Empyema necessitans as a rare manifestation ofStaphylococcus aureusNazanin Zeinali Nezhad1,Aazam Gholami Shahrebabak2*, Amirhossein Shahpar31 Faculty of Medicine, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Kerman, Iran Postal Code: 76169135552 Department of Medical Education, Medical Education Research Center, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Kerman, Iran Postal Code: 76169135553 Faculty of Medicine, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Kerman, Iran Postal Code: 7616913555*Corresponding author : Aazam Gholami Shahrebabak, Assistant Professor of Pediatrics, Department of Medical Education, Medical Education Research Center, Kerman University of Medical Sciences, Haft Bagh Alavi Blvd, Kerman, IranEmail: [email protected]

Introduction Survival is dismal for the 40-60% of children with MDS who relapse post allogeneic HCT1,2,3. Strategies to decrease relapse risk include use of cytoreduction prior to HCT or maintenance treatment after HCT, data on the utility of these approaches remains limited4-12. Rapid withdrawal of immune suppression or use of donor lymphocyte infusion (DLI) can enhance the graft versus leukemia effect and achieve disease control in some cases13,14. Addition of hypomethylating agents to DLI may provide additional benefit15 and second HCT should be considered16-21. While several novel therapies may alter the future landscape of MDS therapy22-28 (Table 1), the optimal approach to relapsed pediatric MDS remains unclear. We report the management of a child who relapsed less than 70 days after initial HCT. Our approach demonstrates that multimodal therapy may permit prolonged survival with excellent quality of life (QOL) despite lack of long-term cure.

Optic neuritis after mRNA COVID-19 vaccination; A case reportRaghad Tarcha, Afraa Ghazal, Lama Al-Darwish, Hoda Abdoh, Maysoun Kudsi.

Hashimoto Thyroiditis in a lingual thyroid: an interesting case

INTRODUCTIONMycosis fungoides: Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma. It represents the most common type of extranodal non-Hodgkin lymphomas 12. Follicular or folliculotropic MF (F-MF, also known as follicular T-cell lymphoma, follicular MF, MF-associated mucinosis, or pleiotropic MF) is an under-recognized subtype of MF. It is characterized histologically by folliculotropism (histologically analogous to epidermotropism) with malignant T cells, with or without associated follicular mucinosis3. In 2005, The WHO/EORTC considered F-MF as a variant of MF in their classification4-7.Mycosis fungoides in the Kingdom of Saudi Arabia: In the Kingdom of Saudi Arabia, few studies are available about MF and F-MF1,8-12. AlGhamdi et al examined the clinicopathologic features of MF in 43 cases of immunohistologically confirmed MF. The average age was 33.5 years was reviewed. The male-to-female ratio was 2:1. Most of the cases presented in an early-stage (I and II) MF. Most of the patients had classic MF and other subtypes included hypopigmented MF and other variants. The patients were followed up for a duration of 27.6 months. The follow-up data indicated that few patients recovered (9.5%) patients recovered; whereas the majority (83.3%) had persistent MF skin lesions. A single patient had the extracutaneous disease; whereas only two patients died of MF 8.Al-Dawsari et al examined the surgical pathology records of Saudi patients from 1995 to 2014 at the Johns Hopkins Aramco Healthcare Center (Eastern Province of KSA). This medical facility is the healthcare provider for the employees working at Saudi Aramco company and their dependents in the Eastern Province of Saudi Arabia. The total number of primary skin tumors was 204 and out of them 22 cases were MF10. Albasri et al examined the pattern of skin cancer in the Madinah region of KSA. Among the 202 cancer cases examined in their series, there were 14 (6.8%) cases of MF. The mean age of the patients was 30.7 years with a male-to-female ratio of 11:3. The distribution of the MF skin lesions included: 4 cases (head and neck), 3 cases (upper limb), and 7 cases (lower limb) 11.Alsaif et al described the Leser-Trelat sign (sudden appearance of seborrheic keratosis) in a 60-year-old Saudi male patient with MF. The lesions appeared on the face and back 12. Alojail et reported the clinical features and treatment regimens in 34 cases of MF in KSA. The cases included both hyperpigmented (11 cases) and hypopigmented (21 cases) MF, poikilodermatous MF, and pagetoid reticulosis (a single, each). The treatment regimens included phototherapy Narrowband UVB (NB-UVB) in combination with topical corticosteroids, phototherapy NB-UVB in combination with the topical corticosteroid, and phototherapy NB-UVB with topical corticosteroid and systemic acitretin 1.Alghubaywi et al examined all MF cases diagnosed at King Abdulaziz Medical City in KSA (January 2016 to July 2022). A total of 73 patients were included in their study. The incidence of MF was slightly higher in females (male to female ratio: 1: 1.3). The average age was 44 years. The most common MF subtypes included classic MF, followed by hypopigmented MF. Most of the cases were presented at an early-stage MF (IA, IB, and IIA). The treatment option was mainly in the form of topical steroids. Immunohistological staining of CD4+/CD8+ with CD8 predominance was common and this may reason for the favorable disease outcome 13. These authors also indicated that MF was under-recognized with 20% of the patients with MF initially misdiagnosed as atopic dermatitis. The correct diagnosis of MF was rendered within a mean of 33 months from the time of presentation to the Dermatology clinics. The authors reasoned the delay in the diagnosis of MF the fact that chronic dermatitis and MF share several clinical manifestations such as the presence of pruritic, erythematous, scaly plaques 13. A summary of the previous studies is shown in Table 1.Follicular mucinosis: Follicular mucinosis, i.e. accumulation of mucin in the epithelium of the hair follicles can be either a primary idiopathic disorder or an associated event with several inflammatory conditions (such as chronic spongiotic dermatitis), benign or malignant neoplasms14-16. In 1957, Pinkus first described mucin deposits in the follicular epithelium (alopecia mucinosa) that are associated with folliculotropism, i.e., infiltration of the epithelial cells of the outer hair sheath by atypical lymphocytes17. In 1959, the term follicular mucinosis was introduced by Jablonska 18. There are two clinical types of follicular mucinosis: idiopathic follicular mucinosis and lymphoma-related follicular mucinosis, i.e., F-MF. The latter can be separated from the classical MF on a clinical and histological basis2,19,20. Currently, there is no specific therapy for idiopathic follicular mucinosis and the skin lesions can resolve spontaneously within a period of 2 to 24. Some therapeutic options include steroids (topical, intralesional, and systemic steroids), photodynamic therapy, antimalarials, interferon, and dapson21,22.Folliculotropic mycosis fungoides: F-MF represents the most common non-classic variant of MF, representing approximately 10% of the cases of MF 23. It usually shows a male predominance and most of the cases occur in adults 24. Its clinical findings include follicle-based infiltrated erythematous grouped papules resembling acne or keratosis pilaris, patches, plaques, and tumor-like lesions with follicular accentuation 2,20,25. Other clinical presentations include prurigo-like lesions, pseudotumors, lichen spinulosus-like lesions, rosacea-like lesions, and lupus tumidus-like plaques 26. Pruritis is a common complaint and it is aggravated by superinfection by staphylococcus auras resulting in pyoderma 25. The lesions of F-MF vary from solitary lesions to extensive lesions giving the appearance of a leonine face 23. The head and neck region is the most commonly affected site. Other sites include the trunk, and the extremities 17. The features of F-MF are seen in nearly 10% of the patients with MF 2,20,25. The salient histological features of F-MF include perivascular and peri‑adnexal dermal lymphocytic infiltrates with variable infiltration and destruction of the follicular epithelium by small, medium‑sized, or large-sized lymphocytes with hyperconvoluted nuclei (cerebriformnuclei). The epidermis is usually spared. Other histological findings include follicular mucinosis, Pautrier’s Micro-abscess, follicular plugging, tagging of the atypical lymphocytes along the follicular epithelium, peri-eccrine infiltrate of atypical lymphocytes23,26. Immunohistochemistry usually reveals prominent CD3 positive infiltrate, witha predominance of CD4 positive lymphocytes over rare CD8 positive T-cells. CD7 expression is reduced or completely lost. Molecular analysis (T-cell receptor-γ gene rearrangement) reveals a monoclonal T-cell population23,26-28. The therapeutic options in F-MF include photochemotherapy combined with interferon alpha-2a and retinoids. Other options include local radiotherapy, topical imiquimod, and total body electron beam irradiation 23.Several F-MF case reports were presented in the literature. Monopoli et al described two adult patients with F-MF. The clinical manifestations included alopecia and follicular erythematous papules, and comedones and cysts, respectively. The histological findings included folliculotropic atypical T-cell infiltrate that extends to the epidermis. There was no associated mucinosis. Clonality analyses revealed the oligo/monoclonal nature of the T-cell lymphocytic infiltrate 27.Rajalakshmi et al examined four cases of F-MF affecting the skin of the face. The mean age of the patients was 17.5 years and there were no differences in gender distribution. The lesions were in the form of hypopigmented patches or erythematous plaques. Two patients had associated alopecia. The salient histological finding included folliculotropism, mucin deposition around the hair follicles, lymphocyte tagging with haloes, atypical lymphocytes with hyperconvoluted/cerebriform nuclei, and infiltration of the eccrine and sebaceous glands by atypical lymphocytes. Other histological features included the presence of epithelioid cells, parakeratosis, and a prominent infiltrate of eosinophils 29. Magro et al reported 6 cases of unilesional follicular MF. All the patients were males with a mean age of 28 years. The patients were presented with a solitary lesion on the face and scalp (five patients) and trunk (a single patient) that persisted for a few months. There were follicular prominence and alopecia. On histology, there was an atypical folliculotropic lymphocytic infiltrate associated with follicular mucinosis. Immunohistology revealed a high CD4: CD8 ratio and loss of CD7 expression. A single untreated case developed similar lesions over the skin of the thigh and buttock after 3-4 years 28. F-MF usually occurs in adults with an average age at the time of diagnosis of 60 years 30. F-MF is exceptionally rare in children and adolescents. Mantri et al reported a case of F-MF in a 16-year-old boy who presented with 6x7 cm plaque on the forehead for a 2-month duration. Immunohistological examination revealed dense atypical T-cell lymphocytes invading and destroying the hair follicles. Follicular mucinosis was also seen. Most of the neoplastic cells were CD4-positive T- T-lymphocytes with scarce CD8-positive T cells around the hair follicles. Treatment was in the form of a spot electron beam and the lesion completely resolved within 2 months 30. Interestingly, Emge et al reported a case of F-MF in a 6-year-old boy. The lymphoma was associated with idiopathic follicular mucinosis31.Taken collectively, these previous reports indicated that F-MF is a rare and aggressive form of MF that has a worse prognosis compared to conventional MF. It usually affects the head and neck region in adults. It has distinct histological features and may or may not be associated with follicular mucinosis. F-MF has several clinical presentations and many histological faces. Therefore, it is often misdiagnosed, or diagnosed with much delay at an advanced stage as compared to the conventional MF.Herein, we report a case of F-MF in a middle-aged male patient. To date and to be best of our knowledge, this is the first case of F-MF to be reported in the Southern region (Asir region) of the KSA. The clinicopathologic features were discussed.

TITLE PAGEArticle TypeClinical pictureTitlePenile Injury Caused by Neodymium MagnetsAuthorsYuki Akiyama1, Ryo Ichibayashi2Affiliations1. Department of Orthopaedic Surgery, Toho University Medical Center, Sakura Hospital, Chiba, Japan2. Division of Emergency Medicine Department of Internal Medicine, Toho University Medical Center, Sakura Hospital, Chiba, JapanCorresponding AuthorRyo Ichibayashi, MD, PhDORCID iD https://orcid.org/0000-0002-1273-4875Division of Emergency Medicine Department of Internal MedicineToho University Medical Center, Sakura Hospital564-1 ShimosizuSakura-shi, Chiba 285-8741, JapanPhone: +81-43-462-8811Fax: +81-43-462-8835e-mail: [email protected] titleDamage caused by neodymium magnetsKeywordsNeodymium magnet, Penile foreign body, Emergency, TreatmentConflict of interestThe authors have no conflict of interest to disclose.Financial supportThe author(s) received no financial support for this article’s research, authorship, and publication.Patient consentWritten informed consent was obtained from the patient to publish this report by the journal’s patient consent policy.Author contributionYA wrote and drafted the manuscript. RI helped draft the manuscript. All authors read and approved the final manuscript.Data availability statementThe data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical considerations.AcknowledgmentsNone.Key clinical messageMultiple neodymium magnets can pinch tissue and cause barotrauma. Be careful if the tissue of the penis or foreskin is pinched, as this may cause foreskin necrosis or damage to the urethra.Clinical picture11-year-old boy. He has no history of developmental disabilities or mental illness. The boy played with a neodymium magnet attached to his penis in the bathroom out of curiosity. However, the neodymium magnet remained attached to his penis and could not be removed, and he was transported to our hospital by ambulance with the chief complaint of penile pain. Emergency crews tried to remove it, but it was impossible because it was painful, and there were concerns that it might damage the foreskin. Two hours had passed since he was transferred to our hospital because he was refused admission by multiple medical institutions. At the time of his visit, his penis had two circular neodymium magnets, each approximately 1 cm in diameter, placed against the foreskin of his penis (Figure 1A). Although it was difficult to remove it by pulling it in the opposite direction, it was possible to remove it by shifting the ground surface. After the foreskin was released, there was a crushed wound, so ointment was applied（Figure 1B）. After confirming that there was no problem with the color tone of his glasses, he returned home. The next day, he returned to the outpatient clinic and confirmed that the color of his glans was standard and that he could urinate. Neodymium magnets were developed in Japan in 1982 and have become famous worldwide due to their effectiveness. It is said to be the strongest magnet currently in use. Neodymium magnets are used in various fields and children’s toys [1]. For this reason, accidents such as accidental ingestion by children and insertion into the urinary tract or anus due to sexual preference are problems in the medical field. Accidents caused by multiple neodymium magnets, especially when accidentally swallowed or inserted with a foreign object, are dangerous because they adhere to each other and pinch tissue, resulting in pressure necrosis [2]. This case also had a crush injury to the foreskin. A month later, the scar remained on my foreskin. Barotrauma caused by neodymium magnets often involves damage to thin tissues, including the intestinal tract and mucous membranes. The structures of the corpus cavernosum and the corpus cavernosum of the urethra, which form the penis, are spongy and soft tissues. This tissue becomes rigid as it fills with blood. For this reason, if not only the foreskin but also the corpus cavernosum of the penis is pinched, there is a possibility that blood flow to the corpus cavernosum and damage to the urethra may occur. After removing the neodymium magnet, it is necessary to observe the color of the glans and foreskin and the state of urination.References1. Taylor MA, Spanos SP, Fenton SJ, Russell KW. Ball Magnets Clicked Together on the Epiglottis. Cureus . 2020. 12(5): e8181. doi: 10.7759/cureus.81812. Yuksel C, Ankarali S, Aslan Yuksel N. The use of neodymium magnets in healthcare and their effects on health. North Clin Istanb . 2018; 5(3): 268-273. doi:10.14744/nci.2017.00483Figure 1A　Neodymium magnet that pinches the foreskin of the penisB　 Foreskin with a crush injury

Title : Synovial Sarcoma of the Maxilla: A Challenging Diagnostic Case Report and Literature ReviewAbstract : Synovial sarcoma, a malignant mesenchymal tumor, is primarily associated with the extremities. Nevertheless, its appearance within the head and neck region, particularly in the maxillary area, is remarkably rare. This rarity underscores the significance of each case in unraveling the complexities of its behavior and management strategies. The core focus of this research is a detailed case report involving a 6-year-old female patient who presented with a conspicuous swelling in the left posterior maxilla. Subsequent incisional biopsy led to microscopic identification of malignant spindle cell proliferation, marked by dysplastic changes and abundant mitoses. Immunohistochemical analysis demonstrated negative reactivity for neural and muscular markers, while positive expression of Vimentin, Bcl-2, and TLE1. These morphological and immunohistochemical findings coalesced to definitively diagnose synovial sarcoma, substantiated by a notable 40% Ki67 proliferative index. The chosen treatment strategy encompassed surgery and radiotherapy, which yielded successful outcomes, with no recurrence observed during the one-year follow-up period. Beyond the specific case, this article undertakes a review of existing literature, meticulously analyzing nine similar cases reported in scholarly sources.Keywords : Case report, Head and neck, Maxilla, Synovial sarcoma

Successful treatment of a high-risk diabetic foot ulcer by ozone therapy and collagen powder: a case report

IntroductionInternational continence society defined mixed urinary incontinence (MUI) as “complaint of involuntary loss of urine associated with urgency and also with effort or physical exertion or on sneezing or coughing”., which include both urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) complaints. Urinary incontinence affects social behaviors, financial burden such as using class of drugs, rehabilitation floor muscles, and psychological suffering such as dissatisfaction in sexual activity. Diagnosis of urinary incontinence is based on history, physical examinations and supplemental evaluations like dye test, cystoscopy, urodynamic study, urine analysis, urine culture, and imaging technics. (1)At the first, conservative treatments are performed for patient such as biofeedback, pelvic floor muscle exercise, electrical stimulation and drug treatment. In the second step of treatment, surgery is considered. The surgery is usually used to address the failure of normal anatomic support of the bladder neck and proximal urethra, and intrinsic sphincter deficiency, meanwhile its implementation should be approached with caution for carefully. In some cases, surgery intervention also failed and other novel interventions should be considered. (2)Platelet rich fibrin glue, stem cells, butolonium toxins and TVT separately applied for treatment of patients, but this is the first time that these mixed modalities were used for the treatment of mixed urinary incontinence which did not respond to pharmaceutical and surgical treatment.

INTRODUCTIONThe concept of cantilevered fixed partial denture (CFPD) was described as early as 1960.1 Subsequently, the innovations in dental materials and adhesive dentistry allowed for the description of full ceramic CFPDs as a sound solution for the replacement of missing anterior teeth in 1997.2 Since this initial description, this therapeutic solution has provided patients with a minimally invasive alternative to three-unit fixed partial dentures (FPD). The indication of CFPD is often disputed in comparison with an implant-based treatment, which in some cases, can present challenges, or even be contraindicated. In this regard, CFPDs benefits from more reproducible esthetics, quicker execution and lower costs.2The question remains, however, whether this method would also be suitable for the replacement of missing teeth in the posterior sector, the main problem being the significant increase in occlusal loads on the premolars and molars.3 Different teams have begun to develop posterior CFPDs and some already have the necessary follow-up to validate this practice.4-8 The material used in these early clinical trials has been zirconia doped with 3%mol yttrium oxide (3Y-TZP), which gives the best mechanical properties at the expense of low aesthetic translucency. Yazigii and Kern recommend a thickness of 0.7mm zirconia of the overlay part and a connector of at least 3mm in vertical section and 3mm in horizontal section to ensure the mechanical resistance of the CFPD’s pontic in the posterior sector.6 This case report describes the realization of a reinforced glass-ceramic CFPD replacing à first premolar, this material opens the possibility of single appointment chairside production, and has superior adhesive and esthetic characteristics compared to zirconia.9-11 Its lower mechanical resistance is however to be taken into consideration,12 but still might be suitable if some prerequisites are met.

Spontaneous Spinal Cord Herniation with Post-operative paraplegia- A case report with 10-year follow-upAbstract:Background: Spinal cord herniation is an uncommon diagnosis in the field of spine surgery. The usual presentation of spontaneous spinal cord herniation is in the form of progressive Brown-Sequard syndrome. We describe a case of a 37-year-old male with progressive back pain and sensory deficits due to spinal cord herniation and a post-operative complication associated with reduction of the hernia.Case description: A 37-year-old male presented with insidious onset upper back pain and altered sensations of pain and temperature over the right half of the body below the nipple 2 months before the examination. The patient did not have motor weakness of lower limbs, abnormal/ involuntary movements, or loss of control over the bowel and bladder. MRI of the thoracic spine showed an anterolateral defect(left) at the level of the T2-T3 vertebra. A posterior approach was chosen and the cord with roots was reduced into the dura. The defect was covered by a dural graft (Lyodura) and the wound was closed with a drain insitu. On the 3rd post-operative day, patient developed paraplegia. Patient was treated by exploration and decompression of the hematoma that compressed spinal cord. The deficits were completely recovered at one-month follow-up.Conclusion: Patients with spinal cord herniation and neurologic deficits when treated timely with reduction of the hernia, have good outcomes. The drain should be removed only when the treating team is satisfied regarding the lack of ongoing hemorrhage. The recovery was maintained till the last follow-up at 10 years.Key words: spontaneous spinal cord herniation, spinal cord defect, paraplegia, Brown-Sequard syndrome

INTRODUCTIONAn unpleasant experience for both the patient and the anesthetist, post-dural puncture headache (PDPH) is a complication of spinal anesthesia or lumbar puncture. It is believed to be caused by cerebral vasodilation, which is an indirect consequence of low cerebrospinal fluid (CSF) pressure, or meningeal traction linked to low CSF pressure.1 PDPH incidence varies, although it is generally thought to be 36% or more after lumbar puncture, 0%-10% after spinal anesthesia, and 81% after an unintentional dural puncture during epidural insertion.2, 3 Although PDPH typically resolves on its own, it can make it difficult for mothers to care for their infants and lengthen hospital stays. Serious side effects such as subdural hematoma, convulsions, sagittal sinus thrombosis, and cranial nerve palsies are more infrequently linked to PDPH.

Alemtuzumab‐induced petechiae and epistaxis in a patient with relapsing remitting multiple sclerosis; A case report Farhad Mahmoudi1*, Sayed Ali Emami1, Farid Masaeli1, Najmeh Rayatpisheh21 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran2School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranCorresponding author*Farhad MahmoudiSchool of Medicine,Isfahan University of Medical Sciences,Isfahan, IranEmail: [email protected]: This case report presents a 58-year-old woman with Multiple Sclerosis (MS) who developed petechiae and epistaxis, rare side effects following Alemtuzumab treatment. While these reactions are infrequent, heightened awareness among healthcare providers is essential as Alemtuzumab gains popularity in MS treatment. Recognizing and managing such hypersensitivity reactions promptly is crucial for improved patient care. 1.Introduction Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system. The course of the disease varies among individuals, leading to a wide range of symptoms and patterns of presentation. Additionally, there are other conditions, such as radiologically isolated syndrome, which can progress to MS(1). While there is no curative therapy for this condition, certain drugs can modify the course of the disease and improve the prognosis and quality of life for patients.Disease-modifying treatments (DMTs) are the preferred treatment option for patients with MS. Alemtuzumab is an intravenously administered DMT drug that has been available since 2014 for the treatment of patients with multiple sclerosis who have not responded adequately to two or more DMTs. It is a recombinant DNA-derived humanized monoclonal antibody that selectively binds to the CD52 antigen on B and T lymphocytes, depleting them from the bloodstream. This drug has been described as a safe and effective treatment with minimal side effects for patients with relapsing-remitting multiple sclerosis.(2)While there are few studies on the cutaneous adverse effects of Alemtuzumab, in this study, we report the first case of an MS patient treated with Alemtuzumab who developed drug-induced petechiae and epistaxis.2. Case presentationA 58-year-old Caucasian woman with relapsing-remitting multiple sclerosis, who had no previous medical conditions, presented to the emergency department due to muscle spasms and stiffness in her right foot. Neurological examination revealed weakness in her right lower limb with 3/5 muscle strength. She was diagnosed with MS at the age of 26 through an MRI and had previously been on weekly Interferon-beta (IFNb) treatment. During acute MS attacks, she received intravenous corticosteroids. Despite being on disease-modifying therapies (DMTs), she experienced more relapses in the last year, and her Expanded Disability Status Scale (EDSS) was 3. During the current hospitalization, the patient underwent brain and cervical spinal MRI, which revealed the appearance of new periventricular white active plaques in addition to previous black old lesions.Considering the progression of her disease condition, she was started on treatment with Alemtuzumab at a dose of 12mg/day IV. There were no drug reactions, and after completing the treatment, her muscle spasms and stiffness resolved, and the patient was discharged from the hospital.The day after, the patient came to the hospital to receive the second dose of the drug. While receiving the treatment, her condition remained stable, and she did not experience any notable symptoms. However, one day after finishing the first dose, the patient started to experience a gradual appearance of petechiae on her upper and lower limbs, chest, shoulders, and back. Moreover, a few minutes later, she developed epistaxis. Her blood pressure and heart rate were 127/73 and 87, respectively. The patient denied any previous history of eczema, skin issues, or respiratory allergies.Dermatology was consulted to investigate the possible causes of petechiae, and ENT was consulted to manage and evaluate the epistaxis. Despite applying pressure to the nostrils and placing ice on the forehead, the epistaxis did not cease. Consequently, the patient underwent posterior nasal packing, which successfully halted the bleeding.

Diagnosis of hypertrophic cardiomyopathy accompanied with secondary hypertension - case report

MEASLES - AN ENT DIAGNOSIS?

A premature newborn born to an adolescent girl with acute Ebola virus disease and malaria survives in a resource-limited setting in an Ebola Treatment Unit in DR Congo. “ A Case Report”.

A document by Eliz Achhami. Click on the document to view its contents.

A Rare Case: IgG4-Related Chronic Inflammatory Disease with Kidney InvolvementFatos METE¹, Tuba MENGENECI¹, Emre ALBAYRAK¹, Yavuz AYAR2, Melike NALBANT3, Ilknur MUTLUCAN4, Zeliha Fusun BABA51Bursa City Hospital, Department of Internal Medicine, Bursa, Turkey2Bursa City Hospital, Department of Internal Medicine, Division of Nephrology, Bursa, Turkey3Bursa City Hospital, Department of Medical Pathology, Bursa, Turkey4Bursa City Hospital, Department of Radiology, Bursa, Turkey5Acıbadem International Hospital, Department of Medical Pathology, Istanbul, Turkey