bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary extragastrointestinal stromal tumor of the prostate: review of the literature and case report
Authors: Benabdallah Wajdi , Ben Othmane Mouna , Ouahchi Ines , Mestiri Sarra , Belkacem Oussama , Bouassida Khaireddine , Hmida Wissem , Jaidane Mehdi 
Published: April 2023

Introduction and importance:The extragastrointestinal stromal tumor (EGIST) is defined as a mesenchymal neoplasm arising from soft tissues outside the gastrointestinal tract, and the prostate is a rare presentation site.Case presentation:A 58-year-old man was presented with lower urinary tract symptoms for 6 months. A digital rectal examination revealed a markedly enlarged prostate with a smooth, bulging surface. Prostate-specific antigen density was 0.5 ng/ml. MRI of the prostate showed an enlarged prostatic mass with hemorrhagic necrosis. Transrectal ultrasound-guided prostate biopsy was performed and pathological reports suggested a gastrointestinal stromal tumor. The patient refused radical prostatectomy and received only imatinib treatment.Clinical discussion:The diagnosis of EGIST of the prostate is extremely rare and depends on the histopathologic features with immunohistochemical results. The treatment is essentially based on radical prostatectomy, but there are other therapeutic modalities associating surgery with adjuvant or neoadjuvant chemotherapy. For patients refusing surgery, treatment with imatinib alone appears to be a therapeutic solution.Conclusion:Despite the rarity, EGIST of the prostate should be included in the differential diagnosis of patients presenting with lower urinary tract symptoms. There is no consensus regarding the treatment of EGIST, and the patients are treated as per the risk stratification.
Malignant carotid body tumor: a report of two cases
Authors: Alfawaz Abdullah A. , Albloushi Dalia , Quttaineh Danah , Alsafran Salman , AlQabandi Omar , Albader Marzouq 
Published: April 2023

Introduction and importance:
Carotid body tumors (CBT) are neoplasms that originate from chemoreceptors of the carotid body. They are neuroendocrine tumors that are usually benign but may have malignant potential. Malignancy is diagnosed with evidence of lymph node metastasis, distant metastasis, or disease recurrence. Multiple imaging modalities are used to diagnose CBTs and the treatment of choice is surgical excision. Radiotherapy is used for unresectable tumors. In this case, series we describe two cases of malignant paragangliomas that were diagnosed and operated on at a tertiary hospital in Kuwait, by the vascular team. Malignant CBTs are rare, documentation of the cases encountered and the subsequent management and outcome is important to give us a better understanding of the disease.

Case presentation:

Case one– A 23-year-old woman presented with a right-sided neck mass. History, physical examination, and appropriate imaging suggested malignant paraganglioma with evidence of lymph node, vertebral, and lung metastases. Surgical excision of the tumor and regional lymph nodes was done. Histopathological assessment of the retrieved specimens confirmed the diagnosis.

Case two – A 29-year-old woman presented with a left submandibular swelling. She was appropriately investigated, and the diagnosis of a malignant carotid body tumor was made with evidence of lymph node metastasis. Surgical resection of the tumor with clear margins was done and histopathological analysis of the resected specimen confirmed the diagnosis.

Clinical discussion:
CBT’s are the most common tumors of the head and neck. Most are nonfunctioning, slow growing, and benign. They typically present in the fifth decade of life but can occur at a younger age in individuals who carry certain genetic mutations. Both cases of malignant CBT’s that we encountered occurred in young women. Furthermore, the 4-year and 7-year history in case number one and two, respectively, supports the fact that CBTs are slow growing tumors. In our case series, the tumors were surgically resected. Both cases were discussed in multidisciplinary meetings and were referred for hereditary testing and radiation oncology for further management.

Conclusion:
Malignant carotid body tumors are rare. Prompt diagnosis and treatment is important to improve patient outcomes.
Clinical manifestations of delayed reaction following mass hornet envenomation: a case report
Authors: Bhattarai Urza , Acharya Anil , Shrestha Ram Sharan , Gautam Arun , Anand Ayush , Manandhar Srista , Sharma Sanjib Kumar 
Published: April 2023

Introduction:
Delayed reaction following mass hornet envenomation is associated with various clinical manifestations.

Case Presentation:
The authors present a case of a 24-year-old male from eastern Nepal, who presented following mass envenomation by hornet stings. He had progressive yellowish discoloration of skin and sclera, myalgia, fever, and dizziness. He had passage of tea-coloured urine followed by anuria. Laboratory investigations suggested acute kidney injury, rhabdomyolysis, and acute liver injury. The authors managed the patient with supportive measures and haemodialysis. There was complete recovery of liver and renal function in the patient.

Discussion:
The findings in this patient were similar to other cases reported in the literature. These patients must be managed supportively, with few requiring renal replacement therapy. Most of these patients recover completely. In low-middle-income countries like Nepal, delay in seeking care and delay in reaching care is associated with severe clinical manifestations. Delayed presentation can lead to renal shutdown and mortality; hence, early intervention is simple, and, crucial.

Conclusion:
This case highlights the occurrence of delayed reaction following mass envenomation by hornets. Also, the authors show an approach to managing such patients, similar to managing any other case with acute kidney injury. In these cases, an early simple intervention can prevent mortality. It is crucial to train healthcare workers regarding toxin induced acute kidney injury and the importance of early identification and intervention.
PIK3CA-related overgrowth spectrum (PROS): a rare case report
Authors: Kalo Cedra , Khana Firas , Jazmati Aya , Kalo Sima , Ishkhanian Silva , Kayyali Alae , Sawas Taher 
Published: April 2023

Study Design:
Case report.

Introduction and Importance:
The purpose of this study is to report an extremely rare case of PIK3CA-related overgrowth spectrum.

Case Presentation:
A 12-year-old boy presented with severe overgrowth in the left lower limb causing severe movement restriction and decreased quality of life.

Interventions and Outcome:
Episodes of myiasis were manually treated through mechanical removal and the patient was placed on rapamycin therapy for managing vascular malformations.

Conclusion:
CLOVES syndrome is a rare overgrowth disorder that can be confused with other overgrowth syndromes; however, clinical and imaging findings are essential for pinpointing the correct diagnosis as genetic sequencing may not always prove reliable.
Retroperitoneal desmoid-type fibromatosis: a case report
Authors: El Charif M. Hadi , Tarhini Hawraa , Dushfunian David , Al Harake Hassan , Khasawneh Hala , Abi Saad George , Khalife Mohamad , Sbaity Eman 
Published: April 2023

Introduction and importance:
Desmoid-type fibromatosis (DF) is a rare subtype of soft tissue sarcomas that most commonly occurs in the anterior abdominal wall. When occurring in the retroperitoneum, DF is usually part of familial syndromes while only rarely sporadic. This makes it imperative to report any instance of experience with DF and the oncological outcomes of the different approaches to management. We report two cases of sporadic and severe DF occurring in the retroperitoneum at our institution.

Case presentation:
The first case is a male that presented with urinary obstruction symptoms and underwent surgical resection of the tumor that extended into the left kidney. The second case is a female with a history of recurrent desmoid tumors of the thigh and was incidentally diagnosed with retroperitoneal DF on imaging. She underwent tumor resection and radiotherapy; however, the tumor recurred with urinary obstruction symptoms that required another surgical resection. Histopathological characteristics and radiological imaging of both cases are described below.

Clinical discussion:
Desmoid tumors often recur, thus significantly influencing the quality of life which is reflected in one of our cases. Surgery remains a mainstay treatment, and both cases presented in this report required surgical resection of the tumors as symptomatic and curative measures.

Conclusion:
Retroperitoneal DF is a rare entity, and our cases add to the scarce literature available on the topic, which may well contribute to the formulation of practice-changing recommendations and guidelines focused on this rare variant of DF.
The use of chloroquine with or without adjuncts in the effective management of scorpion sting in the tropics: case reports
Authors: Udohchukwu Okereke Promise , Obumneme Okereke Wisdom , Collins Uche , Philemon Ugwuanyi , Arinze Ibeh David , Daniel Ginger-Eke Ikenna 
Published: April 2023

Introduction and importance:
Scorpion Sting is a common occurrence in the tropics caused by scorpion envenomation on unsuspecting victims. The sting causes severe pain and may be much more fatal depending on the age and size of the patient and the scorpion specie as well as other factors. Effective treatment is needed specially to alleviate pain. Many parts of the tropics have little or no data describing the use of Chloroquine in managing scorpion sting. These cases show how chloroquine can be used in without other drugs to achieve pain control.

Case presentation:
Patients presented with pain emanating from the right big toe and medial arch, respectively. The said pain had same manifestation and intensity in both patients and followed same course but radiated higher in up to the ipsilateral flank in the first patient but was limited to the ipsilateral iliac region of the second patient.

Clinical discussion:
The sites showed signs of inflammation with pain being most prominent. Diagnosis of scorpion envenomation were made based on the given history. The pain was eliminated using chloroquine given intramuscularly at the site of scorpion sting.

Conclusion:
Scorpion sting can occur at any time in the tropic and lidocaine only cannot alleviate pain. Chloroquine can be used in managing scorpion sting as it also has many other benefits that can make it more preferred to the other conventional approaches used.
Rectal prolapse as a manifestation of inflammatory bowel disease with celiac disease in a 2-year-old male: a rare case report
Authors: Martini Nafiza , Kara Tahhan Nour , Aldarwish Mohamad S. , Mahmoud Jaber 
Published: April 2023

Introduction and Importance:
The co-occurrence of inflammatory bowel disease (IBD) and celiac disease (CeD) is uncommon. The typical sign of this co-occurrence is malabsorption which leads to anemia, diarrhea, and malnutrition. In rare cases, recurrent rectal prolapse may also occur.

Case presentation:
A 2-year-old Syrian male baby presented with failure to thrive and chronic diarrhea for 18 months, along with recurrent rectal prolapse for the last 6 months. Biopsies taken confirmed a diagnosis of stage 3b celiac disease according to the Marsh classification. Furthermore, biopsies taken confirmed a diagnosis of IBD. Then, a high-fiber diet to manage IBD and celiac diet were both needed simultaneously, with signs of rectal prolapse, diarrhea, and bloating, occurring when either or both diets were stopped.

Clinical discussion:
The diagnosis was initially explained by the malnutrition and anemia. Even after the gluten-free diet, the patient showed no improvement in diarrhea and developed inferior gastrointestinal bleeding suggested anal fissure, infectious colitis, polyps, IBD, or solitary rectal ulcer syndrome. The relationship between celiac disease and IBD, in children, is still unclear. Current studies suggest that such co-occurrence is associated with higher risks of developing other autoimmune-related disorders, growth and puberty delay, and comorbidities.

Conclusions:
In the cases of pediatric co-occurrence of IBD and celiac disease, a conservative therapy consisting of two-fold diets for the two diseases should be tried first. If this step succeeds in controlling the clinical picture, it removes the necessity of introducing immunological pharmacologic treatments that may induce unfavorable side effects in a child.
Pregnancy and complete atrioventricular block: a case report
Authors: López Bryam , Batallanos Milagros 
Published: April 2023

Introduction:
Bradycardia in pregnancy due to complete atrioventricular block (CAVB) is a rare but serious occurrence that can be life-threatening to the mother and fetus. Patients with CAVB may be asymptomatic, but symptomatic cases require urgent and definitive management.

Case presentation:
The case of a 20-year-old primigravida with previously undiagnosed CAVB who attended the obstetric emergency service in labor is presented. The route of delivery was vaginal without complications. The decision was made to implant a permanent dual-chamber pacemaker on the third day of the puerperium, and the patient did no present cardiovascular symptoms during outpatient follow-up.

Clinical discussion:
CAVB is a rare but serious condition in pregnancy that can be congenital or acquired. While some cases are relatively benign, others can lead to decompensation and fetal complications. There is no consensus on the best delivery route, but vaginal delivery is generally safe unless contraindicated for obstetric reasons. Pacemaker implantation may be necessary in some cases and can be performed safely during pregnancy.

Conclusion:
This case highlights the importance of cardiac evaluation in pregnant patients, especially those with a history of syncope. It also highlights the need for adequate and urgent management in symptomatic cases of CAVB in pregnancy and adequate evaluation to decide when to implant the pacemaker as a definitive measure.
Laparoscopic sigmoidectomy postopen aortic replacement for abdominal aortic aneurysm: a case report
Authors: Fujimoto Goshi , Deguchi Takashi 
Published: April 2023

Introduction and importance:
Colectomy for colorectal cancer after an open aortic replacement (OAR) for abdominal aortic aneurysms has high perioperative complication and mortality rates.

Case presentation:
The authors report the case of an 87-year-old man who underwent laparoscopic sigmoidectomy. The patient presented with edema of the lower legs and face, and blood test results indicated anemia. The patient had a history of OAR for an abdominal aortic aneurysm 9 years prior, a left common iliac artery aneurysm, and a jump bypass graft. A colonoscopy revealed a type 2 lesion in the sigmoid colon; he was diagnosed with moderately differentiated adenocarcinoma. Preoperative computed tomography did not show any obvious lymph node or distant metastases. Laparoscopic sigmoidectomy with D3 lymphadenectomy was planned. During surgery, the use of the lateral approach allowed sigmoid mesocolon mobilization while confirming the presence of the artificial arteries. As the approach to the root of the inferior mesenteric artery was difficult, D1 lymphadenectomy was performed. No evidence of anastomotic leakage or artificial artery infection was observed postoperatively.

Clinical discussion:
Intra-abdominal adhesions due to the prior OAR makes sigmoid mesocolon mobilization difficult. In cases where laminar structure cannot be recognized, other landmarks are needed.

Conclusions:
After OAR, artificial arteries can be used as landmarks during colectomy. Although laparoscopic surgery is technically challenging, the magnified view provides an advantage in identifying these landmarks. Patients’ surgical records for the previous OAR should be checked, and the positions of the vessels and ureters should be elucidated preoperatively using computed tomography.
Antineuronal autoantibodies induced paraneoplasic syndrome in schizophrenia spectrum disorders: case report
Authors: Jaballah Fares , Ben Hamed Nouha , Hamzaoui Sayma , Ayadi Mohamed A. , Zgueb Yosra , Jomli Rabaa 
Published: April 2023

Background:
Secondary psychiatric symptoms are usually suspected when there is an atypical presentation of the symptoms or a lack of response to psychotropic medication.

Case presentation:
Our case is about a woman aged 62 years old, with a history of mental disorder who presented psychiatric symptomatology after years of being stabilized by antipsychotics. She was later investigated due to a mass in her breast. Carcinoma was diagnosed, and her psychiatric symptomatology was resolved after the tumerectomy.

Discussion:
The therapeutic difficulty is the major problem of psychic disorders in the context of paraneoplastic syndrome. Several literature review have suggested a relationship between schizophrenia and antineuronal antibodies in the context of paraneoplastic syndrome. Treating the tumor can solve psychiatric symptoms better than psychotic treatment.

Conclusions:
The aim of our study is to highlight the importance of a complete medical evaluation to identify the psychiatric presentations of organic disorders associated with psychiatric manifestation and to ensure an early diagnosis.
Osteophyte-related medial collateral ligament injury in asymptomatic osteoarthritis following minor trauma: a case report
Authors: Asavanapakas Panpaporn , Parinyakhup Wachiraphan , Boonriong Tanarat , Boonsri Pattira , Laohawiriyakamol Teeranan , Chuaychoosakoon Chaiwat 
Published: April 2023

Introduction and importance:
A proximal deep medial collateral ligament (MCL) injury usually occurs in high-impact sports such as football or hockey. This injury is not common in low-energy trauma but the predisposing factor, in this case, was an osteophyte located next to the deep MCL ligament, which had likely caused degenerative changes to the ligament from chronic irritation, resulting in reduced strength of the ligament.

Case presentation:
A 78-year-old Thai female presented with left knee pain 1 h after a low-energy trauma caused by a fall. The MRI showed deep MCL and medial meniscal root injuries, a nondisplaced lateral femoral condyle, and also revealed a large osteophyte near the midpart of the MCL, with a blunt persistent projection from the osteophyte pushing against the MCL where the injury was located. She was treated with a knee brace, a gait aid for walking, and analgesic pain control. Her symptoms gradually improved over the next few weeks.

Clinical discussion:
If an osteophyte touches a ligament, it can cause degenerative changes to the ligament from chronic irritation, resulting in reducing the strength of the ligament and may be causing some degree of degenerative changes and tightening of the MCL in its at-rest state, resulting in an increased chance of injury when it is required to resist a sudden external force, even from a minor trauma.

Conclusion:
When there is an osteophyte pushing against a ligament, there is an increased chance of ligament injury when even a minor trauma stresses that ligament.
Factors associated with hypertension among diabetic patients in Gamo Zone, Southern Ethiopia, 2021: case-control study
Authors: Kefelew Etenesh , Getahun Firdawek , Damtie Addisalem , Dawite Firehiwot , Gebeyehu Selamawit , Hailu Tadiwos , Temesgen Rodas , Abebe Getachew , Abebe Mesfin 
Published: April 2023

Background:
The prevalence of hypertension in diabetic patients is nearly twice that of non-diabetic patients. The presence of both hypertension and diabetes accelerates complications and raises the risk of death. Thus, identifying determinants of hypertension in diabetic patients is critical for preventing the development of devastating acute and chronic complications, as well as diabetes-related death.

Methods and materials:
A case-control study was carried out in public hospitals of Gamo Zone, Southern Ethiopia. To select study participants, a systematic random sampling technique was used. The KOBO toolbox was used to collect data, which was then exported to the IBM SPSS version 25 software package for analysis. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with hypertension in diabetes patients, and variables in the multivariable logistic regression analysis with a P value less than 0.05 were declared significantly associated at a 95% CI.

Results:
In this study, age greater than or equal to 50 years [adjusted odd ratio (AOR)=4.08, 95% CI (1.41, 11.82)], higher body mass index [AOR=3.23, 95% CI (1.40, 7.66)], and higher waist to hip ratio [AOR=2.15, 95% CI (1.12, 4.13)] were significantly associated with hypertension in diabetic patients.

Conclusions:
This study found that factors associated with hypertension among diabetic patients included older age (>50 years), a high waait to st#to#hip ratio, and a higher body mass index. The concerned health authorities and healthcare providers in the study area should focus on those identified factors to prevent hypertension among diabetic patients.
Morphometric analysis of foramen ovale, foramen spinosum, and foramen rotundum of human skull using computed tomography scan: a cross-sectional study
Authors: Bhattarai Rakshya , Panthi Sagar , Yadav Gopal K. , Bhandari Siddhartha , Acharya Rochana , Sharma Ananta , Shah Pratima K. , Koirala Sarun , Bhattarai Manoj , Gupta Mukesh K. , Khanal Bhawani 
Published: April 2023

Background:
There is limited literature of objective assessments of foramina of skull base using computed tomography (CT) scan. This study was carried out to analyze the dimensions of foramen ovale (FO), foramen spinosum (FS), and foramen rotundum (FR) using CT scan imaging of the human skull and their associations with sex, age, and laterality of the body.

Materials and methods:
A cross-sectional study was carried out in the Department of Radiodiagnosis and Imaging at BP Koirala Institute of Health Sciences (BPKIHS), Nepal using a purposive sampling method. We included 96 adult patients (≥18 years) who underwent CT scan of the head for any clinical indications. All those participants below 18 years, inadequate visualization or erosions of skull base foramina, and/or not consenting were excluded. Appropriate statistical calculations were done using the statistical package for social sciences (SPSS), version 21. The P-value of less than 0.05 was considered statistically significant.

Results:
The mean length, width, and area of FO was 7.79±1.10 mm, 3.68±0.64 mm, and 22.80±6.18 mm2, respectively. The mean length, width, and area of FS was 2.38±0.36 mm, 1.94±0.30 mm, and 3.69±0.95 mm2, respectively. Similarly, the mean height, width, and area of FR was 2.41±0.49 mm, 2.40±0.55 mm, and 4.58±1.49 mm2, respectively. The male participants had statistically significant higher mean dimensions of FO and FS (P<0.05) than the female participants. There were statistically insignificant correlations of dimensions of these foramina with age and between the left and right side of each foraminal dimensions (P>0.05).

Conclusions:
The sex-based difference in dimensions of FO and FS should be clinically considered in evaluating the pathology of these foramina. However, further studies using objective assessment of foraminal dimensions are required to draw obvious inferences.