Pub Date : 2024-03-19DOI: 10.1097/ms9.0000000000001977
Sahar Miri, A. Norasteh
This study aimed to evaluate the fear of falling, quality of life, and daily functional activity of older women aged 60 years or older with or without a history of falling. 200 older adult women were recruited for the cross-sectional study in Iran. This cross-sectional study collected data from July to August 2023 through convenience sampling. The researchers collected data using a five-part questionnaire, that collected information that included demographic characteristics, the Fall Efficacy Scale in the Elderly-International Version (FES-I), 12-item Quality of Life assessment (SF-12), Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL). FES-I score in older women with a history of falls was significantly higher than those without a history of falls (Median: 38.0, interquartile range (IQR): 31.5 to 44.0 versus Median: 22.0, IQR: 20.0 to 30.0; P<0.001). The median quality-of-life score using the SF-12 was significantly lower in women with a history of falls than in those without a history of falls (Median: 25.0, IQR: 21.0 to 30.0 versus Median: 35.0, IQR: 31.0 to 39.0; P<0.001). The ADL scores were significantly lower among women with a history of falls than those without (P<0.001). A similar result was obtained for IADL scores (P<0.001). Overall, this study’s findings highlight the adverse impact of a history of falls on three key factors: fear of falling, quality of life, and daily functional activity (including both basic and instrumental activities). The findings delineates that ultimately, the history of falls can serve as a valuable indicator for better understanding trends in elderly care and addressing the associated challenges.
{"title":"Fear of falling, quality of life, and daily functional activity of elderly women with and without a history of falling: a cross-sectional study","authors":"Sahar Miri, A. Norasteh","doi":"10.1097/ms9.0000000000001977","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001977","url":null,"abstract":"\u0000 \u0000 This study aimed to evaluate the fear of falling, quality of life, and daily functional activity of older women aged 60 years or older with or without a history of falling.\u0000 \u0000 \u0000 \u0000 200 older adult women were recruited for the cross-sectional study in Iran. This cross-sectional study collected data from July to August 2023 through convenience sampling. The researchers collected data using a five-part questionnaire, that collected information that included demographic characteristics, the Fall Efficacy Scale in the Elderly-International Version (FES-I), 12-item Quality of Life assessment (SF-12), Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL).\u0000 \u0000 \u0000 \u0000 FES-I score in older women with a history of falls was significantly higher than those without a history of falls (Median: 38.0, interquartile range (IQR): 31.5 to 44.0 versus Median: 22.0, IQR: 20.0 to 30.0; P<0.001). The median quality-of-life score using the SF-12 was significantly lower in women with a history of falls than in those without a history of falls (Median: 25.0, IQR: 21.0 to 30.0 versus Median: 35.0, IQR: 31.0 to 39.0; P<0.001). The ADL scores were significantly lower among women with a history of falls than those without (P<0.001). A similar result was obtained for IADL scores (P<0.001).\u0000 \u0000 \u0000 \u0000 Overall, this study’s findings highlight the adverse impact of a history of falls on three key factors: fear of falling, quality of life, and daily functional activity (including both basic and instrumental activities). The findings delineates that ultimately, the history of falls can serve as a valuable indicator for better understanding trends in elderly care and addressing the associated challenges.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"52 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231118","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 : 2024-03-19DOI: 10.1097/ms9.0000000000001984
Narasimhan Raghunathan, Sathya Sankaran, G. D. Miteu
Spinocerebellar ataxia (SCAs) are a rare autosomal dominant neurodegenerative disorder. To date, approximately 50 different subtypes of SCAs have been characterized. The prevalent types of SCAs are usually of PolyQ origin, wherein the disease pathology is a consequence of multiple glutamine residues being encoded onto the disease proteins, causing expansions. SCAs 2 and 3 are the most frequently diagnosed subtypes, wherein affected patients exhibit certain characteristic physiological manifestations, such as gait ataxia and dysarthria. Nevertheless, other clinical signs were exclusive to these subtypes. Recently, multiple molecular diagnostic methods have been developed to identify and characterize these subtypes. Despite these advancements, the molecular pathology of SCAs remains unknown. To further understand the mechanisms involved in neurodegenerative SCAs 2 and 3, patient-derived induced pluripotent stem cell-based modelling is a compelling avenue to pursue. We cover the present state of iPSC-based in vitro illness modelling of SCA subtypes 2 and 3 below, along with a list of cell lines created, and the relevance of research outcomes to personalized autologous therapy.
{"title":"A comprehensive review of iPS cell line-based disease modelling of the polyglutamine Spinocerebellar Ataxias 2 and 3: A focus on the research outcomes","authors":"Narasimhan Raghunathan, Sathya Sankaran, G. D. Miteu","doi":"10.1097/ms9.0000000000001984","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001984","url":null,"abstract":"Spinocerebellar ataxia (SCAs) are a rare autosomal dominant neurodegenerative disorder. To date, approximately 50 different subtypes of SCAs have been characterized. The prevalent types of SCAs are usually of PolyQ origin, wherein the disease pathology is a consequence of multiple glutamine residues being encoded onto the disease proteins, causing expansions. SCAs 2 and 3 are the most frequently diagnosed subtypes, wherein affected patients exhibit certain characteristic physiological manifestations, such as gait ataxia and dysarthria. Nevertheless, other clinical signs were exclusive to these subtypes. Recently, multiple molecular diagnostic methods have been developed to identify and characterize these subtypes. Despite these advancements, the molecular pathology of SCAs remains unknown. To further understand the mechanisms involved in neurodegenerative SCAs 2 and 3, patient-derived induced pluripotent stem cell-based modelling is a compelling avenue to pursue. We cover the present state of iPSC-based in vitro illness modelling of SCA subtypes 2 and 3 below, along with a list of cell lines created, and the relevance of research outcomes to personalized autologous therapy.","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"13 1‐2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228402","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 : 2024-03-19DOI: 10.1097/ms9.0000000000001958
Ajaipal S. Kang, Genelia Kang, Harjaap S. Kathuria
Super giant basal cell carcinoma (SGBCC), defined as greater than 20 cm in diameter, is a rare oncological entity, with scarce literature. We conducted a review to characterize SGBCC, specifically with regards to age, sex predilection, risk factors, geographical location, body site, metastasis, and treatment. A systematic literature search was conducted from 1972 to 2023. All abstracts, studies, and citations were reviewed. The initial result showed 47,281 articles and were filtered down for human, skin, English language, and SGBCC. We identified 20 case reports for our analysis. The sample size was too small to conduct extensive statistical analysis. Majority of the cases were reported in North America and Europe. Males outnumbered almost females 2:1. The mean age was 61 years. The lesion was located on trunk in 16 out of 20 cases. In 13 out of 20 years, the lesion had been present for more than 10 years and 7 out of 20 cases reported metastasis. Several reports documented low socioeconomic status and poor mental health. Regarding treatment, 11 patients underwent surgery, radiation was utilized in 6 patients and immunotherapy (Vismodegib) in 4 patients. Although basal cell carcinoma (BCC) is known to have a favorable prognosis, SGBCC is highly aggressive with ability to metastasize. Our review reveals SGBCC is commonly diagnosed in males in their sixth decade, present for more than 10 years duration, risk factors include low socioeconomic status and poor mental health, commonly found on the trunk with a predilection for metastasis. We believe self-neglect is the likely etiology of the large size. Treatment options may be multimodal with a combination of surgery, radiation therapy or immunotherapy (Vismodegib).
{"title":"Super giant basal cell carcinoma: A comprehensive systematic review","authors":"Ajaipal S. Kang, Genelia Kang, Harjaap S. Kathuria","doi":"10.1097/ms9.0000000000001958","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001958","url":null,"abstract":"Super giant basal cell carcinoma (SGBCC), defined as greater than 20 cm in diameter, is a rare oncological entity, with scarce literature. We conducted a review to characterize SGBCC, specifically with regards to age, sex predilection, risk factors, geographical location, body site, metastasis, and treatment. A systematic literature search was conducted from 1972 to 2023. All abstracts, studies, and citations were reviewed. The initial result showed 47,281 articles and were filtered down for human, skin, English language, and SGBCC. We identified 20 case reports for our analysis. The sample size was too small to conduct extensive statistical analysis. Majority of the cases were reported in North America and Europe. Males outnumbered almost females 2:1. The mean age was 61 years. The lesion was located on trunk in 16 out of 20 cases. In 13 out of 20 years, the lesion had been present for more than 10 years and 7 out of 20 cases reported metastasis. Several reports documented low socioeconomic status and poor mental health. Regarding treatment, 11 patients underwent surgery, radiation was utilized in 6 patients and immunotherapy (Vismodegib) in 4 patients. Although basal cell carcinoma (BCC) is known to have a favorable prognosis, SGBCC is highly aggressive with ability to metastasize. Our review reveals SGBCC is commonly diagnosed in males in their sixth decade, present for more than 10 years duration, risk factors include low socioeconomic status and poor mental health, commonly found on the trunk with a predilection for metastasis. We believe self-neglect is the likely etiology of the large size. Treatment options may be multimodal with a combination of surgery, radiation therapy or immunotherapy (Vismodegib).","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"61 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230253","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}
Dengue fever is a mosquito-borne viral infection presenting with high-grade fever and other constitutional symptoms. This case report details a rare occurrence of lateral rectus palsy in an 18-year-old male subsequent to a dengue infection. The patient initially presented with fever, a generalized tonic-clonic seizure (GTCS), and symptomatic hypoglycemia, leading to multiple organ dysfunction syndrome (MODS) necessitating intensive care. Remarkably, no hemorrhagic manifestations were observed. The MODS gradually resolved by the 12th day of admission, coinciding with the emergence of complaints about uniocular diplopia and right esotropia. Systemic examination, including a normal computed tomography (CT) head scan, did not reveal any abnormalities. Additionally, potential causes contributing to esotropia and diplopia were ruled out. The patient was subsequently managed expectantly for lateral rectus palsy following severe dengue. Follow-up assessments indicated a gradual improvement in esotropia and diplopia, and the patient was advised to continue the prescribed medications. This is the first documented case report of paralytic squint post-severe dengue in Nepal, emphasizing the importance of considering it as a differential diagnosis in tropical regions with endemic dengue infections. The case report advocates early identification and treatment of ophthalmic issues, notably with prednisolone, to achieve favorable outcomes, as evidenced by improvements in visual acuity, esotropia, and diplopia during follow-ups. Further research is essential to determine optimal treatment strategies for such neurological complications associated with dengue fever.
{"title":"Unilateral lateral rectus palsy following dengue: A Case Report","authors":"Biraj Niraula, Bindira Adhikari, Anil Suvedi, Dinesh Gosain, Shivendra Kumar Gaud","doi":"10.1097/ms9.0000000000001988","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001988","url":null,"abstract":"\u0000 \u0000 Dengue fever is a mosquito-borne viral infection presenting with high-grade fever and other constitutional symptoms.\u0000 \u0000 \u0000 \u0000 This case report details a rare occurrence of lateral rectus palsy in an 18-year-old male subsequent to a dengue infection. The patient initially presented with fever, a generalized tonic-clonic seizure (GTCS), and symptomatic hypoglycemia, leading to multiple organ dysfunction syndrome (MODS) necessitating intensive care. Remarkably, no hemorrhagic manifestations were observed. The MODS gradually resolved by the 12th day of admission, coinciding with the emergence of complaints about uniocular diplopia and right esotropia. Systemic examination, including a normal computed tomography (CT) head scan, did not reveal any abnormalities. Additionally, potential causes contributing to esotropia and diplopia were ruled out. The patient was subsequently managed expectantly for lateral rectus palsy following severe dengue. Follow-up assessments indicated a gradual improvement in esotropia and diplopia, and the patient was advised to continue the prescribed medications.\u0000 \u0000 \u0000 \u0000 This is the first documented case report of paralytic squint post-severe dengue in Nepal, emphasizing the importance of considering it as a differential diagnosis in tropical regions with endemic dengue infections. The case report advocates early identification and treatment of ophthalmic issues, notably with prednisolone, to achieve favorable outcomes, as evidenced by improvements in visual acuity, esotropia, and diplopia during follow-ups. Further research is essential to determine optimal treatment strategies for such neurological complications associated with dengue fever.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"52 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231253","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 : 2024-03-19DOI: 10.1097/ms9.0000000000001979
Suaad Hamsho, Ahmad Almohamed, Hasan Haydar, Yousef Alsaffaf, Enas Sultan, Yassen Sukkar, Waddah kazkz
Charcot-Marie-Tooth is a group of inherited neuromuscular disorders that vary clinically and genetically. it is characterized by peripheral nerve damage, leading to muscle weakness and sensory loss. A 13-year-old male presented to the rheumatology department with bilateral hearing impairment since the age of 3 years, pes cavus, and difficulties walking. Some family members had Achilles tendon lengthening surgery. During physical examination, the patient had a shortened Achilles tendon, there are high arches in the feet, curled toes, loss of touch sensation in the feet, ankles, and legs, atrophy in the foot muscles. An eye examination revealed a discrepancy that needed glasses. Neurological findings included horizontal and vertical nystagmus, proprioception disorder, and demyelinating sensorimotor disorder diagnosed as Charcot-Marie-Tooth type 1. The audiogram showed bilateral sensorineural hearing impairment. Magnetic resonance imaging revealed spinal disc bulges. The treatment plan includes Achilles tendon lengthening surgery and physical therapy. Charcot-Marie Tooth patients need to receive supportive treatment including physical therapy, hearing aids, and glasses, to help improve their quality of life. Charcot-Marie-Tooth disease is a genetic disorder that causes difficulties in movement, coordination, and daily activities due to muscle weakness and sensory impairments. In a few cases, patients have been documented to have bilateral hearing impairment as their first symptoms. It affects individuals in Syria and around the world, and requires proper diagnosis and treatment.
{"title":"Bilateral hearing impairment as an early symptom in a patient with Charcot-Marie-Tooth Type 1: the first case report from Syria","authors":"Suaad Hamsho, Ahmad Almohamed, Hasan Haydar, Yousef Alsaffaf, Enas Sultan, Yassen Sukkar, Waddah kazkz","doi":"10.1097/ms9.0000000000001979","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001979","url":null,"abstract":"\u0000 \u0000 Charcot-Marie-Tooth is a group of inherited neuromuscular disorders that vary clinically and genetically. it is characterized by peripheral nerve damage, leading to muscle weakness and sensory loss.\u0000 \u0000 \u0000 \u0000 A 13-year-old male presented to the rheumatology department with bilateral hearing impairment since the age of 3 years, pes cavus, and difficulties walking. Some family members had Achilles tendon lengthening surgery. During physical examination, the patient had a shortened Achilles tendon, there are high arches in the feet, curled toes, loss of touch sensation in the feet, ankles, and legs, atrophy in the foot muscles. An eye examination revealed a discrepancy that needed glasses. Neurological findings included horizontal and vertical nystagmus, proprioception disorder, and demyelinating sensorimotor disorder diagnosed as Charcot-Marie-Tooth type 1. The audiogram showed bilateral sensorineural hearing impairment. Magnetic resonance imaging revealed spinal disc bulges. The treatment plan includes Achilles tendon lengthening surgery and physical therapy.\u0000 \u0000 \u0000 \u0000 Charcot-Marie Tooth patients need to receive supportive treatment including physical therapy, hearing aids, and glasses, to help improve their quality of life.\u0000 \u0000 \u0000 \u0000 Charcot-Marie-Tooth disease is a genetic disorder that causes difficulties in movement, coordination, and daily activities due to muscle weakness and sensory impairments. In a few cases, patients have been documented to have bilateral hearing impairment as their first symptoms. It affects individuals in Syria and around the world, and requires proper diagnosis and treatment.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"50 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230160","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 : 2024-03-19DOI: 10.1097/ms9.0000000000001975
D. Aldiansyah, B. Halim, S. Lumbanraja, E. M. Asroel, M. Fahdy, Hanudse Hartono, Thomson Thomson
The diagnostic criteria for Quintero staging in twin-to-twin transfusion syndrome (TTTS) are not applicable in all cases of TTTS, such as those in which the symptoms overlap with other monochorionic twin complications such as selective intrauterine growth restriction (sIUGR). A 25-year-old woman, G1P0A0, At 22-24 weeks’ gestational age was diagnosed with TTTS, with no outstanding history of medication use during pregnancy, and no family history of genetic disorder or twin pregnancy. In the donor twin, persistently absent end-diastolic flow in the umbilical artery was observed using Doppler velocimetry. Polyhydramnios was observed in the recipient twins. The fetal weight discordance between the twins was 39%. After two weeks of follow-up, we performed fetoscopic laser photocoagulation and successfully ablated five vascular anastomoses and amnioreduction by 2.5 liters. Five days after the laser surgery, the patient developed amniotic fluid leakage, and an amniopatch was performed. We did the caesarean section at 34 weeks because of severe preeclampsia, the donor and recipient birth weights were 1,120 g and 1,837 g, respectively (weight discordance 39%). The APGAR scores were 3/4 and 6/8, respectively. The donor twin died six days after delivery due to respiratory failure, and the recipient twin survived. Neonatal echocardiography of the surviving twin showed no tricuspid regurgitation. No long-term follow-up was performed. The traditional diagnostic criteria for TTTS stage 3 were not met and overlapped with the diagnostic criteria for sIUGR type 2. This is the first procedure reported in Indonesia for Atypical TTTS with the outcome, one twin survived. Some TTTS cases do not meet traditional diagnostic criteria and overlap with other monochorionic twin complications.
{"title":"Atypical Twin-to-Twin transfusion syndrome case managed in a single centre in indonesia with fetoscopic laser photocoagulation and amniopatch: ‘Case Report’","authors":"D. Aldiansyah, B. Halim, S. Lumbanraja, E. M. Asroel, M. Fahdy, Hanudse Hartono, Thomson Thomson","doi":"10.1097/ms9.0000000000001975","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001975","url":null,"abstract":"\u0000 \u0000 The diagnostic criteria for Quintero staging in twin-to-twin transfusion syndrome (TTTS) are not applicable in all cases of TTTS, such as those in which the symptoms overlap with other monochorionic twin complications such as selective intrauterine growth restriction (sIUGR).\u0000 \u0000 \u0000 \u0000 A 25-year-old woman, G1P0A0, At 22-24 weeks’ gestational age was diagnosed with TTTS, with no outstanding history of medication use during pregnancy, and no family history of genetic disorder or twin pregnancy. In the donor twin, persistently absent end-diastolic flow in the umbilical artery was observed using Doppler velocimetry. Polyhydramnios was observed in the recipient twins. The fetal weight discordance between the twins was 39%. After two weeks of follow-up, we performed fetoscopic laser photocoagulation and successfully ablated five vascular anastomoses and amnioreduction by 2.5 liters. Five days after the laser surgery, the patient developed amniotic fluid leakage, and an amniopatch was performed. We did the caesarean section at 34 weeks because of severe preeclampsia, the donor and recipient birth weights were 1,120 g and 1,837 g, respectively (weight discordance 39%). The APGAR scores were 3/4 and 6/8, respectively. The donor twin died six days after delivery due to respiratory failure, and the recipient twin survived. Neonatal echocardiography of the surviving twin showed no tricuspid regurgitation. No long-term follow-up was performed.\u0000 \u0000 \u0000 \u0000 The traditional diagnostic criteria for TTTS stage 3 were not met and overlapped with the diagnostic criteria for sIUGR type 2. This is the first procedure reported in Indonesia for Atypical TTTS with the outcome, one twin survived.\u0000 \u0000 \u0000 \u0000 Some TTTS cases do not meet traditional diagnostic criteria and overlap with other monochorionic twin complications.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"57 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230902","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 : 2024-03-19DOI: 10.1097/ms9.0000000000001985
Munna William, T. N. Yogi, Amrit Bhusal, Mudasira Habib, Amjad Ali Raza, Waqar Ahmad, Ajay Kumar Yadav, Objan Kumar Rawal, Pramod Pathik
Portal Vein Thrombosis (PVT) is a rare medical condition that obstructs blood flow in the portal vein, with cirrhosis as a common predisposing factor. However, its association with oral contraceptive pills (OCPs) particularly with progestins remains inadequately explored. This case report aims to contribute to this understanding, focusing on the rare presentation of PVT-induced intestinal obstruction in a female on prolonged OCP therapy. A 45-year-old female presented with severe abdominal pain, vomiting, and constipation. Diagnosis revealed PVT-induced intestinal obstruction, an exceptionally rare occurrence in the context of prolonged OCP therapy. The patient’s symptoms improved with conservative management, including rivaroxaban, highlighting the crucial role of early intervention. This case brings attention to the limited literature exploring the link between OCPs and PVT. Despite the generally safe reputation of OCPs, they can induce pro-thrombotic conditions, emphasizing the need for heightened clinical awareness. The rarity of intestinal obstruction in PVT, compounded by the absence of common risk factors in this case, underscores the diagnostic challenges associated with such presentations. PVT-induced intestinal obstruction in a patient on prolonged OCP therapy is exceptionally rare, emphasizing the necessity for multidisciplinary management. It provides crucial insights into suspecting, identifying, and treating this uncommon complication in non-cirrhotic individuals, contributing to the limited existing literature on the subject.
{"title":"Intestinal obstruction induced by portal vein thrombosis in a female undergoing oral contraceptive therapy: A case report with comprehensive review","authors":"Munna William, T. N. Yogi, Amrit Bhusal, Mudasira Habib, Amjad Ali Raza, Waqar Ahmad, Ajay Kumar Yadav, Objan Kumar Rawal, Pramod Pathik","doi":"10.1097/ms9.0000000000001985","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001985","url":null,"abstract":"\u0000 \u0000 Portal Vein Thrombosis (PVT) is a rare medical condition that obstructs blood flow in the portal vein, with cirrhosis as a common predisposing factor. However, its association with oral contraceptive pills (OCPs) particularly with progestins remains inadequately explored. This case report aims to contribute to this understanding, focusing on the rare presentation of PVT-induced intestinal obstruction in a female on prolonged OCP therapy.\u0000 \u0000 \u0000 \u0000 A 45-year-old female presented with severe abdominal pain, vomiting, and constipation. Diagnosis revealed PVT-induced intestinal obstruction, an exceptionally rare occurrence in the context of prolonged OCP therapy. The patient’s symptoms improved with conservative management, including rivaroxaban, highlighting the crucial role of early intervention.\u0000 \u0000 \u0000 \u0000 This case brings attention to the limited literature exploring the link between OCPs and PVT. Despite the generally safe reputation of OCPs, they can induce pro-thrombotic conditions, emphasizing the need for heightened clinical awareness. The rarity of intestinal obstruction in PVT, compounded by the absence of common risk factors in this case, underscores the diagnostic challenges associated with such presentations.\u0000 \u0000 \u0000 \u0000 PVT-induced intestinal obstruction in a patient on prolonged OCP therapy is exceptionally rare, emphasizing the necessity for multidisciplinary management. It provides crucial insights into suspecting, identifying, and treating this uncommon complication in non-cirrhotic individuals, contributing to the limited existing literature on the subject.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"47 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228701","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 : 2024-03-19DOI: 10.1097/ms9.0000000000001980
Lilamani Rajthala, Sagar Gyawali, Sabin Banmala, Surendra Shah
Gastric leiomyosarcoma is a rare malignant tumor among the primary gastric carcinomas. Among the different common presentations, dysphagia is an uncommon presentation of gastric leiomyosarcoma. A 29-year-old female presented with complaints of progressive dysphagia for one year associated with vomiting, significant weight loss, and anorexia for six months. On blood investigations, she had anemia, hypokalemia, pre-renal acute kidney injury, and unconjugated hyperbilirubinemia. Upper gastrointestinal endoscopy and contrast-enhanced computed tomography (CECT) were initially suggestive of carcinoma of stomach. Immunohistochemistry was diagnostic of leiomyosarcoma of stomach extending to the gastroesophageal junction and distal esophagus. She underwent total gastrectomy with distal esophagectomy with lateral segmentectomy of liver (non-anatomical) with Roux-en-Y esophago-jejunal anastomosis (end-to-side and retro-colic)) through thoracoabdominal approach. After six weeks, she received four cycles of doxorubicin therapy. Follow-up at 18 months after surgery revealed no recurrence of malignancy. Leiomyosarcoma, a rare malignant tumor arising from stomach involves commonly gastric body followed by antrum and fundus. Imaging including CECT and tissue diagnosis including immunohistochemistry [positive for α-SMA, desmin, calponin, h-caldesmon, or smoothelin] have been mainstay for definitive diagnosis. The standard treatment for leiomyosarcoma of stomach is complete surgical resection of tumor because it has malignant potential and does not respond to targeted treatment with a tyrosine kinase inhibitor. The type of surgery depends on the size and localization of the tumor. Early diagnosis with proper imaging, immunohistochemistry, and biopsy play important role in differentiating gastric leiomyosarcoma from GIST. Surgical resection is the mainstay of treatment.
{"title":"Leiomyosarcoma of stomach extending to gastroesophageal junction and distal esophagus as a rare cause of dysphagia -A case report","authors":"Lilamani Rajthala, Sagar Gyawali, Sabin Banmala, Surendra Shah","doi":"10.1097/ms9.0000000000001980","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001980","url":null,"abstract":"\u0000 \u0000 Gastric leiomyosarcoma is a rare malignant tumor among the primary gastric carcinomas. Among the different common presentations, dysphagia is an uncommon presentation of gastric leiomyosarcoma.\u0000 \u0000 \u0000 \u0000 A 29-year-old female presented with complaints of progressive dysphagia for one year associated with vomiting, significant weight loss, and anorexia for six months. On blood investigations, she had anemia, hypokalemia, pre-renal acute kidney injury, and unconjugated hyperbilirubinemia. Upper gastrointestinal endoscopy and contrast-enhanced computed tomography (CECT) were initially suggestive of carcinoma of stomach. Immunohistochemistry was diagnostic of leiomyosarcoma of stomach extending to the gastroesophageal junction and distal esophagus. She underwent total gastrectomy with distal esophagectomy with lateral segmentectomy of liver (non-anatomical) with Roux-en-Y esophago-jejunal anastomosis (end-to-side and retro-colic)) through thoracoabdominal approach. After six weeks, she received four cycles of doxorubicin therapy. Follow-up at 18 months after surgery revealed no recurrence of malignancy.\u0000 \u0000 \u0000 \u0000 Leiomyosarcoma, a rare malignant tumor arising from stomach involves commonly gastric body followed by antrum and fundus. Imaging including CECT and tissue diagnosis including immunohistochemistry [positive for α-SMA, desmin, calponin, h-caldesmon, or smoothelin] have been mainstay for definitive diagnosis. The standard treatment for leiomyosarcoma of stomach is complete surgical resection of tumor because it has malignant potential and does not respond to targeted treatment with a tyrosine kinase inhibitor. The type of surgery depends on the size and localization of the tumor.\u0000 \u0000 \u0000 \u0000 Early diagnosis with proper imaging, immunohistochemistry, and biopsy play important role in differentiating gastric leiomyosarcoma from GIST. Surgical resection is the mainstay of treatment.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"39 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140229162","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}
In locally advanced rectal cancers (LARC), TNM staging is far from optimal. We aimed to investigate the value of previously described circulating biomarkers as predictors of prognosis. Retrospective analysis of 245 LARC patients diagnosed between January 2010 and December 2022, who underwent neoadjuvant chemoradiotherapy and surgery at two centers. A Cox regression and Kaplan-Meier analysis were performed. Posttreatment platelet-to-lymphocyte ratio (PLR) predicted pCR. Neutrophil-to-lymphocyte ratio (NLR) in two timepoints of the treatment significantly predicted overall survival, whereas platelet-neutrophil (PN) index significantly predicted disease-free survival. In pathological stage II, PN index predicted patients of higher risk of disease-free survival. Blood parameters might allow the definition of subgroups of risk, beyond TNM, for the application of different therapeutic strategies.
在局部晚期直肠癌（LARC）中，TNM 分期远非最佳。我们旨在研究之前描述的循环生物标志物作为预后预测因子的价值。 我们对2010年1月至2022年12月期间确诊的245例LARC患者进行了回顾性分析，这些患者在两个中心接受了新辅助化放疗和手术。研究人员进行了Cox回归和Kaplan-Meier分析。 治疗后血小板淋巴细胞比值（PLR）可预测pCR。治疗两个时间点的中性粒细胞与淋巴细胞比值（NLR）可显著预测总生存期，而血小板-中性粒细胞（PN）指数可显著预测无病生存期。在病理分期 II 中，PN 指数可预测无病生存风险较高的患者。 除 TNM 外，血液参数还可用于定义风险亚组，以应用不同的治疗策略。
{"title":"Prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-neutrophil (PN) index in locally advanced rectal cancer patients: a retrospective cohort study","authors":"Marina Morais, Telma Fonseca, Raquel Machado-Neves, Mrinalini Honavar, Ana Rita Coelho, Joanne Lopes, Emanuel Guerreiro, Silvestre Carneiro","doi":"10.1097/ms9.0000000000001297","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001297","url":null,"abstract":"\u0000 \u0000 In locally advanced rectal cancers (LARC), TNM staging is far from optimal. We aimed to investigate the value of previously described circulating biomarkers as predictors of prognosis.\u0000 \u0000 \u0000 \u0000 Retrospective analysis of 245 LARC patients diagnosed between January 2010 and December 2022, who underwent neoadjuvant chemoradiotherapy and surgery at two centers. A Cox regression and Kaplan-Meier analysis were performed.\u0000 \u0000 \u0000 \u0000 Posttreatment platelet-to-lymphocyte ratio (PLR) predicted pCR. Neutrophil-to-lymphocyte ratio (NLR) in two timepoints of the treatment significantly predicted overall survival, whereas platelet-neutrophil (PN) index significantly predicted disease-free survival. In pathological stage II, PN index predicted patients of higher risk of disease-free survival.\u0000 \u0000 \u0000 \u0000 Blood parameters might allow the definition of subgroups of risk, beyond TNM, for the application of different therapeutic strategies.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232739","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 : 2024-03-18DOI: 10.1097/ms9.0000000000001863
Nguyen Nguyen, Ngoc Quang Nguyen, Le Nam Phuong Trinh, Thi My Duong, Nu Thi Nhu Quynh Ton, Thanh Dang
The combination of septoplasty and turbinoplasty is a common surgical and accepted intervention to correct nasal obstruction. Coblation submucosal reduction turbinator is a new surgical device and it started to be used recently. On the other hand, the medial flap inferior turbinoplasty is not conservative technique, but it provides a reliable and robust reduction. This study aims to compare the symptoms as well as health related quality of life (HQOL) in 55 patients who underwent septoplasty with concomitent medial flap inferior turbinoplasty (group 1), 53 patients who patients underwent septoplasty with concomitent coblation turbinator (group 2). We performed a prospective, randomized study of 108 patients who consulted the otorhinolaryngology department at the university hospital for surgery of septoturbinoplasty. Preoperatively the two patient groups had a quite similar symptom and health related quality of life, and the anterior width of the inferior turbinate showed significant differences between the contralateral and deviated sides but not the posterior part. The significant difference (P<0.05) was noted for postoperatively improved symptom scores on VAS, NOSE and better HQOL (SNOT-22) all patient groups. In addition, the NOSE and SNOT-22 scores in group 2 had significantly greater improvement than group 1 (P<0.05). Septoturbinoplasty treatment of septum deviation and inferior turbinate hypertrophy led to less symptoms as well as better HQOL for all two patient groups. Therefore, these techniques were an effective intervention for turbinate reduction and they are equally efficient in the long term.
{"title":"A comparison of symptoms and quality of life between medial flap and coblation turbinator of inferior turbinate reduction in endoscopic septoturbinoplasty: An analysis of 108 cases","authors":"Nguyen Nguyen, Ngoc Quang Nguyen, Le Nam Phuong Trinh, Thi My Duong, Nu Thi Nhu Quynh Ton, Thanh Dang","doi":"10.1097/ms9.0000000000001863","DOIUrl":"https://doi.org/10.1097/ms9.0000000000001863","url":null,"abstract":"\u0000 \u0000 The combination of septoplasty and turbinoplasty is a common surgical and accepted intervention to correct nasal obstruction. Coblation submucosal reduction turbinator is a new surgical device and it started to be used recently. On the other hand, the medial flap inferior turbinoplasty is not conservative technique, but it provides a reliable and robust reduction.\u0000 \u0000 \u0000 \u0000 This study aims to compare the symptoms as well as health related quality of life (HQOL) in 55 patients who underwent septoplasty with concomitent medial flap inferior turbinoplasty (group 1), 53 patients who patients underwent septoplasty with concomitent coblation turbinator (group 2).\u0000 \u0000 \u0000 \u0000 We performed a prospective, randomized study of 108 patients who consulted the otorhinolaryngology department at the university hospital for surgery of septoturbinoplasty.\u0000 \u0000 \u0000 \u0000 Preoperatively the two patient groups had a quite similar symptom and health related quality of life, and the anterior width of the inferior turbinate showed significant differences between the contralateral and deviated sides but not the posterior part. The significant difference (P<0.05) was noted for postoperatively improved symptom scores on VAS, NOSE and better HQOL (SNOT-22) all patient groups. In addition, the NOSE and SNOT-22 scores in group 2 had significantly greater improvement than group 1 (P<0.05).\u0000 \u0000 \u0000 \u0000 Septoturbinoplasty treatment of septum deviation and inferior turbinate hypertrophy led to less symptoms as well as better HQOL for all two patient groups. Therefore, these techniques were an effective intervention for turbinate reduction and they are equally efficient in the long term.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"43 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231399","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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