Hiatal Hernia With Ulcer at the Gastroesophageal Junction Presenting With Progressive Dysphagia and Epigastric Pain: A Case Report.

A hiatal hernia occurs when the contents of the abdominal cavity, most often the stomach, protrude into the chest cavity through the esophageal hiatus. The hiatus is an elliptical-shaped outlet, typically formed by parts of the right diaphragmatic crus surrounding the distal esophagus. This ailment can transpire due to either the broadening of the specific diaphragmatic opening or a shortening in the overall length of the esophagus, leading to herniation of the stomach into the thoracic region. Raised pressure in the abdominal region may also be one of the culprits. Patients with a hiatal hernia usually remain asymptomatic, but patients might have difficulty swallowing both liquids and solids in the advanced stages of the disease. The disease is rarely accompanied by reflux of gastric acid into the esophagus due to decreased activity of the lower esophageal sphincter, leading to increased complaints of epigastric pain and ulceration near the gastroesophageal junction. Long-standing cases can increase the risk of developing Barrett's esophagus with dysplasia, which may advance to esophageal carcinoma in later stages. Advanced age and obesity are significant risk factors for hiatal hernia. Obese individuals, in particular, experience higher intra-abdominal pressure, which significantly raises the likelihood of developing a hiatal hernia. The hernia may be diagnosed through an upper gastrointestinal endoscopy or radiologically through a chest X-ray in the posterior-anterior view, defining the border of the esophagus. Hence, this facilitates a more seamless and precise diagnosis. Surgical fundoplication treatment improves the patient's condition better than solitary medical management. Overall, addressing the condition surgically often yields more favorable outcomes and enhances the patient's quality of life. Hiatal hernia usually presents with no or minimal clinical manifestations. Thus, this case report highlights the importance of comprehensive clinical management of such cases.

Transposition of the Great Arteries With Ventricular Septal Defect in a One-Month-Old Infant.

Transposition of the great arteries (TGA), also termed complete transposition, is a congenital cardiac defect, and it is subjected to the concordance of the atrioventricular system discordance of the ventriculoarterial (VA) system. Male babies have slightly more preponderance than female babies. In almost half of the cases reported, the discordance in the VA system is the sole finding. In 10% of cases, TGA is often caused by other cardiac deformities, which incorporate defects in the septum of the ventricular chamber and stenosis in the left ventricular outlet. Eventually, these recite the progression, prognosis, and clinical presentation. In most cases, the onset is as soon as the birth. However, it may vary and depend on the difference in the anatomical and functional types, which determine the level of amalgamation between the oxygenated and deoxygenated blood. The etiology of the following condition is still unknown, but this defect is known to have a genetic preponderance. The definitive management of this condition is surgery, but medical management is optional and is prescribed according to the clinical evaluation and includes furosemide. Surgical correction can be performed in the later course of time, ensuring the fitness of the child. The procedure of choice is the arterial switch operation. This case report emphasizes the vital function of extensive critical care of newborns and prompt antenatal screening of high-risk pregnancies. It also highlights the importance of quick healthcare practices for newborns with congenital disabilities.

Malunion of a Clavicle Fracture in a Young Adult: A Case Report and Surgical Intervention.

This case study examines the medical complexity of managing a neglected clavicle in a young patient, resulting in a complicated interstitial non-union. Despite initial therapeutic efforts, the fracture was not treated, resulting in significant pain as well as functional and aesthetic disabilities. This case outlines accurate clinical presentation and diagnostic methods. In addition, malunion clavicle fractures require multifaceted therapeutic approaches including surgical interventions, rehabilitation programs, and psychological support. Through comprehensive research and long-term follow-up, this report reveals the complexity of traumatic fractures, highlighting the importance of early recognition and intervention. To address the issue effectively, it is essential to follow a multidisciplinary approach that includes physical assessment, pharmacotherapy, and physiotherapy. This case report aims to highlight the critical role of comprehensive individual care in improving the patient's condition and emphasizes the importance of vigilant healthcare practices.