Adenosquamous Carcinoma of Gallbladder with Unusual Prognosis: A Case Report

The adenosquamous carcinoma of the gallbladder is a rare variant accounting for only 1-4% of all primary gallbladder carcinoma. Regardless of the histological types, all gallbladder carcinomas have silent and rapid progression resulting in delayed diagnosis and poor prognosis. Even with medical and/or surgical interventions, the median survival of patients with adenosquamous carcinoma, one of the histological variants, is less than a year. However, we present a case of adenosquamous carcinoma with an unusually better prognosis. A 70-year-old female patient, after being diagnosed with gallbladder carcinoma was suggested for surgical resection but was lost to follow-up since then. Two years later, the patient presented and was managed with extended cholecystectomy. The slow progression and non-recurrence of the tumour during follow-up for two years after the surgery indicates a better prognosis in this case

IgG4‐related sclerosing cholangitis, a mimicker of the cholangiocarcinoma: A case report

Abstract An 83‐year‐old‐male patient presented with obstructive jaundice, whose imagings were consistent with the cholangiocarcinoma of the distal common bile duct. The tumor markers were within normal limits. IgG4 level was raised; therefore, IgG4‐sclerosing cholangitis was made as the provisional diagnosis. Steroid therapy was started to which he responded well

Breast Cancer among Cancer Patients Visiting the Department of Internal Medicine of a Tertiary Centre

Introduction: Breast cancer is one of the most common cancers worldwide both in terms of incidence and mortality. Its incidence has been on an increasing trend in developing nations including Nepal, however, there is very limited evidence of its demographic profile in our setting. This study aimed to find out the prevalence of breast cancer among cancer patients visiting the Department of Internal Medicine of a tertiary centre. Methods: A descriptive cross-sectional study was conducted among cancer patients visiting the Department of Internal Medicine of a tertiary care centre using retrospectively collected data from 1 August 2022 to 30 July 2023 after obtaining ethical approval from the Institutional Review Committee. Histopathologically confirmed cancer patients were included and those with incomplete and duplicated data were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 2067 cancer patients, the prevalence of breast cancer was 102 (4.93%) (4.00-5.87, 95% Confidence Interval). The mean age was 50.51±2.08 years. The most commonly affected age group was 40 to 60 years constituting 61 (59.80%) patients. Histologically, invasive breast cancer of no special type was the most common and was found in 91 (89.22%) patients. Conclusions: The prevalence of breast cancer was similar to other studies done in similar settings

Prune belly syndrome: A rare case report

Key Clinical Message In babies presenting with an omphalocele, other components of the prune belly syndrome should be scrutinized for early diagnosis and timely intervention. Abstract A male baby on his 13th day of life presented with an omphalocele. On evaluation, he had congenital absence of left kidney and bilateral cryptorchidism. Therefore, he was diagnosed with prune belly syndrome. He responded well to abdminoplasty, and wait and watch policy was applied for his cryptorchidism

Adenosquamous Carcinoma of Gallbladder with Unusual Prognosis: A Case Report

The adenosquamous carcinoma of the gallbladder is a rare variant accounting for only 1-4% of all primary gallbladder carcinoma. Regardless of the histological types, all gallbladder carcinomas have silent and rapid progression resulting in delayed diagnosis and poor prognosis. Even with medical and/or surgical interventions, the median survival of patients with adenosquamous carcinoma, one of the histological variants, is less than a year. However, we present a case of adenosquamous carcinoma with an unusually better prognosis. A 70-year-old female patient, after being diagnosed with gallbladder carcinoma was suggested for surgical resection but was lost to follow-up since then. Two years later, the patient presented and was managed with extended cholecystectomy. The slow progression and non-recurrence of the tumour during follow-up for two years after the surgery indicates a better prognosis in this case.</jats:p

Aspirin Desensitization and Percutaneous Coronary Intervention in a Patient with Aspirin Hypersensitivity and Acute Coronary Syndrome: A Case Report

Hypersensitivity to aspirin is rare disorder occurring in 1.88% of the patients. Aspirin-hypersensitive patients requiring single antiplatelet agent may be treated with clopidogrel, an alternative antiplatelet agent. However, aspirin desensitization is more cost-effective than the usage of clopidogrel in these patients. Furthermore, aspirin desensitization is of greater value in patients requiring dual antiplatelet therapy, for example following procedures like percutaneous transluminal coronary angioplasty (PTCA) instead of using non-aspirin-based combinations. Herein, we report a 74-year-old hypertensive male presented with features of acute coronary syndrome and planned for percutaneous transluminal coronary angioplasty of RCA followed by dual antiplatelet therapy. Since he had aspirin allergy, desensitization was done using rapid desensitization protocol for which he responded well. This case highlights the importance of aspirin-desensitization in patients with aspirin allergy instead of choosing non-aspirin based antiplatelet agents.

Pelvic and peritoneal hydatidosis: An uncommon presentation of the common entity

Key Clinical Message The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences. Abstract We report a unique case of a 26‐year‐old male who presented with acute urinary retention and abdominal distention. Later, CT‐urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically