Clinical Presentation and Hematologic Features of Acute Leukemia Patients in Al-Thawrah Teaching Hospital, Sana’a, Yemen.

Background : RTyphoid fever remainsa serious health problem in the world. The main cause of this disease is Salmonella enterica serovar Typhi. These microbes have developed resistance to first-line antibiotics (chloramphenicol, ampicillin, and co-trimoksazol) since 1950. Clinical presentation and laboratory features conducted in children infected with resistant strains tend to be more severe. The objective of this study was to determine the differences of clinical presentation and laboratory features in pediatric typhoid fever patient susceptibility to first-line antibiotics. Methods : This was an analytical cross-sectional study of total 119 typhoid fever children with positive blood culture of Salmonella Typhi based on medical data in Department of Child Health Dr. Hasan Sadikin General Hospital, Bandung during 2008–2012. Inclusion criteria included 76 patients with age range 1–15 years old, given an antibiotic, and had susceptibility test done. Numerical variable was the duration of fever in patients after given an antibiotic. Categorical variable included hepatomegaly, diarrhea, platelet count at admission, and leukocyte count at admission. Data were analyzed using a Mann-Whitney and Chi-square test. Results : There was no statistically significant difference in the duration of fever, leucocyte count at admission, and thrombocyte count at admission between sensitive and resistant response to chloramphenicol, ampicillin, and co-trimoksazol (p>0.05). Leucocyte count at admission in children with sensitive and resistant strain to ampicillin almost showed a difference (p=0.07) but still not statistically significant difference. Conclusions : There is no difference of clinical presentation and laboratory features in pediatric typhoid fever patient susceptible to first-line antibiotics. [ AMJ .2015;2(4):584–90] DOI: 10.15850/amj.v2n4.653

S2] it is more common during adolescence and usually presents with clinical features similar to the adult type. in children under the age of 4 years it is rare and has a different presentation.Clinical features are characterized by a triad of rash, uveitis, and arthritis. 3Sarcoidosis has a worldwide distribution, but is more frequently reported from developed countries. 4,5to our knowledge, there are no reports of childhood sarcoidosis from Saudi Arabia.We describe the clinical and laboratory features, treatment and outcome of 8 children with sarcoidosis seen at our hospital. MethodsWe retrospectively reviewed data of children with sarcoidosis seen at King faisal Specialist Hospital and research Center (KfSHrC), riyadh.KfSHrC is the major tertiary care center in Saudi Arabia for most sub-specialties including pediatric rheumatology.Data included demographics, clinical presentation, laboratory parameters, radiological and histopathological features, treatment, disease course, and outcome of these patients.

Background Cervical myelopathy is a serious condition that is considered the most frequent reason for spinal cord dysfunction, which may lead to a range of neurological impairment. Studies regarding clinical presentation and demographic features of cervical myelopathy are currently insufficient in Palestine. Methods A retrospective chart review study was conducted at Al-Makassed Hospital, a tertiary hospital in Palestine. The study sample consists of adult patients aged 18 years and older diagnosed with cervical disc herniation-related cervical myelopathy who underwent surgical decompression from 1/January/2017, to 30/June2025. The data collection period was approximately 6 months, from 20/January/2025 to 31/July/2025, using medical clinical reports. Results Results from a study of 361 Palestinian adults with disc herniation-related myelopathy indicate an average age of 52.9 (± 11.1) years, with a gender distribution of 50.7% male and 49.3% female. Diabetes mellitus was present in 28.5% of cases. Among the patients, 41.0% had single disc herniation while 59.0% had multiple disc herniations, which was more prevalent in those aged 60 and older ( p < 0.018). C5–C6 (59.8%) and C4–C5 (56.5%) were the most affected disc levels. Common symptoms included neck pain and stiffness (91.1%), upper limb paresthesia (58.4%), and hand numbness (31.9%). Hyperreflexia and gait disturbance were also frequent clinical signs. Most patients were classified as Nurick’s grade 2 (41.1%). The prevalence of preoperative severe myelopathy (Nurick’s grade > 3) was higher in those aged 60 and over. The mean follow-up duration was 10.1(± 15.9) months, with postoperative complications occurring in a few cases, including cervical spine compression (0.8%), paravertebral hematoma (0.8%), and surgical wound infection (0.6%). Conclusion Our study underscored the importance of cervical myelopathy and its clinical signs and symptoms. The awareness about clinical presentation and demographic features of Palestinian patients with cervical myelopathy helps in early suspicion and recognition of cervical myelopathy, leading to prompt diagnoses and appropriate management.

P027 - Severe reactivation of multiple sclerosis after discontinuation of fingolimod: An IRIS-associated phenomenon

Brunner's gland hamartoma presenting as a large duodenal polyp

Colonic duplications: Clinical presentation and radiologic features of five cases

The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be identified: a subintimal or subadventitial dissection. It is suggested that a subintimal dissection results in luminal stenosis, thromboembolism and subsequently cerebral ischaemia, whilst a subadventitial IAD could result in the formation of a pseudo-aneurysm and compression on brainstem or cranial nerves. Rupture of such a dissecting aneurysm causes SAH. The exact cause of IAD remains unknown but several factors are associated with its development. Diagnosis is based on clinical presentation and specific features seen on multimodal neuroimaging. The management of IAD depends on the clinical presentation. In the case of cerebral ischaemia, anticoagulants or antiplatelet agents are used, whilst in the case of SAH endovascular treatment is primarily advocated. Prognosis depends on clinical presentation. Presentation with SAH has a worse prognosis.

AimDegenerative lumbar spondylolisthesis (DSL) is one of the reasons behind adult-onset backache due to degenerative spinal pathology. Clinical manifestations of this can range from asymptomatic patients to widely variable clinical signs and symptoms. Spinal canal stenosis (SCS) is the most common associated degenerative condition in the MRI of DSL. Moreover, other associated degenerative conditions may contribute significantly towards the clinical presentation. We have tried to assess the impact of SCS on the clinical symptomatology and presentation of the DSL by correlating the clinical and imaging findings.MethodsThis single-center prospective observational study has analysed 48 patients who were symptomatic due to DSL. The data was collected over a period of 18 months from January 2015 to June 2016 by screening through the adult patients presenting at the orthopaedic or spinal clinics with features suggestive of degenerative lumbar spine disease. Particular inclusion and exclusion criteria were developed as a screening tool and selected patients underwent imaging investigations. Patients had lumbar spine radiographs, both standing and flexion-extension view, and MRI of the lumbar spine. The presenting clinical features were documented. Their clinical and neurological assessment was done thoroughly by two qualified clinicians independently.ResultsThe study population included 29 female (60.5%) and 19 male (39.5%) patients. The mean age of the study population was 49.5 years (SD 9.2 years). As per the radiological diagnostic criteria, 28 patients (58.3%) had features of SCS together with DSL and the rest of the 20 patients (41.7%) had DSL without SCS. Axial back pain and claudication had a statistically significant association with imaging findings. Similarly, patients with associated canal stenosis had statistically significant sensory and motor deficits, altered deep tendon reflexes. Facet joint angle more than 45 degrees at the level of the slip had a higher incidence of indicative presenting symptoms. However, this was not statistically proven.ConclusionDSL is a heterogeneous condition with the simultaneous presence of different degenerative processes in the lumbar spine at various stages. Hence, clinical presentations are widely variable. The concomitant presence of SCS significantly influences the clinical symptomatology with correlation to the MRI findings. Therefore, a judicious weighing of the clinical and imaging findings is crucial for prudent management planning for cases of DSL.

Introduction: Osteoradionecrosis is a rare and debilitating risk of definitive chemoradiotherapy for head and neck squamous cell carcinoma. It is difficult to distinguish between osteoradionecrosis and recurrent or progressive disease, as clinical and radiologic features may be similar. Our aim was to compare the clinical presentation and radiologic features of osteonecrosis with those of recurrent or progressive cancer. Methods: We conducted a single-center case series of 19 patients with head and neck squamous cell carcinoma diagnosed between 2011 and 2019 who subsequently developed clinical and/or radiological suspicion of osteoradionecrosis. The population was a referred sample from head and neck cancer physicians at Northwell Health Cancer Institute. Clinician notes and imaging reports were reviewed to assign a final diagnosis of either cancer, osteonecrosis, or indeterminate. Results: No differences were found in the clinical presentation or radiologic features between groups. Median time between treatment and development of symptoms was longer in patients with a final diagnosis of osteoradionecrosis than recurrent or progressive disease (5 vs. 3 months), but this difference was not statistically significant. Radiation dose and type were not associated with diagnosis. Mean standard uptake value maximums on positron emission tomography/computed tomography were significantly higher in the cancer group (median 14.8 vs. 9.1, p < 0.0152). At 1 year after first suspicion of osteoradionecrosis, 100% of osteoradionecrosis patients were alive, versus 28.6% of cancer patients. Discussion/Conclusion: There is significant overlap in clinical and radiologic features of osteoradionecrosis and cancer. Standard uptake maximums may be helpful in predicting diagnosis. Occurrence of symptoms within 6 months of completing chemoradiotherapy should raise the concern for malignancy.

Genetic Diversity Drives Differing Morphological and Clinical Presentation and Survival in Myelodysplastic-Type CMML with a Low Absolute Monocyte Count

Clinical aspects and biomarkers of Alzheimer's disease in Down syndrome.

Aneurysms in the Left Ventricular Outflow Tract: Clinical Presentation, Causes, and Echocardiographic Features

BackgroundSomatically acquired genomic alterations with MYCN amplification (MNA) are key features of neuroblastoma (NB), the most common extra-cranial malignant tumour of childhood. Little is known about the frequency, clinical characteristics and outcome of NBs harbouring genomic amplification(s) distinct from MYCN.MethodsGenomic profiles of 1100 NBs from French centres studied by array-CGH were re-examined specifically to identify regional amplifications. Patients were included if amplifications distinct from the MYCN locus were seen. A subset of NBs treated at Institut Curie and harbouring MNA as determined by array-CGH without other amplification was also studied. Clinical and histology data were retrospectively collected.ResultsIn total, 56 patients were included and categorised into 3 groups. Group 1 (n = 8) presented regional amplification(s) without MNA. Locus 12q13-14 was a recurrent amplified region (4/8 cases). This group was heterogeneous in terms of INSS stages, primary localisations and histology, with atypical clinical features. Group 2 (n = 26) had MNA as well as other regional amplifications. These patients shared clinical features of those of a group of NBs MYCN amplified (Group 3, n = 22). Overall survival for group 1 was better than that of groups 2 and 3 (5 year OS: 87.5%±11% vs 34.9%±7%, log-rank p<0.05).ConclusionNBs harbouring regional amplification(s) without MNA are rare and seem to show atypical features in clinical presentation and genomic profile. Further high resolution genetic explorations are justified in this heterogeneous group, especially when considering these alterations as predictive markers for targeted therapy.

There is wide discrepancy between common clinical and radiologic presentations of branchial sinuses arising from the pyriform fossa and the theoretic course of third and fourth branchial arch anomalies. The purpose of this study was to revisit the clinical presentations and imaging features of such anomalies in children. A retrospective review of institutional and diagnostic imaging data bases from 1998 to 2008 for reported cases of third and fourth branchial cleft anomalies was conducted. Clinical presentation, pharyngoscopy results, and imaging features in all the patients were evaluated. Surgical and histopathology correlation in patients who underwent excision of the tract was also obtained. Twenty reported cases described as third or fourth branchial apparatus anomalies were identified. There were 12 females and 8 males with a mean age of 84.6 months. The most common presentation was an inflammatory neck mass (18/20, 90%) almost always involving the thyroid gland. Most lesions were on the left side (16/20, 80%). Pharyngoscopy showed a sinus opening at the piriform fossa in 18/20 (90%) cases. None of the cases followed the classic theoretic pathway of third and fourth arch remnants. Histopathology showed tracts lined with pseudostratified squamous epithelium or ciliated columnar epithelium often associated with inflammatory changes in 17 surgically resected cases. Branchial sinuses arising from the pyriform fossa often present with an inflammatory neck mass involving the thyroid lobe, most often on the left side. Imaging and surgical findings suggest that they arise from the embryonal thymopharyngeal duct of the third branchial pouch, because they do not follow the hypothetic course of third or fourth arch fistulas.

We describe a retrospective analysis of the clinical presentation and imaging features in nine patients with adrenal histoplasmosis in nonimmunocompromised patients from a nonendemic region. Clinically, a tuberculosis-like presentation in four patients and a tumor-like presentation in five patients were seen. All patients were seronegative for the human immunodeficiency virus. Ultrasound (US) in all patients, computed tomography (CT) in six, and magnetic resonance imaging (MRI) in three showed suprarenal masses. CT-guided (in five) and US-guided (in four) biopsy and fine-needle aspiration cytology established a definite diagnosis. The work-up for malignancy and tuberculosis was negative. On cross-sectional imaging, eight patients had bilateral adrenal masses and one had a unilateral adrenal mass. Imaging features were variable. All adrenal masses were hypoechoic on US, homogeneous in five, and heterogeneous in four patients. All adrenal masses were hypodense on CT, homogeneous in four, and heterogeneous in two. Heterogeneous enhancement was seen in three, homogeneous enhancement in two, and no enhancement in one patient. MRI in three patients showed that the masses were of variable signal intensity on all pulse sequences. Our case series showed that adrenal histoplasmosis does occur in immunocompetent persons living in areas not endemic for the disease. The imaging features were variable.