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1

Taksande, B., MM Patil, P. Banode, and R. Deshpande. "Rarer in a Rare." Annals of Medical and Health Sciences Research 3, no. 1 (2013): 125. http://dx.doi.org/10.4103/2141-9248.109482.

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2

Ragnarsdóttir, Kristín Vala. "Rare metals getting rarer." Nature Geoscience 1, no. 11 (November 2008): 720–21. http://dx.doi.org/10.1038/ngeo302.

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3

Hackenberger, Branimir K. "Rare, rarer, it still has not happened." Croatian Medical Journal 60, no. 6 (December 2019): 565–69. http://dx.doi.org/10.3325/cmj.2019.60.565.

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4

Gopi, Arun, Placid Sebastian, and C. D. Ramakrishna. "A rare malady with a rarer complication." Indian Heart Journal 68 (September 2016): S264—S266. http://dx.doi.org/10.1016/j.ihj.2015.08.012.

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5

CH, Balasubrahmanyam. "Myasthenia Gravis: Rare Disease with Rarer Presentation." Current Research in Emergency Medicine (CREM) 3, no. 2 (June 12, 2023): 1–3. http://dx.doi.org/10.54026/crem/1052.

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6

Forbes, Elizabeth, and Alan Blyth. "Rarer Operas." Musical Times 126, no. 1707 (May 1985): 286. http://dx.doi.org/10.2307/961310.

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7

Opryszko, Anna. "Rarer Still." Journal of New Librarianship 8, no. 2 (July 25, 2023): 65–68. http://dx.doi.org/10.33011/newlibs/14/6.

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Pursuing professional development in special collections is hard for a paraprofessional, especially when many library schools offer limited instruction in special collections and inadequately prepare students for a professional position. When the "traditional" resources are underwhelming, it is important to know where to seek out knowledge, training, and professional connections. In this column, I explore my path in the field of rare books libraries, and offer advice for others who may be struggling to figure out their own path.
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8

Limaye, HarshadS, AnupaR A Hinduja, Mitusha Verma, and PradyumnaJ Oak. "A Case of CNS Actinomycosis: Rarer than Rare!" Neurology India 69, no. 2 (2021): 475. http://dx.doi.org/10.4103/0028-3886.314572.

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9

Nawarathna, E. M. N. T., A. Danthanarayana, and J. Akarawita. "A case series of rare cutaneous malignancies." Sri Lanka Journal of Dermatology 22, no. 1 (December 31, 2021): 92–94. http://dx.doi.org/10.4038/tsljd.v22i1.23.

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Cutaneous malignancies are rare in people with darker skin types compared to fair skin. Cutaneous malignancies differ according to their origin. Squamous and basal cell carcinomas are by far the most common malignancies. Other types of malignancies are rarer. We report 3 cases of rarer cutaneous malignancies.
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10

Pande, Tanmay, Arpan Yadav, B. K. Varghese, and Anurakshat Gupta. "Are rare hernias rarer: a ten-year observational study." International Surgery Journal 6, no. 12 (November 26, 2019): 4338. http://dx.doi.org/10.18203/2349-2902.isj20195390.

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Background: Hernia is one of the most common ailments encountered in general surgery practice. The inguinal hernia constitutes majority of cases. The available literature describes umbilical, femoral, lumbar, perineal and many others rarer varieties. Our preliminary observations indicated a changing scenario. With a view to ascertain it, investigations were made to find out the incidence of hernia with frequency data of different types and demographic details of patients during last decade at tertiary care teaching hospital in Pune and then comparing it with the existing literature.Methods: Ten years data from October 2008 to October 2018 of all the adult population suffering from hernia reporting to this center was collected from the archives of hospital records maintained in OPD, wards and the department.Results: Inguinal hernia was the most common constituting 76.9% of the total cases. The right side was more affected than the left side with 51.0% cases being on right side. This was followed by umbilical hernia, 12.26% of the total cases. Males were more affected than the females except in incisional hernia. Only two cases of spigelian hernia had undergone repair over last one decade. There were no cases of femoral hernia, lumbar hernia and perineal hernia encountered during the last ten years in this center.Conclusions: The relative frequency of the incidence of different types of hernia was inguinal, umbilical, epigastric; incisional which have been in descending order. In the last decade at this centre which is in contrast with hernia incidence figures quoted in common reference books and the available literature.
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11

Myathari, Ramakrishna, and Anand Gupta. "X-linked agammaglobulinemia rare disease with a rarer presentation." International Journal of Contemporary Pediatrics 8, no. 12 (November 23, 2021): 1980. http://dx.doi.org/10.18203/2349-3291.ijcp20214539.

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X-linked agammaglobulinemia (XLA) is a rare disorder, characterized by absence of mature B cells leading to severe antibodies deficiency. This translates to recurrent sinopulmonary infections in affected children. The most common age group of presentation is 6 months to 2 years. Being an X-linked recessive disorder males are affected, females are carriers. Intravenous immunoglobulins and antibiotics remains the corner stone of treatment. Here in, we report a case of 11-year-old male having recurrent episodes of fever with one episode of hospitalization 3 years back. Child was treated at healthcare facility elsewhere for recurrent fever. He presented to our institute with signs and symptoms suggestive of meningitis, investigated, had culture proven Staphylococcus aureus meningitis with a low Absolute Lymphocyte Count (ALC). On further work up found to have low serum immunoglobulins (IgG, IgM, IgA) and Flowcytometry showing absence of B cells (CD19/CD20). Child was diagnosed to have XLA. This case highlights the importance of having strong clinical suspicion of XLA, despite not having recurrent sinopulmonary infections.
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12

Kim, Wan Kee, and Joon Bum Kim. "Left sinus of Valsalva aneurysm: Rare disease, rarer presentation." Journal of Thoracic and Cardiovascular Surgery 157, no. 3 (March 2019): e169-e170. http://dx.doi.org/10.1016/j.jtcvs.2018.10.070.

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13

Prasad, Prasanth, and Sumesh Raj. "A rare poisoning with a still rarer presentation: imidacloprid." International Journal of Research in Medical Sciences 11, no. 1 (December 30, 2022): 372. http://dx.doi.org/10.18203/2320-6012.ijrms20223666.

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Imidacloprid is a neonicotinoid systemic insecticide. It is used to control agricultural pests. It controls the insects from within the plant. This product is applied to the soil and is taken up by the roots. Imidacloprid belongs to a new chemical family of chloronicotinyl compounds. Its mode of action on the insect nervous system differs from that of a traditional neurotoxic product. This compound is considered relatively safer to human beings, but it can lead to potentially life-threatening complications. Large quantity of this compound when ingested causes fatal complications like respiratory failure, cardiac arrythemias. We reported a case of imidacloprid poisoning with its rarest unreported complications.
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14

Likhari, Kamalpreet. "Malignant peripheral nerve sheath tumor: Rare tumor, rarer presentation." Indian Journal of Ophthalmology - Case Reports 3, no. 2 (2023): 521. http://dx.doi.org/10.4103/ijo.ijo_2540_22.

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15

ALMERIE, S. "ACUTE EPIGLOTTITIS IN ADULTS." Professional Medical Journal 18, no. 04 (December 10, 2011): 722–24. http://dx.doi.org/10.29309/tpmj/2011.18.04.2688.

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16

Jain, Akanksha, Manjula Jain, NehaKawatra Madan, and Anu Beniwal. "Congenital gastrointestinal stromal tumor: A rare case with rarer presentation." Journal of Clinical Neonatology 6, no. 2 (2017): 90. http://dx.doi.org/10.4103/jcn.jcn_170_15.

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17

Ahmed, Naveed, Mian Sarfraz Gul, Iftikhar Ahmed, Shafqat Rehman, Omar Fraz, and Zahid Anwar. "URETHRAL DUPLICATION A RARE CAUSE OF EVEN RARER DORSAL CHORDEE." PAFMJ 71, no. 3 (June 30, 2021): 1124–25. http://dx.doi.org/10.51253/pafmj.v71i3.5695.

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Chordee is a condition in which the penile head has a curvature. It can be towards ventral or dorsal aspect. Dorsal chordee is very rare. In many normal males mild degrees of curvature can exist. Causes of dorsal chordee can be diverse but urethral duplication as its etiology is even rarer. We report a case of six year old boy who presented with severe dorsal chordee with associated double urethra and cleft of the glans dorsally without hypospadia.
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18

Chandra, Charu, Shashank Shekhar, Soumya Ranjan Panda, Prerana Priyadarshini, and Nishu Bhandari. "Malignant Mixedmullerian Tumor of Uterus: Rare Case & Rarer Diagnosis." Indian Journal of Obstetrics and Gynecology Research 3, no. 1 (2016): 75. http://dx.doi.org/10.5958/2394-2754.2016.00016.3.

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19

Coombs, Amy. "Rare nature of mushroom poisoning means drug trials rarer still." Nature Medicine 15, no. 3 (March 2009): 225. http://dx.doi.org/10.1038/nm0309-225a.

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20

Munro, Alastair. "All tumours are rare, but some are rarer than others." Lancet Oncology 18, no. 8 (August 2017): 983–85. http://dx.doi.org/10.1016/s1470-2045(17)30466-7.

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21

Rao, Harish K., Ashish Gupta, and Naresh P. Kumar. "Alveolar soft tissue sarcoma: rare presentation of a rarer malignancy." Indian Journal of Surgery 69, no. 6 (December 2007): 268–69. http://dx.doi.org/10.1007/s12262-007-0042-0.

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22

Herrod, P. J. J., S. Boghossian, and P. Vasas. "Multifocal necrotising fasciitis: a rarer presentation of a rare disease." Case Reports 2014, no. 20 1 (November 20, 2014): bcr2014207089. http://dx.doi.org/10.1136/bcr-2014-207089.

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23

Lallier, M., S. Bouchard, M. Di Lorenzo, S. Youssef, H. Blanchard, J. G. Lapierre, D. Vischoff, M. Tucci, and P. Brochu. "Pleuropulmonary blastoma: A rare pathology with an even rarer presentation." Journal of Pediatric Surgery 34, no. 7 (July 1999): 1057–59. http://dx.doi.org/10.1016/s0022-3468(99)90563-8.

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24

Borkar, Sachin, AkshayG Kumar, Ameya Kale, Saumya Sahu, and Ravi Sharma. "Myxoid Tentorial Chondrosarcoma: A Rarer Variety of a Rare Entity." Neurology India 71, no. 2 (2023): 360. http://dx.doi.org/10.4103/0028-3886.375436.

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25

Warchoł, Izabela, Marcin Książczyk, Dębska-Kozłowska Agnieszka, and Michał Plewka. "Biventricular non-compaction cardiomyopathy: Rare disease and far rarer case." Kardiologia Polska 80, no. 12 (December 30, 2022): 1272–73. http://dx.doi.org/10.33963/kp.a2022.0208.

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26

Ansell, Barbara M. "Rarer connective tissue disorders." Current Paediatrics 8, no. 4 (December 1998): 247–51. http://dx.doi.org/10.1016/s0957-5839(98)80077-8.

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27

Srivastava, T., T. Mathur, R. S. Mittal, B. S. Raghavendra, R. Jain, and R. Handa. "Cerebral Proliferative Angiopathy: A Rare Case with Rare Presentation and Rarer Angiographic Features." EJVES Extra 26, no. 3 (September 2013): e27-e29. http://dx.doi.org/10.1016/j.ejvsextra.2013.05.001.

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28

Srivastava, T., T. Mathur, R. S. Mittal, B. S. Raghavendra, R. Jain, and R. Handa. "Cerebral Proliferative Angiopathy: A Rare Case with Rare Presentation and Rarer Angiographic Features." European Journal of Vascular and Endovascular Surgery 46, no. 3 (September 2013): 393. http://dx.doi.org/10.1016/j.ejvs.2013.05.008.

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29

Philip, Rajeev, Athulya Ashokan, Renjit Philip, and Charamelsankaran Keshavan. "Graves′ disease with thyroid hemiagenesis: A rare abnormality with rarer presentation." Indian Journal of Nuclear Medicine 29, no. 2 (2014): 124. http://dx.doi.org/10.4103/0972-3919.130321.

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30

Ertan, Cem, Mehmet Emre Özpelit, Önder Limon, Deniz Oray, and Nihat Pekel. "Vasospastic myocardial infarction: An even rarer occurrence of a rare entity." World Journal of Emergency Medicine 8, no. 1 (2017): 68. http://dx.doi.org/10.5847/wjem.j.1920-8642.2017.01.013.

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31

Sharma, R., Jugal Kishore, S. Agrawal, L. Rajasekhara, and G. Narsimulu. "P26 A rare case of lymphomatoid granulomatosis with a rarer presentation." Indian Journal of Rheumatology 2, no. 3 (September 2007): S22. http://dx.doi.org/10.1016/s0973-3698(10)60353-6.

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32

Patel, Chirag, Mazyar Malakouti, Akit Patel, Laura Rosenkranz, and Alicia Logue. "Rectal Gastrointestinal Stromal Tumor: A Rare Tumor in a Rarer Location." American Journal of Gastroenterology 112 (October 2017): S1135—S1136. http://dx.doi.org/10.14309/00000434-201710001-02064.

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33

Shanmugam, Subbiah, Sujay Susikar, and Suyash Singodiya. "Maxillary Sinus Schwannoma—A Rare Tumor with Rarer Site of Occurrence." International Journal of Otolaryngology and Head & Neck Surgery 12, no. 03 (2023): 197–202. http://dx.doi.org/10.4236/ijohns.2023.123021.

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34

Baby, Benison P., and Neeru Mittal. "Right hemi diaphragmatic eventration – A rare post SARS-COV-2 infection complication." Lung India 40, no. 5 (2023): 462–64. http://dx.doi.org/10.4103/lungindia.lungindia_92_23.

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ABSTRACT Diaphragm eventration is a rare permanent abnormal elevation of diaphragmatic muscles. They are rare entities with right-sided eventration occurring rarer still. We present a case of a 69-year-old male with right-sided hemidiaphragmatic eventration and post-COVID 19 pulmonary fibrotic changes.
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35

Mankotia, Dipanker Singh, Guru Dutta Satyarthee, and Bhawani Shankar Sharma. "A rare case of thoracic myelocystocele associated with type 1 split cord malformation with low lying tethered cord, dorsal syrinx and sacral agenesis: Pentad finding." Journal of Neurosciences in Rural Practice 6, no. 01 (January 2015): 087–90. http://dx.doi.org/10.4103/0976-3147.143209.

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ABSTRACTMyelocystocele is a rare form of spinal dysraphism. Thoracic myelocystocele is still rarer. The occurrence of thoracic myelocystocele associated with type-1 split cord malformation, low lying tethered cord, dorsal syrinx and spina bifida is extremely rare. Clinical presentation of such a rare case and an early surgical management is discussed briefly.
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36

Murugesu, Jason Arunn. "Pregnancy is rarer after concussion." New Scientist 251, no. 3356 (October 2021): 19. http://dx.doi.org/10.1016/s0262-4079(21)01830-3.

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37

Purandare, SukrutV, SanjeevV Mangrulkar, and ManasiS Shahane. "Some rarer manifestations of tuberculosis." Astrocyte 3, no. 1 (2016): 36. http://dx.doi.org/10.4103/2349-0977.192707.

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38

Zumla, A., and G. Lipscomb. "Purpura and sepis–rarer causes?" British Journal of Dermatology 120, no. 5 (May 1989): 715–16. http://dx.doi.org/10.1111/j.1365-2133.1989.tb01363.x.

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39

Flintoft, Louisa. "Seeking rarer variants for less." Nature Reviews Genetics 14, no. 1 (November 27, 2012): 3. http://dx.doi.org/10.1038/nrg3387.

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40

Manohar, Kuruva, Bhagwant Rai Mittal, Raghava Kashyap, Anish Bhattacharya, Nandita Kakkar, and Uttam Kumar Mete. "F-18 Fluorodeoxy Glucose Positron Emission Tomography/Computed Tomography Findings in a Rare Case of Penile Leiomyosarcoma." Journal of Clinical Imaging Science 1 (December 17, 2011): 58. http://dx.doi.org/10.4103/2156-7514.90955.

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Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.
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41

Prasad, G. Raghavendra, and TM Rashmi. "Lateral Meningomyelocele in a Neonate: A Case Report." Journal of Neonatal Surgery 5, no. 1 (December 6, 2015): 4. http://dx.doi.org/10.47338/jns.v5.271.

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Lateral presentation of meningocele and meningomyelocele is extremely rare. Most of the lateral meningocele described are associated with other syndromes. Isolated lateral meningomyelocele cases are rarer still. We herein report a neonate with isolated lateral gluteal meningomyelocele.
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42

Bhardwaj, Ankit, Sangeeta Sharma, Amit Arya, Suman Kushwaha, and Monali Chaturvedi. "Isolated myocysticercosis: rare presentation in quadriceps muscle." International Journal of Basic & Clinical Pharmacology 9, no. 2 (January 24, 2020): 361. http://dx.doi.org/10.18203/2319-2003.ijbcp20200191.

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Myocysticercosis is not a common disorder and in particular quadriceps muscle is rarer. We are reporting this rare case of myocysticercosis involving quadriceps muscle of right thigh with ultrasonographic demonstration of nodular scolex and associated edema with no neurological involvement.
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43

DI Cicco, M., O. M. Epis, C. Casu, A. Adinolfi, L. Alvaro, V. Campanella, M. Chevallard, et al. "THU0590 WHEN RARE IS EVEN RARER: A COMPLEX CASE OF BEHCET DISEASE." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 537.3–537. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5663.

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Background:Behcet disease is a rare inflammatory disorder with the unique ability to affect vessels of any size. The disease could be associated to thrombosis in both the venous and arterial compartment, and often aneurysms. In particular, the presence of aneurysms of the pulmonary artery is rarely, if ever, seen in conditions other than Behcet. Cardiac involvement, albeit uncommon, is also described and associated to a severe prognosis. The treatment is based on immunosuppressants, meanwhile the use of anticoagulants -especially when aneurysms are present- is debated.Objectives:To describe a complex case of Behcet disease.Methods:We report the case of a 45 years old man of Chinese origin who presented to A&E with fever and acute dyspnea. Blood test revealed raised ESR and CRP and raised neutrophil count. Chest X rays showed bilateral opacities suggesting pneumonia. The patient did not improve over the course of antibiotics. Later on, he presented with an episode of hemoptysis and worsening dyspnea, so he was admitted to the Intensive Care Unit. CT showed bilateral pulmonary thromboembolism and aneurysm of the pulmonary artery. Echocardiogram and cardio-MRI revealed a large, mobile thrombus within the right atrium. Extensive work-up for infections and cancer was unrevealing. ANA, ENA and ANCA antibodies were negative. On the basis of a past medical history of recurrent oral ulcers and papulopustular skin lesions that patient admitted on questioning, a diagnosis of Behcet disease was suspected. In keeping with that, HLA-B51 turned out positive. The patient was promptly started on IV steroid pulses followed by Cyclophosphamide 1 gr IV monthly for six months, then on IV anti-TNF alpha Infliximab. He was also commenced on low molecular weight heparin (LMWH) and subsequently direct factor Xa inhibitor Apixaban.Results:The patient improved significantly with progressive regression of the pulmonary CT changes. He was discharged and able to get back to his daily life activities. After 2 years and a half of treatment, the aneurysm was stable and the intracardiac thrombus completely cleared.Conclusion:This case is of particular interest because of the concomitant presence of two rare vascular complications of Behcet disease-intracardiac thrombosis (<1-2%, less than 100 cases described worldwide) and pulmonary artery aneurysm (1-2%). Prompt introduction of immunosuppressant therapy was associated with a favorable outcome with no recurrence. We could speculate that, to some extent, the concomitant use of anticoagulants may have contributed to the complete resolution of the intracardiac thrombosis.Disclosure of Interests :MARIA DI CICCO: None declared, oscar massimiliano epis Consultant of: yes, Speakers bureau: yes, Cinzia Casu: None declared, Antonella Adinolfi: None declared, Luisa Alvaro: None declared, Valeria Campanella: None declared, Michel Chevallard: None declared, Marina Muscarà: None declared, Mariaeva Romano: None declared, Emanuela Schito: None declared, Nicola Ughi: None declared, Elisa Verduci: None declared, Davide Antonio Filippini: None declared
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44

Gupta, ShatavishaDas, Ranajoy Ghosh, Uttara Chatterjee, Chhanda Datta, Saurav Sarkar, Kaushik Mondal, and Madhumita Barua. "Potter′s sequence: A story of the rare, rarer and the rarest." Indian Journal of Pathology and Microbiology 58, no. 1 (2015): 102. http://dx.doi.org/10.4103/0377-4929.151202.

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45

Das, Barnita, and Modini Pandharpurkar. "A rare disease with a rarer presentation: Nodular episcleritis in Takayasu's arteritis." Indian Journal of Ophthalmology 70, no. 7 (2022): 2675. http://dx.doi.org/10.4103/ijo.ijo_2817_21.

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46

Philip, Rajeev, PPrem Patidar, Pankaj Agarwal, and KK Gupta. "A young diabetic with suicidal risk: Rare disease with a rarer presentation." Indian Journal of Endocrinology and Metabolism 17, no. 5 (2013): 920. http://dx.doi.org/10.4103/2230-8210.117218.

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47

Sett, Suvro S., John B. Mawson, and George G. S. Sandor. "Repair in infancy of right aortic arch with aberrant left brachiocephalic artery in the setting of a variant of the hypoplastic left heart syndrome." Cardiology in the Young 14, no. 4 (August 2004): 441–43. http://dx.doi.org/10.1017/s1047951104004147.

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A right aortic arch, with a retroesophageal transverse arch and an aberrant left brachiocephalic artery, is a rare anomaly by itself. When combined with severe mitral stenosis and hypoplasia of the left ventricle, it is rarer still. We describe the diagnosis and treatment of this rare anomaly in an infant using a modification of the Norwood operation.
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48

Hakim, Wasim, Rosalie Sherman, Tamer Rezk, and Kanwar Pannu. "An Acute Case of Herpes Zoster Ophthalmicus with Ophthalmoplegia." Case Reports in Ophthalmological Medicine 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/953910.

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Herpes zoster ophthalmicus (HZO) with oculomotor nerve involvement is rare, even rarer as an acute presentation rather than sequelae of HZO. In this paper we present a case of cutaneous HZO in which our patient's initial presentation was one of complete ophthalmoplegia.
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49

Fu, Jason, Lance M. Retherford, and Brigid Flynn. "Preterm Caesarean Delivery in a Parturient withCandida parapsilosisEndocarditis." Case Reports in Anesthesiology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/897645.

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We present the first documented case ofCandida parapsilosisinfective endocarditis in a pregnant patient. While the incidence of infective endocarditis during pregnancy is rare, the incidence ofC. parapsilosisendocarditis is even rarer. The numerous specific risks and decision making processes regarding this case are presented.
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50

Scafa, Anthony Kevin, Marco Giugliano, Marco Gallo, and Manolo Piccirilli. "Extradural hemorrhagic spinal cavernous angioma in a paucisymptomatic child: A rare case with review of the current literature." Surgical Neurology International 13 (March 31, 2022): 123. http://dx.doi.org/10.25259/sni_997_2021.

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Background: Cavernous angiomas, also referred to as cavernous hemangiomas or cavernomas (CMs), are vascular malformative benign neoplasms that may develop in any part of the central nervous system. Spinal CMs are uncommon (overall incidence rate of 0.04–0.05%). Pure epidural CMs account for 1–2% of all spinal CMs and 4% of all spinal epidural tumors. Diagnosis is extremely rare in the pediatric age. To the best of our knowledge, only 10 cases have been described so far. The treatment of choice is microsurgical resection. Case Description: We describe here the rare case of a cervicothoracic hemorrhagic spinal epidural cavernoma in a paucisymptomatic, 8-year-old female Bangladeshi child. C7–T2 laminectomy with excision of a scarcely defined, capsulated dark red lesion was performed with good recovery. Conclusion: Spinal epidural cavernomas are rare. Childhood presentation is even rarer. The reason could be found in a greater “compliance” and to a rarer occurrence of acute bleeding in children, thus resulting in a delayed diagnosis. Surgical excision is the gold standard of treatment.
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