Background: Deep infiltrating bowel endometriosis (DIE) can result in debilitating pain, dyspareunia and infertility. Discoid full-thickness resection is a fertility-sparing option for selected rectal lesions. Case Presentation: A 35-year-old African woman presented with severe dysmenorrhea (VAS 9/10), menorrhagia, dyschezia with alternating constipation and bloating, deep dyspareunia and infertility. Transvaginal ultrasound demonstrated adenomyosis, myoma and a 2.72 × 0.78 × 1.75 cm rectal nodule; Enzian classification: A3, B2/2, C2, FA. She underwent diagnostic hysteroscopy with hysteroscopic myomectomy, laparoscopic resection of pelvic endometriosis nodules, adhesiolysis and staged transanal double-discoid (double-disc) full-thickness excision of the rectal (lesion with a transanal circular stapler. Histopathology of the specimens confirmed endometriosis of the uterosacral and rectal lesions. Outcome: The patient was discharged on postoperative day two, described marked symptomatic improvement at a ten-day follow-up visit, had resumed a normal diet and bowel function, and was started on suppressive hormonal therapy (dienogest). No complications were encountered. Conclusion:... Continue Reading

Background: Subcutaneous metastases of papillary thyroid carcinoma (PTC) are rare, with only limited cases documented in theliterature. Their presence can pose diagnostic and management challenges, particularly when mimicking benign postoperative changes.Methods: We present a retrospective study of three consecutive cases of patients with confirmed dermal metastases from PTCidentified during post-treatment surveillance. All cases of cutaneous metastases of PTC were included in this study and were managed at a single tertiary centre between 2020 and 2024.Results: In each case, dermal metastases were detected either within previous surgical scars or within the subcutaneous tissue ofthe neck, highlighting their potential to present subtly and mimic scar tissue. Diagnostic confirmation was achieved via imaging and excisional biopsy, followed by histological analysis. All patients underwent surgical intervention and received adjuvant radioactive  odine therapy. One patient required systemic therapy for progressive metastatic disease.Conclusion: Dermal metastases from PTC remain rare but clinically significant. Imaging and biopsy with... Continue Reading

Background: Poorly controlled type 2 diabetes mellitus (T2DM) increases the risk of severe respiratory infections and pulmonary complications, including lung abscesses and cavitary lesions. In tuberculosis-endemic regions, these findings are often initially attributed to tuberculosis, which may delay the diagnosis and management of other relevant infectious etiologies. Case Presentation: We report a case series of two patients with poorly controlled T2DM who developed pulmonary cavitations in the right upper lung lobe following non-tuberculous infectious processes. The first case involved a 22-year-old woman with a recent dengue infection who developed a cavitary pneumonia without signs of sepsis and showed a favorable clinical course with conservative management using intravenous antibiotics. The second case was a 68-year-old man with T2DM and chronic obstructive pulmonary disease, initially treated for community-acquired pneumonia, who subsequently developed severe diabetic ketoacidosis, septic shock, and extensive pulmonary cavitation, requiring intensive care unit admission, broad-spectrum intravenous antibiotics, and surgical lobectomy.... Continue Reading

Background: Schwannomas are benign peripheral nerve sheath tumours arising from Schwann cells and are uncommon in the upper limb. Median nerve schwannomas constitute approximately 0.1–0.3% of all hand tumours, and extensive involvement of the median nerve by multiple schwannomas across multiple joints is exceptionally rare. Differentiating schwannoma from neurofibroma on imaging can be challenging. Case Presentation: A patient presented with a painful palpable mass along the flexor aspect of the right forearm extending from the elbow to the distal interphalangeal joint. Clinical examination demonstrated a mobile mass with a positive Tinel’s sign along the median nerve distribution. Magnetic resonance imaging revealed a longitudinally extensive lesion along the median nerve but could not reliably differentiate schwannoma from neurofibroma. A core needle biopsy confirmed schwannoma with Antoni A and Antoni B areas and strong S-100 positivity. Complete surgical excision with preservation of the median nerve was performed, resulting in excellent functional recovery.... Continue Reading

Background: Rearrangements or translocations involving the KMT2A gene are well-recognized genetic abnormalities in acute lymphoblastic leukemia (ALL) across both adult and pediatric populations, and their presence is typically associated with adverse prognosis and high-risk disease. In contrast, KMT2A gene amplification is an exceedingly rare abnormality in ALL, with only a few reported cases till date, predominantly in adults. Owing to its extreme rarity, the prognostic significance of KMT2A amplification in pediatric ALL remains unclear, although available reports in adult cases suggest an association with poor outcomes. Case Presentation: This is a case of KMT2A amplification in a 4-year-old child diagnosed with B-cell ALL who presented with standard-risk disease features and achieved complete remission following induction chemotherapy, maintaining remission at 12 months post-diagnosis. Similar findings from limited Western literature also suggest that KMT2A amplification does not adversely affect clinical outcomes in pediatric cases. To the best of our knowledge, this is the first reported case of... Continue Reading

Background:Pulmonary sequestration (PS) is a rare congenital lung anomaly in which non-functioning lung tissue receives systemic arterial supply. While typically diagnosed in childhood, adult presentation, especially of the intralobar type, remains uncommon and often challenging to recognize. Case Presentation:We report the case of a 46-year-old woman who presented to the emergency department with acute dry cough, dyspnea, and a single episode of hemoptysis. She had no prior history of pulmonary infections or chronic illness aside from untreated hypertension. Laboratory results were unremarkable apart from a mildly elevated D-dimer. Imaging via computed tomography angiography revealed a mass-like consolidation with systemic arterial supply from the aorta and pulmonary venous drainage, consistent with intralobar pulmonary sequestration. The patient was admitted for observation and remained clinically stable without recurrent hemoptysis or infection. She was discharged with outpatient cardiothoracic follow-up and remained asymptomatic at follow-up visits. Conclusion:This case highlights the importance of considering intralobar pulmonary... Continue Reading

Background: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis frequently associated with systemic inflammatory diseases. We aimed to describe systemic disease associations, management strategies, and outcomes of PG managed in internalmedicine.Settings: Single-center retrospective case series conducted in an internal medicine department between January 2021 and December 2025.Methods: We retrospectively reviewed all eligible patients treated for PG in our department during the study period. Diagnosis was based on clinicopathological assessment after exclusion of major mimickers; the Delphi consensus criteria were not formally applied because their individual components were not consistently documented in the retrospective records. Demographic, clinical, histological, treatment, and outcome data were extracted from medical records.Results: Ten patients (five women; median age 40 years, range 19-58) were included. Ulcerative PG predominated (6/10), while four patients had pustular PG; lesions mainly involved the lower limbs, and pathergy was observed in five patients. An associated systemic disease was identified in eight patients,... Continue Reading

Objective: Reconstruction of large-segment tibial bone defects caused by osteomyelitis or fracture nonunion remains a major clinical challenge in orthopedic surgery, with the core demand of balancing mechanical stability and biological osseointegration. 3D-printed porous tantalum prostheses have emerged as a novel biomaterial for bone defect repair due to their bionic mechanical properties and excellent biocompatibility, and their combination with the Masquelet induced membrane technique (IMT) is expected to improve the therapeutic effect of large bone defects. However, clinical evidence of this combined strategy for tibial defect reconstruction is still insufficient. Methods: A series of six patients with large tibial bone defects treated in our hospital from December 2021 to December 2023 were retrospectively analyzed, including 1 case of osteomyelitis-induced defect and 5 cases of nonunion-induced defect. All patients received two-stage surgical treatment based on CARE guidelines: Stage I was debridement + vancomycin-loaded PMMA spacer implantation to induce membrane formation; Stage... Continue Reading

Academic publishing is meant to reward scientific merit, methodological rigor, and originality. Yet in closely connected academic communities, professional hierarchies and name recognition can influence how research is received. In parts of Indian psychiatric publishing, there is a growing perception that manuscripts linked to well-known senior academicians or prominent institutions are more likely to be accepted. Whether fully accurate or not, this belief itself reflects a trust deficit within the system. Such dynamics rarely involve overt rule-breaking. Instead, they may arise from informal networks, editorial familiarity, and limited transparency in decision-making. The consequences can discourage early-career researchers and restrict the diversity of ideas entering the literature. Strengthening double-blind review, improving transparency around editorial decisions, and broadening conflict-of-interest disclosures may help restore confidence. A publication system that is visibly fair is essential for maintaining credibility and fostering genuine academic growth. Continue Reading

Background: Isolated cerebral mucormycosis is a rare, life-threatening infection, usually occurring in immunocompromised hosts but also reported in people with intravenous drug use, with a predilection for the basal ganglia. Case Presentation: A 30-year-old previously healthy man with a history of intravenous drug use presented with new-onset generalized seizures, altered mental status, and left-sided hemiplegia. Magnetic resonance imaging showed a 4.4 × 4.3 × 5.1 cm ring-enhancing mass in the right basal ganglia with extension into the thalamus and temporal lobe and mild midline shift. Stereotactic biopsy with conservative debulking revealed a fungal abscess; Gomori methenamine silver staining demonstrated broad pauci-septate hyphae with irregular right-angle branching, supporting a diagnosis of cerebral mucormycosis. He was treated with liposomal amphotericin B and isavuconazole, followed by prolonged oral isavuconazole. Complete excision was not feasible because of the deep lesion location. Conclusion: Follow-up magnetic resonance imaging at 16 weeks showed reduction in lesion size... Continue Reading