Unruptured bilateral supra-clinoid internal carotid artery aneurysms: A case report.

Unruptured supra-clinoid carotid aneurysms are rare aneurysmal dilatation of the supra-clinoid segment of internal carotid artery. Most cases are asymptomatic and discovered incidentally, while others may present with compressive symptoms on cranial nerve II, the optic nerve. We present a case of a 44-year-old female who presented with chronic headache and gradual decreased visual acuity. The patient's imaging workup revealed bilateral supra-clinoid carotid aneurysms.

Epidemiological Characterizations, New Localities, and a Checklist of the Known Scorpions in the Kurdistan Region, Northern Iraq.

Background: Annually, thousands of scorpion stings and rare mortalities are recorded in the Kurdistan Region of Iraq. In the present study, we prepared a checklist for the geographical distribution of scorpion fauna composition, new localities data, and scorpion sting profile for the years 2019-2020 in the region. Methods: Random field surveys for scorpion collection were carried out in 22 localities in the Kurdistan Region from June 2020 to October 2021. Clinical data related to scorpion stings in 2019 and 2020 were obtained from the medical records of public health offices in the region. Results: In this survey, 166 specimens were collected. They were composed of seven scorpion species belonging to three families including: Buthidae, Hemiscorpiidae, and Scorpionidae. The collected species were Androctonus crassicauda, Compsobuthus matthiesseni, Hottentotta saulcyi, Mesobuthus mesopotamicus, Orthochirus fomichevi, Hemiscorpius lepturus, and Scorpio kruglovi. Moreover, three scorpion species comprising Buthacus tadmorensis, Hottentotta mesopotamicus, and Calchas anlasi were recorded in the previous study conducted in the Kurdistan region. In 2019-2020, 3726 scorpion stings were reported, with a peak in the summer season. Most of the patients were 15-49 years old. In the current study, medically significant scorpion species have been identified. Conclusion: The outcome of the present work will increase the awareness of the Kurdish community regarding the distribution of dangerous scorpion species and consequently reduce their stings.

Comparing Invasive Pulmonary Aspergillosis Mortality Between Liposomal Amphotericin B and Voriconazole in Patients With Hematological Malignancy or Hematopoietic Stem Cell Transplantation.

Objectives We evaluated liposomal amphotericin B versus voriconazole for the treatment of invasive pulmonary aspergillosis (IPA) in patients with hematological malignancy or hematopoietic stem cell transplantation (HSCT). Methods This retrospective cohort, single-center study included patients with compatible radiological diagnosis of IPA between 2016 and 2021. Results Forty-six patients with hematological malignancy or HSCT were diagnosed with IPA. Thirty-nine of them fulfilled the criteria for comparing liposomal amphotericin B (n=15) with voriconazole (n=24). Their median age was 48.5 years. Stem cell transplant recipients were 45.65%, and nearly half of the patients (47.83%) had acute myeloid leukemia. Twenty-six (56.52%) of the patients did not require oxygen therapy. The 12-week mortality was 13.33% (two out of 15) in patients who received liposomal amphotericin B compared to 25% (six out of 24) in patients who received voriconazole. There was no mortality judged to be related to IPA. Success or global clinical response was not different between the two drugs: 80% for liposomal amphotericin B versus 83.33% for voriconazole. However, the safety profile favored liposomal amphotericin B. Conclusion In this small cohort, there was an equipoise in the mortality and clinical and radiological outcomes obtained using liposomal amphotericin B or voriconazole for the treatment of IPA in hematological malignancy or HSCT.

Intrahepatic gallbladder mimicking a cystic liver lesion: A case report & literature review.

Intrahepatic gallbladder is a rare congenital variant that occurs due to migration arrest of the gallbladder from reaching its normal position. We present a case of a 60year-old gentleman presenting with chronic abdominal pain and impaired liver enzymes. Abdominal ultrasonography showed a hepatic cystic lesion which later was identified as an ectopic gallbladder within the liver parenchyma through magnetic resonance imaging study of the liver. Although ectopic gallbladder is a rare anomaly, awareness and correct identification of the abnormality prevents misdiagnosis with other liver pathologies as it may mimic other pathologies as presented in this case. It also allows better operative planning when indicated.