We report improvements in debilitating cervicogenic dizziness (CD), as well as neck pain and upper and lower back pain, using Chiropractic BioPhysics[®] (CBP[®]) orthopedic rehabilitation with a one-year follow-up. CD is extremely debilitating and strongly impacts health outcomes. Reports of successful conservative treatments for CD combined with neck and spine pain with improved outcomes and sustained long-term results are rare, and this study adds to the literature. A 29-year-old female suffered from sudden-onset dizziness and frequent syncope elicited by cranio-cervical extension motions. The patient concomitantly reported moderate neck pain, upper mid-back pain, and low back pain, self-reported significant disability, and objectively displayed poor posture and altered spine alignment on radiography. Due to the worsening of her condition, she sought treatment at a facility in Shoreline, WA, USA. Following examination and diagnostic evaluation, she undertook an in-office treatment regimen. The multi-modal orthopedic regimen included postural exercises, postural spinal manipulation, and specific spinal structural traction. This combination Mirror Image (MI®) protocol has been shown to reduce pain and disability in musculoskeletal conditions, with improvement in CD and cervical lordosis. Following 68 in-office treatments over 5.5 months, all initial outcome assessments and physical, orthopedic, and neurological examinations were repeated and recorded. At the post-treatment assessment, the patient reported improvements in CD symptoms and neck, upper back, and lower back pain. Cervical lordosis improved from C2 to C7, measuring +9.4° (kyphotic) to -16.4° (lordotic). At the one-year follow-up, all outcome measures were stable; syncope was fully resolved, and 90% of the previously reported CD symptoms were resolved. Cervical lordosis remained stable at -17.6° (lordotic). This case documents successful treatment in a single patient using conservative spine and posture treatment protocols. This case report followed reporting guidelines. This study may contribute to the evidence aiming to fill the gap in the understanding of CD and potential conservative therapeutic interventions that are directed toward improving spine alignment.

Thevetia peruviana (yellow oleander) is an ornamental shrub found in tropical and subtropical regions, including tropical America. All parts of the plant are toxic due to cardiac glycosides, which can cause severe cardiotoxicity and arrhythmias. Poisoning is associated with significant mortality, often due to deliberate self-harm. This report describes a case of accidental ingestion of Thevetia peruviana seeds by a patient who believed that they could treat benign prostatic hyperplasia (BPH). The patient presented to the emergency department within 30 minutes of ingesting yellow oleander seeds with nausea, vomiting, and abdominal cramps. Although initial vital signs were stable, he developed sinus bradycardia and symptoms of cardiac glycoside toxicity, including dizziness, tachypnea, and visual disturbances. Lab results later showed a serum digoxin level of 4.04 ng/mL, and the poison control center recommended digoxin immune fab (DigiFab). He received a total of 15 vials intravenously, resulting in marked clinical improvement. He was monitored on continuous telemetry in the cardiac unit and discharged in stable condition after four days. Although DigiFab is not approved by the U.S. Food and Drug Administration for oleander poisoning, it remains the most effective reported antidote, and timely administration is crucial for successful management. Given the limited reports of oleander toxicity in the United States, this case highlights the risks of unregulated herbal remedies and the clinical presentation and management of oleander toxicity, underscoring the need for public education about oleander toxicity and the dangers of unregulated herbal remedies.

Background Conductive hearing loss (CHL) is a significant contributor to hearing impairment, especially in low-income settings. Chronic suppurative otitis media (CSOM) is often a dominant cause in developing regions. This study examined the causes and clinical profiles of patients with CHL at Khartoum Ear, Nose and Throat (ENT) Hospital. Methods We conducted a retrospective descriptive cross-sectional study of 106 patients diagnosed with CHL (confirmed by audiometry or tuning-fork testing) who presented between October 2021 and March 2022. Demographic data, etiologies, and associated symptoms were extracted from medical records and analysed descriptively. Results The cohort (mean age 27 years) comprised 61 (57.5%) female patients, predominantly young adults with 54 (51%) patients aged 18-35 years. CSOM was the leading cause of CHL, affecting 50 (47.2%) patients, far exceeding other etiologies. Smaller proportions were due to ear canal foreign bodies in seven (6.6%) participants, external auditory polyps in seven (6.6%), otosclerosis in five (4.7%), and various others (each <4%). The majority of cases were acquired, seen in 99 cases (93.4%) and only four (3.8%) were congenital cases. Most patients had mild-to-moderate hearing loss, with 50 (47.2%) patients reporting progressive loss. Common accompanying symptoms included ear discharge in 70 people (66.0%), tinnitus in 62 (58.9%), ear pain in 61 (57.5%), vertigo in 36 (34.0%), and ear itch in 28 (26.4%) participants. Conclusion CSOM predominated as the etiology of CHL in this Sudanese ENT hospital, reflecting a high burden of preventable ear infection. The findings underscore the need for early detection and management of CSOM and related conditions to reduce CHL. The data from this study highlights the need for public health intervention in tackling preventable infectious diseases in Khartoum.