Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse myelitis, cerebellitis, Guillain-Barre syndrome, and cranial or peripheral neuritis most commonly in immunocompromised patients. These clinical manifestations may occur alone or accompanied by infectious mononucleosis. Usually, EBV encephalitis occurs infrequently and with non-specific symptoms. Herein, we report two patients: a 24-year-old female with generalized tonic-clonic fever and seizures for ten days. The other was a 28-year-old male with repeated fever, headache, 4-day amnesia, and symptoms of meningeal irritation. Since the physical examination results were not very helpful, the definite diagnosis was achieved by sampling, analysis, and polymerase chain reaction for the cerebrospinal fluid. Our patients had a direct EBV invasion of the CNS and were affected by Epstein-Barr virus encephalitis, confirmed by their clinical test results as a positive polymerase chain reaction of cerebrospinal fluid. The PCR results were negative for a panel of microorganisms that cause bacterial meningitis in the CSF, but positive for EBV. Image findings also did not show any significant results. Patients treated with acyclovir and precision control at the relative center with favorable outcomes. Acyclovir possibly will lessen viral replication. Finally, despite obtaining negative test results of EBV infection, every therapeutic effort should be undertaken and maintained continuous attention.

Coronary artery aneurysm is a relatively infrequent abnormality but its diagnosis has been increased after the advent of coronary angiography. Atherosclerosis accounts for the majority of Cases of coronary aneurysms. Other etiologies include congenital aneurysms, dissection, infection, vasculitis, and some other inflammatory conditions.We describe a 41-year-old woman who presented with typical chest pain and dyspnea and had multiple small and large coronary aneurysms associated with stenotic segments.

Background: Patella fractures account for approximately 1% of all fractures and can be classified as simple or complex. Complex fractures often require surgical intervention due to bone fragment displacement. Rehabilitation focuses on restoring range of motion (ROM), strengthening muscles, and reducing knee stiffness, with recovery potentially taking several months. Treatment options for distal pole patella fractures include fragment resection, which may lead to complications such as patella baja and extensor mechanism weakness. Another method, the basket plate technique, has been associated with discomfort in about 30% of patients, often requiring implant removal surgery.   Case Report: We present a novel technique for stabilizing distal pole patella fractures using multifilament polyester non-absorbable coated braided sutures, offering an alternative to traditional fixation methods. Conclusion: This technique provides stable fixation while avoiding the need for implant removal. Although further research is required to compare its efficacy with conventional approaches, initial results suggest it may be a promising option for managing distal pole patella fractures.

Background: Selective serotonin reuptake inhibitors (SSRIs) have proven more problematic in terms of some side effects than the original clinical trials suggested. Sertraline may displace warfarin from plasma proteins and may increase the prothrombin time. The aim of this study was to report a rare Case of the sertraline-induced severe anal pain and rectal bleeding without concurrent of taking any other drugs including non-steroidal antiinflammatory drugs (NSAIDs). Case Presentation: Here we report a Case of a 31-year old married man who referred to a psychiatrist with depressive disorder and started to take sertraline up to 400 mg daily, thereafter the patient reported severe anal pain and bleeding. Other etiologies of this side effect were evaluated with Naranjo evaluation scale and rolled out. The patient did not report any anal pain or bleeding after eight months of stopping sertraline. Conclusion: Reported from sertraline, the psychiatrists must be more cautious when prescribing sertraline and monitor the patient properly for a long time to ensure these rare adverse effects and complications do not happen.