Pub Date : 2024-08-08DOI: 10.1097/ms9.0000000000002439
Jafar Sallameh, Majd Mansour, Abdallah N. Mansour, Ali Afif, Abdalkareem Klayshe, Emad Shahin
Avascular necrosis (AVN) is a rare occurrence in the carpal region, especially in the triquetrum bone, which presents a diagnostic puzzle due to its infrequency and lack of trauma history. This case study explores the signs, diagnosis, and treatment of AVN in a healthy 22-year-old individual, emphasizing the need for early identification using suitable imaging methods. A 22-year-old patient complained of persistent wrist pain, specifically on the ulnar side, without any history of injury. Clinical examination revealed tenderness without signs of inflammation, with normal sensation and movement. Initial X-ray results were inconclusive, prompting further investigation with MRI, which showed a decrease in signal intensity in the triquetrum bone, leading to the diagnosis of AVN. The development of AVN involves compromised blood flow, often due to various factors. While AVN affecting carpal bones is uncommon, the triquetrum bone’s robust blood supply typically protects against such conditions. However, this case highlights an exceptional occurrence. Gelberman’s classification underscores the triquetrum’s vascular nature, explaining why AVN is rare in this bone. MRI plays a crucial role in detecting AVN, especially when symptoms do not align with X-ray findings. Avascular necrosis should be considered in carpal bones, even without a history of trauma, with a focus on MRI for early detection. Although AVN of the triquetrum is rare, this case underscores the importance of timely recognition and conservative management. Further research is necessary to establish optimal treatment strategies for this unusual presentation.
{"title":"Unveiling the uncommon: A case report of avascular necrosis in the triquetrum bone without trauma","authors":"Jafar Sallameh, Majd Mansour, Abdallah N. Mansour, Ali Afif, Abdalkareem Klayshe, Emad Shahin","doi":"10.1097/ms9.0000000000002439","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002439","url":null,"abstract":"\u0000 \u0000 Avascular necrosis (AVN) is a rare occurrence in the carpal region, especially in the triquetrum bone, which presents a diagnostic puzzle due to its infrequency and lack of trauma history. This case study explores the signs, diagnosis, and treatment of AVN in a healthy 22-year-old individual, emphasizing the need for early identification using suitable imaging methods.\u0000 \u0000 \u0000 \u0000 A 22-year-old patient complained of persistent wrist pain, specifically on the ulnar side, without any history of injury. Clinical examination revealed tenderness without signs of inflammation, with normal sensation and movement. Initial X-ray results were inconclusive, prompting further investigation with MRI, which showed a decrease in signal intensity in the triquetrum bone, leading to the diagnosis of AVN.\u0000 \u0000 \u0000 \u0000 The development of AVN involves compromised blood flow, often due to various factors. While AVN affecting carpal bones is uncommon, the triquetrum bone’s robust blood supply typically protects against such conditions. However, this case highlights an exceptional occurrence. Gelberman’s classification underscores the triquetrum’s vascular nature, explaining why AVN is rare in this bone. MRI plays a crucial role in detecting AVN, especially when symptoms do not align with X-ray findings.\u0000 \u0000 \u0000 \u0000 Avascular necrosis should be considered in carpal bones, even without a history of trauma, with a focus on MRI for early detection. Although AVN of the triquetrum is rare, this case underscores the importance of timely recognition and conservative management. Further research is necessary to establish optimal treatment strategies for this unusual presentation.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"27 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1097/ms9.0000000000002451
Sharada K C, Parag Karki, Abhikanta Khatiwada, Saroj Pokhrel
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. While only a few of those born with this anomaly survive into adulthood, it becomes an extremely rare diagnosis in adults. Here, we present a case of ALCAPA in a symptomatic adult female with angina and palpitations that was repeatedly missed on transthoracic echocardiogram. The adult type of ALCAPA is often missed due to non-specific changes in electrocardiogram, leading to reluctance for angiography. Therefore, identifying abnormal coronaries in echocardiogram is crucial. It is essential to consider anomalous coronary arteries as a differential diagnosis in patients with chest pain, despite their rarity. This case report highlights the role of various cardiac imaging modalities in improving the diagnostic yield of ALCAPA.
{"title":"Anomalous left coronary artery from the pulmonary artery in a symptomatic adult, a case report","authors":"Sharada K C, Parag Karki, Abhikanta Khatiwada, Saroj Pokhrel","doi":"10.1097/ms9.0000000000002451","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002451","url":null,"abstract":"\u0000 \u0000 Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. While only a few of those born with this anomaly survive into adulthood, it becomes an extremely rare diagnosis in adults.\u0000 \u0000 \u0000 \u0000 Here, we present a case of ALCAPA in a symptomatic adult female with angina and palpitations that was repeatedly missed on transthoracic echocardiogram.\u0000 \u0000 \u0000 \u0000 The adult type of ALCAPA is often missed due to non-specific changes in electrocardiogram, leading to reluctance for angiography. Therefore, identifying abnormal coronaries in echocardiogram is crucial.\u0000 \u0000 \u0000 \u0000 It is essential to consider anomalous coronary arteries as a differential diagnosis in patients with chest pain, despite their rarity. This case report highlights the role of various cardiac imaging modalities in improving the diagnostic yield of ALCAPA.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"43 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1097/ms9.0000000000002173
Basel A. Zaben, Ahmad M. Abualrub, Waleed M. Malhes, Anas M. Barabrah, Anas R. Tuqan, Ibrahem A. Tahhan, Wael Amro
Biliary atresia is a rare, progressive cholangiopathy that affects newborns, causing jaundice and other manifestations of hyperbilirubinemia. The incidence is higher in Asia than in Europe. The only available treatment is a surgical operation called Kasai portoenterostomy. In our case, we highlighted rare congenital anomalies that came with biliary atresia. A 10-day-old male infant was admitted to the hospital due to recurrent vomiting, yellowish skin, and scleral icterus. Laboratory investigations revealed elevated total serum and direct bilirubin levels. An atrophic gallbladder was observed on ultrasound. Intrahepatic cholangiography confirmed the diagnosis of biliary atresia, leading to the performance of a Kasai procedure. Additionally, the patient had intestinal malrotation and volvulus, which were managed with a Ladd’s procedure. Following surgery, there was notable improvement in liver enzymes and bilirubin levels, and the patient was discharged after 7 days. The infant has been initiated on oral vitamins, ursodeoxycholic acid, and antibiotics. Biliary atresia is a challenging condition characterized by progressive narrowing and fibrosis of the biliary tree. It is rarely associated with rare congenital anomalies like situs inversus totalis, intestinal malrotation, and volvulus. Diagnosis involves abdominal ultrasound and MRCG. The biliary atresia was managed by the kasai procedure and the intestinal malrotation, and volvulus were managed by Ladd’s procedure. This case report highlights the importance of considering rare associations such as situs inversus, intestinal malrotation and volvulus in the diagnosis of biliary atresia in newborn. Early diagnosis and prompt intervention are crucial for optimal outcomes.
{"title":"Biliary atresia with rare associations: a case report and literature review","authors":"Basel A. Zaben, Ahmad M. Abualrub, Waleed M. Malhes, Anas M. Barabrah, Anas R. Tuqan, Ibrahem A. Tahhan, Wael Amro","doi":"10.1097/ms9.0000000000002173","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002173","url":null,"abstract":"\u0000 \u0000 Biliary atresia is a rare, progressive cholangiopathy that affects newborns, causing jaundice and other manifestations of hyperbilirubinemia. The incidence is higher in Asia than in Europe. The only available treatment is a surgical operation called Kasai portoenterostomy. In our case, we highlighted rare congenital anomalies that came with biliary atresia.\u0000 \u0000 \u0000 \u0000 A 10-day-old male infant was admitted to the hospital due to recurrent vomiting, yellowish skin, and scleral icterus. Laboratory investigations revealed elevated total serum and direct bilirubin levels. An atrophic gallbladder was observed on ultrasound. Intrahepatic cholangiography confirmed the diagnosis of biliary atresia, leading to the performance of a Kasai procedure. Additionally, the patient had intestinal malrotation and volvulus, which were managed with a Ladd’s procedure. Following surgery, there was notable improvement in liver enzymes and bilirubin levels, and the patient was discharged after 7 days. The infant has been initiated on oral vitamins, ursodeoxycholic acid, and antibiotics.\u0000 \u0000 \u0000 \u0000 Biliary atresia is a challenging condition characterized by progressive narrowing and fibrosis of the biliary tree. It is rarely associated with rare congenital anomalies like situs inversus totalis, intestinal malrotation, and volvulus. Diagnosis involves abdominal ultrasound and MRCG. The biliary atresia was managed by the kasai procedure and the intestinal malrotation, and volvulus were managed by Ladd’s procedure.\u0000 \u0000 \u0000 \u0000 This case report highlights the importance of considering rare associations such as situs inversus, intestinal malrotation and volvulus in the diagnosis of biliary atresia in newborn. Early diagnosis and prompt intervention are crucial for optimal outcomes.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"12 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1097/ms9.0000000000002436
Hui-yan Li, Haixiao Wu, Chao Zhang
{"title":"A pocket practical guide on bibliometric analysis: bridging informatics with science in a rapid manner","authors":"Hui-yan Li, Haixiao Wu, Chao Zhang","doi":"10.1097/ms9.0000000000002436","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002436","url":null,"abstract":"","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141928857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1097/ms9.0000000000002379
Wissal Touzri, Mohamed El Arbi Tahiri Alaoui, Oussama Bentahar
Lop ear is a congenital auricular deformity (CAD) detected at birth. It can negatively impact aesthetic appearance and the mental health of both the parents and the infant. Therefore, a treatment initiated at an early age is imperative. A male newborn patient on his 11th week of his life presented with his mother to the Maxillofacial Prosthodontic Unit. The extraoral examination showed a pendulous upper part of the auricle covering the antihelix with no deficiencies. The newborn’s hearing function was normal and no associated syndrome was identified. The patient was diagnosed with congenital unilateral lop ear (Tanzer grade II constricted ear). A non-surgical correction with a classic ear moulding device was attempted at the 11th week after birth to reshape the abnormal ear. Congenital auricular deformities (CADs) are traditionally managed by an otoplasty at age 6. Unfortunately, this option can cause many unpredictable complications, such as anaesthesia risks and under-correction. Therefore, the classic non-surgical correction of congenital auricular deformities is a non-surgical and earlier alternative to otoplasty. Moreover, many patient present at an older age; an auricular moulding device can still be a successful treatment option for these older patients. Classic ear moulding is an early non-surgical alternative to otoplasty for managing congenital ear abnormalities. It can be initiated as early as 6 weeks after birth. Including an ear examination as a routine in every child’s immediate post-birth physical examination is crucial for early diagnosis and better outcomes.
{"title":"Classic ear moulding technique for a lop ear deformity: case report","authors":"Wissal Touzri, Mohamed El Arbi Tahiri Alaoui, Oussama Bentahar","doi":"10.1097/ms9.0000000000002379","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002379","url":null,"abstract":"\u0000 \u0000 Lop ear is a congenital auricular deformity (CAD) detected at birth. It can negatively impact aesthetic appearance and the mental health of both the parents and the infant. Therefore, a treatment initiated at an early age is imperative.\u0000 \u0000 \u0000 \u0000 A male newborn patient on his 11th week of his life presented with his mother to the Maxillofacial Prosthodontic Unit. The extraoral examination showed a pendulous upper part of the auricle covering the antihelix with no deficiencies. The newborn’s hearing function was normal and no associated syndrome was identified. The patient was diagnosed with congenital unilateral lop ear (Tanzer grade II constricted ear). A non-surgical correction with a classic ear moulding device was attempted at the 11th week after birth to reshape the abnormal ear.\u0000 \u0000 \u0000 \u0000 Congenital auricular deformities (CADs) are traditionally managed by an otoplasty at age 6. Unfortunately, this option can cause many unpredictable complications, such as anaesthesia risks and under-correction. Therefore, the classic non-surgical correction of congenital auricular deformities is a non-surgical and earlier alternative to otoplasty. Moreover, many patient present at an older age; an auricular moulding device can still be a successful treatment option for these older patients.\u0000 \u0000 \u0000 \u0000 Classic ear moulding is an early non-surgical alternative to otoplasty for managing congenital ear abnormalities. It can be initiated as early as 6 weeks after birth. Including an ear examination as a routine in every child’s immediate post-birth physical examination is crucial for early diagnosis and better outcomes.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1097/ms9.0000000000002409
Z. Rahmat, M. H. Ali, Muhammad Talha, Md. Al Hasibuzzaman
{"title":"FDA approval of casgevy and lyfgenia: A dual breakthrough in gene therapies for sickle cell disease","authors":"Z. Rahmat, M. H. Ali, Muhammad Talha, Md. Al Hasibuzzaman","doi":"10.1097/ms9.0000000000002409","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002409","url":null,"abstract":"","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"38 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141805953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyper-IgE Syndrome (HIES), also known as Job syndrome, is a rare immunodeficiency disorder characterized by elevated IgE levels and recurrent infections. Diagnosing and managing HIES in resource-limited settings is challenging due to the lack of advanced diagnostic tools. This report highlights the necessity of clinical evaluation and basic laboratory investigations for diagnosing HIES. A 3-year-old male presented with fever, cough, and widespread pustular lesions. He had a history of recurrent respiratory infections and otitis media. Physical examination revealed characteristic facial features, skin findings, and laboratory investigations showed elevated IgE levels (>3000 IU/mL) and leukocytosis. A clinical diagnosis of HIES was made, and the patient responded well to antibiotics, antihistamines, and topical steroids. Hyper-IgE Syndrome is caused by genetic mutations affecting immune function, primarily involving STAT3 and DOCK8 genes. Diagnosis in resource-limited settings relies on clinical features and basic investigations. Challenges include the unavailability of genetic testing. Management includes antibiotics and symptomatic relief adapted to available resources. Diagnosing and managing Hyper-IgE Syndrome in resource-limited settings requires adaptation of clinical approaches to available resources. This case underscores the importance of clinical vigilance and basic diagnostic tools in diagnosing rare immunodeficiencies.
{"title":"Challenges in diagnosing and managing hyper-IgE syndrome in a resource-limited setting: a case report","authors":"Pratik Adhikari, Rabin Regmi, Pramodman Singh Yadav, Sujan Kafle","doi":"10.1097/ms9.0000000000002407","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002407","url":null,"abstract":"\u0000 \u0000 Hyper-IgE Syndrome (HIES), also known as Job syndrome, is a rare immunodeficiency disorder characterized by elevated IgE levels and recurrent infections. Diagnosing and managing HIES in resource-limited settings is challenging due to the lack of advanced diagnostic tools. This report highlights the necessity of clinical evaluation and basic laboratory investigations for diagnosing HIES.\u0000 \u0000 \u0000 \u0000 A 3-year-old male presented with fever, cough, and widespread pustular lesions. He had a history of recurrent respiratory infections and otitis media. Physical examination revealed characteristic facial features, skin findings, and laboratory investigations showed elevated IgE levels (>3000 IU/mL) and leukocytosis. A clinical diagnosis of HIES was made, and the patient responded well to antibiotics, antihistamines, and topical steroids.\u0000 \u0000 \u0000 \u0000 Hyper-IgE Syndrome is caused by genetic mutations affecting immune function, primarily involving STAT3 and DOCK8 genes. Diagnosis in resource-limited settings relies on clinical features and basic investigations. Challenges include the unavailability of genetic testing. Management includes antibiotics and symptomatic relief adapted to available resources.\u0000 \u0000 \u0000 \u0000 Diagnosing and managing Hyper-IgE Syndrome in resource-limited settings requires adaptation of clinical approaches to available resources. This case underscores the importance of clinical vigilance and basic diagnostic tools in diagnosing rare immunodeficiencies.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"14 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1097/ms9.0000000000002375
Abdulrahaman Ibn Awadh, Khulud Alanazi, A. Alkhenizan
Data about the impact of albumin-to-alkaline phosphatase ratio [AAPR] on prognosis in hepatocellular cancer patients are inconclusive and conflicting. We systematically searched literatures from 7 databases [PubMed, Medline, Web of Science, Cochrane Library, Embase, Google Scholar and CINAHL], updated to September, 2023. Hazard ratios [HRs] and 95% confidence intervals [CIs] were pooled and synthesized using Comprehensive Meta-Analysis version 3 in order to assess the overall impact of AAPR on patient’s prognosis. In total, 8 studies involving 13 cohorts with 3,774 cases were included. Pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for overall survival [OS] [HR=0,429, 95% CI: 0,361–0,509, P=0,001; HR=0,476, 95% CI:0,421–0,538, P= 0,001; respectively]. Similarly, pooled multivariate results showed that higher AAPR was associated with better disease-free survival [DFS] [HR=0,558, 95% CI:0,452–0,688, P= 0,001]. Moreover, pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for recurrence-free survival [RFS] [HR=0,540, 95% CI: 0,420–0,694, P=0,001; HR=0,647, 95% CI:0,494–0,848, P= 0,002; respectively]. Subgroups analysis showed that elevated AAPR still significantly correlated with better OS across the confounding factors. Moreover, sensitivity analysis suggested the robustness of these findings and no publication bias was detected. In summary, higher AAPR could be considered as a reliable prognostic factor in patients with HCC, which could be used as a routine inspection of HCC patients to individualized prognosis prediction and clinical decision making.
{"title":"Prognosis of hepatocellular carcinoma using the albumin to alkaline phosphatase ratio, literature review and meta analysis","authors":"Abdulrahaman Ibn Awadh, Khulud Alanazi, A. Alkhenizan","doi":"10.1097/ms9.0000000000002375","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002375","url":null,"abstract":"\u0000 \u0000 Data about the impact of albumin-to-alkaline phosphatase ratio [AAPR] on prognosis in hepatocellular cancer patients are inconclusive and conflicting.\u0000 \u0000 \u0000 \u0000 We systematically searched literatures from 7 databases [PubMed, Medline, Web of Science, Cochrane Library, Embase, Google Scholar and CINAHL], updated to September, 2023. Hazard ratios [HRs] and 95% confidence intervals [CIs] were pooled and synthesized using Comprehensive Meta-Analysis version 3 in order to assess the overall impact of AAPR on patient’s prognosis.\u0000 \u0000 \u0000 \u0000 In total, 8 studies involving 13 cohorts with 3,774 cases were included. Pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for overall survival [OS] [HR=0,429, 95% CI: 0,361–0,509, P=0,001; HR=0,476, 95% CI:0,421–0,538, P= 0,001; respectively]. Similarly, pooled multivariate results showed that higher AAPR was associated with better disease-free survival [DFS] [HR=0,558, 95% CI:0,452–0,688, P= 0,001]. Moreover, pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for recurrence-free survival [RFS] [HR=0,540, 95% CI: 0,420–0,694, P=0,001; HR=0,647, 95% CI:0,494–0,848, P= 0,002; respectively]. Subgroups analysis showed that elevated AAPR still significantly correlated with better OS across the confounding factors. Moreover, sensitivity analysis suggested the robustness of these findings and no publication bias was detected.\u0000 \u0000 \u0000 \u0000 In summary, higher AAPR could be considered as a reliable prognostic factor in patients with HCC, which could be used as a routine inspection of HCC patients to individualized prognosis prediction and clinical decision making.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"38 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1097/ms9.0000000000002405
Kehinde Precious Fadele, Kodeeswaran M, Bipin Chaurasia
{"title":"Influence of social media in attracting future neurosurgeons to neurosurgery","authors":"Kehinde Precious Fadele, Kodeeswaran M, Bipin Chaurasia","doi":"10.1097/ms9.0000000000002405","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002405","url":null,"abstract":"","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141808822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1097/ms9.0000000000002406
Khabab Abbasher Hussien Mohamed Ahmed, AlHussein Abbasher, A. Siddig, Mohammed Abbasher, Abubaker Alsedig Abbasher, Ali Abdelhaleem Omar Ahmed, Zinab Shihab Hamednalla Abdelgader, Esraa Hassan Salih Elhaj, Areeba Ahsan, Ghassan E. Mustafa Ahmed, A. Hussien
Dengue virus (DENV) is an RNA virus transmitted by Aides mosquito causing Dengue fever. There is growing recognition of neurological symptoms associated with DENV infection, some of which might be lethal if left untreated. Case reports describing sagittal sinus thrombosis, as a serious neurologic consequence of dengue infection, are rare. It is still unknown how often sagittal sinus thrombosis occurs and what variables increase the risk in dengue patients. Herein we presented an elderly Sudanese patient diagnosed with Dengue fever. He was admitted, then two days after admission the condition was complicated by atrial fibrillation, sagittal sinus thrombosis complicated by massive left temporal lobe infarction with haemorrhagic transformation and recurrent episodes of status epilepticus. After receiving the necessary care, his condition remained the same and no progress or deterioration was seen. Sagittal sinus thrombosis can happen due to several underlying causes. DENV can very rarely lead to such condition. Our patient developed this condition which was later complicated by ischemic stroke with haemorrhagic transformation and status epilepticus. In addition to a familial history of DVT and a history of myocardial infarction, our patient also acquired cardiac mural thrombus and DVT throughout his illness, which increased the suspicion of a protein C, protein S, or antithrombin 3 deficiency. Sagittal sinus thrombosis with haemorrhagic infarction associated with thrombocytopenia is a very rare kind of stroke that occurs in dengue. Dengue as a pathogenic mechanism of ischemic stroke requires validation with further data.
{"title":"Rare occurrence of sagittal sinus thrombosis and haemorrhagic infarction with dengue fever; jumping from traditional symptoms to lethal neurological consequences","authors":"Khabab Abbasher Hussien Mohamed Ahmed, AlHussein Abbasher, A. Siddig, Mohammed Abbasher, Abubaker Alsedig Abbasher, Ali Abdelhaleem Omar Ahmed, Zinab Shihab Hamednalla Abdelgader, Esraa Hassan Salih Elhaj, Areeba Ahsan, Ghassan E. Mustafa Ahmed, A. Hussien","doi":"10.1097/ms9.0000000000002406","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002406","url":null,"abstract":"\u0000 \u0000 Dengue virus (DENV) is an RNA virus transmitted by Aides mosquito causing Dengue fever. There is growing recognition of neurological symptoms associated with DENV infection, some of which might be lethal if left untreated. Case reports describing sagittal sinus thrombosis, as a serious neurologic consequence of dengue infection, are rare. It is still unknown how often sagittal sinus thrombosis occurs and what variables increase the risk in dengue patients.\u0000 \u0000 \u0000 \u0000 Herein we presented an elderly Sudanese patient diagnosed with Dengue fever. He was admitted, then two days after admission the condition was complicated by atrial fibrillation, sagittal sinus thrombosis complicated by massive left temporal lobe infarction with haemorrhagic transformation and recurrent episodes of status epilepticus. After receiving the necessary care, his condition remained the same and no progress or deterioration was seen.\u0000 \u0000 \u0000 \u0000 Sagittal sinus thrombosis can happen due to several underlying causes. DENV can very rarely lead to such condition. Our patient developed this condition which was later complicated by ischemic stroke with haemorrhagic transformation and status epilepticus. In addition to a familial history of DVT and a history of myocardial infarction, our patient also acquired cardiac mural thrombus and DVT throughout his illness, which increased the suspicion of a protein C, protein S, or antithrombin 3 deficiency.\u0000 \u0000 \u0000 \u0000 Sagittal sinus thrombosis with haemorrhagic infarction associated with thrombocytopenia is a very rare kind of stroke that occurs in dengue. Dengue as a pathogenic mechanism of ischemic stroke requires validation with further data.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"72 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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