We hope that this case report elucidates the importance of obtaining a meticulous history in guiding clinicians towards prompt diagnosis, even in instances where there may be an evolving clinical picture.
We hope that this case report elucidates the importance of obtaining a meticulous history in guiding clinicians towards prompt diagnosis, even in instances where there may be an evolving clinical picture.
To determine factors associated with repeat revascularization among adults aged 25 years and above within 5 years of first Percutaneous Coronary Intervention (PCI) at a tertiary care hospital.

A matched case-control study was conducted through a hospital records review. A total of 90 cases with repeat revascularization and 180 controls without repeat revascularization were included. Data was analyzed using Multiple Conditional Logistic Regression.

The mean age was similar in cases and controls (60.05±10.01 vs 62.20±10.43 years) and sex (male 77.8% vs. 76.1%). History of being an ever-smoker (40% vs. 25%), overweight (36.3% vs. 30.6%), and poor glycemic control (23.3% vs. 12.2%) were more among the cases than controls. However, obesity (53.7% vs. 44.3%) and pre-diabetes (16.1% vs. 7.8%) were more in controls compared to cases.Upon matching on the time of index PCI, the adjusted odds of ever smokers among patients with repeat revascularization was 2.47 times the odds of ever smokers among patients who did not undergo revascularization. Increasing stent diameter by 1mm was found to reduce the risk of repeat revascularization by 51%.

Smoking cessation and appropriate selection of stent diameter in patients undergoing revascularization can reduce the risk of repeat revascularization in the future.
Smoking cessation and appropriate selection of stent diameter in patients undergoing revascularization can reduce the risk of repeat revascularization in the future.
Acute Kidney Injury (AKI) is a major and under-recognised cause of morbidity and mortality worldwide. Low and middle-income countries bear the greatest burden of AKI (85%). There is currently no published literature on AKI from the Pacific Islands. The aim of the present study was to report the incidence, aetiology, management and outcomes measures of AKI from the tertiary referral hospital of Samoa.

Single-centre prospective observational study. Participants were recruited by the lead investigator from the hospital patient information system. The inclusion criteria for participation was (1) adults (>18 years) admitted to general wards of Tupua Tamasese Meaole (TTM) Hospital with a diagnosis of AKI between December 1, 2019 and May 31, 2020, and (2) serum creatinine level of >200μmol/L, and (3) compliance with the current Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI diagnosis. The data collection form was adapted from the International Society for Nephrology - Global Snapshot Probased incidence and unfavourable outcomes of AKI are high in Samoa. Greater awareness of this under-recognised condition is warranted among the public, government officers, and health professionals.
Febrile seizures are usually benign and are not presented with neurological manifestation. However, complex febrile seizures are presented with recurrence and might require meticulous management. The aim of this study was to evaluate the demographic, clinical, and laboratory parameters of children with febrile seizures and the correlation between these factors.

In this retrospective study, children presented with febrile seizure in 2019 presented (XXX) were included. Data based on their history, physical examination, and laboratory tests and discharge recommendations were recorded in a checklist. Data were computerized and statistically analyzed using SPSSv25.

Of 77 patients were studied, the mean age of the patients was 29.4±17.6. The mean duration of seizures was 5.09±3.78min and the mean temperature during seizures was 38.41±0.83°C. In 44 (57.14%) patients no cause of the fever was recorded. 10 (12.99%) patients had multiple seizures within 24h 70 (90.91%) seizures ended without medication, and 5 (6.49%) patients were treated with diazepam. The gender of the patients was only correlated with white blood cells, p=0.014. Other laboratory parameters did not show significant correlation with the gender, p>0.05. The discharge recommendation was significantly correlated with recurrence within 24h and type of seizure, p<0.001, respectively. Lab parameters were significantly associated with family history, p=0.036 and post-seizure drug, p=0.005.

Our study showed that biochemical findings may not be suggestive of febrile seizures and recurrence of seizures and family history is associated with the course of treatment in terms of drugs and imaging.
Our study showed that biochemical findings may not be suggestive of febrile seizures and recurrence of seizures and family history is associated with the course of treatment in terms of drugs and imaging.The bronchial carcinoid (BC) tumor is a neuroendocrine lung tumor that accounts for 1-2% of all lung neoplasia occurrences. However, BC tumors remain rare in the literature. Nowadays, video-assisted thoracoscopic surgery VATS can be safely performed with an excellent clinical outcome. The typical procedure involves three incisions. We assume that performing the same procedures with a single utility incision is possible. This report describes our experience performing sleeve bilobectomy for a neglected carcinoid tumor using a uniportal VATS without spreading of ribs.
and importance Heroin-induced leukoencephalopathy (HLE) is a rare illness that causes diffuse white matter destruction, leading to acute or subacute development of neurological signs and symptoms. Physicians must be aware of the likely clinical presentation to properly evaluate and diagnose this clinical entity.

We report the case of a young gentleman who presented with acute stupor following his first instance of heroin vapor inhalation. He later confessed to
-conjunctival application of the drug as well. His Glasgow Coma Scale (GCS) score improved within four days of admission, however, the neurologic sequalae such as cognitive impairment, spastic paraparesis and urge incontinence only partially resolved at three months. https://www.selleckchem.com/products/fm19g11.html Abnormal white matter hyperintensities with restricted diffusion on brain magnetic resonance imaging and history of heroin abuse led to diagnosis of toxic leukoencephalopathy.

Leukoencephalopathy with heroin is mostly observed after inhalation (i.e., "chasing the dragon") but other routes of abuse have also been reported. Although a large spectrum of presentations exists, altered mental status, cerebellar dysfunction and fecal/urinary incontinence are the most commonly seen presenting features. Anti-oxidant therapy has shown promising results in terms of treatment.

The growing rates of opioid use disorders require physicians to be aware of and counsel the patients regarding dangerous neurological sequelae of these drugs.
The growing rates of opioid use disorders require physicians to be aware of and counsel the patients regarding dangerous neurological sequelae of these drugs.The association of ovarian malignancy with pregnancy is rare; accounting for 3-6% of ovarian masses of which malignant germ cell tumors represent the type most frequently associated with pregnancy, whereas the incidence of epithelial ovarian cancer is only 1/12,000 to 1/50,000 of pregnancies. The diagnosis and management of ovarian cancer in pregnancy remain poorly codified because of the rarity of cases and the limited data available on this pathology. We report here the case of a 45-year-old woman with a large ovarian mucinous adenocarcinoma diagnosed during pregnancy, identified by ultrasound and magnetic resonance imaging. The patient was treated by surgical resection followed by adjuvant chemotherapy with carboplatin and paclitaxel with a follow-up of 36 months, she is in complete remission.
Laparoscopic colorectal surgery (LCRS) is the optimal choice for cases of early cancer. However, due to their early stage, one of this procedure's challenges is tumoral localization. So that, there are many methods of locating tumors preoperatively that have been studied by authors. Recently, Korean authors have reported a method of injecting autologous blood to mark the tumor before surgery with high efficiency and safety. This article aims to evaluate the effectiveness by analyzing the section biopsy's results, as well as the safety of this procedure.

This study is descriptive cross-section study with analysis of retrospective occurrences of case series of colonoscopy with autologous blood before surgery from October 2020 to December 2021.

16 patients were recruited to the study. The average age was 62.9±13.1 with male/female ratio was 8/8. 50% (8/16 patients) of all cases was early carcinomas, and by location, 62.5% of all cases was sigmoid colon tumors. All 16 patients (100%) found the tumor marking position. None of the patients had complications of marked endoscopy such as intestinal perforation, peritonitis, abdominal abscess, intestinal adhesions, etc.

The method of autologous blood injection to locate the tumor before laparoscopic colorectal surgery is a technique that can be performed effectively and safely.
The method of autologous blood injection to locate the tumor before laparoscopic colorectal surgery is a technique that can be performed effectively and safely.
Road traffic incidents are the most common cause of multiple organ trauma in low- and middle-income countries. Multiple blunt intra-abdominal organs that rupture in conjunction with a ruptured aorta are terrible and rare.

A 65-year-old man sustained critical injuries during a traffic collision between a motorcycle and truck. The Injury Severity Score was 42 points,. After open abdominal exploration, we repaired the left diaphragmatic rupture with a 13-cm-long tear of IV grade (American Association for the Surgery of Trauma), resected partial small bowel, simple suture of the transverse colon, and Hartmann procedure in the descending colon. Thoracic endovascular aortic repair (TEVAR) was performed 22 h after laparotomy. Reconstruction of the head depicting a cheekbone fracture and inferior to the left orbital bone was performed on the 14th day. The patients survived and were discharged from the hospital, at 22 days without morbidity or mortality.

Diaphragmatic rupture provides a signal to relate head, thoracic, and abdominal blunt trauma. If the patient sustains more serious life-threatening injuries that require emergency laparotomy or craniotomy, and aortic repair may be delayed. Laparotomy is the best initial surgical method in this case. TEVAR is a feasible and gold standard procedure for the treatment of patients with the necessary indications.

It is essential to evaluate the level of organ damage to properly coordinate the specialists. The timing of the operation and therapeutic alternatives should be decided for each patient.
It is essential to evaluate the level of organ damage to properly coordinate the specialists. The timing of the operation and therapeutic alternatives should be decided for each patient.