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In Press

In Press

Multisystem disseminated kaposi sarcoma in untreated advanced HIV infection

Luiza Fernanda Mendonça Nicolau; Zaira Fernanda Martinho Nicolau*; Leandro Moura; Rachel Neves Nicolau; Samira Correa Moreira; Fernando Chiodini Machado

Kaposi Sarcoma (KS) is a cytokine-mediated antiproliferative malignancy. Multiple factors have been implicated, and epidemiologic, serologic, and molecular studies support an association with human herpesvirus type 8 (HHV8) infection [1]. Individuals with HIV infection have an increased risk of developing KS, an AIDS-defining malignancy ...

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Step-up management of walled-off necrosis with artificial intelligence support

Pablo Roberto Silva Marques; Higino Felipe Figueiredo; Daniel Lourenço Lira; Ryan Antonio De Lucena Almeida; Tiago Magalhães Cardoso; João dos Santos Pereira Braga Neto; Zaira Fernanda Martinho Nicolau*

Acute pancreatitis is a major cause of hospitalization for gastrointestinal disease. Although most patients have a self-limited course, a subset develops moderately severe or severe disease, characterized by organ failure, pancreatic necrosis, and potentially life-threatening local complications. Among these complications, organized pancreatic necrosis, ...

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Caudal Regression Syndrome in an infant of a diabetic mother: A 14-year follow-up case report

Sanam Moothiram; Lloyd Tooke

Caudal Regression Syndrome (CRS) is a rare congenital condition characterized by abnormal development of the caudal spine and spinal cord, ranging from isolated partial sacral agenesis to complete lumbosacral agenesis [1]. The overall incidence is estimated at 1-2.5 per 100,000 live births [2]. The condition is most commonly classified ...

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Hypertrophic osteoarthropathy secondary to lung cancer: A case report

Catalina Arango Jaramillo; Luisa Fernanda Carriazo Rojas; Isabella Londoño Ríos; Nicolás Santiago Ortiz Chamorro*, José Gregorio Thorrens Ríos

Hypertrophic Osteoarthropathy (HOA) is an uncommon clinical syndrome characterized by abnormal proliferation of the skin and osseous tissue in the distal extremities. Its clinical manifestations include digital clubbing, periosteal proliferation of long bones, and synovial effusion, accompanied by arthritis or arthralgia. ...

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Acute dyspnea and stridor in primary care: Tracheal adenoid cystic carcinoma in a non-smoker

Gaja Grabnar*; Erika Zelko

Tracheal adenoid cystic carcinoma is a rare cause of airway obstruction and may initially mimic common respiratory conditions. In primary care, recognition is particularly challenging because chest radiography...

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Silent but significant: Asymptomatic chronic lymphocytic leukemia in a young adult presenting with leukocytosis and radiologic lymphadenopathy

Sherin Mohamed, MD*; Roshan Koshy Jacob, MD; Sarath Chandran, MD

Chronic Lymphocytic Leukemia (CLL) represents the most prevalent adult leukemia in Western populations, with a median age at diagnosis of approximately 70 years. The disease is exceptionally rare in patients under 40 years of age, and such presentations ...

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Alternating Wenckebach periodicity: A common, yet overlooked, ECG phenomenon in high-frequency rhythms

Nicola Ferrara, MD*; Irene Scimè, MD; Luciano Sutera Sardo, MD

Electrocardiographic interpretation of high-rate atrial tachyarrhythmias can be challenging. We report a case of atrial tachycardia with a particular regularly irregular conduction pattern. Alternating Wenckebach periodicity is a common, yet overlooked, electrocardiographic phenomenon ...

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Deep infiltrative endometriosis mimicking rectal cancer in a post-menopausal woman: A case report

Amy R Sharkey*; Ahmed Elowaidy

Imaging characteristics of rectal endometriosis overlap with rectal cancer, which can lead to misdiagnosis. We describe a 71-year-old woman, presenting with post-menopausal bleeding, found to have a rectal mass on pelvic MRI, which was presumed malignant at the time of reporting. However, biopsies were inconclusive ...

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An unusual case of disseminated peritoneal leiomyomatosis: A case report

Amy R Sharkey*; Ahmed Elowaidy

Disseminated Peritoneal Leiomyomatosis (DPL) is a rare, usually benign condition, marked by multiple leiomyomas in the peritoneal cavity. Although typically benign, DPL can present significant diagnostic challenges. ...

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Terminal ileal ulcers; Diagnostic dilemma

Mohammed Omar Khalifa Elsayed*

Terminal Ileal (TI) ulcers are occasionally detected in asymptomatic, healthy individuals, regardless of their medication history, including the use of aspirin or Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). In most cases, these ulcers resolve completely on their own without treatment, though some are associated ...

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Advances in the mechanisms of traditional Chinese medicine in the treatment of heart failure

Dexiu Li*

Heart Failure (HF) represents the advanced stage of various cardiovascular diseases and remains a major global public health challenge despite advances in pharmacological and device-based therapies. Traditional Chinese medicine (TCM) has emerged as a promising adjunctive ...

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The longest uvula - stretched to the epiglottis from normal swallowing reflexes activated by a fibroma on its tip

Jerry E Bouquot*; Lakshmi Garladinne; Melissa Luna

An enlarged uvula is known to result from more than a dozen different toxic, infectious or traumatizing phenomena, including pharyngitis, smoking cocaine or crack, snoring/sleep apnea, and several sexually transmitted infections.

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A conceptual AI-integrated ZnO quantum dot nanophotonic device for early non-invasive breast tissue assessment

Zahra Fakhroueian*; Fereshteh Abbasvandi; Pouriya Esmaeilzadeh*; Marzieh Eghtedardoost

This work proposes a conceptual optical–AI integrated framework based on ZnO quantum dot fluorescence for non-invasive early breast tissue assessment. The system is designed as an external wearable optical platform, in which controlled near-infrared excitation stimulates photoluminescent responses from functionalized quantum dot interfaces.

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Distribution characteristics of cerebral hemodynamic load in different brain regions of acute cerebral infarction patients undergoing acetazolamide PECT imaging

Xiao Lin; Caihua Zou; Ye Liang; Jingwei Shang*; Wenqiang Li*; Tianzi Li*

To investigate the incidence of Cerebral Hypoperfusion Lesions (CHL) in patients with acute cerebral infarction and their distribution characteristics in different brain tissues. A total of 177 patients with acute cerebral infarction were enrolled.

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Prevalence of elevated lipoprotein(a) among women consulting the Women’s Hospital in Karbala, Iraq: A hospital-based study

Mutaz Al-Khnifsawi*

Lipoprotein(a) [Lp(a)] is an emerging, genetically determined lipid parameter recognized as an independent risk factor for atherosclerotic cardiovascular disease. The study aimed to determine the prevalence of elevated Lp(a) levels among Iraqi women attending the Women’s Hospital in Karbala Iraq.

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Case report: Endobronchial mass in a young male with AA amyloidosis secondary to Crohn’s disease

Konstantinos Dodos*; Tsampika-Vasileia Kalamara; Vasiliki E Georgakopoulou

AA amyloidosis, also known as secondary amyloidosis, is a systemic disorder resulting from chronic inflammatory conditions and characterized by extracellular deposition of Serum Amyloid A (SAA)-derived fibrils. Although renal involvement is most common, pulmonary manifestations are rare and may present diagnostic challenges.

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Previously unreported: The bone ring – uniformly thick, constantly active, always immature bony wall around an intraosseous hemangioma

Jerry E Bouquot, DDS, MSD, DABOMP, DABOM (Hon)*; Lakshmi Garladinne, BDS, MS, MDS, MA, DABOMR; Melissa Luna, BDS, DABOMP

Hemangiomas within the mandible or maxilla are rare and typically present as radiolucencies with well- demarcated borders. It is rare to have focal or diffuse sclerosis at the border, but we present a case with an extremely unusual and completely unexplained sclerotic ring around such a vascular lesion.

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A narrative review and perspectives of PANDAS/PANS in the COVID-19 age: Impact of the infection and vaccination

Stefano Pallanti*; Carlotta Colzi; Marcello G Tanca; Daniela Marotto; Nikos Makris

The COVID-19 pandemic has significantly affected mental health worldwide. In children and adolescents with neuropsychiatric conditions, especially those with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and its subtype Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

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Catastrophic hemorrhagic complication post-fibrinolysis in STEMI patient: A rare case report in a limited resource setting

Wilbert Huang, MD*; Harold JM Charlex, MD; Ryzufar Altarif Farsal; Mazaya IB Amadea, MD; Hendrianus The, MD

Despite the efficacy of fibrinolysis, it also imposes patient to risk of bleeding that could be fatal. A 68-year-old male presented with anginal chest pain 4 hours onset. Vital signs were BP 59/40 mmHg, HR 45×/minute, RR 22×/minute and SpO2 88%. Patient had history of PCI on 2015.

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A rare case of giant pituitary metastasis from a duodenopancreatic neuroendocrine tumor and literature review

Stamatis Banos; Mary Solou*; Evangelos K Papadopoulos; Ioannis Ydreos; Lampis C Stavrinou; Efstathios J Boviatsis

Pituitary metastases are rare and often mimic benign adenomas, leading to diagnostic delays. Even more uncommon are metastases from gastrointestinal or pancreatic Neuroendocrine Tumors (NETs), especially when presenting as giant sellar masses.

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Acute ruptured hemorrhagic ovarian cyst: CT findings in a life-threatening presentation

Himanshi Batra, MD; Anmol Kasera; Akhila Prasad, MD; Akanksha Yadav, MD; Paramjeet Singh, MD; Rupayan Kundu, MD*

Though infrequently encountered, a ruptured hemorrhagic ovarian cyst can cause sudden, severe abdominal pain and can be mistaken for other emergency gynecologic or abdominal conditions. A 36-year-old woman presented with acute onset severe abdominal pain with vomiting and a sudden and deteriorated with significant drop in hemoglobin.

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Supernumerary teeth extraction via robot-assisted surgery without flap elevation

Linyang Xie#; Sina Ahmadi#; Chengpeng Lv; Junbo Tu; Xiang Liang; Sijia Na*

Impacted supernumerary teeth often require surgical intervention, which may involve extensive bone removal and risk to adjacent anatomical structures. Minimally invasive techniques, especially those facilitated by robotic technology, provide a viable alternative.

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Herlyn–Werner–Wunderlich syndrome in an adolescent with severe dysmenorrhea

Victoria Tischer Sawka*; Guilherme Welter Wendt

A 16-year-old nulliparous female with a history of severe dysmenorrhea since menarche (age 14) presented with worsening lower abdominal pain. Her cycles were irregular (24-30 days), with normal flow lasting five days. After four cycles, she developed severe dysmenorrhea, associated with nausea, dizziness, and functional impairment.

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Erysipelothrix endocarditis acquired from household cat presenting with ischaemic stroke

Bolaji Paul*; Hadley Emma; Mudalige Gagira; Thiri Lawun; Dharmasiri Michelle; Lee Mihye

A 75 yr old woman presented to our stroke service with acute onset of word finding difficulty and confusion. She was subsequently diagnosed with a left Middle Cerebral Artery (MCA) territory stroke. During admission she developed high-grade fevers and examination identified a diastolic murmur. ...

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Aggressive pituitary macroadenoma causing refractory Cushing’s disease: A 14-year follow-up

Senay Topsakal*; Sema Taban; Ibrahim Celik

Cushing’s Disease (CD) is most commonly caused by ACTH-secreting pituitary microadenomas, whereas macroadenomas are rare and often associated with aggressive behavior, treatment resistance, and poor prognosis. We report a challenging case of CD caused by a pituitary macroadenoma with an unfavorable long-term outcome. ...

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Intrapartum surgical treatment of congenital diaphragmatic hernia: A review of 10 cases and literature review

Liu Yanling; Li Yongxin; Peng Huiling; Zhang Qiang; Yang Xinghai*

Congenital Diaphragmatic Hernia (CDH) poses significant respiratory challenges at birth due to lung hypoplasia and pulmonary hypertension. The Ex-utero Intrapartum Treatment (EXIT) procedure offers a potential strategy to secure the airway while maintaining uteroplacental circulation in selected severe cases. ...

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Epistemic divide between “why” vs. “how” questions in interrogating explainable artificial intelligence for clinical decision support

Alexander Lazarov*; Adit Jindal

Autonomous digital systems have emerged as practical options supporting clinicians in real-world medical settings. These systems serve as collaborative partners to physicians rather than instrumentation or competitors, with smooth integration occurring when human and machine judgments align. Challenges arise ...

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Co-occurrence of high-grade myeloid neoplasm and plasma cell myeloma-type post-transplant lymphoproliferative disorder

Lauren Borecky; Kevin Leeper; Jun Wang*; Mojtaba Akhtari

The co-occurrence of a myeloid and plasma cell neoplasm is an incompletely understood phenomenon with few cases reported in the literature. Even rarer is the coexistence of two separate hematologic malignancies in a post-transplant patient. We present a unique case of a concurrent acute myeloid neoplasm with monocytic differentiation ...

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A rare case of a pediatric low grade appendiceal mucinous neoplasms and review of literature

Boukettaya Wiem*; Khlifi Khawla; Nsiri Emna; Braiki Mariem; Mizouni Abdelkader; Chabchoub Elyes; Daoues Yasmine; Ben Fatma Leila; Chabchoub Imen

Colorectal cancer is extremely rare in children. Primary appendiceal carcinomas are often found incidentally when the appendix is surgically removed. Appendiceal Mucinous Adenocarcinomas are even less common. We report a case of a 10-year-old girl presented with abdominal pain associated with vomiting episodes. ...

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“Whispers of temptation”: The connection between auditory hallucinations and substance use disorder in patients with schizophrenia – A case series

Alvin J Joseph*; Sachin Nagendrappa

Schizophrenia is frequently complicated by comorbid Substance Use Disorders (SUDs), with prevalence rates reported to be between 40-50% across clinical and community settings. Multiple explanatory frameworks have been proposed, including the diathesis–stress model, cumulative risk exposure ...

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Two cases of pediatric colorectal carcinoma with atypical presentation

Ivan Boronsuzov; Ivan Shtarbanov; Boryana Avramova*

Pediatric colorectal carcinomas are very rare cancers, particularly before puberty, with annual incidence of 1-2/1,000,000 cases [1,2]. From all cases only 1-4 % occurs in children and adolescents [2]. In pediatric group the tumor is more frequent in male aged above 15 years [3].

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Radiation therapy for pseudotumor of skull base: A single institutional case series

Ramesh Keerthi Gadam, MBBS; Fen Wang, MD, PhD*

IgG4-related skull base pseudotumor is a benign fibroinflammatory disorder involving tissues of the skull base. If inadequately controlled, it may progress to a more diffuse disease with involvement of the optic nerve, additional cranial nerves, and skull bones.

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Intracular pressure and central corneal thickness profile in non-glaucomatous subjects with melanoderma in Togo

Mawuli AK Santos*; Yawa Edeba Nagbe; Kossi Dzidzinyo; Nidain Maneh; Kokou Vonor; Koffi D Ayena

Intraocular Pressure (IOP) is a major diagnostic and prognostic factor in glaucoma management [1]. However, measured IOP values are influenced by Central Corneal Thickness (CCT), which can lead to underestimation or overestimation of true IOP. Pachymetry is therefore essential ...

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Epidemiological profile of distance visual impairment among adults aged 50 years and older in Northern Togo in 2024

Mawuli AK Santos*; Kossi Dzidzinyo; Yawo S Prempe; Nidain Maneh; Kokou Vonor; Koffi D Ayena

Visual impairment is a major public health problem, particularly among older adults. Recent data remain scarce in some regions of Togo, especially in rural and hard-to-reach areas of the northern part of the country.

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Metastatic merkel cell carcinoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome

İ Merve Uçar Baytaroğlu*; Ayşegül Merç Çetinkaya

Merkel Cell Carcinoma (MCC) is a rare, aggressive cutaneous neuroendocrine malignancy strongly associated with immunosuppression. We report the third documented case of MCC in a patient with Systemic Lupus Erythematosus (SLE), highlighting the critical role of chronic immunosuppressive therapy rather than the autoimmune disease itself as the primary risk factor for MCC development.

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Long-term follow-up outcomes in patients with pulmonary stenosis monitored at a pediatric cardiology unit

Şenay Yapici Karaca, MD; Ergül Çil, MD; Yücel Karaca, MD*

Pulmonary Stenosis (PS) refers to various levels of obstruction between the right ventricular outflow tract and the peripheral pulmonary arteries, most commonly occurring at the valvular level. Echocardiography is widely accepted as an effective and reliable tool for the diagnosis and follow-up of PS.

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Herpes simplex virus-1 associated esophagitis concomitant with gastritis in an immunocompetent host

Emin BODAKÇİ*

Herpes Simplex Virus (HSV) esophagitis is the most common viral esophagitis in clinical practice [1]. Herpes Esophagitis (HE) is typically caused by Herpes Simplex Virus type 1 (HSV-1), although less frequently, it is caused by HSV type 2 (HSV-2). Most cases of HE occur in immunocompromised hosts, but occasionally immunocompetent patients develop this condition [2].

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Data-driven modeling in biomechanics: The synergy of artificial ıntelligence and numerical analysis

Halil Burak Mutu*

Recent advances in biomechanics increasingly rely on the combination of computational modeling and artificial intelligence to understand and predict the behavior of biological tissues. Traditional methods, such as finite element analysis, often struggle with the inherent complexity, heterogeneity, and adaptability of living systems, requiring significant computational resources.

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Splenic rupture after ibrutinib discontinuation

Arcaro Teresa; Vozella Federico; Cerchiara Elisabetta; Bianchi Antonella; Gambaro Francesco Luigi; Bruno Amalia; Faiella Eliodoro; Perrone Giuseppe3; Rigacci Luigi*

Chronic Lymphocytic Leukemia (CLL) is the most prevalent leukemia in adults in Western Countries. Remarkable strides have been achieved in treatment of CLL. One notable class of agents revolutionizing CLL treatment is Bruton’s Tyrosine Kinase Inhibitors (BTKi), which have reshaped the landscape by proving viable alternatives to traditional chemotherapy and immunotherapy.

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Sepsis with thrombocytopenia and renal failure after a holiday at a lake in Eastern Europe

Isabelle Ried*; Manuela Segerer; Robert Hilge; Wolfgang Guggemos; Stefan Sack; Tobias Heer

Leptospirosis is a zoonotic bacterial infection that is acquired through contact with infected animal urine, contaminated water, or soil. An infection may be missed due to late seroconversion.

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Leprosy unmasked by immunosuppression: A diagnostic pitfall with cutaneous sarcoidosis mimicry

Vartan Matossian*; Ginearosa Carbone; Caitlin Lawlor; Stephen Hosea; Meredith Perrin; Lindsay Katona

Leprosy, also known as Hansen’s Disease, is a bacterial infection of the skin and peripheral nerves caused by Mycobacterium leprae [1]. Despite being uncommon in developed nations, leprosy remains a significant global health concern,

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Incidental diagnosis of superior vena cava syndrome secondary to lung mass in a patient presenting with haemorrhoids

Lusanda Y Zongo*; Northern Mamphiswana; Lithalethu Nkomonye; Charles Choto; Amina Hoossen; Singleton Sandla; Ayabulela Sitshange; Siviwe Yako; Sijabulile Sosibo

We report the case of a 56-year-old male who presented with a two-week history of painless rectal bleeding and perianal discomfort due to Grade II internal haemorrhoids. During evaluation, a thorough systemic examination revealed facial puffiness,

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Giant recurrent retroperitoneal dedifferentiated liposarcoma: Case report and multidisciplinary therapeutic considerations

Lamattina S; Passa Roberto*; Castagliuolo P; Pagnoni C; Angelucci M; Alloni R; Valeri S

Retroperitoneal dedifferentiated liposarcoma represents a rare and aggressive mesenchymal neoplasm, frequently associated with a high propensity for local recurrence.

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Germline CHEK2 and lynch like phenotype in a rare metachronous presentation as haematological and gynaecological malignancies

Amrit Kaur Kaler*; Imran Nisar Shaikh; Riya Manoharan; Krisna Jariwala; Yogesh Kulkarni; Shalaka Satpute; Hardik Mahendrakumar Patel

A germline CHEK2 nonsense variant was identified in a patient presenting with both diffuse large B-cell lymphoma, a subtype of non-Hodgkin’s lymphoma, and endometrioid adenocarcinoma, through next-generation

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The relationship between N-methyl-D-aspartate receptor and anxiety disorders accompanied by thyroid nodules

Meilan Su; Haishui Duan; Zhirong Fang; Yuan Chang; Juan Zeng; Xiaoting Wu; Song Wang*

We previously found that N-Methyl-D-Aspartate Receptors (NMDAR) are likely associated with the pathogenesis of Anxiety Disorders (AD) and Thyroid Nodules (TN). This study aimed to investigate the predictive value of NMDAR and its subunits in the development of TN among patients with AD.

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Molecular and clinical characterization of Meckel-Gruber syndrome: A case study

Najmieh Saadati; Mina Zamani; Hamid Galehdari*

We aimed to report a rare clinical case of Meckel syndrome diagnosed by early ultrasound for prenatal diagnosis with characteristic signs, and molecular genetic validation using whole exome sequencing (WES) to make an update on genetic heterogeneity and polymorphism of this entity in our population.

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Definition of vitamin B12 deficiency: Concepts, biomarkers, grey zones, subclinical states, and diagnostic perspectives

Emmanuel Andres*; Xavier Jannot; Jean-Edouard Terrade; Noel Lorenzo-Villalba

Vitamin B12 deficiency, cobalamin deficiency, remains difficult to define because no single biomarker provides a reliable gold standard, and international consensus on diagnostic thresholds is lacking.

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Stigma of mental illness and how to overcome

Manal Mohamed Elkayal*

Stigma toward people with mental illness is a multi-dimensional process that links stereotypes, negative attitudes, and discriminatory behaviors to those who have mental disorders. It operates at public, self (internalized), and structural (institutional) levels, and reduces help-seeking.

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Mitral valve replacement in severe mitral annular calcification: Managing periprosthetic leak and persistent symptoms

Elliot Brown, MD*; Giuseppe Imperatore; Sajidur Rahman-Kader, MD; Daniel Musat; Habib Jabagi, MD

Severe Mitral Annular Calcification (MAC) represents a rare but technically demanding condition that significantly increases operative risk during mitral valve surgery. Patients undergoing Mitral Valve Replacement (MVR) in this context are predisposed to structural, haemodynamic, and rhythm-related complications.

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Not always in pairs! A case of unilateral Pneumocystis pneumonia

Giovanni Del Fabro *; Emanuela Chimienti; Arben Lleshi; Brigida Stanzione; Michele Spina; Sergio Venturini

Pneumocystis Jirovecii Pneumonia (PJP) is an opportunistic infection increasingly observed in non-HIV immunocompromised patients, with mortality rates up to 50%. The typical radiological pattern is bilateral interstitial pneumonia with diffuse ground-glass opacities. However, atypical presentations, including

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Comparative study of laparoscopic Total Extraperitoneal Herniorrhaphy (TEP) and lichtenstein herniorrhaphy for the treatment of unilateral primary inguinal hernia in adults

Fang Zhang

To compare the clinical efficacy of laparoscopic Total Extraperitoneal Herniorrhaphy (TEP) and Lichtenstein herniorrhaphy in treatment of unilateral initial inguinal hernia patients.

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Combinations of nifedipine and cyclosporine induced gingival enlargement

Di Le, SMD; Haixia Xing, SMD*

A 52-year-old male complained with gum overgrowth for ten years. He took immunosuppressants (cyclosporine) for post-kidney transplant treatment for twenty years. He took nifedipine sustained-release tablets to control blood pressure. At clinical observation, obvious firm gingival hyperplasia affected both labial and lingual papillary region,

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Botulinum toxin type a treatment for Meige syndrome - A case of blepharospasm combined with oromandibular dystonia and literature review

Xiao Long*

Meige Syndrome (MS) is characterized by blepharospasm and oromandibular dystonia that are often refractory to oral medications.

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Surgical repair of extensive myelomeningocele using integra® dermal regeneration template

Paulina Gisman*; Michał Puliński; Tomasz Janowicz; Michał Szostawicki

Myelomeningocele (MMC) is a severe congenital malformation of the central nervous system arising around the fourth week of fetal life due to neural tube closure failure. This defect results in an open communication between the neural placode and the external environment.

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Pleural effusion as a clinical presentation of Whipple disease: A case report

Celeste Pugliaro*; Vincenzo Milano; Genti Shyti; Federico Di Marco; Fulvio Braido

Whipple disease is a rare condition caused by the actinomycete Tropherima whipplei, ranging from asymptomatic carriage to chronic localized and systemic infections. The long and nonspecific prodromal symptoms.

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Perinatal tuberculosis – A rare but serious neonatal infection

AS Philip; L Tooke*

Perinatal Tuberculosis (TB) is a rare yet severe infectious disease which may affect neonates. This is a case of an infant who had non-specific manifestations of this disease, which mimic neonatal sepsis.

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Muscle weakness associated with CVA1 gene mutation: Clinical insights from a vietnamese case

Tam Thi Minh Mai; Huu Cong Nguyen; Anh Hong Vu; Trung Cong Nguyen; Ha Thi Vu*

Congenital generalized lipodystrophy with CAV1 variants is a group of conditions characterized by abnormal adipose tissue distribution, including complete or partial loss of adipose tissue or accumulation in internal organs.

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Emergency treatment of ventricular electrical storm caused by self - administration of aconitum and aconite poisoning in a gout patient

Liu Lili*; Yang Xiaoyan; Zhu Junjun; Li Jinzhi; Wu Jun; Chen Yingying

A 54-year-old male patient was admitted to the emergency room at 21:45 on March 26, 2022, due to “chest tightness for 5 hours after self-administration of Aconitum and Aconite”. On admission, he was in a painful state, complaining of palpitations, chest tightness, fatigue, and amaurosis.

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A case of pulmonary nocardiosis complicated by pneumothorax during the treatment for interstitial pneumonia associated with rheumatoid arthritis

Karin Matsuda; Hiroki Ohkoshi*; Kenta Homma; Satoshi Furuya; So Shimamura; Chisa Omori; Yuki Hoshino; Yoshinori Uchida; Masafumi Saiki; Shinnosuke Ikemura; Tsuyoshi Uchida; Hirochika Matsubara; Kenzo Soejima

A 76-year-old man had been treated with prednisolone, tacrolimus, azulfidine, and nintedanib for interstitial pneumonia associated with rheumatoid arthritis for two years. A CT scan displayed a gradually enlarging cyst with wall thickening beneath the pleura in the superior segment of the left lung.

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Successful application of a probiotic supplement in patients with type 2 diabetes mellitus

Petra Wiechel; Julia Jantz; Pamela Canaviri-Paz; Johan DeFaire; Andreas Pfützner*

Type 2 Diabetes Mellitus (T2DM) is a progressive metabolic disorder characterized by persistent hyperglycemia resulting from the combined effects of insulin resistance in peripheral tissues, pancreatic β-cell dysfunction, and chronic low-grade systemic inflammation.

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Gastric antral perforation with a fish bone, laparoscopic surgical intervention in a sub-saharan setting: A case series

Basimbe Francis*; Musolo Allan; Kakooza Francis; Hakim Din Iman; Tumusiime Cresent; Najjuka Geraldine

Foreign body ingestion is a common occurrence in clinical practice experienced in many parts of the world, especially among the pediatric population. However, their occurrence in an adult population is rare.

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Thalassemia in the 21st century: Challenges, and solutions, a review article

Suad M Jatal*; Sawsan J Harfouch; Rim M Harfouch

Thalassemia represents a group of inherited disorders characterized by defective hemoglobin synthesis, leading to ineffective erythropoiesis and hemolytic anemia. The disease is most prevalent in the Mediterranean, Middle East, Indian sub-continent, and parts of Southeast Asia and Africa.

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An unexpected diagnosis: Solitary fibrous tumor of the pleura revealed during appendicitis workup

FNU Samaksh*

Solitary Fibrous Tumor of the Pleura (SFTP) is a rare, slow-growing mesenchymal neoplasm that accounts for approximately 5% of all pleural tumors, affecting both men and women [1]. The estimated incidence is 2.8 cases per 100,000 hospitalized patients.

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A common clinical challenge: Cervical lymphadenopathy with fever – what should we look out for? A case report

Lilia Driever; Tomislav Stjepic*; Joseph Osterwalder

Isolated cervical lymphadenopathy with fever is a common reason for consultation in primary care. A straightforward, practitioner-focused diagnostic pathway is largely lacking in literature. Unlike hospital medicine—where rapid certainty and access to extensive, costly diagnostics is the norm.

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U-Net as a deep learning-based method for platelets segmentation in microscopic images

Ajay Kumar; Charlie A Coupland; Tania F Vaz; Will Jones; Ruben Valcarce-Dineiro; Simon DJ Calaminus; Eva Sousa*

Manual counting of platelets, in microscopy images, is greatly time-consuming. Our goal was to automatically segment and count platelets images using a deep learning approach, applying U-Net and Fully Convolutional Network (FCN) modelling. Data preprocessing

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Exploration of the mechanism and treatment methods of lisfranc injury

Shaodong Dong; Xian He; Xiaoji Gong; Fu Zhou; Yong Yuan*

Lisfranc injury, also known as the tarsometatarsal joint complex injury, refers to the bone or ligament damage of the tarsometatarsal joint and the intercuneiform joint, including stable injury, partial sprain, severe midfoot displacement unstable fracture or fracture dislocation.

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Histologic diagnostic features of echinococcosis in clinical practice

Amy L Rousselot, MS, DO; Jian Jing, MD, PhD*

Echinococcosis is a zoonotic parasitic disease caused by Echinococcus tapeworms, leading to the development of hydatid cysts, most commonly affecting the liver and lungs. Clinical manifestations are often nonspecific, making diagnosis challenging.

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Depression as primary symptom presentation of glioblastoma multiforme: A case series

Jordanne Nichols, MS*; Vanessa Grant-Kirschke, MS; Rebecca Bolen, BA; Ian George, PhD

Glioblastoma Multiforme (GBM), a subclass of astrocytoma, is widely recognized as the most aggressive form of neurologic tumors [1]. Astrocytomas that subsequently have increased microvascular proliferation and/or necrosis present within the tumor are classified by the World Health Organization (WHO) as stage IV astrocytomas

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Chronic tinea cruris caused by Trichophyton indotineae in a healthy young woman in Morocco: A case report

Ilham Snoussi*; Ouiame El Jouari; Salim Gallouj*

Trichophyton indotineae is an emerging dermatophyte species that has become a significant cause of chronic superficial fungal infections, especially in endemic regions. Its global spread and resistance to terbinafine pose challenges to effective treatment

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Anesthetic management of a patient with hypertrophic cardiomyopathy on mavacamten

Robert J Suriani Jr, MD; Luca Zazzeron, MD*

Hypertrophic cardiomyopathy (HCM) is characterized by asymmetric Left Ventricular (LV) hypertrophy, resulting in a dynamic LV Outflow Tract (LVOT) obstruction that can cause hemodynamic collapse. While HCM treatment has traditionally involved pharmacologic rate control and in severe cases, surgical intervention

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A surprise in the stool: A red taenia saginata!

Zakaria Rahmaoui*; Marwa Elbakkali; Souad Azelmat; Maryem Iken; Othmane Touzani; Badre Eddine Lmimouni; Hafida Naoui

We report the case of a 49-year-old female patient, with no significant medical history, presenting with chronic abdominal pain for nearly two years, associated with alternating episodes of diarrhea and constipation. In the absence of alarm signs or evidence of organic disease, a diagnosis of functional bowel disorder was considered.

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The role of the industrial Internet of Things (IoT) in modernizing pharmaceutical operations: A review of current trends

Emmanuel Alex Onyemaechi*; Johnson Tosin Patience; Jonathan Boomni Oye; Wei Haoming; Konstantin Koshenchkin

This review critically examines the transformative role of the Internet of Things (IoT) in revolutionizing pharmaceutical operations. This article explores how IoT technologies, through real-time monitoring, predictive maintenance, and automated process controls, enhance manufacturing.

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Successful multimodal management of a rare grade 3 primary hepatic neuroendocrine tumor: A case report

Niccolo Simonetti, BS; Enas Abdallah, MD, MSc*; Daniel A Anaya, MD, MSHCT, FACS; Hakob Kocharyan, MD; Mintallah Haider, MD

A 54-year-old male was seen for abdominal discomfort and was subsequently diagnosed with a Grade 3 primary liver neuroendocrine tumor replacing the left lobe. Based on the aggressive nature of the diagnosis, the patient was treated with systemic therapy with minimal response.

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Heterotopic pregnancy in a patient with prior ectopic pregnancy: Case report

Steven Laxton, MD*; David Whetstone, MD; Cynthia Wear, MD

This report is of a case of a 24-year-old female that experienced a heterotopic pregnancy with rupture of the ectopic with a history of an ectopic pregnancy that occurred 2 years prior. This report serves to add to current medical literature a case of heterotopic pregnancy.

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An overview: Challenges and concerns in adopting health technology in Northern Nigeria

Emmanuel Alex Onyemaechi; Konstantin Kosheckin; Mamadou Makan Kanoute*

The integration of ICT in the health sector offers numerous benefits, such as enhanced management efficiency, optimized organizational structures, and streamlined data handling. However, this review highlights significant barriers to digital health integration In Northern Nigeria, such as inadequate infrastructure, policy gaps, and literacy challenges.

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Unresectable pancreas cancer: Analysis of safety and efficacy of irreversible electroporation in elderly patients

Oliveira DS*; Setuguti DT; Melo RAB; Siqueira LTB

The objective of our study is to present our experience in Irreversible Electroporation (IRE) in the treatment of unresectable pancreas cancer in elderly patients. A retrospective study with ten patients over 80 years old who underwent percutaneous or surgical IRE to treat unresectable pancreas cancer between 2021 and 2024 after a multidisciplinary tumor board approval.

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CRISPR/Cas9-mediated humanization of laboratory animals: A comprehensive review and meta-analysis

Andrey Akinin*

The CRISPR/Cas9 system has revolutionized biomedical research by enabling precise genetic modifications in laboratory animals. This systematic review and meta-analysis assess the effectiveness of CRISPR/Cas9-mediated humanization across various applications, including disease modeling, immune system humanization, and therapeutic development.

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Anterior abdominal wall lipoma, mimicking adnexal lesion: A case report

Anas Hamdoun*; Mamoun Al Awad; Ziyad Alajlan; Reham Khubrani

Although lipomas are the commonest abdominal wall masses, the ones related to the peritoneum are extremely rare. We present here the second one in the literature and the first one mimicking ovarian dermoid for a 28-year-old lady who presented with right lower quadrant acute abdominal pain.

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The role of CEUS - PMFI in the early diagnosis of middle hepatic vein thrombosis in a patient with multiple cryptogenic abscesses: A case report

Carla Cipri; Marcello Ferrari; Rosario Maccarone; Angela Teti; Giuseppe Casuscelli; Sveva Loria; Saverio Loria; Matilde Lico; Giancarlo Gismondo-Velardi*; Pasquale Leone; Debora Ierace; Alfredo Vallone; Francesco Loria

Hepatic Vein Thrombosis (HVT) is a rare but clinically relevant condition that can complicate hepatic pathologies and contribute to high morbidity. A prompt detection is crucial for therapeutic measures and prevent severe complications. We present a case of a 58-year-old male with middle hepatic vein thrombosis associated with cryptogenic hepatic abscesses.

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Pseudoaneurysm: A case report

Biswajit Mishra*

Pseudoaneurysms of the superficial palmar arch are rare entities and only a few cases have been described in the English literature [1-10]. Penetrating trauma, repetitive trauma to a particular point is common aetiology. They can occur as a complication after previous surgery like carpal tunnel release [1] and arterial puncture.

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Primipara with peripartum cardiomyopathy: A case report

Tingting Chen; Xiufen Cai; Ying Yang*

Peripartum Cardiomyopathy (PPCM) is a rare but potentially fatal idiopathic cardiomyopathy that predominantly occurs in the late stages of pregnancy or within several months postpartum. It is clinically manifested as heart failure, posing a severe threat to the life of pregnant and postpartum women.

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Abdominal cystic lymphangioma: A rare case of cutaneous congenital malformation

Ilham Snoussi*; Ouiame El Jouari; Faical Abbad; Salim Gallouj

A uncommon benign lymphatic malformation called Lymphphangioma Circumscriptum (LC) is caused by dilated lymphatic veins in the epidermis and subcutaneous tissue. It frequently manifests in early childhood and can be acquired or congenital.

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Repeated hemichorea-hemiballismus as the initial presentation of ketotic hyperglycemia in a 79-year-old female: A case report and literature review

Mostafa A Mostafa*; Mohamed A Elsayed; Basma Seif; Lena S Mansour; Hagar Selim; Yasmin Attia

Hemichorea-Hemiballismus (HCHB) is a rare neurological movement disorder characterized by involuntary, violent, jerky movements typically affecting one side of the body, often due to lesions in the basal ganglia from various etiologies.

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Isolated sixth cranial nerve palsy in a patient with new onset diabetes mellitus

Poornima Jaiswal Charpuria*

Diabetes mellitus, a notorious global health concern, presents with a broad spectrum of microvascular and macrovascular complications, of which peripheral neuropathy and diabetic retinopathy are well known; however, isolated sixth nerve palsy is a rare entity noticed in the diabetic population.

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CMRI in a patient with left-sided cardiac defibrillator: Reducing artifact with fast gradient echo sequencing

Sidharth Addepalli, BS; Nika Samadzadeh Tabrizi, MD*; Thomas Fabian, MD; Stacey Langford, MD

Myocardial viability is primarily evaluated with cardiac Magnetic Resonance Imaging (cMRI); however, patient Implantable Cardioverter-Defibrillators (ICDs) have been shown to increase image artefact and reduce diagnostic viability. A 65-year-old man with ischemic cardiomyopathy, coronary artery disease and an ICD presented with a chief complaint of chest pain and dyspnea.

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Serum metabolites in the modulation of inflammatory factors on hepatic cancer: Mendelian randomization and mediation analysis

Weixin Wang; Linpei Li; Bicai Yang; Siyu Shen; Wenchun Chen; Hongyao Chen; Bo Pan*

To explore the causal relationships between inflammatory factors and hepatic cancer and identify the role of serum metabolites as potential mediators. In this study, we employed two-sample Mendelian Randomization (MR) analysis based on publicly available large-scale Genome-Wide Association Study (GWAS) data to investigate the causal relationships between 91 inflammatory factors, 1400 serum metabolites.

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Successful non-surgical treatment of laryngeal damage in a child patient with relapsing polychondritis and a literature review

Yinghua Zhao; Ruohan Yu; Zhengang Wang*

Relapsing Polychondritis (RP) is a rare auto-immune disease with children accounting for less than 5% of cases, and patients with tracheal chondritis have poor prognosis. Polyarthritis with fever was initially presented in a female patient of 12-year-old. Auricular chondritis, saddle nose and dyspnea developed within 3 months.

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Diabetic kidney disease and hypertension: What is inherited and what is acquired?

Marilena Stoian*

Diabetes Mellitus (DM) remains one of the commonest causes of structural and functional kidney abnormalities leading to End Stage Renal Disease (ESRD). The next most common cause is hypertension. It is utmost important to investigate the association between diabetic nephropathy and hypertension because it is a major causal factor of end- stage kidney failure in Type 2 Diabetes Mellitus (T2DM).

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A rare case of alcohol consumption after roxithromycin presenting as suspected myocarditis

Yuxiao Zhu; Luyao Ma*

Disulfiram-like reactions occur when certain antibiotics are combined with alcohol, and the specific properties of different antimicrobial classes may lead to varying clinical outcomes. Roxithromycin, a macrolide antibiotic commonly prescribed for respiratory and mycobacterial infections, has not been clearly identified as a trigger for disulfiram-like reactions when combined with ethanol.

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Interventional pillars in robotics and didactics approach to imaging modalities: Radiology and robotics in 2025

V Lunde Dadon*; Linda Dadiane

In this brief review we will discuss the automation of muscoskeletal functions in nerve signals, and motions derived from osteopathic medicine. We will them merge this knowledge with the new approach to robotics and didactics in Interventional radiology.

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Pemphigus vegetans: A case report and review of literature

Reem A Alqusaimi*; Jawaher A Alzayed; Ameen A Alawadhi

Pemphigus Vegetans (PVeg) is a rare variant of pemphigus vulgaris, an autoimmune blistering disorder typically affecting adults. It is characterized by hypertrophic vegetating lesions and flaccid pustules, often preceded by lesions in the oral cavity.

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Comparison of intravenous infusion of dexmedetomidine and magnesium sulfate on bleeding volume and surgeon satisfaction during tympanoplasty

Elnaz Shariatpanahi; Mohamad khajavi; Mahshid Nikooseresht; Mohamadali Seifrabiei; Seyede Faranak Emami*

Increased Bleeding Volume during Tympanoplasty (BDT), in addition to disturbing the surgeon's vision, increases the need for transfusion of blood products and the risk of a hemolytic reaction. This study aimed to compare the effect of intravenous infusion of Dexmedetomidine (D) and Magnesium Sulfate (MS) on BDT.

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Can nail brittleness be an adverse effect of Elexacaftor/Tezacaftor/Ivacaftor?

Argyri Petrocheilou*; Georgios Zarafonitis; Ioanna Loukou

Recent advances in cystic fibrosis therapeutics have resulted in the development of CFTR modulators that have led to great improvements in CF care. Novel adverse effects are still being reported. A case of brittle nails that were reported after initiation of treatment with Elexacaftor/Tezacaftor/Ivacaftor (ETI) is presented here. The parents have provided informed consent for this case presentation.

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Post traumatic splenic cyst

Jessica Folk*; Vishal Mittal; Adam Haag

A restrained 17-year-old male initially presented to the emergency department following a high-speed motor vehicle collision with no active complaints. Exam was reassuring notable only for a knee abrasion and patient was discharged home. The following day patient had some vague abdominal plate and the primary physician ordered an abdominal flat plate was obtained at that time (Figure 1).

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Holohemispheric subdural hematoma: Infantile acute subdural hematoma localized in the dural border cell layer

Nobuhiko Aoki*

Acute Subdural Hematoma (ASDH) in an infant without external signs of head trauma is sometimes thought to be symptomatic of Shaken Baby Syndrome (SBS) or Abusive Head Trauma (AHT) in the United States or of Infantile Acute Subdural Hematoma (IASDH) due to minor head trauma in Japan

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Stroke as the first sign of heart tumor- What the neurologist should know about heart

Patrycja Zięba; Sebastian Słomka*

Primary heart cancers are rare, but cancer metastases occur much more often, which is why they are diagnosed mainly in non-oncology departments. Approximately 85% of heart cancers are benign, with myxoma predominating [1,4].

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Development of rhinitis medicamentosa in young chronic nasal drop users

Arnabjyoti De*

Rhinitis Medicamentosa (RM), commonly known as rebound nasal congestion, is an increasingly prevalent condition among young individuals who chronically use topical nasal decongestants. This article explores the development of RM, highlighting the mechanisms, clinical features, prevalence, risk factors, and management strategies.

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Ecthyma-like lesion in a boy with chronic disseminated candidiasis and acute lymphoblastic leukemia: An iceberg beyond the tip. Case report and literature review

Paola Muggeo; Maria Natale*; Nadia Maggi; Massimo Grassi; Celeste Raguseo; Jessica Forte; Nicola Santoro

Chronic disseminated candidiasis is a clinical condition severely affecting patients with hematological malignancies. It has been mainly reported in adult patients, while cases in children and adolescents are rare. Diagnosis is challenging and not well established yet, but a thorough clinical examination can be helpful.

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Impact of genomics on the identification and family characterization of genetic diseases collagen

Stephanie Paz Ramírez*; Lina Johanna Moreno Giraldo

Osteogenesis Imperfecta (OI) is a genetic disorder primarily resulting from pathogenic variants in the COL1A1 or COL1A2 genes, responsible for collagen synthesis. This autosomal dominant condition is characterized by high morbidity and mortality due to its disabling symptoms, including pain and skeletal deformities. OI is a rare disease and part of the group of orphan diseases.

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