INTRODUCTIONTakotsubo syndrome is an acute heart disease that mimics the typical features of acute coronary syndrome (ACS) . Although takotsubo syndrome has an uncertain prevalence in the general population, in women with suspected ACS, the prevalence is estimated to be around 5-6% . The annual incidence is very low and is approximately 0.02% .Unlike ACS, TS is reversible and the heart often heals within four to eight changes weeks. The syndrome is characterised by transient systolic and diastolic left ventricular dysfunction with wall motion abnormalities . This condition, which was first described by Dote et al. in Japan in 1990 , usually affects postmenopausal women who have experienced some physical or psychological stress. However, it can also occur in the absence of these triggers .The prevalence of saccular aneurysms in the general population is estimated at 3.2%. Approximately 20 to 30% of cases present in the form of multiple aneurysms . Intracranial aneurysms are generally diagnosed after episodes of subarachnoid haemorrhage (SAH), which causes a high rate of morbidity and mortality . Rupture of an aneurysm is believed to be responsible for 0.4 to 0.6% of all aneurysm deaths, and approximately 10% of patients die before arriving at the hospital. Takotsubo syndrome is generally reported to have an incidence of 0.8-17% in patients with SAH caused by ruptured aneurysm . However, this case report is relevant for the clinical and pathophysiological observation of the possible association between aneurysms of the internal carotid arteries (ICA) and TS, with the latter being able to serve as an alert for possible aneurysms and thus allow for intervention prior to disruption.
IntroductionTinea capitis is a common infection of the scalp and hair caused by dermatophyte fungi that principally affects children1. It is an uncommon infection in adults and generally occurs in postmenopausal women and immunocompromised patients. Adult tinea capitis may have atypical clinical presentations2 34. The causative pathogens in children and adults belong to two genera: Trichophyton andMicrosporum 5. The clinical manifestations characterized by an erythematous and scaly plaques, itching, suppurative swelling with purulent discharge, areas of alopecia and regional lymphadenopathy. It is often misdiagnosed as a bacterial infection, leading to unnecessary antibiotic prescription or surgical intervention. Treatment delay may result in permanent hair loss6 7. The diagnosis of tinea capitis is made by fungal culture (gold standard), microscopy, wood’s lamp and trichoscopy5 8.
INTRODUCTION:Ramsay-Hunt syndrome is a disease caused by reactivation of latent varicella zoster virus in the geniculate ganglia. It involves facial nerve paralysis and it is usually associated with a rash on the auricle and/or external ear . Sometimes the blisters are not very noticeable and can be overlooked by the inspector. Other accompanying symptoms may be ache and fullness of the ear (78%), vertigo/dizziness (51%), hearing loss (45%), nausea, vomiting, tinnitus and hyperacusia .The diagnosis is mainly based on the history, clinical findings and neurological examination. Polymerase chain reaction assays may be useful by detecting DNA of the virus in exudates from ear scraping or cerebrospinal fluid (CSF) .It represents 7% of all peripheral facial paralysis and recovery rates are lower in this group [4,5]. Early treatment with a combination of acyclovir and prednisone is reported to be effective [6-8].
Hemophagocytic syndrome (HPS), also known as hemophagocytic lymphohistiocytosis (HLH), is a group of syndromes in which multiple pathogenic factors lead to the proliferation of activated lymphocytes and histiocytes that secrete large amounts of inflammatory cytokines[](#ref-0001).HLH is a multi-organ hyperinflammatory syndrome caused by the secretion of large amounts of inflammatory cytokines from
IntroductionCornual pregnancy is rare, accounting for approximately 2-4% of all ectopic pregnancies . By definition, it refers to the implantation and development of a gestational sac at the proximal and lateral regions of the uterus (aka uterine horns or cornua). As with the majority of other types of ectopic pregnancy, cornual pregnancy diagnosis is based on clinical suspicion, β-hCG measurements and transvaginal ultrasound findings . As with other types of ectopic pregnancy, cornual pregnancy is associated with severe patient morbidity and mortality . Therefore, timely and accurate diagnosis is key as it directly affects treatment type and urgency. Several management options are available from the conservative (methotrexate administration and expectant management) up to the more radical side of the spectrum (cornuotomy, cornual resection, hysterectomy) . Hysteroscopy is an additional option that combines effective and complete removal of the gestational sac, without severely affecting uterine anatomy, however its application usually requires imaging guidance .In this report, we present the case of a cornual ectopic pregnancy, which could not be diagnosed via traditional ultrasonographic imaging and instead was verified by MRI imaging. Subsequently, guided by the MRI imaging data, hysteroscopic resection and removal of all products of gestation was safely and successfully performed without any complications and with the patient making a swift recovery.
INTRODUCTION:Tuberculosis remains a significant global health burden, with central nervous system (CNS) involvement being a rare but serious manifestation. While pulmonary tuberculosis is the most common form, extrapulmonary manifestations can affect various organs and systems. The CNS involvement in developing countries constitutes nearly 10% of all tuberculosis patients . Tuberculomas with compressive myelopathies without bone involvement are an even rarer occurrence. In the differential diagnosis of extensive spinal cord injuries, particularly in young patients with a history of pulmonary tuberculosis or tuberculous meningitis, it is important to consider the possibility of an intradural extramedullary tuberculoma .Here we will be discussing a case of intradural extramedullary tuberculosis of the thoracic spine, with progressive neurological dysfunction. Surgery aims to decompress the spinal cord and remove the tuberculoma, thereby relieving the pressure on the neural tissues and preventing further neurological deterioration [3-5]. The specific surgical technique employed depends on the location and extent of the tuberculoma.Following surgery, anti-tubercular therapy is initiated to target the underlying tuberculosis infection. This typically involves a combination of multiple anti-tuberculosis medications, such as isoniazid, rifampicin, ethambutol, and pyrazinamide . The duration of anti-tubercular therapy may vary but generally lasts several months to ensure complete eradication of the infection. Continual postoperative monitoring assumes paramount importance in assessing neurological recovery and treatment response. Concurrently, physiotherapy and rehabilitation assume significance in facilitating the functional restoration and enhancing the overall quality of life .This report aims to discuss the diagnostic challenges, treatment strategy, and clinical outcomes, highlighting the importance of a multidisciplinary approach in managing this uncommon condition.
Background: Aberrant migration of parathyroid glands from their embryologic origin may result in undescended parathyroid glands. We present a case of an ectopic parathyroid adenoma at the level of the pyriform sinus. Methods: A 41-year-old female was evaluated for primary hyperparathyroidism. Following non-localizing ultrasound and planar sestamibi imaging, the patient underwent
Epithelial–myoepithelial carcinoma in the parotid gland with HRAS mutation: a case reportTaisei Yasudaa, Masami Osakia, and Masahiko Sugitaniba Department of Otolaryngology-Head and Neck Surgery, Ageo Central General Hospital, Saitama, Japanb Department of Pathology, Ageo Central General Hospital, Saitama, JapanCorresponding Author:Taisei YasudaDepartment of Otolaryngology-Head and Neck SurgeryAgeo Central General Hospital1-10-10 Kashiwaza, AgeoSaitama, Japan, 362-8588Tel: +81-48-773-1111E-mail: [email protected]
AUTHORSDr. Saroj Poudel Clinical Pharmacist Critical Care Medicine, Nepal Mediciti Email: [email protected]. Rupak Chalise Anesthesiologist Critical Care Medicine, Nepal Mediciti Email: [email protected]. Manoj Bist Medical Officer Critical Care Medicine, Nepal Mediciti Email: [email protected]. Ashim Regmi Junior Consultant Critical Care Medicine, Nepal Mediciti Email: [email protected]. Anup Ghimire Junior Consultant Critical Care Medicine, Nepal Mediciti Email: [email protected]. Kishor Khanal Intensivist and ICU Coordinator Critical Care Medicine, Nepal Mediciti Email: [email protected]