bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL CHARACTERISTICS AND MULTIMODAL IMAGING FINDINGS IN UNILATERAL FROSTED BRANCH ANGIITIS: A CASE REPORT
Authors: Lari Giorgio , Battista Marco , Marchese Alessandro , Bordato Alessandro , Lattanzio Rosangela , Querques Giuseppe , Modorati Giulio , Bandello Francesco , Miserocchi Elisabetta 
Published: March 2023

Purpose:
Our aim was to report a comprehensive multimodal imaging case of unilateral frosted branch angiitis in a 40-year-old White woman.

Methods:
Case report involving clinical examination, ultra-wide field fundus photograph, ultra-wide field fluorescein angiography, optical coherence tomography (OCT) and OCT angiography.

Results:
A 40-year-old patient presented with unilateral acute vision loss. On fundus examination, extensive retinal veins sheathing, macular edema, and vascular congestion were observed while ultra-wide field fluorescein angiography revealed a hyperfluorescent “hot” optic disc and blood retinal barrier disruption. Optical coherence tomography angiography displayed foveal avascular zone enlargement and excluded papillary neovascularization. Extensive laboratory workup for infectious, autoimmune, and inflammatory disorders was negative; thus, a diagnose of acute idiopathic unilateral frosted branch angiitis was made. Intravitreal injection of dexamethasone implant was administered with a good clinical response.

Conclusion:
Multimodal imaging is crucial to correctly diagnose and treat frosted branch angiitis. To the best of our knowledge, the use of optical coherence tomography angiography as a complementary tool to the diagnostic process in frosted branch angiitis has been described in literature just once as a photographic essay of cytomegalovirus-related frosted branch angiitis1 and it might be of great value for better characterizing clinical features of this disorder and for following disease activity in a noninvasive fashion.
Occurrence of False-Positive Tests and Cross-reactions Between COVID-19 and Dengue With Implications During Diagnosis: A Mixed Evidence Synthesis
Authors: Digwo Daniel C. , Elebe Chidinma P. , Chigor Vincent N. , Madueke Stella N. , Ezeh Christian K. , Ike Anthony C. 
Published: March 2023

Abstract
This review aimed to assess the occurrence of false-positive serological reaction between dengue and coronavirus disease 2019 (COVID-19) and its implications for diagnosis. Evidence syntheses were conducted by systematically reviewing available literature using multiple databases, including Web of Science, PubMed, Google Scholar and medRxiv. Among a total of 16 presented cases from clinical settings, cross-reaction to COVID-19 serological tests was observed in two (12.5%) dengue-positive patients, while 14 patients (87.5%) confirmed positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) showed a cross-reaction with dengue serological tests, leading to misdiagnosis and mismanagement by attending clinicians. Of 1789 SARS-CoV-2-positive sera, cross-reaction to dengue serological tests was observed in 180 sera (10%), which is higher than the cross-reaction observed for SARS-CoV-2 in archived pre-COVID-19 sera positive for a dengue infection (75 of 811, 9.2%, P = 0.674). Clinicians in tropical regions are therefore advised to interpret serological tests with caution and use a more pragmatic approach to triage these infections.
Immunoprofile of adenosquamous carcinoma in gastric cancer
Authors: Wu Cheng-Han , Lai Cheng-Lun , Teng Chieh-Lin Jerry , Fang Wen-Liang , Huang Kuo-Hung , Fen-Yau Li Anna , Yu Hung-Yuan , Chiang Nai-Jung , Chao Yee , Hung Yi-Ping , Chen Ming-Huang 
Published: March 2023

Background:
Gastric adenosquamous carcinoma (GASC) is a rare subtype of gastric cancer. Research on GASC treatment is limited, and its outcome is usually poor. We investigated the clinical features, immunoprofile of GASC, and determined the optimal treatment modality for these patients.

Methods:
Patients with GASC from Taipei Veterans General Hospital were retrospectively reviewed. Clinical features and treatment outcomes were evaluated. Adequate samples were examined for surrogate biomarkers for immunotherapy by IHC staining.

Results:
Total 14 (0.35%) GASC patients were found among 4034 gastric cancer patients. The median tumor size was 6.8 cm in 10 patients with stage III GASC, and all these patients underwent radical gastrectomy followed by adjuvant therapy. The median progression-free survival (PFS) and overall survival (OS) were 6.0 and 11.5 months, respectively. Two patients with stage IV GASC received frontline immunotherapy. Their median PFS and OS were 9.0 and 12.5 months. In immunoprofiling, 25.0% (n = 3), 75.0% (n = 9), and 33.3% (n = 4) of the samples had deficient mismatch repair (dMMR) protein, combined positive score (CPS) of ≥1, and CPS of ≥10, respectively. The univariate analysis revealed that programmed death-ligand 1 ≥5% (HR: 0.12; 95% CI: 0.01-0.97; p = 0.047) was significant associated with superior OS. One stage IV patient with CPS ≥10 and dMMR proteins received nivolumab monotherapy as frontline treatment that resulted 14-month PFS.

Conclusion:
Patients with GASC are more likely to yield positive results for CPS and dMMR. Biomarkers should be examined, and immunotherapy can be considered as frontline systemic treatment.
A 5-year-old Syrian female was born with Oguchi disease: a rare case report
Authors: Habeeb Rasha , Baba Marwa , Bazkke Bashar , Zazo Aya , Marashi Ameen 
Published: March 2023

Introduction:
Oguchi disease is a rare autosomal recessive disease that causes congenital stationary blindness, which is distinguished by the Mizuo–Nakamura phenomenon and caused by mutations of rhodopsin kinase gene or the arrestin gene.

Case presentation:
A 5-year-old Syrian female complains of stationary night blindness, investigated by fundus photo and optical coherence photograph and diagnosed as Oguchi disease.

Discussion:
Oguchi disease is an autosomal recessive retinal disorder causing stationary nyctalopia. It is characterized by Mizuo–Nakamura phenomenon, which is the alteration of fundus reflex color from golden-yellow to normal with dark adaptation. Literature reports suggest that mutations in rhodopsin kinase or arrestin genes may cause Oguchi’s disease.

Conclusions:
Optical coherence tomography is of great importance in Oguchi’s disease. Optical coherence tomography usually shows an absence of the inner and outer segments line in the extrafoveal area during a partly dark-adaptation phase.
The relationship between knowledge, attitude, and practice of plasma donation with age and gender as moderators: a cross-sectional survey
Authors: Tousif Kashif , Saeed Sajeel , Hamid Sidra , Haider Tehseen , Basit Jawad , Rauf Khalid Abdul , Ali Muaz , Dhillon Rubaid Azhar , Ur Rehman Mohammad Ebad , Farhan Muhammad 
Published: March 2023

Introduction:
Convalescent plasma therapy has gained worldwide notoriety since its inception as a form of soul treatment for terminally ill patients. This study investigates the link between knowledge, attitude, and practice of plasma donation while simultaneously probing the moderative role of age and gender in this context.

Method:
A cross-sectional study was undertaken in Rawalpindi, Pakistan, on COVID-19-recovered patients (coronavirus disease 2019). In all, 383 persons were chosen using simple random sampling. A prestructured questionnaire was first validated and then used as a tool for data collection. jMetrik version 4.1.1 and SPSS version 26 were used to enter and analyze the data. Reliability analysis, hierarchal regression, and logistic regression analysis were applied.

Results:
A total of 85.1% and 58.2% of 383 individuals had a favorable attitude and sufficient knowledge toward plasma donation, respectively. Plasma donation was observed in 109 (28.5%) of the individuals. Plasma donation practice was shown to be strongly related to plasma donation attitude [adjusted odds ratio (AOR)=4.48; P<0.05] and knowledge (AOR=3.78; P<0.001). Females who had more plasma donation knowledge and attitude tend to donate more compared to males. However, no interactional effect of gender×knowledge and attitude, and age×knowledge and attitude was found with plasma donation practice.

Conclusion:
Plasma donation was uncommon, even though the majority of individuals had a good mindset and were well-informed. Fear of getting a health problem was linked to the decreased practice.
Superior mesenteric artery syndrome mimicking gastric outlet obstruction: a case report and a literature review
Authors: Khanal Bhawani , Panthi Sagar , Bhattarai Raksha , Khatiwada Pradeep , Acharya Rochana , Neupane Durga , Yadav Padmini , Sharma Ananta , Pokharel Lenish , Basnet Ujwal 
Published: March 2023

Introduction:
Superior mesenteric artery (SMA) syndrome, an uncommon cause of intestinal obstruction, may present with clinical features mimicking gastric outlet obstruction.

Case presentation:
The authors present a case of a 65-year-old gentleman who presented to our institute with complaints of sudden onset abdominal distension and multiple episodes of bilious vomiting for 4 days. On examination, he was cachexic and dehydrated and was diagnosed later with SMA syndrome based on contrast-enhanced computed tomography abdomen findings.

Discussion:
After the diagnosis of SMA syndrome was made, the patient was planned for the operation. On exploration, a hugely distended stomach dilated first and the second part of the duodenum with SMA compressing the third part of the duodenum was found for which duodenojejunostomy was done.

Conclusion:
The high degree of suspicion is necessary for cachectic patients presenting with features of gastric outlet obstruction to diagnose SMA syndrome. Physical examination supported by radiological investigations can diagnose SMA syndrome to some extent. Treatment should be focused on relieving obstruction along with fluid and electrolyte resuscitation and nutritional supplementation. Some cases may require surgical correction.
Nerve sheath myxoma masqueraded as intramuscular myxoma: an extremely rare tumor with unusual location – a case report and literature review
Authors: Tos Salem M. , Radaydeh Afnan , Giacaman Narmeen , Ibdah Mohammad G. , Ass’ad Omar M. , Ibaidi Nouraldin M.M. , Abuaita Mahmoud A.A. , Abu Rub Saifeddin 
Published: March 2023

Background:
Nerve sheath myxoma (NSM) is a very rare benign nerve sheath tumor that mostly affects young adults, with a peak incidence in the 30s. Patients usually present with an asymptomatic swelling commonly affecting the dermis and subcutaneous tissues of the head, neck, and upper extremities. Lower extremities are a much rarer location, and when this occurs, the knee/pretibial region is the most common location. NSM has not been reported within the anterior tibialis muscle.

Case Presentation:
The authors present the first reported case of NSM in the anterior tibialis muscle in a 39-year-old man presented as deep swelling in the left leg.

Discussion:
NSM is difficult to diagnose clinically or using standard imaging techniques; MRI and ultrasonography cannot differentiate it from other anomalies. Histopathology alone is not enough to distinguish NSM from neurothekeomas, which were considered synonymous in the past. They can be distinguished by using immunohistochemical markers.

Conclusion:
Soft tissue tumors in lower extremity muscles are somewhat difficult to diagnose. Excision of the tumor by a specialized orthopedic surgeon and histopathological/immunohistochemical analysis were the only avenues to correctly diagnose the NSM.
Golimumab therapy-induced isolated myelitis in a Behcet’s disease patient: a case report
Authors: Kudsi Maysoun , Shahada Zienab , Haidar Ghina , Safiah Mhd Homam , Khalayli Naram 
Published: March 2023

Introduction:
Although central nervous system demyelinating lesions as a side effect of tumor necrosis factor (TNF)-alpha inhibitors have been reported, this treatment is still used in some autoimmune diseases.

Case Presentation:
A 34-year-old Syrian male presented with difficulty walking and tingling, and numbness on the left side of his body over the next 4 days, during golimumab treatment. Over the past 2 months, fatigue, recurrent calf spasms, and extremity numbness were found. Sense disturbance and hyper-reflexes of the lower extremities were found on neurological examination. MRI demonstrated variant demyelinating lesions. Steroid therapy was initiated, and golimumab was discontinued, with good outcomes as the symptoms have disappeared.

Discussion:
The incidence of demyelination following anti-TNF therapy is uncommon. Most studies have reported that the average time between the anti-TNFα inhibitor treatment and the demyelinating lesion presence is from 5 months to 4 years, and these lesions may appear even after the cessation of the anti-TNFα inhibitor; meanwhile, a total cure of the symptoms after treatment cessation happened in our case, which suggests a causal relation, although a temporal relationship, in this case, cannot be established. The authors believe that golimumab plays a role in the demyelinating lesions development, although it may be a clinical manifestation during the course of Behcet’s disease.

Conclusion:
Caution should be taken for the side effects of Golimumab treatment, such as demyelinating lesions, and long-term monitoring of patients with Bechet disease is required.
Massive bone defects due to infection at the surgical site associated with a distal humeral fracture that was treated using fibula autograft: a case report
Authors: Fouladpour Amin , Asadi Kamran , Aris Arash , Mollaei Amirabbas , Vajargah Pooyan Ghorbani , Karkhah Samad , Salari Amir 
Published: March 2023

Introduction and importance:
Distal humerus fractures comprise between 2 and 5% of all fractures, and approximately one-third of all humerus fractures are of this type. In the present report, the authors described the massive bone defects due to infection at the surgical site associated with a distal humeral fracture that was treated using fibula autograft.

Case presentation:
A 28-year-old female patient experienced a fall from a height of 4 m and was referred to Poursina Educational and Medical Center. Clinical examinations and radiological imaging showed an open fracture of the right distal humerus. In the postoperative 50-day follow-up, the complication of infection at the surgical site causes bone loss of up to 8 cm. The posterior triceps-split approach (Campbell) to the distal humerus was used in this surgery. To evaluate the quality of surgery, standard radiographs of anteroposterior and lateral of the elbow joint and humeral shaft were performed after surgery.

Clinical discussion:
At 5 months postoperatively, the patient’s initial results are good, and the range of motion of the elbow joint is ~10–120°.

Conclusion:
Based on the results of the present study, fibular transplantation in distal humerus fractures is considered one of the bone treatment options for repair.
Association of subclinical hypothyroidism with metabolic syndrome components in a group of apparently healthy Syrians: a retrospective cross-sectional study
Authors: Alourfi Zaynab , Hijazi Nermeen , Alsultan Mohammad 
Published: March 2023

Background:
Thyroid disorders were reported to be associated with various diseases, particularly dyslipidemia. This study aimed to assess the prevalence of thyroid disorders in a group of apparently healthy Syrians and investigate the relationship between subclinical hypothyroidism and metabolic syndrome (MetS).

Methods:
A retrospective, cross-sectional study was performed at Al-Assad University Hospital. Participants were healthy individuals aged 18 years and older. Data about their biochemical tests, weight, height, BMI, and blood pressure were collected and analyzed. Participants were categorized according to their thyroid tests into euthyroid, subclinical hypothyroid, subclinical hyperthyroid, and according to their BMI into normal, overweight, and obese, and according to the International Diabetes Foundation into normal and having MetS.

Results:
A total of 1111 participants were involved in this study. Subclinical hypothyroidism and subclinical hyperthyroidism were found in 4.4 and 1.2% of participants, respectively. The incidence of subclinical hypothyroidism was significantly increased in females and in the presence of positive antithyroid peroxidase. Subclinical hypothyroidism was significantly associated with MetS, a higher waist circumference, central obesity, and triglycerides; however, there was no correlation with high-density lipoprotein.

Conclusion:
The prevalence of thyroid disorders among Syrians was consistent with the results of other studies. These disorders were significantly more common in females compared to males. Add to that, subclinical hypothyroidism was significantly associated with MetS. Since MetS is a known factor for morbidity and mortality, this may raise the attention needed to perform future prospective trials to evaluate the possible benefits of subclinical hypothyroidism treatment with a low dose of thyroxin.
Exertional rhabdomyolysis with acute kidney injury resulting from lower extremity training: a case report
Authors: Hashi Mohamed Abdulrashid , Abdikadir Osman Abdirahman , Abdullahi Adani Abdulkamil , Muse Osman Marian 
Published: March 2023

Introduction:
Acute kidney injury (AKI) is a severe complication of rhabdomyolysis, a clinical syndrome characterized by the damage of skeletal muscle and the subsequent release of its breakdown products into the bloodstream.

Case Presentation:
A 32-year-old previously healthy male who had generalized body pain, dark-colored urine, nausea, and vomiting for 2 days, presented to the hospital after he performed a vigorous gym workout. Blood results revealed creatine kinase of 39 483 U/l (normal range: 1–171 U/l), myoglobin 224.9 ng/ml (normal range: 0–80 ng/ml), serum creatinine 4.34 mg/dl (normal range: 0.6–1.35 mg/dl), and serum urea 62 mg/dl (normal range: 10–45 mg/dl). Based on clinical and laboratory findings, he was diagnosed with exercise-induced rhabdomyolysis with AKI; he was successfully treated with isotonic fluid therapy and titrated accordingly without requiring renal replacement therapy. After 2 weeks of follow-up, a full recovery was seen.

Clinical Discussion:
Between 10 and 30% of people with exercise-induced rhabdomyolysis are thought to develop AKI. Exercise-induced rhabdomyolysis is typically characterized by symptoms such as muscle discomfort, weakness, fatigue, and black urine. An initial diagnosis is often made when creatine kinase levels are more than five times the upper limit, and there has been a recent history of intense physical activity.

Conclusion:
This case highlighted the potentially life-threatening risks associated with unexpected physical activity and underlined the critical preventative steps to lower the likelihood of experiencing exercise-induced rhabdomyolysis.
Laubry–Pezzi syndrome: three case reports and review of the literature
Authors: Charfo Mahamadou B. , Ettagmouti Yacine , Mahoungou Mackonia Noel M. , Arouss Salim , Drighil Abdel N. 
Published: March 2023

Introduction and importance:
Laubry–Pezzi syndrome is a rare congenital heart disease characterized by the association of ventricular defect septal to aortic cusp prolapse responsible for aortic regurgitation (AR).

Case presentation:
We reported three cases of Laubry–Pezzi syndrome diagnosed in our department of cardiology on a cohort of more than 3000 cases of congenital heart disease. A 13-year-old patient presented a Laubry–Pezzi syndrome with severe AR and significant volumetric left ventricle overload and was operated on in time to allow a good evolution of his condition. A 43-year-old patient, followed for congenital cardiac pathology, presented with severe dyspnea. The echocardiogram found global dysfunction of the left ventricle with an ejection fraction of 35%, a perimembranous ventricular septal defect (VSD) almost completely closed by the prolapse of the noncoronary cusp, and severe eccentric aortic insufficiency due to the prolapse of the noncoronary cusp. Aortic valve replacement and VSD closure were indicated. The third patient is a 21-year-old patient with Down syndrome, in whom a grade 2/6 systolic murmur was detected. Transthoracic echocardiography revealed a perimembranous VSD measuring 4 mm without any hemodynamic repercussions and a moderate aortic insufficiency due to the prolapse of the noncoronary cusp. Clinical and echocardiographic monitoring with Osler prevention was indicated as a modality of management.

Clinical discussion:
The pathophysiology is explained by the Venturi effect, the restrictive shunt of the VSD creates an area of low pressure that sucks the adjacent cusp resulting in aortic prolapse and regurgitation. The diagnosis is essentially based on transthoracic echocardiography; it must be conducted before the emergence of AR. The management of this rare syndrome still remains nonconsensual, whether it is through timing or operative techniques.

Conclusion:
Management must be early by closing the VSD with or without aortic valve intervention to prevent the onset or worsening of AR.
APACHE scoring as an indicator of mortality rate in ICU patients: a cohort study
Authors: Mumtaz Hassan , Ejaz Muhammad K. , Tayyab Muhammad , Vohra Laiba I. , Sapkota Shova , Hasan Mohammad , Saqib Muhammad 
Published: March 2023

Introduction:
Predictive scoring systems are tools that assess the magnitude of a patient’s illness and forecast disease prognosis, usually in the form of mortality, in the ICU. We aimed to determine the mortality rate among patients admitted to ICU using the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system correlating with lengths of stay in the ICU.

Methodology:
A cohort study using team approach to care was conducted from July 2021 through July 2022 at KRL Hospital. Five hundred fifty-two patients aged 18–40 years, admitted for medical or surgical reasons (other than cardiac) who stayed in the ICU for more than 24 h were included. The APACHE II score was determined using 12 physiological variables at the end of the first 24 h of ICU admission. Data were analyzed using IBM Corp. released in 2015 (IBM SPSS Statistics for Windows, Version 23.0, Armonk, New York).

Results:
The average age of study participants was 36.34±2.77, ranging from 18 to 40 years. Three hundred fifteen participants were males and 237 were females. Patients were categorized into four separate groups as per their respective APACHE II scores. Patients with an APACHE II score of 31–40 were assigned to group 1. Patients with an APACHE II score of 21–30 were assigned to group 2. Patients with an APACHE II score of 11–20 were assigned to group 3. Lastly, patients with an APACHE II score of 3–10 were assigned to group 4. All patients in group 1 and group 2 died and none survived. Groups 1 and 2 contained a sum of 228 patients. A total of 123 patients were assigned to group 3, out of which 88 patients (71.54%) survived and 35 patients (28.45%) died. From these observations, it is evident that a higher APACHE II score is correlated with increased mortality.

Conclusion:
APACHE II scoring serves as an early warning indication of death and prompts clinicians to upgrade their treatment protocol. This makes it a useful tool for the clinical prediction of ICU mortality.