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Febrile Lumbar Pain Revealing a Massive Collection: Complicated Psoas Abscess Managed Surgically

Published on: 5th March, 2026

Psoas abscess is a rare but potentially life-threatening condition with non-specific clinical manifestations. The condition may be primary or secondary, depending on whether it has an underlying cause. The condition may be diagnosed with the help of imaging studies, especially contrast-enhanced computed tomography (CT).A 55-year-old female patient with a history of treated hypertension presented with a 15-day history of fever and left-sided low back pain. Her laboratory parameters showed a high leukocyte count of 22,000 cells/mm³ and elevated levels of C-reactive protein (367 mg/L). Her renal functions were within normal limits, and the urine culture was negative. Contrast-enhanced CT revealed a large left-sided intra-abdominal fluid collection extending from the diaphragm to the left iliac fossa, measuring 66 x 305 mm with air bubbles. The collection also showed a left-sided intramuscular psoas collection of 66 x 50 x 131 mm. The patient received intravenous broad-spectrum antibiotics (third-generation cephalosporin, aminoglycoside, and metronidazole). The patient underwent mini-lumbotomy, and nearly 1 liter of pus was drained. The patient’s postoperative course was satisfactory with complete resolution of symptoms. The histopathological examination showed non-specific changes.Psoas abscess should be suspected in patients with febrile low back pain and inflammatory syndrome. Contrast-enhanced CT scans are essential for diagnosis and assessment of the extent of disease. In complicated cases with large abscess formation, early surgical drainage along with appropriate antibiotics will provide the best outcome.This case highlights the importance of early diagnosis and adapted management for successfully navigating the complexities associated with this condition.
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Not Every Bladder Mass Is Malignant: A Case of Inverted Urothelial Papilloma in a Young Adult

Published on: 30th March, 2026

Inverted Urothelial Papilloma (IUP) is an unusual variety of urothelial tumors that typically occurs in adults, with a predominance in males. The definitive diagnosis of IUP relies on histopathological examination, as the clinical presentation and endoscopic appearance are non-specific. The recommended treatment for IUP includes the complete transurethral resection, with some controversy regarding the need for cystoscopic follow-up. In this case, we present an atypical instance of IUP in a 21-year-old male patient, diagnosed with gross hematuria and irritative lower urinary tract symptoms. A clinical assessment revealed a 3.0 × 2.6 cm intravesical mass. The definitive diagnosis was confirmed histopathologically and further substantiated by immunohistochemistry, which demonstrated low expression of p53 and Ki-67, effectively ruling out malignancy. This case underscores the diagnostic challenges posed by bladder masses in young adults, emphasizing the necessity of integrating morphological and immunohistochemical findings to prevent overdiagnosis of urothelial carcinoma. The paper focuses on the diagnostic approach and management of this rare condition in the young male population.
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Urinary Biomarkers: Is the Era of Exclusive Follow-Up Cystoscopy Coming to an End? A Mini-Review of Emerging Molecular Diagnostics and Risk-Stratified Surveillance

Published on: 8th April, 2026

Bladder cancer is among the most costly malignancies to treat, primarily due to the high rate of recurrence for Non-Muscle-Invasive Bladder Cancer (NMIBC) and the subsequent necessity for lifelong cystoscopic surveillance. Although cystoscopy is widely regarded as the gold standard, it is an invasive procedure that can be costly and is associated with patient discomfort and anxiety. In recent years, a novel generation of urinary biomarkers (comprising genomic, epigenomic, and proteomic assays) has emerged, exhibiting diagnostic capabilities that increasingly challenge the prevailing role of cystoscopy in surveillance protocols. This mini-review examines the landscape of FDA-approved and emerging urinary biomarkers, compares their diagnostic accuracy, evaluates the first randomized controlled trials supporting biomarker-guided surveillance, and proposes a risk-stratified algorithm for the future integration of urinary biomarkers into clinical practice.
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Renal Malakoplakia: A Diagnostic Challenge Presenting as a Subcapsular Collection despite Clinical Recovery

Published on: 9th April, 2026

Background: Renal malakoplakia is a rare chronic granulomatous inflammatory disorder characterized by defective macrophage function. It typically occurs in immunocompromised patients with recurrent urinary tract infections. We present a case of renal malakoplakia in a diabetic patient who progressed to nephrectomy despite initial conservative management.Case presentation: A 57-year-old female patient with a medical history of insulin-dependent type 2 diabetes mellitus was admitted to the hospital with symptoms including fever, left flank pain, and dysuria. A physical examination revealed a tender left lumbar mass. Laboratory investigations revealed a leukocytosis (16,500/mm³), elevated C-reactive protein (142 mg/L), and preserved renal function. A urine culture revealed the presence of multidrug-resistant Escherichia coli (>106CFU/mL). A subsequent Computed Tomography (CT) scan revealed an enlarged left kidney with a 9 × 6 cm multiloculated subcapsular collection, causing significant parenchymal compression, along with two non-obstructive inferior pole calculi. The initial management strategy encompassed ultrasound-guided percutaneous drainage and targeted antibiotic therapy, with the latter being contingent upon bacterial sensitivities. Notwithstanding the patient’s positive clinical recovery, Technetium-99m Dimercaptosuccinic Acid ((99m)Tc-DMSA) renal scintigraphy performed four weeks after the episode revealed a non-functional left kidney, exhibiting a 15% differential function. Following a multidisciplinary discussion, a total left nephrectomy was performed. A histopathological examination revealed extensive replacement of renal parenchyma by polymorphous inflammatory infiltrate with pathognomonic Michaelis-Gutmann bodies. These bodies are spherical, basophilic, perinuclear inclusions that demonstrate strong positivity for Periodic Acid-Schiff and Perls stains. The postoperative course was complicated by self-limited lymphorrhage. At the 3-month follow-up, the patient reported complete resolution of symptoms and remains under nephrological surveillance.Conclusion: This case underscores the diagnostic challenges posed by renal malakoplakia, a condition that can present with a wide spectrum of mimics, including infectious and neoplastic processes. Early diagnosis and prolonged antibiotic therapy with agents capable of intracellular penetration may preserve renal function; however, nephrectomy remains necessary when irreversible parenchymal damage has occurred. Diabetes mellitus has been identified as a significant risk factor for malakoplakia development through impaired leukocyte function. 
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Potential of Quantum Computing to Advance Psychiatry through Genetic Medicine, Gene Therapy, and Human-Centered Artificial Intelligence

Published on: 1st July, 2026

Psychiatric disorders represent some of the most biologically complex challenges in medicine, arising from intricate interactions among genetic, epigenetic, environmental, developmental, and social factors. Advances in artificial intelligence (AI) have improved our ability to analyze large-scale biological datasets, identify biomarkers, and support precision medicine initiatives. However, the growing volume and complexity of genomic and multi-omic information increasingly challenge the capabilities of even the most advanced conventional supercomputers. Quantum computing offers a potential next step in biomedical discovery by enabling rapid analysis of multidimensional datasets, molecular simulations, and optimization problems relevant to genetic medicine and gene therapy. Extending these findings conceptually, we propose the forward-looking hypothesis that continued advances in quantum computing may eventually complement artificial intelligence and human expertise to facilitate increasingly sophisticated analyses relevant to psychiatric genetics and precision medicine. At present, no direct evidence of which we are aware demonstrates clinical implementation of quantum computing in psychiatric genomics. Accordingly, the concepts discussed in this Opinion should be viewed as a forward-looking scientific perspective that builds upon current advances in computational science and biomedicine while awaiting future experimental and clinical validation. Importantly, these advances should complement rather than replace human expertise. Human-in-the-loop systems remain essential for ensuring scientific rigor, ethical oversight, clinical judgment, and patient-centered care. The convergence of quantum computing, AI, genetic medicine, and human expertise may ultimately establish a transformative framework for future precision psychiatry and mental health therapeutics.
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Adult Bladder Exstrophy with Premalignant Changes Following Failed Reconstruction: A Case Report

Published on: 1st April, 2026

Background: Bladder exstrophy is a rare congenital abnormality that is usually managed with multiple surgical interventions. Long-term consequences include recurrent urinary tract infections, bladder stones, fistulae, and metaplastic changes with malignant potential.Case Presentation: We present a case of a 21-year-old male with a history of failed childhood surgeries for bladder exstrophy who presented with a vesicocutaneous fistula and a 7 cm bladder stone. He underwent an open cystolithotomy with bladder augmentation and creation of a Benchekroun continent valve. However, the patient developed recurrent fistulae due to poor tissue quality. Histopathological examination confirmed early squamous metaplasia in the bladder mucosa. After discussion in a multidisciplinary meeting, the patient underwent a radical cystectomy with ileal conduit urinary diversion using the Bricker technique. He is doing well at 3 months with no evidence of any complication.Conclusion: This case illustrates the difficulties encountered in managing adult patients with bladder exstrophy and failed reconstructions. The presence of squamous metaplasia, poor bladder tissue, and recurrent complications all contributed to the decision for radical cystectomy. It is important to recognize these changes and address them appropriately in a timely manner to prevent further complications and possible malignant changes.
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Assessment of the Quality of Life in Patients Undergoing Radical Cystectomy with Urinary Diversion

Published on: 24th June, 2026

Radical cystectomy with urinary diversion is the standard treatment for muscle-invasive bladder cancer. The impact of the type of urinary diversion on quality of life (QoL) remains debated. This cross-sectional study assessed QoL in 57 patients who underwent radical cystectomy between 2014 and 2022 at two urology departments in Rabat, Morocco, using the Bladder Cancer Index (BCI), the SF-36, and the Body Image Scale (BIS). Multiple linear regression identified socioeconomic status, body image perception, urinary discomfort, and comorbidities as the main determinants of QoL, with the type of urinary diversion playing an indirect role mediated through these factors. These findings underscore the need for a multidimensional approach when evaluating and optimizing QoL outcomes after radical cystectomy.
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Cholera: Knowledge, Attitudes and Practices from Indigenous Peoples of Mombénzélé in Likouala to the Republic of Congo

Published on: 21st July, 2026

Introduction: In the Republic of Congo, Mombénzélé village’s an area endemic for cholera where environmental and socio-economic factors favor the persistence of the epidemic. This study assessed the knowledge, attitudes, and practices (KAP) of the indigenous peoples of Mombénzélé regarding cholera to design culturally appropriate and sustainable prevention strategies.Materials and methods: This was a preliminary cross-sectional pilot study, descriptive and analytical in nature, conducted from April 21 to 31, 2026, in the indigenous community of Mombénzélé (Impfondo district, Republic of Congo). The study assessed adults. Convenience sampling was used. Data were collected via a questionnaire in Lingala and face-to-face interviews, with secure data entry on tablets. Analysis using SPSS, including socio-demographic profiles, KAP variables, and chi-square tests (p < 0.05), was conducted in strict compliance with ethical principles and anonymization guidelines. Results: The population studied is predominantly male (60%) and without formal education (92%). Cholera is largely unknown to 92% of individuals, who believe exclusively in mystical causes. Hygiene practices are dangerous, with a complete lack of water treatment (100%) and systematic recourse to traditional healers (60%). Vulnerability is exacerbated by open defecation (56% in the river) and a refusal to use chlorinated water (88%). Sociodemographic factors significantly influence behaviors, notably age, which impacts funeral practices (p = 0.033), and educational level, which determines access to the river (p = 0.0033). The main activity influences the consumption of treated water (p = 0.0218) and determines (p = 0.000026) funeral practices. Household size impacts the perception of cholera lethality (p = 0.009) and guides the choice of funeral practices (p = 0.045).Discussion: A cholera epidemic has struck the Mombénzélé village, affecting 96% of adults and exacerbated by a complete lack of awareness of the symptoms and a rejection of chlorinated water. The health crisis has driven 76% of the population to traditional medicine. Conclusion: To contain the health crisis in Mombénzélé, it’s essential to deploy a strategy combining the training of bilingual mediators and the improvement of water infrastructure, in order to overcome the lack of information on the transmission of cholera and to adapt prevention to the realities and cultural barriers of the indigenous community.
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Bilateral Severe Encrustation of Long-Term Indwelling Double-J Stents in a Young Non-Lithiasic Patient

Published on: 16th March, 2026

Ureteral double-J stents are a commonly used device in urological practice to allow urinary drainage, avoid ureteral obstruction processes, and protect the upper urinary tract after surgical procedures. However, long indwelling time may give rise to numerous complications, such as infection, migration, and fragmentation of the stent, especially encrustation. Encrustation of stents is a well-known complication that has been closely related to the time active of the stent and can cause significant morbidity if not timely addressed. In severe cases, abundant mineral deposition can result in the development of large calculi encasing the stent and rarely progress to staghorn stones. These cases may pose challenges in terms of the extraction of the stent and may result in complex endourological intervention. The encrustation likelihood is substantially higher if stents are left forgotten or remain in place longer than the advised period. Most patients with heavily encrusted stents have symptoms including flank pain, urinary tract infection, hematuria, or obstructive uropathy, but can present without any symptoms, and this can delay the diagnosis.
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Occurrence, Risk Factors, and Clinical Implications of Malaria–typhoid Co-infection among Febrile Patients Attending Camrail Medical Center, Douala, Cameroon

Published on: 4th June, 2026

Background: Malaria and typhoid fever remain major public health problems and important causes of febrile illness in sub-Saharan Africa, particularly in urban settings characterized by poor sanitation, unsafe water supply, overcrowding, and persistent malaria transmission. The clinical manifestations of both diseases frequently overlap, making accurate diagnosis difficult and often leading to empirical treatment, inappropriate antimicrobial use, and delayed patient management. This study assessed the occurrence, associated risk factors, and clinical implications of malaria–typhoid co-infection among febrile patients attending the Camrail Medical Center in Douala, Cameroon. Methods: A hospital-based analytical cross-sectional study was conducted among 220 febrile patients recruited systematically at the outpatient department. Data were collected using structured questionnaires, clinical assessment forms, and laboratory investigations. Malaria infection was diagnosed using standard parasitological methods, while typhoid fever was assessed using routine laboratory procedures. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression in SPSS version 25. Results: Malaria mono-infection accounted for 31.8% of cases, typhoid mono-infection for 10.9%, and malaria–typhoid co-infection for 15.5%, whereas 41.8% of participants had neither infection. Significant predictors of co-infection included unsafe water sources (AOR = 3.12; p = 0.001), poor food hygiene (AOR = 3.85; p < 0.001), non-use of bed nets (AOR = 2.21; p = 0.021), and exposure to stagnant water (AOR = 2.76; p = 0.004). Co-infected patients experienced significantly more severe clinical manifestations, including high fever, vomiting, diarrhea, abdominal pain, and headache. Age-stratified analysis showed a higher proportion of co-infection among participants aged ≤25 years (18.8%) compared with those aged ≥26 years (12.9%), although the difference was not statistically significant (p = 0.194). Gender-based analysis demonstrated no significant association between sex and infection category (p = 0.606).Conclusion and recommendations: Malaria–typhoid co-infection remains a significant public health concern in Douala. Integrated diagnostic approaches, improved environmental sanitation, safe water access, food hygiene promotion, and strengthened malaria prevention measures are essential to reducing the burden of co-infection and limiting inappropriate antimicrobial use.
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