Spontaneous resolution of three hepatic artery aneurysms due to segmental arterial mediolysis in a patient with Sjögren’s syndrome

Adipose Tissue Allograft for the Management of a Pre-Ulcerative Plantar Lesion in a Diabetic Neuropathic PatientMatthew J. Regulski1, DPM, Molly C. Saunders2, Sharron E. McCulloch21Ocean County Foot & Ankle Surgical Associates, P.C., Forked River, New Jersey; Medical Director, Wound Institute of Ocean County, Toms River, New Jersey2Britecyte, Inc., Frederick, Maryland

1. Introduction:Postpartum autoimmune thyroiditis typically presents within one year following delivery and exhibits a prevalence of 8% in the general population. However, this incidence significantly escalates to 20% among individuals with a history of type 1 diabetes or a familial predisposition to thyroid disorders.(1) Lymphocytic hypophysitis (LH) is a rare condition characterized by inflammation of the pituitary gland that usually affects women during the last trimester of pregnancy or the first six months after delivery. (2) Two autoimmune conditions prominently manifest in connection with pregnancy: postpartum autoimmune thyroiditis and autoimmune hypophysitis. We present an extremely rare incidence of thyroid storm due to postpartum thyroiditis followed by the surprising diagnosis of lymphocytic hypophysitis, leading to panhypopituitarism.

Title Page:The Phenotypic Spectrum of the Cornelia de Lange-like “Alazami-Yuan Syndrome” : A Case Report of the 7th Diagnosed Individual and Review of the Literature

Title: A 24-year-old patient with testicular benign capillary hemangioma :A rare Case Report.Hasan Haydar a,+ ,Mouhammed Sleiaya, Sliman Marina b , Abdulrahman Haydar c, Mohammed Alqreea d , Bauthaina Alomar a, Mohamad Yasin Lutfie, Simon Youssef fa Faculty of Medicine, Hama University, Hama, Syrian Arab Republic.b Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.c Faculty of Dentistry, Arab private university for science and technology, Hama, Syrian Arab Republic.d Orthopedic surgery Department ; Faculty of medicine ; Damascus University  ;Damascus Syrian Arab Republic.e Hama National Hospital,Urology Department, Hama, Syrian Arab Republic.f Hama National Hospital,pathology Department,  Hama, Syrian Arab Republic.*Corresponding author: Hasan Haydar, Faculty of Medicine, Hama University, Hama, Syrian Arab Republic. email: [email protected]+ Hasan Haydar ,Mouhammed Sleiay, Sliman Marina , Abdulrahman Haydar, Mohammed Alqreea, Bauthaina Alomar, , Mohamad Yasin Lutfi, Simon Youssef are co-first authors. All contributed equally in this paper \RLEmails & ORCID:Hasan Haydar: [email protected]: 0000-0002-7335-2096Mouhammed Sleiay:[email protected]: [email protected] Haydar : [email protected] Alqreea : [email protected] Alomar :[email protected] Yasin Lutfi: [email protected] Youssef:   [email protected]

Sarcoidosis in a Young Adult: A Rare Sequelae of COVID-19 Infection

Title : Shiitake mushroom-induced Flagellate Dermatoses A Rare Presentation In a Tertiary Hospital in Nepal: A Case ReportCorresponding author : Ashish TamangIntroductionShiitake mushroom-induced flagellate dermatoses, also known as flagellate erythema, is an intriguing rash associated with the consumption of raw or undercooked shiitake mushrooms (Lentinula edodes).1 While these mushrooms are widely appreciated for their culinary and potential health benefits, they can occasionally trigger an immune-mediated skin reaction in susceptible individuals. The characteristic rash manifests as intensely pruritic linear streaks, resembling whiplash marks, and typically appears within 24 hours to 5 days after mushroom ingestion.2The pathogenesis of shiitake flagellate dermatoses centers around a thermolabile polysaccharide called lentinan, which is present in shiitake mushrooms. Lentinan activates interleukin-1 secretion, leading to vasodilation, hemorrhage, and the distinctive rash.3 Notably, this flagellate dermatosis is not observed when mushrooms are thoroughly cooked at temperatures exceeding 145°C.4 As mushroom consumption continues to rise globally, recognizing this etiology becomes crucial, preventing diagnostic challenges and the recurrence of this characteristic rash.

Dulaglutide induced weight loss in a morbidly obese adult with Type 2 diabetes mellitus:  A Case ReportSohail Bade1, Sahil Bade1, Grishma Sharma1, Narayan Bhurtel2, Yadvinder Singh3 Sudip Paudel4, Frena Pulami Magar5, Kshitij Chapagain11 MBBS doctor, Dhulikhel Hospital, Dhulikhel, Nepal2 MBBS doctor, Kathmandu Metro Hospital, Nepal3 MBBS doctor, Swacon International Hospital, Nepal4 MBSS doctor, Tribhuvan University Teaching Hospital, Nepal5 MBBS doctor, Singapore Gurkha Polyclinic Ltd, NepalCorresponding AuthorDr. Sohail Bade, Dhulikhel Hospital, [email protected]

A document by Nils Freitag. Click on the document to view its contents.

Title: Genital rash: A manifestation of metastatic Crohn’s diseaseRunning title: Metastatic Crohn’s DiseaseChetwood JD, Arzivian A, Shin JS, Tamilarasan GT

INTRODUCTIONHereditary thrombotic thrombocytopenic purpura (TTP) is a rare autosomal recessive inherited disease involving the ADMATS13 gene. Common causes of TTP include infection, inflammation or pregnancy. However, hereditary TTP occurs mostly in children and pregnant women, accounting for only 5% of all total cases of TTP.1Homozygous or double heterozygous mutations of theADAMTS13 gene, result in plasma ADAMTS13 activity absence or severe deficiency. ADAMTS13 is located on chromatin 9q34, contains 29 exons, and encodes a 1427 amino acid multidomain protein.2 The most common types of types of mutations are nonsense , followed by missense, frameshift insertions, or deletions, which can be distributed throughout the gene.3Reduced or absent ADAMTS13 activity in the plasma results in the failure of timely degradation of abnormally released von Willebrand factor (VWF) multimers, which can spontaneously bind to platelets, leading to microvascular thrombosis and subsequent organ dysfunction.4,5 Most Hereditary TTP cases are diagnosed during childhood or early adolescence after the first acute episode. Here, we present a case of hereditary TTP in a 30 year old female, which resulted from a compound heterozygous mutation of ADAMTS13 c.1045C > T (p.Arg349Cys) and c.2411G > A(p.Cys 804Tyr).

This is the case of a 4-year-old girl, who was admitted to our pediatric orthopedic department to investigate a lameness associated with fever that had been evolving for 5 days. Mobilization of the right hip was painful. The laboratory tests were normal, as well as the X-ray of the pelvis. Ultrasound revealed a slight effusion in the right hip. MRI showed two anomalies located at the anterior and posterior walls of the right acetabulum, which appeared as hypo-intense on T1 and enhanced after contrast injection (fig1). An infectious or tumoral origin was suspected, and a CT-guided biopsy was planned. However, the day before the biopsy, it was discovered that the girl had developed right exophthalmos and periorbital ecchymosis (fig2). A cerebral CT scan was performed, revealing a lytic lesion of the greater wing of the right sphenoid bone with periosteal reaction invading the right external oculomotor muscle (fig3). A metastatic origin was suspected for both the orbital and acetabular lesions. A thoracoabdominal CT scan was performed in order to identify the primary tumor. A left retroperitoneal mass was found opposite L3 and L4, extending over 4 cm (fig3). A CT-guided biopsy confirmed the diagnosis of neuroblastoma. The patient was transferred to a specialized pediatric oncology center for further therapeutic management. The important clinical teaching of our case is to remember that exophthalmos with periorbital ecchymosis, excluding a traumatic context, in a child under 5 years old, should lead to suspicion of metastatic neuroblastoma, known as Hutchinson’s syndrome [1].References: 1. Dari D, Merad S, Medjahedi A. Syndrome d’Hutchinson : impact diagnostique de la scintigraphie à la 131I-MIBG et de l’imagerie hybride TEMP/TDM dans la prise en charge du neuroblastome. Médecine Nucléaire 2021; 45(4):218–9.

A case report on retrograde approach for recanalization of stumpless chronic total occlusion (CTO)Dayu Wang, MM1; Ruibin Wei, MM1; Junteng Zheng, MM1; Zhen Liu, MM 1; Jian Hou, PhD1#;Jianhao Li, MM1#;1 Department of Cardiology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China#Correspondence to:Jian Hou, Department of Cardiology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China 511400, GD, China; E-mail: [email protected] Li, Department of Cardiology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China 511400, GD, China; E-mail: [email protected]

A document by Yasmine Elsherif. Click on the document to view its contents.

When approaching the common femoral artery (CFA), although arterial puncture is successful, inserting the sheath along the guidewire can sometimes prove challenging. This is particularly true in cases of severe CFA calcification, a history of multiple punctures due to chronic limb-threatening ischemia, or after CFA endarterectomy. Typically, attempts are made to

Bronchial foreign body presenting as pneumothorax and pneumomediastinum in a young child.Rajendra Shilpakar1, Nipun Shrestha1, Dhruba Shrestha1*1 Siddhi Memorial Hospital (For Women and Children), Bhaktapur, Nepal.Keywords: Foreign body aspiration, Pneumomediastinum, Pneumothorax, Subcutaneous emphysema

“UNUSUAL COEXISTENCE: A CASE OF MIXED SMALL AND LARGE CELL NEUROENDOCRINE TUMOR IN A BLADDER PREVIOUSLY AFFECTED BY BILHARZIAL CYSTITIS”1Mohammed Saleh E. Khalifa SALEM,1Abdulhamid ALHEREK, 1Martin VAN ROOYEN, 1Alain Mwamba MUKENDI1University of the Witwatersrand, Division of Urology, Department of Surgery, Klerksdorp Hospital, Klerksdorp, Northwest, South Africa.*Corresponding AuthorAlain Mwamba MukendiCel: 0027711576350E-mail: [email protected]

Cutaneous leishmaniasis mimicking psoriasis: a case report