Vidya Chikkarahalli Srikantaiah

A dermoid cyst, also called a benign cystic teratoma, often presents as a midline mass in the trunk or sacrococcygeal region, and more commonly in the skin of the face, forehead, and scalp. Although the ischiorectal fossa contains very few structures, a wide variety of pathological entities, such as developmental cysts, epidermoid cysts, lipomas, neurofibromas, and tailgut cysts, have been reported. Dermoid cysts in the ischiorectal fossa are rare, and very few cases have been reported in the scientific literature. This case report presents an uncommon presentation of a dermoid cyst in the ischiorectal fossa in a 25-year-old female patient.

Kienbock’s disease is a rare and painful disorder of the wrist, of unknown etiology, characterised by osteonecrosis of the lunate bone visible on wrist radiographs. It is typically seen in individuals aged 20-40 years, often in the dominant wrist, with a history of trauma. If left untreated, it can lead to fragmentation of the lunate, collapse and shortening of the carpus, and secondary arthritic changes throughout the proximal carpal area. We present a case of Kienbock’s disease Lichtman stage IV with Chronic Regional Pain Syndrome (CRPS) in a 53-year-old female who presented with right wrist pain and swelling persisting for one month, alongside a loss of range of motion of about 20 degrees in palmar and dorsal flexion, following a fall on an outstretched hand one year prior. Initially, the patient was managed conservatively with splinting, physiotherapy, and pharmacotherapy (Vitamin C, Vitamin D, Diclofenac) until the CRPS subsided. Subsequently, the patient underwent total wrist arthrodesis with bone grafting, resulting in pain relief and a satisfactory pain score.

The divergence of the maxilla from the pterygoid process of the sphenoid bone forms the pterygomaxillary fissure, which lies in the medial part of the infratemporal fossa. It transmits the posterior superior alveolar nerve and the terminal segment of the internal maxillary artery and connects the infratemporal fossa with the pterygopalatine fossa. The purpose of this study is to evaluate the height, width and distance of the pterygomaxillary fissure from the zygomatic bone, articular tubercle, and zygomatico-temporal suture. Forty dry human skulls were examined by the Department of Anatomy. Using a digital caliper, the right and left sides of the skulls of both sexes were measured for height, width, and distance from the upper end of the pterygomaxillary fissure to the articular tubercle of the zygomatic arch (AB), zygomaticotemporal suture (AC), and zygomatic body (AD). The average height of the pterygomaxillary fissure was 22.68 mm in males & 22.34 mm in females, the width was 7.33 mm in males & 7.22 mm in females, distance from the articular tubercle (AB) was 33.37 mm in males & 31.79 mm in female, zygomatic temporal suture (AC) was 36.91 mm in male & 34.89 mm in female, zygomatic bone (AD) was 29.88 mm in male &28.44 mm in female. There is no statistically significant difference between the right and left sides of the skulls of both genders. Because fissures smaller than 2 mm may prevent neurostimulator implants from being inserted into the pterygopalatine fossa, this study attempted to determine the location of the pterygomaxillary fissure using the three anatomical markers. Therefore, caution should be exercised when performing maxillofacial procedures on female patients.

Amyloid beta (Aβ) deposition in the brain is regarded as an early toxic effect in the aetiopathogenesis of Alzheimer’s Disease (AD). Currently, Aβ is considered a key marker for AD and a promising target for drug development for the future management of debilitating diseases such as AD. However, the pathomechanism of Aβ has not yet been precisely understood in terms of AD patients, specifically regarding the pathological forms of Aβ and how it associates with other biochemical markers to cause dementia. Identifying Aβ as a key hallmark, especially at the earliest stages of the disease, is essential for understanding the progression of AD and its applicability for the development of novel therapeutics aimed at managing cognitive impairment and AD. This review aims to explain the neurotoxicity of Aβ and its correlation with various other biological markers that contribute to the induction of AD and memory deterioration.

Congenital anomalies are diverse in nature and can affect multiple organ systems, posing significant diagnostic and management challenges. Among these, nubbins, characterised by the absence or underdevelopment of distal terminal phalanges, present a rare clinical finding. The present case report discusses a neonate born via normal vaginal delivery who demonstrated immediate cries upon birth. The patient’s clinical presentation led to a series of diagnostic investigations. The absence of distal terminal phalanges in both hands was concerning; however, radiographs of the forearms showed normal structural findings. The detection of mild Developmental Dysplasia of the Hip (DDH) on hip Ultrasonography (USG) necessitated regular monitoring with USG and radiographs of both hips to ensure proper hip joint development. The USG of the spine revealed no anomalies, which was reassuring. The most significant finding came from the Echocardiogram (ECHO), which identified a small ostium secundum Atrial Septal Defect (ASD) with mild tricuspid regurgitation and pulmonary hypertension. The present case underscores the importance of ongoing research and collaboration in advancing our understanding and management of rare congenital anomalies.

Simple Bone Cysts (SBCs) are benign, fluid-filled lesions primarily located in the metaphysis of long bones in children and adolescents. Depending on the clinical situation, management is performed, but the ultimate goal is to minimise surgical complications. Hereby, the authors present a case report presents the management of a seven-year-old male with a pathological refracture of the subtrochanteric region of the right femur due to an SBC. The patient presented with pain, swelling, and inability to bear weight on the affected limb. Diagnostic evaluation revealed a fracture in the subtrochanteric region along with a lytic, expansile lesion at the fracture site. The patient had a history of a similar fracture three years prior. Treatment involved closed reduction and internal fixation with two Flexible Intramedullary Nails (FIN), followed by immobilisation with a unilateral hip spica cast for six weeks. Follow-up radiographs showed satisfactory fracture reduction and signs of resolution of the bone cyst. The patient demonstrated good functional outcomes and successful management of the pathological refracture. The present case report contributes to the existing literature on the management of pathological refractures in paediatric patients and highlights the effectiveness of FINs as a treatment option in such cases.

Alzheimer disease (AD) is the most common cause of dementia worldwide. Its clinical manifestations include a progressive loss of memory and other cognitive domains, as well as brain atrophy. An elevated homocysteine level (>15 µmol/L), known as hyperhomocysteinemia, is also an attributing risk factor for AD, vascular pathologies, and brain atrophy. Neuroimaging studies including T2-weighted magnetic resonance imaging scans revealed white matter hyperintensities in the periventricular and deep white matter, enlarged ventricles, widened sulci, and decreased white matter mass, which are features of aging, as well as cerebrovascular changes. This case series investigated changes in biochemical marker levels including serum homocysteine, folate, and vitamin B12, and the degree of atrophic variations in cortical-subcortical white matter in AD. The present study hypothesized that serum homocysteine levels might be used as a surrogate marker to screen for AD at an earlier stage.

Journal of Clinical and Diagnostic Research aims to publish findings of doctors at grass root level and post graduate students, so that all unique medical experiences are recorded in literature.