Volume 9

Diabetes and Covid-19 Pandemic – A T1 Patient Perspective – Derek C Beatty

Case Report

1. History
A patient treated and cared for by NHS Scotland and NHS England the author has in his 44 years T1D Diabetes journey experienced surgery provided by the NHS by way of Vitrectomy, Ophthalmic laser and correction, and Orthopedic knee correction following a balance issue associated with IV antibiotic treatment for Otitis Externa and Osteomyelitis associated with long term T1 Diabetes with neuropathy. Interestingly IV antibiotic treatment led to glycemic issues offering explanation as to why on occasion glycaemia abnormalities can occur with antibiotic treatment for infection. Further research in this area is required and offers likely reasons why with sneaky infections like Covid-19 and similar infection risk BG Blood Glucose levels can fluctuate with greater risk of exposure to infection. Interestingly 4 days after the first vaccination of a Covid-19 vaccine the author suffered a serious retinal ophthalmic blood clot, possibly caused by raised BG after the Covid vaccine which contains a little of the infection virus to create a resistance to future infection. Other patients treated with Covid vaccinations have reported similar and tragically some have died. The author self-treated the ophthalmic haemorrhage by diligently wearing an OLED light mask delivering light into the retina to keep the rods and cones active during sleep at night for a year resulting in injury correction.

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Skull Metastasis from Papillary Thyroid Carcinoma: Case Report and Literature Review

Case Report

1. Abstract
1.1. Introduction: Although papillary thyroid carcinoma is a relatively common form of malignancy, metastatic spread to the skull is exceptional. Here, we report a case of papillary thyroid carcinoma revealed by frontal skull metastasis.

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Loops Around the Heart – A Giant Snakelike Right Coronary Artery Ectasia with Unique Convolute and Fistula to the Coronary Sinus

Case Report

1. Abstract
Coronary artery dilatation is an uncommon finding and is incidentally found during diagnostic coronary angiography or at necropsy. The pathogenesis of dilatation of coronary arteries is still not very well understood and therapeutic strategies are not clear. It is useful to know the difference between aneurysm and ectasia. In this report we demonstrate the diagnostic workup of an asymptomatic patient with a remarkable snakelike dilatation of the right coronary artery with unique convolute. For the first time we used intracoronary injection and simultaneous echocardiographic visualization of contrast agent (Sonovue) to proof a fistula to the coronary sinus. Like our patient, most of the patients are asymptomatic in absence of coronary artery disease and we decided on a conservative approach because of his very complex anatomy.

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A COVID Journey in Diabetes: T1D Diabetes Patient 44 years – Winning in Insulin Chicanes

Case Report

1. Diabetes Complications of Hypoglycaemia, Hypoglycaemia and Neuroglycopenia are often encountered by patients treated with insulin. It is feared by patients and families often leading to emotional and mental scars and can affect lifestyle and confidence. Hypoglycaemia can occur in premature babies, persons with hypopituitarism and Addison’s Disease. Low blood glucose can affect
athletes and the elderly leading to falls. Cases are individual and often difficult for families, clinicians, lawyers and courts to understand.

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Vonlay; A Paradigm Shift in Post Endodontic Restoration: A Case Report

Case Report

1. Abstract
Porcelain veneers have long been a popular restorative option that have evolved into a well- accepted treatment that can be fabricated
in various ways. Onlays are another common treatment modality used in contemporary dentistry to restore large areas of decay and
to replace old restorations.

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Dental Implants in Patients with Sickle Cell Disease: A Review of Literature

Research Article

1. Abstract
1.1. Study Objective: The study aims to review the current literature on sickle cell disease and dental implant as a treatment
modality for the replacement of the missing dentition.
1.2. Material and Methods: A comprehensive systematic literature review was conducted using the PubMed, Medline, Embase,
Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar, the US National Institutes of Health Trials Registry,
WHO Library, with no language filter. The search strategies were developed to cover publications January 2010 through October 2020. Five studies met the inclusion criteria.

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Neoadjuvant Therapy for HER-2 Positive Acantholytic Squamous Cell Carcinoma of the Breast: A Case Report

Case Report

1. Abstract
HER2-positive breast ASCC is exceptionally rare, its clinicopathological characteristics are insufficiently studied, and the implications
of neoadjuvant therapy, comprising targeted treatment against HER2. Here we reported that a 58-year-old woman with a histopathological diagnosis of HER2-positive ASCC gave a neoadjuvant therapy of albumin-paclitaxel, carboplatin in conjunction with trastuzumab every 3 weeks. After mastectomy and axillary lymph node dissection, immunohistochemical diagnosis of ER, PR, and HER2 was positive, followed by 17 cycles of trastuzumab therapy and no indications of disease were detected. So this neoadjuvant
therapy is of high value in HER2-positive ASCC patients

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Viral Load and Antibody Responses in an Asymptomatic/Minimally Symptomatic SARSCov2 Positive Cohort in Sri Lanka

Technical Paper

1. Abstract
Asymptomatic patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are silent carriers of the disease. We aimed to characterize their dynamics of disease occurrence, viral shedding and antibody responses using a cohort of asymptomatic/ minimally symptomatic patients from Sri Lanka during the first
wave of COVID-19. The cohort includes the first 26 of a cluster of 936 SARS-CoV-2 positive Navy personnel that were reported.
Sequential nasopharyngeal swab and blood samples were collected at various time points up to nine months. RT-PCR was done to measure SARS Cov2 viral loads, while blood samples were subjected to ELISA assays to detect SARS-CoV-2 IgM, IgG antibodies and neutralization assays. Eight (31%) patients were symptomatic at the time of diagnosis while 13 (50%) were pre-symptomatic and 5 (19%) remained asymptomatic.

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A Rare Presentation of Acute Hemolytic Anemia in a Newborn Infant

Review Article

1. Abstract
Hereditary Elliptocytosis (HE) is a heterogeneous group of inherited Red Blood Cell (RBC) disorders characterized by the presence of elongated, oval, or elliptically shaped RBCs on the peripheral blood smear. Hemolytic anemia in these disordersranges from absent to life-threatening .Transient hemolytic anemia has been
reported in neonates with some of the more severe HE syndromes.

We will present a newborn with acute hemolysis anemia that experienced recurrent hemolysis with strong positive family history of Anemia and one mortality because of hydrops fetalis due to severe hemolysis.

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McKittrick-Wheelock Syndrome: A Rare Occasion in a Young Patient

Review Article

1. Abstract
Mckittrick-Wheelock syndrome is a fatal and life threatening diagnosis if no interventions taken on time. It is due to a large distal colon polyp that secretes body salts including sodium and pottasium and thus, causing severe diarrhea and dehydration to the patient.

Clinical features of this syndrome are severe dehydration, hypokalemia, hyponatremia, lethargy and unintentional weight loss. This is a treatable disease especially by the means of multidisciplinary approach. Resection of the polyps that causing the syndrome is considered the primary treatment along with the replacement of
fluids and body salts. Early intervention may prevent major organs dysfunction especially kidney failure.

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