bluuebunny/crossref_metadata_2025 huggingface dataset:
Measles outbreak in Ethiopia amid COVID-19: an effect of war-induced hampering of vaccination and pandemic
Authors: Nazir Abubakar , Oduoye Malik O. , Tunde Afolayan M. , Hafsat Abubakar , Guta Jalene G. , Akilimali Aymar , Elembwe Hardy , Kitumaini Chris , Onesime Jones , Bavurhe Rodrigue F.
Published: March 2023

Measles, a highly infectious viral disease, is a leading cause of death among young children in many developing countries, including Ethiopia. Despite Ethiopia being the first large country to conduct a mass immunization campaign for measles in 2020 following coronavirus disease 2019 (COVID-19) outbreak, in which over 14.5 million children in the country were vaccinated, there was another outbreak of measles in the country in the year 2022, especially in the eastern parts of the country. According to the WHO, a total of 9850 measles cases were suspected, out of which 5806 cases were confirmed, with 56 deaths (CFR=0.6%) in Ethiopia from January to 30 September 2022. The total number of cases crossed 10 000 cases by the end of October 2022. Amid COVID-19 and war times in Ethiopia posed serious challenges for the under-5 children to get access to vaccination against measles. We, therefore, urge the Ethiopian government to reach an amicable and diplomatic agreement with the civilians causing internal and intraethnic wars in the country as soon as possible, as this would prevent further hampering of measles vaccination for the Ethiopian people, most especially the children.
A huge primary adenoid cystic carcinoma of the lung: case report and review of the literature
Authors: Laklaai Zakaria , Chanoune Khadija , Benjelloune Hanane , Zaghba Nahid , Yassine Najiba
Published: March 2023

Introduction:

Primary adenoid cystic carcinoma of the lung is an uncommon thoracic neoplasm. It is considered a slow-growing tumor with a low-grade malignancy, which can be confusing as to its underlying malignancy, and the main treatment for this tumor is surgery.

Presentation of the Case:

Here, we report a case of cystic adenoid carcinoma of the lung in a 50-year-old man presenting with an unusual radiological presentation. The tumor was classified as T4N3M1a according to the TNM classification, eighth edition, and the decision was to treat the patient with palliative chemotherapy. The pathologist and surgeons must fully understand the adenoid cystic carcinoma of the lung to prevent misdiagnosis.

Conclusion:

Primary adenoid cystic carcinoma of the lung is a rare tumor with a poor prognosis. The diagnosis can be challenging both clinically and histologically. Here, we present a case with an atypical radiological presentation, making the diagnosis even more difficult.
Fatal sepsis with peripheral necrosis due to Capnocytophagus canimorsus infection after dog bite: a case report
Authors: Peeters Maxim , Pelzer John , Yazar Ozan , Salemans Pieter , Wong Chunyu , Decraemer Gilles , Bouwman Lee
Published: March 2023

Introduction and Importance:

Capnocytophaga canimorsus is a commensal bacterium in dogs and cats’ saliva that can be transmitted to humans by licking, biting, or scratching. Although rare, an infection with C. canimorsus can have lethal consequences. Based on this case, the authors want to emphasize the importance of adequate wound care, close monitoring, and the use of prophylactic antibiotics after a dog bite or cat bite

Case Presentation:

The authors present the case of a healthy 52-year-old patient with severe sepsis, disseminated intravascular coagulation, multiorgan failure, and peripheral necrosis of the lower arms, lower legs, nose, and genitals due to an infection with C. canimorsus after a dog bite. The patient eventually died on the ICU.

Clinical Discussion:

Due to the severeness of the sepsis, the patient was admitted to the ICU for maximum supportive care. As a last resort to save his life, an amputation of his nose, genitals, lower arms, and a transtibial amputation was proposed. In good consultation with the family, the decision was made not to perform this very mutilating surgery. The therapy was stopped because the loss in quality of life was too severe to justify continuation. The patient died soon after stopping supportive therapy.

Conclusion:

Based on this case, the authors would like to point out that, although rare, an infection with C. canimorsus can have devastating consequences with a high mortality and morbidity rate. It is important to know about this complication and to be aware of the importance of adequate wound care, close monitoring, and the use of prophylactic antibiotics after a dog bite or cat bite.
Abdominal cocoon syndrome, a rare cause of intestinal obstruction presenting in an Asian adult male: a case report
Authors: Thambi Vimala D. , Kowtha Praveen , Fatima Ambreen , Devarala Bhagya , Mushtaq Javaria , Shariff Sanobar , Uwishema Olivier
Published: March 2023

Introduction and Importance:

Primary sclerosing encapsulating peritonitis (SEP), commonly known as abdominal cocoon syndrome (ACS), is considered to be one of the rare causes of intestinal obstruction. This syndrome is characterized by the formation of a fibrous-collagenous membrane that encapsulates the intestine and other abdominal organs. Several theories have been proposed to explain the disease’s etiology. Patients often present with symptoms of partial intestinal obstruction, which is challenging to diagnose before laparotomy. Of all the available investigations, the contrast-enhanced computed tomography of the abdomen is the most sensitive, showing a sac-like fibrous membrane covering the bowel loops along with the fluid collection. Definitive treatment includes excision and adhesiolysis.

Case Presentation:

We present a case report of ACS in a 30-year-old male patient.

Clinical Findings and Investigations:

The patient presented with a chronic history of progressive colicky abdominal pain associated with nausea, vomiting, constipation, and weight loss.

Interventions and Outcome:

Multiple investigations, including abdominal X-rays, ultrasound, and upper GI endoscopy, were unremarkable. However, the contrast-enhanced computed tomography abdomen suggested small bowel obstruction with a differential diagnosis of SEP. Later explorative laparotomy and histopathological examination confirmed the diagnosis of ACS. Adhesiolysis was performed intraoperatively, which resolved the patient’s symptoms. The patient was asymptomatic at the 6th month follow-up visit.

Relevance and Impact:

Being a fairly rare condition, primary SEP can lead to a plethora of misdiagnoses and discomfort to the patient if not diagnosed on time. This case report aims to create awareness of this disease outside of the expected demographics- perimenarchal Asian girls. It is highly important for this unusual case to serve as an educative tool for physicians all over the world.
A silent, giant staghorn calculus managed with open surgery: a case report
Authors: Thapa Bineet , Bhomi Krishna K. , Shrestha Rit , Lamichhane Deepika , Rijal Anjan , Subedi Neeraj , Khadka Mohan , Adhikari Suman , Joshi Bhola R.
Published: March 2023

Introduction and Importance:

Staghorn calculus usually fills the pelvis of the kidney, the infundibulum, and most of the calyces. It is a rarity for staghorn stones to be asymptomatic; in addition to that, the calculus discussed in this case report was of a very large size and was removed intact. Open pyelolithotomy, the procedure used, is one that comes with a wide range of complications but can be deemed effective in certain cases. In this scenario, it led to no impediments to normal physiology.

Case Presentation:

Here the authors report the case of a 45-years-old Nepalese male who presented with a large yet asymptomatic staghorn calculus. It was managed with an open pyelolithotomy, and the patient had no intraoperative or postoperative complications.

Discussion:

Staghorn stones can be complete or partial and often naturally progress to renal impairment. Thus, an aggressive therapeutic approach is crucial, with careful evaluation of the site and size of the stone, the patient’s preference, and the institutional capacity. Ideally, staghorn calculi are completely removed, and it is imperative that the functions of the affected kidney are preserved as far as possible and when applicable. Although percutaneous nephrolithotomy is recommended for the removal of staghorn stones, several clinical, technical, and socioeconomic factors contributed to the use of open pyelolithotomy in the management of the case discussed here.

Conclusion:

Open pyelolithotomy can prove highly effective in removing large stones intact and in a single setting, the importance of which was accentuated by its unique clinical presentation and pathological anomalies.
Precision medicine and implications in medical education
Authors: Lamichhane Pratik , Agrawal Anushka
Published: March 2023

Precision medicine (PM) is a revolutionary approach that gathers and analyzes massive amounts of data on patient's history, lifestyle, genetic, and environmental factors to tailor the most effective treatment for the patient. The low utilization of PM in healthsector today can be tackled with the introduction of PM in medical education. In near future, medical education will observe gradual integration of PM in undergraduate and postgraduate curricula. The increased need of training of faculties, protection of patient's data and the use of advanced technologies are the likely ramifications of introduction of PM in medical education and healthcare.
Isolated pleural mucormycosis in an immunocompetent patient: a case report
Authors: Mohseni Ahangar Reza , Rezaei Majd Amirmohamad , Taherinezhad Ledari Ali
Published: March 2023

Introduction:

Pulmonary mucormycosis is an uncommon, difficult-to-diagnose disease with currently no suitable treatments. It is associated with hematological malignancies, diabetes, and immunosuppression.

Case presentation:

We report a 16-year-old boy who developed pleural mucormycosis for unknown reasons. The patient presented to our hospital because of fever, chills, weakness, lethargy, loss of appetite, pleuritic chest pain, and shortness of breath. Histopathological testing ultimately diagnosed mucormycosis.

Discussion:

Pulmonary mucormycosis is a potentially fatal infection with a challenging clinical presentation that requires prompt diagnosis. Diagnosis of pleural mucormycosis was verified by histopathological analysis of pleural fluid and pleural tissue biopsy.

Conclusion:

This study emphasizes the relevance of histological examination in detecting mucormycosis, which will aid in early management by highlighting the difficulty of diagnosis.
A post-traumatic ossified subdural chronic hematoma successfully managed in a 34-year-old woman: a case report
Authors: Mansour Marah , Adi Mohammad , Mousa Hana , Haroun Nada , Rustum Muhamad , Joha Mohamad , Abdulrahman Mohammed
Published: March 2023

Introduction and Importance:

Ossified or calcified subdural chronic hematoma is an uncommon condition with an incidence of 0.3–2% of all chronic subdural hematomas. It can cause significant mortality and morbidity, especially in young patients. Because of the rare incidence of this condition, its pathophysiology and management preferences have not yet been clearly established, which raises the importance of reporting such cases in order to add valuable databases to the literature.

Case Presentation:

A 34-year-old woman with a history of head trauma several years ago presented with refractory headaches, convulsions, and muscle weakness. Computed tomography showed an extra-axial calcified lesion in the frontal lobe. Surgical treatment was decided considering the patient’s age, in addition to the presence of serious medically uncontrolled symptoms. The calcified lesion was successfully removed surgically, and the patient recovered completely. Pathological examination confirmed the diagnosis of ossified subdural chronic hematoma.

Clinical Discussion:

The symptoms of ossified subdural hematomas are not specific. However, the presence of a history of head trauma should raise suspicion of this condition. Computerized tomography is usually used as the diagnostic method. Nevertheless, it is unable to differentiate ossified chronic subdural hematomas from other intracranial extra-axial calcified lesions that need to be considered as a differential diagnosis. Pathologic investigations are needed to provide the final diagnosis.

Conclusions:

We highly recommend surgical therapy for ossified subdural hematomas that are symptomatic and persistent, especially in young patients. We further stress the significance of postsurgical anticonvulsant prophylaxis, particularly in patients presenting convulsions.
DLBS3233 enhances nephrin and podocin expression also reduces oxidative stress marker and insulin receptor serine diabetic rats’ podocytes
Authors: Mohani Chandra I. , Rudijanto Achmad , Aulanni’am Aulanni’am , Soeharto Setyawati
Published: March 2023

Background:

Numerous oxidative stresses are detected in patients with diabetic kidney disease, resulting in insulin resistance that damages the pancreas and kidney. Renal podocytes insensitive to insulin lead to decreased nephrin and podocin and increased insulin receptor serine. The authors did an experiment on diabetic rats to examine the effect of DLBS3233 on repairing insulin resistance.

Materials and Methods:

Thirty adult male Wistar rats were randomly divided into six groups (n=5 per group): group of nondiabetic rats as a negative control (group 1); untreated diabetic rats (group 2); diabetic rats treated with DLBS3233 4.5 mg/kg BB (group 3); 9 mg/kg BB (group 4); 18 mg/kg BB (group 5); and diabetic rats treated with pioglitazone (group 6). The authors checked Homeostatic Model Assessment for Insulin Resistance to corroborate insulin resistance prior to DLBS3233 administration in diabetic rats. Immunohistochemistry was performed to examine the expression of renal antimalondialdehyde (MDA) antibodies, nephrin, podocin, and insulin receptor serine. The data were analyzed using analysis of variance and the t-test.

Result:

In the DBLS3233 group, immunohistochemistry showed enhanced expression of renal nephrin and podocin, as well as diminished expression of anti-MDA antibody, along with decreased insulin receptor serine. From statistical analysis, anti-MDA antibodies and insulin receptor serine showed lower expression, whereas the expression of nephrin and podocin were enhanced compared to untreated groups (P<0.05).

Conclusion:

DLBS3233 reduces oxidative stress by decreasing MDA and improves insulin resistance by increasing the expression of renal nephrin and podocin as well as decreasing insulin receptor serine.
Adenocarcinoma of the small bowel revealing celiac disease in an adult: case report
Authors: Hassine Hajer , Ben Azouz Sarra , Yacoub Haythem , Debbabi Habiba , Cherif Dhouha , Kchir Héla , Maamouri Nadia
Published: March 2023

Cancer of the small bowel is a rare malignancy. With an incidence of less than one per 100 000 people, it makes up only 5% of all gastrointestinal tract cancers. Celiac disease is a relatively common pathology and is often associated with the development of small bowel lymphoma. However, it is also a known risk factor for small bowel adenocarcinoma. The authors are reporting a case of a patient with recurrent bowel obstruction found to have a small bowel adenocarcinoma and an underlying celiac disease.
Spontaneous splenic hematoma secondary to dengue infection: a rare case report
Authors: Pahari Soumya , Basukala Sunil , Kunwar Prakash , Thapa Kriti , Khand Yugant , Thapa Ojas
Published: March 2023

Introduction and Importance:

Dengue infection may have various surgical complications. Splenic hematoma is a rare complication of dengue hemorrhagic fever and may be life-threatening.

Case Presentation:

A 54-year-old male, diagnosed with dengue infection detected at another hospital, presented on the 10th day of fever with left upper abdominal pain for 7 days without history of trauma. Urgent ultrasonography of the abdomen revealed findings suggestive of a splenic subcapsular hematoma, which was confirmed by computed tomography scan. The grade II splenic hematoma was being managed conservatively. Unfortunately, the patient developed hospital acquired pneumonia and died from septic shock.

Clinical Discussion:

Hemorrhagic manifestations are seen in the febrile and critical phase of dengue, but the spleen is infrequently involved. Splenic hematoma can lead to splenic rupture, which can be rapidly fatal. Specific treatment guidelines of such hematomas are needed in the context of dengue infection, as the treatment modality is controversial.

Conclusion:

Patients must be carefully evaluated for the complications and surgical manifestations of dengue as abdominal pain and hypotension from splenic hematoma may be misinterpreted as components of dengue hemorrhagic fever and dengue shock syndrome.
A localized sinusoidal lesion of granulomatosis with polyangiitis with extranasal involvement in a Syrian female: a rare case report
Authors: Kherbek Haidara , Deeb Ismaeel , Daoud Rima , Ali Zain , Hleibieh Yana , Kherbek Sarah , Alshehabi Zuheir , Yakoub Hikmat
Published: March 2023

Introduction:

Granulomatosis with polyangiitis (GPA) is a rare, immunologically mediated systemic vasculitis that presents as an aseptic necrotizing granulomatous inflammation of the small and medium vessels.

Case presentation:

The authors report the case of a 47-year-old Syrian female smoker who was admitted to the hospital due to painless palpable masses in her left cheek and left upper lip. Her medical and family histories were unremarkable. Physical examination demonstrated facial asymmetry and bulging in the left cheek and left suborbital region, with marked limitation of the mouth opening and notable oozing from the maxillary sinus seen within the area of the extracted second premolar, in addition to swelling in the parotid gland region, which caused facial nerve weakness. Lab findings were significant for an elevated neutrophil count (16 400/mm3) and positivity of Cytoplasmic- Antineutrophil Cytoplasmic Autoantibody (c-ANCA). Microscopic examination revealed noncaseating necrotizing granulomas surrounded by histocytes and multinucleated giant cells. The disease kept its local invasion going despite the treatment with cyclophosphamide. Thus, surgical debridement was considered a notable improvement.

Discussion:

GPA is a systemic disease that usually affects multiple organs, especially the kidneys and the upper and lower respiratory tracts. The diagnosis of GPA is made based on a biopsy and the presence of c-ANCA. The treatment of GPA is patient-adjusted, and it usually consists of two major phases: induction and maintenance. However, surgery is preferred for patients who do not respond to pharmacotherapy.

Conclusion:

This article demonstrates a rare case of GPA in the head and neck region; that highlights the significant role of c-ANCA and histological exam in confirming the diagnosis as well as the importance of surgery when the disease is intractable.
Pleural and pericardial effusion revealed underlying acute lymphoblastic leukemia: a case report
Authors: Ashour Reham , Ibrahim Rahma , Haidar Mai , Alhussein Qossay
Published: March 2023

Introduction and Importance:

Acute lymphoblastic leukemia (ALL) is the most common hematological malignancy in children. It often presents with signs and symptoms related to bone marrow failure, but any organ can be affected. The extramedullary symptoms of leukemia are frequent and various. However, leukemia rarely causes serous effusions, especially as the first manifestation.

Case Presentation:

This case report presents a 17-year-old male who developed cardiac tamponade and pleural effusion that led to severe dyspnea. Examinations and diagnostic procedures revealed underlying pre-B-cell ALL.

Clinical Discussion:

Pleuropericardial effusion in leukemia is often the result of chemotherapy, infection, and relapse. It is rarely the first manifestation of the disease, especially B-cell ALL. However, analysis of the aspirated fluid may reveal an underlying one, which will help make an early diagnosis and administer the appropriate treatment.

Conclusion:

When approaching a patient with serous effusion, hematological malignancies should be considered the leading cause.
Is the New Langya virus in China a threat to global health? A short communication
Authors: Uwishema Olivier , Shariff Sanobar , Rai Anushree , Arab Sara , Nicholas Aderinto , Uweis Lama , Abbass Mortada , El Saleh Rayyan , Adanur Irem , Wellington Jack
Published: March 2023

The recently detected virus in eastern China in 2018 led to some health concerns, especially with the global trend of spreading viruses. As a new RNA-detected genus of the henipavirus family was found in Eastern China, the number of patients affected has reached 35 through zoonotic spread, with symptoms ranging from simple fever to fatal affection of vital organs such as the brain, liver, and kidneys. Researchers have found that shrew animals might be a potential reservoir for the Langya virus; however, data is still limited regarding human-to-human transmission. Current efforts by the Chinese Health Ministry and the Taiwan Centers for Disease Control and Prevention to deduct the spread of the virus and track its origin by trying to sequence the disease genome are evident. With all this in mind, the recommendation to face this new novel virus revolves around protecting the most vulnerable population at risk of being infected, such as farmers, and preventing the spread of the virus. Efforts must be directed toward screening animals for henipavirus and diving more deeply into the etiology of how this virus has spread to humans to help understand the spread of zoonotic viruses in the future.
A case of pituitary apoplexy mimicking viral meningitis
Authors: Lally Anne , Funari Abigail , Ghosh Sayak R. , Karandish Alireza , Ledet Alexander J. , Agarwal Vijay
Published: March 2023

Introduction and Importance:

Pituitary apoplexy (PA) is a clinical syndrome caused by ischemia or hemorrhage of the pituitary gland, typically in the context of an adenoma. It typically presents with a thunderclap headache and sterile cerebral spinal fluid (CSF). The authors identify a case of PA, which initially presented with the signs and symptoms of viral meningitis.

Presentation of Case:

A 44-year-old man presented to the emergency department with headache, nuchal rigidity, fever, and delirium. The patient reported a 10-year history of chronic that were partially responsive to acetaminophen. Four days after admission, the patient developed right-sided cranial nerve III, IV, and VI palsies. Labs revealed anemia and hyponatremia. The CSF was leukocytic, lymphocyte-predominant, and had elevated protein. In addition to these results, negative CSF bacterial cultures led the care team to believe this case was viral meningoencephalitis. Routine MRI of the brain at presentation revealed a 3.1×2.5×3.2 (craniocaudal×anterior posterior×transverse) expansile mass centered within the sella turcica. An endocrine workup revealed hypopituitarism. The diagnosis of PA was then made. A microscopic transsphenoidal resection of the sellar mass was performed, and histopathologic analysis confirmed necrotic pituitary adenoma tissue. Following an uncomplicated procedure, the patient recovered fully from his cranial nerve palsies and continues to do well.

Discussion:

Because life-threatening hypotension from acute adrenal insufficiency can be caused by PA, timely diagnosis is crucial. When a patient presents with meningism, PA should be included in the differential diagnosis.

Conclusion:

This report illustrates a case of PA presenting with symptoms and a CSF profile classically associated with viral meningitis.
Effect of COVID-19 on cardiac electrophysiology practice: a systematic review of literature
Authors: Almas Talal , Ehtesham Maryam , Khan Alishba A. , Ramtohul Rahul K. , Nazir Maheen , Zaidi Syed M. J. , Alsubai Abdulla K. , Al-Ansari Haya , Awais Muhammad , Alsufyani Reema , Alsufyani Majid , Almesri Abdulla , Ismail Hebatalla , Hadeed Sebastian , Malik Jahanzeb
Published: March 2023

The authors conducted a systematic review on the effect of coronavirus disease 2019 on electrophysiology (EP) practice and procedure volume in various settings. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed/MEDLINE, Scopus, Web of Science, CINAHL, and Embase were examined with combinations of medical subject headings terms for identification of the relevant studies. After excluding duplicates, irrelevant, and ineligible studies, 23 studies were included for full qualitative analysis. The overall study-level volume reduction of EP procedures ranged from 8 to 96.7%. All studies reported an overall reduction in EP physiology procedures being carried out except one in Poland, which reported an overall increase in the total EP procedures carried out in 2020. This study still reported a decrease in EP procedure volume during the first lockdown phase. Procedural volume reduction was seen most commonly for cardiovascular implantable electronic device placement (20/23 studies, 86.9%), electrophysiology studies (11/23 studies, 47.8%), and ablations (9/23, 39.1% studies). The most common reason stated for the observed decline in EP procedures was the cancellation and postponement of nonurgent elective cases in the hospitals (15/23 studies, 65.2%). There has been an overall reduction in EP procedure volume across different centers. The impact of the decline in EP procedures will be seen only after the services resume to prepandemic levels, but an increase in-patient volume and procedure waiting time is expected. This review will provide insights into improving healthcare service delivery in times of unprecedented public health emergencies.
Pulmonary mucoepidermoid carcinoma in children: a rare diagnosis not to be overlooked – case report
Authors: Dardouri Teheni , Ezzine Abir , Ben Fredj Maha , Boudriga Hajer , Mensi Sihem , Ayadi Aïda , Abroug Saoussen , Nouira Manel , Chatti Kaouthar
Published: March 2023

Introduction and importance:

Pulmonary mucoepidermoid carcinoma (PMEC) in children is a rare entity. The diagnosis is often unrecognized, often treated as pneumonia, a more frequent diagnosis at this age.

Case presentation:

The authors report in this article, the case of a 12-year-old child with a clinical history of chronic cough evolving for 6 months with recurrent episodes of pneumonia. The presence of a foreign body was suggested on the thoracic computed tomography (CT). PMEC was histopathologically determined on biopsy. Fluorine-18-fluorodesoxyglucose positron emission tomography (18 F-FDG PET)/CT was performed as part of the extension work-up prior to surgical management.

Clinical discussion:

Preoperative imaging with 18F-FDG PET/CT seems to be a valuable tool for predicting tumor grade, nodal stage, and postsurgical prognosis in mucoepidermoid carcinoma. PMEC patients with high 18F-FDG PET/CT uptake may need extensive mediastinal lymph node dissection and adjuvant therapy.

Conclusion:

PMEC has different presentations depending on the degree of tumor differentiation on PET/CT whose input in the management of these rare cancers requires further studies.
Unconventional but effective: breaking through IBS-D clinical practice guidelines – correspondence
Authors: Shaikh Omer Ahmed , Shaikh Gulrukh , Aftab Rameel Muhammad , Baktashi Haisum , Ullah Irfan , Asghar Muhammad Sohaib
Published: March 2023

Irritable Bowel Syndrome (IBS) is a chronic, one of the commonest and persistent gastrointestinal (GI) disorder. Previously, the management plan for IBS-D included enhancing awareness; first line treatment included an increased dietary fiber intake, opioids for diarrhea and antispasmodics for pain management. A recent treatment guideline by the American Gastroenterology Association (AGA) suggests a modified approach to treating patients with IBS-D. Eight drug recommendations were made, and a set of instructions on when to employ which medication was devised. With the incorporation of these structured guidelines, a more tailored and focused approach to IBS management may become plausible.
Dual insulin resistance causes: how frequently type 2 diabetes mellitus and COVID-19 infection caused diabetic ketoacidosis? a case report
Authors: Bereda Gudisa
Published: March 2023

Background and importance:

Infection with coronavirus disease 2019 (COVID-19) worsens insulin resistance and causes diabetic ketoacidosis (DKA). Patients with COVID-19 infection who develop DKA run the risk of worse outcomes. In both diabetic and nondiabetic patients, the COVID-19 infection may hasten the development of ketoacidosis, which could have negative effects on the fetus.

Case presentation:

A 61-year-old retired Black African female was taken into the emergency room on 22 April 2022, with significant complaints of frequent midnight urination, shortness of breath, blurry vision, and tingling in her hands and feet. On a chest radiography, bilateral diffuse, patchy airspace opacities that might be due to multifocal pneumonia or viral pneumonia were seen. The severe acute respiratory syndrome infection was confirmed by real-time reverse transcription-PCR testing from nasopharyngeal swabs. She received intravenous fluids and an intravenous insulin infusion and monitored her blood electrolyte levels as part of her treatment. She received subcutaneous enoxaparin 80 mg every 12 h a day for prophylaxis of deep venous thrombosis due to her confirmed COVID-19.

Clinical discussion:

In a large number of patients, COVID-19 has the ability to trigger DKA, and type 2 diabetes mellitus amplifies the underlying COVID-19 infection. Diabetes mellitus and COVID-19 are noted to have a reciprocal relationship in this regard.

Conclusions:

By making the body resistant to insulin and raising blood sugar levels, a COVID-19 infection can cause DKA. It is probable that her severe acute respiratory syndrome coronavirus 2 infection has a detrimental effect on the pancreatic beta cells, which are responsible for her body producing insufficient levels of insulin.
How food preparation and food choice influence the nutritional growth of children: a rising matter for the nutritionists and dietitians in Nigeria
Authors: Oduoye Malik O. , Olaide Zainab , Muhammod-Rabiu Nusaybah OIZA , Mujtab Abulkathir , Joseph Grace , Banga Styves , Masimango Gaston , Akilimali Aymar
Published: March 2023

This current work describes how the nutritionists and dietitians in Nigeria to tackle the nutritional deficiencies among the under-5 children in Nigeria due to poor food preparation by the parents and caregivers as well as how the food is chosen for these children. Studies have shown that the resultant effects of poor food preparation and the skewness of food choices on particularly the more vulnerable group of under-5s are malnutrition. According to the State of the World’s Children, published by the United Nations International Children’s Emergency Fund, the prevalence of child malnutrition in Sub-Saharan Africa, including Nigeria, is particularly high. Thus, it is high time for the nutritionists and dietitians in Nigeria to step up their advocacy, community sensitization, and awareness campaigns on appropriate diet and approach to food issues, especially on how food is prepared by most Nigerian parents and caregivers, and also work on their decision-making process governing the food choices they make for their children.
Prolonged use of noninvasive ventilation in the management of COVID-19-induced ARDS: a case report
Authors: Kandel Ashim , Achhami Eliz , Adhikari Lukash , Rijal Shreejal , Bhattarai Nabin , Thapa Megha
Published: March 2023

The severity of coronavirus disease 2019 and its manifestations varies considerably from person to person. Acute respiratory distress syndrome is the more feared and severe complication usually managed with early intubation and invasive ventilation. We report a case from a tertiary hospital in Nepal admitted with coronavirus disease 2019 acute respiratory distress syndrome and managed primarily on noninvasive ventilation. Considering the scarcity of invasive ventilation and the rising number of cases during the pandemic and its complications, early use of noninvasive ventilation in appropriate patients can decrease the need for invasive ventilation.
Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma: a case report
Authors: Rijal Sabina , Basukala Sunil , Shah Kunda B. , Thapa Anup , Bohara Sujan , Shah Aashish
Published: March 2023

Introduction:

Xanthogranulomatous cholecystitis (XGC) is an uncommon type of chronic cholecystitis. Clinical presentation, laboratory findings, and radiological analysis mimic gallbladder carcinoma. A definitive diagnosis is made by histological study. Cholecystectomy, along with adjuncts as required, is performed for management.

Case Presentation:

We present a case of a 67-year-old female who was planned for interval cholecystectomy for gallstone pancreatitis. Her clinical, laboratory and radiological findings were suggestive of cholelithiasis and was planned for laparoscopic cholecystectomy. Her intraoperative findings mimicked gallbladder carcinoma. The surgery was aborted, and a biopsy was sent for histopathological analysis. XGC was diagnosed, and the patient underwent laparoscopic cholecystectomy with no postoperative complications during the 6-month follow-up period.

Discussion:

XGC is a rare disorder resulting from chronic inflammation of the gallbladder. There is the presence of xanthogranuloma with predominant lipid-laden macrophages in the gallbladder wall along with fibrosis. Clinical presentation, laboratory findings, and radiological analysis mimic gallbladder carcinoma. Ultrasonography usually shows diffuse wall thickening of the gallbladder, intramural hypoechoic nodules, unclear liver and gallbladder interface, and the presence of gallstones. The final diagnosis is made by histopathological analysis. Laparoscopic or open cholecystectomy, along with adjuncts as required, is performed for management with a low postoperative complication rate.

Conclusion:

XGC is a rare, benign disease that is often confused with gallbladder cancer before histological analysis. XGC can be managed with laparoscopic cholecystectomy with minimal postoperative complications.
Post-traumatic chronic-encapsulated and calcified intracerebral hematoma mimicking a supratentorial hemangioblastoma: a case report and literature review
Authors: Borni Mehdi , Abdelmouleh Souhir , Abdelhedi Anis , Affes Ameur , Boudawara Mohamed Z.
Published: March 2023

Introduction and importance:

Chronic-encapsulated intracerebral hematomas are a rare type of hematoma. They tend to be mistaken for abscesses or tumors. The etiology of these hematomas is not yet clear, although they have mainly been linked to arteriovenous malformations, cavernomas, and head trauma. Surgical evacuation is effective in improving neurological symptoms with a good prognosis. However, the lesion may be difficult to diagnose.

Case presentation:

Here, the authors report a case of a chronic-encapsulated and calcified intracerebral hematoma following recurrent mild head injuries mimicking a supratentorial hemangioblastoma in a healthy 26-year-old female patient presented with progressive raised intracranial pressure and left body heaviness with good outcomes after en bloc surgical resection.

Clinical discussion:

The chronic-encapsulated intracerebral hematoma was first described by Hirsh et al. in 1981. Their etiology is not yet clear, although they have mainly been linked to arteriovenous malformations, cavernomas, and head trauma. Pathologically, they are characterized by the presence of a fibrous capsule composed of an outer collagen layer and an inner granulated layer. Radiologically, they appear as cystic lesions with a homogeneous high signal on T1-weighted and T2-weighted images associated with a lower signal ring sign and ring enhancement after gadolinium administration that may suggest hemangioblastoma.

Conclusion:

Although chronic parenchymal hematomas remain a rare phenomenon, it has become increasingly logical to consider this entity in differential diagnoses with other lesions. In cases with recurrent head trauma, a detailed investigation will aid in making the diagnosis of such a rare pathology.
Compound heterozygosity for Hb C/Hb S (HBB: c.19G>A/HBB: c.20A>T) diseases observed in a Syrian family: a case report
Authors: Moassas Faten , Daboul Amir , Assád Manar , Murad Hossam
Published: March 2023

Introduction:

Hemoglobin S and Hemoglobin C disease is a type of sickle cell disease caused by two mutations at codon 6 of β-globin gene. These mutations cause changes in the shape of the red blood cells. Little is known about its presence in our region.

Case Presentation:

The authors describe a case of a Syrian family consisting of father, mother, two daughters, and son. The mother presented with anemia, episodes of fatigue, and extreme pain (vaso-occlusive crisis). Beta and alpha-globin gene mutations have been analyzed using molecular detection methods. The results revealed that, the mother, second daughter, and son were all double heterozygous for hemoglobin C and S associated with the –α3.7 deletion mutation. The husband and the first daughter were found to have the hemoglobin C trait.

Discussion:

Hemoglobin (Hb) SC has been known to have a higher frequency in black populations and is restricted to persons of West African descent. In our case, all family members had dark brown skin color, and they were all diagnosed with Hb C or Hb SC. The mother, second daughter, and son had the clinical manifestations associated with Hb SC disease, and their values of mean cell volume and mean cell hemoglobin were low due to the presence of the –α3.7 deletion mutation. The husband and the first daughter do not have any serious health problems.

Conclusions:

To the best of the knowledge, this is the first case of compound heterozygous for hemoglobin C and S to be reported from a Syrian family.
Unusual location of gouty arthritis with shoulder joint involvement in an elderly male patient: a rare case report
Authors: Shrateh Oadi N. , Jobran Afnan W.M. , Zaid Momen A. , Hamed Heba K. , Asees Mohammad Y. , Soboh Omar , Dallashi Ahmad A.
Published: March 2023

Introduction:

Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. Gout has been reported in many locations but is rarely localized in the shoulder joint.

Case presentation:

A 73-year-old man who visited an outpatient clinic with the main complaint of a right shoulder ache lasting 2 weeks came to our attention. The patient reports his discomfort as being of an unbearable character, happening largely at night and preventing him from falling asleep. In the previous 6 months, he had two episodes of the same ailment that lasted around 3–5 days each and spontaneously resolved. Due to the pain’s continuance without improvement, the patient now seeks medical assistance. Gout with right shoulder involvement was identified as the cause. Prednisolone 40 mg/day for 10 days, allopurinol 300 mg/day, and colchicine 0.5 mg/day were all prescribed for the patient. After 6 months of follow-up, the patient had significantly improved.

Discussion and conclusions:

The condition of gout affecting the shoulder joint is quite rare. According to past medical history and clinical manifestations, doctors and orthopedic surgeons should take gouty shoulder arthritis into consideration when there is serious erosion.
Highly pathogenic avian influenza (HPAI A H5N1) outbreak in Spain: its mitigation through the One Health approach – a short communication
Authors: Oduoye Malik O. , Akilimali Aymar , Nazir Abubakar , Yusuf Hassan A. , Cakwira Hugues , Zubairu Abdullahi Z. , Biamba Chrispin , Abdullahi Abdullahi N. , Farooq Alia , Wajid Muhammad A. , Banga Styves , Masimango Gaston
Published: March 2023

Highly pathogenic avian influenza (HPAI A H5N1) has occurred over the past few years, especially during the 1918–1919 Spanish Flu pandemic, which wiped out many people in the world. It caused acute illness in about 25–30% of the world’s population, which led to the deaths of up to an estimated 40 million people. Of recent, public health authorities in Spain reported the detection of avian influenza A in two poultry workers on a single farm, following an outbreak in poultry confirmed on 20 September which was likely to be due to exposure to infected poultry or contaminated environments and poor interprofessional collaborations among the Spanish health workers. This is a public health challenge for the Spanish government and the world at large. Thus, we believed that through the One Health approach in Spain, there would be a stop to and prevention of further spread of the recent outbreak of avian influenza A in Spain, as well as other infectious diseases and future outbreaks in the country and the world at large.
Lipidomics, Acute Ischemic Stroke, Symptoms, and Outcomes
Authors: Martha Sarah R. , Pen Alice Y. , McGuire Laura Stone , Alaraj Ali , Maienschein-Cline Mark , Basu Sanjib , Loeb Jeffrey A. , Thompson Hilaire J.
Published: March 2023

Background

Acute ischemic stroke is one of the leading causes of death and disability globally. Recent advances in omics methodology enable lipidomic profiling, which may provide knowledge of the underlying pathology of acute ischemic stroke and its associated outcomes.

Objective

This study aims to examine the longer-term relationships between symptoms and outcomes following acute ischemic stroke and the underlying lipidomic signatures over 6 months during recovery between acute ischemic stroke patients who received reperfusion therapies and those who did not.

Methods

This prospective cohort study will enroll 104 participants post-acute ischemic stroke in two groups based on their receipt of reperfusion therapy (Group 1) or not (Group 2; n = 52/group). Peripheral plasma samples will be collected from both groups for lipidomic analysis over 6 months. Arterial blood samples will be collected during the procedure for those receiving reperfusion. Self-reported symptoms and outcome data will be collected from both groups.

Discussion

We will compare and examine the associations among plasma lipidomic biomarkers and symptoms and cognitive, functional, and health-related quality of life outcomes over 6 months between acute ischemic stroke patients who did and did not receive reperfusion intervention.
Leukocytosis and C-Reactive Protein Levels as Indicators of Infection in Children With Diabetic Ketoacidosis
Authors: Hamtzany Omer , Weiser Giora , Heiman Eyal , Avnon-Ziv Carmit , Auerbauch Adi , Levy-Khademi Floris
Published: March 2023

Background

Diabetic ketoacidosis (DKA) is one of the serious complications of type 1 diabetes mellitus and may be aggravated by infection. Diagnosing an infection in a patient with DKA is often complicated because of the overlap of symptoms and the presence of leukocytosis in both conditions. Reliable indicators for the diagnosis of bacterial infection in DKA may reduce unnecessary use of antibiotics and enable closer monitoring of patients at risk.

Methods

This is a retrospective study. The study cohort included 180 children and adolescents with type 1 diabetes mellitus who were admitted to the Pediatric Emergency Department at Shaare Zedek Medical Center and had blood test results. We compared white blood cell count, C-reactive protein (CRP) levels, blood glucose levels, pH, the degree of acidosis, and the incidence of infection in patients with and without DKA.

Results

The incidence of probable bacterial infection in the entire cohort was 13.9%: 15.7% in the DKA group and 7.5% in the non-DKA group (P = 0.65). The incidence of leukocytosis was significantly higher in patients with DKA (P = 0.0003), although this was not related to bacterial infection. The CRP levels were higher in the DKA group with infection than without infection, and this was statistically significant (P = 0.008).

Conclusions

Our findings suggest that leukocytosis in DKA is not a reliable indicator of concomitant bacterial infection. In contrast, CRP levels were not related to the DKA or degree of acidosis and were significantly higher in patients with infection within the DKA group, and are therefore a more reliable indicator of concomitant infection in these patients.
The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression
Authors: Cuenca-Martínez Ferran , Varangot-Reille Clovis , Calatayud Joaquín , Suso-Martí Luis , Salar-Andreu Cristina , Gargallo Pedro , Blanco-Díaz María , Casaña José
Published: March 2023

Purpose:

To evaluate and explore the influence of the weight of a backpack on standing posture and gait in children and adolescents.

Methods:

We conducted a search of MEDLINE (PubMed), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science, with the last search in July 2021. Standardized mean differences (SMD) and 95% confidence intervals were calculated for relevant outcomes and were pooled in a meta-analysis using the random-effects model. The participants were healthy children or adolescents. The outcomes were postural variables, spatiotemporal gait variables, gait kinematics, and muscle activity. We analyzed the influence of a loaded backpack on posture while standing and spatiotemporal and kinematic variables while walking. We used GRADE, Risk of Bias 2, ROBINS-I, MINORS, and PEDro scales to rate the quality, certainty, and applicability of the evidence.

Results:

Wearing a loaded backpack induces a significant increase of the craniohorizontal angle while standing and a decrease of walking speed and stride length while walking. Only the craniovertebral angle had a significant relationship with the weight of the backpack.

Conclusions:

Wearing a backpack induces postural changes while standing and affects gait in children and adolescents; however, almost all the changes are not related to the backpack weight.
Development and Initial Evaluation of a Soft Ankle Support for Children With Ankle Impairments
Authors: Civil Danielle A. , Orlando Julie M. , Cunha Andrea B. , Li Bai , Lobo Michele A.
Published: March 2023

Purpose:

Develop and initially evaluate a soft ankle support (SAS) garment for children with ankle impairments.

Description of Cases:

Two participants were evaluated at baseline and interviews with their parent(s) to identify wants and needs for the SAS. The SAS was developed and evaluated via participant report and functional measures in barefoot, ankle-foot orthosis (AFO), and SAS conditions.

Outcomes:

Children and parents expressed dissatisfaction with AFOs' dimensions, weight, adjustability, comfort, and ease of use. Gait and gross motor function were similar for SAS and AFOs' conditions; however, participants rated the SAS better for weight and bulk, integration with shoes, adjustability, comfort, cost, and washability.

Discussion:

The SAS and AFOs performed similarly in this initial testing, yet the SAS also met participants' needs across key metrics not well addressed by AFOs. Ankle support devices that meet users' broad needs may support improved adherence and user satisfaction.