Malignancy of nasal cavity and paranasal sinuses are considered to be rare accounting for less than 1% of all malignancies and 3% of head and neck cancers. Primary squamous cell carcinoma of nasal septum is deemed to be extremely rare. The published series and case report have been too few to allow existence of its own staging system. Further, because of its rarity, the disease is often misdiagnosed as its symptoms are similar to everyday nasal symptoms. We report a case of a 40-year-old woman who was complaining of blocked nasal passage and epistaxis for 5 years and squamous cell carcinoma was found on biopsy.

Dendritic fibromyxolipoma (DFML) is an uncommon, benign soft tissue tumor. It is seldom reported in the hypopharynx. However, its endoscopic appearance may mimic an aggressive soft tissue neoplasm hence the importance of its recognition. We discuss a rare case of DFML of the pyriform fossa in a 66-year-old male who presented with progressive hoarseness. The histopathological diagnosis was made following conservative excision of the mass using carbon dioxide laser, preserving swallowing and voice. 

Paracoccidioidomycosis (PCM) is considered endemic in various Latin American countries, with the highest incidence reported in humid tropical and subtropical regions. A few cases of PCM are reported in the non-endemic region. The authors report two cases of PCM prostatitis, which is considered a rare form of this entity presentation, with only a few cases reported globally. In the first case, a 57-year-old patient was incidentally diagnosed with PCM prostatitis by post-radical-prostatectomy examination of a piece of a surgically removed tissue. In another case, a 52-year-old patient was diagnosed with PCM prostatitis, who was initially thought to have benign prostatic hyperplasia. A review of the medical literature indicates that a histopathological examination can confirm the diagnosis of PCM prostatitis and may be employed in symptomatic cases to avoid surgical intervention and associated adverse effects.

Background: Colorectal cancer (CRC) is the third most prevalent cancer in the world. Preparation for a colonoscopy, the gold standard in screening for CRC, has been done with different methods. The use of opioids may cause inadequate colonic preparation. This study’s aim was to compare the quality of bowel preparation using split doses versus the same-day dose of polyethylene glycol (PEG) in opiate-dependent non-addicted patients in a tertiary care center, Northeast of Iran. Methods: The present study is a randomized double-blind controlled trial study (IRCT20180103038196N6). Two groups of 100 opiate-dependent patients each referred for screening colonoscopy were enrolled in the study during 2017. Subjects were randomized to receive split-dose or the same-day dose of PEG. The quality of bowel preparation was assessed using the Ottawa Bowel Preparation Scale. Results: In this clinical trial, opiate-dependent patients that were candidates for colonoscopy were enrolled with mean age of 56.21 (12.34) years in split-dose group and 53.85 (13.45) years in same-day dose group. Results showed that the Ottawa score was significantly lower (better results) in the split-dose group than the same-day dose group and the preparedness was better in right and mid-colon areas (3.05 vs. 3.83, P = 0.022, 0.72 vs. 1.12, P=0.003, 0.52 vs. 0.79, P=0.035 respectively). But in the rectosigmoid colon, the Ottawa score was lower (better results) in the same-day dose group than in the split-dose group (P = 0.020). The total Ottawa score was also lower in the split-dose (P = 0.022), which means better preparation in the split-dose group Conclusion: The split-dose preparation is better than the conventional previous evening preparation in terms of bowel preparation quality and patient compliance.

Klippel-Trenaunay-syndrome (KTS) is a rare vascular disorder consisting of a triad of features including capillary malformations, varicose veins and soft tissue abnormalities. It overlaps with few other rare vascular disorders such as ‘Sturge Weber syndrome’ and ‘Parks Weber syndrome’ with few notable distinguishing features. The diagnosis is clinical, however, imaging is necessary for confirmation. The treatment is conservative and individualized. In this case report, we present a variant of KTS which demonstrates only two of the three features.

Background: To determine disease severity in the COVID-19 pandemic, it is necessary to monitor several clinical and laboratory parameters. Non-invasive and objective inflammatory markers can be a practical and objective route in the determination of disease activity. The C-reactive protein/albumin ratio (CAR) is an inflammatory marker thought to have prognostic value for most diseases, primarily sepsis. The aim of this study was to evaluate the diagnostic performance of CAR in determining the clinical severity of COVID-19 disease. Methods: We conducted a retrospective examination of health records of patients diagnosed with COVID-19 between 15 March and 26 May 2020. Patients with pulmonary computed tomography findings consistent with COVID-19 and confirmed by a positive result in the real-time reverse transcriptase-polymerase chain reaction test were included. The cases were separated into two groups of mild and severe according to symptom severity. Results: Of the 105 patients, 39 (37.1%) were males with a mean age of 63.2±14.5 years. In the regression analysis, the severity of COVID-19 was associated with age (OR = 1.04; 95% CI: 1.001, 1.074; p = 0.04), heart disease (OR = 4.37; 95% CI: 1.02, 18.8; p= 0.03), CAR (OR = 1.77; 95% CI: 1.05, 2.98; p = 0.03), lymphocyte count (OR = 0.54; 95% CI: 0.32, 0.96; p = 0.02). For the diagnosis of severe disease, the highest sensitivity of CAR was 76.5%, specificity 76.1% and the greatest area under the curve (AUC) was 0.70. Conclusion: We found a significant relationship between disease severity and CAR in COVID-19 patients. CAR is an inexpensive and practical marker for the diagnosis of severe COVID-19.