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Magnetic resonance imaging brain scan with contrast. (A) Axial view showing (arrow) transverse and sigmoid sinus venous thrombosis. (B) Axial view showing (arrow) left ophthalmic vein thrombosis. (C) Sagittal view showing (arrow) left ophthalmic vein thrombosis. (D) Axial view showing (arrow) focal perichiasmatic enhancement of the left optic nerve.

Lesson Learned Through a Case of Pneumococcal Meningitis: Sometimes Doing Less Is More Harmful

Pneumococcal meningitis is commonly associated with intracranial complications. We present a case of pneumococcal meningitis leading to partial loss of vision in the left eye secondary to vascular complications. A 62-year-old African American female with a past medical history of breast cancer and hypothyroidism presented with complaints of altered mental status, neck pain, headache, and […]

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Computer tomography without contrast of abdomen showing colonic distension with air fluid levels without mechanical obstruction.

Hypokalemia in an End-Stage Renal Disease Patient

Kidneys play an essential role in K+ homeostasis, but the role of the colon in K+ homeostasis is not well recognized. Increased colonic K+ excretion plays a vital role in regulating plasma K+ level in patients with end-stage renal disease.1 We present a case of hypokalemia in a patient with end-stage renal disease with colonic pseudo-obstruction. […]

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Computed tomography scan demonstrating drug packets.

Ethico-Legal Challenges of Drug Packing—A Case Report

Body-packing, or the internal concealment of illicit drugs, has been described worldwide and is typically used to smuggle drugs across secure borders. Body-packers who swallow or insert packets of illicit drugs into body cavities are at risk for acute toxicity and gastrointestinal obstruction. We present a case of body-packing that exposed the challenging ethical and […]

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Thinning of the hair in the frontoparietal scalp was due to androgenic alopecia.

At the Root: Cutaneous Langerhans Cell Histiocytosis

Hair loss is of deep concern to patients, mainly because of its effect on appearance. On rare occasions, however, areas of balding can signal malignancy. A 33-year-old woman was referred to our dermatology clinic because of a 15-year history of scalp eruption accompanied by intense itching and progressive hair loss. Previously, she was diagnosed with […]

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Importance of Genetic Testing in the Diagnosis of Transthyretin Cardiac Amyloidosis

To the Editor: Systemic amyloidosis results from extracellular deposition of fibrillar material derived from aggregation of precursor proteins into insoluble beta-pleated sheets. The most frequently recognized types are due to prolonged inflammation, deposition of immunoglobulin light chains, and accumulation of transthyretin, a tetrameric protein synthesized in the liver. Transthyretin amyloidosis can occur owing to wild-type […]

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