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Rhabdomyosarcoma (RMS) is a very rare, highly malignant neoplasm thought to originate from the pluripotent mesenchymal tissue. Predominantly diagnosed among children and teenagers, however they can also be encountered in adults. There are a few risk factors associated with RMS like family history of malignancy and genetic syndromes like neurofibromatosis type 1, Li-Fraumeni syndrome, Noonan syndrome and Beckwith-Wiedemann syndrome; however, most cases of RMS are sporadic. Other factors like radiotherapy for other malignancy and pre-natal radiation exposure also are associated with increased risk of developing RMS. The most common reported sites for RMS are head, neck, trunk, pelvis and lower limbs. Omental involvement of primary RMS has been rarely reported in the literature. Principally, the survival of treated RMS cases has improved, primarily due to multidisciplinary management approaches. In this paper, we report a case of primary pleomorphic RMS in a 50-year-old female who presented with abdominal pain.Alcohol neurolysis and intramuscular blocks are interventions for spasticity management. Here, we illustrate two clinical cases with spasticity impeding ease of care and pain which required selective alcohol intramuscular blocks with alcohol neurolysis. Post-interventions, both cases demonstrated improvement in pain and joint range of motion which facilitated better positioning and reduced caregiver burden. Pertinent learning points from alcohol neurolysis with intramuscular blocks are discussed concerning therapeutic effectiveness and intervention safety.<br /><br /> It has been observed that 5% of adolescents are affected by pubertal timing disorders. However, there is limited data about this in Pakistan. This cross-sectional study aimed to observe the patterns and causes of delayed puberty (DP) among patients presenting at the endocrine clinic of a tertiary care hospital in Karachi.<br /><br /> This observational study was conducted at the endocrine clinic of Jinnah Postgraduate Medical Centre (JPMC) Unit II from 2007 to 2015. A detailed history was obtained from patients presenting with DP. We noted the available demographic data, main complaints, and family history of DP. Physical examinations were performed and the data recorded. Tanner staging was used to assess pubertal development. Relevant laboratory and imaging investigations were performed; data analysis was performed using SPSS 17 (IBM Corp., Armonk, NY).<br /><br /> A total of 2670 patients were registered in the endocrine clinic during the study period, of which 171 presented with DP; 119 were males and 52 were females. There patients presenting with DP could not be classified due to incomplete data.<br /><br /> This study showed that CDGP was the most common cause of DP in our patients with the most common presentation being short stature in males and amenorrhea in females. It is essential to differentiate CDGP in children from a small fraction of the pathological and treatable causes of DP.<br /><br />This study showed that CDGP was the most common cause of DP in our patients with the most common presentation being short stature in males and amenorrhea in females. It is essential to differentiate CDGP in children from a small fraction of the pathological and treatable causes of DP.Oesophagojejunostomy leakage after total gastrectomy with D2 lymphadenectomy remains a significant clinical issue. In this paper, we present a case of a 63-year-old female patient who, on the first day after surgery, was diagnosed with oesophagojejunostomy leakage in the chest. The general condition of the patient was stabilized by the implementation of conservative treatment and thoracic drainage. Thanks to covered oesophageal stents, the leakage from the fistula between the anastomotic connection, pleura, and skin was reduced. In the subsequent step, treatment with fibrin glue resulted in complete closure of the fistula. The complementary use of fibrin glue may be effective in the treatment of small oesophagojejunostomy leakages when other endoscopic methods are not sufficient.Background Cisplatin is a common anticancer drug with potential cardiac and renal toxicities. Rutin, a natural compound present in various medicinal plants, has been shown to protect against chemotherapy-induced toxicities. In this study, we explored the protective effect of rutin against the dose-dependent cardiotoxic effects of cisplatin such as perfusion pressure, histopathologic effect on the myocardium, and oxidative stress in isolated perfused rat hearts. Methodology The cardiotoxic effects of cisplatin were studied at three dosages (1, 7, and 14 mg/L) in isolated perfused rat hearts. The dose-dependent, cisplatin-induced toxic effects on left ventricular pressure (LVP), heart rate (HR), dp/dt (maximum), dp/dt (minimum), perfusion pressure, pressure-time index, contractility index, and duration of diastole were assessed. The effects of cisplatin were measured one minute before perfusion of cisplatin and 60 minutes after perfusion of the isolated rat hearts. Results Cisplatin (1-14 mg/L) caused a signifitology. Moreover, cisplatin-induced reduction in glutathione and increased level of malondialdehyde in the myocardium was reversed by concurrent administration of rutin in isolated rat hearts. Conclusions Cisplatin produced a dose-dependent impairment of several parameters of cardiac function such as LVP, contractility index, and pressure-time index. It caused histopathological alterations in isolated rat hearts. These harmful effects of cisplatin were suppressed by rutin trihydrate, suggesting the potential protective effects of rutin against cisplatin-induced cardiotoxicity. Rutin trihydrate also improved the reduced glutathione contents and suppressed the malondialdehyde contents in the cardiac tissue of isolated rat hearts, suggesting that the observed beneficial effects of rutin trihydrate in this study could be related to its antioxidant properties.Myasthenia gravis (MG) is an autoimmune disorder characterized by abnormal neuromuscular transmission. The thymus is believed to play a key role in the pathogenesis of MG, and thymectomy has been an optional treatment for the disease. Relapse of MG after thymectomy has been reported. Exacerbations and new onset of MG following COVID-19 vaccination have also been documented. This report presents a case of a stable MG patient with recent COVID-19 vaccination experiencing flare-ups of symptoms shortly after video-assisted thoracoscopic (VATS) thymectomy. A 31-year-old female received the second dose of the BNT162b2 mRNA COVID-19 vaccine eight days before thymectomy and developed flare-ups of symptoms four days after the surgery. [https://www.selleckchem.com/products/Pancuronium-bromide(Pavulon).html AChR antagonist] Although the substantial link between MG exacerbations post-thymectomy and pre-thymectomy COVID-19 vaccination cannot be concluded, this observation warrants further research.<br /><br /> Snake envenomations are a serious cause of mortality and morbidity in the world.<br /><br /> This study was conducted to investigate snake bites in pediatric patients in Kahramanmaraş and to determine whether pro-brain natriuretic peptide (proBNP) has a prognostic value in these patients.<br /><br /> Pediatric patients aged &lt;18 years who presented to the pediatric emergency department with snakebites were reviewedretrospectively. The demographical, clinical, laboratory, treatments, and outcomes data were collected from their medical records. Stage 0 and 1 envenomation was considered as a non-serious complication and stage 2 and 3 envenomation was considered as a serious complication.<br /><br /> A total of 32 pediatric patients, six females and 26 males, between 2016 and 2021, were included in the study. The mean age was 12.52±3.28 years. There were seven patients without serious complications and 25 patients with serious complications. The best cutoff point for proBNP to predict serious complications was found to be ≥272.5 ng∙L<br /><br /> (sensitivity, 83.3%; specificity, 100%, <br /><br /> =0.011). We also detected complex regional pain syndrome in one of our patients.<br /><br /> In this study, proBNP was shown to be predictive of a poor outcome of snakebites. Moreover, complex regional pain syndrome, which is rarely reported in the literature, should be kept in mind during the long-term follow-up of snakebites.<br /><br />In this study, proBNP was shown to be predictive of a poor outcome of snakebites. Moreover, complex regional pain syndrome, which is rarely reported in the literature, should be kept in mind during the long-term follow-up of snakebites.We present a 26-year-old African-American gentleman with no significant past medical history who presented with a three-day history of dry cough. Computerized tomography of the chest showed scattered infiltrates consistent with a pseudo-miliary pattern. A transbronchial biopsy showed non-caseating granulomas confirming our suspicion for pulmonary sarcoidosis. Miliary sarcoidosis is rare; therefore, health care providers should consider other diagnoses such as tuberculosis, malignancy, and pneumoconiosis.Vertebral hemangiomas (VHs) are benign vascular tumors that develop from the endoderm of blood vessels, although their exact pathogenesis is poorly understood. Most hemangiomas are small, about a third are multiple in number, and a very small number of these hemangiomas cause symptoms. Even more rare are aggressive VHs, which comprise a small number of all VHs, and are associated with expansion and extraosseous extension into the paraspinal and epidural spaces. Management of aggressive VHs involve pre-op embolization, spinal surgery, and reconstruction. Pain management, physical rehabilitation, and close neurological follow-up are imperative to near-total recovery. Aggressive VHs are most commonly seen in the thoracic region but may rarely involve a large number of vertebrae. Cutaneous hemangiomas, when seen along with VHs, are often metameric. We present a rare and challenging case of compressive myelopathy and a large cutaneous hemangioma or a "purple shoulder", found during an exam in a young male. He was found to have an extensive VH extending through 13 vertebral levels (C7 to D12), non-metameric to the cutaneous lesion. A thorough physical examination and evaluation along with prompt surgical treatment were the cornerstone of treatment and prevention of permanent neurological deficits.Ketone-prone diabetes or Flatbush diabetes is being increasingly recognized worldwide. It is typically seen in obese middle-aged men with a family history of Type 2 DM. Atypicality in the onset of age and gender variation is increasingly observed worldwide. Predisposition to glucose desensitization is one of many unclear pathophysiologic mechanisms which is why extensive studies are obligatory. After intensive insulin therapy, many patients eventually become insulin-independent and attain euglycemia with oral hypoglycemic agents or with diet alone due to the recovered functionality of pancreatic beta cells. Our report sheds light on the atypicality of presentation and summarizes the main diagnostic features of this rare form of diabetes. Increased awareness of this entity can facilitate early diagnosis and management.Follicular lymphoma is the second most common type of B-cell non-Hodgkin lymphoma. It is known as one of the indolent lymphomas. Although some cases presenting with abdominal masses with or without symptoms have been reported, generally, primary extranodal follicular lymphoma is uncommon. Moreover, small bowel obstruction (SBO) as an initial presentation is extremely uncommon. We encountered a unique case of mesenteric follicular lymphoma that presented with SBO as the initial clinical presentation. A 61-year-old male presented with a three-day history of abdominal pain and recurrent vomiting. Abdominopelvic computed tomography revealed air-fluid levels in multiple small bowel loops, with a transition point associated with a mass-like mesenteric abnormality. The small bowel was resected, and a wedge resection was performed to relieve the obstruction and make a diagnosis. Histopathology and immunohistochemical staining confirmed the diagnosis of follicular B-cell lymphoma. Mesenteric lymphomas are less likely to present with SBO as the initial clinical presentation due to their extraluminal location.