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Background Lateral mass screw and rod fixation is widely used for posterior cervical arthrodesis and stabilization in cases of cervical instability, trauma, neoplasm, decompression, and deformity correction. However, clinical and radiological data on its outcomes, especially in our setting, remain limited. Objective Clinical and radiographic evaluation of posterior cervical arthrodesis and stabilization using lateral mass screws and rod fixation. Methods A retrospective cross-sectional study of lateral mass screw and rod fixation from September 2019 to September 2024 was performed, and the clinical and radiographic parameters were evaluated. Sixty-six patients were assessed via a structured questionnaire. Clinical parameters were assessed by the ASIA score, functional assessment in degenerative conditions (mJOA), and radiographic evaluation (computed tomography and dynamic X-ray) of 325 lateral mass screws inserted into the evaluated patients. Complications were assessed from a patient chart and radiology archive. Results Patients ranged from 16 to 75 years in age (40.1), and 84.9% of the patients were between the ages of 20 and 60. Trauma accounted for 92.4% of the indications, with fracture dislocations being C4/C5 (28.8%), C5/C6 (25.8%), C6/C7 (16%), and C4/5 (10.8%)—unilateral locked facets in 4.5% and floating lateral masses in 6% of patients. A total of 325 screws were placed, with C5 being the most common (110 screws). There was no postoperative change in the ASIA score. The complications included dural tear (3%), joint violation (1.9%), hardware failure (1 patient), and postoperative surgical site infection (6%). The postoperative follow-up ASIA score was significantly associated with the preoperative score, with a likelihood ratio and Fisher’s exact test P value < 0.001. The mean postoperative follow-up mJOA score was 13.3 ± 0.58, which was greater than the preoperative mean mJOA score, which was 8.67 ± 1.16. Conclusion Lateral mass screw and rod fixation is an effective method of cervical stabilization in our setting. Clinical trial number Not applicable.

Thyroid surgery requires a thorough knowledge of the neck anatomy and its anatomical variations. This is of utmost importance since it is well known that variations of the recurrent laryngeal nerve are prone to iatrogenic injuries. Injury to the recurrent laryngeal nerve is one of the most severe complications of thyroid surgery. Surgeons must comprehensively understand the anatomy of the recurrent laryngeal nerve during thyroid operation. To assess the anatomical variations of recurrent laryngeal nerves, with inferior approach using inferior thyroid artery as a consistent anatomical landmark, and outcomes in patients who had undergone thyroid surgery in Tibebe Ghion Specialised Hospital, Bahir Dar, Ethiopia. An institutional-based prospective observational study of 102 consecutive patients was conducted from June 2021 to August 2022 at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. Data were collected prospectively using a standardized intraoperative checklist and intraoperative photographs. The study included 102 patients (92 female, 10 male). Age distribution was 18–39 years: 53.9%; 40–60 years: 42.2%; 61–80 years: 3.9%. A total of 156 RLNs were dissected: 87 right and 69 left. Right-side branching was observed in 24.1% of nerves (single trunk 75.9%; bifurcation 18.4%; trifurcation 5.7%); left-side branching occurred in 10.2% (single trunk 89.8%; bifurcation 10.2%). In relation to the ITA, right RLNs were posterior in 68.9%, anterior in 27.7%, and interdigitating among arterial branches in 3.4%; left RLNs were posterior in 91.3%, anterior in 7.3%, and interdigitating in 1.4%. Using the operative landmark of the tracheoesophageal groove (TEG - defined here as the space between the trachea and esophagus at the level of dissection), 93.1% of right RLNs were identified within or adjacent to the TEG and 6.9% were lateral to the tracheal surface; 100% left RLNs were identified within or adjacent to the TEG. Early postoperative course was uneventful in 92.2%; transient hoarseness occurred in 2.0%. Anatomical consideration of the variations in the course, branching pattern, and relation of recurrent laryngeal nerve with inferior thyroid artery and tracheoesophageal groove is essential to minimize complications associated with surgical procedures of the neck, especially thyroidectomy.

Background Pediatric germ cell tumors (GCTs) are rare, heterogeneous neoplasms with peak incidence in children under 4 years of age and during adolescence. The clinical presentation and treatment outcomes of GCTs are not well-studied in developing countries. This study aimed to assess the clinicopathological patterns and treatment outcomes of pediatric GCT patients treated at the largest tertiary referral hospital in Ethiopia. Methods A retrospective cross-sectional study was conducted at Tikur Anbessa Specialized Hospital, Ethiopia, on pediatric GCT patients treated between January 1, 2013, and December 31, 2023. Data were collected and analyzed using SPSS version 25. The Kaplan–Meier survival estimate was employed to evaluate Overall Survival (OS) and Event-Free Survival (EFS). The log-rank test was used to compare Kaplan–Meier curves, P < 0.05 was considered to indicate a statistically significance. Results A total of 91 patients were included in the study. The median age at diagnosis was 4 years, with a predominance of females. Children under 5 years of age constituted 61.6% (n = 56) of the cases. Sacrococcygeal swelling was the most common presenting symptom, accounting for 38.2% (n = 34), followed by abdominal mass accounted for 36%. Most patients (93.4%, n = 85) had extra-cranial GCTs, with mature teratoma being the most prevalent histological subtype (52.6%). Approximately 42.5% of patients received a combination of chemotherapy and local control measures, primarily surgery. Kaplan–Meier survival analysis revealed that the 1-year and 5-year OS rates were 92.7% and 85%, respectively, while the 1-year and 5-year EFS rates were 95% and 84%, respectively. Conclusion This study demonstrated that the median age at diagnosis for pediatric GCTs was 4 years, with a female predominance. Mature teratoma was the most frequent histological subtype. The observed 1-year and 5-year OS rates were comparable to other studies conducted in similar setting in low- and middle-income countries.

Langerhans cell histiocytosis (LCH) is a rare pediatric histiocytic disorder characterized by diverse clinical manifestations, ranging from isolated lesions to severe multisystem involvement. This case series presents three distinct presentations observed in children. The first case involved a 4‐year‐old female presenting with generalized lymphadenopathy, polyuria, polydipsia, bilateral vision loss, and systemic symptoms, indicative of significant pituitary and multisystem involvement. Imaging revealed lesions involving the pituitary gland, hypothalamus, and sphenoid sinus. The second case described a 10‐year‐old male experiencing respiratory distress, significant weight loss, polyuria, and multiple lytic bone lesions. Diagnostic imaging identified extensive colonic involvement, bilateral hydronephrosis, and pulmonary lesions, emphasizing unusual systemic features. The third patient, an 18‐month‐old child, initially presented with persistent respiratory symptoms, a diffuse rash, severe acute malnutrition, and hepatomegaly and was initially misdiagnosed as having tuberculosis. Later imaging studies revealed extensive pulmonary cystic lesions. Immunohistochemistry from the tissue biopsy demonstrated CD1a positivity, confirming LCH diagnoses. Treatment strategies included standard induction protocols with vinblastine and corticosteroids. These cases show how LCH can present in many different ways in pediatric patients, often in unexpected patterns. Early recognition, thorough imaging, and histological confirmation are crucial for accurate diagnosis. Being aware of the wide range of symptoms can help ensure prompt treatment and better outcomes for this serious but manageable condition.

Plummer‐Vinson Syndrome (PVS) is a rare disorder characterized by the triad of dysphagia, iron‐deficiency anemia, and esophageal webs. Limited data on its prevalence exist, with most information derived from case reports. We present the case of a 60‐year‐old woman with a 6‐month history of a progressively enlarging anterior neck mass and worsening symptoms of heart failure, heat intolerance, and dysphagia. Diagnostic evaluation revealed a multinodular goiter, microcytic hypochromic anemia, hyperthyroidism, hypokalemia, and esophageal webs. She was diagnosed with PVS in conjunction with thyro‐cardiac disease and acute decompensated heart failure. Treatment included iron supplementation, pneumatic dilation, and management of her thyroid and cardiac conditions, resulting in significant clinical improvement. This case demonstrates the importance of early recognition and treatment of PVS to prevent complications and reduce morbidity.

Tropical sprue (TS) is a rare malabsorption disorder primarily seen in tropical regions, often presenting with chronic diarrhea, weight loss, and nutrient deficiencies. Due to its overlapping symptoms with other gastrointestinal conditions, TS remains a diagnostic challenge, especially in nonendemic areas. We report a 14‐year‐old Ethiopian female with no history of travel who presented with a four‐month history of chronic diarrhea, abdominal pain, and severe acute malnutrition (SAM). Laboratory tests revealed macrocytic anemia (hemoglobin 7.4 g/dL, MCV 106 fL) with low folic acid, vitamin B12, and iron levels. A terminal ileum biopsy demonstrated villous atrophy, crypt hyperplasia, increased intraepithelial lymphocytes, and mild inflammation. Celiac disease was excluded via negative anti–tissue transglutaminase (tTG) serology and the successful reintroduction of gluten. She was treated with nutritional supplementation and a three‐month course of doxycycline, leading to full clinical recovery without recurrence. To our knowledge, this is the first documented case of TS in Ethiopia in a patient with no international travel history. This case underscores the importance of considering TS in patients with unexplained malabsorption, even in nonendemic regions. The favorable response to antibiotics further supports an infectious etiology. Increased awareness and timely diagnosis are essential for optimal management.

T‐cell/histiocyte‐rich large B‐cell lymphoma (THRLBCL) is a rare and aggressive subtype of diffuse large B‐cell lymphoma (DLBCL) that is uncommon in children. Here, we present the case of an 8‐year‐old male with a 3‐month history of low‐grade intermittent fever, significant weight loss, loss of appetite, and progressive abdominal swelling. Examination revealed splenomegaly and a palpable midabdominal mass, with laboratory findings showing bicytopenia. Imaging demonstrated hepatosplenomegaly, diffuse hypodense liver and spleen lesions, and mesenteric and retroperitoneal lymphadenopathy. A core‐needle biopsy of the mesenteric mass confirmed the diagnosis, with histopathology revealing scattered large mononuclear and binucleate cells in a background of small lymphocytes and histiocytes. Immunohistochemistry showed positivity for CD45, CD20, and EMA and negativity for CD30, CD15, and Bcl‐2, excluding alternative diagnoses such as nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) and classical Hodgkin lymphoma (cHL). The patient was initially stabilized with a prephase regimen of cyclophosphamide, vincristine, and prednisone (COP), followed by induction and consolidation with R‐COPADM (rituximab, cyclophosphamide, vincristine, prednisone, and methotrexate). Posttreatment imaging revealed significant resolution of lymphadenopathy and hepatosplenomegaly, with no residual or recurrent disease. At follow‐up, the patient remains in clinical remission with no signs of progression. This case highlights the importance of early recognition, detailed histopathological evaluation, and the role of immunohistochemistry in accurately diagnosing THRLBCL in children, ensuring timely initiation of effective therapy and improving outcomes in this rare pediatric malignancy.

Abstract A cecal volvulus in malrotation in a postpartum patient is an infrequent clinical entity. We present a case of a 24-year-old male patient with cecal volvulus in malrotation. The patient underwent counterclockwise detorsion, division of Ladd’s bands, right hemicolectomy with end ileostomy, transverse colopexy, and early ileostomy reversal. This case highlights the challenges in diagnosing and managing these rare conditions.

Volvulus is the rotation or twisting of the intestine around its vascular pedicle. The occurrence of descending volvulus after sigmoidectomy is extremely rare. We report a case of a 35-year-old male who presented with abdominal distention, cramping, and no passage of feces or gas for three days. He had a history of recurrent sigmoid volvulus, previously treated with sigmoidectomy. On this occasion, clinical examination and imaging revealed a distended bowel with air-fluid levels. During exploratory laparotomy, descending colon volvulus, a rare finding, was confirmed. The patient underwent a left hemicolectomy and transverse stoma and recovered well postoperatively. Descending colon volvulus is a rare but serious complication after sigmoidectomy, and early diagnosis is essential. In volvulus-endemic regions, awareness of this condition is critical to prevent delayed diagnosis and complications.

Abstract Small bowel obstruction (SBO) is a common surgical emergency, but appendico-ileal knotting is an exceptionally rare cause. This condition involves the appendix forming a constricting loop around the ileum, potentially leading to closed-loop obstruction and bowel ischemia. We report the case of a 57-year-old male from Ethiopia who presented with classical features of SBO, including abdominal pain, bilious vomiting, and failure to pass stool and flatus. Imaging was inconclusive, and an exploratory laparotomy revealed appendico-ileal knotting involving the terminal ileum. The bowel was viable, and a simple appendectomy was performed. The patient had an uneventful recovery and was discharged on postoperative Day 5. Histopathology confirmed acute appendicitis with mucocele. This case underscores the diagnostic challenge of this rare condition and emphasizes the need for early surgical intervention to avoid complications.