Helminths are an important cause of parasite infestation in low-resource countries. The Majority spread with soil to skin contact. In unusual patients presenting below 1 year, treatment can be challenging. The disease can be self-limiting, treatment reduces progression to serious disease. Here, we present a three-month-old with Cutaneous Larva Migrans.

A middle-aged Sudanese woman has been presented complained about multiple joint pain, skin rash, chest pain, hair loss, severe abdominal pain associated with abdominal distension, bloody diarrhoea and vomiting. Lab investigation and computed tomography (CT) abdomen revealed the patient have an intussusception on top of SLE. The patient was treated

We present a case of a 37-year-old woman referred to our hospital with a 1-week history of significant weakness, anorexia, and mild abdominal pain. According to laboratory and radiographic data, the patient was diagnosed with perforated appendicitis and gangrene.

Tachycardia and atrial fibrillation are cardiovascular symptoms of Graves’ hyperthyroidism， if left untreated and further deterioration can result in heart failure and liver dysfunction, we describe a female patient to present the continuum of the pathophysiology development, to highlight the hemodynamic variation is dominant contributing factor of Graves’ hyperthyroidism complication

Covid-19 infection may have extrapulmunary manifestations such as blood hypercoagulability that may causes thrombosis in both arterial and venous system.Deep dorsal penile vein thrombosis is very rare and the most common cause is coagulation disorders.It causes penile pain especially during erection and it is diagnosed by ultrasound.

CRPS is a type of severe pain syndrome and can be triggered by previous surgery or trauma. CRPS type II is associated with a confirmed nerve injury. We want to present to your attention a case report of successful treatment of CRPS type II using unilateral epidural stimulation.

Linear IgA/IgG bullous dermatosis (LAGBD) is a rare, autoimmune blistering skin disease. We report a case of LAGBD in a 70-year-old woman. All common treatments were discontinued due to side effects or lack of treatment response. The patient was successfully treated with omalizumab which cleared her lesions after three months.

Thymomas are tumours frequently associated with autoinmune manifestations or immunodeficiencies like Good syndrome. In rare cases, pure white cells aplasia (PWCA) has been described in association with thymomas. PWCA is characterized by agranulocytosis of autoinmune background primary refractory to granulocyte colony-stimulating factor (G-CSF). It is necessary to use inmunosupressor drugs.

Carotid web has been identified as one of the missed causes of recurrent stroke. The diagnosis and management of such cases, impose a challenge to medical practitioners. This etiology should be kept in mind, especially in case of recurrence of stroke in a similar cerebral territory.

Title: Increased Nuchal Translucency: Is Advanced Sequencing the Answer? A Mini Commentary.

Objective: Valve-sparing root replacement is commonly used for management of aortic root aneurysms in elective setting, but its technical complexity hinders its broader adoption for acute Type-A Aortic Dissection (ATAAD). The Florida Sleeve (FS) procedure is a simplified form of valve sparing aortic root reconstruction that does not require coronary reimplantation. Here, we present our outcomes of the Florida Sleeve (FS) repair in patients with dilated roots in the setting of an ATAAD. Methods: We retrospectively reviewed 24 consecutive patients (2002-2018) treated with FS procedure for ATAAD. Demographic, operative, and postoperative outcomes were queried from our institutional database. Long term follow-up was obtained from clinic visits for local patients, and with telephone and telehealth measures otherwise. Results: Mean age was 49 ± 14 years with 19 (79%) males. Marfan syndrome was present in 4 (16.7%) patients and 14 (58.3) had ≥2+ aortic insufficiency (AI). Nine (37.2%) had preoperative mal-perfusion or shock. The FS was combined with hemi-arch replacement in 15 (62.5%) patients and a zone-2 arch replacement in 9 (37.5%) patients. There were 2 (8.3%) early postoperative mortalities. Median follow-up period was 46 months (range; 0.3-146). The median survival of the entire cohort was 143.4 months. One patient (4.2%) required redo aortic valve replacement for unrelated aortic valve endocarditis at 30 months postoperatively. Conclusion: FS is simplified and reproducible valve-sparing root repair. In appropriate patients, it can be applied safely in acute Stanford type-A aortic dissection with excellent early and long-term results.

Atrial Fibrillation (AF) is the most common arrhythmia affecting the general population, with the prevalence projected to reach 12.1 million cases in 2030. Recently, attention has focused on the role of the Left Atrial Appendage (LAA) and its association with the most feared complication of AF: thromboembolism. Common sense indicates that the LAA should be excluded in all patients with AF; however, procedures to exclude the LAA have yet to become the standard of care. Recent studies in the cardiac surgery literature , , indicate a clear benefit of LAA exclusion amongst patients with AF undergoing cardiac surgery. Interestingly, this benefit was found to extend well beyond the postoperative period, in cohorts that were equally anticoagulated and had similar CHA2DS2-VASC scores. It appears reasonable that our medical community should strongly consider initiating a prospective randomized trial in an effort to fully elucidate the need for routine LAA exclusion in this patient population.

The swift advances in interventional cardiology combined with the increasing risk of cardiac surgical procedures resulted in diminishing volume of coronary and valvular surgery and affected the future of cardiac surgery service and training. Application to cardiac surgery training programs have steadily declined. This cross-sectional study aimed at identifying main weakness facing cardiac surgery and advocating some recommendations to improve the status of current and future of cardiac surgery.

Anomalous aortic origin of a coronary artery from the opposite sinus is a rare congenital condition that can cause sudden death in young people. When it is associated with acute aortic dissection, acute myocardial infarction can occur due to enlargement of the sinus of Valsalva. We report the case of a 71-year-old man with anomalous origin of the right coronary artery from the left sinus of Valsalva, who developed right ventricular infarction due to the compression of the right coronary artery between the aorta and pulmonary artery trunk.

The heart transplantation (HT) is undoubtedly the best treatment for end-stage heart failure patients (2). However, the organ shortage remains a major challenge in cardiac surgery. Facing this problem, the medical community starts to extend the donor criteria to select more suitable organs for HT. The use of ECDs is still controversial, since it is associated with a high incidence of primary graft failure (3), and although it guarantees longer survival than without transplantation, there is still some hesitation in accepting this practice.

Background: Thoracic aortic aneurysm is a significant risk factor for aortic dissection and rupture. Guidelines recommend referral of patients to a cardiovascular specialist for periodic surveillance imaging with surgical intervention determined primarily by aneurysm size. We investigated the association between socioeconomic status and surveillance practices in patients with ascending aortic aneurysms. Methods: We retrospectively reviewed records of 465 consecutive patients diagnosed between 2013-2016 with ascending aortic aneurysm ≥4cm on computed tomography scans. Primary outcomes were clinical follow-up with a cardiovascular specialist and aortic surveillance imaging within 2 years following index scan. We stratified patients into quartiles using the area deprivation index (ADI), a validated percentile measure of 17 variables characterizing socioeconomic status at the census block group level. Competing risks analysis was used to determine interquartile differences in risk of death prior to follow up with a cardiovascular specialist. Results: Lower socioeconomic status was associated with significantly lower rates of surveillance imaging and referral to a cardiovascular specialist. On competing risks regression, the ADI quartile with lowest socioeconomic status had lower hazard of follow-up with a cardiologist or cardiac surgeon prior to death (HR 0.46 [0.34, 0.62], p<0.001). Though there were no differences in aneurysm size at time of surgical repair, patients in the lowest socioeconomic quartile were more frequently symptomatic at surgery than other quartiles (92% vs 23-38%, p<0.001). Conclusion: Patients with lower socioeconomic status receive less timely follow-up imaging and specialist referral for thoracic aortic aneurysms, resulting in surgical intervention only when alarming symptoms are already present.

Letter to the Editor: Telemedicine in the era of coronavirus 19: Implications for postoperative care in cardiac surgeryContributing Authors:Anish Verma (Corresponding Author) – Fifth Year Medical StudentRachel Pathimagaraj – Fourth Year Medical StudentDaniel Warrington - Fifth Year Medical StudentJames Whiteway - Fifth Year Medical StudentAll authors are based at the United Kingdom institution, The University of Manchester – Faculty of Biology, Medicine and Health.

ABSTRACT Post infarction ventricular septal rupture (PIVSR) is an infrequent but potentially fatal complication of acute myocardial infarction. • The 30-day mortality rate with the transcatheter approach when performed in the acute phase (less than two weeks) was 25.3% compared to 50% when surgery is performed in the acute phase (within three weeks). • There is no correlation between defect size and mortality. • NYHA class IV and time to VSD closure are risk predictors for transcatheter closure for a 30-day mortality rate of 31.5%.