A Case Report, Pediatric of Hepatoblastoma in Misrata, Libya

Introduction: Hepatoblastoma is primary liver tumor, it’s the most common in young children. As a pediatric cancer representing 1% and mainly affect infancy to 5 years of age. And it’s the most common malignant in young children, Representing about 79% of all liver tumors in children. May be 100 cases reported per year of hepatoblastoma. Most common site of hepatoblastoma is right lobe of liver and the most common...

Phytoterols as Anti-Alzheimer Agents

Alzheimer’s disease (AD), a slowly progressive neurodegenerative disorder, is the main cause of dementia worldwide. AD is a genetic and an environmental disease involving a diversity of etiophatogenic processes. In fact, an efficacious treatment for this complex and multifactorial disorder remains to be discovered, demanding the urgent development of new therapeutic approaches for the disease, such as the use of b...

Bifocal Femoral Neck and Atypical Subtrochanteric Fractures Treated with Cemented Long Stem Hemiarthroplasty A Case Report

Introduction: Bisphosphonate related fractures present a quandary for orthopaedic surgeons due to the presence of adynamic bone and complex deforming forces around the fracture. With the increased use of anti-resorptive medication, such fractures are becoming increasingly common with a variety of unique presentations reported in the literature. Case Report: A 82-year-old woman was diagnosed with acute displaced tr...

The Constant Mimic Disease: Angioimmunoblastic T-cell Lymphoma, A Mimic for DRESS Syndrome

Introduction/Aims/Background: Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon and aggressive lymphoma which is usually presented in elderly patients. The etiology of AITL is unknown, with a prevalence around 1-2% of non-Hodgkin lymphomas. It may present a broad clinical spectrum of symptoms. Fewer than 8 cases of AITL presenting a DRESS like-syndrome as first clinical features, have been reported worldwid...

A Rare Case of Graves’ Dermopathy in The Covid-19 Pandemic

A man aged 27 with an history of persistent hyperthyroidism didn't have total thyroidectomy for the delay of the procedure during COVID-19 pandemic. This delay, in addition to the persistence of hyperthyroidism, caused the development of pretibial oedema of both legs suggesting thyroid dermopathy treated with oral prednisone.

Postpartum Ovarian Vein Thrombosis as a Cause of Acute Abdomen A Case Report

Introduction: Ovarian vein thrombosis is a likely severe complication correlated with conditions such as pelvic inflammatory disease, malignancy, and recent surgery. Also, it’s associated with pregnancy. Case Report: A 28-year-old female presented to the casualty complaining of right iliac fossa pain for 1 day prior to admission (4 days post-delivery of her second child) associated with slight fever and anorexia,...

Veno-Venous Extracorporeal Membrane Oxygenation for an Acute Type-B Aortic Dissection Compromised with Acute Respiratory Distress Syndrome: A Case Report

Background: Type B aortic dissection (TBAD) is sometimes complicated by respiratory failure with the need for ventilation. Case Presentation: A 51-year-old man who suffered from back pain was diagnosed with acute TBAD. On the third day of hospitalization, he complained of dyspnea and presented severe hypoxia and acidosis, then was transported to our hospital for intensive care. Computed tomography (CT) showed a di...

A Case Report of an Abnormal Course of the Superficial Branch of the Radial Nerve

The Superficial Branch of the Radial Nerve (SBRN) in the forearm usually has a constant course, but sometimes there may be differences in its course and position. This report is about a case of difference in the normal course of this nerve. Normally, in the forearm, the SBRN passes between the brachioradialis muscle tendon and the Extensor Carpi Radialis Longus (ECRL) to become superficial. In this case, the SBRN...

A Case of Nasopharyngeal Posterior Wall Injury due to an Unusual Metallic Foreign Body

We present a case of unusual nasopharynx injury caused by a metallic shaving entering the oral cavity, perforating the soft palate, and injuring the nasopharynx mucosa. The imaging revealed that the foreign body is embedded very close to the clivus of the occipital bone. After ruling out major vascular and neurological injury, the foreign body was successfully retrieved, and the post-operative course was favorable...

Rapid Resolution of Left Ventricular Thrombus Post-STEMI on Rivaroxaban: Effective Lysis or Asymptomatic Embolic Event?

Guidelines recommend the use of warfarin for the treatment of LVT, but Novel Oral Anticoagulants (NOACs) are being frequently used despite the lack of significant randomized trials in support of it. A 78-year-old male with an apical LVT two days post STEMI, demonstrated by Trans-Thoracic Echocardiogram (TTE), was treated with aspirin, clopidogrel and Rivaroxaban. Less than 72 hours later, a second TTE showed the a...

A Case of Severe Coronary Sinus and Right Coronary Artery Anomaly with Relatively Mild Symptoms

A 72-year-old male with no previous cardiac history, other than hypertension, presented with intermittent angina not associated with activity. He also suffered from fatigue and dyspnea. The electrocardiogram showed RBBB, and the echocardiogram showed slight hypertrophy of the right ventricle and interventricular septum of 14 mm, a normal ejection fraction, but with a degree of diastolic dysfunction. The patient wa...

The Impact of the COVID-19 Pandemic on Assisted Reproductive Technology and Intra-uterine Insemination Volumes in Canada: A National Survey Study

Research Question: What was the impact of the COVID-19 pandemic on assisted reproductive technology (ART), insemination, and clinic volumes across Canada? Design: An online survey study was conducted of Canadian fertility clinics. Participants were asked to comment on their centre’s procedural and clinic volumes during the COVID-19 pandemic, Including Partner or Donor Inseminations (IUI/DI), in-vitro fertilization...

Acute Brucellosis Presenting as Splenic Infarction: A Case Report from Qatar

Splenic infarction is a very rare presentation of Brucellosis, very few cases were reported, especially that Brucellosis is one of the most common infectious diseases worldwide, a 33-year-old man presented with 3 days severe abdominal pain with previous history of indolent fever for a month, an abdominal Computed Tomography (CT) scanning showed splenomegaly with hypodense lesion that confirmed by to represent a sp...

Sinus Surgery Causing Beneficial Ostitis

A 52-year-old male with Cystic Fibrosis (CF) presented to the otorhinolaryngologist with a history of nasal obstruction, rhinorrhea and long-lasting severe headache localized to the frontal sinuses. Nasal endoscopy showed no signs of polyps or mucopurulent discharge. Computed Tomography (CT) of the sinuses revealed sinus opacification (Figure 1A). Endoscopic sinus surgery was performed including bilateral uncinect...

A Case of Psychosis with Multiple Intra-Axial Temporal Lobe Calcifications

A 69 year old man married with 4 adult children 3 sons and a daughter presented to the emergency department exhibiting “bizarre behaviour” complaining that certain devils are bothering him and that he sees them, saying things to him, abusing him and have been touching his head, looking through his eyes and holding his tongue. History of being diagnosed with Schizophrenia 40 year ago on multiple antipsychotics and...

Use of Bioink in Transferring Rest Seat Extension to the Working Cast

The use of cast partial denture has decreased in the past two decades due to increased preference of implant supported fixed restorations by both patient and their dentists. However, certain clinical situations do not render the use of implants in which case, the cast partial dentures are still the choice of treatment. During the fabrication of the cast partial denture, transfer of occlusal rest seat to the workin...

Loop Connector to Improve Esthetics of a Fixed Partial Denture

Diastema between natural teeth is not preferred by most patients. However, there are situations when generalized diastema in natural dentition do not allow placement of a prosthesis which does not incorporate the same characteristic in its design. We present a case of a mandibular kennedy class four partial edentulous situation in a young female patient who also presented with a high lip line and a deep bite. A fo...

Duplication of Canine Guidance Using a Temporary Cantilever Bridge

Duplication of anterior guidance is not difficult, but transfer of the anticipated anterior guidance can be cumbersome, especially in tricky clinical partial edentulous situations where permanent canine is missing. The role of a provisional restoration can be handful for a clinician to determine whether a conservative approach can be used to fulfil the treatment objectives. Use of a cantilever prosthesis to replac...

Delayed Post-Traumatic Vertebral Body Collapse ”Kummell Disease”: Case Report

Kummell disease is a relatively rare group of conditions, which refers to a lack of blood supply to the bone leading to collapse due to poor nourishment. It typically presents in the elderly patients’ thoracic vertebrae, as a compressive deformation of the vertebral body as a result of minor trauma experienced weeks to months before the onset of the disease. Osteoporosis tends to be the biggest risk factor for Kum...

Acquired Arteriovenous Malformation with Scar Pregnancy Causing Late Massive Uterine Bleeding: A Case Report

We present a case of acquired arteriovenous malformation with scar pregnancy in a patient with a previous Caesarean for placenta previa. Incidence of scar pregnancy is reported as 1 in 2,000 pregnancies. The incidence of arteriovenous malformation with scar pregnancy is rarer. Due to paucity of literature regarding arteriovenous malformation with scar pregnancy, these cases may present as a diagnostic dilemma for...

A Hypophosphatasia Patient with Multiple Stress Fractures

Hypophosphatasia (HPP) is a rare, genetic disease characterized by mutations in the Tissue Non-Specific Alkaline Phosphatase (TNSALP) gene, decreased activity of the TNSALP enzyme in target tissues. In this case we aim to introduce a patient who suffers from this very rare disease. A forty years-old woman applied to the orthopedic outpatient clinic with gait disturbance and leg pain. She was operated because of mu...

Chronic Osteomyelitis Associated Primary Diffuse Large B-Cell Lymphoma of Femur. Report of a Diagnostically Challenging Case

Diffuse Large B Cell Lymphoma (DLBCL) associated with chronic inflammation is a recently described entity associated with Epstein Barr virus (EBV) infection. Here we report a case of DLBCL developing in a background of chronic osteomyelitis and metallic implant following fracture after 17 years. Radiographs revealed a mixed lytic and sclerotic lesion at the distal end of right femur. Sinus tract biopsy showed plas...

Touch on the Brake at Edge of Uremia Cachexia: A Case Report

Different from ordinary Protein-Energy Wasting (PEW), cachexia of uremia aggravates the complications of uremia in the vicious circle of low protein, volume overload and inflammatory response, which seriously affects the quality of life and survival rate of patients. Uremia cachexia is rare in dialysis center of our hospital. This case is an 81-year-old female who has been on dialysis regularly for two years. From...

Unilateral Tonsil Hypertrophy and Homolateral Adenopathy

The most common aetiology of unilateral palatine tonsil hypertrophy is a squamous cell carcinoma; in most case, there is an isolated, indurated and increased in size amygdala with or without ulceration of the mucosa. The second aetiology is lymphomas, characterized by a sub-mucosal mass, its growth leads to the asymmetrical size of the amygdala. In the first situation, a cervical node can be observed and in the se...

Metastatic Prostate Cancer with Undetectable PSA

The intimate relationship between PSA and Prostate cancer -in terms of diagnosis and follow up-has been established since its introduction in the 1980s [1]. The burden of the disease can be correlated to the level of PSA which explains the elevation in serum levels of PSA in patient with metastatic prostate cancer [2]. However, less than 1% of patients with prostate cancer present with inappropriately low PSA [3].

Diy Biology and Biohacking: A New Research Journey

Scientific curiosity is generating new ventures in form of DIY Biology and biohacking which opens up an alternative route to structured and organized research. People even without traditional degrees are exploring various hacks to augment and enhance the quality of their lives. The applications range from dietary modifications to implants, open source medicine and gene manipulation. This is leading to result orien...

Hypothalamic Fever and Obesity in Sarcoidosis

Hypothalamic-pituitary involvement in sarcoidosis occurs in less than 5% of patients. Some clinical signs of hypothalamic lesions are non-obvious or can be mistaken in a complex context. Hypothalamus is involved in temperature regulation, food intake, and mood regulation. Few cases have been reported.

A Case of Pheochromocromocytoma with Recurrent Hypotensive Attacks

Introduction: Most of the pheochromocytomas are presented with hypertension although sometimes hypotension could be seen. Because intra operative mortality of pheochromocytomas is high, preoperative preparation with alfa- and beta blockers is required. But there is not enough knowledge about preoperative preparation of pheochromocytomas with hypotension. We aim to mention about preoperative preparation of a case o...

Melanoma In-Situ Associated with Melanotan II Use

Injectable synthetic melanotropic peptides may be used to enhance tanning, improve erectile function and treat Female Hypoactive Sexual Desire Disorder (FSDD). The peptides, Melanotan I (MT1) and Melanotan II (MTII) have been touted as sunless tanning agents, with the potential to decrease harmful effects of UV damage. Most recently, bremelanotide (PT141), an active metabolite of MTII, has been FDA approved for th...

Snakes and Bladders: The Case of a Simple, Single-System Ureterocoele

We present the case of a patient with a ureterocoele and an interesting radiological finding. A ureterocoele is a saccular dilation of the distal ureter. It is a well-known pathological feature within the paediatric population; it is less common in the adult urology setting. Presenting features are varied and include pain, haematuria, urinary obstruction and recurrent urinary tract infections. A 41-year old man pr...

Cutaneous Anthrax in Kamakwie, Karene District, Northern Sierra Leone

Background: Anthrax is a zoonotic bacterial infection caused by a gram-positive bacillus called Bacillus anthracis. It is a disease of public health importance with high mortality rate. The mortality rate could approach absolute without treatment, and about 64% in centres with best of care. Also, because of its role as a biological weapon and in bioterrorism; post 9-11 in the United States, anthrax spores had been...

The Effective Use of Cinemagraphic Remedial Make Up to Conceal Disfiguring Scars

Disfiguring burn scars are a constant reminder to patients that an accident has occurred, and their lives are changed forever. Today social media has become a platform for communication that puts pressure on users to conform or blend into popular culture. Readily shared techniques that enable individuals to filter and manipulate their public image have resulted in increasing pressure to fit in to the perfect physi...

A Rare Clinical Presentation of Unilateral Pulmonary Agenesis in a Neonate– Pneumothorax

Congenital pulmonary agenesis is extremely rare anomaly. We present a case report of a one-day old boy with pneumothorax and respiratory distress with unilateral right lung agenesis.

Presymptomatic Testing in Twins with Unknown Zygosity: A Reflective Report on Ethical Challenges

Portugal is one of the European countries where genetic counseling is emerging although the profession of non-medical genetic counsellors has not yet been recognized. Presymptomatic testing for late-onset neurodegenerative disorders in Portugal was implemented in the mid-nineties following a national protocol base on the international pioneer experience of Huntington Disease. Twins do pose a unique issue in the co...

Combination of Basal Insulin Analogues and GLP-1 Receptor Agonists in the Treatment of Obese Subjects with Type 2 Diabetes: Presentation of Clinical Cases

We present the cases of 7 obese subjects with type 2 diabetes (age 58+3 years, BMI 37+1.6Kg/m2, HbA1c 9.1+0.3%, fasting blood glucose 191+20mg/dl) treated with combinations of metformin (850 or 1000mg twice daily), insulin (premixed insulin preparations twice or three times daily or basal-bolus regimens with insulin glargineU100 plus pre-meal rapid-acting insulin analogues; total insulin dose 106+20 units/day) and...

Right-Sided Arcus Aorta (Rsaa) Syndrome

Right-Sided Arcus Aorta (RSAA) syndrome was new defined in patients with chronic chough and exertional dyspnea. We aimed to present and discuss the new diagnostic findings of spirometry in cases with right sided arcus aorta is a syndrome. We retrospectively evaluated the patients whom diagnosed with right sided arcus aorta between 2007 and 2019.Totally 29 patients diagnosed RSAA and mean age was 45.6 years-old. Pa...

An Intraparotid Schwannoma Mimicking a Warthin’s Tumour

In this report, we describe the rare presentation of a cystic Intraparotid Facial Nerve Schwannoma (IPFNS) in a young female who initially presented with a painful unifocal parotid mass gradually enlarging over 5 years. Preliminary imaging and cytology offered this to be a Warthin’s tumour. Here we describe the limitations of current diagnostic tools in the workup of intraparotid cystic lesions and highlight the i...

Signet Ring Cell Neuroendocrine Tumor

A 63 years old woman with history of diabetes and hypertension, presented for bone pain. Pelvic X Ray showed multiple osteoconsensant lesions of the iliac wings, the sacrum and the femurs (Figure 1). CT scan objectified multiple hepatic metastases with a laterorectal mass (Figure 2). Colonoscopy showed aspect of extrinsic compression. Endoscopic ultrasound objectified a rectal mucosal lesion of 5x3, 5 centimeters...

Calcaneal Osteomyelitis with Persisting Negative X-Rays and Blood Tests

Osteomyelitis in children is a potentially dangerous disease that requires early diagnosis and treatment in order to reduce the risk of sequelae. We describe a case of calcaneal osteomyelitis with the aim of highlighting the challenges in the diagnosis of this condition, that need to be considered also in case of persisting negative blood and radiological tests. A 19 month-old female baby presented to our Emergenc...

All Ceramic Fixed Partial Denture to Replace Missing Maxillary Anterior Tooth

The use of dental porcelain is a routine material for restorative dentistry. Combination of alloy with ceramic has one of the main success stories in restorative dentistry during the last few decades. Advances in Zirconia reinforced ceramic has been seen as a substitute to alloys when a short span fixed partial denture is designed. A young boy reported with missing left maxillary central incisor. The existing occl...

Impact of Cumulative and/or Combined Effects of ESAs and IV Iron Doses Received During Dialysis on Survival in Hemodialysis Patients

Background: Intravenous iron (IV iron) and Erythropoiesis-Stimulating Agents (ESAs) are key therapies for anemia management during hemodialysis (HD). Studies suggest adverse outcomes with cumulative high exposure to either IV Iron or ESAs but may not reflect clinical situations where iron and ESAs are combined. This study retrospectively assesses the impact on mortality of different dosing strategies. Methods: All...

Low Volume Salivary Reservoir in Complete Denture Prosthesis for Xerostomia

Diabetes mellitus is a metabolic syndrome that affects most of the systems of the human body. Xerostomia is a common complication which is compounded if the patient is elderly. Denture wearing in such cases is difficult since it is very uncomfortable. The denture can be modified, however, to accommodate a reservoir for salivary substitute. An elderly male patient suffering from diabetes mellitus (type 1) sought co...

Double Lip Correction for Enhancing Complete Denture Aesthetics

Mucosal reaction to a sharp object like a natural tooth results in hyperplasia of cells, which, when present in aesthetic, critical structures like lips becomes a source of embarrassment and also affects the outcome of a complete denture prosthesis. An elderly female patient complained for masticatory disability since she had lost most of her natural teeth. Extra oral examination revealed presence of maxillary dou...

A Giant Primary Leiomyosarcoma of the Neck: Report of One Case

Leiomyosarcomas are rare malignant tumors of smooth muscles, accounting for 4% of sarcomas of head and neck sarcomas. They are characterized by slow growth with metastatic potential, hence the value of early diagnosis and management. Through a case of primary cervical leiomyosarcoma, we illustrate clinical, therapeutic and evolutionary particularities of this rare tumor. We report a case of a 47-year-old patient w...

Intermittent LBBB and PR Interval Prolongation Late After Trans-Catheter Aortic Valve Replacement: A Red Herring or a Cause of Concern?

"Trans-Catheter Aortic Valve Replacement (TAVR) has become mainstream treatment for severe symptomatic aortic stenosis. However, Atrio-ventricular conduction abnormalities like heart block and Left Bundle Branch Block (LBBB) are frequently encountered post-TAVR. A subset of patients who develop LBBB exhibit intermittent LBBB the significance of which is largely, unknown. We present a case of intermittent LBBB and...

Preliminary Study on Clinical Types of Primary Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma is a malignant tumor that is prevalent in South China, and in Southeast Asia [1]. Common clinical presentations include a cauliflower-like neoplasm in the nasopharynx with a rough mucosal surface. However, a few cases have also presented with normal mucosa with submucosal growth and invasion of cancer cells, such that multiple biopsies indicated that the mucosa was normal. Other cases have...

Two Contrasting Cases of Carcinoma Showing Thymus-Like Differentiation (Castle) of the Thyroid

Carcinoma showing thymus-like differentiation (CASTLE) is a rare malignant tumor originates from remnant thymus tissue of thyroid. We encountered two cases of CASTLE and each case illustrated the varied clinical manifestations. Case 1 was a 46-year-old female patient that had already been diagnosed with papillary thyroid carcinoma by Fine Needle Aspiration Cytology (FNAC). The main complaint was a gradually growin...

Multilevel Noncontiguous Spinal Fractures Involving Seventeen Vertebrae: A Rare Case Report

Multilevel noncontiguous spinal fractures are defined as injuries to the vertebral column at more than one site and separated by at least a single uninjured vertebra. We report the case of a 39-year-old man being hit by a moving train, breaking much of his spine, surviving, and returning to gainful employment. He sustained multilevel noncontiguous spinal fractures involving 17 vertebrae (C1, 2, 4, 6, 7, T1, 2, 6,...

Prevalence of Dental Caries in Japanese Professional Soccer

In this study, prevalence of dental caries was evaluated in 195 Japanese professional soccer players. The prevalence of dental caries was evaluated using the WHO caries diagnostic criteria (DMF index) that is obtained from numbers of Decayed (D), Missing (M) and Filled (F) teeth (DT, MT and FT, respectively). The mean age, height and weight in 195 soccer players were 26.9 ± 4.7 years old, 177.1 ± 6.1 cm, and 71.6...

Possible Consequences on the Patient because of the Psychological Impact and Parental Denial in the Diagnosis of Cystic Fibrosis: A Case Report

Relationship between parents and children is unique for its endurance, responsibility, delicacy and vulnerability. Facing a chronic, incurable disease diagnosis in child sometimes could be unacceptable by parents. We present a clinical case of a girl with diagnosed cystic fibrosis as a toddler, but failure in maternal coping with the diagnosis lead to significant progression of the disease and severe, irreversible...

Malignant Gastrointestinal Stromal Tumour – A Case Report

Gastrointestinal stromal tumours (GIST) constitute a broad spectrum of nonepithelial neoplasms arising from connective tissue elements located along the entire length of the gastrointestinal wall. They are rare neoplasms which account for 0.1–1% of gastrointestinal malignancies. The majority are located in the stomach and small intestine, while those arising from the oesophagus, colon and rectum are uncommon. Usua...

Sexual Dysfunction in Tunisian Behcet’s Patients: Influencing Factors

Objectives: To evaluate the sexual activity of Tunisian patients with Behçet disease (BD) and to identify its influencing factors. Methodology: Monocentric, Cross-sectional and descriptive study over a six-monthperiod gathering Behçet’s patients. Data was collected from the medical records and completed in a face-to-face meeting during which each patient responded to questionnaires related to sexual activity (The...

Giant Small Bowel Polyp with Intussusception Managed by Single-Balloon Enteroscopy in a 6-year-Old Peutz-Jeghers Syndrome Patient

A 6-year-old boy with a family history of Peutz-Jeghers syndrome (PJS) presented with intermittent abdominal pain for three months. Physical examination showed typicalmelanotic macules on lips and finger tips (Figure 1a, b arrow). Abdominal ultrosonography showed multiple intussusceptions.

Giant Angiomyxolipoma of the Scalp

Angiomyxolipoma (AML), is a rare lipoma variant with characteristic histopathological and immuno-histochemical features . Here we present a case of angiomyxolipoma appearing in the subcutaneous tissue of the scalp with the size of 9.0x3.0 cm. Review of literature reveals 24 cases of AML with two cases of scalp lesion being reported up to date. This is the first case study which has been demonstrated the rate of gr...

Total Hip Arthroplasty in a Patient with Crowe Type 4 Dysplasia, a Challenge for Orthopaedic Surgeons

Introduction: Total Hip Arthroplasty (THA) is a technically demanding procedure in patients with high hip dislocation due to both femoral and acetabular deformity, and morphologic abnormalities. Several problems and complications can be encountered, like nerve palsy, dislocation, non-union of the osteotomy site, peri-prosthetic infection, residual limp and periprosthetic fractures. We are presenting a long journey...

Suggested Protocol for Antenatal and Postnatal Action in Response to Absence of the Ductus Venosus, Referring to Nine Cases of Prenatal Detection

The absence of the ductus venosus (ADV) is a rare congenital vascular malformation, with an estimated incidence of 1/2532 foetuses diagnosed by ultrasound in week 11-14 of gestation. Its prevalence in the general population is unknown, because no systematic screening for this condition is performed [1]. The ductus venosus (DV) is a foetal shunt that connects the intra-abdominal section of the umbilical vein (UV) a...

Absence of Zika Virus Associated Congenital Syndrome despite Prolonged Maternal Viremia until the 27th Week of Gestation

Background: Vertical transmission of Zika virus has been previously reported in several studies. The percentages of fetuses or infants with possible Zikaassociated birth defects among completed pregnancy rising to 11% in those infected at first-trimester. Case report: We describe a case of symptomatic Zika virus infection during pregnancy in a 37-years-old Mexican woman with maternal viremia for 133 days that resu...

Chronic Excited Catatonia: A Case Report

The fifth edition of the DSM considers catatonia a separate disorder for the first time. The diagnosis requires the presence of at least three of its twelve characteristic features. Catatonia may occur in the context of numerous medical conditions and psychiatric disorders, including affective disorders and schizophrenia. It is listed as “unspecified” when the nature of the underlying condition has not been elucid...

Pneumopericardium: Rare Complication of Cocaine Abuse

A 29-year old malepresented at the emergency department (ED) with chest pain and localised tenderness of the neck after snorting cocaine. Physical exam showed moderate subcutaneous emphysema on the right side of the neck. No ST-elevation compatible with cocaine-induced cardiac ischemia was seen on ECG and blood analysis was normal (negative troponins). Chest X-ray revealed subtle evidence of pneumomediastinum. Fur...

Laryngeal Granuloma Post Elective Tonsillectomy

SC, a healthy 16 year old female presented with worsening dysphonia 4 weeks after an uneventful elective tonsillectomy for recurrent tonsillitis. Her dysphonia was persistent since her operation progressing to almost complete aphonia. Oral cavity and neck examination were unremarkable. Flexible nasoendoscopy demonstrated bilateral large fleshy masses partially occluding the posterior glottis preventing adduction o...

Intractable Hiccups, a Rare Primary Presentation of Oesophageal Cancer

A previously well 48year old man presented with intractable hiccups for six weeks. Examina- tion revealed hepatomegaly and an epigastric mass. CT scan showed an oesophageal tumour and liver metastasis (Figures 1-3). He was referred to a hospice for palliation and died seven weeks later. Dysphagia and weight loss are the commonest presentations of oesophageal cancer. Although hiccups is a rare primary presentation,...

Multidrug-Resistant Tuberculosis Patients Presenting with Bronchiectasis and Usefulness of the Six-Minute Walk Test: A Case Series Report with Literature Review

Multi-Drug Resistant Tuberculosis (MDR-TB) is associated with extensive lung damage which impinges on the quality of life during and post-treatment. The six-Minute Walk Test (6-MWT) demonstrates significance in predicting the cardiopulmonary functional status in tuberculosis patients with bronchiectasis. We present a case series of MDR-TB patients with the multifarious manifestation of bronchiectasis and response...

Hypersexual Disorder - A Case Report and Analysis

The concept of hypersexuality or Hypersexual Disorder (HD) has been around for some time but has been mostly bracketed within the category or as a symptom of bipolar mania. Controversy surrounds however the true place of hypersexual disorders amongst the various disorders in both the Diagnostic & Statistical Manual (DSM) and the International Classification of Diseases (ICD). Clinical practice and shared opinion w...

Nasal Glioma: A Case Report and Review of Literature

The nasal glioma is one of the rare-dysplasia disease that mainly happen in the early stage of infancy or young children. And now many scholars consider that nasal glioma is mainly composed by the brain tissue and meninges protruding to the nasal cavity during the development of skull base, included dura mater, pia mater, arachnoid and disconnect with the intracranial during the development. We reported a case of...

Temporomandibular Joint Deformities and Atlantoaxial Impaction in Rheumatoid Arthritis

Rheumatoid arthritis is the most common type of autoimmune arthritis characterized by inflammation of the synovial membranes. Even though any articulation can be involved, temporomandibular joints are considered among the last ones to be affected. Cervical spine involvement is also considered a feature of long-standing disease, atlantoaxial impaction with vertical subluxation of the odontoid process through the fo...