Highlights Malignant transformation in unresected teratoma. Massive retroperitoneal tumour in an adult male. Immature teratoma in an adult. Retroperitoneal teratoma: An incidental finding.

Superficial venous aneurysms are rare clinical entity. They can remain asymptomatic to be detected incidentally or can present with pain. They can be readily diagnosed by duplex ultrasonography or discovered only during surgical exploration. The objective of this clinical case report is to highlight this rare occurrence and avoid misdiagnosis. A 69-year-old male presented at our tertiary care hospital with complaints of pain and swelling which was gradually increasing in size. Initially it was misdiagnosed to be femoral hernia, and the diagnosis of Great Saphenous Vein aneurysm was made following duplex ultrasonography. Following which, the patient underwent successful surgical excision.

As the COVID-19 cases are anticipated to rise globally, there may be rise in associated cardiovascular complications. COVID-19 could trigger several cardiomyopathies, including a rare complication of Takotsubo Cardiomyopathy (TCM). It is often presumed that mental trauma, elevated catecholamine’s excessive immune responses, and viral cytotoxicity could be pathways for inducing TCM. Health professionals should be familiar with different cardiovascular complications and appropriate screening tools, which include cardiac ultrasound and bedside echocardiography. In high-risk COVID-19 patients, a simple history of previous psychiatric conditions and some other possible risk factors for the Takotsubo syndrome could assist in screening. Besides, the diagnosis must be considered, and efficient management should be initiated. There can be multiple direct and indirect factors manifesting as Takotsubo cardiomyopathy in COVID-19 patients. On other hand, Takotsubo cardiomyopathy may also be observed in the non-COVID-19 patients due to other stressors. Therefore, more extensive research work and further studies are required to learn more about the exact mechanism and relation between Takotsubo cardiomyopathy and COVID-19. Here, we aim to complete a literature review of suspected or known Takotsubo cardiomyopathy related to COVID-19. The main objective of this manuscript is to provide information reported by healthcare providers across the globe on reported comorbidities, potential pathophysiology, and optimal management of stress cardiomyopathy that generally has a favorable outcome.

Background: Chronic venous insufficiency (CVI) is a condition that occurs due to dysfunctional venous wall and/or valves in the lower limb veins. Some common etiological factors of CVI are obesity, age of more than 50 years, family history of CVI, smoking and pregnancy. The combination of obesity and other genetic and environmental factors creates a higher risk for the development of CVI.Methods: The grade of the venous disease was recorded using the CEAP (anatomical and pathophysiologic criteria). BMI (body mass index) was calculated for each patient and the patients were classified into underweight, normal, overweight and obese categories. Mean, standard deviation, p value and percentage of each stage of venous disease in each group was calculated accordingly and studied.Results: In this study, it was established that a patient with a high BMI (>25 kg/m2) had a higher probability of developing CVI in comparison to a patient with a lower BMI. According to the data, 28.6% of normal weight patients had CVI, 64.3% of overweight patients had CVI and 81.5% of obese patients had CVI.Conclusions: In this study, we concluded that as the BMI increases the probability of development of CVI (C3-C6) also increases. Thus, the presence of CVI should be identified and treated promptly in obese individuals with close follow-up in order to prevent complications.

Splenic artery aneurysm (SAA) is a rare clinical entity that carries a risk of rupture and life threatening hemorrhage. The objective of this clinical case report is to highlight this rare occurrence during pregnancy to avoid misdiagnosis. A 25 year old primigravida in her 3rd trimester of pregnancy was brought to trauma and emergency care with severe epigastric pain with rapid onset of unexplained shock. The shock was out of proportion to external or visible blood loss or any other injury. She was taken for emergency laparotomy. Intra-operatively, hemoperitoneum was encountered in peritoneal cavity due to ruptured splenic artery aneurysm. Massive transfusion protocol was activated and aneurysmectomy with splenectomy was performed. Post operatively, the patient was transferred to intensive care unit. Unfortunately, the patient succumbed due to complications of irreversible shock. Pregnant women with SAA can present with non-specific symptoms and hypovolemic shock. In such cases of hemorrhage, obstetricians should always keep in mind the other non-obstetric causes of intra-abdominal bleeding.