A 24-year-old male defence personnel reported to the casualty department of our institution around 2:45 a.m. after a suicidal attempt by his service rifle during his night duty hours. The appearance was very horrific with total disfigured anatomy of the left half of his face [Figure 1]. His general medical condition was poor with vitals recorded […]
Read MoreA 60-year-old game-keeper with a medical history of mild depression presented to his local primary care centre with a high-velocity GSW to his face, following an attempted suicide with a shotgun. The practice immediately called for an ambulance and the air ambulance and ground team were mobilised. The first responder was at the scene 7 min […]
Read MoreA four year old girl was brought to her pediatrician by her parents because of intermittent bilious emesis, which had started two weeks earlier. There were no other changes in her bowel or bladder habits, and she had not lost weight. Her parents reported that she occasionally pulled at and ate her hair, but they […]
Read MoreA 33 year old woman, para 2, presented to the emergency department with a report of vaginal bleeding and abdominal pain of several days’ duration. She had no history of pelvic inflammatory disease. Right adnexal tenderness was noted on physical examination. On screening, the serum β human chorionic gonadotropin level was 47,281 IU per liter, […]
Read MoreA 55 year old woman with a long history of hypertension presented to the hospital with a 1-day history of periorbital discomfort, inferior chemosis, and conjunctival injection of the left eye (Panel A). She reported having a 2-year history of episodic headache and pulsatile tinnitus in the left ear. Examination of the left eye revealed […]
Read MoreFigure 1 A 38-year-old woman’s left thumb was amputated by a boat propeller while she was scuba diving, and it was not retrieved. Panel A shows her left hand three weeks after the accident. Four months after the accident skin from the groin was attached to the thumb stump and web area, and three months later […]
Read MoreHeterotopic heart transplantation (HHT) is a surgical procedure that allows the graft to be connected to the native heart in a parallel fashion to provide a kind of biological biventricular support. Performed first in a human being by Barnard in 1974, this surgical technique was a useful approach during the precyclosporin era as it reduced […]
Read MoreA 26 year old woman presented with pain and discoloration in the fingertips of both hands on exposure to cold (Panels A and B) . She had had the same symptoms every winter for the past decade. The patient’s history and physical examination revealed no signs or symptoms suggestive of systemic lupus erythematosus or scleroderma. […]
Read MoreThis scanning electron micrograph shows a human spermatozoon contacting a hamster egg (×13,200). The ability of a patient’s spermatozoa to penetrate hamster eggs is used in an assay to measure male fertility. In the assay, a number of hamster eggs are exposed to spermatozoa. The penetration of more than 10 to 25 percent of the […]
Read MoreA 42 year old woman presented with nearly complete defects of the left auricular and lateral temporal bone as a result of advanced basal-cell carcinoma. She did not want an adhesive auricular prosthesis and was not a candidate for traditional repair techniques because of trauma and irradiation damage to the postauricular skin. A prelaminated radial […]
Read MoreA 67-year-old man presented with a large right inguinal mass that had progressed in size for 25 years. Eighteen years earlier, he had been hospitalized in a general surgery clinic with an inguinal hernia but declined surgical repair because of concern about the complications associated with the procedure. He returned to the clinic after an […]
Read MoreA 10 year old Kenyan girl presented with abdominal pain that had grown progressively worse over a period of 3 days. Nonprojectile, nonbloody vomiting and abdominal distention had also developed. On examination, she was cachectic, with a distended abdomen and a soft, tender mass at the right iliac fossa that was associated with guarding and […]
Read MoreA 34-year-old female, Gravida 4 Parity 3+0, was seen in the emergency room of a tertiary care hospital, in Karachi, with labor pains. She had all previous uneventful vaginal deliveries with healthy and alive babies. The baby was the fourth outcome of a consanguineous marriage, the couple being maternal first cousins. The parents did not […]
Read MoreVassilios Lougaris, Vincenzo Salpietro, Maricia Cutrupi, Manuela Baronio, Daniele Moratto, M. R. Pizzino, Kshitij Mankad, Silvana Briuglia, Carmelo Salpietro & Alessandro Plebani We report the case of a 15 years old girl with Proteus syndrome and describe novel immunological findings in PS. The index patient, born to non consanguineous parents, was born via caesarian section at 36 weeks of gestation, with normal weight and length (3500 g and […]
Read MoreA 57-year-old man with a 5-year history of intermittent edema of the legs was admitted to the hospital because of varices in the right abdominal and chest walls (Panel A). The varices had been gradually increasing in size and number over a period of 18 years. Abnormal results of laboratory tests included a total bilirubin […]
Read MoreA 37-year-old Chinese woman presented to our department four years and 11 months ago with bilateral lower limb crush injuries sustained in a traffic accident. The lower limb injuries were at different anatomic levels (Figure 1A-C). On the right side, her lower limb was crushed from her hip joint to 16cm below her knee joint, but the […]
Read MoreA 41-year-old woman presented to the ophthalmology clinic with a 2-month history of intermittent pain, blurry vision, and sensitivity to light in her left eye. She wore monthly disposable soft contact lenses that she kept in her eyes while swimming and showering. The patient had difficulty keeping her left eye open during the physical examination, […]
Read MoreA 17-year-old boy presented with a 1-week history of proptosis of the left eye. Physical examination revealed a tumor involving the periorbital region (Panel A). Magnetic resonance imaging revealed an orbital mass (Panel B). Laboratory test results included a hemoglobin level of 89 g per liter, a platelet count of 90,000 per cubic millimeter, and […]
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