As the editor of the Journal of Case Report in Clinical Practice and someone who has been teaching scientific writing in Iran and the Middle East for many years, I always emphasize two points regarding the case report.

1. Generally, your case report should be rare and not commonly seen. In the history of the last two centuries, which war do you think would kill more than 40,000 defenseless people in a few months with the weapons provided by the three member countries of the Security Council, and create more than two million refugees [1-4]? All the people of the West, including academics, protest, but with the efforts of the same three members of the Security Council, the United States, United Kingdom, and France, not a single resolution against the Zionist regime is passed. In my opinion, as the editor of the Journal, this is definitely a case report.

2. The purpose of writing a case report is for the medical doctor to do the best work with his/her practice in medicine, which in the case of killing the people of Gaza and documenting it as a tragic event unique in history, will probably cause the free people of the world in the future, to elect rulers who believe in human rights and respect for human life. Anyway, what is important is that despite the support and at best, indifference of the Western countries, this killing has offended the conscience of the free people of the West so much that after the Vietnam war, almost all the academics of the American universities have protested and this protest movement of the universities America has developed to other Western universities. The cruel killing of infants who needed NICU or were in NICU and died due to lack of electricity and oxygen will be written in the history of modern medicine [5, 6].

So far, different types of SOX5 variants have been reported in patients with LAMSHF syndrome, which are mainly clustered in the HMG domain. The LAMSHF syndrome has a broad variety of clinical manifestations such as developmental delay, speech delay, intellectual disability, and behavioral disturbances. In this article, we aim to present three cases with Lamb–Shaffer syndrome who are heterozygotes for a novel variant (c.1684G>A) in the SOX5 gene in a family from the north of Iran.A 38-year-old male case with moderate mental retardation and strabismus, with a head circumference size of 56 cm, was tested for genetic diagnosis. The results of whole- exome sequencing (WES) indicated the c.1684G>A pathogenic variant (NM_006940.6) in the SOX5 gene in a heterozygote state. Family analysis showed that the proband’s sister and father, who have similar symptoms, also carry the detected variant.Like the previous cases, the presented cases with a missense variant in the HMG- domain also have a mild phenotype. The introduction of new patients, especially with new pathogenic variants, is fundamental to increasing our knowledge about the disease and possible genotype–phenotype correlations.

This article discusses a case of ochronotic arthropathy, a manifestation of alkaptonuria. Alkaptonuria is characterized by the accumulation of homogentisic acid [HGA] in tissues, leading to a distinctive blue-black pigmentation and early joint degeneration. A 68-year-old female patient, with a history of alkaptonuria, presented with progressive hip pain and was eventually treated with an elective total hip replacement. Due to vertebral calcifications, the operation was performed under general anesthesia. Pre- and post-operative care was guided by the patient’s comorbidities and potential complications related to alkaptonuria, including potential cardiac and respiratory issues. Following surgery, the patient exhibited significant improvements in hip joint functionality. The paper also discusses the challenges in diagnosing alkaptonuria, the absence of definitive treatment, and the potential of dietary restrictions and symptomatic treatments. Moreover, it addresses surgical considerations for ochronotic arthropathy and emphasizes the role of regular calcium and vitamin D intake in maintaining bone quality. The success of the hip replacement surgery in this case suggests a potential intervention for managing ochronotic arthropathy in alkaptonuria patients.

Recurrent facial nerve paralysis is an unusual occurrence.Recurrent facial palsy, oro-facial swelling, and a fissured tongue. Lower Motor Neuron Palsy. No definitive therapy is available, and frequent recurrences are common.Idiopathic recurrent Lower Motor Neuron facial palsy with atypical presentations can be indicative of Melkerson-Rosenthal syndrome.

Hemophagocytic lymphohistiocytic syndrome is a rare, significant, and life-threatening disease. We are reporting this case with the hope that it may contribute to saving some patients if treated appropriately. A 4-year-old boy presented with fever and pancytopenia. He was treated based on the symptoms that matched the criteria of (HLH). Furthermore, the bone marrow biopsy report revealed the presence of Leishman’s bodies.Hemophagocytic lymphohistiocytic syndrome is a rare, important and life-threatening disease that we are reporting this case due to the hope of saving some patients if treated. A 4-year-old boy with fever and pancytopenia, who was treated according to the symptoms matching the criteria of HLH, as well as the bone marrow biopsy report showing Leishman’s bodies.HLH is a life-threatening disease based on cumulative increase and unrestricted excessive activity of T lymphocytes, cytokines and macrophages, which occurs in two primary and secondary forms, which requires the rejection of all risk factors, symptoms similar to the disease, including infections, lymphoproliferative and autoimmune diseases and other causes, and after ruling out other causes, the patient should be treated quickly with the treatment protocol of this disease, which is reported.due to the rarity of this disease and the urgent need for timely diagnosis and treatment; we are trying to report this patient.

Anti-IgLON5 is a neurological condition with neurodegenerative and autoimmune etiology. A 64-year-old man with a 2-year history of aplastic anemia presented with symmetrical parkinsonism, fluctuating consciousness, supranuclear gaze palsy, mild fasciculation, and muscular atrophy. He had disturbances in his sleep cycle and brain MRI. CSF analysis was positive for the IgLON5 antibody. We initiated immunotherapy with high-dose methylprednisolone, intravenous immunoglobulin, and rituximab. The patient showed a mild to moderate response to treatment. We reviewed 29 published case reports regarding anti-Iglon-5 and examined the clinical manifestation. None of the cases showed aplastic anemia, which was the main presentation in our case. All of the patients experienced sleep disturbances, while other symptoms were heterogeneous. Anti-Iglon-5 is usually diagnosed late, leading to a weak prognosis. This study helped us establish a better understanding of the correlation between anti- Iglon5 disease and other autoimmune disorders like anemia.

Ectopic migration of intrauterine contraceptive devices (IUCDs) to neighboring organs is infrequent, but can lead to severe consequences. This article presents two cases of IUCD migration resulting in serious outcomes, including sigmoid colon penetration in the first case (a 25-year-old) and right ovary penetration and contraceptive failure leading to pregnancy in the second case (a 19-year- old). The IUCD was inserted 6 months ago and 2 years ago in the first and second cases, respectively. Both cases underwent surgical exploration and IUCD removal. Fortunately, both patients experienced uneventful recoveries without any complications. In conclusion, although uncommon, IUCD ectopic migration may result in contraceptive failure and, in some cases, organ perforation. Thorough evaluation during care visits is necessary for proper IUCD placement, and radiological assessment should be performed in cases of a ‘missed IUCD,’ even if the patient is asymptomatic. Timely removal of an ectopic IUCD is strongly advised to minimize potential risks.

The abdomen is the second most common site for sepsis. This potentially life- threatening condition necessitates finding the source and providing prompt medical and/or surgical treatment. This presentation reveals an uncommon cause of intra- abdominal sepsis.A 43-year-old woman presented to the emergency department with abdominal pain, tachycardia, tachypnea, and generalized abdominal tenderness. The evaluation of the laboratory tests showed an elevation in white blood cell count and liver enzymes. Ultrasonography of the liver revealed the presence of hydatid cysts, and the abdomino- pelvic computed tomography scan with contrast displayed multiple pyogenic cysts in her liver, one of which had ruptured into the peritoneum. She underwent surgery, received antimicrobial agents, and was successfully discharged without experiencing any complications.One clinical presentation of a hepatic hydatid cyst could be intra-abdominal sepsis, which requires emergency surgery along with antibiotic and anti-helminthic drugs.

Granulomatosis with polyangiitis, previously known as Wegener’s, is a necrotizing vascular disease that affects small blood vessels and may cause damage to the respiratory tract and kidneys. In this article, we report on a 50-year-old male with a complicated disease process who experienced rare bladder and renal complications and several adverse drug reactions. Despite using drug alternatives, the side effects remained mostly the same. Therefore, by studying different cases and articles, we establish the relation between these findings and the specifications of granulomatosis with polyangiitis. This case underscores the complexity of managing this condition and the need for personalized treatment strategies.

Gestational choriocarcinoma, a rare variant of gestational trophoblastic disease, typically arises from abnormal trophoblastic cell proliferation post-pregnancy, often associated with a hydatidiform mole. While most choriocarcinoma cases develop within the uterine cavity, an exceedingly rare manifestation occurs within a previous cesarean section scar. In our study, a 31-year-old woman with a history of hydatidiform mole presented with amenorrhea and spotting. Initial assessments revealed elevated beta-human chorionic gonadotropin (βhCG) levels and a heteroechoic mass at her prior cesarean section scar in sonographic examination. Histopathologic findings and the metastatic workup categorized the patient as FIGO stage I, indicating no metastasis. Due to the absence of metastasis, adjuvant chemotherapy was omitted. Total abdominal hysterectomy confirmed choriocarcinoma. Post-surgery, βhCG levels notably decreased, remaining negative during the two-year follow-up with no reported symptoms. Our findings suggest that surgical resection and meticulous βhCG monitoring may be a promising treatment strategy for non-metastatic choriocarcinoma.

Automatic airbag deployment during car accidents undoubtedly plays a vital role in preventing injuries. However, it may occasionally lead to aural damage, including noise-induced hearing loss, tympanic membrane perforation, and tinnitus. Here, we present a case of left curtain airbag deployment immediately following a low-speed car accident, which resulted in the driver experiencing tinnitus. In addition to the case presentation, we have included a brief literature review on potential otologic and non- otologic injuries caused by airbags