Kimura Disease as a Rare Cause of Proptosis: A Case Report

Kimura disease (KD) is a rare chronic inflammatory disorder of unknown aetiology that primarily affects the head and neck region with lymph node involvement. Young to middle-aged adult Asian males are predominantly affected. The most common presentation is painless subcutaneous swelling in the head and neck region, while proptosis or orbital involvement is very rarely reported. KD shares some features with other inflammatory and neoplastic disorders, including lymphoma; thus, investigations to confirm the diagnosis should not be delayed. Systemic corticosteroids are commonly used to treat KD and show an excellent response; however, the optimal treatment is still uncertain, and KD has a high recurrence rate. We describe the case of a patient with KD who presented with proptosis and post-auricular swelling, which responded well to oral prednisolone treatment.

PENERIMAAN DIRI DARI KEGAGALAN AKADEMIK PEREMPUAN PERFEKSIONISME

This research aims to describe how academic perfectionism women rise from failure. This research uses a qualitative method with a case study approach. The number of participants in this study was four people obtained by purposive sampling technique with the characteristics of middle-aged adult women, the type of perfection in completing academic tasks, had experienced academic failure, and were willing to become research participants. In-depth interviews and observations collect data. This study indicates that educated perfectionist women always try to achieve maximum results io doing academic work. They also always have high targets that must be completed in their academic life. When they experience academic failures, at first, they tend to be sad, but after that, they can get up quickly. That is because they have a good self-concept of achievement, emotional maturity, belief in God's destiny, and a sense of optimism in themselves, and they also get reinforced motivation through social support from close relatives.

Association between Cognitive Function and Depression with Human T-Cell Lymphotropic Virus 1 Seropositivity and Serointensity in UK Adults

Several viral, bacterial, and parasitic diseases have been associated with cognitive function and neuropsychiatric outcomes in humans, including human T-cell lymphotropic virus 1 (HTLV-1). In this study, we sought to further generalize previously reported associations of cognitive function and depression with HTLV-1 seropositivity and serointensity using a community-based sample of adults aged approximately 40 to 70 years (mean = 55.3 years) from the United Kingdom. In this sample, the results of adjusted linear regression models showed no associations of HTLV-1 seropositivity or serointensity with reasoning, pairs-matching, or reaction-time cognitive tasks or with depression. In addition, neither age, sex, educational attainment, nor income moderated associations of HTLV-1 seropositivity or serointensity with cognitive function or depression. In this middle-aged to older middle-aged adult community sample, HTLV-1 seropositivity and serointensity do not appear to be associated with reasoning, pairs-matching, and reaction-time tasks or with depression.

A “polymorphous low-grade neuroepithelial tumor of the young (PLNTY)” diagnosed in an adult. Report of a case and review of the literature

Background: Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a rare neuropathological entity, recently introduced in neuro-oncology. These tumors, histologically similar to oligodendrogliomas, cause epilepsy, occurring in children and young adults. Only few cases of PLNTY have been described in literature and all reported cases invariably focused on the onset of these tumors in children and young adults. Case Description: We report the case of a 50-year-old woman suffering from epilepsy since the 1st year of her life. Computed tomography scan and magnetic resonance imaging of the brain documented the presence of a calcified mass involving left temporal lobe. The tumor was surgically excised and the histological examination showed a hypocellular and massively calcified neoplasm with morphological and immunohistochemical features consistent with the diagnosis of “PLNTY.” Conclusion: A review of the literature revealed that there are 31 cases of PLNTY reported in literature, most of which are children or young adults. The present case represents the second PLNTY diagnosed in a middle-aged adult to the best of our knowledge, suggesting that PLNTY should always be included in the differential diagnosis of low-grade brain tumors, also in adult patients.

Mucormycosis an avoidable complication of COVID-19: a case report

Mucormycosis is caused by the fungi belonging to the order Mucorales. There has been an increasing trend of rising fungal infection during the second wave of COVID in India, seen among patients recovering from COVID-19. A 37-years-old middle-aged adult, with the diagnosis of left paranasal sinus mucormycosis, left side pneumothorax (intercostal drainage tube in-situ) with COVID pneumonia reported to the emergency department (ED) during the COVID-19 pandemic in our hospital in India. The patient presented in the ED on oxygen support via a non-rebreathing mask at rate of 10 l/min with a history of progressive left eye redness, pain, and tenderness, periorbital swelling, sudden onset, and mild shortness of breath from 8 days. The patient had a history of taking steroids during the management of COVID-19, also had left intercostal drainage tube (ICD) in-situ, and underwent post endoscopic sinus surgery in the private hospital. The patient was clinically examined by multispeciality experts and subjected to laboratory investigations. The patient was diagnosed with left PNS mucormycosis and planned for debridement. The patient developed renal failure secondary to antifungal therapy had sudden deterioration and could not be saved. The mortality rate of mucormycosis is very high due to delayed presentation, toxicity associated with the antifungal therapy, etc. There is a need to identify risk factors, perform specific laboratory tests, and initiation of prompt treatment. Monitoring and competent nursing care are required during antifungal therapy and prolonged hospital stay.

Post Vaccination Titers of Serum Anti-Diphtheria in Indonesian Young and Middle-Aged Adults

Objective: This study aimed to evaluate the antibody responses in two adult age groups after diphtheria vaccination. Study Design: An observational analytic study was carried out to determine the difference in serum titer of anti-diphtheria antibody. Methods: Serum antibody titers were measured just before and 3 months after injection of Diphtheria toxoid vaccine. Vaccine was given to two adult age groups of health care personnel in hospital: the young (< 40 years) and the middle-aged (≥ 40 years). Data were analyzed using the Mann-Whitney test (p < 0.05). Results: Significant increase in serum anti-diphtheria antibody titers were recorded after vaccination in both age group (p < 0.001 in young adult and p = 0.001 in middle-aged adult, respectively). There were no substantial differences between the two groups in terms of antibody titer before vaccination (p = 0.741), 3 months after vaccination (p = 0.317) and in the increase of antibody titer (p = 0.479). Conclusions: This study showed that there was no significant difference in the increase of anti-diphtheria antibody titers between the two age groups, proving that both young and middle-aged adults had an equal immune response to a given diphtheria vaccine.