IntroductionDermatomyositis (DM) is a rare idiopathic inflammatory myopathy characterized by progressive symmetric proximal muscle weakness and distinctive cutaneous manifestations, such as heliotrope rash, V sign, Shawl sign and Gottron’s papules. It is often associated with underlying malignancies, making it a well-recognized paraneoplastic syndrome.1 The association between dermatomyositis and various malignancies has been utterly documented. Cancer of the lung, breast, ovary, testis, and gastrointestinal tract are among the most commonly reported.2 Only two dermatomyositis instances were linked to squamous cell carcinoma of cervix in a multinational analysis of 618 patients by Hill et al.2 An extensive review of the literature turned up a small number of additional cases of dermatomyositis in conjunction with cervical squamous cell carcinoma.3–7 However, dermatomyositis as a paraneoplastic manifestation of cervical carcinoma is relatively uncommon and requires further exploration.8Paraneoplastic syndromes are uncommon disorders associated with malignancies that cannot be explained by direct extension of the primary tumor or metastasis but result from an altered immune response to the neoplasm.3 Cervical cancer remains a significant global health issue, especially in low- and middle-income countries, where screening and early detection programs are often inadequate.9 The paraneoplastic nature of dermatomyositis in cervical cancer highlights the importance of recognizing this association, as it may serve as an early indicator of underlying malignancy.4 Early diagnosis and treatment of both the neoplasm and the paraneoplastic syndrome are crucial for improving patient outcomes.8This case report presents a rare instance of dermatomyositis as a paraneoplastic syndrome owing to carcinoma of the cervix. An extensive review of literature and discussion of the clinical presentation, along with management strategies, attempts to add to the expanding body of information on this uncommon association.

Large Fibroma of the Hard Palate: A Rare Clinical Presentation

A document by Reza Shabanian. Click on the document to view its contents.

CLINICAL CASE REPORT

Mexiletine as Adjunctive Therapy for Refractory Ventricular Arrhythmias in Type 2 Long QT Syndrome: A Long-Term Case Study

A Case of Mental and Behavior Disorder Caused by Using Tiletamine E-cigarette and Its TreatmentHuijie Du1,2,#， Xiaowei Luo2，#, Xin Zhang1, Shuqin Jia1, Wei Wang1,2, Lu Yang1, Yang Yang1, Mei Bai1,2,*1Department of Psychiatry，The First People’s Hospital of Guiyang, Guiyang, Guizhou 550002, China.2Department of Clinical Medicine, Guizhou Medical University, Guiyang, Guizhou 550001, China.#Huijie Du and Xiaowei Luo contuibuted equally as first authors.*Correspondence to Mei Bai. Email: keaikoala @126.com.AbstractTiletamine is a kind of narcotic drug for animals. In recent years, because of its rapid hallucination and pleasure characteristics, it has been used by criminals and illegally added to electronic cigarettes as a substitute for new-type drugs. At present, there are many users of this kind of substances, but the reports are rare, and most of the previous reports are mental disorders caused by tiletamine combined with other psychoactive substances. This article reports a case of mental and behavioral disorders caused by using tiletamine e-cigarette, and reviews the previous literature, in order to provide reference for clinical identification and management of such mental disorders, and help raise public awareness of the risks of this type of psychoactive substances.Key words Tiletamine，E-cigarette，Poisoning，Mental and behavior disordersTiletamine is a dissociative anesthetic, which is classified as a non-selective N-methyl-D-aspartate (NMDA) receptor antagonist in pharmacology. It can reduce the opening frequency and time of NMDA receptor ion channel pore, block the release of excitatory neurotransmitters, reduce the excitability of neurons, and play an anesthetic role [1].However, the use of tiletamine alone may cause generalized rigidity and convulsion[1]. Therefore, in clinical practice, it is usually mixed with zolazepam, a benzodiazepine with sedative and anticonvulsant effects, in a 1:1 ratio to make an animal anesthetic named ”Zoletil” [2]. Zoletil demonstrates rapid induction, serves as an excellent muscle relaxant, and ensures a favorable arterial oxygen hemoglobin saturation level. These characteristics make it particularly suitable for use in veterinary clinical examinations as well as various minor surgical procedures involving both domestic and wildlife animals[3].Despite the importance of tiletamine in the veterinary field, its illegal abuse cannot be ignored. Currently,tiletamine is only approved for animal anesthesia, but not for human use. In recent years, with the corresponding lawenforcement agencies, regulatory departments and other efforts to crack down on traditional drugs and some addictive substances, criminals to escape the crackdown, began to look for new alternatives. tiletamine has quickly become their new target because of its similar chemical structure andhallucinogenic effect to ketamine [2].There are few reports on the abuse of tiletamine in humans, and most of the previous reports were of tiletamine combined with other psychoactive substances. There are no treatment plans provided for tiletamine poisoning or abuse either.

A document by Synthia Thapa. Click on the document to view its contents.

A document by Jin Wang. Click on the document to view its contents.

MRSA Septic Thrombophlebitis and Pulmonary Embolism: A case report highlighting the tight bond with infective endocarditis.Santiago Saenz-Ancira, MD1. Javier Higuera-Ornelas, MD2. Lorenzo Olivero, MD1, Ermin Tale, MD1, Pawel Borkowski, MD1, Suraj Adhikari, MD11. Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, New York City, NY, USA2. Department of Human Genetics, McGill University, Montréal, QC, Canada

Distinguishing Vaccine-Related from Infection-Related Myocarditis: A Case ReportEmma Nordahl BSc 1, Reem Fakak BSc*1, Joseph Moutiris MD1,21Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus2Department of Cardiology, Evangelismos Hospital, Paphos, Cyprus* Corresponding Authorfakakreem@gmail.com

Clinical Case Report

CASE REPORT

A document by Uguru Orji. Click on the document to view its contents.

Title PageTitle: Cerebral Air Embolism Associated with Pulmonary Tuberculosis: A Case ReportShort title: Cerebral Air Embolism and Pulmonary Tuberculosis: A Case ReportAuthor(s): Jorge Ramírez-Quiñones1a, Jacqueline Moreno-Arias1a, Ricardo Otiniano-Sifuentes1a, Littman Apaza-Nina2a,b.1 Department of Cerebrovascular diseases. Instituto Nacional de Ciencias Neurológicas. Lima, Perú.2 Department of Neuroradiology. Instituto Nacional de Ciencias Neurológicas. Lima, Perú.a Neurologist, b Radiologist.Corresponding author: Jorge Ramírez-Quiñones.E-mail address: jorgerq1210@gmail.com

IntroductionThyroid gland anomalies may occur during embryonic development, among which ectopic thyroid tissue is the most common. Ectopic thyroid tissue is defined as normal thyroid tissue located anywhere outside the pre-tracheal region. It accounts for roughly 50% of developmental thyroid abnormalities and is more common in women, with a female-to-male ratio of approximately 4:1. Its incidence is estimated between 1 in 100,000 and 1 in 300,000 individuals. This condition most frequently occurs in the midline, particularly in the lingual region, which represents about 90% of cases. In such patients, 70–90% lack normal thyroid tissue in its typical location, and hypothyroidism is common. (1,2,3,4,5)Lateral ectopic thyroid tissue is rare, occurring in only 1–3% of cases. It is usually located in the submandibular area and less frequently in the para-carotid region. In these cases, a normally positioned thyroid gland is typically present. The term lateral aberrant thyroid (LAT) refers to thyroid tissue that is histologically similar to normal thyroid tissue but located in the lateral neck and anatomically separate from the orthotopic thyroid gland. (6)Due to its rarity, the diagnosis and management of LAT remain challenging. In this study, we present and evaluate a case of LAT and compare it with previously reported cases in the literature to provide clearer diagnostic and management insights.

Reversal of traumatic chiasmopathy and visual field recovery with combined erythropoietin and steroid therapy: a case report

not-yet-known not-yet-known not-yet-known unknown Abstract: Thyroglossal duct cyst (TDC) is a common congenital neck mass, usually presenting as a solitary lesion. Double TDCs are extremely rare, making this case particularly significant. Here, we report a unique and rare occurrence in which two anatomically separate thyroglossal duct cysts were found in a 50-year-old male. One was located at the left vallecula, and another was positioned below the hyoid bone, with no anatomical connection between them. Initial diagnoses were epiglottic cyst and thyroglossal duct cyst. Surgery used the Sistrunk procedure for

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