Introduction and importance: The co-occurrence of acute ischemic stroke and acute myocardial ischemia; cardiocerebral infarction (CCI) has been linked to increased morbidity and mortality. The incidence of these conditions to occur simultaneously has been reported to be less than 1% according to the published data. Left Ventricular Non-Compaction (LVNC), on the other hand, is characterized by large left ventricular (LV) trabeculae, a thin compacted layer, and deep intertrabecular recesses. In the inter-trabecular recesses, where blood flow is slow, cardiac mural thrombi may form, which can lead to systemic embolization. Case presentation: In this report, we describe a 51-year-old male patient with a history of hypertension and diabetes who developed a non-ST segment elevated myocardial infraction and an acute ischemic stroke that were thought to be related to left ventricular hypertrabeculation. Clinical discussion: Although it is rare, the simultaneous occurrence of myocardial infarction and an acute ischemic stroke can be fatal. There are numerous potential mechanisms for CCI, including cardiac thrombi-embolism, hypoperfusion during AMI. Both conditions have a narrow therapeutic window and management is very crucial. Conclusion: To the best of the author's knowledge, this is the first reported case of cardiocerebral infraction (CCI) in the setting of non-compaction left ventricle. Early and precise diagnosis is critical to the successful management of these conditions.

Introduction: Left ventricular thrombus (LVT) is a common complication in patients with systolic heart failure and can cause thromboembolic consequences including stroke. In order to determine the characteristics of LV thrombus among heart failure patients with reduced ejection fraction (HFrEF), the present study was undertaken. Methods and Materials: This was retrospective cross-sectional study conducted from referral tertiary hospital in a year period. A total of 810 transthoracic echocardiograms were carried out in our center from January 2021 to December 2021. Forty participants had met the inclusion criteria of the study. Results: About 75% of the population was male and the mean age at diagnosis was 51 years (SD: 15). Ischemic cardiomyopathy and dilated cardiomyopathy (DCMP) found to be the most underlying cause of LVT represented (57.5% and 42.5% respectively). Hypertension, hypothyroidism, and atrial fibrillation were found to be the commonest associated risk factors of LVT, 45%, 12.5%, and 30% respectively. Simpson’s Biplane’s approach yielded a mean LVEF of 25.25 ± 6.97. 60% of the patients had a LVEF of ≤ 25%. The mean LV end-diastolic and end-systolic diameters were 59.2 ± 9.4 mm and 51 ± 8.3mm respectively. Warfarin was administered to 19 (47.5), Rivaroxaban to 8 (20), and Dabigatran to 10 (25). The most prevalent anticoagulant among the individuals in our study was warfarin. A stroke complication was found in 8 patients (20%), two of them were hemorrhagic stroke and they were on dabigatran. A Peripheral Arterial Disease (PAD) affected 6 of the patients (15%). One of those with PAD had also ischemic stroke. Conclusion: This study determines that Ischemic and Dilated cardiomyopathy were the most common cause of left ventricular thrombosis among HFrEF patients in Somalia.

Heart failure (HF) remains a global health burden characterized by frequent hospitalizations and high mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has emerged as a composite marker reflecting nutritional and inflammatory status, but its prognostic utility in acute HF settings remains underexplored. To investigate the association between the HALP score and prolonged hospital stay and in-hospital mortality among patients admitted with acute heart failure. This retrospective study included 222 patients hospitalized with acute heart failure at a tertiary care center in Somalia between January 2024 and April 2025. Patients were stratified by hospital stay duration: short (≤7 days) vs long (>7 days). The HALP score was calculated using routine laboratory values, and a previously validated cut-off was used for stratification. Logistic regression analysis was used to identify predictors of long hospital stay. Model performance was assessed using Hosmer–Lemeshow test, Nagelkerke R², classification statistics, and ROC curve analysis. A total of 222 patients were analyzed; 86 (38.7%) had prolonged hospitalization. Patients with the HALP score above the prognostic threshold were significantly more likely to experience long hospital stay (p = 0.002). In multivariable analysis, The HALP score ≥ cut-off (OR: 10.19, 95% CI: 2.49–41.63, p = 0.002) and prior stroke (OR: 8.44, 95% CI: 1.15–61.88, p = 0.035) independently predicted prolonged hospital stay. Model fit was adequate (Hosmer–Lemeshow p = 0.105), and explanatory power was moderate (Nagelkerke R² = 0.31). However, the HALP score’s standalone discriminative ability was poor (AUC = 0.511). The HALP score is an independent predictor of prolonged hospitalization in acute heart failure patients. While its individual discriminative power is limited, its role within multivariable risk stratification models appears promising. Further prospective validation is warranted.

Background: Heart failure (HF) is an increasing burden in Sub-Saharan Africa, with coronary artery disease (CAD) emerging as a major cause. However, angiographic data in HF patients remain scarce in this region. Methods: This retrospective study included 169 HF patients who underwent coronary angiography between 2023 and 2025 at Mogadishu Somali Türkiye Training and Research Hospital. CAD severity was classified as minor, moderate, or severe (≥ 70% stenosis in epicardial arteries or ≥ 50% in the left main). Demographic, clinical, and echocardiographic data were analyzed. Logistic regression identified predictors of severe CAD. Results: The mean age was 54.3 ± 10.9 years, and 33.1% were male. CAD was present in 53.3% of patients, with severe CAD in 23.1%. Single-vessel disease was most frequent, followed by double-vessel, triple-vessel, and left main involvement. Based on SYNTAX scoring, 27.2% had low, 10.1% intermediate, and 6.5% high scores, indicating a subset with complex anatomy. On univariate analysis, diabetes (P < 0.001), dyslipidemia (P < 0.001), smoking (P = 0.03), and khat chewing (P = 0.03) were significantly associated with severe CAD. Patients with severe CAD also had lower ejection fraction (26.3% vs 29.8%, P = 0.01) and higher SYNTAX scores (34.7 vs 19.6, P < 0.001). In multivariate analysis, diabetes (OR = 7.44, 95% CI: 3.04– 18.17, P < 0.001) and smoking (OR = 2.61, 95% CI: 1.10– 6.23, P = 0.03) remained independent predictors. Conclusion: Severe CAD is common among HF patients in Somalia and is strongly associated with diabetes and smoking. Systematic ischemic evaluation and aggressive risk factor control should be prioritized to improve outcomes. This study provides one of the first angiographic datasets from the region, offering evidence to guide screening, optimize scarce diagnostic resources, and inform future multicenter research.

Introduction and importance: Bilateral subdural hematoma (SDH) is a very rare condition which can occur without any apparent etiology. It's characterized by a lower frequency of focal neurological impairments, which could delay the diagnosis and postpone treatment. The reported incidence of an acute spontaneous subdural hematoma (SSH) varies between 2% and 6.7% of all acute SDH. SDH following Plasmodium vivax (P. vivax) infection are uncommon to our knowledge, only two cases of SDH linked with P. vivax infection have been documented in the literature.Case presentation: We describe a case of a 31-year-old male with a history of mitral mechanical valve replacement on anti-coagulant presented with spontaneous bilateral subdural hematoma in the presence of malaria. The patient had a limited vague symptom, which delayed a prompt diagnosis of his disease. Clinical discussion: Spontaneous subdural hematoma has only a few documented cases. Hypertension, infections, vascular malformations, ruptured aneurysms, thrombocytopenia caused by hematological and oncological ill-nesses, acquired or inherited types of coagulopathies, and drug abuse are all risk factors. Also, SDH has been documented in the literature as a consequence of Plasmodium infection. In addition to that this patient was on anti-epileptic medicines which might potentiate vitamin K antagonists. Numerous factors were thought to have contributed to this significant bleeding.Conclusion: Patients on anticoagulants who exhibit nebulous symptoms, including a mild headache, should be subjected to a thorough history and examination. And any factor delaying an accurate diagnosis should be eliminated. This will complement the patient's plan and management.

Introduction: Coronary Artery Disease (CAD) is the leading cause of death and disability adjusted life years worldwide, primarily in low- and middle-income nations. The study aims to determine if khat use is linked to a more complicated form of CAD and a larger lesion burden. The SYNergy between Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score is used to assess CAD severity and degree. Methodology: This observational, hospital-based descriptive study enrolled patients referred for coronary angiograms from August 2022 to May 2023. Data was collected from Khat and Non-Khat users, and analyzed using the SYNTAX score. The study compared demographics, clinical presentations, coronary angiographic findings and lesion complexity between Khat and Non-Khat users. Results: This study enrolled 177 participants, with a khat chewer group being (45.2%) compared to non-khat chewers (54.8%). The age distribution was similar, with 79.7% male and 20.3% female. Smoking was more common in the khat group (38.4%). Risk factors included hypertension, diabetes mellitus, dyslipidemia, and chronic kidney disease. There was no significant difference in lesion complexity between khat users and non-khat users.Khat chewing patients had a higher incidence of acute coronary syndrome (54% vs 24%) and higher incidence of spontaneous coronary dissection. Conclusion: The research suggests that khat use could be harmful to the cardiovascular system, including the coronary arteries. More research is required to completely understand the underlying mechanisms of action and evaluate the impact of khat on coronary arteries.