Annals of Medicine and Surgery

The availability and accessibility of neurosurgical care across Africa remains limited despite recent advancements. Overall, Africa accounts for 15% of the global neurosurgical disease burden but has access to less than 1% of neurosurgeons globally. While the number of neurosurgeons has increased in recent decades, huge workforce shortages remain, with the region facing the second-largest neurosurgical deficit. Access to adequate facilities and equipment is also lacking. Barriers like poverty, conflicts, and distance from care centres negatively impact patients' ability to access services...

INTRODUCTION AND IMPORTANCE: Intraspinal tuberculoma is rare and challenging situation, which results in serious neurological dysfunctions. CASE PRESENTATION: This case report shows an intraspinal tuberculoma with osseous involvement in a 31-year-old male patient with subacute progressing neurologic deficit. His medical history included tuberculosis of pulmonary and intestinal 8 years previously, at which time he had been treated with intestinal obstruction operation and antituberculosis treatment...

INTRODUCTION AND IMPORTANCE: Brucellosis is one of the most common infectious diseases in the world, especially in developing countries. Recent reports show that Syria is among the top ten countries where brucellosis is most prevalent. The purpose of this study is to estimate the seroprevalence of brucellosis antibodies among the hospitalized patients, in one of the largest hospitals in northern Syria. MATERIALS AND METHODS: A cross-sectional study was conducted among the hospitalized patients...

INTRODUCTION AND IMPORTANCE: Paraneoplastic pemphigus (PNP) is an uncommon autoimmune mucocutaneous disease characterized by severe stomatitis, polymorphous skin eruptions, and the presence of underlying neoplasms. Unique histopathological features include suprabasal acantholysis and clefts with scattered necrotic keratinocytes. CASE PRESENTATION: A 27-year-old female patient presented with a 3-month history of a painless swelling, approximately the size of a pea, on the left lateral aspect of her neck and axillary area...

INTRODUCTION: Ileocecal knot syndrome, a rare cause of small bowel obstruction where the ileum wraps around the cecum, poses a significant challenge for preoperative diagnosis. Prompt intervention is crucial due to the risk of rapid bowel deterioration and increased mortality. CASE PRESENTATION: A 45-year-old female presented with central abdominal pain associated with vomiting, abdominal distension, and obstipation. On examination, she was ill-looking with hypotension, tachycardia with a feeble pulse, direct and rebound abdominal tenderness, and absent bowel sounds...

INTRODUCTION AND IMPORTANCE: Systemic lupus erythematosus (SLE) predominantly affects young women and is associated with an increased risk of thrombosis. Antiphospholipid antibody syndrome (APS) may complicate the clinical picture, often leading to recurrent arteriovenous thrombosis. This case report underscores the significance of two unique aspects: the rare occurrence of an atrial thrombus and the presence of antinuclear antibody (ANA)-negative SLE. CASE PRESENTATION: A 32-year-old woman presented with a history of symmetric polyarticular joint pain, oral ulcers, significant weight loss, and a history of unprovoked popliteal thrombosis and two unexplained abortions...

INTRODUCTION AND IMPORTANCE: Extraction of mandibular third molars can lead to complications such as chronic sclerosing osteomyelitis (CSO), an inflammatory bone marrow disease that tends to progress. CSO involves the cortical plates and often the periosteal tissues and is caused by a variety of microorganisms, including Corynebacterium spp. The treatment of chronic osteomyelitis (CO) and CSO remains challenging, as there is no universal treatment protocol. This case report investigated whether jaw bone that has healed from chronic sclerosing osteomyelitis can be considered healthy bone when planning dental implants...

BACKGROUND: The dimensionless Rajan's heart failure (R-hf) risk score was proposed to predict all-cause mortality in patients hospitalized with chronic heart failure (HF) and reduced ejection fraction (EF) (HFrEF). PURPOSE: To examine the association between the modified R-hf risk score and all-cause mortality in patients with HFrEF. METHODS: Retrospective cohort study included adults hospitalized with HFrEF, as defined by clinical symptoms of HF with biplane EF less than 40% on transthoracic echocardiography, at a tertiary centre in Dalian, China, between 1 November 2015, and 31 October 2019...

INTRODUCTION AND IMPORTANCE: Pseudoulnar palsy, characterized by weakness in the fourth and fifth digits, is a condition typically attributed to infarction of the medial aspect of the precentral gyrus's "hand knob." This anatomical site is located in the primary motor cortex of the brain, in the posterior lobe of the frontal cortex. This report presents a novel case of pseudoulnar nerve palsy in conjunction with wrist drop stemming from an infarction of the hand knob gyrus. CASE PRESENTATION: A 78-year-old female with hypertension and hyperlipidemia experienced sudden right wrist weakness and impaired mobility in her fourth and fifth digits...

INTRODUCTION AND IMPORTANCE: PHACE syndrome is a rare neurocutaneous disorder characterized by large segmental hemangiomas on the face and is associated with multiple developmental defects. PHACE stands for posterior fossa malformations, hemangiomas, arterial abnormalities, cardiac defects, and eye anomalies, with the most common manifestation being hemangioma in the cervico-facial region in early childhood. CASE PRESENTATION: The authors report a case of a 15-year-female with complaints of facial hemangioma which on multisystemic imaging showed features of central nervous system (CNS) anomalies that led to the diagnosis of PHACE syndrome...

BACKGROUND: Adverse healthcare's events are a critical issue worldwide, neonatal intensive care unit adverse events are a considerable issue. It is important that we recognize the basic equipment needed to address these circumstances. The aim of this study is to asses' equipment preparedness for neonatal resuscitation in the neonatal intensive care unit. METHOD: A hospital-based, cross-sectional study was conducted on 210 neonates admitted to neonatal intensive care unit at comprehensive specialized hospital from 26/03/2022 to 26/05/2022...

INTRODUCTION AND IMPORTANCE: This manuscript underscores the critical significance of prompt diagnosis and intervention in cases of post-traumatic gastroduodenal artery pseudoaneurysms. Such occurrences, particularly in the paediatric population, are rare but potentially life-threatening complications following abdominal trauma, necessitating heightened clinical awareness. Despite their rarity, the devastating consequences of delayed recognition and management emphasize the necessity for advanced imaging modalities and individualized treatment strategies...

BACKGROUND: Carotid body tumours (CBTs) are neoplasms originating from the paraganglionic cells of the carotid body. Excision is the main route of treatment. This study sought to assess the surgical outcomes of post-carotid body tumour resection without preoperative embolization and discern any underlying relationships between modified Shamblin classes (MSC) and related complications. METHODS: A retrospective medical record review of prospectively collected data is performed at Sulaymaniyah Teaching Hospital between 2008 and 2019, for 54 patients...

INTRODUCTION AND IMPORTANCE: Paecilomyces species are rare fungi that are resistant to standard treatment and have increasing clinical relevance. The Purpureocillium lilacinum, formerly known as Paecilomyces lilacinus, has a unique sensitivity for the corneal surface. However, only a few cases have been documented globally. This case report presents the successful management of a patient with Paecilomyces lilacinus keratitis with topical voriconazole and oral itraconazole. CASE PRESENTATION: A 40-year-old woman came to our ophthalmology clinic complaining of right eye pain due to a severe corneal infection in her right eye...

INTRODUCTION: Surgical complications in younger patients can lead to infections, delayed healing, prolonged hospital stays, and other negative outcomes, significantly affecting their recovery. This study explores the potential impact of breastfeeding on mitigating these complications, aiming to enhance our understanding of postoperative care for paediatric and adolescent patients. METHODOLOGY: The authors conducted a systematic search on databases such as PubMed, Scopus, Web of Science, and EMBASE, using relevant MESH keywords, adhering to the "Preferred Reporting Items for Systematic Reviews and Meta-analysis" methodology...

INTRODUCTION AND IMPORTANCE: Dandy Walker variant is an intracranial disorder involving variable hypoplasia of cerebellar vermis without posterior fossa enlargement. An anomaly scan performed at mid second trimester has good sensitivity and specificity for detecting foetal congenital anomalies. Despite that, some cases like the authors' might go undiagnosed due to normal biometric parameters for that gestational age and may be detected later in intrauterine life. CASE PRESENTATION: A primi-gravid mother underwent sonographic evaluation at 20+4 weeks of gestation that revealed all foetal parameters within normal limits...

BACKGROUND: Fetomaternal Rhesus incompatibility is a medical condition that affects the pregnant woman [of blood group (A, B, AB, O) and a negative Rhesus] and the foetus (of positive Rhesus). The objective of this study is to determine the prevalence and to present the clinical characteristics of fetomaternal Rhesus incompatibility in a tertiary care hospital. METHODS: The authors conducted a retrospective cross-sectional study and 37 participants were recorded during the study period of 4 years...

INTRODUCTION AND IMPORTANCE: Amyloidosis is an infiltrative disease caused by the deposition of abnormal proteins. While cardiac amyloidosis is relatively common, gastrointestinal (GI) tract involvement is less frequent. In this case, the authors report a delayed diagnosis of systemic amyloidosis presenting mainly with digestive symptoms. CASE PRESENTATION: An 81-year-old male presented with the complaint of persistent diarrhoea for over a year and the progressive development of edemas during the last 4 months...

BACKGROUND: Energy drinks (ED) are popular beverages that contain high levels of caffeine, sugar, and other supplements, such as vitamins, which are marketed to enhance mental alertness and physical performance. Studies have shown that energy drink consumption is prevalent among medical students. Therefore, this study aimed to assess the prevalence, attitudes, and factors associated with energy drink consumption among medical students in Jordan. MATERIALS AND METHODS: A cross-sectional study was conducted among medical students from six public universities in Jordan...

INTRODUCTION AND IMPORTANCE: Fibroepithelial vaginal polyps (FEPV) are rare mucosal polypoid lesions primarily found in adult women. However, FEPV in paediatric patients, especially beyond the neonatal period, is exceedingly uncommon. Documenting cases improves diagnosis and management. FEPV can mimic malignancy, posing challenges for interpretation. Early detection, treatment, and follow-up are crucial for optimal outcomes. CASE PRESENTATION: The authors present the case of a 2-year-old girl with a recurrent FEPV...