Brain Calcifications Secondary to Idiopathic Hyperthyroidism and Hypoparathyroidism.

Thyroid and parathyroid hormones are essential components of the metabolic system and its regulation. Concurrent hyperthyroidism with hypoparathyroidism is an extremely rare finding and is not considered a common etiology of brain calcifications seen on imaging. Brain calcifications can cause a range of neurologic symptoms, including movement disorders, cognitive impairment, and seizures.

Correction: Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population.

[This corrects the article DOI: 10.7759/cureus.48994.

Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population.

Background And Aim: While proton pump inhibitor (PPI) therapy has proven to be effective in managing gastroesophageal reflux disease (GERD), a notable portion of patients who experience GERD symptoms may not respond to this treatment. Research suggests that roughly 30% of individuals with a presumed GERD diagnosis may continue to experience symptoms, whether partially or completely, even when receiving PPI therapy. The aim of this study was to assess the treatment of gastrointestinal diseases with a novel potassium-competitive acid blocker (P-CAB), vonoprazan, in terms of its effectiveness and safety in the Pakistani population.

Asymptomatic Dandy Walker Malformation In An Elderly Male With Acute Haemorrhagic Stroke - A Case Report.

Dandy-Walker Malformation (DWM) is a rare congenital anomaly of the posterior cranial fossa. Features of DWM include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. MRI is the modality to confirm the diagnosis.

Termination of seizures in the paediatric age group, best benzodiazepine and route of administration: A network meta-analysis.

This network meta-analysis aims to compare various benzodiazepines and their route of administration using the data published exclusively in randomized controlled trials (RCTs). Two thousand two hundred sixty-three children presenting with an episode of seizure to ER or to a paramedic where they were administered a benzodiazepine as the first-line treatment were included. All the outcomes were measured for their mean with 95% CI and rank probability.

A Case Report of Behcet's Disease With Thromboses in the Superior Vena Cava and External Iliac Vein.

Behcet's disease (BD), also known as Behcet's syndrome, is a rare, chronic, autoimmune disorder of unknown origin. Its manifestations are thought to be caused by vasculitis, resulting in damage to blood vessels of all sizes throughout the body. We report a 25-year-old Pakistani male who is sexually active and presents with a one-year history of shortness of breath, cough, exertional dyspnea, and neck and facial swelling.

Unusual Initial Presentation Of Primary Antiphospholipid Syndrome As Postpartum Symmetrical Peripheral Gangrene.

Antiphospholipid syndrome (APS) is an acquired prothrombic state with recurring thromboembolic and obstetric complications in the presence of antiphospholipid antibodies. Isolated skin manifestation especially symmetrical peripheral gangrene (SPG) in postpartum phase is reported rarely. To highlight this unusual presentation of APS with SPG we present a case of young female who developed SPG on her third postpartum day.

Electrocardiographic Abnormalities in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Objective: The objective of this article was to determine the frequency of different electrocardiographic (ECG) abnormalities in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).

Design: This is a cross-sectional study.

Place And Duration: The study was conducted at the medicine department at Civil Hospital Karachi, Pakistan, between November 2018 and May 2019.

A Rare Presentation of Brucellosis as Myocarditis.

Brucellosis is commonly transmitted by consumption of unpasteurized dairy products and most commonly presents as fever, arthralgia, fatigue, hepatosplenomegaly, and peripheral arthritis. Our patient presented with a history of three months of high-grade fever, undocumented significant weight loss, jaundice, and hepatosplenomegaly. On the seventh day of admission, he developed sudden onset of shortness of breath, and his jugular venous pressure was raised with fine crackles at the lung bases bilaterally and pedal edema up to the ankles bilaterally.

GeneXpert in stool: Diagnostic yield in Intestinal Tuberculosis.

Background: Diagnosing intestinal (Luminal) tuberculosis is challenging due to limited yield of diagnostic modalities like CT scan, colonoscopy with blind ileal biopsies. GeneXpert MTB/RIF (Xpert) assays for diagnosing tuberculosis have been performed in the body secretions with excellent results. Its yield in stool is tested in this study.

Amyloidosis with Multiple Myeloma Presenting with Acromegalic Features.

Amyloidosis and multiple myeloma are included in the same spectrum of clonal plasma cell disorders. Amyloidosis can present with localized deposits or manifest as systemic disease involving multiple organs. Here we are reporting a case of an elderly female, having amyloidosis leading to facial disfigurement and neuropathy for many years and then presenting with concomitant multiple myeloma as an incidental diagnosis with no typical symptoms related to it at all.

Neuromyelitis Optica (NMO) with Abdominal Tuberculosis (TB).

Neuromyelitis Optica (NMO), previously regarded as a form of multiple sclerosis, is defined by Gault and Devic, as a retrobulbar neuritis or papillitis accompanied by acute myelitis and occasionally other neurological symptom or signs not restricted to the spinal cord or optic nerves. With the diagnosis of specific antibodies, probable role of humoral immunity supports its pathogenesis. Only a few cases of NMO have been reported in association with pulmonary tuberculosis (TB).

Vitamin D deficiency in fibromyalgia.

Objective: To check the Vitamin D levels in patients diagnosed as fibromyagia in our population.

Methods: Study was done at Medical OPD of Civil Hospital Karachi, from January to March 2009. Female patients diagnosed as Fibromyalgia according to American College of Rheumatology (ACR) criteria and exclusion of systemic illness on examination, and normal reports of blood CP, ESR, serum calcium, phosphate and Alkaline Phosphatase, were asked to get Vitamin D levels in their serum.

Liver histology in hepatitis C virus positive patients with normal and elevated alanine amino transferase levels.

Objective: To compare liver histology in HCV RNA positive patients with normal and elevated Alanine Aminotransferase Level (AST).

Methods: This Cohort (prospective) study was conducted at Civil Hospital Karachi from Jan 2007 to July 2007. Forty patients with positive HCV RNA were included.

Frequency, characteristics and risk factors of carotid artery stenosis in ischaemic stroke patients at Civil Hospital Karachi.

Objective: To determine the frequency and characteristics of carotid artery stenosis in acute ischaemic stroke patients and to assess the significance of common risk factors for carotid stenosis in these patients.

Method: One hundred consecutive patients admitted with acute ischaemic stroke were included in the study. The relevant history, physical examination and laboratory investigations were done as per the Performa.

Acute acalculous cholecystitis in dengue fever.

Objective: To investigate the frequency, clinical features, management and outcome of acute acalculous cholecystitis in dengue fever patients.

Methods: Forty patients were admitted with the diagnosis of dengue fever, according to the clinical manifestations and laboratory investigations. The diagnosis of dengue fever was confirmed by a positive IgM antibody test result for a late or convalescent phase blood specimen.

Three consecutive audits to achieve acceptable colonoscopy completion rates.

Objective: To compare the acceptable colonoscopy completion rates in three successive audits, identifying the reasons for failure of completion and rectifying them to improve the performance at our endoscopy unit.

Methods: Study was conducted at Endoscopy unit of Medical Unit One Civil Hospital Karachi. The first audit was conducted retrospectively on the colonoscopy results, done from November 2004 to November 2005.