ISSN: p-ISSN - 2454-129X; e-ISSN - 2454 -1303 Discipline: All medical, surgical and dental specialties Starting Year: 2015 Current volume: Volume 12 Issue per year: 12 (monthly) Editor-in-chief: Dr. Amit Agrawal, India Indexing: Index Copernicus, Journal Guide, BASE, Research Bible, Google Scholar E-mail: editor.ijcr@mansapublishers.com
Simultaneous central and peripheral nervous system involvement inthe same patient: An interesting case report
Involvement of the central and peripheral nervous systems (PNS) in the same patient is a rare phenomenon. The causes can be clubbed as infective, demyelinating diseases like multiple sclerosis, or may be post-vaccination. Neurotoxins are also associated with demyelination. Either of the two may present earlier, followed by the other one. Due to the involvement of both central and peripheral, the patient usually becomes moribund much earlier. If not diagnosed earlier, the patient may have difficulty surviving. Here, we present an interesting case in which both the central and PNSs were involved in the same patient. The cause we found out was infectious, and the patient improved with therapy and has been under follow-up for the last 3 months on treatment. The case in itself is very essential for primary care physicians, as non-specific multiple neurological symptoms, if diagnosed early, may benefit the patient.
Progressive multifocal leukoencephalopathy
Copyright (c) 2026 Tarun Sharma, Prachi Jain, Subhash Chander, Rohit Aswal, Monalisa Sethi, Aradhna sharma https://creativecommons.org/licenses/by-nc-nd/4.0
Effectiveness of self-assembling peptide P11-4 as a minimally invasiveintervention for initial smooth-surface carious lesions in permanentteeth: A case report
White spot lesions (WSLs) are the earliest visible manifestation of enamel caries and present significant esthetic concerns, particularly in adolescents. Conventional treatments, such as fluoride, casein phosphopeptide-amorphous calcium phosphate, and resin infiltration, have limitations, including incomplete remineralization or irreversible enamel alteration. Self-assembling peptide P11-4 (SAP P11-4; Curodont Repair, Credo AG, Switzerland) is a biomimetic material that promotes subsurface hydroxyapatite formation within the lesion body. A 16-year-old female presented with International Caries Detection and Assessment System 1–2 WSLs on the labial surfaces of teeth 11, 12, 21, and 22. Clinical examination excluded fluorosis, enamel hypoplasia, and post-orthodontic demineralization. Following surface preparation, SAP P11-4 was applied under rubber dam isolation. The procedure was well tolerated, with no adverse events. Progressive reduction in lesion opacity was observed, with favorable esthetic and structural outcomes maintained at 1 year, supporting SAP P11-4 as a minimally invasive treatment option.
Copyright (c) 2026 Muskan Jain, Rakesh Kumar Yadav, Rhythm Bains, Promila Verma https://creativecommons.org/licenses/by-nc-nd/4.0
Endoxifen in the management of behavioral addiction – A case report exploring its use beyond mood stabilization
Impulsivity is one of the core features of behavioral addiction. Recent evidence suggests a role of increased protein kinase C (PKC) activity in the pathophysiology of impulsivity. Consequently, it has been hypothesised that endoxifen, a direct PKC inhibitor, may be useful in the management of impulsivity. We report the case of a 29-year-old woman with a 5–6-year history of impulsive high-risk behaviors in the form of dating-app overuse, substance use, and mood symptoms such as impaired self-care, irritability, disturbed sleep, and appetite, for which she was diagnosed to have a mood disorder with behavioral addiction. Addition of endoxifen at a dose of 8 mg/day led to marked improvement in impulsivity, cravings for substances, and mood symptoms, with good tolerability and sustained benefit over 3 months.
Copyright (c) 2026 Dnyanraj Choudhary, Rupali Karwa https://creativecommons.org/licenses/by-nc-nd/4.0
Unregulated topical steroid use in India: From skin relief to lifethreatening complications
Unregulated and prolonged use of corticosteroids, both topical and oral, remains a significant public health concern in India, resulting in severe iatrogenic complications. We report a 35-year-old male who developed iatrogenic Cushing’s syndrome, steroid-induced diabetes mellitus, and pulmonary aspergilloma within an old tuberculous cavity following prolonged unsupervised use of high-potency topical steroid (likely clobetasol-based) for widespread eczema. This case highlights the complex interplay of endocrine disruption, metabolic derangements, and immunosuppression leading to opportunistic fungal colonization in structurally damaged lungs. Strict regulation of over-the-counter sales of potent corticosteroids, enhanced public awareness, and improved oversight of healthcare practices are urgently needed to prevent such avoidable morbidity.
Copyright (c) 2026 Sameer Mohan Agarwal, Deepak Sharma, Saurabh Srivastava, Nishu Jha, Manisha Dhinwa, Mohd. Aqib Ghauri, Sunil Kumar https://creativecommons.org/licenses/by-nc-nd/4.0
Miller Fisher syndrome associated with polycythemia vera: A rareclinical co-occurrence
Miller Fisher syndrome (MFS) is a rare, acute immune-mediated neuropathy characterized by ophthalmoplegia, ataxia, and areflexia. Polycythemia vera (PV) is a chronic myeloproliferative neoplasm marked by autonomous erythroid overproduction and elevated thromboembolic risk. The clinical co-occurrence of these two distinct conditions is exceptionally rare. We report a case of a 42-year-old male presenting with a 3-day history of walking unsteadiness, bilateral eyelid drooping, and blurred vision following a low-grade fever. Diagnosis of MFS was confirmed through cerebrospinal fluid analysis, showing albumin-cytological dissociation, and a strongly positive serum anti-GQ1b antibody titer. Concurrently, severe erythrocytosis led to a bone marrow diagnosis of PV, notably testing negative for the Janus activated kinase gene but positive for the additional sex combs like 1 mutation. Despite compounded hyperviscosity and thrombotic risks, the patient was successfully treated with standard intravenous immunoglobulin and therapeutic venesection, resulting in full neurological resolution.
Copyright (c) 2026 krishnan balagopal, Suneesh S, Mintu Ann Joy, Nikhil Philip , Elizabeth Kuruvilla, Anirudh Pai https://creativecommons.org/licenses/by-nc-nd/4.0
Adnexal mass after subtotal cesarean hysterectomy: Arare case report
Serous cystadenoma is a frequently encountered benign epithelial ovarian tumor in women of reproductive age. Management becomes more challenging in patients with previous pelvic surgeries because of dense adhesions and altered pelvic anatomy. We describe the case of a 31-year-old woman with a prior subtotal cesarean hysterectomy performed for placenta accreta spectrum disorder, who presented with chronic left lower abdominal pain. Radiological imaging demonstrated a multiloculated left adnexal cystic lesion with septations and mural nodularity, raising suspicion of neoplastic pathology. An exploratory laparotomy with adhesiolysis and cyst excision was undertaken successfully. Histopathological examination confirmed serous cystadenoma. This case emphasizes the significance of thorough preoperative assessment, multidisciplinary planning, and careful surgical dissection in patients with complex postoperative pelvic adhesions.
Copyright (c) 2026 Ani Chandanan, Charu Yadav, Asha Saxena, Jyotika Parmar https://creativecommons.org/licenses/by-nc-nd/4.0
Undiagnosed bleeding disorder and pediatric airway: Prudence of ananesthetist prevails!
A 7-year-old, 28-kg male child with cerebral palsy and intellectual disability was diagnosed to have left-sided pelvi-ureteric junction obstruction and left hydronephrosis, for which he was planned for left-sided pyeloplasty under general anesthesia. The patient had developed a spontaneous oro-nasal bleed, which was managed successfully in the perioperative period without any hemodynamic instability and perioperative respiratory adverse events (PRAE). The patient was extubated on the table without any airway complications after confirming complete neuromuscular blockade recovery
Perioperative respiratory adverse events
Copyright (c) 2026 Kumbhar Prathamesh Gurudas, Suruchi Richhariya, T Jayasree https://creativecommons.org/licenses/by-nc-nd/4.0
Homeopathic management of carbuncle: A case report
A carbuncle is a deep bacterial infection involving adjacent hair follicles and surrounding subcutaneous tissue, commonly managed with incision and drainage along with antibiotic therapy. A 52-year-old male presented with a painful swelling over the nape of the neck of 5 days’ duration, associated with foul-smelling purulent discharge mixed with blood and pain aggravated at night. The patient was a known case of type 2 diabetes mellitus and hypertension and was on regular allopathic medication. Clinical examination revealed an indurated, tender swelling with purulent discharge and localized inflammation, leading to the diagnosis of a carbuncle. Individualized homeopathic treatment with Tarentula cubensis was prescribed along with local dressing using Calendula officinalis mother tincture. Progressive reduction in pain, discharge, and swelling was observed during follow-up, with complete healing achieved within 1 month without surgical intervention. This case highlights the possible role of individualized homeopathic medicine as a therapeutic approach in carbuncle in a diabetic without recourse to antibiotics or surgical intervention.
Copyright (c) 2026 Mallesh Reddy https://creativecommons.org/licenses/by-nc-nd/4.0
Case ReportA rare case of waxing and waning supraclavicular swelling due tointernal jugular vein saccular varix in a 79-year-old male with chronicobstructive pulmonary disease
Supraclavicular swellings encompass a broad range of infectious, neoplastic, and vascular etiologies. A 79-year-old male with a history of chronic smoking and chronic obstructive pulmonary disease presented with a right-sided neck mass that had progressed from the size of a pea to a lemon over 3 months. The swelling exhibited a unique “waxing and waning” pattern, appearing prominently during coughing and Valsalva maneuvers and resolving completely afterward. Clinical examination revealed a 3 × 3 cm soft, non-pulsatile cystic mass. Ultrasound and computed tomography angiography confirmed a focal saccular aneurysmal dilatation of the right internal jugular vein, measuring 3.2 cm in diameter. In the absence of complications, such as thrombosis or compressive symptoms, conservative management and regular follow-up are preferred over surgical intervention. This case emphasizes the importance of considering rare vascular anomalies in the differential diagnosis of dynamic neck masses.
Copyright (c) 2026 Prince Handa, Ishwar Singh, Ashish Gopal, Sabareesh Mylswamy, Shafaat Ahmad, Anubha Mangla https://creativecommons.org/licenses/by-nc-nd/4.0
Beyond tuberculosis: A rare case of neuromelioidosis
Melioidosis is an emerging infectious disease in India caused by Burkholderia pseudomallei, with central nervous system (CNS) involvement being particularly rare and associated with high mortality. Neuromelioidosis often mimics tuberculosis, malignancy, or other granulomatous infections, leading to delayed diagnosis and treatment, especially in non-coastal regions. We report a case of a 44-year-old male from Rajasthan with a 4-year history of type 2 diabetes mellitus who presented with prolonged fever, headache, irritability, and focal neurological deficits. Neuroimaging revealed multiple right temporo-occipital T2 hyperintense lesions with hemorrhagic changes initially misinterpreted as tubercular granulomas. Cerebrospinal fluid analysis demonstrated clear fluid with five lymphocytes/mm3, protein 82 mg/dL, glucose 72 mg/dL, and sterile culture. Microbiological work-up for tuberculosis and commontropical infections was negative. Blood culture subsequently grew B. pseudomallei, establishing the diagnosis of Neuromelioidosis. The patient was treated with intravenous meropenem followed by oral cotrimoxazole, resulting in clinical and radiological improvement, though residual neurological deficits persisted. Neuromelioidosis should be considered in diabetic patients presenting with unexplained CNS lesions, even in non-endemic or arid regions, such as Rajasthan. This case highlights the expanding geographical footprint of melioidosis in India and underscores the need for heightened clinical suspicion, early microbiological diagnosis, and appropriate prolonged therapy to reduce morbidity and mortality.
Copyright (c) 2026 Harsh Pratap Singh, RK Bhimwal, Arun Bargali, Prateek Sharma, Surender Detha, Aman Jhajharia https://creativecommons.org/licenses/by-nc-nd/4.0
Levetiracetam-induced Stevens–Johnson syndrome/toxic epidermalnecrolysis overlap: A fatal case report
Levetiracetam is a second-generation antiepileptic drug (AED) that is generally regarded as having a favorable safety profile and a lower propensity for severe cutaneous adverse reactions (SCARs) than the aromatic AEDs such as carbamazepine, phenytoin, and lamotrigine. Nevertheless, rare and occasionally fatal SCARs, including Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), have been reported with its use. We describe a 29-year-old female with hypertension, hypothyroidism in the past 3 years, and a 1-year history of a seizure disorder who developed painful oral mucosal ulceration followed by generalized erythematous and dusky macules with epidermal detachment 10 days after the initiation of levetiracetam. The extent of epidermal detachment was estimated at approximately 18% of the body surface area, placing the eruption within the SJS/TEN overlap spectrum. Causality assessment using the Naranjo Adverse Drug Reaction Probability Scale and the World Health Organization–Uppsala Monitoring Centre criteria categorized the reaction as probable. Despite immediate withdrawal of the offending drug, fluid and electrolyte resuscitation, meticulous wound care, and supportive intensive management, the patient developed secondary sepsis with multiorgan dysfunction and died. Although levetiracetam is considered comparatively safe, clinicians must remain vigilant for life-threatening cutaneous reactions. Early recognition, immediate withdrawal of the suspected agent, and prompt referral to a specialized burn or intensive care unit are critical determinants of outcome.
Copyright (c) 2026 Aravind Manoj Kumar Rajendran https://creativecommons.org/licenses/by-nc-nd/4.0
Cosmetic catastrophe: A case report of delayed anaphylactic shocklikely following hair dye exposure
Hair dye-related allergic reactions are increasingly common, mainly due to para-phenylenediamine (PPD) in permanent hair dyes. Systemic hypersensitivity reactions such as anaphylaxis are rare and may present atypically. We report a 61-year-old man with hypertension and ischemic heart disease who presented with recurrent syncope and hypotension. During intensive care stay, he developed progressive facial, periorbital swelling, and worsening hypotension. History revealed recent hair dye application followed by scalp and facial pruritus, suggesting possible hair dye-induced anaphylaxis. The patient improved with adrenaline, antihistamines, corticosteroids, and fluids. This case highlights the importance of detailed exposure history and early recognition of anaphylaxis in unexplained syncope or shock.
Copyright (c) 2026 Kiran Kuraning, Ganesh K M, Pooja Prathapan Sarada, Garud Suresh Chandan, Padmakumar Arayamparambil Vijayan https://creativecommons.org/licenses/by-nc-nd/4.0
When diabetes defies classification: A diagnostic crossroads betweenidiopathic type 1 diabetes and emerging type 5 diabetes
Atypical forms of diabetes increasingly challenge conventional classification systems, particularly in young lean individuals presenting with insulin deficiency but lacking autoimmune markers. We report the case of a 22-year-old Indian male with poorly controlled diabetes diagnosed at 17 years of age who presented with fever, generalized weakness, burning micturition, hypotension, severe metabolic acidosis (arterial pH 6.9), ketonuria, and anemia. Immunological evaluation, including glutamic acid decarboxylase, insulin autoantibodies, insulinoma-associated antigen-2, zinc transporter 8, and islet cell antibodies, was negative. The patient was managed with intravenous fluids, insulin infusion, electrolyte correction, nutritional support, and antibiotics with gradual clinical improvement. The coexistence of profound insulin deficiency, ketosis, lean body habitus, and probable chronic undernutrition created a diagnostic dilemma between idiopathic type 1 diabetes (type 1B diabetes) and malnutrition-related diabetes mellitus, recently re-emphasized as type 5 diabetes. This report highlights the evolving spectrum of atypical diabetes phenotypes, the limitations of current classification systems, and the importance of recognizing malnutrition-associated diabetes in resource-limited settings.
Copyright (c) 2026 Avi Singh, DR. MOHD LARAIB, Deepak Sharma, Saurabh Srivastava https://creativecommons.org/licenses/by-nc-nd/4.0
The hidden spear: A case series on elongated styloid process
The styloid process (SP) is a slender, pointed projection of the temporal bone at the base of the skull, typically 20–30 mm long. It serves as a crucial anchor for muscles and ligaments involving the tongue and larynx. When its length exceeds 30 mm or when the stylohyoid ligament becomes calcified, it is termed an elongated SP. In some cases, this condition is associated with Eagle syndrome. Eagle’s syndrome refers to unilateral or bilateral elongation of the SP or calcified stylohyoid ligament, along with other symptoms, such as dysphagia, otalgia, tinnitus, and globus pharyngeus. Many individuals with an elongated SP do not show any symptoms, and the condition is often discovered incidentally on radiographs. Early diagnosis is important to prevent confusion with other causes of orofacial pain and to provide appropriate treatment. Awareness among dental practitioners, especially in oral medicine and radiology, is essential for the proper identification and management of this condition. The present case series report covers cases of elongation of the SP as incidental findings, discussing clinical and radiographic features along with a brief review of the literature.
Copyright (c) 2026 Aryan Agrawal, Avika Pareek, Tanishka Choudhary, Manoj Meena, Pallavi Baghla, Shobhit Kaswan, Kanishka Singh https://creativecommons.org/licenses/by-nc-nd/4.0
Acquired long QT syndrome in a patient with human immunodeficiencyvirus and disseminated Mycobacterium avium complex
Acquired long QT syndrome is usually seen secondary to metabolic abnormalities and medications, including macrolide antibiotics, anti-psychotics, and anti-arrhythmics. QT prolongation has also been seen in patients with human immunodeficiency virus (HIV), particularly those with poorly controlled HIV status, immunocompromised state, and electrolyte imbalances associated with chronic HIV infection. We present a case report of a young male with poorly controlled HIV (CD4 count 11 cells/uL, high viral load) who presented with fatigue, shortness of breath, and a mechanical fall, with an initial electrocardiogram showing a prolonged corrected QT (QTc) interval, and was eventually found to have disseminated Mycobacterium avium complex (MAC) infection upon bone marrow biopsy. The primary clinical dilemma involved starting initial macrolide-based antibiotic therapy for disseminated MAC, and in the presence of a QTc >500. The case highlights the complex challenge of managing critical illness in advanced HIV and balancing the pro-arrhythmic danger of treatment against the immediate mortality of untreated infection when widespread MAC necessitates the use of macrolides.
Disseminated Mycobacterium avium complex
Copyright (c) 2026 Bhupinder Singh, Rakshit Singh Saini, Ira Gupta, Sakshi Verma https://creativecommons.org/licenses/by-nc-nd/4.0
Suspected diphtheria turn out to be Bacillus cereus: A rare case study
Bacillus cereus rarely causes respiratory tract infections. We present a suspected case of diphtheria with sepsis, which turned out to be B. cereus. A 6-year-old female child presented with fever, cough, dyspnea, and dysphagia. On examination, bilateral submandibular swelling and pseudomembrane were present in the oral cavity. A throat swab and blood were taken for microbiological examination. Gram stain of throat swab showed Gram-positive bacilli, and there were no Corynebacterium diptheriae-like bacilli in Albert’s stain. B. cereus grew both in the throat swab and the blood. Antibiotics were changed according to the culture report. Targeted therapy was successful, and the patient was discharged uneventfully. This is a rare case highlighting B. cereus as a potential pathogenic cause for a life-threatening infection in otherwise immunocompetent children whose vaccination status was complete. Microbiological testing, such as stains and culture, is essential for accurate diagnosis and timely management.
Copyright (c) 2026 Ankur Goyal, Ekta Singh, Sapna Goyal, Nisha Rathore, Pragya Shakya, Vijay Yadav https://creativecommons.org/licenses/by-nc-nd/4.0
A rare compound heterozygosity of hemoglobin Siriraj and β-thalassemia in a 72-year-old male: A case report
Microcytic hypochromic Anemia in elderly patients is commonly attributed to iron deficiency or chronic disease. However, hemoglobinopathies may remain undiagnosed until late adulthood. A 72-year-old male with no significant clinical symptoms, with a history of hypertension, diabetes mellitus (type 2), and peripheral neuropathy, came to our Center for blood glucose levels. High-performance liquid chromatography (HPLC) revealed an abnormal hemoglobin (Hb) pattern with an HbC fraction of 74.6% and an elevated HbA2 of 8.9%. Subsequent molecular analysis using Sanger sequencing identified compound heterozygosity for Hb Siriraj and β-thalassemia. This case highlights the importance of considering rare Hb variants and molecular testing in elderly patients with unexplained microcytic anemia. The coexistence of Hb Siriraj and β-thalassemia is rare in the Indian population.
Copyright (c) 2026 V Sankara Aparna Akella, R Shalini, Rajesh V Bendre, Shivaprasad Siddapuram, Eeswari Doddagatta Marri https://creativecommons.org/licenses/by-nc-nd/4.0
Pancreaticobiliary malignancy masquerading as tuberculosis: A caseof multifocal skeletal and hepatic metastases
A 41-year-old female with remote treated pulmonary tuberculosis (TB) presented with 4 months of progressive back pain and dry cough. Magnetic resonance imaging of the dorso-lumbo-sacral spine revealed multifocal altered marrow signals in multiple vertebrae and both iliac bones, consistent with osseous metastases. Triphasic computed tomography of the abdomen demonstrated multiple peripherally enhancing hepatic nodules with inner cystic change (largest 35 × 31 mm), common bile duct widening to 6 mm with diffuse wall thickening, and bilateral pleural effusions with a left basal soft-tissue lesion. Pleural fluid analysis showed CA19-9 >1000 U/L, lactate dehydrogenase 856.2 U/L, adenosine deaminase 11.1 U/L, glucose 35 mg/dL, and total protein 4.1 g/dL, consistent with malignant exudative effusion. A prior history of TB and overlapping symptoms created diagnostic anchoring bias. The patient developed sepsis and succumbed before histopathological confirmation. This case underscores the critical importance of tumor marker profiling, multimodal imaging, and early oncologic referral in patients with multifocal skeletal and hepatic lesions, regardless of prior TB history
Copyright (c) 2026 GIRIN RAY, Chandra Paul Gupta, Satyaki Basu https://creativecommons.org/licenses/by-nc-nd/4.0
Silent architects of the jaw: A case series on odontome
Odontomes are the most common benign odontogenic tumors of the jaw, which are usually slow-growing and non-aggressive. They are generally asymptomatic and diagnosed during routine radiographic investigations and are mostly associated with tooth eruption disturbances. Here, in this case series, we report six cases of compound and composite odontoma, with a relevant review of the literature. The present case series report covers cases of odontomes with an age group varying from 20 to 70 years, discussing clinical and radiographic features along with a brief review of the literature.
Copyright (c) 2026 Avika Pareek, Manoj Meena, Pallavi Baghla, Shobhit Kaswan, Kanishka Singh, Aryan Agarwal, Tanishka Choudhary https://creativecommons.org/licenses/by-nc-nd/4.0
Mixed germ cell tumor of the testis in a young adult: A case repo
Testicular germ cell tumors (TGCTs) are the most common solid malignancy in young men aged 15–35 years, with mixed germ cell tumors posing particular diagnostic and staging challenges due to their combined seminomatous and non-seminomatous composition. We report a 22-year-old male who presented with a 4-month history of progressive right scrotal swelling. Imaging revealed bilateral common iliac and paraaortic lymphadenopathy. He underwent right radical orchidectomy. Histopathology confirmed a mixed seminomatous–non-seminomatous germ cell tumor (90% seminoma, 10% embryonal carcinoma) with lymphovascular invasion, staged as pT2 (AJCC 8th Edition). This case underscores the importance of complete pre-operative tumor marker assessment, including serum alpha-fetoprotein, meticulous histopathological sampling, and a multidisciplinary approach for optimal management.
Copyright (c) 2026 Bhushan M Warpe, Shweta S Joshi https://creativecommons.org/licenses/by-nc-nd/4.0
Choriocarcinoma following term pregnancy with successfulsubsequent pregnancy
Gestational trophoblastic neoplasia (GTN) denotes subtypes of gestational trophoblastic disease that have invasion potential, for example, invasive mole. Gestational choriocarcinoma (CC). Gestational CC is an extremely malignant tumor and considered the most common histologic type of GTN encountered following normal pregnancy; however,CC is a potentially curable disease, and the outlook is excellent in most cases. This case report involves clinical management and long-term follow-up of a 32-year-old female who presented 28 days after cesarean delivery with recurrent episodes of massive delayed postpartum hemorrhage. Her evaluation revealed an elevated beta-human chorionic gonadotropin level (36053.9 mIU/mL) and uterine vascular mass on pelvic ultrasound. Diagnosis of CC was confirmed histologically on the specimen retrieved during suction and curettage. The patient received 6 cycles of chemotherapy (vincristine-cisplatin) with a good response. She got pregnant 1 month after the last dose of chemotherapy. Her subsequent pregnancy was uneventful, and she gave birth to a healthy baby at 38 weeks. Such cases display a diagnostic challenge in low-resource settings and concerns regarding fertility preservation in survivors of CC.
Copyright (c) 2026 Mustafa Mohammed Mustafa Abdoalrhman https://creativecommons.org/licenses/by-nc-nd/4.0
Emberyonal Rhabdomyosarcoma of The Prostate In Young Sudanese Male: Case Report
Rhabdomyosarcoma (RMS) is an aggressive soft-tissue cancer. Embryonal RMS (ERMS) is common in when originating in the prostate, usually carrying a poor prognosis. A 15-year-old male from Sudan presented with acute urinary retention. Examination and biopsy confirmed ERMS of the prostate with metastasis to the lungs and pelvic lymph nodes. Despite palliative surgery, transurethral resection of the prostate, and chemotherapy, the patient passedaway 6 months later due to chemotherapy complications. This is the first documented case of prostatic ERMS inSudan. The case underscores the malignancy’s aggressive nature and the critical need for early detection, accurate diagnosis, and multidisciplinary care to improve survival rates.
Copyright (c) 2026 Amer Abbo Hassan, H Basil Amer Abbo, Hatim Osman https://creativecommons.org/licenses/by-nc-nd/4.0
Unusual presentation of antiphospholipid antibody syndrome in ayoung male: Diagnostic and therapeutic challenge
The acquired autoimmune thrombophilia known as antiphospholipid syndrome (APS) or antiphospholipid antibody syndrome is defined by arterial or venous thrombosis in the presence of persistent antiphospholipid antibodies. APS in young guys is uncommon and frequently underdiagnosed because of unusual presentation and multisystem involvement, whereas it is more frequently observed in females, particularly accompanying maternal morbidity, acute abdominal distension, jaundice, and black urine. These were the symptoms observed in a 35-year-old male patient who had no past comorbidities. Massive ascites and hepatocellular dysfunction were found upon examination. Investigations revealed conjugated hyperbilirubinemia, significantly increased liver enzymes, positive lupus anticoagulant, and negative anticardiolipin and anti-β2 glycoprotein I antibodies. Imaging showed severe portal vein thrombosis that extended into the splenic and superior mesenteric veins with mesenteric ischemia, as well as Budd-Chiari syndrome with hepatic vein non-opacification. The patient had hepatic vein stenting after receiving therapeutic anticoagulation with low molecular weight heparin right away. He was switched to acenocoumarol for long-term oral anticoagulation.
Copyright (c) 2026 Harshal Deshbhratar, Udit Narang, Samyak Golchha, Rajashree khot, Ganesh Raut https://creativecommons.org/licenses/by-nc-nd/4.0
A study on clinical significance of facial diagnosis and iris diagnosis in facial palsy: A case report
According to the principles of naturopathy, disease is considered to arise from the accumulation of waste and toxic matter within the body, leading to impaired physiological functioning. Naturopathy emphasizes non-pharmacological interventions aimed at detoxification and restoration of normal bodily functions without adversely affecting vital organs. Facial palsy is one of the most common cranial nerve disorders and presents with characteristic facial asymmetry due to involvement of the facial nerve branches. It is commonly defined as an acute peripheral facial nerve palsy of unknown etiology, with many cases classified as idiopathic. This case report highlights the clinical significance of facial diagnosis and iridology as traditional natural diagnostic tools in the assessment of facial palsy. A 54-year-old male presented with reduced mobility of the left forehead and eyebrows, involuntary blinking of the left eye, facial pigmentation changes, and swelling of the jaw region. Facial diagnostic observations revealed asymmetry, altered facial expressions, and muscle weakness, while iridological examination showed nerve rings and lesions corresponding to facial and neurological regions. The findings suggest that facial diagnosis and iridology may serve as supportive, non-invasive assessment tools in the clinical evaluation of facial palsy.
Copyright (c) 2026 N Vijayaraghavan, P G Ahalya, C Pratap Singh https://creativecommons.org/licenses/by-nc-nd/4.0
Late recurarization after sugammadex in a magnesium-sensitized patient precipitated by clindamycin
Copyright (c) 2026 Kavita Dugg, Sarvjit kaur https://creativecommons.org/licenses/by-nc-nd/4.0
Oral metastasis of occult lung adenocarcinoma presenting as maxillary alveolar swelling: A case report
Metastasis to the oral cavity from pulmonary malignancy is an exceptionally rare event, accounting for 1% of all oral malignancies. This report describes a unique case of a 66-year-old female in whom a destructive non-tender maxillary alveolar swelling served as a singular manifestation of an otherwise occult primary lung adenocarcinoma. The patient presented with a soft, non-tender swelling and a persistent sinus tract despite the extraction of teeth. Radiographs confirmed a 25×24×25 mm irregular mass causing complete erosion of the maxillary alveolus and floor of the right maxillary sinus. Diagnosis was established via biopsy and an immunohistochemical panel, which demonstrated co-positivity for thyroid transcription factor-1 and cytokeratin 7. This confirmed Stage IV disease, necessitating a transition to palliative care. The patient succumbed 2 months after diagnosis. This case underscores the necessity for clinicians to include distant metastasis in the diagnosis of non-healing or aggressive oral lesions, as timely identification is critical for appropriate staging and management.
Copyright (c) 2026 Prakruti Vijay Suthar, Shilpa Jayesh Parikh, Mruga Manoj Joshi, Jigna Sathya Shah https://creativecommons.org/licenses/by-nc-nd/4.0
Hemangiolymphangioma of the cervical region: A rare case report
Hemangiolymphangioma is a rare developmental anomaly. Vascular anomalies are classified under two categories, including vascular tumors and vascular malformations, based on cellular turnover, histology, and clinical features. Hemangioma is an example of a vascular tumor, and lymphangioma is an example of a vascular anomaly. Malformations can be seen in mixed combinations of vascular elements, such as blood and lymph. Histologically, vessels filled with both blood and lymph are named as lymphangiohemangioma or hemangiolymphangioma, depending on the dominant tissue present. This paper reports a case of hemangiolymphangioma in a 20-year-old male patient.
Copyright (c) 2026 Shilpa Bairagi, Sarita Nibhoria, Harmanpreet Kaur, Navjot Kaur, Harman Gill, Kuldeep Singh https://creativecommons.org/licenses/by-nc-nd/4.0
Severe necrotizing methicillin-sensitive Staphylococcus aureuspneumonia, septic shock, and multiorgan failure in a young man withclassical dengue fever: A case report
Dengue fever is one of the most common mosquito-borne viral illnesses worldwide. Although most cases are selflimiting, concomitant bacterial infections may result in severe complications and increased mortality. A 32-year-old previously healthy male presented with a 7-day history of rash over the right side of the neck extending to the occipital region, 4 days of fever, vomiting, malaise, headache, neck swelling with restricted neck movements, and 1 day of cough and shortness of breath. Evaluation revealed neck cellulitis, bilateral pneumonia, thrombocytopenia, acute kidney injury, myocarditis, hepatic dysfunction, and methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia. Dengue immunoglobulin M was positive. Despite initial broad-spectrum antibiotic therapy, the patient developed progressive necrotizing pneumonia requiring mechanical ventilation. Following escalation to targeted antimicrobial therapy together with adjunctive therapy, significant clinical improvement was observed, and the patient was discharged in stable condition. Severe bacterial coinfection should be considered in dengue patients with atypical clinical deterioration. Early recognition and prompt treatment of MSSA-associated necrotizing pneumonia may be life-saving.
Methicillin-sensitive Staphylococcus aureus
Copyright (c) 2026 Lexy Vijayan https://creativecommons.org/licenses/by-nc-nd/4.0
Bimaxillary jaw involvement in pediatric Burkitt lymphoma: A rare case with radiologic–histopathologic–immunohistochemical correlation
Burkitt lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma characterized by rapid proliferation and high chemosensitivity. Bilateral jaw involvement in sporadic BL is rare and may pose a diagnostic challenge. Here, we report the case of a 12-year-old male who presented with rapidly progressive bilateral facial swelling following dental trauma and extraction, with onset noted within 2 days post-extraction. Clinical and radiographic findings revealed diffuse gingival enlargement, loss of lamina dura, and displacement of developing teeth. Histopathological examination demonstrated a characteristic “starry-sky” appearance, while immunohistochemistry confirmed CD20+, CD10+, and LCA+ B-cell lineage with a Ki-67 index approaching 100%. The patient was treated with multi-agent COPADM chemotherapy and showed marked regression within 1 month. Early recognition of atypical oral swellings, especially those with rapid onset following dental procedures, and prompt biopsy are critical for timely diagnosis and effective management of this aggressive yet highly curable malignancy.
Bilateral jaw swelling, Burkitt lymphoma
Copyright (c) 2026 Mruga Manoj Joshi, Shilpa Jayesh Parikh, Prakruti Vijay Suthar, Jigna Sathya Shah https://creativecommons.org/licenses/by-nc-nd/4.0
Achondroplasia - How do I manage this? A case report and review of the literature
Achondroplasia, while being the most common form of disproportionate short stature, is a relatively rare case to encounter during anesthetic practice. With various problems, such as bony anomalies of the vertebral spine and difficult airway, planning anesthetic management of these patients requires special considerations. We report the case of a 54-year-old female with Achondroplasia, with fracture of the neck of the right femur treated by open reduction and internal fixation of the fracture. An appropriate sensory level could not be achieved on administration of spinal anesthesia despite an adequate dosage of Bupivacaine. Subsequently, conversion to general anesthesia was required. Surgery was uneventful, and the patient was discharged from the hospital after 48 h.
Copyright (c) 2026 Gautami Pai, Pabitra Ghoshal https://creativecommons.org/licenses/by-nc-nd/4.0