Backgorund: Sinonasal inverted papilloma (SIP) is a benign tumor of the nasal cavity and sinus. It is characterized by aggressive malignant transformation and a high rate of recurrence. Inadequate removal of the tumor during surgery is one of the most significant contributors to recurrence. SIP has been reported to rarely occur in conjunction with Squamous Cell Carcinoma (SCC) invading the lacrimal drainage system and the orbit. The mechanism of this secondary SCC transformation has yet to be explained. Case presentation: Herein, the authors present the case of a 66-year-old woman with a rapidly enlarging sinonasal inverted papilloma with secondary squamous cell carcinoma of the right nasal cavity presenting with epiphora. Conclusions: Nasolacrimal duct obstructions require a thorough examination as it may hide a malignant pathology.

Objective: Investigating high iodine containing low osmolar contrast agent (visipaque) effects on thyroid function tests and thyroid sonography characteristics. Methods: 65 euthyroid cases and 92 controls composed the samples in baseline. Thyroid function tests, Urine Iodine Concentration (UIC) and thyroid sonography were conducted for both groups before and 1 and 3 months after angiography. Serum levels of T4, T3, T3RU, TSH, TPO-Ab and UIC were measured, and hypo/heyperthyroidism prevalence was compared between groups. Results: Mean T3,T4 and TSH changes 1 month after angiography were insignificant in both groups (P:0.61,P:0.4 and P:0.14, P:0.23 in cases and controls for T3 and T4). Medians among cases and controls were 12.8 and 16.75 µg/dl, respectively, at baseline. These values varied to 28.45 and 15.2µg/dl, and 12.95 and 14.2µg/dl 1 month and 3 months after angiography in case and control groups, respectively. UIC increase one month after angiography was significant among cases (P=0.002). TPO-Ab+ were same 3 months after angiography. Thyroid volume changes were significant among cases (P<0.001) and insignificant among controls (P=0.680). No significant difference was seen between cases and controls in overt hypothyroidism, however, a considerable change was seen in thyroid volume and UIC one month after angiography among cases. The hypothyroidism rate among cases was insignificant which may be either related to few cases or short half-life of visipaque (2.1 hour) so that 97% of injected dose was excreted in urine within 24 hours. Conclusion: Thyroid function test is not recommended before angiography in patients without previous thyroid records.

Left ventricular aneurysms, both true and pseudo aneurysm, are a consequence of coronary heart disease. Trans thoracic echography is the gold standard in the assessment of the left ventricular aneurysm; the most frequent complication is the development of blood stasis and left ventricular thrombi with the risk of systemic embolization, the use of long-term oral anticoagulant therapy is controversal , Left ventricular aneurysm surgery , often with myocardial revascularization, is indicated in well-defined cases, with several surgical technique, depending on the type of aneurysm, the anatomical caractehristics and the team skill’s, we report in this article tow cases of the left ventricular aneurysm.

Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), affecting people. Turkey was reported to the public by COVID-19 first cases of the Ministry of Health on March 10, 2020; and 520,167 cases and 14316 deaths were reported on December 03, 2020, respectively. The survival of these patients is usually determined over a 7-day intensive care follow-up. The survivors begin to recover clinically after the 15th day. So the riskiest period in terms of mortality is between 7-14 days. The antiviral called Favipiravir was administered only to intensive care patients in the first period and then allowed to patients in the clinic with oxygen saturation below 90% to achieve an improvement in the early period of patients with impaired oxygen saturation. But, it did not benefit patients with support with mechanical ventilation in ICU and their mortality rates. The cause of death is generally a respiratory failure due to the functional loss of lungs. Antiviral treatment is certainly needed to administer in the early period of disease to prevent a severe inflammatory response.

While hepatitis is the most common infectious cause of acute liver injury, although rare, acute human immunodeficiency virus (HIV) infection should be considered in the workup for infectious causes of acute liver injury. We present a case of a 36 year old woman with no past medical history who presented to the hospital for 8 days of abdominal pain and nausea worsened with food. Labs were significant for lymphocytopenia, transaminitis, elevated alkaline phosphatase, and direct bilirubinemia. Viral hepatitis serologies were negative and imaging showed nonspecific gallbladder wall thickening, no gallbladder stones, no intra or extra-hepatic biliary ductal dilatation. No evidence of congestive heart failure. Serologies for cytomegalovirus (CMV), Epstein Barr virus (EBV), rickettsia, enterovirus, adenovirus, and parvovirus were negative. Workup for autoimmune liver disease was also negative. Liver biopsy was notable for a focus of granulomatous necrosis, suggestive of infectious or drug induced etiology. During this admission, patient was also found to have a new diagnosis of HIV with CD4 count of 235. Patient was started on bictegravir, emtricitabine, and tenofovir alafenamide with progressive improvement and eventual resolution of AST, ALT, alkaline phosphatase, and bilirubin elevation since starting anti-retroviral therapy.