Brain MRI: A safe and a specific tool in the diagnosis of Gayet Wernicke's encephalopathy in pregnant women: Case report.

Gayet-Wernicke encephalopathy (GWE) is a neuropsychiatric syndrome due to Vitamin B1 (thiamine) deficiency, fatal in 30% of cases and preventable if treatment is initiated early, characterized by the classic triad of encephalopathy, ocular involvement: ophthalmoplegia and/or nystagmus and ataxia. GWE is mainly observed in alcoholics, but can also appear in any state of malnutrition. In obstetrics, hyperemesis gravidarum can be complicated by GWE due to low thiamine stores and increased thiamine requirements. We report a case of Gayet-Wernicke encephalopathy complicating incoercible vomiting in a pregnant woman.

Rapid pulmonary fistulization complicating a psoas abscess with intraoperative hypoxemia: a rare case report.

Introduction and importance: Psoas abscess is a relatively uncommon condition that can present with vague clinical features. Patients with this condition often present in different ways to different specialties leading to delays in diagnosis and management. Case presentation: The authors present a 47-year-old woman with complaint of vague abdominal pain, fever, and raised inflammatory markers who underwent CT examination. On CT, a collection was noted in the right iliac fossa that extended along the right retroperitoneum through the retrocrural space in the right lung base communicating with a cavitary pulmonary lesion with air-fluid level. The psoas abscess was drained. Clinical discussion: Our case presents a number of rare and intriguing features. Notably, the patient, who was immunocompetent, experienced a primary Staphylococcus infection that swiftly progressed to a sizable pulmonary abscess, a phenomenon uncommon in such hosts. The rarity further extends to the source of infection, originating abdominally but culminating in thoracic complications through contiguous spread from a retroperitoneal site. Despite the potential severity, the patient's outcome was remarkably positive. Conclusion: This case underscores the potential rapidity of pulmonary involvement in psoas abscesses, emphasizing the need for heightened awareness and consideration of respiratory signs during preoperative assessments.

Corrigendum to "Nutcracker syndrome unveiled by severe Typhoid fever: A rare case report" [Radiology Case Reports 19 (2024) 1646-1649].

[This corrects the article DOI: 10.1016/j.radcr.2024.01.034.].

A case report: intravenous leiomyomatosis extending from the uterus to the right atrium.

Introduction and importance: Intra veinous leiomyomatosis (IVL) is one pathology of a known group of ectopic leiomyomatosis that gathers many entities all defined by the presence of benign tumours arising from uterine smooth muscle cells. The authors aim through this case report to address the underdiagnosis of IVL in pre-menopausal women and the potential confusion with other cardiac tumours. Case presentation: A 48-year-old woman initially treated for a suspected intracardiac myxoma underwent two surgeries. Seeking gynaecological care for menometrorrhagia related to a polymyomatous uterus, she was scheduled for radical surgery. Unexpectedly, extended explorations during a hysterectomy revealed a tumour originating from the pelvis, extending to the right atrium and inferior vena cava, indicative of intravascular leiomyomatosis. Clinical discussion: IVL's diagnosis is often incidental during hysterectomy analysis, with symptoms mimicking uterine fibroids. Treatment involves radical surgery, emphasizing the importance of complete resection to reduce the significant risk of recurrence. Conclusion: Pre-menopausal women with a history of hysterectomy or myomectomy and a detected right chamber mass should be screened for intravascular leiomyomatosis. Diagnosis relies on histological examination, guiding tailored treatment choices such as surgical resection with a focus on bilateral adnexectomy for optimal outcomes.

Compliance With World Health Organization (WHO)-World Federation of Societies of Anesthesiologists (WFAS) Standards for General Anesthesia at Ibn Sina University Hospital Center, Morocco.

INTRODUCTION: Patient safety in anaesthesia has significantly improved over the past decades, largely due to pharmacological and technological advancements, as well as the widespread adoption of guidelines and standards recommended by international organisations. This study aimed to evaluate the practice of anaesthesia and its compliance with the international standards for safe anaesthesia practice recommended by the World Federation of Societies of Anaesthesiologists (WFSA) and the World Health Organization (WHO). This study also describes the operating room within Ibn Sina University Hospital Centre (CHUIS) of Rabat, Morocco, the referral centre, with the aim of identifying its potential and shortcomings. METHODS: This was a prospective analytical descriptive study from March 1, 2021, to July 31, 2021. All facilities within an operating room and information regarding patients undergoing general anaesthesia, whether it be emergency or scheduled procedures, administered by an anaesthetist, were included. A survey form based on the WHO-WFSA International Standards for a Safe Practice of Anesthesia was used to collect data about the anaesthesia sites. Sources of information included direct observation of anaesthesia procedures, patient records, registers, and qualified anaesthesia personnel. Manual data analysis and encoding were performed using Microsoft Word and Excel (Microsoft Corporation, Redmond, Washington, United States).  Results: All the facilities within the operating rooms of CHUIS were surveyed. In total, 250 patients were recorded, with 43.6% at Ibn Sina Hospital, 18.4% in the Children's Hospital, 14% at the National Institute of Oncology, 12% at the Specialties, 6% at Maternity Hospital Souissi, and 6% at Orangers Maternity Hospital. The median age of patients was 50 years old with 37% of them aged 36-55 years. Overall, 67.6% of these patients were admitted for scheduled interventions. Anaesthetic risk assessment showed that 67.2% of the patients were in American Society of Anesthesiologists (ASA) class I. Pre-anaesthesia consultations were conducted in 65.6% of cases, and pre-anaesthesia visits were conducted in 89.6% of cases. Anaesthesia checklists were used in 89.6% of cases. General anaesthesia, including tracheal intubation 85.2% and facemask 7.2%, was the most common type of anaesthesia. Regarding anaesthetic agents, propofol was the most used intravenous narcotic, with fentanyl still being used in most cases 92% and rocuronium in 82% of cases. Electrocardiogram, non-invasive blood pressure, and pulse oxygen saturation (SPO2) monitoring were consistently used, while capnography was not available in 6% of cases. Crystalloid fluid resuscitation was used in 91.2% of cases, and colloid resuscitation was used in 1.2% of cases. The post-anesthesia care unit (PACU) was present in 58.8% of cases. Postoperative analgesia was administered in 80% of cases. Adverse events occurred in 58.4% of cases. Preoperative transfusion strategies were employed in 18% of cases. Patient transfers to the intensive care unit were done for 18%. CONCLUSION: Despite the shortcomings of the healthcare system in Morocco, our study indicates that the anaesthesia practice at CHUIS remains highly acceptable by adhering to the highest international standards.

Nutcracker syndrome unveiled by severe Typhoid fever: A rare case report.

Typhoid fever, caused by Salmonella Typhi, is a severe bacterial infection prevalent in developing countries, and can result in life-threatening complications if untreated. Nutcracker Syndrome is a rare vascular disorder involving compression of the left renal vein between the aorta and the superior mesenteric artery. It can lead to various symptoms and poses diagnostic and management challenges. We present a case study of a patient diagnosed with typhoid fever in a Unit of Critical Emergency Care. Coincidentally, the evaluation through CT-scan revealed the presence of Nutcracker Syndrome. This report underscores the incidental discovery of Nutcracker Syndrome during the assessment of a patient with typhoid fever in a critical emergency care setting.

Case report: Total obstruction of the left main bronchus by a blood clot leads to pneumonectomy in a pregnant woman.

Introduction and importance: Airway obstruction resulting from blood clot formation is observed across various clinical scenarios and is often preceded by hemoptysis. This condition can significantly compromise respiratory function, potentially leading to life-threatening ventilatory distress. Case presentation: In this report, the authors present a case of acute airway obstruction associated with hemoptysis in an 18-week pregnant woman admitted to the emergency department for acute respiratory distress. Clinical and radiographic evidence strongly suggested the presence of an endobronchial blood clot causing focal airway obstruction. Diagnosis was confirmed through direct endoscopic evaluation. Clinical discussion: Initial attempts to remove the obstructing clot from the airway involved lavage, aspiration, and forceps extraction by using a bronchoscope. In cases in which these measures proved ineffective, other management strategies include rigid bronchoscopy, embolization, and surgical resection. Conclusion: Central airway obstruction is a critical condition caused by numerous factors such as tumours or blood clots. Treatment focuses on securing the airway, ensuring breathing, and using tools such as bronchoscopy for diagnosis and treatment. Surgery is considered a last resort when other methods are ineffective.

Cesarean Delivery of a Parturient with Lumboperitoneal Shunt under Spinal Anesthesia.

Lumboperitoneal shunt may be indicated as a treatment for idiopathic intracranial hypertension aiming to facilitate the dynamic flow of cerebrospinal fluid into the peritoneum for patients. Parturients with lumboperitoneal shunt are a few, making it difficult to choose the analgesic or anesthetic technique for delivery. We present the case of a successful spinal anesthesia for a cesarean delivery in a parturient who was diagnosed with idiopathic intracranial hypertension that was treated by lumboperitoneal shunt.