Pub Date : 2024-07-15DOI: 10.1097/ms9.0000000000002372
A. Jobran, J. Alsamhori, Moath Rushdi Atyani, Mohammed Abdulrazzak, Zarmina Islam, Sifwa Safdar, Shoaib Ahmad, Hassam Ali
The progression in research and studies made by each nation’s scientific communities serves as one of the primary metrics for evaluating that nation’s scientific development, in this study of medical students at Palestinian medical colleges, attention was given to individuals who had been involved in research activities during their undergraduate training. We conducted an online survey among medical students in Palestinian medical institutions, focusing on those engaged in research processes throughout their undergraduate studies. The study started in March 2022 and ended in the final week of May 2022. Participants were instructed to respond to statements regarding research work in the online self-administered questionnaire. In our study, out of 425 participants, only 4.9% published an article. There were no significant gender disparities between males and females who published at least one article. There was a strong association between the year of study and publishing, with clinical students being more likely to publish (90.4%) than preclinical students (8.6%). our study revealed that students published either to enhance their curriculum vitae (33.0%) or out of personal interest (19.0%). While participants in our study demonstrate high levels of awareness and favorable attitudes toward research, active participation in the research community is still insufficient. More opportunity and mentorship are among the stated obstacles to participation in research. To overcome these obstacles, we suggest making long-term investments in research training, starting research clubs, and offering coaching and mentorship.
{"title":"Publication practices of medical students at medical schools in palestine: Experiences, attitudes, and barriers to publishing","authors":"A. Jobran, J. Alsamhori, Moath Rushdi Atyani, Mohammed Abdulrazzak, Zarmina Islam, Sifwa Safdar, Shoaib Ahmad, Hassam Ali","doi":"10.1097/ms9.0000000000002372","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002372","url":null,"abstract":"\u0000 \u0000 The progression in research and studies made by each nation’s scientific communities serves as one of the primary metrics for evaluating that nation’s scientific development, in this study of medical students at Palestinian medical colleges, attention was given to individuals who had been involved in research activities during their undergraduate training.\u0000 \u0000 \u0000 \u0000 We conducted an online survey among medical students in Palestinian medical institutions, focusing on those engaged in research processes throughout their undergraduate studies. The study started in March 2022 and ended in the final week of May 2022. Participants were instructed to respond to statements regarding research work in the online self-administered questionnaire.\u0000 \u0000 \u0000 \u0000 In our study, out of 425 participants, only 4.9% published an article. There were no significant gender disparities between males and females who published at least one article. There was a strong association between the year of study and publishing, with clinical students being more likely to publish (90.4%) than preclinical students (8.6%). our study revealed that students published either to enhance their curriculum vitae (33.0%) or out of personal interest (19.0%).\u0000 \u0000 \u0000 \u0000 While participants in our study demonstrate high levels of awareness and favorable attitudes toward research, active participation in the research community is still insufficient. More opportunity and mentorship are among the stated obstacles to participation in research. To overcome these obstacles, we suggest making long-term investments in research training, starting research clubs, and offering coaching and mentorship.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"26 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646492","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}
Nonalcoholic steatohepatitis (NASH) is a severe medical illness that has few available therapeutic options. Resmetirom, a liver-targeting agonist of the thyroid hormone receptor (THR), has recently been licenced by the FDA. We assess the effectiveness and safety of resmetirom in patients with non-alcoholic steatohepatitis (NASH). PubMed, SCOPUS and Cochrane Central were searched till March 2024 to find potential articles. Outcomes assessed included MRI-PDFF, Fat Reduction, and NASH Resolution Without Fibrosis, changes in AST, ALT, GGT, LDL, and triglyceride (TG) levels, along with diarrhea, nausea, UTI, and headache. Subgroup analysis was performed between outcomes before and after 6 months. Outcomes were analyzed with random effects model and results presented as mean difference (MD) for continuous outcomes and odds ratios (OR) for safety analysis, along with their 95% confidence intervals. Risk of bias assessment was performed using Cochrane Risk of Bias tool. Four RCTs were included in our analysis. Resmetirom shown a substantial improvement in MRI-PDFF with a mean difference of -19.23 (P<0.00001). Additionally, it resulted in a 30% reduction in fat (odds ratio: 3.54, P=0.004) and resolution of NASH without fibrosis (odds ratio: 2.41, P=0.04). There was no notable enhancement observed in AST levels, with a mean difference of -0.87 and a P-value of 0.73. The usage of resmetirom resulted in significant improvement in ALT levels (mean difference: -4.36, P-value: 0.32), GGT levels (mean difference: -17.87, P-value: <0.00001), TG levels (mean difference: -23.48, P-value: <0.00001), LDL levels (mean difference: -12.80, P-value: <0.00001), and rT3 levels (mean difference: -2.08, P-value: <0.00001). The use of Resmetirom was associated with a higher likelihood of experiencing diarrhea (odds ratio [OR]: 2.07, P<0.0001) and nausea (OR: 1.81, P=0.0003). However, there was no significant difference observed in the occurrence of urinary tract infections (UTI) (OR: 1.04, P=0.85) or headaches (OR: 0.79, P=0.48). Resmetirom demonstrates efficacy in enhancing MRI-PDFF score, diminishing adipose tissue, resolving NASH without fibrosis, reducing GGT, TG, LDL, rT3 levels in NASH patients. Nevertheless, there is also an observed heightened susceptibility to experiencing diarrhea and nausea. Additional trials are necessary to further examine the efficacy and safety of this medication.
{"title":"Efficacy and safety of resmetirom among patients with Non-alcoholic steatohepatitis: a systematic review and Meta-Analysis","authors":"Saad Mazhar, Aima Azhar, Ariba Khan, Gulrukh Shakil, Deepa Devi, Sapna Kumari, Sayed Jawad","doi":"10.1097/ms9.0000000000002314","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002314","url":null,"abstract":"\u0000 \u0000 Nonalcoholic steatohepatitis (NASH) is a severe medical illness that has few available therapeutic options. Resmetirom, a liver-targeting agonist of the thyroid hormone receptor (THR), has recently been licenced by the FDA. We assess the effectiveness and safety of resmetirom in patients with non-alcoholic steatohepatitis (NASH).\u0000 \u0000 \u0000 \u0000 PubMed, SCOPUS and Cochrane Central were searched till March 2024 to find potential articles. Outcomes assessed included MRI-PDFF, Fat Reduction, and NASH Resolution Without Fibrosis, changes in AST, ALT, GGT, LDL, and triglyceride (TG) levels, along with diarrhea, nausea, UTI, and headache. Subgroup analysis was performed between outcomes before and after 6 months. Outcomes were analyzed with random effects model and results presented as mean difference (MD) for continuous outcomes and odds ratios (OR) for safety analysis, along with their 95% confidence intervals. Risk of bias assessment was performed using Cochrane Risk of Bias tool.\u0000 \u0000 \u0000 \u0000 Four RCTs were included in our analysis. Resmetirom shown a substantial improvement in MRI-PDFF with a mean difference of -19.23 (P<0.00001). Additionally, it resulted in a 30% reduction in fat (odds ratio: 3.54, P=0.004) and resolution of NASH without fibrosis (odds ratio: 2.41, P=0.04). There was no notable enhancement observed in AST levels, with a mean difference of -0.87 and a P-value of 0.73. The usage of resmetirom resulted in significant improvement in ALT levels (mean difference: -4.36, P-value: 0.32), GGT levels (mean difference: -17.87, P-value: <0.00001), TG levels (mean difference: -23.48, P-value: <0.00001), LDL levels (mean difference: -12.80, P-value: <0.00001), and rT3 levels (mean difference: -2.08, P-value: <0.00001). The use of Resmetirom was associated with a higher likelihood of experiencing diarrhea (odds ratio [OR]: 2.07, P<0.0001) and nausea (OR: 1.81, P=0.0003). However, there was no significant difference observed in the occurrence of urinary tract infections (UTI) (OR: 1.04, P=0.85) or headaches (OR: 0.79, P=0.48).\u0000 \u0000 \u0000 \u0000 Resmetirom demonstrates efficacy in enhancing MRI-PDFF score, diminishing adipose tissue, resolving NASH without fibrosis, reducing GGT, TG, LDL, rT3 levels in NASH patients. Nevertheless, there is also an observed heightened susceptibility to experiencing diarrhea and nausea. Additional trials are necessary to further examine the efficacy and safety of this medication.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644211","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 : 2024-07-12DOI: 10.1097/ms9.0000000000002356
Milad Mellat-Ardakani, Kaveh Atighi, Shahryar Rahmani, Saba Simiyari, F. Salahshour
Limited studies have been conducted on the epidemiology of aortic aneurysms in Iran. In this study, we aimed to comprehensively evaluate the burden and epidemiology of aortic aneurysms across various age groups, genders, and provinces in Iran from 1990 to 2019. We used global burden of disease (GBD) study data, in the current study. We retrieved data on the burden of aortic aneurysms across genders and age groups at national and subnational levels from 1990 to 2019. We extracted mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life year (DALY), numbers, rates, and age-standardized rates. Additionally, we extracted the burden of AA attributable to its risk factors, such as lead exposure, high systolic blood pressure, high dietary intake of sodium, and smoking. National ASDR (age-standardized DALY rate) was also observed to be reduced from 1990 (22.20 [17.46 to 26.86]) to 2019 (19.97 [17.98 to 21.98]). %). However, the inclinations were evaluated to be slighter than the world (%change ASDR=−19.5%). In 2019, three leading risk factors yielding death in AA patients were smoking (ASMR attributable=0.73 [0.67 to 0.80]), high sodium intake (ASMR attributable=0.11 [0.03 to 0.27]), and lead exposure (ASMR attributable=0.04 [0.02 to 0.07]). Mortality and DALYs due to AA both decreased slightly during the last three decades. Considering the role of smoking in the burden of AA in Iran, interventions targeting smoking cessation among high-risk groups, such as males, may be helpful to reduce the burden of AA in Iran in the coming years.
有关伊朗主动脉瘤流行病学的研究十分有限。在本研究中，我们旨在全面评估 1990 年至 2019 年伊朗不同年龄组、性别和省份的主动脉瘤负担和流行病学情况。 在本研究中，我们使用了全球疾病负担（GBD）研究数据。我们检索了 1990 年至 2019 年国家和国家以下各级不同性别和年龄组的主动脉瘤负担数据。我们提取了死亡率、生命损失年数（YLL）、残疾生存年数（YLD）和残疾调整生命年数（DALY）、数量、比率和年龄标准化比率。此外，我们还提取了可归因于铅暴露、高收缩压、高钠膳食摄入量和吸烟等风险因素的 AA 负担。 据观察，全国ASDR（年龄标准化残疾调整寿命年率）也从1990年的22.20[17.46至26.86]降至2019年的19.97[17.98至21.98]。%).然而，与全球相比，其变化趋势较小（ASDR变化%=-19.5%）。2019年，导致AA患者死亡的三个主要风险因素是吸烟（ASMR归因=0.73 [0.67 至 0.80]）、高钠摄入（ASMR归因=0.11 [0.03 至 0.27]）和铅暴露（ASMR归因=0.04 [0.02 至 0.07]）。 在过去三十年中，AA 导致的死亡率和残疾调整寿命年数均略有下降。考虑到吸烟在伊朗 AA 负担中的作用，针对男性等高危人群的戒烟干预措施可能有助于在未来几年减轻伊朗的 AA 负担。
{"title":"Burden of aortic aneurysm in Iran from 1990 to 2019: an analysis based on global burden of disease study","authors":"Milad Mellat-Ardakani, Kaveh Atighi, Shahryar Rahmani, Saba Simiyari, F. Salahshour","doi":"10.1097/ms9.0000000000002356","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002356","url":null,"abstract":"\u0000 \u0000 Limited studies have been conducted on the epidemiology of aortic aneurysms in Iran. In this study, we aimed to comprehensively evaluate the burden and epidemiology of aortic aneurysms across various age groups, genders, and provinces in Iran from 1990 to 2019.\u0000 \u0000 \u0000 \u0000 We used global burden of disease (GBD) study data, in the current study. We retrieved data on the burden of aortic aneurysms across genders and age groups at national and subnational levels from 1990 to 2019. We extracted mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life year (DALY), numbers, rates, and age-standardized rates. Additionally, we extracted the burden of AA attributable to its risk factors, such as lead exposure, high systolic blood pressure, high dietary intake of sodium, and smoking.\u0000 \u0000 \u0000 \u0000 National ASDR (age-standardized DALY rate) was also observed to be reduced from 1990 (22.20 [17.46 to 26.86]) to 2019 (19.97 [17.98 to 21.98]). %). However, the inclinations were evaluated to be slighter than the world (%change ASDR=−19.5%). In 2019, three leading risk factors yielding death in AA patients were smoking (ASMR attributable=0.73 [0.67 to 0.80]), high sodium intake (ASMR attributable=0.11 [0.03 to 0.27]), and lead exposure (ASMR attributable=0.04 [0.02 to 0.07]).\u0000 \u0000 \u0000 \u0000 Mortality and DALYs due to AA both decreased slightly during the last three decades. Considering the role of smoking in the burden of AA in Iran, interventions targeting smoking cessation among high-risk groups, such as males, may be helpful to reduce the burden of AA in Iran in the coming years.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"46 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141653101","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 : 2024-07-12DOI: 10.1097/ms9.0000000000002364
Hritvik Jain, Jyoti Jain, Ramez M. Odat, Aman Goyal, Rukesh Yadav
{"title":"FDA announces recall of over 300,000 arrow radial artery catheterization kits: a call for action – an editorial","authors":"Hritvik Jain, Jyoti Jain, Ramez M. Odat, Aman Goyal, Rukesh Yadav","doi":"10.1097/ms9.0000000000002364","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002364","url":null,"abstract":"","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"26 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141653489","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}
Breast cancer is the most common malignancy among women worldwide, predominantly manifesting as invasive ductal carcinoma (IDC), which usually metastasizes to the bones, lungs, and liver. However, metastasis to the bladder is exceedingly rare, with few documented cases and limited understanding in the existing literature. A 57-year-old woman with a history of IDC presented with a lump in her left breast and was initially treated with chemotherapy and a modified radical mastectomy. Years later, she developed urinary symptoms, which upon investigation revealed multiple bladder tumors and right kidney hydronephrosis. Diagnostic imaging, including ultrasound and CT scans, supported these findings. The discovery of bladder metastasis from IDC highlights significant diagnostic challenges due to the atypical presentation. The case underscores the importance of considering unusual metastatic sites in patients with known breast cancer, especially when they present with non-specific urinary symptoms. This report explores the potential pathophysiological mechanisms of such rare metastatic occurrences and discusses the implications for clinical practice. This case exemplifies the critical need for heightened awareness and thorough evaluation in patients with unusual symptoms and a history of breast cancer. It calls for more comprehensive diagnostic approaches and possibly adjusted treatment protocols to better manage atypical metastases, ultimately aiming to improve patient outcomes and contribute to a deeper understanding of metastatic breast cancer behavior.
{"title":"A case report of breast cancer metastasis to the bladder from invasive ductal carcinoma","authors":"Tian Hou, Guangtai Shen, Xin Hu, Tubuxin Bai, Heping He, Zhipeng Zhang, Wenqi Bao, Ruibo Tian, Xiao-jie Yu, Tianyang Sun, Xiaoli Ding, Xin Wang, Yuhai Zhang","doi":"10.1097/ms9.0000000000002352","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002352","url":null,"abstract":"\u0000 \u0000 Breast cancer is the most common malignancy among women worldwide, predominantly manifesting as invasive ductal carcinoma (IDC), which usually metastasizes to the bones, lungs, and liver. However, metastasis to the bladder is exceedingly rare, with few documented cases and limited understanding in the existing literature.\u0000 \u0000 \u0000 \u0000 A 57-year-old woman with a history of IDC presented with a lump in her left breast and was initially treated with chemotherapy and a modified radical mastectomy. Years later, she developed urinary symptoms, which upon investigation revealed multiple bladder tumors and right kidney hydronephrosis. Diagnostic imaging, including ultrasound and CT scans, supported these findings.\u0000 \u0000 \u0000 \u0000 The discovery of bladder metastasis from IDC highlights significant diagnostic challenges due to the atypical presentation. The case underscores the importance of considering unusual metastatic sites in patients with known breast cancer, especially when they present with non-specific urinary symptoms. This report explores the potential pathophysiological mechanisms of such rare metastatic occurrences and discusses the implications for clinical practice.\u0000 \u0000 \u0000 \u0000 This case exemplifies the critical need for heightened awareness and thorough evaluation in patients with unusual symptoms and a history of breast cancer. It calls for more comprehensive diagnostic approaches and possibly adjusted treatment protocols to better manage atypical metastases, ultimately aiming to improve patient outcomes and contribute to a deeper understanding of metastatic breast cancer behavior.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656050","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 : 2024-07-11DOI: 10.1097/ms9.0000000000002294
Mohamed A. S. Aramin, Shadi Abuhashem, Khalid Jamal Faris, Belal M. M. Omar, Mohd Burhanuddin, Puli Sai Teja, Mark Ibraheim
Surgical correction of post-infarct ventricular septal defect (PIVSD) is associated with a significant incidence of morbidity and mortality. We aimed to evaluate the effectiveness and safety of surgical versus transcatheter approaches in the management of PIVSD. A systematic review and meta-analysis of retrospective from five databases including the Cochrane Library, PubMed, Web of Science, Ovid, and Scopus) until 9 March 2024 was conducted. Risk ratio (RR) for dichotomous outcomes was used and data with a 95% confidence interval (CI) are presented. A total of 7 retrospective observational studies with 603 patients were included in the analysis. surgical closure was associated with a significantly lower short-term mortality and lower number of residual shunt or reintervention rate compared to percutaneous closure, with a relative risk (RR) of 1.21 (95% confidence interval (CI):1:00 to 1.46, P = 0.05) and 2.68 (95% confidence interval: 1.46 to 4.91, P = 0.001) respectively. surgical closure was associated with a non-significantly lower long-term mortality rate compared to percutaneous closure, with a relative risk (RR) of 1.10 (95% confidence interval: 0.82 to1.48, P = 0.52). No difference is reported when time from AMI or PIVSD to intervention is compared groups, with a relative risk (RR) of -0.24 (95% confidence interval: -4.49 to 4.2, P = 0.91). Our meta-analysis shied the light on the significance of surgical closure in terms of short-term mortality and need for re-intervention. However, no significant difference was observed in term of long-term mortality and time to intervention.
{"title":"Surgical closure versus transcatheter closure for ventricular septal defect post infarction, a meta-analysis","authors":"Mohamed A. S. Aramin, Shadi Abuhashem, Khalid Jamal Faris, Belal M. M. Omar, Mohd Burhanuddin, Puli Sai Teja, Mark Ibraheim","doi":"10.1097/ms9.0000000000002294","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002294","url":null,"abstract":"\u0000 \u0000 Surgical correction of post-infarct ventricular septal defect (PIVSD) is associated with a significant incidence of morbidity and mortality. We aimed to evaluate the effectiveness and safety of surgical versus transcatheter approaches in the management of PIVSD.\u0000 \u0000 \u0000 \u0000 A systematic review and meta-analysis of retrospective from five databases including the Cochrane Library, PubMed, Web of Science, Ovid, and Scopus) until 9 March 2024 was conducted. Risk ratio (RR) for dichotomous outcomes was used and data with a 95% confidence interval (CI) are presented.\u0000 \u0000 \u0000 \u0000 A total of 7 retrospective observational studies with 603 patients were included in the analysis. surgical closure was associated with a significantly lower short-term mortality and lower number of residual shunt or reintervention rate compared to percutaneous closure, with a relative risk (RR) of 1.21 (95% confidence interval (CI):1:00 to 1.46, P = 0.05) and 2.68 (95% confidence interval: 1.46 to 4.91, P = 0.001) respectively. surgical closure was associated with a non-significantly lower long-term mortality rate compared to percutaneous closure, with a relative risk (RR) of 1.10 (95% confidence interval: 0.82 to1.48, P = 0.52). No difference is reported when time from AMI or PIVSD to intervention is compared groups, with a relative risk (RR) of -0.24 (95% confidence interval: -4.49 to 4.2, P = 0.91).\u0000 \u0000 \u0000 \u0000 Our meta-analysis shied the light on the significance of surgical closure in terms of short-term mortality and need for re-intervention. However, no significant difference was observed in term of long-term mortality and time to intervention.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"139 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655998","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 : 2024-07-08DOI: 10.1097/ms9.0000000000002362
Muili AbdulBasit Opeyemi, N. Aderinto, Ayodeji Akinmeji, Fatihi Bamigbola Mustapha, J. M. Mubarak, Ayodele Yusuf Joshua, Piel Panther Kuol, Adeyemo Rebecca Opeyemi, Kehinde Alare, G. Olatunji, Kokori Emmanuel
Glioblastoma (GBM) is a highly aggressive and deadly brain tumor. The challenges in managing GBM in Low- and Middle-Income Countries (LMICs) have been underexplored. This review provides a review of surgical management techniques, challenges, outcomes, and future directions for GBM treatment in LMICs. A search of academic databases yielded studies from various LMICs, focusing on surgical management techniques and their outcomes. The data were analyzed in the context of socio-economic, cultural, and infrastructural factors. Comparative analyses were performed to highlight disparities between LMICs and high-income countries. GBM management in LMICs faces multifaceted challenges, including healthcare infrastructure deficiencies, delayed diagnosis, high treatment costs, cultural beliefs, and limited research funding. This adversely affects patient outcomes and survival rates. Surgical excision followed by radiation and chemotherapy remains the standard of care, but LMICs have not significantly benefited from recent advancements in GBM management. Intraoperative neurosurgery ultrasound is identified as an affordable and practical alternative for LMICs. Patient outcomes following GBM surgery in LMICs vary widely, making early detection challenging. Cultural sensitivity and ethical considerations are crucial factors in improving healthcare practices. Surgical management of GBM in LMICs is hindered by complex challenges that require multi-faceted interventions. By addressing socio-economic, cultural, and infrastructural factors, LMICs can improve GBM care and outcomes. Raising awareness and advocating for change are crucial steps in this process.
{"title":"Surgical outcomes of glioblastoma multiforme in low and middle-income countries: current state and future directions","authors":"Muili AbdulBasit Opeyemi, N. Aderinto, Ayodeji Akinmeji, Fatihi Bamigbola Mustapha, J. M. Mubarak, Ayodele Yusuf Joshua, Piel Panther Kuol, Adeyemo Rebecca Opeyemi, Kehinde Alare, G. Olatunji, Kokori Emmanuel","doi":"10.1097/ms9.0000000000002362","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002362","url":null,"abstract":"Glioblastoma (GBM) is a highly aggressive and deadly brain tumor. The challenges in managing GBM in Low- and Middle-Income Countries (LMICs) have been underexplored. This review provides a review of surgical management techniques, challenges, outcomes, and future directions for GBM treatment in LMICs. A search of academic databases yielded studies from various LMICs, focusing on surgical management techniques and their outcomes. The data were analyzed in the context of socio-economic, cultural, and infrastructural factors. Comparative analyses were performed to highlight disparities between LMICs and high-income countries. GBM management in LMICs faces multifaceted challenges, including healthcare infrastructure deficiencies, delayed diagnosis, high treatment costs, cultural beliefs, and limited research funding. This adversely affects patient outcomes and survival rates. Surgical excision followed by radiation and chemotherapy remains the standard of care, but LMICs have not significantly benefited from recent advancements in GBM management. Intraoperative neurosurgery ultrasound is identified as an affordable and practical alternative for LMICs. Patient outcomes following GBM surgery in LMICs vary widely, making early detection challenging. Cultural sensitivity and ethical considerations are crucial factors in improving healthcare practices. Surgical management of GBM in LMICs is hindered by complex challenges that require multi-faceted interventions. By addressing socio-economic, cultural, and infrastructural factors, LMICs can improve GBM care and outcomes. Raising awareness and advocating for change are crucial steps in this process.","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"117 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666667","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 : 2024-07-08DOI: 10.1097/ms9.0000000000002353
Bassel Achmeh, Mohamad Nabil Wahbi, Huda Daood
Acute hemorrhagic leukoencephalopathy (AHLE) is a rare and devastating condition that can present with various neurological symptoms. The predisposing and initiating factors of AHLE are not fully understood. AHLE has a high morbidity and significant mortality rates, however, our case presents a surviving young girl. 13 years old previously healthy girl was referred to the emergency department due to drowsiness, preceded by an upper respiratory infection 10 days earlier. Firstly, she was treated empirical with anti viral medication (Acyclovir) directed to herpes simplex virus and intra venous ( IV) methylprednisolone pulses. When She did not respond well, intravenous immunoglobulin (IVIG) was administrated, which helped with the end-result diagnosis based on clinical and imaging findings. AHLE is a fatal rare demyelinating disease characterized by an acute rapidly progressive fulminant inflammation of the white matter, it is usually misdiagnosed due to being a diagnosis of exclusion, and the much more common other diseases, including infectious encephalitis, meningitis, fulminant multiple sclerosis, other causes of acute disseminated encephalomyelitis (ADEM). different types of CNS infiltrates, such as neutrophils in AHLE and lymphocytes in ADEM, do not support the idea of differentiating the two diseases. The process of differentiating between these two diseases relies mostly on laboratory and imaging findings, which are well demonstrated in this case report. We conclude this report by highlighting the dearth in published knowledge about this disease, and encouraging further studies be conducted about this topic.
{"title":"Acute hemorrhagic leukoencephalopathy: a case report and literature review","authors":"Bassel Achmeh, Mohamad Nabil Wahbi, Huda Daood","doi":"10.1097/ms9.0000000000002353","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002353","url":null,"abstract":"\u0000 \u0000 Acute hemorrhagic leukoencephalopathy (AHLE) is a rare and devastating condition that can present with various neurological symptoms. The predisposing and initiating factors of AHLE are not fully understood. AHLE has a high morbidity and significant mortality rates, however, our case presents a surviving young girl.\u0000 \u0000 \u0000 \u0000 13 years old previously healthy girl was referred to the emergency department due to drowsiness, preceded by an upper respiratory infection 10 days earlier. Firstly, she was treated empirical with anti viral medication (Acyclovir) directed to herpes simplex virus and intra venous ( IV) methylprednisolone pulses. When She did not respond well, intravenous immunoglobulin (IVIG) was administrated, which helped with the end-result diagnosis based on clinical and imaging findings.\u0000 \u0000 \u0000 \u0000 AHLE is a fatal rare demyelinating disease characterized by an acute rapidly progressive fulminant inflammation of the white matter, it is usually misdiagnosed due to being a diagnosis of exclusion, and the much more common other diseases, including infectious encephalitis, meningitis, fulminant multiple sclerosis, other causes of acute disseminated encephalomyelitis (ADEM). different types of CNS infiltrates, such as neutrophils in AHLE and lymphocytes in ADEM, do not support the idea of differentiating the two diseases. The process of differentiating between these two diseases relies mostly on laboratory and imaging findings, which are well demonstrated in this case report.\u0000 \u0000 \u0000 \u0000 We conclude this report by highlighting the dearth in published knowledge about this disease, and encouraging further studies be conducted about this topic.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"7 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667959","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 : 2024-07-08DOI: 10.1097/ms9.0000000000002361
Maysoun Kudsi, Bassel Achmeh, Naram Khalayli, Karam Rabah, Nour Rabah, Lama Al_Darwish, F. Alghawe
We aimed to study systemic lupus erythematosus (SLE) central neurological patterns and their correlations with the disease activity. Our retrospective observational study was carried out on admitted SLE patients. The patients’ demographic data, clinical examinations, laboratory tests, imaging studies and systemic lupus erythematosus disease activity index (SLEDAI) were recorded. 36 SLE patients had neurological manifestations from 203 patients, but 8 patients were excluded. 90.2% were females. The age of neuro-lupus manifestation was 24,1+2,9 years. Neurological manifestations were the initial presentation in 25% of patients. General seizures were the frequent manifestation. SLEDAI was 29.51±18.43, while it was 18.3±9.2 among patients without neuropsychiatric systemic lupus erythematosus (NPSLE). 25% of patients had pleocytosis on cerebrospinal fluid (CSF) analysis. Small lesions were seen in 57,1% of patients on brain magnetic resonance imaging (MRIs), and large lesions were observed in 10,6%. These findings were compatible with the disease activity. Central nervous system involvement ranged between 10%-80%, and much more with active disease. The frequent finding was general seizures. Psychosis and cognitive impairment were relatively frequent. Adult NPSLE manifestations had developed before or around the time of SLE diagnosis and within the first year after diagnosis. These manifestations were directly correlated to the disease activity. Abnormality in CSF is characterized by slight pleocytosis, and elevation of protein with normal fructose. MRI is the neuroimaging test of choice for NPSLE in clinical practice. Central neurological involvement in SLE was seen early in the course of the disease , and correlating to the disease activity.
{"title":"Central neurological manifestations in a sample of syrian patients with systemic lupus erythematosus: cross sectional study","authors":"Maysoun Kudsi, Bassel Achmeh, Naram Khalayli, Karam Rabah, Nour Rabah, Lama Al_Darwish, F. Alghawe","doi":"10.1097/ms9.0000000000002361","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002361","url":null,"abstract":"\u0000 \u0000 We aimed to study systemic lupus erythematosus (SLE) central neurological patterns and their correlations with the disease activity.\u0000 \u0000 \u0000 \u0000 Our retrospective observational study was carried out on admitted SLE patients. The patients’ demographic data, clinical examinations, laboratory tests, imaging studies and systemic lupus erythematosus disease activity index (SLEDAI) were recorded.\u0000 \u0000 \u0000 \u0000 36 SLE patients had neurological manifestations from 203 patients, but 8 patients were excluded. 90.2% were females. The age of neuro-lupus manifestation was 24,1+2,9 years. Neurological manifestations were the initial presentation in 25% of patients. General seizures were the frequent manifestation. SLEDAI was 29.51±18.43, while it was 18.3±9.2 among patients without neuropsychiatric systemic lupus erythematosus (NPSLE). 25% of patients had pleocytosis on cerebrospinal fluid (CSF) analysis. Small lesions were seen in 57,1% of patients on brain magnetic resonance imaging (MRIs), and large lesions were observed in 10,6%. These findings were compatible with the disease activity.\u0000 \u0000 \u0000 \u0000 Central nervous system involvement ranged between 10%-80%, and much more with active disease. The frequent finding was general seizures. Psychosis and cognitive impairment were relatively frequent. Adult NPSLE manifestations had developed before or around the time of SLE diagnosis and within the first year after diagnosis. These manifestations were directly correlated to the disease activity. Abnormality in CSF is characterized by slight pleocytosis, and elevation of protein with normal fructose. MRI is the neuroimaging test of choice for NPSLE in clinical practice.\u0000 \u0000 \u0000 \u0000 Central neurological involvement in SLE was seen early in the course of the disease , and correlating to the disease activity.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":" 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670032","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}
Osteochondroma is a benign skeletal neoplasm presenting with the proliferation of bony tissue. Osteochondroma of the foot is uncommon and that of the cuneiform is an extremely rare entity. We present the case of a 22-year-old woman with osteochondroma of the left medial cuneiform who was having pain in the first ray of the left foot. Most cases of osteochondromas are non-tender and painless mass with a benign asymptomatic course; however, progression to inflammation and neurovascular complications may cause considerable morbidity. The majority of cases are treated conservatively, while some severe cases require surgical management. Operative treatment of osteochondroma with excision of the mass remains a safe and successful alternative to conservative management whenever required.
{"title":"A rare case report of osteochondroma of the left medial cuneiform","authors":"Rohit Shrestha, Sandesh Shankat Maharjan, Abhishek Pandey, Kriti Pradhananga, Archana Pandey","doi":"10.1097/ms9.0000000000002358","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002358","url":null,"abstract":"\u0000 \u0000 Osteochondroma is a benign skeletal neoplasm presenting with the proliferation of bony tissue. Osteochondroma of the foot is uncommon and that of the cuneiform is an extremely rare entity.\u0000 \u0000 \u0000 \u0000 We present the case of a 22-year-old woman with osteochondroma of the left medial cuneiform who was having pain in the first ray of the left foot.\u0000 \u0000 \u0000 \u0000 Most cases of osteochondromas are non-tender and painless mass with a benign asymptomatic course; however, progression to inflammation and neurovascular complications may cause considerable morbidity. The majority of cases are treated conservatively, while some severe cases require surgical management.\u0000 \u0000 \u0000 \u0000 Operative treatment of osteochondroma with excision of the mass remains a safe and successful alternative to conservative management whenever required.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"22 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141836475","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：