Introduction and Importance: Ossified or calcified subdural chronic hematoma is an uncommon condition with an incidence of 0.3–2% of all chronic subdural hematomas. It can cause significant mortality and morbidity, especially in young patients. Because of the rare incidence of this condition, its pathophysiology and management preferences have not yet been clearly established, which raises the importance of reporting such cases in order to add valuable databases to the literature. Case Presentation: A 34-year-old woman with a history of head trauma several years ago presented with refractory headaches, convulsions, and muscle weakness. Computed tomography showed an extra-axial calcified lesion in the frontal lobe. Surgical treatment was decided considering the patient’s age, in addition to the presence of serious medically uncontrolled symptoms. The calcified lesion was successfully removed surgically, and the patient recovered completely. Pathological examination confirmed the diagnosis of ossified subdural chronic hematoma. Clinical Discussion: The symptoms of ossified subdural hematomas are not specific. However, the presence of a history of head trauma should raise suspicion of this condition. Computerized tomography is usually used as the diagnostic method. Nevertheless, it is unable to differentiate ossified chronic subdural hematomas from other intracranial extra-axial calcified lesions that need to be considered as a differential diagnosis. Pathologic investigations are needed to provide the final diagnosis. Conclusions: We highly recommend surgical therapy for ossified subdural hematomas that are symptomatic and persistent, especially in young patients. We further stress the significance of postsurgical anticonvulsant prophylaxis, particularly in patients presenting convulsions.

Introduction: Adult-Onset Still’s Disease (AOSD) is a rare inflammatory disease. It usually causes high fevers, joint pain, a fleeting rash, and very high ferritin levels. The symptoms can mimic infections, autoimmune disorders, or cancers, so it can be hard to diagnose. Liver involvement is common but usually mild. Severe hepatitis is rare. Case Presentation: We report a 24-year-old woman who had 3 weeks of daily high fevers, a temporary salmon-pink rash, sore throat, muscle pain, and joint pain. Her blood tests showed high white blood cells with mostly neutrophils, persistent monocytosis, severely elevated liver enzymes, and very high ferritin. Tests ruled out infections, autoimmune diseases, and cancers. She met criteria for AOSD, and her glycosylated ferritin was low. The patient responded rapidly to intravenous methylprednisolone, but relapsed with polyarthritis upon tapering, which resolved completely within 48 hours of initiating anakinra. Discussion: This case highlights the diagnostic challenges of AOSD presenting predominantly with hepatic involvement and atypical laboratory features such as persistent monocytosis. Recognition of extreme hyperferritinemia as a diagnostic clue can prevent delays in diagnosis. The dramatic response to IL-1 blockade underscores cytokine dysregulation as a central pathogenic mechanism. Conclusion: Clinicians should consider AOSD in patients with febrile hepatitis and extreme hyperferritinemia. Early initiation of biologic therapy targeting IL-1 can achieve rapid remission, improve quality of life, and prevent complication.

Introduction: Scabies is a parasitic skin condition, with crusted scabies (CS) being a severe and highly contagious variant characterized by thickened skin lesions and a high mite count. CS is typically associated with immunocompromised individuals but can also develop in those suffering from malnutrition, as malnutrition weakens immune responses and impairs skin integrity. Case Presentation: We report a case of CS in a 50-year-old malnourished male with no history of scabies or systemic disease, recently incarcerated. He presented with widespread itching, hyperkeratotic papules on the palms and soles, and secondary impetigo. The patient showed signs of malnutrition, with a BMI of 15.6 kg/m² and muscle wasting. Sarcoptes scabiei mites, eggs, and scybala were identified microscopically. The case was classified as Grade 3 CS. Treatment included two doses of ivermectin (8 mg) one week apart, 10% sulfur ointment, and benzyl benzoate soap. Follow-up was incomplete, highlighting challenges in managing socially vulnerable patients. Discussion: This case emphasizes the importance of early recognition, accurate diagnosis, and effective treatment of CS, especially in settings with poor sanitation and overcrowding. The patient’s malnutrition likely contributed to the severity of the condition, as compromised immunity can facilitate mite proliferation. Conclusion: A holistic approach addressing malnutrition, sanitation, and patient education is crucial in managing CS in resource-limited settings.

Furosemide is commonly used off-label in the neonatal intensive care unit to promote diuresis and improve pulmonary mechanics in preterm infants, but prolo

Introduction: Cannabinoid hyperemesis syndrome (CHS) is a debilitating disorder of chronic, heavy cannabis users characterized by cyclic severe nausea, vomiting, and abdominal pain that is classically relieved by hot baths. Standard antiemetics often fail, and dysregulation of endocannabinoid signaling with involvement of heat-sensitive TRPV1 channels has been proposed. Topical capsaicin - a TRPV1 agonist - has been reported in small series and case reports to reproduce the hot-water effect and rapidly relieve symptoms. Case presentation: A 28-year-old man with daily high-potency cannabis use (∼2 g/day for 7 years) presented to the emergency department with 48 hours of intractable non-bilious vomiting (∼20 episodes/day), severe periumbilical cramping (8/10), and a history of similar episodic flares relieved by prolonged hot showers. Initial ED therapy (IV fluids, ondansetron, metoclopramide, pantoprazole) produced minimal benefit; labs showed hypokalemic, hypochloremic metabolic alkalosis and pre-renal azotemia, with otherwise unremarkable imaging and enzymes. After informed consent, ∼2 g of 0.1% topical capsaicin cream was applied across the abdomen. The patient experienced an acute burning sensation for ∼15–30 minutes; retching ceased within 10 minutes, pain fell to 2/10 by 30 minutes and resolved by 90 minutes, and he tolerated oral intake. Vital signs normalized and electrolytes/renal function returned to baseline at 48-hour follow-up. He was discharged with counseling on cannabis cessation and a capsaicin tube for prodromal use. Conclusion: Topical capsaicin produced rapid, durable symptom resolution in this case of refractory CHS with only transient local discomfort. The effect is plausibly mediated by TRPV1 activation followed by peripheral desensitization, recapitulating the therapeutic hot-water response. Given consistent positive signals from case reports, series, and small pilot data, topical capsaicin is a low-risk, accessible adjunct for refractory CHS, but larger controlled studies are needed to define optimal dosing, duration, and long-term outcomes.