Gastric varices: Endoscopic view

This article does not have an abstract  

Right ventricular myocardial infarction: The electrocardiography (ECG) pattern

This article does not have an abstract  

A case report of stomach and esophagus melanoma with liver metastases in a 63-year-old woman

BACKGROUND: Melanoma originates from melanocytes, which are dendritic pigmented cells. Malignant melanoma is divided into cutaneous and non-cutaneous types, and cutaneous one is the most common type. Gastric melanoma has rarely been reported, and is divided into primary and secondary categories.CASE REPORT: We report a 63-year-old woman with continues epigastric pain complaining of bloody defecation with elucidated blood, lack of appetite, weight loss, and icteric skin. She was a known case of hypertension, and a surgery of the left eye mass was done for her, which the patient's eye was discharged completely. The patient's biopsy sample was not sent for pathology, and there was no pathology result. The patient was evaluated with endoscopy because of epigastric pain of 6 months before. In addition to class A esophagitis, a nodule with an approximate dimension of 1 cm was seen in the Z-line of the esophagus, and two black lesions in the greater curvature of the stomach were seen, which biopsy of all these lesions was done. In the pathological study of biopsy specimens in a microscopic view, the replication of scattered hotspots in submucosa with atypical cells, large nuclei, and dark brown pigmentation were observed. In the immunohistochemistry study, HMB-25, Ki-67, carcinoembryonic antigen (CEA), and S100 were positive. Ultimately, the patient was diagnosed with melanoma.CONCLUSION: This report demonstrates the importance of medical documentation in determining the origin of diseases. as, if there was documentary evidence of the evacuated eye mass, differentiation of the primary or metastatic melanoma was possible

ERCPMP: An Endoscopic Image and Video Dataset for Colorectal Polyps Morphology and Pathology

In the recent years, artificial intelligence (AI) and its leading subtypes, machine learning (ML) and deep learning (DL) and their applications are spreading very fast in various aspects such as medicine. Today the most important challenge of developing accurate algorithms for medical prediction, detection, diagnosis, treatment and prognosis is data. ERCPMP is an Endoscopic Image and Video Dataset for Recognition of Colorectal Polyps Morphology and Pathology. This dataset contains demographic, morphological and pathological data, endoscopic images and videos of 191 patients with colorectal polyps. Morphological data is included based on the latest international gastroenterology classification references such as Paris, Pit and JNET classification. Pathological data includes the diagnosis of the polyps including Tubular, Villous, Tubulovillous, Hyperplastic, Serrated, Inflammatory and Adenocarcinoma with Dysplasia Grade & Differentiation. The current version of this dataset is published and available on Elsevier Mendeley Dataverse and since it is under development, the latest version is accessible via: https://databiox.com

Outer Ear Infections in Iran: A Review

BACKGROUND: Otitis externa is the fungal and bacterial infection of the outer ear. AIM: We aimed to investigate the published papers about the outer ear infections in Iran and suggest standardised investigations and treatments. METHODS: We used different electronic databases like PubMed, Scopus, Web of Science, Iranmedex, Google Scholar, and Magiran with specific keywords. RESULTS: We obtained forty published full-text articles for review of data. Our results indicated the women were more infected than men. The ages of patients were < 1-81 years. As clinically symptoms, itching and Feel the ear fairy were the most common presenting complaints in most cases. Most infections were the pure bacterial and fungal origin, respectively. However, some of the studies were mixed fungal-bacterial infections — Pseudomonas spp. And Aspergillus niger were the most common bacteria and fungi isolates respectively in Iranian patents. CONCLUSION: Fungal and bacterial specific cultures may be recommended, and anti-fungal drugs may be added, to treatment regimens in patients with otitis externa to reduce the clinical symptoms

Right ventricular myocardial infarction: The electrocardiography (ECG) pattern

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High prevalence of Mucosa-Associated extended-spectrum β-Lactamase-producing Escherichia coli and Klebsiella pneumoniae among Iranain patients with inflammatory bowel disease (IBD)

Abstract Background Several pieces of evidence suggest that certain pathobionts belonging to Enterobacterales are associated with the development and progression of inflammatory bowel diseases (IBD). Extended-spectrum β-lactamases (ESBLs) ESBLs are frequently found in the Enterobacterales members, particularly in Escherichia coli and Klebsiella spp., and might trigger antibiotic-induced perturbations of the intestinal microbiota and led to more severe disease activity in IBD. Therefore, the severity of IBD could be influenced by ESBL-producing Enterobacterales, and hence, this study aimed to investigate the presence of ESBLs and carbapenemases among mucosa-associated E. coli and Klebsiella pneumoniae isolated from colonic biopsies of Iranian patients with IBD. Methods In this cross-sectional study, E. coli and K. pneumoniae were isolated from inflamed ileum and/or colon tissue of patients with IBD, including Ulcerative colitis (UC) and Crohn’s disease (CD), during colonoscopy. Demographic data and clinical characteristics were recorded, and UC and CD disease activity and extent were evaluated according to the full Mayo score and Crohn’s disease activity index (CDAI), respectively. Phenotypic and molecular detection of ESBL- and carbapenemase-producing E. coli and Klebsiella pneumoniae were carried out. Disease activity and other clinical and microbial features were compared in patients with and without gut colonization with ESBL producers. Results A total of 83 IBD patients, including 67 UC and 16 CD, were enrolled in the initial analysis. Intestinal colonization with ESBL-producing E. coli and/or Klebsiella pneumoniae was found in 37 (55.2%) of UC and 9 (56.2%) of DC patients – mostly harbored E. coli containing the bla CTX−M and bla TEM genes. UC patients with intestinal colonization with ESBL-producers had more severe disease compared with patients without colonization. Moreover, 10.2% of tested E. coli and 34.8% of K. pneumoniea were recognized as potential carbapenemase producers. Conclusion Intestinal colonization with ESBL producers could arise disease activity in IBD patients. Further large-scale case-control studies should be performed to investigate the possible confounding factors that could contribute to this outcome

A case of human acute otoacariasis caused by Rhizoglyphus sp, the first report from Iran

Otoacariasis is the presence of ticks and mites in the auditory canal. A 50-year-old Iranian man was subjected at the an ear, nose, and throat clinic at Rouhani Hospital in Babol with complaint of left ear pain. Otoscopic examination showed mite infestation in the left auditory canal. The infestation was eradicated with the 2% H2O2 solution. Treatment began by applying oral ciprofloxacin (500 mg/day) twice daily for 7 d. We report the rare case of an ear canal infestation with the Rhizoglyphus and their eradication with 2% H2O2 solution

Unusual presentation of transthyretin (ATTR) cardiac amyloidosis: A case report of pruritus as a possible initial symptom and challenging diagnosis

Key Clinical Message This case emphasizes the significance of cardiac amyloidosis as a potential diagnosis in individuals manifesting with lesion‐free pruritus and normal liver tests. Abstract Amyloidosis is a complex disorder in which misfolded proteins accumulate in various organs of the body. Cardiac amyloidosis (CA) can lead to heart failure, cardiac arrhythmia, sudden cardiac death, and deposition of proteins in coronary arteries. Diagnosing CA can be difficult, as the cardiac manifestations of amyloidosis can be similar to more prevalent etiologies. In addition, the accumulation of proteins in soft tissues, including the skin, can cause pruritus. In this paper, we present a 70‐year‐old man with generalized pruritus and no skin lesions, later diagnosed as CA after detecting ascites fluid. This case underscores the importance of considering amyloidosis in patients presenting with nonspecific symptoms, particularly those affecting the skin, and highlights the need for increased awareness of this disease among clinicians