Breast carcinosarcoma, metaplastic neoplasm of the breast, a rare type of breast tumors that accounts about 0.08 to 0.2 % of all breast cancers. carcinosarcoma is a mixed type of neoplastic cells. carcino related to epithelial cells origin. Sarcoma is a mesenchymal cell malignant tumor. This is a sever bad prognosis cancer. A few cases was reported about breast carcinosarcoma, here in we have a case of 58 female patient that has a late stage of breast mass that was diagnosed as a breast carcinosarcoma. In this case report we will show the presentation of the patient, discuss the risk factors and put our treatment plan.
Trichobezoar is a rare condition caused by the accumulation of foreign material, specifically hair, into the gastrointestinal tract. Underlying psychiatric disorders are common among patients diagnosed with bezoars. This condition is most commonly associated with trichophagia, trichotillomania might also be present. Typically, this disorder is acquainted in adolescent females who complain of alopecia, along with an upper abdominal mass which might cause gastric outlet obstruction. However, many cases of Trichobezoars of different ages, including infants, have been reported. In this case report, a case of an 18-year-old female with gastric outlet obstruction is demonstrated.
In the last two decades, there has been a significant increase in interest in cardiovascular biomarkers for early diagnosis, primary disease control, and management. This has been fueled by the importation of advanced gene technology for the identification of novel biomarkers, as well as a better understanding of disease pathophysiology. This article provides a thorough examination of available biomarkers as well as their evaluation. A growing number of biomarkers are being used to assess the risk of cardiovascular disease (CVD) and to improve primary prevention. However, clinicians face a difficult task in evaluating and identifying appropriate biomarkers and when they should be used. Since the turn of the century, researchers have been examining the capabilities and limitations of novel biomarkers in the management of CVD. These studies show that much work remains to be done in order to identify novel biomarkers that are more precise and cost-effective for use in early heart disease prevention.
Introduction: Metastasis of melanomas to the cerebellopontine angle (CPA) are very rare. Dissemination via blood, cerebrospinal fluid and/or leptomeninges may be the principal pathway for metastatic spread of malignant melanomas to the CPA. Case presentation: A 68-years old man presented with two years history of hearing lost in the right ear with associated dizziness and headaches. A skin lesion was seen on the patient’s right forearm. MRI revealed a nodular abnormal signal intensity at the right CPA which was resected and pathology revealed metastatic melanoma. Conclusion: Aggressive treatment regime comprising of a combination of surgery, chemotherapy and radiotherapy is very efficacious in prolonging the survival of patients with metastatic melanomas to the brain especially the metastasis to the CPA.
The present study used a quasi-experimental research method with pretest-posttest research with a control group to show the effectiveness of Fernald’s multisensory method and educational games on writing disorder in elementary school students. The statistical population of this study consisted of all students with writing problems in Shabestar in the 98-99 academic year who were studying. 30 people were selected as the sample (the first 10 people in the experimental group of Fernald’s multisensory method, the second 10 people in the experimental group of educational games and the third 10 people in the control group) who were randomly selected from among students with writing difficulties in three (First experimental group, second experimental group and control group) were included. Data collection tools included Fernald’s multisensory method and educational games and the Colorado Learning Disabilities Questionnaire. Covariance analysis method was used to analyze the research hypotheses using SPSS.23 software. According to the results of analysis of covariance, Fernald’s multisensory educational method has the greatest effect on students’ writing disorder.
Trichobezoar is a rare condition caused by the accumulation of foreign material, specifically hair, into the gastrointestinal tract. Underlying psychiatric disorders are common among patients diagnosed with bezoars. This condition is most commonly associated with trichophagia, trichotillomania might also be present. Typically, this disorder is acquainted in adolescent females who complain of alopecia, along with an upper abdominal mass which might cause gastric outlet obstruction. However, many cases of Trichobezoars of different ages, including infants, have been reported. In this case report, a case of an 18-year-old female with gastric outlet obstruction is demonstrated.
In periodontology, clinical criteria are usually not sufficient to distinguish the presence of active disease, monitoring response to treatment, or assess disease progression. Studies have shown that resistin is involved in the etiology of periodontitis. The purpose of this paper was to assess the salivary resistin levels in patients with chronic periodontitis (CP). In this case-control study the saliva samples were collected from 45 patients with CP and 45 age- and sex-matched healthy individuals. Salivary resistin was determined by ELISA method. The results were analyzed by Mann-Whitney test. The software used in this study was SPSS 17. P value less than 0.05 was considered significant. In this study, the mean salivary resistin level was 0.769 (+0.396) ng/ml in the patients group and 0.145 (+0.068) ng/ml in the healthy group, with a significant difference (P 0.05). The results of this research showed that the salivary levels of resistin in patients with CP are higher than in healthy individuals and salivary resistin can be considered as a marker in the pathogenesis, early diagnosis and determination of the inflammatory status of CP.
Raynaud’s phenomenon is one of the commonest manifestations of rheumatic diseases. However, it can be caused by non-Rheumatic conditions as well. Among non-rheumatic causes, cancers are widely reported as the culprit”. Raynaud’s phenomenon caused by non-rheumatic diseases are commonly resistant to standard treatment options They are associated with more severe infections. Among non-rheumatic causes, cancers are widely reported as the culprit. We present a case of non-Hodgkin lymphoma presenting solely with Raynaud’s phenomenon.
Hip arthroplasty is a reliable means in the treatment of hip conditions. By restoring its mobility, stability and indolence. However, this prosthetic surgery exposes to the risk of the occurrence of complications that can affect the functional prognosis. The most common complications are dislocations, fractures, loosening, and infections. These complications may require surgical revision of the total hip prosthesis (THA). We present three cases of patients who required revision THA, and we present the therapeutic recommendations for each of the complications in the literature, to ensure adequate management, and the recovery of a painless, mobile and functional hip.
Coccydynia is localized pain in the coccyx, exacerbated when sitting and getting up. The diagnosis is essentially clinical, the interrogation must always seek the notion of trauma in the history. Digital rectal examination is painful when mobilizing the coccyx. Standard X-rays, dynamic X-rays, and Magnetic Resonance Imaging (MRI) are quite important for both positive diagnosis and differential diagnosis. Therapeutic management is multidisciplinary, starting with hygiene measures, medical treatment and manipulation and massage techniques. Coccygectomy is proposed after failure of conservative treatments. Its results are generally good. Its main complication is infection.
Breast cancer in male gender is rare with an incidence of 1 % of all breast cancers. There are many theories and risk factors that play a role in the development of breast cancer among males. The development of a second primary cancer is also rare. Herein we have a case of a male breast cancer that devolved after a 20 years of treated testicular cancer. There are many risk factors that should be studied to know correlation between the two diseases. In this case report we will show the presentation of the patient, discuss the risk factors and put our treatment plan.
Background: Breast cancer is the most common malignancy and leading cause of death among women in Bangladesh. Mutations in BRCA genes increase the risk for breast cancer. A large number of distinct mutations and polymorphisms in the BRCA1 gene have been reported worldwide, a frameshift mutation in BRCA1 gene exon 2 (185delAG) is one of the commonly reported mutations. Therefore, the study was planned to determine the frequencies of mutation and polymorphisms in BRCA1 gene exon 2. Materials and Methods: A cross-sectional descriptive type of study was done on 100 adult Bengali Bangladeshi female patients with ductal carcinoma of breast of age range between 25 to 70 years by ‘selection checklist.’ Genomic DNA was isolated from the peripheral blood samples. Amplification of the desired sequence of BRCA1 exon 2 was checked in gel and then digested with restriction endonuclease enzyme (Hinfl). The fragments obtained were analyzed on a gel and photographed under UV light. Sanger sequencing was done on 10 blood samples for confirmation. Sequenced data was analyzed by Geneious Software version 11. Results: The onset of cancer was predominantly below 50 years and 44% of patients did not experience menopause as they developed cancer at a younger age. Gel photographs after enzyme digestion showed wild-type bands of 149bp in all samples. The chromatogram reveals wild-type sequence of exon 2 of BRCA1 gene. Conclusions: BRCA1 mutation status helps us in the cancer risk prediction, selection of therapeutic management and genetic counseling of the patients and families. Therefore, it is necessary to study the whole BRCA1 gene in our population.
Pollicization of the index finger has been the subject of several publications; it occupies an interesting place in the restoration of the handgrip. Although it is still suffering from some technical insufficiencies, we were able to achieve a pollicization of the index finger on a 54 years old woman. The results were very satisfactory. We report in this work the surgical technique used, with an update on the various existing techniques.
Tarlov cyst (TCs) is also called perineural cyst, which is a rare disease of the posterior nerve root prevalently localized in the lumbo-sacral region, however, it is also possible in every part of the spinal cord. These cysts represent a dilation of the nerve-root sheath that often communicate with subarachnoid space through a valve-like mechanism containing cerebrospinal fluid (CSF) and neural tissue. Tarlov cyst is often asymptomatic and discovered incidentally in the MRI, however, sometimes it can be symptomatic and is characterized by many symptoms, such as low back pain, sacral radiculopathy, sciatica, coccydynia or cauda equina syndrome, constipation, dyspareunia, urinary incontinence, and retention as well as blurry vision and headache. Moreover, these cysts can be a cause of CSF leak and therefore culprit of idiopathic intracranial hypotension. The etiopathogenesis is still unclear, but it is documented that a trauma, an old hemorrhage, and congenital and iatrogenic causes may be responsible for it. Association between the Tarlov cysts and the arachnoiditis have been studied in the last years. Tarlov cyst appears to be a consequence of the arachnoiditis. In general, there are four stages of arachnoiditis. In the last stage, it is possible that some patients cannot walk anymore becoming wheelchair bound. Moreover, arachnoiditis is often associated to type I ACM, syringomyelia and Ehlers-Danlos syndromes. Although Tarlov cyst has been known since 1938, the year in which Dr. Isador Max Tarlov described it first as an incidental finding in cadavers, nowadays many doctors do not really know this disease and underestimate it by thinking that it cannot be responsible for the above listed symptoms. The main aim of this work is to educate the medical community to consider Tarlov cyst in the differential diagnosis of back pain patients, and in other diseases. While the surgery represents the most effective therapy for such patients, a treatment of the arachnoiditis with the stem cells therapy should be also considered.
The novel coronavirus pneumonia COVID-19 which is reportedly caused by SARS-CoV-2 infection can potentially lead to a course of clinical symptoms and fatal illnesses. Reported first in 2019, it has now affected more than 596,873,121 people, worldwide. In addition to its clinical manifestation in humans, the COVID-19 virus in cancer patients is significantly declining a positive prognosis. In the time of an ongoing global pandemic, oncologists are struggling to provide appropriate care to cancer patients due to their increased susceptibility to severe complications of COVID-19 which can be attributed to their immunosuppressed status caused by the malignancy and anticancer treatments. Similarly, the lack of literature, evidence, and consensus on whether to give antineoplastic agents to patients with active COVID-19 infection pose a unique challenge for physicians. In this article, we present a case of a 47-year-old female who was diagnosed with squamous cell carcinoma of the esophagus and later tested positive for SARS-CoV-2. Under unanimous decision, oncological treatment for the malignancy was initiated with a combination of chemotherapy and radiation without a consequential delay as per multidisciplinary tumor board (MDT) meeting decision which results in clinical improvement.
Since they were first discovered and used in animal models in the 1950th, stem cells are assuming a key role in the research field. These types of cells are undifferentiated cells deriving from a single cell that is able of a clonal proliferation differentiating into different cells and tissues. It is possible to classify them into two main groups considering their main features. Moreover, speaking about stem cells, it is important to mention the key role of some small non-coding RNA molecules also known MiRNAs (microRNAs) in the cell cycle regulation. Generally, stem cells are very useful in cellular therapy helping the regeneration of entire organs. They also allow a deep understanding of development and pathogenesis of many diseases and are useful in drug development. In general, the aim of this article is to talk about stem cells and their uses in multiple medical fields and especially in neurological diseases. A comprehensive explanation of stem cell classification and miRNAs role in the cell cycle regulation of these cells in clinical application as well as gene alterations in some diseases is included. And finally, very interesting stem cell research will be also discussed. Unfortunately, studies on adhesive arachnoiditis, a rare neurological disease mostly associated to Tarlov cysts (TC), are still few. In addition, other associations between arachnoiditis and Chiari malformation, as well as syringomyelia and ACM, have been found. And, finally, association between idiopathic intracerebral hypertension and arachnoiditis granulations (AGs) were also demonstrated.
Kienböck’s disease is a rare condition. It affects young adults who are mostly manual workers. Radiology allows diagnosis and classification of the disease using the Lichtman classification which will guide the therapeutic strategy. The aim of the present work is to review the clinical data, recent advances in assessment methods (MRI and arthroscopy) and our therapeutic results compared to the literature. Material and methods: This is a retrospective study of fifteen cases of Kienböck’s disease, collected in the Traumatology-Orthopaedics Department I of the Mohamed V Military Hospital in Rabat, Morocco, over a 20 years period, from 2001 to 2020. This study included 10 men and 5 women, with an average age of 29 years. All of our patients underwent plain radiographs that allowed diagnosis and staging. Only 6 patients benefited from MR imaging and none of them had cartilage arthroscopic assessment. Radial shortening osteotomy were performed for 14 patients and lunate decompression by forage for one patient with good results in 53% and 14% of poor results. Discussion: Comparing the results of our study with those of the literature, we found concordance regarding clinical, radiological and therapeutic methods. However, this study has shown insufficient use of MRI for viability evaluation of the lunate and cartilage arthroscopic assessment, due in first place to their high cost for developing countries as ours. Thus, treatment choices weren’t accurate enough, which explains our 47% poor to fair results. Conclusion: Kienböck’s disease is a rare condition that should be early diagnosed with accurate staging using recent advances in assessment methods which allows proper treatment choices to prevent its evolution toward total destruction of the wrist. However, patient’s desires and needs, surgeon’s experience and capabilities of their facilities precondition the final decision.
Fractures of the clavicle represent 2.6 to 5% of all fractures. Respiratory and vascular-nerve complications of isolated clavicle fractures are rare. We report the case of a 29-year-old cyclist who presented a fracture of the right clavicle following a sport accident, complicated by both pneumothorax and deep vein thrombosis of axillary vein. Patient underwent thoracic drainage and curative anticoagulation followed by internal osteosynthesis of the clavicle as soon as he was stabilized on respiratory level. At the last check-up, the clavicle healed and no recurrence of pneumothorax nor deep vein thrombosis was noted.
Ring avulsions are rare and represent a wide variety of soft tissue and bone injuries, ranging from circumferential lacerations with or without vascular involvement to complete amputations. Treatment options are variable and depend on the injury pattern as well as functional and aesthetic requirements. We hereby report three cases of ring avulsions in three young males; all classified Urbaniak III, two treated with a revision amputation and the other with intrapalmar ray resection. In last follow-up of 12 months, the three patients were satisfied with cosmetic as well as functional results.
Background: Neuropathies a result of damage to the peripheral nerves are a heterogeneous group of diseases which may occur due to underlying genetic abnormalities. Exciting capabilities of the whole exome sequencing to detect disorders at the level of genome, especially in heterogeneous disorder groups, made it easy to determine which of the genetic variation disease causing in an individual patient. This paper reports a novel COL4A1 gene variation that was found in a case with para-clinical diagnosis of neuropathy, following molecular analysis. Case presentation: We report a 54 year-old man from the Al-Zahra Hospital, Isfahan University of Medical Sciences admitted to genome genetic center with para-clinical diagnosis of neuropathy based on electromyography. Further molecular analysis of patient genomic DNA using whole exome sequencing, revealed a heterozygous COL4A1 pathogenic variant NM_001303110: c.A1G: p.M1V. The result verified by Sanger Sequencing.
