Transverse Myelitis as a Presenting Symptom of Celiac Disease.

Celiac disease (CD) is associated with several neurological diseases. We report a case of a 25-year-old man with CD that was discovered during hospitalization for acute transverse myelitis. The diagnosis of CD was suspected after positive serological tests and was confirmed with duodenal biopsy. Steroid pulse therapy and plasma exchange stabilized the patient's condition. The patient started a gluten-free diet and rituximab therapy before discharge. Although the association of CD with various neurological diseases is well established, this case report describes a less explored association between CD and transverse myelitis.

Outcomes of dual-chamber implantable cardioverter defibrillator for left bundle branch area pacing: A systematic review of literature.

OBJECTIVE: This systematic review of literature aimed to evaluate the safety and efficacy of dual-chamber ICDs for LBBAP in patients with left bundle branch block (LBBB). METHODS: Digital databases were searched systematically to identify studies reporting the left bundle branch area pacing (LBBAP) with implantable cardioverter defibrillator (ICD) placement in patients with LBBB. Detailed study and patient-level baseline characteristics including the type of study, sample size, follow-up, number of cases, age, gender, and baseline characteristics were abstracted. RESULTS: In a total of three studies, 34 patients were included in this review. There was a significant improvement reported in QRS duration in all studies. The mean QRS duration at baseline was 170 ± 17.4 ms, whereas the follow-up QRS duration at follow-up was 121 ± 17.3 ms. Two studies reported a significant improvement of 50% in LVEF from baseline. No lead-related complications or arrhythmic events were recorded in any study. The findings of the systematic review suggest that dual-chamber ICD for LBBAP is a promising intervention for patients with heart conditions. CONCLUSION: The procedure offers significant improvements in QRS duration and LVEF, and there were no lead-related complications or arrhythmic events recorded in any of the studies.

An Atypical Case of Intracranial Dermoid Cyst in an Adult Female: A Case Report and Literature Review.

Intracranial dermoid cysts are unusual cystic tumors that are often benign, develop slowly, and are present from birth. They are made up of mature squamous epithelium and may house ectodermal features such as glands (apocrine, eccrine, and sebaceous). Dermoid cysts may be asymptomatic and can be detected incidentally during brain imaging for unrelated causes. Dermoid cysts tend to grow gradually and may eventually exert pressure on the brain and surrounding areas. Unfortunately, they can seldom burst, resulting in an unfavorable prognosis for the patient depending on the size, location, and clinical presentation. Headache, convulsions, cerebral ischemia, and aseptic meningitis are the most frequent symptoms. Magnetic resonance imaging (MRI) and computed tomography (CT) of the brain aid in accurate diagnosis and therapy planning. In some cases, the treatment consists of surgical monitoring with regular surveillance imaging. In other cases, surgery is needed, depending on the symptoms and the location of the cyst in the brain.

Gender Disparity in Work Distribution Among Cardiology Trainees: Pakistan's Perspective.

Gender disparity in work distribution among cardiology trainees is a crucial issue that can impact career development and the overall representation of women in the field. This cross-sectional survey aimed to examine the gender disparity in work distribution among cardiology trainees in Pakistan. A total of 1156 trainees from various medical institutions across the country participated in the study, with 687 male trainees (59.4%) and 469 female trainees (40.5%). Demographic characteristics, baseline characteristics, work distribution patterns, perceptions of gender disparity, and career aspirations were assessed. The findings revealed that male trainees reported being assigned more complex procedures compared to female trainees (75% vs 47%, P < 0.001), while female trainees reported a higher frequency of being assigned administrative tasks compared to male trainees (61% vs 35%, P = 0.001). Both genders reported similar perceptions of the overall workload. However, female trainees experienced significantly higher rates of perceived bias and discrimination compared to male trainees (70% vs 25%, P < 0.001). Moreover, female trainees expressed a higher perception of unequal opportunities for career advancement due to gender disparities (80% vs 67%, P < 0.001). While male and female trainees showed similar aspirations for pursuing advanced subspecialties within cardiology, male trainees expressed a higher intention to pursue leadership positions within the field (60% vs 30%, P = 0.003). These findings shed light on the existing gender disparities in work distribution and perceptions within cardiology training programs in Pakistan.