No abstract

Multivalvular destruction may be a clinical manifestation of infective endocarditis (IE), which is a devastating infection of the heart either alone or superimposed with congenital subaortic membrane as in this case report. Here, we report a case of multivavular destruction with severe vegetation presented as a manifestation of infective endocarditis (IE) in a neglected case of 18-year-old male with previous rheumatic heart disease. Transesophageal echocardiography is an important imaging modality for diagnosis of superimposed aortic and heart lesions. Early necessary investigation and correct diagnosis is mandatory to prevent bad complications. doi: https://doi.org/10.12669/pjms.37.2.2798 How to cite this:Alshoabi SA, Aljaber NN, Gameraddin MB, Omer AM. Multivalvular destruction as the primary presentation of aggressive infective endocarditis with subaortic valve membrane. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2798 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Diffuse astrocytoma is an infiltrating type of glioma (World Health Organization grade II), which even with histopathology, is difficult to diagnose. Magnetic resonance imaging (MRI) is the cornerstone for diagnoses and follow-up of brain gliomas. This report describes a case of diffuse astrocytoma in a 48-year-old man who presented with sudden right-sided weakness and repeated convulsive attacks. On brain computed tomography, the case was diagnosed and treated as an acute infarction. Ten days later, the patient returned with a total loss of consciousness. Brain MRI images revealed an irregularly outlined lesion involving the splenium of the corpus callosum that extended into the left periventricular parietal lobe of the brain with cystic foci in the septum pellucidum. Contrast-enhanced and new sequences of MRI was helpful in approach to diagnosis because of its superior tissue characterization. The histopathology results ultimately confirmed the diagnosis of diffuse astrocytoma. The patient died postoperatively.

Hypoxic-ischemic encephalopathy (HIE) is a major cause of brain damage and neurodevelopmental abnormalities in full-term newborn infants. We are reporting the results of a study comparing cranial magnetic resonance imaging (MRI) and cranial sonography (US) in 150 neonates with suspected HIE. Magnetic resonance imaging findings were normal in 44 patients (29%); 18% of patients showed only basal ganglia (BG) brightness, 10.6% showed brightness of the BG with intracerebral hemorrhage, and 63% of patients showed additional diagnostic details. Cranial US was normal in 75 patients (50%) and showed increased periventricular echogenicity in 32%, intraventricular hemorrhage in 9%, and additional diagnostic details in 13%. There was a positive correlation between MRI studies and US (P = .013). These data suggest that US is a worthwhile modality for the diagnosis of HIE but that early MRI findings will provide additional information in many cases in the detection of cerebral intraventricular hemorrhage.

The clinical significance of knowing the status of thyroid nodules is the need to exclude thyroid cancer. The purpose of this study is to evaluate ultrasound (U/S) features of thyroid nodules and correlate them with fineneedle aspiration cytology (FNAC). A descriptive prospective study was conducted at the Radiology