Background: One of the main goals of treatment in polycythemia vera (PV) is the prevention of arterial and venous thrombosis. However, less commonly, patients may also experience hemorrhagic events. This case report aims to raise awareness of these complications. We describe a patient with PV who developed an acute non-traumatic subdural hematoma (SDH) - a rare presentation - with severe impact on life expectancy. Case Presentation: A 53-year-old man, diagnosed with PV at the age of 46, presented to the emergency department with right arm weakness, which progressed to right leg weakness and dysarthria. Computed tomography revealed a large acute interhemispheric SDH requiring craniotomy. During hospitalization, the patient had persistent leukocytosis above 16×10⁹/L. He did not recover consciousness and was discharged with a Glasgow Coma Scale (GCS) score of 9. Conclusion: Hemorrhagic complications in PV may result from antiplatelet or anticoagulant therapy, acquired Von Willebrand Syndrome (aVWS), or platelet dysfunction.... Continue Reading

Background: Jejunoileal atresia (JIA) is a leading cause of neonatal intestinal obstruction. Despite advances in neonatal surgery, mortality remains high in resource-limited settings due to delayed presentation, sepsis, and limited perioperative support. We report seven consecutive neonates with JIA managed at our hospital, highlighting diagnostic findings, anatomical variations, surgical approaches, and early outcomes. Methods: This combined retrospective and prospective descriptive study included seven consecutive neonates admitted with intestinal obstruction between October 2024 and October 2025. Diagnosis was based on clinical evaluation, plain abdominal radiography, and ultrasonography. All underwent open laparotomy via a supra-umbilical transverse incision. Primary end-to-oblique single-layer hand-sewn anastomosis was performed in six cases. One required staged management with resection, double-barrel stoma formation, subsequent anastomosis, and correction of malrotation. Outcomes were analyzed, including follow-up to six weeks post-discharge. Results: Seven neonates were included (median birth weight 2.9 kg; median age 3 days). Two had jejunal atresia type I (28.6%),... Continue Reading

Background: Schwannomas are benign peripheral nerve sheath tumours arising from Schwann cells and are uncommon in the upper limb. Median nerve schwannomas constitute approximately 0.1–0.3% of all hand tumours, and extensive involvement of the median nerve by multiple schwannomas across multiple joints is exceptionally rare. Differentiating schwannoma from neurofibroma on imaging can be challenging. Case Presentation: A patient presented with a painful palpable mass along the flexor aspect of the right forearm extending from the elbow to the distal interphalangeal joint. Clinical examination demonstrated a mobile mass with a positive Tinel’s sign along the median nerve distribution. Magnetic resonance imaging revealed a longitudinally extensive lesion along the median nerve but could not reliably differentiate schwannoma from neurofibroma. A core needle biopsy confirmed schwannoma with Antoni A and Antoni B areas and strong S-100 positivity. Complete surgical excision with preservation of the median nerve was performed, resulting in excellent functional recovery.... Continue Reading

Academic publishing is meant to reward scientific merit, methodological rigor, and originality. Yet in closely connected academic communities, professional hierarchies and name recognition can influence how research is received. In parts of Indian psychiatric publishing, there is a growing perception that manuscripts linked to well-known senior academicians or prominent institutions are more likely to be accepted. Whether fully accurate or not, this belief itself reflects a trust deficit within the system. Such dynamics rarely involve overt rule-breaking. Instead, they may arise from informal networks, editorial familiarity, and limited transparency in decision-making. The consequences can discourage early-career researchers and restrict the diversity of ideas entering the literature. Strengthening double-blind review, improving transparency around editorial decisions, and broadening conflict-of-interest disclosures may help restore confidence. A publication system that is visibly fair is essential for maintaining credibility and fostering genuine academic growth. Continue Reading

Background: Isolated cerebral mucormycosis is a rare, life-threatening infection, usually occurring in immunocompromised hosts but also reported in people with intravenous drug use, with a predilection for the basal ganglia. Case Presentation: A 30-year-old previously healthy man with a history of intravenous drug use presented with new-onset generalized seizures, altered mental status, and left-sided hemiplegia. Magnetic resonance imaging showed a 4.4 × 4.3 × 5.1 cm ring-enhancing mass in the right basal ganglia with extension into the thalamus and temporal lobe and mild midline shift. Stereotactic biopsy with conservative debulking revealed a fungal abscess; Gomori methenamine silver staining demonstrated broad pauci-septate hyphae with irregular right-angle branching, supporting a diagnosis of cerebral mucormycosis. He was treated with liposomal amphotericin B and isavuconazole, followed by prolonged oral isavuconazole. Complete excision was not feasible because of the deep lesion location. Conclusion: Follow-up magnetic resonance imaging at 16 weeks showed reduction in lesion size... Continue Reading

Background:Intravascular synovial sarcoma is a rare disease with only 14 cases documented globally to date. To the best of our knowledge, we present the 15th case, highlighting the diagnostic challenge, rapidly progressive course of this malignancy and the need for greater clinical awareness. Case Presentation:A female patient in her early 20s presented with a painful swelling in the right inguinal region and right lower limb oedema, initially considered to be DVT. Imaging revealed a mass involving the right external iliac and common femoral veins. She underwent surgical excision of the mass, and histopathological evaluation confirmed intravascular biphasic synovial sarcoma, supported by molecular diagnostic testing. Patient received postoperative chemotherapy. However, there was local recurrence of the disease within 5 months of completing chemotherapy and within a year of surgical resection. Conclusions:This case emphasizes that not all cases presenting as DVT may be benign, especially in young patients without apparent risk factors.... Continue Reading

BackgroundFamilial pulmonary fibrosis (FPF) accounts for 10–20% of idiopathic pulmonary fibrosis cases and is associated with mutations in telomere-related genes, including TERT, TERC, RTEL1, PARN, and more recently CTC1. Telomere dysfunction predisposes to progressive fibrotic interstitial lung disease (ILD) and may increase susceptibility to environmental triggers. Emerging evidence suggests that COVID-19 pneumonitis can unmask or accelerate fibrosis in genetically predisposed individuals. We report a case of genetically confirmed FPF due to a likely pathogenic CTC1mutation presenting with progressive post-COVID pulmonary fibrosis. Case PresentationA 59-year-old woman with post-COVID pulmonary fibrosis presented with progressive dyspnoea, orthopnoea, and functional decline over six months. She required long-term oxygen therapy (5 L/min). Family history was significant for two first-degree relatives with usual interstitial pneumonia. Pulmonary function tests showed severe restriction (FVC 48%, DLCO 19%). Imaging evolved from organizing pneumonia during acute COVID-19 to established bilateral fibrotic ILD with traction bronchiectasis and features suggestive of pulmonary... Continue Reading

Background: Germline CHEK2 mutations confer a significant risk of developing multiple malignancies, often at an earlier age than in the general population. While less widely recognised than BRCA1/2, CHEK2 is increasingly clinically relevant and requires tailored surveillance and multidisciplinary management. Case Presentation: We report a 57-year-old man from northern Portugal, a carrier of a germline CHEK2 mutation, who developed three primary malignancies over a decade: renal cell carcinoma, rectal adenocarcinoma, and papillary thyroid carcinoma. His family history revealed clustering of cancers, including breast, prostate, laryngeal, brain, and sarcoma, with a paternal aunt confirmed as a CHEK2 carrier. Care was organised longitudinally, with primary care playing a central role in coordinating follow-up across oncology, genetics, endocrinology and haematology. Despite a heavy oncological burden and ongoing tobacco exposure, the patient consistently showed optimism, trust in his medical team and good engagement with follow-up, reflecting a high level of psychosocial resilience. Conclusion: Our... Continue Reading