Association Between Keratoconus and Shoulder Dislocation: A Cross-Sectional Study.

Introduction Few studies have highlighted the correlation between shoulder dislocation and keratoconus (KC). This study aimed to examine the association between KC and shoulder dislocation using patients with KC and matched controls. Methods This cross-sectional study was conducted at Jordan University Hospital. We included patients diagnosed with KC from Jordan University Hospital's Ophthalmology Department between 2015 and 2018. We also included age- and sex-matched controls recruited randomly from fitness centers and shopping malls. All participants had complete ophthalmic and orthopedic assessments. KC was diagnosed by clinical examination followed by Pentacam (Scheimpflug Images, Oculyzer, WaveLight, Alcon, USA) confirmation. Results A total of 238 patients, with a mean age of 29.53 (±11.20) years, were included in this study. They were 144 (60.5%) men and 94 (39.5%) women. Moreover, 120 (50.4%) had KC while 118 (49.6%) did not have KC. Only 11 (4.6%) patients had previous shoulder dislocation. We did not find a significant difference in the frequency of shoulder dislocation between patients with and without KC (p = 0.512). Conclusion This study provides further evidence on the lack of association between shoulder dislocation and KC, an association that was presumed due to shared collagen characteristics.

Anorectal Melanoma: An Uncommon Cause of Lower Gastrointestinal Bleeding.

Anorectal melanoma (ARM) is a rare, aggressive disease. Given that it presents with local symptoms that resemble other common benign anorectal conditions, ARM is often low on the differential diagnosis. Delayed diagnosis and nonconsensus of treatment options lead to poor prognosis. Here, we report the case of an 85-year-old woman with a history of Irritable bowel syndrome who presented with altered bowel habits and bleeding per rectum. CT revealed a rectal mass with metastatic lesions to the bone, liver, and lungs. Immunohistochemical staining was positive for Human Melanoma Black-45, melanoma antigen recognized by T cells, and SRY-related HMG-box 10. A final diagnosis of ARM was made.

Tenesmus: An Unusual Presentation of Delayed Prostate Adenocarcinoma Recurrence.

We describe a case of prostate cancer recurrence 25 years after radical prostatectomy. Our patient is a 77-year-old male with past medical history pertinent for obesity and coronary artery disease. The patient's initial presentation in 1994 was for persistent lower urinary tract symptoms. He was subsequently diagnosed with high-grade prostate adenocarcinoma and underwent radical prostatectomy. The patient was followed up postoperatively for 16 years and deemed to be in clinical and biochemical remission with undetectable prostate-specific antigen (PSA). Twenty-five years post-operatively, the patient was evaluated with an investigatory colonoscopy for tenesmus, constipation, and change in stool caliber. Colonoscopy revealed significant anal canal stenosis. Biopsy of the lesion showed prostate adenocarcinoma recurrence. Prostate cancer recurrence presenting with only gastrointestinal symptoms is highly unusual, especially in a patient who never received radiotherapy and had been in remission for 25 years.

You Only Find What You Look for: Anchor Bias During the COVID-19 Pandemic.

Hypersensitivity pneumonitis (HP) is an immune-mediated syndrome caused by allergen inhalation. High-resolution computed tomography (HRCT) of HP usually shows diffuse ground-glass opacities, but can show centrilobular ground-glass nodules, areas of air-trapping, or fibrotic changes. The clinical presentation of HP as well as the imaging findings can resemble coronavirus disease 2019 (COVID-19) pneumonia. This resemblance, in the absence of a high level of suspicion for other etiologies, led to anchor bias and delayed diagnosis in the case presented here.

COVID-19 Vaccine and Hyperosmolar Hyperglycemic State.

Coronavirus disease 2019 (COVID-19) is a multi-system disease that causes multiple complications. It is linked to the development of new-onset diabetes or unmasking of underlying diabetes. Despite the uncertain exact mechanism, pancreatic angiotensin-converting enzyme 2 (ACE2) receptor, the main enzyme related to COVID-19 pathophysiology has been implied. COVID-19 vaccine was authorized to help control the rapid spread of COVID-19 disease. We report a case of new-onset diabetes type 2 presenting as hyperosmolar hyperglycemic state (HHS) in a patient after receiving COVID-19 vaccine with some literature review of the potential mechanisms by which COVID-19 may cause new-onset diabetes type 2.