Articles

The integration of artificial intelligence (AI) technology into various fields, particularly healthcare, has demonstrated considerable potential in improving efficiency and accuracy. However, the potential risks associated with unprofessional or inappropriate use of AI cannot be overlooked. The current landscape of healthcare demonstrates a growing reliance on AI tools, which is expected to expand in the future. The existing literature highlights the effectiveness  of various AI applications, including chatbots, in specific medical domains. This study aims to review relevant literature in the pharmaceutical and galenic fields while evaluating a prominent AI chatbot provider. Based on the findings, this article presents critical considerations for researchers and practitioners. A thorough assessment of the benefits and risks associated with AI technologies is essential as these tools become increasingly prevalent in pharmaceutical practices.

Scoliosis is a condition of abnormal lateral curvature of the spinal column greater than 10 degrees as measured by Cobb’s angle. The two main groups of scoliosis are idiopathic scoliosis and non-idiopathic scoliosis. The diagnosis of an idiopathic scoliosis is made if a non-idiopathic one has been excluded. Idiopathic adolescent scoliosis is a more common form. Neuromuscular scoliosis, which is a type of non-idiopathic scoliosis, is characterized by diverse muscular and neurological impairments. Anesthesia and surgery for neuromuscular scoliosis have a higher risk of perioperative complications than for idiopathic cases.

Dentistry has much to offer in the detection and solution of crime or civil proceedings. Forensic dentistry requires an interdisciplinary knowledge of dental science, and it is the role of the Forensic Odontologist to establish a person's identity. Teeth, with their physiologic variations, pathosis record information that remains throughout life and beyond. Forensic Odontology has an important role in the recognition of abuse among children. Teeth may also be used as a weapon against children, and physical evidence such as DNA, bite marks, fingerprints may objectively link suspects to a crime and develop important investigative leads. Gender identification and sex determination by analyzing the pulp tissue in primary teeth can be regarded as an effective tool in providing valuable forensic information. The rights of children and their aspirations are of paramount importance, and the Pediatric dentist can contribute immensely to the field of Forensic Odontology in providing justice to these unfortunate children.

Background: Postmenopausal bleeding (PMB) is bleeding from the genital tract after 12 months of amenorrhea in a woman over the age of 50, or 24 months if below the age of 50 years, in 10% of women presented with PMB, the cause is endometrial cancer.Purpose: To assess the clinical presentation types and outcomes of diagnostic measures provided for women presenting with PMB at Saad Abu-Alela Hospital, Khartoum, Sudan.Methodology: It was a descriptive, cross-sectional study conducted at Saad Abu-Alela Teaching Hospital in the period from January to December 2022.An interview questionnaire was used for data collection. Fifty-nine (59) postmenopausal women were included in this study, age, parity, risk factors, duration of bleeding, duration of menopause, ultrasound findings, and hysteroscopy findings were recorded.Results: The majority of study participants were aged between 50-54 years, menopause duration was most 1-4 years, most of the participants were educated and medically free, DM and HTN, and most of the participants were multiparous. Duration of PMB ranged between weeks in a third of cases and up to more than a year in some cases, amount of bleeding was mild in more than half. Ultrasound is used to assess the endometrial thickness and other findings, also hysteroscopy and biopsy or Dilation and curettage and hysterectomy.Conclusion: The ultrasound and endometrial biopsy via inpatient hysteroscopy and dilatation and curettage were the best tools for evaluation of (PMB), benign conditions were the most frequent outcome and endometrial cancer.

Foreign bodies of the esophagus are part of the traumatic emergencies in ENT. They are most often encountered in children, whereas in adults they occur in a particular context and are rarely overlooked.This was a 48-year-old patient from a neighboring country referred by a colleague for a history of neglected laryngeal contusion with infectious cervical fistula evolving for 2 years. Further questioning revealed a notion of accidental ingestion of dentures. The first endoscopy was of capital interest in especially in the diagnosis and management of this long-retained foreign body. The extraction under general anesthesia was done by a combined endoscopic and external approach. The postoperative course was marked by superinfection and swallowing disorders.Cervical suppurations secondary to esophageal foreign bodies are rare, especially in adults. Clinicians should consider this possibility in the face of any chronic cervical suppuration that resists treatment.

Endoscopic dacryocystorhinostomy (EDCR) is a well accepted surgical treatment for patients with nasolacrimal duct obstruction (NLDO). Previously, external dacryocystorhino-stomy was considered as the gold standard treatment for NLDO, however, EDCR has gained momentum due to its several advantages. The EDCR has been sounding more aesthetic and as functional compared to the traditional external dacryocystorhinostomy in the surgical treatment of nasolacrimal duct obstruction with comparable outcomes. Purpose: to determine the success rate and complications of endoscopic dacryocystorhinostomy without stenting.Materials and methods: it was a retrospective study performed in the department of Otorhinolaryngology and Head and Neck Surgery (ORL-HNS), Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from June 2019 to September 2024. A total of 19 patients charts were reviewed. All the cases were performed under general anesthesia. All the cases had undergone without silicon stenting and were regularly followed up for a period of 3 months. Post operative stomal patency and complications were noted based on subjective and endoscopic evaluation.Results: Out of 19 patients, 12 were female and 7 were male with the age range of 12 to 70 years. Transnasal synechiae was seen in 2 female and 1 male patients. Stomal patency was 100% with no recurrence of epiphora in 17 patients (89.4%) during 3 months of follow up. 2 female patients with released synechiae didn’t come for 3 months follow up.Conclusion: It is a safe and minimally invasive procedure and has a comparable success rate to external DCR with an additional advantage of more aesthetic value.

Gilbert’s Syndrome (GS) is a hereditary disease that can cause hyperbilirubinemia due to a mutation in the promoter of the UGT1A1 gene, which causes a decrease in uridine diphosphate glucuronyltransferase enzyme activity. Polymorphisms in the UGT1A1 gene are associated with induced hyperbilirubinemia by Tyrosine Kinase Inhibitors (TKI) in Chronic Myeloid Leukemia (CML). We report a case of patient who developed hepatotoxicity when treated on Imatinib and subsequently diagnosed with Gilbert’s syndrome. Eight months after initiating Imatinib, the patient developed conjunctival jaundice and signs of hepatotoxicity with increase in liver enzymes and hyperbilirubinemia with elevated level of unconjugated bilirubin. Gilbert’s syndrome was suspected in the presence of predominantly unconjugated hyperbilirubinemia and a prior history of transient episodes of jaundice. Genetic testing revealed homozygosity for the UGT1A1 TA7 (*28) polymorphism. Imatinib was stopped due to continuous increase of aminotransferases and hyperbilirubinemia and restarted after improvement of Liver Function Tests (LFTs) with a reduced dose of 200 mg/day but LFTs worsted again, and the patient was switched to Dasatinib 100 mg/day, without hepatic cytolysis and a mild persistent hyperbilirubinemia after a follow up of 20 months.Patients with an unexplained rise in serum bilirubin levels on Imatinib therapy should be screened for the genetic UGT1A1 polymorphisms.

Background: To enhance the duration of sensory anaesthesia and to prolong the duration of post-operative pain relief during spinal anaesthesia, various adjuvants have been tried along with local anaesthetic agent. The present study was undertaken to evaluate and compare the onset and duration of sensory block, motor block and duration of post-operative pain relief by using intrathecal 0.5% Hyperbaric bupivacaine with fentanyl 25µg versus only 0.5% Hyperbaric bupivacaine selected groups.Methods: We enrolled 70 ASA Ι & ΙΙ patients undergoing surgeries below umbilicus level for our Prospective Randomized trial. Those who met our inclusion criteria were randomized using simple random sampling technique, after obtaining informed consent. Patients in Group A received fentanyl 25µg with 0.5% Hyperbaric Bupivacaine and patients in Group B received only 0.5% Hyperbaric Bupivacaine intrathecally. Parameters like onset and duration of sensory and motor block and postoperative pain relief were observed. In postoperative period, VAS score was monitored & time for rescue analgesia was noted, when VAS exceeded 5 or above.Results: It was found that Patients in Group A had significantly prolonged duration of postoperative analgesia as compared to Group B (Z value 17.35). Results of Onset & Duration of sensory and motor block were suggesting insignificant result. Post-operative complication was insignificant in our study.Conclusion: Addition of Fentanyl 25µg with 0.5% Hyperbaric Bupivacaine in Spinal anaesthesia have insignificant effect on duration of sensory and motor blockade and prolongs postoperative pain relief.

Melanoma is a highly malignant neoplasm arising from melanocytes, which are melanin-producing neural crest cells primarily located in the basal layer of the epidermis, making cutaneous melanoma the most common subtype. However, melanocytes are also found in other anatomical locations, and primary non-cutaneous melanomas, though rare, have been documented. Due to the aggressive nature of this malignancy, it carries a poor prognosis, particularly because it tends to metastasize to various, often atypical, sites. Recognizing these variable presentations is essential for timely diagnosis. Here, we report a rare case of metastatic brain melanoma in a young female and review the relevant literature, highlighting the importance of imaging in identification.