Large ovarian dermoid, a cause for fetal growth restriction and oligohydramnios: rare instance in literature

Ovarian dermoids mostly remain asymptomatic during pregnancy. Large dermoids may present with torsion, hemorrhage or rupture. However, a dermoid cyst causing fetal growth restriction (FGR) and oligohydramnios is a very rare entity. We report a case of a large ovarian dernoid (15×12 cm) hampering intrauterine fetal growth. Due to the COVID-19 lockdown, patient was unable to get ultrasound examinations in early gestation, and thereby surgical intervention was not possible during the second trimester. As a result, this growing teratoma finally led to FGR by either exerting a pressure effect upon the uterus or by dwindling its blood supply.

Global Art Market in the Aftermath of COVID-19: A Case Study on the United Arab Emirates

How has COVID-19 affected the global art market? This virus interrupted 2020 in unforeseen ways globally, including the cancellation of the most important art events of the year. Through a close chronological study of the Emirati art scene’s response, both in commercial and noncommercial venues, this essay explains how, and why, the UAE’s art scene was able to react quickly and perhaps more effectively than that of other nations, and what that means for its future. Based on fieldwork and press articles, this article posits that the Emirati art scene evolved from being virtually non-existent to a thriving contemporary art hub in a matter of decades because it has always had to adapt to challenges such as nonexistent art infrastructure or the 2008 financial crisis. By studying the UAE, we find examples of exhibitions that quickly moved from being in situ to online, a rare instance of galleries and art auction house collaborating, government and institutional structures stepping up to support artists and galleries, and the renaissance of Art Dubai taking place in person in 2021 after being abruptly cancelled in 2020. This knowledge provides insight into how the global art market is changing to face the consequences of COVID-19.

“They Remembered That They Had Seen It in a Jewish Midrash”: How a Samaritan Tale Became a Legend of the Jews

This article relates the transmission history of a single Samaritan text and its fascinating trajectory from a Samaritan legend into early modern rabbinic tradition, and on to nineteenth and early twentieth century Jewish studies circles. It focuses on the only Samaritan narrative cited in all of Louis Ginzberg’s monumental Legends of the Jews (1909–1938). Often called the “Epistle of Joshua son of Nun,” I trace the trajectory of this story from a medieval Samaritan chronicle to Samuel Sulam’s 1566 publication of Abraham Zacuto’s Sefer Yuḥasin. From there, we move to early modern belles lettres in Hebrew and Yiddish, western scholarship and then to the great Jewish anthologizers of the fin de siècle, Micha Yosef Berdyczewski, Judah David Eisenstein and Louis Ginzberg. I will suggest reasons why this tale was so appealing to Sulam, a Sephardi scholar based in Istanbul, that he appended it to Sefer Yuḥasin, and what about this tale of heroism ingratiated it to early modern European and then early Zionist readers. The afterlife of this tale is a rare instance of Samaritan influence upon classical Jewish literature, undermining assumptions of unidirectional Jewish influence upon the minority Samaritan culture from antiquity to modern times.

A Rare Case Report of Life-Threatening Severe Protein-Losing Gastroenteropathy

Protein-losing gastroenteropathy is a rare syndrome of protein loss from the gastrointestinal system. It manifests with hypoproteinemic edema, which may be due to either lymphatic leakage due to increased interstitial pressure or leakage of protein-rich fluids due to intestinal disorders. Our case describes a 65-year-old female with life-threatening protein-losing enteropathy (PLE) requiring multiple transfers to intensive care unit for vasopressor support. In this rare instance, her extensive initial workup did not reveal any etiology for PLE, but she was later found to have underlying Crohn’s colitis. Protein-losing enteropathy is an underdiagnosed complication of inflammatory bowel disease and must be considered while treating patients with colitis.

A Rare Case of Nsaid Induced Gastric Body Diaphragmatic-Like Stricture

Protein-losing gastroenteropathy is a rare syndrome of protein loss from the gastrointestinal system. It manifests with hypoproteinemic edema, which may be due to either lymphatic leakage due to increased interstitial pressure or leakage of protein-rich fluids due to intestinal disorders. Our case describes a 65-year-old female with life-threatening protein-losing enteropathy (PLE) requiring multiple transfers to intensive care unit for vasopressor support. In this rare instance, her extensive initial workup did not reveal any etiology for PLE, but she was later found to have underlying Crohn’s colitis. Protein-losing enteropathy is an underdiagnosed complication of inflammatory bowel disease and must be considered while treating patients with colitis.

Extradural abscess following synthetic fabric duraplasty

Background: Duraplasty refers to the neurosurgical process of reconstructing dural defect. Variety of materials is used for such reconstruction, including natural, semisynthetic, and synthetic materials. Although synthetic materials are readily available and easy to apply, these are associated with foreign body reaction which may lead to serious consequences in some cases. We describe one such rare instance of extradural abscess after polypropylene synthetic fabric duraplasty. Case Description: Our patient is a 33-year-old lady who suffered road traffic accident leading to massive brain laceration, contusion of bilateral frontal lobes, and anterior skull base fractures. Emergency craniotomy was carried out and dural defect repaired with polypropylene (G-Patch; G. Surgiwear® Ltd.) synthetic fabric as the duraplasty material. Three months later, the patient presented with discharging wound at the incision site. Neuroimaging showed ring enhancing lesion in frontobasal extradural space with cutaneous extension. The lesion failed to heal despite intravenous antibiotics and surgery was planned. Intraoperatively, abscess was found between G-Patch and dura. Histopathology showed granulomatous foreign body reaction. The lesion healed after synthetic dura removal and abscess drainage. Conclusion: Although various materials are used for duraplasty, there is no clear consensus on what material should be used for dural repair. Synthetic materials are bio-inert, offer good handling and malleability. Polypropylene has been used safely for both single- and double-layered duraplasty. However, foreign body reaction may occur and very rarely present as extradural abscess. Randomized trials should be done to establish the safety and efficacy profile of commonly used duraplasty materials.

Role of Anticoagulation in the Management of Tumor Thrombus: A 10 year single center experience

Background: Children with cancer diagnosis are overall at a higher risk of thrombosis. For a newly diagnosed bland thrombus, patients are commonly started on anticoagulants to prevent further extension and embolization of the clot. In the rare instance that a pediatric patient has a tumor thrombus, the role of anticoagulation is less clear. Procedure/Methods: Patients under 21 years of age with a finding of tumor thrombus on imaging from 2010-2020 at Texas Children’s Hospital were identified and their medical records were reviewed. Results: A total of 50 patients were identified. Most thrombi were incidental findings at diagnosis; however, there were two patients who presented with pulmonary embolism (PE). Inferior Vena Cava extension was noted in 36% of the patients and 24% patients had an intracardiac tumor thrombus. Hepatoblastoma (26%) was the most common malignancy associated with tumor thrombus. Anticoagulation was initiated in 10 patients (20%). Only 2 of these 10 patients showed response to anticoagulation. However, 40% (4/10) patients in the anticoagulation cohort were noted to have bleeding complications (p <.05). Conclusion: Children with intravascular extension of solid tumors were not commonly started on anticoagulation at the time of diagnosis, irrespective of the extent of tumor thrombus. Furthermore, we observed a significant trend toward higher incidence of bleeding complications after initiation of anticoagulation. There is inadequate evidence at this time to support routine initiation of anticoagulation in pediatric patients with intravascular extension of solid tumors.