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Background: Progressive multifocal leukoencephalopathy (PML) is a rare and fatal opportunistic viral demyelinating infectious disease of the central nervous system (CNS). There are various clinical presenting symptoms for the disease. Case presentation: This paper presents a clinical case of PML in a patient with B-Chronic lymphocytic leukemia (B-CLL), previously treated with Chlorambucil, later complicated later with COVID-19 and mucormycosis. Conclusion: PML can develop in the setting of cellular immune dysfunction. Late diagnosis of this disease based on nonspecific symptoms is common, therefore when we face a neurological complication in a CLL or immunocompromised patient, we should consider PML infection. A remarkable feature of this case is the possible triggering effect of COVID-19 vaccination for emergence of PML as the disease can be asymptomatic or sub-clinical before diagnosis. [ABSTRACT FROM AUTHOR]

Background: Depression and sleep disorders are interrelated and have high prevalence. Based on previous findings, medical students experience high rates of depression and low sleep quality, due to the challenges during medical training programs. During the COVID-19 pandemic, medical students faced extra physical and psychological pressure. This study aimed to evaluate sleep quality and depressive symptoms and their possible association among medical students during COVID-19 pandemic. Results: One hundred twenty-one medical students completed the survey. Twenty-six percent of participants had a good sleep quality. Mean sleep duration of participants was approximately 6 h per day. Moreover, they had a mean sleep latency of 28 min and a mean PSQI score of 7.76. We found the prevalence of moderate, moderately severe, and severe depression among participants to be 22%, 6%, and 7%, respectively. The participants' mean PHQ-9 score was found to be 8.4. Conclusions: We found a relatively high depression rate, poor sleep quality, and a significant inverse relationship between sleep quality and depression severity score among medical students who were doing their clinical rotations during the COVID-19 pandemic. Additionally, quarter of moderate to severely depressed participants were taking antidepressants. Our findings highlight the need for future interventional studies that address these issues among medical students. [ABSTRACT FROM AUTHOR]

Introduction: Kleine-Levin syndrome (KLS) is a rare disorder often associated with recurrent hypersomnia, first described by Klein in 1925 but named in 1942 by Critchley and Hoffman. KLS is more common in adolescence and is also more common in men than women. It must be distinguished from repetitive depressive disorder, or psychotic disorder. Case Presentation: In this report, we present a 27-year-old woman with KLS who showed symptoms such as overeating and mood changes, unwillingness to talk to anyone, and a sedentary lifestyle. Meanwhile, during these periods, other symptoms such as lack of speech, decreased energy, lethargy, and slowness of mental and mood movements were observed in the patient. Eventually, with lithium consumption, her symptoms improve significantly. However, the exact cause of this syndrome and its definitive treatment is still unknown and will require further reports and studies. [ABSTRACT FROM AUTHOR]