HPV comprises a family of over 200 genotypes, which can be loosely categorized based on oncogenicity into low risk (LR) and high-risk (HR) genotypes. LR genotypes, such as 6 and 11, preferentially infect cutaneous sites to cause skin warts and condyloma acuminata. HR genotypes, such as 16, 18, 31, 33, 45, 52 and 58, among others, preferentially infect mucosal sites and are associated with the development of certain vaginal, vulvar, cervical, penile, anal and oropharyngeal cancers.
A cross-sectional study was conducted from November 2018 to May 2019 in and around Jinka town, to assess the community’s knowledge, attitude, and practice on common zoonotic disease. A total of 330 randomly selected participants had voluntarily filled the semi-structured questionnaire. Accordingly, age, religion, education, occupation and marital status of the respondents were significantly associated with their knowledge on the zoonotic disease.
The novel corona virus (2019-nCoV, or COVID-19) epidemic started in Bethlehem/Palestine and spread to many Palestinian cities and villages. The numbers of new infections in Palestine are increasing, which have activated all the public health, governance and even private concerns. A series of mandatory actions have been taken by the ministry of health (MOH), governmental and community support.
COVID-19 is one of the greatest global health pandemic crises of the 21th century, affecting millions of people worldwide. Neither known treatments nor vaccines currently exist for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as a result, the disease is spreading throughout the world causing health and economic consequences
The first and only Corona Israeli hospital opened on March 2020 designated to treat positive COVID-19 in-patients solely. We present our clinical experience and outcome on 52 COVID-19 in-patients on Corona B department. The research cohort included 52 COVID-19 adult Israeli patients. Information on epidemiologic, demographic, clinical, laboratory, imaging and treatments features. Research individuals were categorised into disease severity categories of mild versus moderate and severe disease was compared.
A 78-year-old man presented to our hospital with a 1-year history of abdominal distension and constipation. Except for hypertension, he had no documented medical history. Physical examination was unremarkable. Laboratory examination confirmed no abnormality. Although no clues for abdominal distension were found, esophagogastroduodenoscopy demonstrated a large pedunculated duodenal mass with surface erosions. It was removed successfully with nylon loop
followed by snare resection. Pathological examination revealed massive Brunner gland proliferation and an abnormal architecture, which was consistent with the Brunner gland adenoma. Helicobacter pylori testing was negative.
COVID-19 is a worldwide public health problem that has attracted much attention due to its clinical and para-clinical findings. In the western Asia, Qom was the first city to report COVID-19 cases on a large scale. We report gastrointestinal (GI) manifestations, as the only primary signs of COVID-19 infection have been reported. Data were obtained from patients, referred to GI clinics in Qom city, from February 25th to March 15th, 2020 who had refractory GI symptoms but there was no detection of digestive diseases after typical medical examinations. They were requested to do follow up tests, eventually the patients were tested for COVID-19. The presence of COVID-19 was confirmed based on the WHO guidelines.
Now-a-days chronic liver disease is one of the major health problems in the world. In developing countries, chronic liver disease due to hepatitis virus (like hepatitis B and hepatitis C virus) is increasing day by day. It is rapidly emerging as a major health problem. So, the present study was conducted to document the hepatitis B and hepatitis C virus in patient with chronic liver disease by an easy and simple marker like HBsAg, Anti HBc (total) and Anti HCV in a tertiary hospital.
It is said that no discovery is complete until its implications have been fully realized. The identification of a previously unrecognized phenomenon says little of its potential effects. What appears as a stroke of good luck can culminate in disaster; misfortune may harbor unimagined potential. Discovery is a double-edged sword that manifests only over time. Nowhere is this aphorism more applicable than in contemporary medical science. The tried-and-true mode of discovery in 20th century medical therapeutics falls along this line: the beneficial effect of a substance is observed empirically during random testing or, conversely, new compounds are synthesized based on some existing pharmacologic principle; the substance undergoes testing in animals and, if no undesirable consequences ensue, clinical studies in humans are conducted.
Antibiotic drugs are the most frequently prescribed medications among hospitalized patients for life-saving purposes, mainly in immunocompromised patient, like in patient with end stage renal disease on hemodialysis (HD) or those who had documented bacterial infection. Antibiotics disposition and their pharmacokinetics and pharmacodynamics properties are affected in hemodialysis patient which increases the number of antibiotics dosing errors. Several epidemiological studies found that the majority of medication error related to antibiotics occurred during the prescribing phase (30.8%). However, there is missing data about the prevalence of errors in antibiotics dosing in HD patients.
We report the case of 69 years old female with a history of uncontrolled type 2 diabetes, who presented refractory and chronic right-sided purulent otorrhea with temporal headaches for 6 months, treated with no improvement by multiple attempts of ambulatory empiric therapy. After the appearance of grade III facial palsy and painful swelling in the right periorbital and zygomatic areas, the patient consulted in our department where a CT scan showed massive cortical and trabecular destruction of the right petrous bone and the mastoid extended to the lateral orbital wall, the zygomatic arch and the greater sphenoid wing realising extensive osteomyelitis of the skull base and the lateral face. The treatment was started immediately based on intravenous broad-spectrum antibiotics. Despite aggressive long-term treatment, the patient passed away, underlying the increased SBO morbidity and mortality secondary to delayed diagnosis.
Pseudomeningoceles are rare complications of laminectomy surgery. Such clinical condition results from an inadvertent surgical dural rupture. We describe in the present study the report of a patient who developed iatrogenic pseudomeningocele in the lumbar region after performing a left laminectomy in L5 topography. After the neurological assessment of the patient, bilateral hypoaesthesia was observed, in addition to a floating bulging in the lumbar region that was accentuated during the valsalva maneuver, with the hypothesis of a pseudomeningocele.
Alzheimer’s disease (AD) is the most common degenerative brain disease in the aged population. By 2050, AD prevalence is expected to increase from 4.7 million (based on 2010 census) to 13.8 million people. It is characterized by the progressive decline of cognition and memory, as well as changes in behavior and personality. Pathological hallmarks of AD include mainly formation of senile plaques consisting of amyloid-beta (Aβ) peptide in the intercellular space and neurofibrillary tangles (NFTs) in the cell bodies, which are primarily composed of abnormally modified tau protein.
This simple method specifically stained ramified microglia in rat cerebral cortex, and the quality was quite comparable to that obtained by an indirect fluorescent antibody technique (IFAT) and an avidin biotin-peroxidase complex method (ABCM). The DFAT also clearly stained activated microglia in axotomized rat facial nucleus, and the quality was equivalent to that obtained by the ABCM.
Tuberous Sclerosis Complex or Bourneville’s disease is an autosomal dominant disease with high penetrance and variability characterized by multisystem involvement by benign lesions, originally defined by the classic triad of Vogt: sebaceous adenoma, epilepsy and mental retardation. The involvement of the brain is responsible for a significant proportion of the morbidity and mortality of this disease and skin lesions are the most common manifestations. The authors report 31-year-old patient case referred to the service by intractable epilepsy with definitive clinical criteria for tuberous sclerosis.
This is a report to create awareness among clinicians on a very rare condition of thunderclap headache. A 51-year-old lady presented with recurrent thunderclap headaches over the preceding 3 days. This presentation sounds like Subarachnoid haemorrhage initially, but further investigation revealed reversible cerebral vasoconstriction syndrome. In this report, the clinical presentation, investigation and management for Reversible Cerebral Vasoconstriction Syndrome (RCVS) including its outcome are described.
Priapism as such is rare in spinal cord injury. It can be ischemic or non ischemic Priapism. The ischemic variety is painful and spontaneous while non ischemic is painless making diagnosis delayed. Penile gas gangrene in spinal cord injury is rare, but could be initiated in patients with ischemic Priapism as a triggering factor. Mortatility can be reduced by awaring care givers, general practitioners and paramedical staff about absence of penile pain in Priapism underlying spinal cord injury , which needs early recognition and appropriate management.
The aim of this study was to assess, identify and have a better understanding of the importance of patient safety culture within the healthcare organization and to create insights on the impact of cultural management systems regarding patient safety. The research method of this study is an integrated literature of the patient safety culture and perspectives of healthcare workers, assessed using the Modified Stanford Instrument (MSI) and Manchester Patient Safety Framework (MaPSaF).
The pandemic scenario created by the Severe Acute Respiratory Syndrome – Coronavirus-2 (SARS-CoV-2) brought physical and psychological distress among people who found themselves under a situation which unabled most of them to proceed with their usual routine or rites of passing to cope with losses of lifestyle, relatives, and friends. This short review explores the role of mourning rites as coping mechanisms in order to maintain mental stability during the stressing scenario proposed by the pandemic.
Everybody is born with the mammary gland. Mammary gland development occurs through various stages throughout embryonic, and stays dormant for males. Although it is uncommon, male also gets breast cancer, occasionally. Male breast cancer accounts for approximately 1% of all breast cancer cases, and it is increasing. When compared with other rare diseases, male breast cancer is understudied. Typically, male breast cancer is treated in the same way as female breast cancer. In this article, the various aspects and attributes of male breast cancer and its treatment methods are reviewed.
Outcome of most of the biliary and pancreatic malignancy is not good. Demography and involvement of different sites of these malignancies by endoscopic retrograde cholagiopancreatography (ERCP) are not widely studied in Bangladesh. We have studied ERCP based different biliary and pancreatic malignancy and their demographic characteristics.
Primary adenocarcinoma of the duodenum is a rare clinical condition, accounting for only 5% of all gastrointestinal neoplasms and 0.5% of all intestinal neoplasms. Nonspecific clinical presentation contributes to the majority of cases being diagnosed in advanced stages. The prognosis is poor, with a median survival of five years, varying from 23% to 57% in patients undergoing curative surgery (cephalic duodenopancreatectomy).
The ongoing COVID-19 pandemic has now thrown us into turmoil by adversely affecting the entire socio-economic structure of the world. Currently (Dec 20, 2020), there are 76.4 million incidences worldwide and 17.6 million in the USA, and counting. Primarily in this scenario, all the resources available at hospitals and medical care units are reasonably redirected to address the contagious COVID-19 infected patients. This is an issue for a cancer patient, who may be at risk or infected with Coronavirus needs to be managed amid multiple unknown complications.
The appendix testis may be involved in the normal testicular descent and there are reports of decreased incidence of appendix testis in children with undescended testis. The aim of this study was to evaluate the incidence of appendix testis in children with undescended testis in comparison to the incidence in children with normally descended testis.
We experienced a rare case of 9-months-old girl with an abdominal neuroblastoma that exhibited radiographic evidence of tumor extension into the mesenteric artery. Imaging studies were suggestive of neuroblastoma which also confirmed by the histologic analysis that show a diagnosis of neuroblastoma too. The patient never underwent initial chemotherapy for the treatment of neuroblastoma but experienced operation for tumor and resection was successfully achieved. This case and the treatment strategy are discussed in this paper.
This article reports a case series of children diagnosed of Acute Idiopathic Scrotal Edema in a secondary referred hospital over a 10-year period, including the description of its clinical manifestations, management and evolution of this condition. A retrospective chart review was performed. It was found to include 11 patients, between 19 months and 12 years old, who presented scrotal edema and/or erythema with no self-explanatory trigger.
A 10-year-old girl is evaluated in the Emergency Department (ED) for acute pain, blurred vision and swelling of her left eye, which worsened when blowing her nose, after a contusion. She had hit her left eye with her knee while playing on a trampoline earlier that morning. The patient’s past history is unremarkable other than allergic rhinitis and sinusitis.
Leukodystrophy is a typical example of progressive cerebral periventricular white matter brain disorders. The occurrence of leukodystrophic white matter on magnetic resonance imaging in with children non-progressive poorly defined non-specific disorders has been recognized.
Diagnosis of inflammatory myopathy are usually based on clinical examination and histopathology of the muscles and muscle biopsy, usually guided by PET-CT. This is not uncommonly presented by extramacular signs like interstitial lung disease, dysphagia, few skin signs, loss of weight, arteritis, cardiomyopathy, Pulmonary hypertension, respiratory failure, and cancer.
Extramedullary plasmacytoma is a rare disease, characterized histopathologically by infiltration of plasma cells of different maturities and producing monoclonal immunoglobulin outside the bone marrow. J.R.G., 52 years old, male, sought medical assistance due to amaurosis and blocked eye movements. We performed Magnetic Nuclear Resonance of the skull that showed discrete intermediate signal tissue, next to the optic nerve canal and homolateral superior orbital fissure, with slight extension to the lower orbital fissure, associated with thickening of the corresponding meninges, involving the proximal portion of the optic nerve, measuring 1.3 x 1.1 x 2.5 cm. Non-specific aspect, but suggestive of lymphoproliferative lesion. Right and extraorbital tumor excision was performed, in which it was not possible to completely resect the tumor.
We report the laboratory results of conjunctival RT-PCR tests and some clinical features of these patients infected with COVID 19 in Shenyang, China. We collected conjunctival samples of the patients to do the laboratory tests by RT-PCR Medical observed patients were enrolled if they had clinical symptoms. Then we analyzed the RT-PCR results and clinical features in order to find some relationships. The study includes 14 confirm diagnosed cases 16 suspected cases and some medical observed patients. One of these patients who was suspected as COVID-19 case at initiate visit diagnosed positive finally, and 22 medical observed cases were excepted with negative clinical and RT-PCT results. All the conjunctival results of RT-PCR test were negative.
This retrospective study analysed patients diagnosed as penetrating ocular traumatic endophthalmitis between January 2016 to January 2019 at a hospital, Liaoning province, China. Epidemiological data including age, gender, traumatic agents, time from trauma to endophthalmitis onset, culture results, treatment, visual acuity and prognosis. Risk factor analysis was used to compare presented data.
This report describes a complication of symptoms consistent with transiency visual acuity damage and hearing injury following sclerotherapy with a polidocanol injection to a facial vascular malformation. After the direct injection of 5cc polidocanol-room air emulsion into the subcutaneous malformation, a 3-year-old boy developed bilateral eyelid swelling the next day, and on 7 days later at referral, visual acuity in the left eye was light perception.
The present study included 210 inpatients, out of them 180 were diagnosed as suspected cases of sepsis in the period over 12 months from December 2018 to December 2019, at a private hospital in Cairo, Egypt. Out of 210 investigated cases 180 (85.7%) were infected. Single bacterial isolates were recovered from 120 cases (66.7%), while 60 (33.3%) cases were found to be carrying more than one bacterial isolate. The results of the current study revealed that 34.4% (62/180) of isolates were Gram-positive and 65.6% (118/180) were Gram-negative.
Streptococcus pyogenes is the most common bacterial agent of sore throat. However, prescription of antibiotics due to clinical diagnosis only could disturb the microbiota and result in antibiotic resistant. 591 throat swabs samples were obtained from 308 participants. Swabs culture followed by isolation of all types of bacterial growth, which were subjected to morphological, microscopic and biochemical analysis.
To present a newsworthy hypothesis that illustrates how pollution predisposed long-term living and elderly population to an exacerbation of any preexisting inflammatory conditions, linked to NLRP3 inflammasome overregulation, in individuals with Alzheimer’s Disease (AD) and SARS-CoV-2 infections. Also, to discuss the possibility of correlation between AD/SARS-CoV-2 infection and air pollution.
Many herbs and natural food materials have been historically recognized as an effective panacea that can establish a balanced inflammatory response and promote healthy immune response as well as have antibacterial and viral effects. The clinical use of some medications can cause serious side effects. We propose that natural ingredients could serve as food supplement immune tonic with antibacterial & antiviral properties that serve as a better prophylactic and therapeutic approach against COVID-19 and others infections.
This prospective cohort study analyzed the role and use of tranexamic acid (ATX) in control of bleeding in patients undergoing primary total hip arthroplasty. The observation was based on administration of a single dose of venous tranexamic acid 20 mg per kg of weight of patients after anesthetic induction. A group of 40 patients admitted for the treatment of hip coxarthrosis during December 2017 to December 2019 were evaluated in this study. In this group, 20 patients used ATX and others were related in the control group.
The aim of the present study was to evaluate the efficiency of knee physical examination routinely used in orthopedic clinical practice for the diagnose of meniscal injuries. This study was based on a review of medical records of patients submitted to knee arthroscopy to treatment meniscal lesions clinically diagnosed in the Gaffrèe & Guinle University Hospital at the knee outpatient clinic from 2011 to 2013.
A Lumbar spinal stenosis is characterized by a central or transforaminal ways of compression which results in pain and compressive functional progressive loss. Studies show that the best form of treatment for this condition is a surgical decompression that has lately been associated with endoscopy video.
Twenty patients with lombar disc hernia and indication of surgical treatment were randomly allocated into two groups. The first group received 150 mg of pregabalin one hour before the anesthetic indication, the second group received conventional treatment without pregabalin. After the surgeries, the patient was asked to identify the intensity of his pain on a visual scale. The pain assessment occurred 24 hours and 7 days after the procedure.
Postoperative nerve root injury with dysesthesia is the most frequent sequela following lumbar endoscopic transforaminal discectomy. At times, it may be accompanied by transient and rarely by permanent motor weakness. The authors hypothesized that direct compression of the exiting nerve root and its dorsal root ganglion (DRG) may play a role by manipulating the working cannula or endoscopic instruments.
Surgical site infection (SSI) is a devastating complication of any surgery with negative impact on health care system worldwide. SSIs after orthopedic procedures have a wide range of effect on mortality and morbidity involving loss of implants and extension to bone and joint. This study aimed to determine the incidence of SSIs after different orthopedic procedures and their risk factors. Determining the characteristics of these SSIs and the common pathogens responsible for them were also aimed.
Epidermolysis Bullosa (EB) is a rare, heritable skin disease that encompasses several subtypes, which vary widely in presentation and prognosis. One subtype, Recessive Dystrophic Epidermolysis Bullosa (RDEB), is especially rare and debilitating. It occurs due to a mutation in the COL7A1 gene that encodes for type VII collagen leading to chronic, diffuse skin and mucosal blistering. Given the rarity of the disease, guidelines for treatment of pregnant patients with RDEB do not currently exist. This case describes the pregnancy course of a 21-year-old female with RDEB.
Proportion of elderly individuals in the population has increased, consequently, practitioners are often confronted to wound healing in elderly patients. The objective of this article is to approach skin aging and its consequences on skin healing, disorders of skin healing due to dermatoporosis and finally, specific comorbidities of the elderly that can cause wound healing perturbations. Considering these specificities, skin healing in the elderly is complicated and require a multidisciplinary management.
Tourette’s syndrome is a complex genetic disorder characterized by repetitive, sudden, or tic-like movements. Tics usually appear in childhood and their severity changes over time. In most cases, tics are less common in the last years of adolescence and adulthood. People with Tourette’s syndrome perform repetitive, involuntary movements known as tics. In addition, people with Tourette’s syndrome make sounds that are incomprehensible. Some tics involve only one muscle group, such as the occasional blinking or contact of the chin with the shoulder, or the shaking of the nostrils, which are usually the first
signs of Tourette’s syndrome.
The immune infiltration and molecular mechanisms underlying septic cardiomyopathy (SC) have not been completely elucidated. This study aimed to identify key genes related to SC and elucidate the potential molecular mechanisms. The weighted correlation network analysis (WGCNA), linear models for microarray analysis (LIMMA), protein-protein interaction (PPI) network, CIBERSORT, Kyoto Encyclopedia of Genes and Genomes pathway (KEGG), and gene set enrichment analysis (GSEA) were applied to assess the key pathway and hub genes involved in SC.
Lupus Nephritis (LN) is one of the most common and serious manifestations in SLE patients that causes significant morbidity and mortality. Current conventional biomarkers for lupus nephritis like urine sediments, proteinuria, anti-dsDNA antibodies and C3 or C4 are sometimes mislead for prediction of treatment response. Recently IL-2 R alpha has shown to be a good marker to predict treatment response of lupus nephritis.
This is an entrancing case report of extremely severe metabolic acidosis occurred to a 46-year-old female who was admitted to intensive care medicine, Ninewells hospital. She presented with vomiting and collapsed with significant deranged metabolic acidosis. Despite carrying very guarded prognosis on admission, fortunately she survived following effective management from multidisciplinary team in the hospital. This case describes the metabolic acidosis in association with the mortality including the clinical presentation, management and the outcome.
The present paper proposes an interpretation of quantum mechanics whereby the matter wave and its eigenstates are formed through an underlying, bifurcative self-interaction of the quantum field. Subsequently it will be shown that based on the latter the proton-to-electron mass ratio can accurately be calculated.
The application of local anesthetics is frequently involved in anesthesia in the surgical treatment of various cancers. It is used in addition to or instead of general anesthesia as a way to provide control of sensation and pain to specific regions or parts of the patients’ bodies. They are thought to reduce the requirement for volatile anesthetics and opioids used in the surgery. This mini-review briefly summarized and commented on the frequent use of local anesthetics in cancer surgeries.
Cyclophosphamide (CP) is used for the treatment of ovarian cancer, breast cancer, chronic lymphocytic leukemia, non-Hodgkin’s lymphoma, neuroblastoma, soft tissue sarcoma, rhabdomyosarcoma, and Wilms’ tumor. It causes dyslipidemia in experimental animals. Zinc oxide is the most widely used nanoparticles among various nanomaterials. Zinc oxide nanoparticles were ameliorated hepatotoxicity, hematotoxicity oxidative stress, and disturbance in the antioxidant defense system induced by cyclophosphamide in experimental animals.
Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiorespiratory symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period. We report a case of a 74-year-old female who presented with one-month history of progressive shortness of breath and left sided chest pain.
The recommended treatment for ventricular thrombosis is based on vitamin K antagonists use for at least 3 months. Till now there are not completed trials that allow use of direct oral anticoagulants for this specific complication in neither chronic nor acute settings. We report the case of a subacute left ventricular apical thrombosis complicating a myocardial infarction in a 78-years-old patient effectively treated with low-dose apixaban (2.5 mg twice daily) associated with dual antithrombotic therapy.
Ovarian torsion refers to the complete or partial rotation of the ovary on its ligamentous supports, often resulting in impedance of its blood supply. It is one of the most common gynecologic surgical emergencies and may affect females of all ages. Torsion of the ovary in the pregnancy is very rare and it commonly occurs during the third trimester. It is frequently associated with ovary stimulation in In-vitro-fertilisation (IVF) or Ovary masses.
Endometrial cancer (EC) is the sixth most common cancer in women and accounts for about 8.2 % of the worldwide incidence of cancer in women. Its incidence varies across regions and is rising as life expectancy increases. Although, there have been significant recent advances in our understanding of endometrial cancer. But there is paucity of a reliable screening test. When diagnosed at an early stage, EC is highly curable and has excellent overall 5 –year survival rates.
Early treatment of pain is of a great importance as unrelieved pain can have profound psychological effects on the patient, and acute pain that is poorly managed initially can degenerate into chronic pain, which may prove to be much more difficult to treat. In this review article, we will shed the light on different ways of some analgesic drugs monitoring and analysis using different techniques in addition to the most recommended combinations of our cited drugs for pain relief.
The objective of the study is to investigate the inhibitory activity of selected flavonoids from the plant Carica Papaya Linn. using molecular docking against SARS-CoV-2 or Covid-19. In silico bioinformatics tools was used to investigate the capabilities of flavonoids as an acclamatory inhibitor of Covid-19. The 3D structure of the receptor was retrieved from PDB and of the ligands from PubChem databases. Docking analysis of the selected compounds was performed employing Autodock and PyRx.
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