Sympathetic crashing acute pulmonary edema following pacemaker insertion.

Key Clinical Message: Sympathetic crashing acute pulmonary edema (SCAPE) complicating pacemaker implantation is a very uncommon and dangerous occurrence. Following pacemaker implantation, patients need stringent monitoring, and compelling evidence about SCAPE treatment is required. Abstract: Sympathetic crashing acute pulmonary edema complicating a pacemaker insertion as the case in our patient is extremely rare. We report a case of 75-year-old man with a complete AV block, which requires urgent pacemaker implantation. Half an hour following the insertion of the pacemaker, an abrupt SCAPE emerged and the patient was incubated immediately.

Type 3 of progressive familial intrahepatic cholestasis (PFIC-3): Case report.

Genetic testing should always be advised in both parents and children of families with progressive familial intrahepatic cholestasis as early detection will provide more options to a better qualitative life.

Misdiagnosis of a Massive and Advanced Seminoma as an Inguinal Hernia: A Case Report.

Misdiagnosing a seminoma as an inguinal hernia is an uncommon medical concern. A 22-year-old male presented with an enlarged, painless lump in the right scrotum above the right testis. He had previously been given a diagnosis of inguinal hernia by a general practitioner in a rural area two years ago. Pelvic trauma had never occurred before. Scrotal ultrasonography revealed that his right testis was hypoechoic, asymmetrical, and solidly enlarged. A radical orchiectomy was done to remove the tumor. A histological examination of the mass confirmed the diagnosis of classical seminoma. Six months later, the patient had no complications and was in good condition. General practitioners must be more mindful of this tumor, particularly its presentation, since seminoma tumors might be misdiagnosed as an inguinal hernia. This is necessary to preserve the reproductive organs and achieve good outcomes.

Knowledge, attitudes, and practices related to COVID-19 infection, related behavior, antibiotics usage, and resistance among Syrian population: A cross-sectional study.

Background and Aims: Antibiotic resistance is seen as a worldwide health risk as a result of the overuse of antibiotics. Many countries noted that antibiotic usage was high during the COVID-19 pandemic. The purpose of this study is to evaluate Syrians' knowledge, attitudes, and practice about the use of antibiotics and antibiotic resistance during the COVID-19 epidemic. Methods: A cross-sectional study was conducted using an online questionnaire to collect the data from the Syrian population from February 5 to March 4, 2022. Syrians 18 years or older all over the world were able to participate in this study. A convenience snowball sampling method was used. SPSS version 20.0 was used to analyze the data. To examine the results, binominal logistic regression was used. Statistical significance was defined as a p < 0.05. Results: Out of 2406 respondents, 60.2% knew that transmission of COVID-19 could occur even if the patient has not developed any symptoms, and 91.6% were able to recognize the main clinical symptoms of COVID-19. There was a statistically significant difference between male and female knowledge of COVID-19 (p = 0.002), with males having 3.78 ± 2.1 (2.7-3.87) and females scoring 3.93 ± 2.3 (3.7-4.1). Newly graduated students have more knowledge of COVID-19 than other subtypes of Job (p = 0.0001), and those with medical practice are more knowledgeable than those without (p = 0.0001). Only 16.6% answered that taking antibiotics would not speed up the recovery from all the infections. 65.3% answered correctly that misuse of antibiotics could cause antibiotic resistance. Conclusion: Our study concluded that the Syrian population demonstrated good knowledge of COVID-19 and moderate acceptance of the new norm. Knowledge regarding antibiotic use and resistance and practice of preventive measures was poor, which can encourage the health authorities to develop community education programs to increase public awareness of the usage of antibiotics and safety protocols during the COVID-19 pandemic.

A rare coincidence of Turner syndrome and bronchiectasis: A case report.

Similar to bronchiectasis, Turner syndrome is possible to have more pathological manifestations or etiologies than what has already been documented. Slower recovery process is expected when treating a patient with several comorbidities like Turner syndrome. Turner syndrome patients are vulnerable and should be extensively monitored to lower late presentation rates.

Stage IV uterine leiomyosarcoma resection: A case report.

We present a case of stage IV uterine leiomyosarcoma that was treated with total hysterectomy, bilateral salpingo-oophorectomy, and extensive resection of a 14 kg abdominal mass, as well as complete eradication of accompanying symptoms. This case may prompt researchers to look for other surgical solutions to similar issues.

Cerebrovascular accident after transurethral resection of the prostate: A rare complication.

INTRODUCTION: Benign prostatic hyperplasia is considered a worldwide disease among males in middle age. Transurethral resection of the prostate (TURP) is a wide used intervention for this condition. A few reports mentioned cerebrovascular accidents after TURP. PRESENTATION OF CASE: A 65-year-old male presented with recurrent urinary retention in the past two years. Clinical examination showed a full urinary bladder with abdominal discomfort. Abdominal ultrasound revealed an enlarged prostate (90 ml) with approximately 500 ml of urine. After that, we performed transurethral resection of the prostate (TURP). The surgery was uneventful. After three days of discharge, he presented with a loss of vision in the left eye and left lower limb pain. Computed tomography of the brain showed right occipital lobe infarction. Ultrasound of the left lower limb revealed deep venous thrombosis. Echocardiography showed a patent foramen ovale. As a result, he had deep venous thrombosis with patent foramen ovale that led to infarction. We started with anticoagulants for two weeks. Later, he reclaimed his vision completely. CLINICAL DISCUSSION: Cerebral vascular accidents are a rare complication of transurethral resection of the prostate. Early recognition and diagnosis of this condition will lead to good results. Searching for cardiac anomalies is the first step to reaching the diagnosis. CONCLUSION: Urologists should suspect cardiac anomalies in patients who underwent TURP surgery and develop cerebrovascular accidents. Collaboration with other specialties is considered basic to help with this complication.

Chronic gastric dilatation with gastric fundus perforation in anorexia nervosa patient.

INTRODUCTION: As a complication of anorexia or bulimia nervosa, gastrointestinal problems such as stomach dilatation and necrosis are extremely rare. Our purpose is this case to pay attention on anorexia and bulimia patients to envisage the occurrence of chronic digestive injuries by performing the accurate diagnosis and selective prompt treatment. CASE PRESENTATION: A 40-year old female patient admitted to the emergency department with complaints of digestive symptoms. In his history there was just anorexia nervosa. Computed tomography and X-rays showed major gastric distension reaching the pelvis and perforation of the fundus. The large curvature of the stomach and the necrotic part was removed surgically. But the patient died in the second day after admission in the hospital because he was affected by a septic shock as a complication of distribution the infection because the doctors didn't resect whole the stomach during the open surgery. DISCUSSION: We report a rare case that shows gastric dilatation and necrosis post-anorexia nervosa, which requires accurate X-ray and CT scan, but treatment depends on whether or not gastric necrosis is present and the size of the necrosis. According to what mentioned in the medical literature this is the second case that cause death of the patient after surgery for treatment the gastric dilatation as a complication of anorexia nervosa. CONCLUSION: The thing that distinguishes this case is the large size of the extension of the stomach from the diaphragm to the pelvis and the perforation of the fundus with a diameter of 5 cm and the death of the patient after surgery, so we can add it in the medical literature to avoid the complications of these psychiatric diseases.

A large femoral primary cutaneous Ewing's sarcoma in a 35-year-old woman: Case report.

INTRODUCTION: Extraskeletal Ewing's sarcoma is a rare malignant tumor of mesenchymal origin, which is histologically similar to primary osseous Ewing's sarcoma. It has been well described in deep soft tissues. However, location in cutaneous or subcutaneous tissue has rarely been reported. Being seen principally in children, it can be seen, rarely, in old men. CASE PRESENTATION: We present a case of large primary cutaneous Ewing sarcoma within the left thigh of a 35-year-old woman, without osseous involvement. Physical examination. Histologically, it was a small round cell tumor that marked strongly for CD99. The diagnosis of cutaneous Ewing sarcoma was performed. DISCUSSION: The things that distinguish our case are that it is the first case in Syria, in addition to the size of the large tumor with diameters of 15 × 20 cm, and it is in a 35-year-old woman. CONCLUSION: Ewing sarcoma is a rare malignant small round cell tumor of the skin and subcutaneous tissue. It should be differentiated from other cutaneous neoplasms composed of small round cells.