history of bowel disease or previous gastrointestinal symptoms. Physical examination revealed severe dehydration, hypotension, and diffuse abdominal discomfort. Acute kidney injury with anuria and significant leukocytosis were documented. Furthermore, the patient had severe lactic acidosis....

 Open Access DOI:10.23937/2378-3656/1410088

Stevens - Johnson Syndrome and Intestinal Perforation following regorafenib Administration for Metastatic Rectal Cancer: A Case Report

Tetsuhito Muranaka, Yoshito Komatsu, Kentaro Sawada, Hiroshi Nakatsumi, Yasuyuki Kawamoto, Satoshi Yuki, Riichiro Abe, Kanako C Hatanaka and Naoya Sakamoto

Article Type: Case Report | First Published: February 09, 2016