Distinguishing Hemophagocytic Lymphohistiocytosis, Immune Reconstitution Inflammatory Syndrome, and HIV-Associated Immune Thrombocytopenic Purpura: A Challenging Case of Thrombocytopenia in AIDS.

Thrombocytopenia is a frequent hematologic complication in advanced HIV/AIDS, presenting significant diagnostic challenges due to overlapping etiologies. Hemophagocytic lymphohistiocytosis (HLH), immune reconstitution inflammatory syndrome (IRIS), and HIV-associated immune thrombocytopenic purpura (HIV-ITP) can all manifest with overlapping clinical features, which, despite their differing frequencies, may complicate diagnosis and management. We present a case of a 33-year-old male patient with advanced HIV/AIDS, metastatic Kaposi sarcoma, and inconsistent antiretroviral therapy (ART) adherence, who developed progressive thrombocytopenia, anemia, and pancytopenia.

Alice in Wonderland Syndrome in a Child Following Epstein-Barr Virus Infection: A Case Report.

Alice in Wonderland syndrome (AIWS) is a rare and often underrecognized neuropsychiatric phenomenon characterized by transient episodes of visual and somatosensory perceptual distortions, including micropsia, macropsia, altered body image, derealization, and disrupted perception of time. It most commonly affects children and adolescents and can be triggered by various conditions, including migraine, epilepsy, medications, and infections. We present the case of a 10-year-old previously healthy girl who developed intermittent episodes of micropsia, time distortion, and depersonalization shortly after recovering from a self-limited febrile illness.

Significant Improvement of Fibromyalgia Symptoms With Osteopathic Manipulative Treatment: A Case Report.

Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive dysfunction. While pharmacologic therapies and lifestyle modifications are commonly used, many patients experience suboptimal relief. We present the case of a 41-year-old African American female with a seven-year history of fibromyalgia, who sought care in a family medicine clinic for persistent pain, fatigue, and functional impairment despite ongoing pharmacologic management.

Atypical Presentation of Bordetella pertussis in a Six-Month-Old with Cleaved Lymphocytes and Mild Respiratory Distress.

, the causative agent of whooping cough, typically presents in infants with paroxysmal coughing, inspiratory whoop, and post-tussive vomiting; however, atypical presentations are increasingly recognized, particularly in partially or recently immunized individuals. We present the case of a six-month-old previously healthy, fully immunized female infant who was evaluated for a three-day history of low-grade fever, feeding difficulties, increased irritability, and mild respiratory symptoms, in the absence of the characteristic pertussis cough or respiratory distress. Physical examination was largely unremarkable, with no signs of cyanosis, retractions, or abnormal lung sounds.

Co-presentation of Cotard's Syndrome and Autohemophagia: A Report of a Rare Case.

Cotard's syndrome is a rare neuropsychiatric condition characterized by nihilistic delusions in which patients believe they are dead, do not exist, or have lost their internal organs or bodily functions. Autohemophagia, the act of consuming one's own blood, is an exceedingly uncommon behavior often associated with underlying psychiatric pathology, particularly within the spectrum of psychosis or severe personality disturbance. We present the case of a 28-year-old female who presented with profound nihilistic delusions consistent with Cotard's syndrome, alongside repeated acts of deliberate self-injury followed by ingestion of her own blood.

Abdominal and pelvic surgery in traumatic brain injury patients; a registry-based retrospective analysis.

Background: Concurrent injuries with traumatic brain injury (TBI) can significantly impact patient prognosis. Abdominal and pelvic injuries accompanying TBI are infrequent and less discussed. We aimed to investigate the characteristics and outcomes of TBI patients who underwent abdominopelvic surgeries.

Phenobarbital versus valproate for generalized convulsive status epilepticus in adults. An updated systematic review and meta-analysis.

Background And Objectives: Status epilepticus (SE) is a neurological emergency with significant mortality and morbidity with generalized convulsive SE (GCSE) being the most prevalent. A meta-analysis reported an overall mortality rate of 15.9 % in adults and 3.

From Brew to Bronchoscopy: A Case of Hyponatremia That Was Anything but Basic.

We present the case of a 53-year-old female with a history of chronic alcohol use, hypertension, chronic obstructive pulmonary disease (COPD), and significant smoking history, who presented with severe hyponatremia. Initial laboratory studies revealed a sodium level of 115 mEq/L. The patient reported chronic vomiting, poor oral intake, and heavy alcohol consumption.

Nonlinear optical dynamics and complex wave structures in nonlinear dispersive media.

The research focuses on optical solitons and employs the generalized auxiliary equation technique to obtain soliton resolutions for the nonlinear Kairat-X equation. This equation considers wave number groups influenced by time and velocity dispersion in non-linear mediums. Because of their stability and numerous uses in signal processing, telecommunications, and quantum physics, optical solitons are appreciated.

Atypical Presentation of Moyamoya Disease Presenting With Severe Headache: A Case Report.

Moyamoya disease (MMD) is a rare and progressive cerebrovascular disorder characterized by the stenosis or occlusion of the terminal portions of the internal carotid arteries, accompanied by the formation of a compensatory network of abnormal collateral vessels at the base of the brain. The disease commonly presents with transient ischemic attacks (TIAs), ischemic and hemorrhagic strokes, seizures, cognitive impairments, and headaches. While most cases manifest in childhood or early adulthood, atypical or delayed presentations have been reported.

Postoperative complications of anterior cervical discectomy and fusion: A comprehensive systematic review and meta-analysis.

Background: Anterior cervical discectomy and fusion (ACDF) is one of the most frequently performed spine procedures for different indications in the cervical spine. Various postoperative complications have been reported following the ACDF. This systematic review and meta-analysis aimed to calculate the incidence rate of different postoperative complications associated with ACDF surgery and also identify underlying risk factors for each complication.

Monkeypox in a Non-endemic Setting: Challenges in the Diagnosis and Management of an Atypical Case.

Monkeypox is a zoonotic viral disease caused by the monkeypox virus, an Orthopoxvirus closely related to smallpox. While historically confined to endemic regions in Africa, recent outbreaks have demonstrated its capacity to spread globally, posing significant diagnostic and therapeutic challenges. We present the case of a 28-year-old previously healthy Caucasian male who repeatedly sought care in the emergency department (ED) for nonspecific flu-like symptoms, including fever, lymphadenopathy, dysphagia, and a progressive vesiculopustular rash.

Fully endoscopic microvascular decompression for hemifacial spasm: a systematic review.

Hemifacial spasm (HFS) is a distressing condition caused by facial nerve compression and characterized by involuntary facial muscle twitching, adversely impacting quality of life. Microvascular decompression (MVD) is effective but poses risks. Fully endoscopic MVD (E-MVD) as an emerging technique offers enhanced safety and efficacy.

Performance of Machine Learning Models in Predicting BRAF Alterations Using Imaging Data in Low-Grade Glioma: A Systematic Review and Meta-Analysis.

Background: Understanding the BRAF alterations preoperatively could remarkably assist in predicting tumor behavior, which leads to a more precise prognostication and management strategy. Recent advances in artificial intelligence (AI) have resulted in effective predictive models. Therefore, for the first time, this study aimed to review the performance of machine learning and deep learning models in predicting the BRAF alterations in low-grade gliomas (LGGs)using imaging data.

Performance of Radiomics-based machine learning and deep learning-based methods in the prediction of tumor grade in meningioma: a systematic review and meta-analysis.

Currently, the World Health Organization (WHO) grade of meningiomas is determined based on the biopsy results. Therefore, accurate non-invasive preoperative grading could significantly improve treatment planning and patient outcomes. Considering recent advances in machine learning (ML) and deep learning (DL), this meta-analysis aimed to evaluate the performance of these models in predicting the WHO meningioma grade using imaging data.

A scoping review on the obstacles faced by beta thalassemia major patients in Pakistan- Matter of policy investment.

Beta-thalassemia major (β-TM) is a genetic disorder, prevalent especially in the Mediterranean region, Southeast Asia, and the Indian subcontinent. With improvements in management over the years, β-TM has transitioned from a fatal childhood disease to a chronic condition. However, in Pakistan, there is still a lack of a comprehensive national policy and strategic plan, which has resulted in a growing number of β-TM patients, placing a substantial burden on individuals and the national healthcare system.

Characteristics and recovery trends of severe TBI patients with a favorable functional outcome at 6-month follow-up.

Traumatic Brain Injury (TBI) is a devastating cause of death and disability. Outcomes following TBI have been extensively studied; however, less attention has been given to identifying characteristics of individuals who have a favorable outcome following severe TBI. We conducted a retrospective analysis of a database containing information on TBI patients admitted to a level 1 trauma center between 2015 and 2021.

Development of a simple prediction model for tracheostomy requirement after surgical resection of medulloblastoma in children.

Objective: Postoperative tracheostomy is a significant complication following medulloblastoma (MB) resection. This study aimed to develop a predictive model for postoperative tracheostomy requirement in children undergoing MB surgical resection. This model was derived as a side product of a larger research project analyzing surgical outcomes in pediatric MB patients.

Challenges in the Diagnosis and Management of Renal Cell Carcinoma With Sarcomatoid Differentiation: A Case Report.

Metastatic sarcomatoid renal cell carcinoma (sRCC) is a significant therapeutic and diagnostic challenge due to its rarity and aggressiveness, which contribute to its poor prognosis. This case report presents the case of a 47-year-old Caucasian man with shortness of breath and right-sided abdominal pain. History revealed an extensive smoking history, a left renal mass diagnosed two months ago with inconclusive results, and an enlarged mass on computed tomography (CT) scan one week ago in an emergency department (ED) visit that showed signs consistent with metastatic disease.

Histopathological Complexities and Diagnostic Challenges in Familial Adenomatous Polyposis: A Case Report.

Familial adenomatous polyposis (FAP) is a rare inherited disorder characterized by numerous adenomatous polyps throughout the colon and rectum, leading to a significantly increased risk of colorectal cancer. We present the case of a 19-year-old male patient with a known family history of FAP who presented with recurrent lower abdominal pain, altered bowel habits, and rectal bleeding. Initial examination identified rectal polyps, and subsequent colonoscopy revealed multiple adenomatous polyps.

Characteristics and outcome of patients requiring Decompressive Craniectomy for Traumatic Brain Injury: a retrospective analysis.

Brain swelling after Traumatic Brain Injury (TBI) can elevate intracranial pressure, necessitating Decompressive Craniectomy (DC) as the preferred surgical intervention. This study aimed to analyze a large institutional database to identify clinical characteristics of patients requiring primary DC and their outcomes. We reviewed TBI patients admitted to our center from 2015 to 2021, utilizing a prospectively maintained registry.

Hypercalcemia-Associated Hodgkin's Lymphoma Presenting as Normal Pressure Hydrocephalus: A Case Report.

Hodgkin's lymphoma is a malignancy of the lymphatic system that can rarely present with advanced-stage features such as spinal cord involvement and hypercalcemia. We present the case of a 63-year-old Caucasian male with advanced Hodgkin's lymphoma, presenting with hypercalcemia and symptoms resembling normal pressure hydrocephalus. The patient exhibited gait impairment, altered mental status, and urinary incontinence, forming the classic triad seen in normal pressure hydrocephalus.