Rafay Khan

Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure

Urothelial carcinoma in a few cases may result in cardiac metastasis. A rare presentation of this condition is its diagnosis as a result of cardiac tamponade. Tamponade is an unusual entity as a result of urothelial carcinoma and has only been reported in four cases. There have also been only a total of fifteen cases of cardiac metastasis from this form of malignancy. It is through this discussion that we emphasize the importance of early detection and monitoring of cardiac symptoms with the implementation of echocardiogram imaging. Although not feasible in all patients it may be considered in those presenting with cardiac and pulmonary symptoms. In this case we discuss the presentation of a 71-year-old gentleman with a history of urothelial carcinoma after cystectomy and while on chemotherapy presented with new onset atrial fibrillation and later was diagnosed with cardiac tamponade as a result of malignant metastasis.

Bladder cancer is one of the most common forms of malignancies involving the urinary system and multiple risk factors have been associated with its etiology. The most common of which include cigarette smoking and various occupational or chemical exposures. It is usually diagnosed in older individuals with an average age of 70. In rare cases it is observed in children as well as young adults where it usually presents as a low-grade, non-invasive disease. In the present case report a 27-year-old male patient is discussed: The patient presented with no significant risk factors and was treated for mucinous adenocarcinoma of the bladder while further investigations were performed to identify other associated factors related to this form of malignancy. Debate in the literature exists in regards to the characteristics of bladder neoplasms in younger patients compared with older patients, however there is a lack of research into the etiology or prognosis in young patients. The present case study illustrates the case of a young adult with no clear risk factors who was diagnosed with a rare case of mucinous adenocarcinoma of the bladder.

Cocaine-Induced Delayed Myocardial Infarction Complicated by Apical Thrombus

Right-sided endocarditis is predominantly seen in patients with a history of intravenous drug abuse. However, it is well shown in the literature to be associated with patients containing foreign bodies such as pacemakers, central venous lines, and in those with congenital heart disease. In patients with pacemaker leads and in those with automatic implantable cardioverter defibrillators (AICDs), it is important to suspect foreign body infection when there are signs and indications of bacteremia. When these leads become infected, they can spread the infection to the tricuspid valve resulting in vegetations. The proper management is removal of the infected lead and foreign body along with a prolonged course of antibiotics. However, it is unusual and a relatively rare entity to see foreign body infection resulting from a wound ulcer resulting in not only endocarditis but also abscess formation on the tricuspid valve. Here we report a case of a 60-year-old male with recent AICD placement presenting as diabetic ketoacidosis due to tricuspid abscess formation as a result of a foot ulcer. J Clin Med Res. 2016;8(1):44-46 doi: http://dx.doi.org/10.14740/jocmr2404w

Pancreatic cancer is one of the deadliest cancers commonly diagnosed at an advanced stage. Early diagnosis is crucial for the timely and potentially curative treatment of this highly fatal disease. Although screening tests have improved the survival rate in malignancies such as colon, breast, cervical and prostate cancer, there is currently no effective screening method available for the early detection of pancreatic cancer. As the sensitivity and specificity of existing biomarkers, such as carbohydrate antigen 19-9, for the early detection of pancreatic cancer is low, there is a pressing need for the identification of novel cancer markers. An increase in erythropoietin (EPO) levels has been observed in several cases of pancreatic neoplasms. However, the potential role of EPO as a biomarker of pancreatic cancer or malignant transformation requires further investigation. We herein present a case of increased EPO levels in an adult male patient with stage IV pancreatic cancer.

Thyroid disorders have been found to be associated with multiple organ systems and thus have a broad spectrum of presenting symptoms and clinical conditions. Certain aspects of the gastrointestinal (GI) system have yet to be fully understood and documented. Hypothyroidism and even hyperthyroidism have been identified in patients with motility symptoms involving the GI tract. These symptoms can vary and can be a complication of undertreated or undiagnosed condition involving the thyroid. Unfortunately, the mechanism in which these hormones can impact intestinal motility remains poorly understood and not well documented. In this case report, we discuss the presentation of a 71-year-old female with poorly managed hypothyroidism presenting with significant abdominal distention and pain secondary to underlying volvulus formation. By better understanding the complications induced by hypothyroidism, physicians may be able to prevent further life-threatening outcomes with early management and intervention. J Clin Med Res. 2015;7(12):995-997 doi: http://dx.doi.org/10.14740/jocmr2357w

Radiation and Bilateral Spontaneous Pneumothoraces

Introduction: Over the past decade the incidence of invasive group A streptococcal infections causing streptococcal toxic shock syndrome (STSS) or toxic shock like syndrome has been increasing.

Myopericarditis: A Diagnosis of Uncertainty