జర్నల్ ఆఫ్ క్లినికల్ కేస్ రిపోర్ట్స్

During routine dissection for gross anatomy practical teaching by unknown age of adult male cadaver for the undergraduate medical students at department of human anatomy, college of medicine and health sciences, university of Gondar, Ethiopia we had encountered anatomical variation in branching pattern of right axillary artery. The third part of right axillary artery gave rise to a common trunk that divides into anterior and posterior circumflex humeral arteries. This anatomical variation in the branching pattern of axillary artery is very crucial for surgical procedures that surgeons perform an intervention or a diagnostic procedure in cardiovascular diseases.

Immune Thrombocytopenic Purpura (ITP) is a heterogeneous disease with unpredictable treatment responses. This unpredictability is attributed in part to different pathogenic mechanisms including oxidative stress. The anti-oxidant effect of ascorbic acid in treatment of ITP has been described but evidence on its efficacy is contentious.

We describe a patient with refractory ITP in whom ascorbic acid was used as a useful adjuvant treatment. A 60-year old man with diabetes and hypertension presented with myocardial infarction and underwent primary coronary intervention. He had steroid dependent ITP, with a poor response to azathioprine, rituximab and splenectomy. He had drug induced cholestasis with dapsone. Therefore high doses of steroids were required to maintain safe platelet counts for antiplatelet drugs, which lead to poor glycemic control. High dose ascorbic acid was started, following which his platelet count remained above 100 x 109/L, permitting tailing off of prednisolone while continuing dual antiplatelet therapy.

Background: Splenectomy and hydatid cyst resection using either laparoscopy or laparotomy methods are frequently performed procedures. However, cases of patients sufering from both massive splenomegaly and hydatid cyst are rare. Case Presentation: Patient was a 62-year-old man who complained of upper abdominal pain and was diagnosed with massive splenomegaly. In a Computed Tomography (CT) scan performed prior to surgery, a hypodense lesion with the measurements of 45 × 43 mm was found in the sixth segment of the liver. Therefor we performed an open splenectomy and hydatid cyst resection through one incision. Discussion: Splenomegaly is a rare condition with the prevalence rate of around 2% in the US. However, tropical splenomegaly is common in Asia and Africa. Splenomegaly may occur due to various reasons, including ET Symptomatic splenomegaly is the most common cause of splenectomy. In myeloproliferative complications, splenectomy is performed to relieve the patient’s pain, early satiety and other splenomegaly related symptoms. Conclusion: Simultaneous surgical procedures on both massive splenomegaly and hydatid cysts are rare. We suggest a CT scan be performed and the best type of incision be chosen based on the pathology and site of lesion, before performing a midline incision. Keywords: Massive splenomegaly • Mercedes benz incision • Hydatid cyst

A 62-year-old male with recently diagnosed stage IV pancreatic cancer was started on chenotherapy with 5-Fluourouracil. Shortly after initiation, he suffered cardiac arrest. We will review the proposed pathophysiology of 5-Fluourouracil cardiotoxicity, the reported incidence, treatment, and the antidote for 5-Fluorouracil overdose or toxicity. Myocardial infarction is an adverse cardiac reaction associated with 5-fluorouracil (5-FU). Data on the incidence, risk, and prognosis of 5-FU-related myocardial infarction are limited. Fluorouracil (5-FU) is the most commonly proposed chemotherapy drug for colorectal cancer. Cardiogenic side effects such as autopsy arterial vessels seizures, ventricular arrhythmias, and cardiac ischemia are also rare.

In late December 2020, vaccination for the coronavirus disease 2019 (COVID-19) started among the personnel of the United States Forces Korea and related units, including the medical team. Because its usage was approved based on emergency circumstances, sufficient research on the possible side effects has not been conducted yet. We experienced an unusual neurologic side effect after injection of the SARS-CoV-2 mRNA-1273 vaccine. A 32-year-old U.S Army male soldier with headache, blurred vision, and cramping chest pain after second-dose injection visited the emergency room. Subsequently, left-sided weakness developed during the observation. Imaging of the cervical lesion for the diagnosis of acute intracranial disease was performed but revealed no definite disease. While under close observation, the patient’s symptoms progressed to nearly hemiplegic but then improved gradually in an ascending and peripheral-to-center manner with only supportive care. We report this case as the first unilateral neurologic side effect of the SARS-CoV-2 mRNA-1273 vaccine.

Background: Splenectomy and hydatid cyst resection using either laparoscopy or laparotomy methods are frequently performed procedures. However, cases of patients suffering from both massive splenomegaly and hydatid cyst are rare.

Case presentation: Patient was a 62-year-old man who complained of upper abdominal pain and was diagnosed with massive splenomegaly. In a Computed Tomography (CT) scan performed prior to surgery, a hypodense lesion with the measurements of the (45 x 43) m m² was found in the sixth segment of the liver. Therefor we performed an open splenectomy and hydatid cyst resection through one incision.

Conclusion: Simultaneous surgical procedures on both massive splenomegaly and hydatid cysts are rare. We suggest a CT scan be performed and the best type of incision be chosen based on the pathology and site of lesion, before performing a midline incision.

A 24 years young male with no prior history of jaundice now presented with progressive jaundice and hepatomegaly. Autoimmune serology and liver biopsy revealed features of autoimmune hepatitis. He was started on oral prednisolone and azathioprine, following which he attained remission. However, he persisted in having hyperbilirubinemia with a predominant unconjugated fraction. Hemolytic causes of unconjugated hyperbilirubinemia were ruled out, and the diagnosis of Gilbert Syndrome was established.