Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 206 206 EN Shahin Akhondzadeh Professor of Neuroscience School of Medicine Tehran University of Medical Sciences, Tehran, Iran 2018 07 14 Introduction:lthough herbal medicine have been used by traditional healers and physicians for thousands of years, these herbs are still being probed by researchers hoping to unlock their full therapeutic potentials. There is still much to learn about the biochemical and clinical effects of the individual constituents and of the various parts (petals, stigmas, leaves, and roots) of these plants. Many of today’s synthetic drugs originated in the plant kingdom, and less than two hundred years ago, the major pharmacopoeias of the world were dominated by herbal drugs- https://crcp.tums.ac.ir/index.php/crcp/article/view/206 https://crcp.tums.ac.ir/index.php/crcp/article/download/206/106

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 2 6 EN Shima Asadi-Komeleh Department of Rheumatology, School of Medicine AND Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. Abdolrahman Rostamian Department of Rheumatology, School of Medicine AND Vali-Asr Hospital AND Center for Research on Occupational Disease, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Shahbazi Department of Biology, Payame Noor University, Tehran, Iran. Shafieh Movassagi Department of Rheumatology, School of Medicine AND Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. Parviz Soofivand Department of Rheumatology, School of Medicine AND Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 10 26 2018 03 17 The primary hypertrophic osteoarthropathy (PHOA or pachydermoperiostosis) is a rare (5% of total HOA) hereditary disease. One study described that the prevalence of PHOA is 0.16%. PHOA characterized by skin thickening (pachydermia), finger clubbing, and proliferation of periosteum (periostitis) with subperiosteal new bone formation and enlarged extremities secondary to periarticular and bone proliferation. Clinical manifestations are variable; the term complete syndrome is used for the patient with pachydermia, coarsening of the face skin and scalp, periostitis, and cutis verticis gyrata; the incomplete form is used when there is no sparing of the scalp; and the frusted form is used for pachydermia with minimal or absent periostitis. We describe a 29-year-old white man with PHOA, and clinical and radiological characteristics of this syndrome, as well as therapeutic approach of PHOA. https://crcp.tums.ac.ir/index.php/crcp/article/view/145 https://crcp.tums.ac.ir/index.php/crcp/article/download/145/97

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 7 9 EN Maryam Nasimi Department of Dermatology, School of Medicine AND Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Robabeh Abedini Department of Dermatology, School of Medicine AND Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Azita Nikou Department of Dermatopathology, School of Medicine AND Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Elham Alipour Department of Dermatology, School of Medicine AND Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 12 30 2018 03 11 Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma, which often appears in the form of patches, plaques, and tumors as originally described by Alibert and Bazin. The manifestation of MF as annular lesions is uncommon, and herein we report one of those cases. A 54-year-old woman complaining of itchy skin lesions from three years before, came to our clinic with no response to topical steroids. In skin examination, there were annular lesions with erythematous slightly raised borders, and some scattered erythematous thin plaques in trunk and extremities with a predilection to lower extremities. Epidermal and poikilodermic changes were not evident. There were no lymphadenopathy and hepatosplenomegaly. Biopsies were obtained from three different lesions and the diagnosis of all samples was consistent with MF. A diagnosis of stage 1B of MF was made and the patient went under oral psoralen and ultraviolet A (PUVA) therapy. MF has different clinical manifestations that can be confused with other inflammatory dermatological disorders. Until now, less than 10 cases of MF with annular lesions have been reported in the English literatures, and most of them initially were under treatment with other differential diagnosis of annular lesion than MF https://crcp.tums.ac.ir/index.php/crcp/article/view/169 https://crcp.tums.ac.ir/index.php/crcp/article/download/169/98

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 10 13 EN Pantea Arya Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Sara Hashempour Department of Psychiatry, School of Medicine AND Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Akbar Shafiee Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Azita Kheiltash Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Padideh Ghaeli Department of Psychiatry, School of Medicine AND Roozbeh Hospital AND School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2018 01 11 2018 05 23 Hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH) occurs as a rare but clinically important phenomena in various conditions including malignant neoplasms, infections, and central nervous system disorders, and as an adverse effect of numerous drugs. To the authors’ knowledge, there are a few reports on SIADH associated with quetiapine in the literature. This case presents a 58-year-old woman receiving quetiapine for the treatment of bipolar disorder. The patient was hospitalized due to generalized tonic-colonic seizure. After checking her laboratory tests, she was found to be hyponatremic, and the treatment began accordingly. The situation was resolved after discontinuation of quetiapine therapy. Quetiapine was thought to be the cause for the patient’s symptoms, and she was diagnosed with SIADH induced by this medication. Close monitoring of the sodium level is recommended in patients taking quetiapine. https://crcp.tums.ac.ir/index.php/crcp/article/view/171 https://crcp.tums.ac.ir/index.php/crcp/article/download/171/99

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 14 17 EN Mojtaba Fazel Department of Pediatrics, Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Zeinab Kavyani Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Masoome Sadat Sadeghzadeh Department of Pediatrics, Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Maassoumeh Akhlaghi Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2018 01 13 2018 05 22 Relapsing polychondritis (RP) is very rare inflammatory disorder characterized by episodic, progressive, and destructive courses affecting cartilages. Renal involvement also is very rare presenting sign in these patients. It has seldom been described in children. We describe an 11-yearold girl with RP and complaint offrequent episodes of hematuria, and dysuria with fever and periorbital edema that auricular cartilage involvement appeared after renal involvement. Renal involvement in the setting of RP is mainly important, and need close observation. https://crcp.tums.ac.ir/index.php/crcp/article/view/173 https://crcp.tums.ac.ir/index.php/crcp/article/download/173/107

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 18 20 EN Zahra Tavoli Department of Obstetrics and Gynecology, School of Medicine AND Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Tabatabaei Department of Obstetrics and Gynecology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2018 02 01 2018 05 20 Incisional hernia is defined as dehiscence of fascia and bowel obstruction. The clinical manifestation includes gross disruption of the wound with drainage, presence of a bulging with exertion or Valsalva maneuver, painful continuous bulge if bowel or omentum is incarcerated, and bowel obstruction or infarction. We report a 63-year-old woman with the history of three times cesarean section with a midline incision. She was operated for ovarian tumor. Total laparoscopic hysterectomy and lymphadenectomy was performed. She attended to hospital 5 days after surgery with the chief complaint of abdominal pain, nausea, and vomiting. There was a bulge tender around the umbilical port and patient’s creatinine was 4 mg/dl in laboratory test. The ultrasound confirmed a port site hernia. A strangulated hernia was diagnosed and treated with laparotomy. https://crcp.tums.ac.ir/index.php/crcp/article/view/178 https://crcp.tums.ac.ir/index.php/crcp/article/download/178/101

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 21 25 EN Hamidreza Khorshidi Department of General Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Mehrdad Taghipour Department of General Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Babak Yousefi Department of General Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Arash Dehghan Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. 2018 02 03 2018 05 20 Esophageal squamous cell carcinoma (SCC) is a common neoplasm which incidence shows an increasing trend in most populations. This article presents a case of 79-year-old woman with diagnosis of differentiated squamous cell carcinoma of the esophagus as two adjacent mas with metastasis, which invaded the perigastric and distal esophagus lymph nodes. The patient underwent esophagectomy and gastroesophagotomy. The jejunostomy tube was also embedded. The presence of two simultaneous esophageal tumoral lesions is extremely uncommon and requires further assessments. The prognosis and survival of such patients not seems to be worse than those of patients with isolated esophageal neoplasm. https://crcp.tums.ac.ir/index.php/crcp/article/view/179 https://crcp.tums.ac.ir/index.php/crcp/article/download/179/102

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 26 29 EN Sussan Soltani Mohammadi - Department of Anesthesiology, Pain and Intensive Care Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farideh Toorany Sina-Shemiran Plastic Surgery Center, Tehran, Iran. Abdolrahim Shahhosseini Department of Ophthalmology, Ayatollah Kashani Hospital, Tehran, Iran 2018 02 12 2018 05 23 Parry Romberg syndrome is a rare progressive degenerative disease characterized by unilateral atrophy affecting the skin, connective tissue, muscle, and bone, typically occurs in children and young adults. The end result is facial asymmetry associated with other skin, dental, visual, cardiovascular, and neurological disorders that ceases without apparent cause after a highly variable period. Inconsistency in the pattern of atrophy and multisystem involvement make intraoperative anesthetic management of these patients a challenge for anesthesiologists. We present a case of Parry Romberg syndrome and her associated clinical findings with specific attention to the anesthetic consideration of this disease. https://crcp.tums.ac.ir/index.php/crcp/article/view/185 https://crcp.tums.ac.ir/index.php/crcp/article/download/185/104

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 1 2018 07 24 30 34 EN Seyed Sadeq Kalantar Department of Neurology, School of Medicine AND Kamkar Arabnia Hospital, Qom University of Medical Sciences, Qom, Iran. Nasbeh Amrzargar Department of Neurology AND Rofeideh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Sakineh Ranji Burachaloo Iranian Neurological Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2018 02 26 2018 04 17 Cerebral venous thrombosis (CVT) is an uncommon but fatal type of stroke with a wide spectrum of signs and symptoms. We report a 40-year-old woman who presented with acute intractable neck pain and lateral cervical bending. Investigations with neuroimaging revealed evidence of thrombosis in her right transverse and sigmoid sinuses. The precipitating factors for the thrombosis were consumption of oral contraceptive pills during the month of Ramadan, and dehydration due to fasting. The patient immediately was treated with the therapeutic dose of anticoagulant. We concluded that in patients with severe cervical pain, especially those who are predisposed to thrombotic complications, CVT should be considered in the differential diagnosis. https://crcp.tums.ac.ir/index.php/crcp/article/view/186 https://crcp.tums.ac.ir/index.php/crcp/article/download/186/105