Trans-catheter PFO closure is typically done utilizing femoral access for both ICE and device deployment. We hereby report the first two cases of PFO closure through the jugular veins guided by ICE from the arm in patients without any femoral options.

Single-stage endovascular treatment of cardiac and vascular diseases with combined endovascular techniques has bee increasingly reported in the contemporary literature. Although more complex cases are currently being treated with such techniques, there are still crucial issues regarding their safety and efficacy.silmutaneous

Pyoderma gangrenosum (PG) being a primary sterile neutrophilic dermatosis, the etiology is still uncertain and it rarely affects children. A high index of suspicion is essential to execute its prompt treatment. To the best of our knowledge this is the first reported case in our country

Cytomegalovirus (CMV) is an opportunistic organism. We report a young, healthy, immunocompetent female with no apparent cardiovascular risk factors presenting with acute myocardial infarction. She had CMV viremia and went on to develop CMV-colitis and hepatitis. This report highlights that CMV can cause clinically significant multi-organ disease in immunocompetent-patients

Cardiac arrythmia is a major complication of COVID-19. This occurs often in patients with severe COVID-19 with pre-existing cardiovascular diseases. We report an unusual case of paroxysmal atrial fibrillation in an adult male with low cardiovascular risk factor who presented with a moderate form of COVID-19.

Pulmonary Tuberculosis (PTB) and Novel Coronavirus disease 2019 (COVID 19) primarily affect the lungs. Both diseases present with fever, cough, and shortness of breath and possess thrombotic potential as well. Therefore in COVID 19 pandemic, PTB must be taken into consideration for suspected cases in order to avoid fatal consequences.

Primary tuberculosis of the parotid gland is rare even in endemic countries. the clinical manifestations are polymorphic and non-specific. it is important for clinicians to be aware of this pathology.

Severe coronary calcification predicts stent under-expansion, malapposition, and poor outcomes in percutaneous coronary intervention. Rotational atherectomy permits debulking of coronary calcium allowing for stent expansion. More recently, intravascular lithotripsy has been used to fracture calcium and aid revascularization. Here we report two cases where both strategies were required for revascularization.

We are experienced a challenge for the surgeon for tracheocutaneous fistula closure in managing such a complication such as chronic cough, infection and other co-morbidities. The need for a secondary closure is also warranted when the stoma does not close on itself within a specified time.

We hypothesized that the combination therapy of SGLT-2(Sodium-glucose co-transporter-2)inhibitor and Glucagon-like peptide-1 receptor agonist(GLP-1RA) provide renal protection in adults with T2D with estimated GFR (eGFR) below 30ml/minute/1.73 m2. We hereby describe four consecutively treated high renal risk patients with T2D with eGFR between 21 to 30ml/minute/1.73m2.

The patients' discouragement from presentation due to the COVID-19 pandemic resulted in the progression of many manageable diseases to a critical condition. we report a case of carbuncle promotion to the necrotizing fasciitis in the context of undiagnosed diabetes mellitus and delay in visiting physicians due to fear of COVID-19.

Patient with a long history of CLL and known trisomy 12 presented with rapidly rising lymphocytosis, bulky adenopathy, and splenomegaly. Peripheral blood and bone marrow exam showed preponderance of prolymphocytes. Cytogenetic analysis showed an abnormal male karyotype with trisomy 12 and a new t(8;21) translocation in the same 6 metaphases.

Giant cell arteritis (GCA) is rarely associated with cancer. The association paraneoplastic vasculitis and tumors appears to be more frequent with hematologic cancers. The authors report the case of 83-years-old Caucasian man, diagnosed with prostatic adenocarcinoma who developed a paraneoplastic GCA responsive to corticosteroids associated with disease progression.

This paper reported a case of devastating iatrogenic ICA rupture in endoscopic endonasal surgery (EES) rescued by a covered stent. We also discussed the therapeutic strategies of iatrogenic ICA rupture in EES, which is of help in the management of this devastating complication.

An uncommon complication after a fibula graft for a mandibular reconstruction is a fracture of the tibia. This report describes a case and the treatment of a fracture of the tibia after a partial mandibulectomy and neck dissection, followed by a mandibular reconstruction with a vascularized left fibula graft.

Deranged liver enzymes due to hyperthyroidism rather than intrinsic liver pathology are not uncommon. We present two cases that highlight the impact of hyperthyroidism on liver biochemistry tests and good response to treatment. A high index of suspicion is paramount in patients presenting with unexplained deranged liver enzymes or jaundice.

An obstetric ultrasound of a multi-gravid mother at 37-week of gestation showed a female fetus with alobar holoprosencephaly, polydactyly, short ribs, narrow chest and short upper and lower extremity bones, consistent with Holoprosencephaly-polydactyly syndrome and Asphyxiating thoracic dystrophy overlap. Apgar score was 0 in the first and fifth minutes.

This case report deals with a clinical case of a patient who underwent inpatient treatment of the underlying disease acute leukemia. In the selection of treatment for complications, medications of various groups were prescribed. This therapy led to the clinical death of the patient, caused by drug-induced QT/QTc prolongation.