European Journal of Molecular & Clinical Medicine

Background: Immediate implants have provided the opportunity to achieve better and faster functional results. PRF (Platelet rich fibrin) and Sticky bone graft possess inherent property of accelerating soft and hard tissue healing and regeneration especially in indecisive implant cases. GTR (Guided tissue regeneration) along with PRF serves as a reliable treatment modality as it promotes sustained osteogenic effect. They prevent the collapse of the socket by reducing the crestal bone loss and enhance the soft tissue aesthetics
Case Description: In this case report, a 25-year-old female patient reported with non-vital 11 and external root resorption. The mobile tooth was atraumatically extracted Flap elevation exposed fenestration defect. Immediate implant was placed in relation to 11 followed by placement of Sticky bone graft, PRF and GTR membrane in the defect space.
Conclusion: Immediate implant showcases several advantages over conventional implants. The success depends on careful case selection, diagnosis, asepsis, atraumatic extraction and preservation of labial cortical plate and good oral hygiene maintenance during follow-up period.
Clinical Significance: Successful placement of immediate implant in an aesthetic zone presenting with a fenestration defect, using platelet rich fibrin and sticky bone graft is the uniqueness of this case report

Gallstone disease is extremely common in Western societies, with cholecystectomy being the standard treatment for patients with symptomatic gallstones. The incidence of common bile duct stones (CBD) with concomitant gallstones increases with age from 8 to 15% in patients younger than 60 years and up to 60% in the elderly. There are only a few reports of gallstones after cholecystectomy in the literature. Most of these reports describe the presence of stones in the gallbladder/cystic duct remnant or secondary to migration of the surgical clips. We report a single unique case of primary bile duct stones 7 years after open cholecystectomy.

Background:As an uncommon cause of portal hypertension, splenic arteriovenous fistula (SAVF) may show as stomach discomfort, diarrhea, ascites, and/or hematemesis. Formation of a fistula may be traumatic or spontaneous..^[1,2]
Case Presentation : A 7 years old Female with history of recurrent episodes of hematemesis, endoscopy in 2021 showed tortous esophageal varices with multiple site of bleeding, Thoraco-abdominal CTA in 2021 showed thrombus in portal vein and Splenomegaly. During operation there was incidental finding of SAVF, the fistula then ligated and followed by retrograde thrombectomy portal vein and distal splenorenal shunt. Post operative abdominal ultrasound showed portal vein diameter 6mm with velocity 15.7cm/s, there was no recurrent hematemesis and patient was discharge on 7^th day post operation.
Disscussion : Several misunderstandings regarding shunt surgery in the pediatric age range, such as increased failure rates in children less than 10 years, especially those with veins smaller than 10 mm in diameter. No long-term evidence exist to support these assumptions. Moreover, shunts are cost-effective, less distressing psychologically than recurrent endoscopic operations, and promote normal physical growth in youngsters. [4,5] Distal splenorenal shunt surgery provides a safe and reliable alternative to recurrent endoscopic operations for the avoidance of bleeding and improvement of hypersplenism in children with portal hypertension, according to a study published in the journal Pediatric Surgery.

Idiopathic orbital inflammation (IOI) is a benign, non-infective clinical syndrome
characterized by inflammation of the orbit without identifiable local or systemic disorders. Orbital
myositis is one classification of IOI and rare in adult male patients. In this article, we report a 41-yearsold
male who presented to the eye clinic with swollen, redness, pain, chemosis, and squints on his left
eye 2 weeks ago. He had a history of recurrent swollen on his left eyelid and self-treated with
methylprednisolone. Visual acuity on right and left eye were 20/25 and 20/30, respectively. The
intraocular pressure on the right and left eyes were 18 mmHg and 24 mmHg, respectively. No
abnormality in the fundus examination. There was a restriction on the left eye movement to all gaze,
and the eye was fixed to the superior temporal direction. Head MRI-scan showed hypertrophy of the
lateral and medial rectus muscles on the left eye without any other abnormality in the intracranial
cavity. The laboratory examination showed leukocytosis, neutrophilia, lymphopenia, normal thyroid
function, low C-Reactive Protein level, and a negative result for the antinuclear antibody test and antids-
DNA test. The patient was diagnosed with myositis of idiopathic orbital inflammation and was
treated with a high dose of methylprednisolone 1 mg/kg BW/day. Two weeks later, the patient had
improvement in his eye movement and the swollen was resolved. The treatment is still ongoing. Finally,
we can conclude that comprehensive evaluation and treatment with high-dose corticosteroid results in a
better outcome in an adult male patient with myositis IOI.

Spontaneous esophageal rupture is a rare clinical condition, occurs most often in the lateral,
lower 1/3 of the esophagus and is associated with a mortality rate of 20–75%. As a result of
these nonspecific findings, Spontaneous esophageal perforation is often misdiagnosed as an
aortic emergency, pericarditis, myocardial infarction, pulmonary embolus, spontaneous
pneumothorax, perforated peptic ulcer, or pancreatitis .We outline 6 cases of spontaneous
esophageal perforation came to our institution and will discuss about their diagnosis ,required
interventions ,complications and 2-year follow up.

Sebaceous glands are exocrine glands that constitute an integral part of the skin. Ectopic sebaceous glands commonly seen in the buccal mucosa and the lateral part of the vermillion border of the lips in the oral cavity are called fordyce granules and are observed in 80% of the population. Sebaceous elements in odontogenic cysts are relatively rare. Pluripotency of odontogenic epithelium explains the concurrent occurrence of sebaceous glands with odontogenic cystic lesions. A case report of orthokeratinized odontogenic cyst with sebaceous differentiation in a 24-year-old male patient is discussed in this article with emphasis on histogenesis, literature review and differential diagnosis.

Acquired angioedema is a rare complication of systemic lupus erythematosus (SLE). It is generally secondary to C1 inhibitor deficiency due to antibody formation directed against the C1 inhibitor molecule. Face, mouth, tongue, lips, extremities and genitalia are generally involved but also respiratory and gastrointestinal mucosa may be affected. We report a case of a young woman with SLE who presented a severe airway obstruction caused by angioedema. We discuss her diagnostic and therapeutic management including a review of the literature.