Carotid artery dissection should be considered in the differential diagnosis when a clinician face with a case presenting with an unilateral Purtscher-like retinopathy.

Chronic Diarrhea as a Presentation of Behçet’s DiseaseMarawan Elmassry MD1*, Sayed Matar MD2, Jerapas Thongpiya MD1, Pitchaporn Yingchoncharoen MD1, Mostafa Abohelwa MD1, Sameer Islam MD31-Department of Internal Medicine, Texas Tech university Health Sciences Centre, Lubbock, TX, USA.2- Department of Pathology, Brigham and Women Hospital, Harvard Medical School, Boston, MA, USA.3- Department of Gastroenterology and Hepatology, Texas Tech university Health Sciences Centre, Lubbock, TX, USA.*Corresponding Author: Marawan Elmassry MDTexas Tech University Health Sciences Centre at Lubbock, Texas, USA.3601 4th street, Lubbock, TX 79430.Telephone/ Fax: +1-806-773-2831E-mail: [email protected] of interest: The authors have no financial conflicts to disclose.Patient’s consent: Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.

Although the incidence of hematological toxicity due to FTD/TPI treatment is high, the incidence of severe adverse events has been reported to be relatively low. However, it should be noted that patients with renal impairment are prone to severe hematological adverse events.

Some peritoneal dialysis catheter infections cannot be detected via a physical examination. Ultrasonography can aid in the diagnosis of such infections.

Introduction Survival is dismal for the 40-60% of children with MDS who relapse post allogeneic HCT1,2,3. Strategies to decrease relapse risk include use of cytoreduction prior to HCT or maintenance treatment after HCT, data on the utility of these approaches remains limited4-12. Rapid withdrawal of immune suppression or use of donor lymphocyte infusion (DLI) can enhance the graft versus leukemia effect and achieve disease control in some cases13,14. Addition of hypomethylating agents to DLI may provide additional benefit15 and second HCT should be considered16-21. While several novel therapies may alter the future landscape of MDS therapy22-28 (Table 1), the optimal approach to relapsed pediatric MDS remains unclear. We report the management of a child who relapsed less than 70 days after initial HCT. Our approach demonstrates that multimodal therapy may permit prolonged survival with excellent quality of life (QOL) despite lack of long-term cure.

1. INTRODUCTIONOsteochondromas (OC) are benign tumors that account for 20-50% of benign and 10% of all bone tumors. The incidence rate of OC in males is twice that of females and its peak is usually in the second decade of life (1). These lesions are inherited in an autosomal dominant manner and cause the formation of isolated lesions or multiple exostoses during the development of bones in the process of enchondral ossification in the long bones (2). Also, OC is associated with the mutation of some tumor suppressor genes, including EXT1 or EXT2 genes. OC have a periosteal origin and are formed in the active parts of bones, including the metaphysis of long bones and the cartilage at their ends. Studies show that OC can be caused after surgery/radiation-induced injury and hematopoietic stem cell transplantation (3).Osteocartilaginous exostosis is mainly detected in childhood and in the form of palpable masses, with chronic pain and sometimes with edema (4). The presence of misplaced bone masses in the joint capsule and sometimes with cartilaginous coating in radiographic images is one of its common manifestations. The most common joints involved in OC are the hip and knee joints. Patellar OC is rare and mostly affects the patellar bursa. Moraes et al. (2014) reported a patellar OC measuring 8 × 6 × 3 cm anterior to the patella in a 60-year-old man who was painless and without limitation of flexion-extension in the knee joint (5). In the present case, rare retro-patellar OC was observed in the area of the patellar ligament.

Nemaline myopathies (NEM) are heterogeneous congenital muscle disorders that cause skeletal muscle weakness and in the most severe cases, death.We describe a neonatal patient presenting with hypotonia and muscle biopsy showing nemaline myopathy. Genetic testing identified a de novo variant c.43G>C (p.Asp15His) in theTPM3 gene not previously described

Nasal packing constitutes a common step in nasal procedures. A correct fixation is of uttermost importance to avoid posterior dislocation and aspiration. This case report highlights the risk of acute airway situations involving nasal packs and discuses common errors that should be avoided to prevent this life-threatening complication.

In open bite cases, a comprehensive diagnostic differentiation is crucial in determining the best corrective therapy. In non-surgical open bite treatment, fixed appliances, either labial or lingual, are usually employed. With the addition of extra-radicular screws, more sophisticated orthodontic movements may now be performed without the necessity for orthognathic surgery.

Delayed cerebellar ataxia induced by Plasmodium falciparum malaria: A rare complicationEmmanuel Edwar Siddig1,2,*, Sarah Misbah EL-Sadig3, Hala Fathi Eltigani1, Ahmed Mudawi Musa4, Nouh Saad Mohamed5, Ayman Ahmed4,6,71 Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan2 Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.3 Faculty of Medicine, University of Khartoum, Khartoum, Sudan4 Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan5 Molecular Biology Unit, Sirius Training and Research Centre, Khartoum, Sudan6 Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil 4123, Switzerland7 University of Basel, Petersplatz 1, Basel 4001, Switzerland* Correspondance: Emmanuel Edwar Siddig; University of Khartoum, Khartoum, Sudan.Email: [email protected]: 0000-0001-6314-7374

We report on pregnant woman affected by NF1 and HIV infection. So far, both NF1 and HIV in pregnancy had never reported. During 7-year follow-up, she experienced 4 pregnancies without any complication linked to NF1. The newborns were HIV-negative. A multidisciplinary counseling could improve ante and post-partum management.

Primary pulmonary synovial sarcoma (SS) is a rare neoplasm. Its clinicoradiologic attributes are not yet well defined. We report the observation of a patient followed for primary pulmonary synovial sarcoma. we report the radio-clinical features of this rare tumor.

We describe a case of ICM implantation in a 74-year-old woman with SIT and ESUS for detection of AF. ICM implantation was performed successfully without any complications. AF was detected at 28 days after ICM insertion. ICMs can be safely implanted in patients with SIT, allowing successful detection of AF.

Device insertion is a common cardiovascular procedure. Devices are implanted into the right heart; which is a safeguard against systemic thromboembolism. Lead insertion into the left ventricle is rare. This is a case of a defibrillator lead inadvertently inserted into the left cavity. This was discovered 6 years later.

Pediatric patients undergoing chemotherapy may present upper airway obstruction due to severe oral mucositis. Although reversible, its clinical course correlates with the course of neutropenia and may be complicated. Thus, airway management in these patients must be determined on an individual case basis.

A 34-year-old woman with breast cancer and the BRCA2: p.Gln3047Ter was treated with olaparib. After tumor progression, cancer genomic profiling testing revealed the BRCA2 p.Gln3047Ter and p.Gln3047Tyr, with 48.9% and 0.37% allele frequency, respectively. These findings shed light on reversion mutation as a resistance mechanism to olaparib in breast cancer.

Acute aortic dissection with coronary malperfusion is a life-threatening disease, resulting in demanding postoperative management. We report a successful insertion of percutaneous heart pump Impella through the intact true lumen in a patient with residual aortic dissection after the graft replacement and its recovery from the post-cardiotomy cardiogenic shock.

A Case of Trichotillomania (TTM) and Bulimia Nervosa (BN) in a Patient with Adult-Onset Attention-Deficit/Hyperactivity Disorder (ADHD)