Journals
2025 EN
Sabir Alifa · Chaudhri Muhammad Sohail · Azam Muhammad
+5 more
ABSTRACT Hardware entrapment during percutaneous coronary intervention is a significant complication necessitating proactive anticipation by interventionists. Here we present a case of a 59‐year‐old man with a history of stent placement in LAD 1 month back, who now presented with stent thrombosis and acute ST‐elevation MI. Percutaneous intervention was done for thrombus aspiration through the previously deployed stent, but the thrombus aspiration device (thrombuster) got stuck in the stent. Despite attempted percutaneous retrieval methods, the device remained inaccessible, leading to emergency surgical device retrieval and simultaneous coronary bypass.
Journals
2025 EN
Lugata John · Makower Laetitia · Rapheal Ashley
+9 more
ABSTRACT Uterine leiomyomas, commonly known as fibroids, are the most prevalent pelvic tumors in females, affecting 20%–30% of women of reproductive age. These fibroids can lead to significant symptoms and morbidity. Vaginal fibroids are rare as primary vaginal tumors; approximately 300 cases have been documented in medical literature to date. Notably, there have been no reports of vaginal leiomyomas in Sub‐Saharan Africa. A 28‐year‐old woman presented to our specialty hospital in Northern Tanzania at 30 weeks and 1 day of gestation with a vaginal mass that had been present since conception. She had a history of a vaginal mass that was excised in 2019 at a regional hospital. Magnetic resonance imaging revealed a soft tissue mass with a necrotic component, variable areas of restriction, and extra pelvic extension. The mass compressed the urinary bladder and vagina, as well as displacing the uterus upward and the rectum to the right side. The mass measured 21.7 × 13.5 × 9.0 cm. Due to premature rupture of membranes and fetal distress, she underwent an emergency cesarean section, and both mother and baby recovered well post‐operatively. Three months later, she returned for excision of the vaginal mass, and the final histological report indicated a vaginal leiomyoma.
Journals
2025 EN
Farooqui Azhar · Alama Mohamed · Antoun Ibrahim
ABSTRACT Managing pericardial effusion in autoimmune diseases like systemic lupus erythematosus becomes particularly challenging when accompanied by pulmonary hypertension (PH). The risk of acute right ventricular overload and hemodynamic collapse makes pericardial drainage a high‐stakes decision. This case highlights the necessity of a multidisciplinary, individualized approach in high‐risk patients. It also underscores the effectiveness of immunosuppressive therapy (e.g., mycophenolate mofetil) and pulmonary vasodilators (e.g., Ambrisentan, Tadalafil) in achieving gradual resolution. Close collaboration with PH specialists is essential for safely navigating these complex cases.
Journals
2025 EN
Memon Maria · Ibrahim Nouman · Khan Muhammad Momin
+5 more
ABSTRACT Prompt identification of Hyperparathyroidism‐Jaw Tumor Syndrome (HPT‐JT) is vital, particularly for those with a family history or unusual symptoms like progressive facial changes. By employing a thorough diagnostic strategy that includes biochemical tests, imaging, and genetic analysis, we can achieve early diagnosis and effective intervention. In this case, the patient displayed maxillofacial tumors, hypercalcemia, and increased parathyroid hormone levels. Imaging confirmed a parathyroid adenoma, while histopathology showed characteristics of brown tumors. Subtotal parathyroidectomy is the recommended treatment. Additionally, regular follow‐ups every 6 months involving biochemical tests and imaging are crucial for ensuring the best patient outcomes.
Journals
2025 EN
Khalil Ibrahim · Hossain Md. Imran
ABSTRACT Brugada syndrome (BrS) is a rare, genetically predisposed arrhythmic disorder associated with an elevated risk of sudden cardiac death (SCD) due to ventricular arrhythmias. Fever is a recognized trigger that can unmask the Type 1 Brugada electrocardiogram (ECG) pattern and precipitate life‐threatening arrhythmias, even in individuals without prior cardiac symptoms. A 38‐year‐old male with no known cardiac history presented with fever, palpitations, and dizziness. His temperature was recorded at 39°C, and a 12‐lead ECG revealed a Type 1 Brugada pattern, confirming a fever‐triggered BrS diagnosis. The patient was promptly treated with antipyretics to reduce fever, followed by isoproterenol infusion to manage recurrent ventricular tachycardia (VT). Initially, amiodarone was administered provisionally due to uncertainty in diagnosing VT as BrS‐related, but it was discontinued upon confirmation of the diagnosis. Despite initial stabilization, he developed episodes of ventricular fibrillation (VF), requiring emergency defibrillation. After fever resolution, an implantable cardioverter‐defibrillator (ICD) was implanted for secondary prevention of SCD. This case highlights the critical role of fever as a precipitating factor in BrS, particularly in young, previously asymptomatic individuals. Febrile states exacerbate sodium channel dysfunction, increasing the likelihood of ventricular arrhythmias and SCD. Early recognition, aggressive fever control, beta‐agonist therapy, and ICD implantation after fever resolution are vital in mitigating risks. Clinicians should maintain a high index of suspicion for BrS in cases of arrhythmias triggered by fever, especially in young and otherwise healthy patients, to prevent fatal outcomes.
Journals
2025 EN
Francis Bernard R. · Arshad Nouman · ElDin Mohammad
+1 more
ABSTRACT ST elevation in aVR on the electrocardiogram (ECG) indicates high‐risk acute coronary syndrome (ACS) but is rarely reported in pulmonary embolisms (PEs). We present a 47‐year‐old female with a history of PE and ankylosing spondylitis admitted for chest pain, nausea, and an episode of possible collapse. Her ECG showed ST elevation in aVR with anterolateral ST depressions, prompting a normal emergency coronary angiogram. Bedside echocardiography revealed right ventricular (RV) dilatation, and lab tests showed elevated D‐dimer levels and troponin. Urgent computed tomography of the pulmonary arteries (CTPA) confirmed large bilateral PEs. The patient was treated with Enoxaparin and transitioned to Warfarin, resulting in symptom improvement. ST‐segment elevation in lead aVR may mimic ACS but suggests significant conditions like PE, often from RV strain and impaired coronary blood flow due to acute RV failure. Clinicians should suspect PE in patients with aVR changes, especially with relevant clinical history and signs of RV pressure overload on echocardiography, to prevent misdiagnosis and ensure timely care.
Journals
2025 EN
Sayedahmed Ahmed · Sherfi Hisham · Elobaid Mohamed
+3 more
ABSTRACT Olmesartan‐associated sprue‐like enteropathy is an uncommon side effect and should be considered as a differential diagnosis in patients who are on Olmesartan and presenting with chronic unexplained diarrhea.
Journals
2025 EN
Mohammadzadeh Saba · Amiri Afsaneh · Hosseinsabet Ali
ABSTRACT In patients with dilated cardiomyopathy, it is important to thoroughly examine the right ventricle for the presence of a thrombus during transthoracic echocardiography, in addition to the left ventricle, especially when left ventricular thrombosis is present.
Journals
2025 EN
Ahmed Ahmed Alshafei Elmahi · Ahmed Mehad Mortada BadrAlden · Ibrahim Aisha Gameraldeen Abdalrhim
+8 more
ABSTRACT Joubert Syndrome's rarity and diagnostic complexity, especially in Sudan, pose significant challenges in low‐resource settings. Sibling cases with neurodevelopmental delays and MRI‐confirmed molar tooth sign highlight the urgent need for heightened clinical suspicion, accessible neuroimaging, and genetic counseling to address underdiagnosis in underrepresented populations.
Journals
2025 EN
Ibrahim Muzafar · Mohamed Osama
ABSTRACT Gunshot injuries to the external genitalia are rare but may lead to urethral strictures, significantly affecting quality of life. Treating anterior urethral strictures from such trauma is challenging, particularly when delayed, due to tissue loss and fibrosis. Historically, staged urethroplasty using buccal mucosa graft (BMG) or penile skin grafts was the standard. However, single‐stage urethroplasty using a combination of BMG and penile skin flap is gaining attention as a viable alternative. A 30‐year‐old male soldier from eastern Sudan sustained a gunshot wound to the genital area 3 months ago, resulting in distal penile and right testicular injuries. Initial management included right scrotal exploration, testicular repair, and suprapubic catheter. Upon presentation, he reported mild penile pain, inability to achieve erection, and normal scrotal wound healing. Examination revealed a 3‐cm hard nodule in the distal penile shaft. Retrograde urethrogram (RGU) showed a 2‐cm tight distal penile urethral stricture. The patient underwent single‐stage urethroplasty. A circumferential incision was made, and the fibrotic urethra and corpora cavernosa were excised. A 4‐cm BMG was harvested and quilted to the corpora cavernosa, and a 6‐cm vascularized dorsal penile skin flap was rotated to reconstruct the urethra. At 2‐month follow‐up, the patient exhibited satisfactory urine flow (Q max 23 mL/s), mild post‐void dribbling, and subjectively experienced a progressive improvement in potency. Postoperative RGU confirmed the restoration of normal urethral caliber. This case demonstrated that single‐stage urethroplasty using a penile skin flap and buccal mucosa graft is a practical and effective approach for traumatic distal penile urethral strictures, even in low‐resource, conflict settings and where advanced surgical expertise is unavailable.