One of the diagnostic criteria for Acute Myeloblastic Leukemia (AML) is the presence of 20% myeloid blasts in peripheral blood or bone marrow. Some cases with recurrent cytogenetic abnormalities also fall in this category with blast cell count less than 20%. Thus, in the presence of these genetic abnormalities, the patients are classified as AML regardless of blast cell count. One of these genetic heterogeneities is t(8; 21) (q22, q22.1) which is more commonly seen in children and young adults. In this study, a 14-year-old boy is reported with a final diagnosis of AML, which was presented with fever and bicytopenia, clinically suspicious for acute leukemia. Laboratory results reported less than 20% blasts in bone marrow aspiration smears but genetic alteration t(8; 21) (q22, q22.1) was detected by molecular exams.

Ascites is not a usual finding in prehepatic portal hypertension, including portal vein thrombosis, but when portal vein thrombosis is acute and massive, ascites can be a presenting feature. We report a 9-year-old boy with tense ascites and portal and superior mesenteric vein thrombosis. A 9-year-old boy was evaluated for tense ascites which led to umbilical hernia since one month before admission. He did not have any clinical or laboratory stigmata of parenchymal liver disease. Imaging studies showed superior mesenteric and portal vein thrombosis. In laboratory tests for pre-thrombotic states, he suffered from significant protein S deficiency. Thrombophilic states like protein S deficiency predispose patient to vascular thrombosis. This vascular thrombosis can be present with signs and symptoms related to their territories. Prevention of thrombosis and rethrombosis with anticoagulant therapy is recommended.

Aplastic anemia is characterized by bone marrow failure and pancytopenia. It could be due to autoimmune disorders, radiation, drugs, or chemicals. Drugs that mostly cause aplastic anemia include chloramphenicol, non-steroidal anti-inflammatory drugs, antiepileptic drugs, gold salts, and antithyroid drugs. Clinical sign and symptoms often result from pancytopenia that includes signs of anemia and bleeding. In some patients, fever and sepsis are seen that are due to neutropenia. Azathioprine is a purine antimetabolite, an immunosuppressive drug that causes myelosuppression and pancytopenia, especially in patients who have some degrees of TPMT (Thiopurine Methyltransferase) activity. We present a patient who admitted to our hospital with fever and pancytopenia and a history of recent azathioprine treatment. Because of delay in the recovery of pancytopenia, she was suspected of aplastic anemia, and bone marrow aspiration and biopsy were done for her.

Buccal Fat Pad is an encapsulated mass of adipose tissue located within the buccal facial spaces, between the buccinator and masseter muscles. Intraoral traumatic herniation of Buccal Fat Pad, often seen in young children, has been reported as a rare case. In this report, we present a case of traumatic Buccal Fat Pad herniation which at first was misdiagnosed as a malignant tumor.

Hydatid cyst is a parasitic infection caused by the larvae of Echinococcus granulosus. We report a rare case of primary echinococcal synovitis in a 37-year-old woman who was referred to our clinic with pain and swelling of the right knee.

Hypoglycemia and hypoglycemic unawareness is usually a complication of tight glycemic control in insulin-dependent diabetes mellitus. To our knowledge, this is the first case report of hypoglycemic unawareness subsequent to cardiac failure induced hypoglycemia of prolonged duration. Through this case report, we aimed to highlight that hypoglycemia should be suspected as a cause of decreased level of consciousness in patients suffering from recurrent congestive cardiac failure , as it can be easily overlooked and the condition can easily be reversed by simply administering adequate glucose.

Tracheobronchopathia Osteochondroplastica (TPO) is a rare benign disorder of the lower part of the trachea and the upper part of the main bronchi. A 55-year-old female patient had been referring to our pulmonary and critical care center suffering from chronic dry cough and breathlessness on exertion and retrosternal pain for several months who was admitted to our center when she was complaining about breathlessness on exertion and chronic dry cough and retrosternal pain.

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