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Yellow nail syndrome (YNS) is a rare disorder characterized by a triad of yellow discoloration and destructive changes of nails, lymph edema and a variety of pathologies in the respiratory system. This disorder can be associated with and herald the presence of internal diseases. An increased awareness of these conditions may help with the early diagnosis and therapy of the associated disorders. We report a 24 years old whom with yellow nail syndrome whom was admitted at hospital. She also had fever, lymph edema and pulmonary manifestations.

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Children are the victims of a spectrum of pathological lesions which usually lead to varying degrees of jaw swelling. Dentigerous cyst is the most prevalent type of odontogenic cyst and is associated with crown of an unerupted or developing tooth. Radicular cyst is one of cysts in association with non vital teeth. Radicular cysts arising from deciduous teeth are rare. This report presents a case of radicular cyst associated with a primary molar following pulp therapy and a case of dentigerous cyst in right maxillary region in a 10-year-old child. Diagnosis and early treatment of these lesions in children is of great importance, especially in cases where the lesions enclose permanent teeth. The purpose of this case report was to describe the management of two odontogenic cysts in children

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Gabapentin was first approved for treatment of epilepsy by FDA, but later it received more attention due to its effects on pain relief, especially neuropathic pain and post-herpetic neuralgia, and in treatment of anxiety and insomnia. The most common side effects of gabapentin include somnolence, ataxia, and fatigue. However, no studies have reported gabapentin induced psychotic disorder. Here, we report a patient on gabapentin with symptoms of delusional disorder.
A 42-year-old married housewife without any history of psychiatric disorder, received gabapentin (100 mg once a day) for treatment of first time insomnia. Psychotic symptoms including persecutory delusion occurred and about 12 hours after the onset of symptoms the patient discontinued gabapentin for 24 hours. Consequently, all symptoms were quickly subsided. The patient's assessment was performed using the Naranjo scale. The patient’s score was 9, thus other possible causes of psychosis were ruled out. According to this report, gabapentin could induce psychotic symptoms in patients who have not even had a history of drug use or specific illnesses.
 
 

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 Identifying and determining the origin of the first human case of COVID-19, which has caused pandemic will be of great benefit in preventing and controlling next epidemics and pandemics. The first confirmed case of COVID-19 was reported in December 2019 in China. This article reports three cases of pneumonia compliant with COVID-19 admitted to Qaemshahr Razi Hospital in Mazandaran province, Iran before the first official report of confirmed case of the disease (November-December 2019). The pattern of radiological involvement was completely consistent with COVID-19 in all three patients. Two patients died of acute progressive respiratory failure despite supportive respiratory therapy and systemic corticosteroids, and the other patient recovered. Study of these cases highlights the fact that emerging and re-emerging diseases should be considered in management of patients with infection and unusual symptoms.

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Single superficial femoral artery (SFA) aneurysm is rare and occurs in approximately 5 per 100,000 patients. Rupture is a rare complication in this aneurysm. In this case report, we present the diagnostic and therapeutic work up of a ruptured SFA aneurysm of the right lower limb in a 75-year-old diabetic man with ischemic heart disease. Pre-surgical diagnosis was through physical examination findings and color Doppler flow imaging. The defective part of the artery was resected and then reconstructed through autologous saphenous vein grafting harvested from the opposite limb. No early post-surgical complication was observed. If a pulsatile mass is found in the thigh, the SFA aneurysm should be considered as a differential diagnosis to prevent premature death and lower limb amputation by timely surgery.

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 Desmoid tumors (DTs) are slow-growing tumors with no malignant or metastatic features but are locally invasive. These tumors have an unpredictable but varied clinical course. Intra-abdominal sporadic DTs are very rare and have a worse prognosis due to the mass effect on abdominal organs. This paper reports the diagnostic and surgical treatment of a 34-year-old man with DT of the small intestine without any genetic predisposing factor or history of trauma and abdominal surgery. The patient initially had mild pain in the periumbilical area and then presented with exacerbation of abdominal pain, acute abdominal symptoms, and peritonitis during elective diagnostic procedures. Abdominal CT scan with contrast injection showed a hypodense area with irregular borders and open-air foci of 171*160*85 mm in the middle of the abdomen and displacement of intestinal loops. Diagnostic and therapeutic laparotomy revealed a very large mass (18 cm in diameter) in the mesentery of a large part of the small intestine, a purulent abscess adjacent to the mass, and perforation of the D4 part of the duodenum. Debulking resection of the tumor was performed due to the involvement of the upper mesenteric artery. Preoperative elective core needle biopsy, surgical biopsy, and immunohistochemistry reports revealed desmoid tumor. Desmoid tumor as a benign tumor can have aggressive manifestations similar to intra-abdominal malignancies.

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Animal bites are a frequent reason for primary care and emergency department visits by children. Rabies is endemic in Iran, with 5 to 11 deaths reported annually. Over 90% of rabies cases in the country are caused by dog bites, and more than 50% of the victims are children under 15 years old. The mortality rate of rabies is 100%.
A 4-year-old girl, who had been bitten by a dog and sustained facial lacerations 16 days prior to admission, presented with fever and loss of consciousness. Despite wound washing, receiving four doses of the rabies vaccine and immunoglobulin, and taking cephalexin on the fifth day after the bite, she developed rabies encephalitis. Rabies was confirmed through a skin biopsy and saliva PCR. Treatment included vancomycin, meropenem, and acyclovir in addition to favipiravir. The patient was intubated due to impaired consciousness and respiratory issues, and her hypertension was managed with medication. A brain CT scan showed normal findings. Cerebrospinal fluid analysis revealed protein at 52, glucose at 63, and no cellular presence. Vancomycin and acyclovir were discontinued when blood culture, wound culture, cerebrospinal fluid, and PCR results returned negative. Echocardiography results were acceptable, and the patient’s lab tests showed no other abnormalities except for leukocytosis at admission, an ESR of 60, and a CRP of 40.
The patient remained intubated for two weeks and continued to receive supportive measures, ongoing drug therapy, ventilator adjustments, and water and electrolyte balance management. During hospitalization, she showed no response to the apnea test, oculovestibular reflex, or doll's eye maneuver. Two weeks later, she developed bradycardia and subsequently died, with a final diagnosis of furious rabies.
Despite receiving the rabies vaccine and immunoglobulin, the patient died within a month of the bite, which may be attributed to the location of the bite on her face, the timing of her treatment, or the quality of the vaccine.