This is a new case of simultaneous occurrences of AMN and COVID-19 in a previously healthy woman. The importance of the current report lies in increasing the awareness of all physicians about the probable association of COVID-19 with retinal vascular injury and ischemia.

We report a 54-year-old man with treatment-resistant depression (TRD) and hypothyroidism who responded to LT3/LT4 combination, rather than LT4 alone. He was able to discontinue all antidepressant medications eventually. Interestingly, the patient has a DIO2 polymorphism.

Hepatic epithelioid angiomyolipomas are uncommon mesenchymal neoplasms. They are difficult to diagnose by imaging, especially when the fatty component is scant or absent. The gold standard for the diagnosis is histologic examination coupled with an immunohistochemical study. Positive HMB-45 immunostaining of the myoid cells is a major diagnostic feature.

Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) are an heterogeneous subgroup of rare neoplasms. Triple componed MiNEN associating neuroendocrine tumor, adenocarcinoma and squamous cell carcinoma are rarely described in the literature. Here we present the unique case of a 56-year-old women with neuroendocrine tumor, adenocarcinoma and squamous cell carcinoma of the duodenum

Some peritoneal dialysis catheter infections cannot be detected via a physical examination. Ultrasonography can aid in the diagnosis of such infections.

INTRODUCTION AND IMPORTANCE:  In blunt abdominal trauma, small bowel and mesentery injury (SBMI) is the third most common organ injury with an estimated incidence of 1–5%. Traumatic mesenteric injuries are difficult to diagnose and their undiagnosed complications are severe with high mortality rates. CASE PRESENTATION: A 21-year-old male presented to the emergency room with severe colicky pain in the right-hypochondrium two hours after dinner. He gave a history of nausea, vomiting and diarrhea after dinner and before the pain started. The morning after admission, a Contrast Enhanced Computed Tomography (CECT) scan was done which showed a large mesenteric hematoma. On subsequent questioning, our patient then recalled a blow to the abdomen while playing basketball two days ago. Since the patient was hemodynamically stable, non-operative management (NOM) was chosen with close monitoring. Regular follow-up ultrasonography (USG) scans showed progressive spontaneous resolution of the hematoma. CLINICAL DISCUSSION: Nonspecific symptoms of mesenteric hematoma make it difficult to reach a diagnosis. It is usually identified by history or medical imaging. Mesenteric hematoma can be managed conservatively if there is no active bleeding. In stable patients, selective visceral angiography should be performed and bleeding vessels should be embolized where possible. CONCLUSION: Our case highlights successful conservative management of a large traumatic mesenteric hematoma. This case emphasizes the importance of eliciting a detailed history of major or minor trauma for any patient with abdominal pain. Previous cases have also highlighted the importance of non-operative management and avoidance of emergency laparotomy in stable patients.

Helminths are an important cause of infection in poorly developed countries. The Majority spread with soil to skin contact. In unusual patients presenting below 1 year, treatment can be challenging. The disease can be self-limiting, treatment reduces progression to serious disease. Here, we present a three-month-old with Cutaneous Larva Migrans.

We present the case of a 41 year old gentleman who was admitted to hospital with a presumed case of surgical dysphagia. A clinical diagnosis of pharyngeal-cervical-brachial variant of Guillain-Barré Syndrome was made and he treated with a 5 day course of IVIG resulting in gradual but signigicant symptomatic relief.

A middle-aged Sudanese woman has been presented complained about multiple joint pain, skin rash, chest pain, hair loss, severe abdominal pain associated with abdominal distension, bloody diarrhoea and vomiting. Lab investigation and computed tomography (CT) abdomen revealed the patient have an intussusception on top of SLE. The patient was treated

We present a case of a 37-year-old woman referred to our hospital with a 1-week history of significant weakness, anorexia, and mild abdominal pain. According to laboratory and radiographic data, the patient was diagnosed with perforated appendicitis and gangrene.

The distinction between tuberculosis and sarcoidosis presents sometimes a clinical challenge. Their sequential occurrence in the same patient is uncommon. We present the case of a 42-year-old female with a proven diagnosis of tuberculous lymphadenitis who has developed successively nasal tuberculosis and pulmonary and liver sarcoidosis.

Tachycardia and atrial fibrillation are cardiovascular symptoms of Graves’ hyperthyroidism， if left untreated and further deterioration can result in heart failure and liver dysfunction, we describe a female patient to present the continuum of the pathophysiology development, to highlight the hemodynamic variation is dominant contributing factor of Graves’ hyperthyroidism complication

Covid-19 infection may have extrapulmunary manifestations such as blood hypercoagulability that may causes thrombosis in both arterial and venous system.Deep dorsal penile vein thrombosis is very rare and the most common cause is coagulation disorders.It causes penile pain especially during erection and it is diagnosed by ultrasound.

CRPS is a type of severe pain syndrome and can be triggered by previous surgery or trauma. CRPS type II is associated with a confirmed nerve injury. We want to present to your attention a case report of successful treatment of CRPS type II using unilateral epidural stimulation.

Linear IgA/IgG bullous dermatosis (LAGBD) is a rare, autoimmune blistering skin disease. We report a case of LAGBD in a 70-year-old woman. All common treatments were discontinued due to side effects or lack of treatment response. The patient was successfully treated with omalizumab which cleared her lesions after three months.

We report a 56-year-old woman with multiple cardiovascular risk factors who initially present with chest discomfort. She underwent successful primary percutaneous coronary intervention (PCI) on left anterior descending and right coronary artery . Few hours later and after the hemodynamic deterioration of patient,

Thymomas are tumours frequently associated with autoinmune manifestations or immunodeficiencies like Good syndrome. In rare cases, pure white cells aplasia (PWCA) has been described in association with thymomas. PWCA is characterized by agranulocytosis of autoinmune background primary refractory to granulocyte colony-stimulating factor (G-CSF). It is necessary to use inmunosupressor drugs.

Carotid web has been identified as one of the missed causes of recurrent stroke. The diagnosis and management of such cases, impose a challenge to medical practitioners. This etiology should be kept in mind, especially in case of recurrence of stroke in a similar cerebral territory.

Objective The aim of this project was to identify gaps and research waste in the dissemination of Cochrane gynaecology evidence in the Cochrane database of systematic reviews (CDSR). Design A research article Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Trials looking at benign gynaecological conditions, contained in the CGF specialised register, published between the years 2010-2011. Methods Gynaecology trials from the CGF specialised register were matched, by the specific gynaecological issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 740 trials, published from 2010 to 2011, were exported from the specialised register, after removing duplicates and out of scope trials, 185 of these trials were found to be already included in Cochrane reviews. 422 trials were found to be unused, however 192 (26%) of these could be included in an existing CGF SR if it were updated. 230 trials (32%) were not matched to any review title and from these 21 new review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Plant and herbal extracts for symptoms of menopause’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for women with gynaecological problems.

Title: Increased Nuchal Translucency: Is Advanced Sequencing the Answer? A Mini Commentary.

Objective: Valve-sparing root replacement is commonly used for management of aortic root aneurysms in elective setting, but its technical complexity hinders its broader adoption for acute Type-A Aortic Dissection (ATAAD). The Florida Sleeve (FS) procedure is a simplified form of valve sparing aortic root reconstruction that does not require coronary reimplantation. Here, we present our outcomes of the Florida Sleeve (FS) repair in patients with dilated roots in the setting of an ATAAD. Methods: We retrospectively reviewed 24 consecutive patients (2002-2018) treated with FS procedure for ATAAD. Demographic, operative, and postoperative outcomes were queried from our institutional database. Long term follow-up was obtained from clinic visits for local patients, and with telephone and telehealth measures otherwise. Results: Mean age was 49 ± 14 years with 19 (79%) males. Marfan syndrome was present in 4 (16.7%) patients and 14 (58.3) had ≥2+ aortic insufficiency (AI). Nine (37.2%) had preoperative mal-perfusion or shock. The FS was combined with hemi-arch replacement in 15 (62.5%) patients and a zone-2 arch replacement in 9 (37.5%) patients. There were 2 (8.3%) early postoperative mortalities. Median follow-up period was 46 months (range; 0.3-146). The median survival of the entire cohort was 143.4 months. One patient (4.2%) required redo aortic valve replacement for unrelated aortic valve endocarditis at 30 months postoperatively. Conclusion: FS is simplified and reproducible valve-sparing root repair. In appropriate patients, it can be applied safely in acute Stanford type-A aortic dissection with excellent early and long-term results.

We report a case of coronary artery vasculitis in Behçet’s disease. The patient was treated with the off-pump coronary artery bypass grafting. This case shows the diagnostic value of coronary computed tomography angiography in coronary artery inflammatory disease.

Atrial Fibrillation (AF) is the most common arrhythmia affecting the general population, with the prevalence projected to reach 12.1 million cases in 2030. Recently, attention has focused on the role of the Left Atrial Appendage (LAA) and its association with the most feared complication of AF: thromboembolism. Common sense indicates that the LAA should be excluded in all patients with AF; however, procedures to exclude the LAA have yet to become the standard of care. Recent studies in the cardiac surgery literature , , indicate a clear benefit of LAA exclusion amongst patients with AF undergoing cardiac surgery. Interestingly, this benefit was found to extend well beyond the postoperative period, in cohorts that were equally anticoagulated and had similar CHA2DS2-VASC scores. It appears reasonable that our medical community should strongly consider initiating a prospective randomized trial in an effort to fully elucidate the need for routine LAA exclusion in this patient population.

In patients with midventricular obstructive hypertrophic cardiomyopathy (HCM), a transapical approach allows excellent exposure for midventricular myectomy. Although the ventriculotomy is required on the antero-lateral left ventricular wall, the minimal ventriculotomy would be ideal, especially for cases with concomitant apical aneurysm. We report a case of midventricular obstructive HCM with concomitant apical aneurysm. Through the minimal ventriculotomy within the aneurysm, the hypertrophic septum was successfully hollowed out under repeated ultrasound guidance. Intraoperative ultrasound guidance is useful for transapical septal myectomy in midventricular obstructive HCM.