Most Viewed Articles

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.

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.

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. 

Poxviruses are big, double-stranded DNA viruses that can infect a variety of animal hosts, including humans. Other clinically significant poxvirus infections, such as monkeypox (mpox), cowpox, and molluscum contagiosum, continue to present new and re-emerging public health issues even after smallpox was eradicated. The epidemiology, transmission dynamics, clinical manifestations, diagnostic methods, and treatment approaches of the four main human poxvirus infections are all covered in this study’s methodical narrative synthesis.Relevant studies published between 2000 and 2025 were found by a systematic search of PubMed, Scopus, and Google Scholar; 34 of them were included in the final analysis. Results show that poxviruses differ significantly in host range, transmission patterns, and disease severity, despite sharing common biological traits including cytoplasmic replication and distinctive cutaneous lesion progression. While mpox has resurfaced worldwide, exhibiting persistent human-to-human transmission during the 2022–2023 outbreak, smallpox is still historically relevant because of its high fatality and successful eradication. Cowpox is still an uncommon zoonotic disease associated with animal reservoirs, while Molluscum contagiosum is still very common, especially in children and immunocompromised people. Antiviral medications like tecovirimat offer treatment options for severe cases, and advances in molecular diagnostics, especially polymerase chain reaction, have improved detection.The impact of dwindling population immunity and growing human-animal interaction is demonstrated by the resurgence and persistence of poxvirus diseases. To reduce future epidemics, more surveillance, better diagnostic capabilities, and integrated One Health policies are crucial.

Monoclonal gammopathy of undetermined significance (MGUS) may be associated with peripheral neuropathy; however, IgG MGUS–associated chronic inflammatory demyelinating polyneuropathy (CIDP) is uncommon and generally follows a slowly progressive or relapsing course. We report a man in his early 40s who developed rapidly progressive sensorimotor weakness resulting in quadriparesis and inability to ambulate within eight weeks. Examination demonstrated severe proximal and distal weakness, glove-and-stocking sensory loss, and absent reflexes. Cerebrospinal fluid protein was markedly elevated, and nerve conduction studies/electromyography demonstrated acquired demyelination with secondary axonal loss. Evaluation identified IgG MGUS, supporting the diagnosis of MGUS-associated CIDP after alternative etiologies were excluded. Intravenous immunoglobulin was discontinued on day 3 following the development of a pulmonary embolism. The patient subsequently completed eight plasma-exchange sessions, with improvement in lower-extremity strength to 3/5, upper-extremity strength to 4/5, and sensory symptoms. He was discharged to rehabilitation with planned monthly plasma exchange.recognised clinical spectrum of IgG MGUS–associated CIDP and demonstrates that meaningful neurological improvement may occur with plasma exchange despite rapid progression and severe initial disability.

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.

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.

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.

Background: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are two common conditions in aging men. Their association exceeds mere age-related coincidence and involves shared vascular, neurological, endocrine-metabolic and psychosexual mechanisms. Objective: To evaluate the prevalence of ED in patients followed for symptomatic BPH, to identify factors associated with its severity, and to analyze the evolution of erectile function after medical treatment. Methods: A prospective cross-sectional study conducted at the Urology Department A of Ibn Sina Hospital, Rabat, from August 1 to November 30, 2021. After excluding 37 records, 100 male patients aged 50 to 80 years followed for BPH were included. LUTS were assessed using the IPSS score and erectile function using the IIEF-5 score. Sociodemographic, clinical, biological, ultrasonographic, cardiovascular and therapeutic data were analyzed. The significance threshold was set at p < 0.05. Results: Mean age was 66 ± 15 years. The overall prevalence of ED was 72%, with 30% mild, 33% moderate, and 27% severe forms among interpretable cases. Only 25% of patients had spontaneously reported their sexual dysfunction. Factors significantly associated with ED were age (p < 0.001), LUTS severity by IPSS (p < 0.001), obesity (p < 0.001), and history of prostatic surgery (p < 0.01), arterial hypertension (p < 0.02) and nocturia (p < 0.05). Alpha-blocker–tadalafil combination therapy improved the IIEF-5 score by +4.3 to +5.2 points. Alpha-blockers alone did not significantly improve erectile function. Conclusion: ED is common and largely under-reported in patients with BPH. LUTS severity, particularly nocturia, is closely linked to erectile impairment. Systematic sexual assessment should be an integral part of BPH management, and the alpha-blocker–PDE5i combination represents a relevant therapeutic strategy in patients with associated ED.

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.