Narrative Case Research Articles

Myxoid Liposarcoma of the Thigh in Early Puerperium—Rare Case Report and Narrative Review

Background: Liposarcoma (LPS) is a rare malignant tumor, but it is also one of the most common adult soft-tissue sarcomas. Myxoid liposarcoma (MLPS) accounts for 30% of all LPS cases. Diagnosis during pregnancy and the puerperium is very rarely reported, and only a few cases have been reported in the thigh. Case presentation: We report the case of a 36-year-old female patient on the 11th day of the puerperium after a cesarean section. The patient presented to the gynecology ward owing to the sudden appearance of a tumor in the medial part of her right thigh. The lesion was non-painful, mobile, soft, approximately 20 cm in diameter, and protruded above the level of the rest of the thigh surface. A suspicion of hematoma was raised. The final diagnosis was high-grade MLPS. Conclusions: An MLPS diagnosis is uncommon in female patients and even rarer during pregnancy. This case represents a novel occurrence, as the first instance in which symptoms manifested during the puerperium. Proper treatment and early detection could improve disease outcomes.

Benign Mesenchymal Tumor of the Vulva: A Case Report and Narrative Review of the Literature

Benign Mesenchymal Tumor of the Vulva: A Case Report and Narrative Review of the Literature

Are Neuromuscular Disorders That Cause Fatigue a Contraindication to Sports Participation? A Case Report and Narrative Review of the Literature

Engaging in sports, particularly at a competitive level, requires sustained muscle contractions before the onset of physical fatigue. Fatigue is highly prevalent in neuromuscular diseases, especially those affecting neuromuscular transmission (e.g., myasthenia gravis) or muscle membrane excitability (e.g., myotonia, certain metabolic myopathies). A decremental response in repetitive nerve stimulation (RNS) represents the neurophysiological analogue of exercise-induced muscle weakness. Patients with such responses exhibit abnormal suppression of muscle activity during repetitive or prolonged effort. Consequently, it is often assumed they should avoid strenuous physical activity. To assess the safety of sports participation in individuals with fatigability-related neuromuscular disorders, we examined the literature and report a new case of a patient with myotonia congenita who engaged in competitive sports without adverse events. The review identified only a few cases involving patients with myasthenia gravis or muscular dystrophies who also participated in competitive sports safely and with favorable outcomes. No adverse events were reported. While these findings suggest that sports participation may be feasible for selected patients, they cannot be generalized. Large-scale studies involving athletes with neuromuscular conditions are needed to evaluate the safety and long-term impact of exercise in these populations.

Starting From Scratch: A Rural District’s Path to Supporting New Multilingual Students Without State or Federal Support

This fictional case narrative based on real-world challenges explores and builds upon prior research on the complex issue of multilingual learner–English learner 1 (ML-EL) program services in rural or low ML-EL incidence 2 school districts. 3 The lack of funding, accountability, and trained ML-EL program administrators has expanded school districts’ challenges as they seek to serve an increasingly diversified population. This case illustrates how several rural school districts support ML-EL students and families. 4 Grounded in loose coupling and critical race theory, the case activities encourage students to examine the facts of the case from the prospective of a school administrator.

Thematic analysis of medical examiner narratives to understand the socio-spatial context, recency of drug use, and likely mechanism of stimulant toxicity deaths.

Thematic analysis of medical examiner narratives to understand the socio-spatial context, recency of drug use, and likely mechanism of stimulant toxicity deaths.

Exploring the Impact of Anxiety and Depression on Patients with Chronic Diseases: Understanding the Severity and Its Implications for Care

Background: Chronic diseases such as diabetes, cardiovascular disorders, respiratory illnesses, and cancer profoundly affect both physical and mental health. The World Health Organization attributes 71% of global deaths to chronic illnesses, with a significant overlap between these conditions and mental health disorders like anxiety and depression. Emotional and psychological distress are often intrinsic components of chronic illness, exacerbated by the demands of long-term disease management. Methods and Materials: This qualitative and narrative analysis drew from global reports, peer-reviewed studies, patient interviews, and clinical observations. Key data sources included WHO, peer-reviewed journals such as BMC Primary Care, and qualitative accounts from patient support platforms. Patient experiences and case narratives were used to illustrate the psychological burdens of chronic disease, including the roles of pain, social isolation, financial strain, and altered identity. Results: Findings indicate a high prevalence of mental health issues among patients with chronic illnesses, often driven by lifestyle limitations, chronic pain, and social disconnection. Approximately 40% of individuals with chronic conditions display symptoms of anxiety and depression. Key contributors include loss of autonomy, distorted body image, and financial stress. Chronic illness can also alter brain chemistry, further predisposing individuals to mood disorders. Many patients feel hopeless, stigmatized, or burdensome, which exacerbates mental health deterioration and may increase the risk of suicide. Conclusion: Mental health conditions in patients with chronic diseases are not merely secondary complications but central to the illness experience. Addressing psychological wellbeing is vital to managing chronic conditions effectively. Integrating mental health care into chronic disease management—through supportive therapies, resilience training, and telehealth access—can significantly improve health outcomes and quality of life. A holistic, patient-centered approach is essential in both prevention and care.

A qualitative study on Turkish-Islamic literature theses

This study, which examines the methodologies of graduate theses conducted in the field of Turkish-Islamic Literature between 1984 and 2021, emphasizes the significance of qualitative research methods widely used in social sciences. A total of 306 master’s theses and 57 doctoral dissertations were analyzed. These theses were classified according to years, subjects, and universities. The theses were categorized into five main topics: biography, concept analysis, text analysis, translation-Ottoman texts-transcription-critical edition, and Turkish-Islamic Literature genres. These topics were examined in detail in terms of content and methodology. Findings revealed that biography was the most researched topic, with 249 master’s and 44 doctoral theses. Additionally, transcription studies were found to be concentrated on works from the pre-Republican period, while studies on concept analysis and Turkish-Islamic Literature genres were less frequent. A significant increase in the number of academic studies in Turkish-Islamic Literature was observed, reflecting both rising academic interest and expanding research opportunities. Most of these studies were conducted at the faculties of theology at Marmara University and Ankara University. However, it was noted that many theses did not adequately address qualitative research methods and designs. The findings highlight the importance of qualitative research methods and designs in interdisciplinary fields like Turkish-Islamic Literature. Narrative research and case study designs were identified as the most commonly employed approaches, which correlates with the prevalence of biographical and text analysis studies. In conclusion, this research provides a methodological examination of graduate theses in the field of Turkish-Islamic Literature and outlines the current state and future directions of these theses.

Somatic literacies and emergent response-abilities: An embodied feminist eco-pedagogy as a pathway toward planetary health

ABSTRACT In our time of unprecedented environmental and ecological crisis, social work needs a radical re-imagining of its pedagogical and practice foundations. In the interest of extending the reaches of planetary health discourse in social work thought and education, this article introduces an embodied eco-pedagogy model grounded in decolonial and feminist thought and animated by a teaching case narrative. By interweaving poetic and lived expression with theoretical, scientific, and practical discussions, we trace the four phases of this spiral model, emphasizing the complexity and criticality of cultivating embodied ways of being, thinking, sensing, and relating as essential spiritual, affective, and ethical resources for fostering ecological consciousness and transformative healing in our era of the Anthropocene. Ultimately, this eco-pedagogy opens possibilities for cultivating somatic literacies and, by extension, co-creating new life-affirming stories while strengthening our collective response-abilities to our living, animate Earth.

An integrated lean-digital framework for optimizing civil- engineering supply chains: mixed-methods evidence from multi-project case analyses

All around, civil engineering megaprojects are still struggling with budget overruns, schedule slippage,and disjointed supply-chain coordination. This paper conducts an embedded, multiple-case study ofpublicly recorded projects spanning Asia, Africa and the Middle East. Using a pragmatist mixed-methodsapproach, we thematically coded secondary reports, audits and peer-reviewed case narratives;descriptive statistics were used to investigate related cost- and time-performance data. Convergenttriangulation found four common levers distinguishing better performers, early strategic alignmentamong stakeholders, proactive scenario-based risk management and digitally enabled transparencythrough (BIM) and (IoT) twins. Collaborative contracting cultures such as Integrated Project Delivery.Projects using these levers reduced lead-time variation by as much as 17% and cost overruns by 4–6percentage points. Building on these ideas, we suggest an Integrated Lean-Digital Frameworkcascading through Strategic Alignment, Collaborative & Digital Integration, OperationalExecution and Continuous Improvement & Sustainability. Though reliance on secondary datareduces statistical generalizability, deliberate case selection and cross-source triangulation improvetransferability, therefore offering a consistent path to fight fragmentation. This synthesisoffers practical advice for managers and politicians.

Clinical Characterization of Lymphatic Leakage Complicating OLIF Surgery.

This is a narrative review and case report. To summarise and share relevant treatment experiences by analysing the clinical features of lymphatic leakage occurring after oblique approach retroperitoneal lumbar interbody fusion (OLIF), with a view to providing reference and guidance for clinical practice. Clinical data of 3 patients with lymphatic leakage after OLIF surgery from December 2018 to April 2024 in the International Zhuang Medicine Hospital affiliated to Guangxi University of Traditional Chinese Medicine and the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine were retrospectively analysed. Through postoperative bed rest, change of body position, regulation of diet and other treatments, postoperative lymphatic leakage was effectively controlled, and all 3 patients recovered and were discharged from the hospital. Surgical operation damage to lymphatic vessels is an important cause of postoperative lymphatic leakage, nonsurgical treatment should be the first choice for treating lymphatic leakage, and strengthening high-protein diet is the key to treating lymphatic leakage.

Political Communication in Television Media: A Study of Encoding/Decoding on Voters in the 2024 Election

This study analyzes the role of the media in shaping public opinion ahead of the 2024 Presidential Election, focusing on the Maghrib adhan broadcast featuring Ganjar Pranowo on MNC Group television station in September 2023. This phenomenon raises polemics regarding media independence, given that MNC Group is owned by Hary Tanoesoedibjo, chairman of the Perindo Party who supports Ganjar as a presidential candidate. The broadcast is considered an attempt at identity politics to build a politician's image. This research uses a critical paradigm with a qualitative descriptive approach, combining Stuart Hall's encoding-decoding theory and Roland Barthes' semiotics to analyze the political symbols in the broadcast. Data collection was done through in-depth interviews, observation, and literature study. The results show that political shows are not taken for granted by the audience, but through a decoding process that is influenced by their social and cultural background. The media, in this case RCTI, utilizes symbols and narratives to shape the image of politicians, although the meaning received by the audience varies, depending on their decoding position. This finding confirms the role of the media as a tool of domination in shaping public opinion and creating political hegemony, which risks reducing the objectivity and independence of the media in a democracy.

Accuracy of Digital Impressions for Veneer Restorations: A Narrative Review and Case Illustration.

Background: Intraoral scanners have become increasingly popular for final dental prostheses due to their precision, efficiency, and patient-friendly approach. However, their use for capturing final impressions of highly esthetic and thin restorations, such as ceramic veneers, presents unique challenges. Veneer preparations differ significantly from traditional full-coverage crowns, with their smaller and more delicate margins often located at or below the gingival level. This complexity may lead to hesitancy among clinicians regarding the routine use of intraoral scanners in such cases. Methods: A comprehensive literature review was performed to evaluate the effectiveness of intraoral scanners for final digital impressions in ceramic veneer restorations within the esthetic zone. Studies published between January 2010 and January 2025 were included in the review. Additionally, a case illustration was provided, detailing the use of an intraoral scanner to capture final impressions for a patient requiring 10 ceramic veneers in the esthetic zone. Results: The review demonstrated that intraoral scanning is a reliable technique for veneer impressions, delivering clinically acceptable outcomes. The benefits include enhanced patient comfort, improved workflow efficiency, and a reduction in chairside time. Nonetheless, clinicians must overcome a learning curve with digital technologies and ensure optimal conditions, such as maintaining a dry tooth surface during scanning. The presented case successfully illustrated the use of intraoral scanning, resulting in precise impressions and the fabrication of highly esthetic and functional veneers. Conclusions: Intraoral scanning is a predictable and effective method for capturing final impressions for veneer restorations. It offers results comparable to traditional methods while enhancing patient experience and enabling the fabrication of high-quality restorations within an efficient workflow.

Digital activism in Kenya: moving from the digital center to the digital periphery of Long Covid experience

Digital activism around Long Covid has reverberated around the globe, as patients, researchers, and clinicians worked together to understand the chronic condition. However, Long Covid networks, much like other social networks, have hierarchies and barriers that can impede equitable access. In this article, we examine how the global digital center and periphery shape how people with Long Covid connect to networks to learn about their illness symptoms, diagnoses, treatments, and experiences. We introduce case narratives of two Kenyan women—one elite Nairobian who was connected to the digital center and another middle class woman who connected with her through a peripheral digital community—to describe how elite patients were engaged at the digital center, and non-elite patients were engaged in the periphery with digital and non-digital connections through which they cultivated other social networks to communicate, share, and experience their illness experiences. The Kenyan case study introduces a context where people have sophisticated digital lives and are engaged in global information networks. Yet, we argue that some Long Covid patients’ experiences are impossible to divorce from the digital activism that has drawn together a remarkable global patient community, causing a ripple effect on how people define and experience the self and illness throughout the world. We conclude that many Kenyans may be engaging with digital networks differently and from different places of geographic, cultural, linguistic, and technological power, possibly cultivating divergent idioms, interpretations, and experiences of the post-viral condition. This demonstrates not only how social networks function at the digital periphery but also the complexities situated within the periphery itself, which is at important social nodes, connected to the digital center.

Prostate Artery Embolization (PAE) in the Treatment of Benign Prostatic Hyperplasia: A Case Series and Narrative Review.

Background/Objectives: Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), particularly in high-risk surgical candidates. This study aims to evaluate the efficacy, safety, and clinical outcomes of PAE, combining a retrospective case series with a narrative review of the literature. Methods: A single-center retrospective analysis was conducted on 10 patients aged ≥ 70 years with moderate-to-severe LUTS due to BPH who underwent PAE between January 2021 and January 2024. Inclusion criteria included IPSS > 18, Qmax < 12 mL/s, prostate volume > 45 cc, and resistance to medical therapy. Embolization was performed using 300-500 µm tris-acryl gelatin microspheres via the PErFecTED technique. Follow-up included IPSS, Qmax, prostate volume (PV), PSA levels, and complications. A narrative review of 18 studies (n = 1539 patients) was also conducted to contextualize findings. Results: Technical success was achieved in all patients (100%), and clinical success (IPSS reduction ≥ 50%) in 90%. At 12 months, the following significant improvements were observed: mean IPSS decreased from 24 to 12 (p < 0.0001), Qmax increased from 8.7 to 12.6 mL/s (p < 0.0001), PV reduced from 66.4 to 49.4 cc (p < 0.0001), and PSA from 5.0 to 3.4 ng/mL (p < 0.0001). Outcomes remained stable up to 36 months. Two patients developed transient post-procedural fever; no major complications were recorded. Conclusions: PAE is a safe and effective treatment for LUTS related to BPH, offering durable symptom relief and minimal morbidity, particularly in elderly and comorbid patients. While the evidence supports its role as an alternative to TURP, larger prospective trials are necessary to confirm its long-term efficacy and optimize patient selection.

Triple P Model: Revitalizing Peer Feedback with Key Stakeholders Engagement

Introduction Peer feedback is crucial for enhancing learners' competency and skills in achieving educational goals. Despite its proven impact on learning outcomes, learners often lack the necessary skills and confidence to engage in meaningful peer feedback. Objective Our primary aim was to create a practical and memorable feedback model that considers all key individuals involved in educational feedback processes. Method We utilized a narrative case study within the 6for6 program, a research skills development initiative for rural physicians. Employing the nominal group technique, the 6for6 core team held regular meetings to address challenges in peer feedback processes and craft a practical and memorable model. Results The developed peer-feedback model focuses on three key persons: presenters, peers, and pedagogues (Triple P). Each person has an associated rubric and a simple acronym for ease of recall. Additionally, a Learning Plan Template was adapted to help learners organize their thoughts and progress toward their goals. Conclusion Recognizing feedback as an interactive and multi-faceted process, our model, created within the 6for6 program, encompasses main persons and has the potential to enhance learning opportunities and outcomes. While initially designed for rural physician research skills development, this model is adaptable to various educational settings and contexts.

A Narrative Literature Review and Case Study Highlighting Errors in Automatic External Defibrillator Use at a Community Event.

Early basic life support and defibrillation using automated external defibrillators (AEDs) are key for improving survival in those suffering an out-of-hospital sudden cardiac arrest. To improve survival, access to AEDs by lay responders is growing, and use is included in basic cardiac life support training. These devices are considered extremely safe, evidenced by the paucity of medical literature on AED misuse and expert opinion. However, it's crucial to point out that even medical personnel can make errors in their use. This case study of AED misuse during a community event and narrative literature review underscores the potential for errors in using an AED, which could cause considerable patient harm. To prevent errors in AED use, it is important to train on (1) equipment in use or likely to be encountered in the field, (2) how to dump an electric charge, especially when using a fully automated machine, (3) the need to follow specific machine instructions, (4) proper application of the defibrillator pads (including one-piece pads with metronome), (5) the need to assess the patient and not rely entirely on the AED prompts, which can contain false alerts and inappropriate instruction, and (6) the need for closed-loop communication, even when participating in a community event.

Early management of cleft lip and palate using presurgical nasoalveolar molding and 3D-printed feeding plate and nasal stent: A narrative review and case report.

Early management of cleft lip and palate using presurgical nasoalveolar molding and 3D-printed feeding plate and nasal stent: A narrative review and case report.

Relating Adolescents’ Well-Being with the COVID-19 Pandemic through Recreational Activities

Recreation, which ensures adolescents' holistic well-being, got ambushed by the COVID-19 pandemic homestay, sedentariness, and e-schooling, thereby limiting multi-domanial growth. Appraising youngsters' lives during the pandemic, we conducted this phenomenological study using an inductive approach to explore adolescents' recreational activities during the COVID-19 pandemic, and the effect of pandemic-influenced recreation on their physical, psychological, and socio-emotional well-being. N=30 school and college-aged adolescents (15 boys, 15 girls) within 12-19 years (mean age: 16.4±1.94 years) from Delhi, India, were selected through purposive sampling. Semi-structured interviews (n=30), focus group discussions (n=10), and case narratives (n=3) helped in accumulating open-ended data from January 1, 2021–March 31, 2021. Content analysis concluded negative domination of the COVID-19 pandemic on juveniles' physical, psychological, and socio-emotional well-being through curtailing their free recreation. Due to scarce time devotion and insubstantial recreational choices, it was found that participants compellingly opted for indoor, sedentary, and digital activities while rejecting outdoor-physical pursuits. Further, parents, friends, teachers, homeschooling, and COVID-19 lockdown affected teenagers' recreation at family/home and community levels. Our results tracing lack of free recreation as the most prominent cause for adolescents' negative well-being during the pandemic, supported the argument we made in the study. These being highly relevant to public health and policy additionally highlighted the significance of continuous recreation during emergencies/otherwise, and researching latent developmental aspects especially recreation for layman to understand its worth. Laterally, management implications were suggested for adolescents’ ecological systems (parents, teachers, government authorities) to optimize recreation in all legal, moral, and social ways.

Association of type 1 stiff-person syndrome and insulinoma: a case report and narrative review.

Stiff-person syndrome (SPS) is a rare neurological disorder that causes progressive muscle rigidity, gait disturbances, and functional impairment; type 1 is autoimmune, with positive anti-GAD antibodies (Ab), while type 2 is paraneoplastic and associated with antiamphiphysin Ab. A 41-year-old man with a silent medical history presented with stiffness and functional impairment; after numerous rheumatological and neurological investigations, he was diagnosed with SPS, with evidence of high titer anti-GAD Ab. After treatment with benzodiazepines was started, the patient began to experience episodes of confusion, which persisted even after reducing the dosage. During one of these episodes, he was admitted to the emergency department and a glucose level of 26mg/dL was found. Differential diagnosis led to detection of an insulin-secreting neuroendocrine tumor of the pancreas; thus, a paraneoplastic origin of SPS was hypothesized. However, antiamphiphysin Ab were negative, anti-GAD Ab were persistently elevated, and symptoms only transiently improved after removal of the tumor. This is the first case, to our knowledge, demonstrating association between type 1 SPS and insulinoma, along with describing partial and transient improvement of neurological symptoms after resolution of the associated hypoglycemic syndrome.

Identity, ideology, and capital in EFL learning: a narrative case study

Research on learners’ commitment to English language learning in the field of second language acquisition (SLA) around the world is predominantly characterized by a positivist and quantitative approach. Conventionally, this type of studies uses the psychological construct ‘motivation’ to account for learners’ efforts in language learning practices. Such paradigmatic orientation constituted a knowledge gap on the role of society, structural inequality, and uneven distribution of resources in English language learning. To address this gap, with a poststructuralist approach, this paper reports on an in-depth narrative case study of an underprivileged learner’s engagement in English language learning in Bangladesh through Darvin and Norton's (Ann Rev Appl Linguist 35: 36–56, 2015) expanded model of ‘investment’, a sociological counterpart of the psychological theory of ‘motivation’. Data for the study were collected over a two-year period through narrative interviews, a written autobiography, and informal conversations. The collected data were analyzed deductively following Polkinghorne's (Int J Qual Stud Educ 8: 5–23 1995) ‘analysis of narrative’ approach in connection with the expanded model of ‘investment’ which focuses on identity, ideology, and capital. In particular, findings demonstrate that (a) imagined identity and group membership influence commitment to language learning; (b) ideologies embedded in language education policy, linguistic gatekeeping, and methodologies of English language teaching configure language learning practices; and (c) the fluid nature of the three forms of capital (i.e., economic, social, and cultural) enables the participant to engage in learning English. The findings of this study have implications for language educators and second language acquisition (SLA) researchers.