Stafne bone defect (SBD) is a rare developmental bone defect characterized by an asymptomatic focal concavity of the cortical bone, typically on the lingual aspect of the mandibular body, which generally contains salivary gland tissue. It can be detected during routine dental examinations and typically appears as an ovoid, well-defined, well-corticated, radiolucent depression in the posterior mandibular region below the inferior alveolar nerve (IAN) (in: Neville et al, Oral and maxillofacial pathology, Elsevier, Inc, St. Louis, MO, 2016).An 80-year-old male presented to our clinic for a routine dental examination. Panoramic radiography and cone-beam computed tomography (CBCT) displayed two well-defined, well-corticated, ovoid radiolucencies inferior to the IAN canal on the left mandibular molar region. The working diagnosis was SBD, and the patient was informed of the findings. Irregular margins on the superior aspect of the anterior defect were noted on CBCT imaging; therefore, follow-up with panoramic images at 6 months, 1 and 5 years was recommended.

UNASSIGNED: The landscape of brain metastases radiotherapy is evolving, with a shift away from whole-brain radiotherapy (WBRT) toward targeted stereotactic approaches aimed at preserving neurocognitive functions and maintaining overall quality of life. For patients with multiple metastases, especially in cases where targeted radiotherapy is no longer feasible due to widespread dissemination, the concept of hippocampal sparing radiotherapy (HA_WBRT) gains prominence.
UNASSIGNED: In this narrative review we explore the role of the hippocampi in memory formation and the implications of their postradiotherapy lateral damage. We also consider the potential advantages of selectively sparing one hippocampus during whole-brain radiotherapy (WBRT). Additionally, by systematic evaluation of relevant papers published on PubMed database over last 20 years, we provide a comprehensive overview of the various changes that can occur in the left or right hippocampus as a consequence of radiotherapy.
UNASSIGNED: While it is important to note that various neurocognitive functions are interconnected throughout the brain, we can discern certain specialized roles of the hippocampi. The left hippocampus appears to play a predominant role in verbal memory, whereas the right hippocampus is associated more with visuospatial memory. Additionally, the anterior part of the hippocampus is more involved in episodic memory and emotional processing, while the posterior part is primarily responsible for spatial memory and pattern separation. Notably, a substantial body of evidence demonstrates a significant correlation between post-radiotherapy changes in the left hippocampus and subsequent cognitive decline in patients.
UNASSIGNED: In the context of individualized palliative radiotherapy, sparing the unilateral (specifically, the left, which is dominant in most individuals) hippocampus could expand the repertoire of strategies available for adapted WBRT in cases involving multiple brain metastases where stereotactic radiotherapy is not a viable option. Prospective ongoing studies assessing various memory-sparing radiotherapy techniques will define new standard of radiotherapy care of patients with multiple brain metastases.

UNASSIGNED: Unilateral twin ectopic pregnancy is extremely rare in natural pregnancy, with an incidence rate of only 1 in 200,000-2,500,000, represents a major health risk for reproductive-aged women, leading to even life-threatening complications. There is a lack of data on the prevalence of this rare disease after in-vitro fertilization-embryo transfer (IVF-ET) cycles.
UNASSIGNED: We present a case of a 51-year-old woman with rare unilateral twin ectopic pregnancy after frozen embryo transfer treated with bilateral salpingectomy, followed by a review of the literature.
UNASSIGNED: Twin ectopic pregnancy is a very rare type of pregnancy that requires a high index of suspicion to diagnose and treat early to prevent complications and maternal death.

Ectopic pregnancies occur when a fertilized egg implants outside the uterus, usually in the fallopian tube. Twin ectopic pregnancies are rare and pose significant diagnostic and management challenges. This case report presents the clinical details and management of a unilateral twin ectopic pregnancy in a 31-year-old female patient. The purpose of this report is to highlight the complexities associated with the diagnosis and management of this uncommon condition. In this case, we performed the left salpingectomy. We confirmed pathologically and histologically in pregnancy in the same tube.

A 60-year-old female with known seropositive rheumatoid arthritis and other co-morbids, presented with right eye hypertensive retinopathy and exudative macroaneurysms. Over the years, she developed vitreous haemorrhage, macula oedema and full thickness macula hole. Fluorescein angiography showed macroaneurysms and ischaemic retinal vasculitis. Initial diagnosis was thought to be hypertensive retinopathy with macroaneurysms and retinal vasculitis secondary to rheumatoid arthritis. Laboratory investigations did not support other causes for macroaneurysms and vasculitis. Hence, delayed diagnosis of IRVAN syndrome was made after detailed review of clinical findings, investigations, and angiographic evidence. Our understanding of IRVAN continues to evolve in the face of challenging presentations. To our knowledge, this is the first reported case of IRVAN associated with rheumatoid arthritis.

UNASSIGNED: Unilateral choanal atresia is a congenital anomaly where a newborn baby is born with a unilateral imperforate posterior nare. In most of the time the diagnosis may be missed for years after birth. A rhinolith is an entity formed by gradual deposition and coating of different salts of calcium and magnesium over an endogenous or exogenous nidus in the nasal cavity. Coexistence of a rhinolith and choanal atresia is a very rare encounter in clinical practice and to the best of our knowledge this is perhaps the first documented case in Tanzania.
METHODS: We present a 15-year old boy who was attended at our department with a longstanding history of left sided non-foul smelling nasal discharge which was noticed first when he was 5 years old but at the age of 13 years, he presented with ipsilateral nose bleeding and episodic foul smelling nasal discharge. He was attended at various peripheral health facilities without relief.
UNASSIGNED: The patient underwent left sided nasal endoscopy where unilateral choanal atresia and a rhinolith were found. Transnasal endoscopic choanal atresia release and rhinolith removal were done under general anaesthesia in operating room. Postoperatively, he was kept on a nasal decongestant, a broad-spectrum antibiotic, intranasal corticosteroid and an analgesic.
CONCLUSIONS: Clinicians must have a high index of suspicion so as to establish the diagnosis of unilateral choanal atresia in patients with persistent unilateral non-foul smelling discharge and also nasal foreign bodies in those with foul smelling nasal discharge.

BACKGROUND: Migraine is a historically unilateral head pain condition, the cause of which is not currently known. A growing body of literature suggests individuals who experience migraine with left-sided headache (\"left-sided migraine\") may be distinguished from those who experience migraine with right-sided headache (\"right-sided migraine\").
OBJECTIVE: In this scoping review, we explore migraine unilaterality by summarizing what is currently known about left- and right-sided migraine.
METHODS: Two senior medical librarians worked with the lead authors to construct and refine a set of search terms to identify studies of subjects with left- or right-sided migraine published between 1988, which is the year of publication of the first edition of the International Classification of Headache Disorders (ICHD), and December 8, 2021 (the date the searches were conducted). The following databases were searched: Medline, Embase, PsycINFO, PubMed, Cochrane Library, and Web of Science. Abstracts were loaded into Covidence review software, deduplicated, then screened by two authors to determine study eligibility. Eligible studies were those involving subjects diagnosed with migraine (according to ICHD criteria) in which the authors either: a) compared left- to right-sided migraine; or b) described (with analysis) a characteristic that differentiated the two. Data were extracted by the lead author, including ICHD version, the definition of unilateral migraine used by the authors, sample size, whether the findings were collected during or between attacks, and their key findings. The key findings were grouped into the following themes: handedness, symptoms, psychiatric assessments, cognitive testing, autonomic function, and imaging.
RESULTS: After deduplication, the search yielded 5428 abstracts for screening. Of these, 179 met eligibility criteria and underwent full text review. 26 articles were included in the final analysis. All of the studies were observational. One study was performed during attack, nineteen between attacks, and six both during and between attacks. Left- and right-sided migraine were found to differ across multiple domains. In several cases, reciprocal findings were reported in left- and right-migraine. For example, both left- and right-sided migraine were associated with ipsilateral handedness, tinnitus, onset of first Parkinson\'s symptoms, changes in blood flow across the face, white matter hyperintensities on MRI, activation of the dorsal pons, hippocampal sclerosis, and thalamic NAA/Cho and NAA/Cr concentrations. In other cases, however, the findings were specific to one migraine laterality. For example, left-sided migraine was associated with worse quality of life, anxiety, bipolar disorder, PTSD, lower sympathetic activity, and higher parasympathetic activity. Whereas right-sided migraine was associated with poorer performance on multiple cognitive tests, a greater degree of anisocoria, changes in skin temperature, higher diastolic blood pressure, changes in blood flow through the middle cerebral and basilar arteries, and changes on EEG.
CONCLUSIONS: Left- and right-sided migraine differed across a wide range of domains, raising the possibility that the pathophysiology of left- and right-migraine may not be identical.

Microscopic unilateral laminotomy for bilateral decompression (ULBD) is a minimally invasive technique used in the treatment of lumbar spinal stenosis and could limit spinal instability and be associated with better clinical outcomes. However, there is ongoing debate regarding its utility compared to conventional laminectomy (CL). The primary objective was to collate and describe the current evidence base for ULBD, including perioperative parameters, functional outcomes, and complications. The secondary objective was to identify operative techniques.
A scoping review was conducted between January 1990 and August 2022 according to the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Major databases were searched for full text English articles reporting on outcomes following microscopic unilateral laminotomy in patients with lumbar spinal stenosis.
Seventeen articles met the inclusion criteria. Two studies were randomised controlled trials. Two studies were prospective data collection and the rest were retrospective analysis. Three studies compared ULBD with CL. ULBD preserves the osteoligamentous complex and may be associated with shorter operative time, less blood loss, and similar clinical outcomes when compared to CL.
This review highlights that ULBD aims to minimise disruption to the normal posterior spinal anatomy and may have acceptable clinical outcomes. It also highlights that it is difficult to draw valid conclusions given there are limited data available as most studies identified were retrospective or did not have a comparator group.

UNASSIGNED: The purpose of this study was to compare the safety and efficacy of unilateral vs. bilateral pedicle screw fixation (BPSF) for lumbar degenerative diseases.
UNASSIGNED: Electronic databases including PubMed, Web of science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO were searched by computer. The deadline was set for June 1, 2022. This study included all high-quality randomized controlled trials (RCTs), prospective clinical controlled studies (PRO), and retrospective studies (Retro) that compared unilateral and bilateral pedicle screw fixation in the treatment of lumbar degenerative diseases. Revman5.3 software was used for meta-analysis after two researchers independently screened the literature, extracted data, and assessed the risk of bias in the study.
UNASSIGNED: Fourteen studies with a total of 1,086 patients were included. Compared with BPSF, unilateral pedicle screw fixation (UPSF) has shorter operation time and hospital time, and less blood loss and operation cost, operation time [SMD = -1.75, 95% CI (-2.46 to -1.03), P < 0.00001], hospital time [SMD = -1.10, 95% CI (-1.97 to -0.22), P = 0.01], Blood loss [SMD = -1.62, 95% CI (-2.42 to -0.82), P < 0.0001], operation cost [SMD = -14.03, 95% CI (-20.08 to -7.98), P < 0.00001], the ODI after bilateral pedicle screw fixation was lower, and the degree of lumbar dysfunction was lighter, [SMD = 0.19, 95% CI (0.05-0.33), P = 0.007], better fusion effect, fusion rate [RR=0.95, 95% CI (0.91-1.00), P = 0.04]. VAS-Low back pain [SMD = 0.07, 95% CI (-0.07-0.20), P = 0.35], VAS-Leg pain [SMD = 0.18, 95% CI (-0.00-0.36), P = 0.05], SF-36 [SMD = 0.00, 95% CI (-0.30-0.30), P = 1.00], complications rate [RR = 0.94, 95% CI (0.9154-1.63), P = 0.82], the overall difference was not statistically significant.
UNASSIGNED: Currently limited evidence suggests that UPSF significantly reduces blood loss, significantly shortens the operative time and hospital stay, and reduces blood loss and costs. After BPSF, the ODI was lower, the degree of lumbar spine dysfunction was lower, and the fusion rate was significantly higher. The VAS, SF-36, and complications scores of the two groups were comparable, and there was no significant clinical difference.

Harlequin syndrome (HS) is a rare autonomic disorder. The causes and risk factors of the disease are not fully understood. Some cases of HS are associated with traumatic injuries, tumors, or vascular impairments of the head. Symptoms of HS can also occur in some autoimmune disorders, ophthalmic disorders, sleep disorders, and with certain organic lesions. In this context, a thorough review of the pathophysiology of HS in relation to neurological, ophthalmological, and dermatological conditions is necessary. In this mini-review, we aim to review the pathophysiological changes and underlying mechanisms in primary and secondary HS. Additionally, we discuss possible management approaches for patients with HS in light of the discussed pathological mechanisms. The main symptoms of HS that are correlated with autonomic nervous system impairments include sudden unilateral flushing of the face, neck, chest, and rarely arm, with concurrent contralateral anhidrosis. Despite reported co-occurring syndromes (such as cluster headaches), several studies have shown that HS could frequently overlap with other syndromes that are disruptive to the idiopathic nerve pathways. HS usually does not require any medical treatment. In some severe cases, symptomatic treatments could be needed. However, total symptomatic relief may not be achieved in many cases of HS. We therefore suggest an approach to comprehensive management of HS, which may lead to better long-term control of HS.