Euthanasia: Growing Acceptance amid Lingering Reluctance
Published on: 14th February, 2025
Euthanasia has long been a contentious topic. Societal acceptance and legalization of euthanasia have increased over the past decades but still lag behind that of physician-assisted suicide (PAS). Euphemisms such as “death with dignity” have facilitated the integration of PAS into end-of-life discussions with reduced stigma. We hypothesize that the persistent use of the term “euthanasia” hinders open, compassionate communication about this practice, particularly among healthcare professionals who adhere to the ethical principle of nonmaleficence. To address this issue, we propose the adoption of euphemisms, such as “eumori,” meaning “good death,” similar to the terminology used in (PAS). These proposed terms mitigate the negative connotations associated with euthanasia. This approach serves as an initial yet significant step toward reframing euthanasia within the context of end-of-life care. Further research and dialogue are essential to explore and address other barriers to broader acceptance of euthanasia as a viable end-of-life option.
Pneumothorax as Complication of CT Guided Lung Biopsy: Frequency, Severity and Assessment of Risk Factors
Published on: 12th February, 2025
Background: CT-guided lung biopsy is routinely performed minimally invasive procedure. Imaging findings in the lung can have a broad differential diagnosis; therefore, it is indicated for definitive determination of pulmonary nodules or masses. Post-biopsy complications are common with most of them manageable in daycare. As pneumothorax is the most common complication, frequency and severity of pneumothorax with assessment of risk factors and follow-up for resolution is necessary.Methods: A prospective evaluation of 123 biopsies with automated coaxial biopsy of 18 gauge was done. Post-biopsy pneumothorax was evaluated for its incidence and resolution. The studied risk factors were; patient age, sex, lesion location, lesion size, shortest pleural lesion depth, traversed lung parenchymal distance, presence of emphysema, fissure penetration, needle thoracic wall angle, and lesion characteristics.Results: Reported immediate post-procedural pneumothorax was 22% with 19% of mild, 4% of moderate and 2.4% of severe cases. 51.9% of cases showed resolution within 24 hours. The intervention was required in only 4.8% of biopsy cases. A significant p - value of pneumothorax with the nodule depth increased traversed lung parenchymal distance, acute needle angle, fissure puncture, and presence of emphysema was seen. Emphysema was an independent variable in pneumothorax in multivariate analysis.Conclusion: Pneumothorax is an unamenable consequence of CT-guided lung biopsy and a cautious approach should be kept in view of the variables that are associated with it to reduce its incidence and severity in patients.
Evolution of Antifungal Activity of Artemisia herba-alba Extracts on Growth of Aspergillus sp. and Rhizopus sp.
Published on: 11th February, 2025
Plant extracts and their constituents have a long history as antifungal agents, but their use in biotechnology as preservatives, due to the increasing resistance of fungi to fungicides, has been rarely reported in Libya. The aim of this study is to evaluate the antifungal activity of ethanol extract and water extract of the wild native plant Artemisia herba-alba against two genera of mold fungi Aspergillus sp. and Rhizopus sp. This mold fungal causes significant damage to crops in the field or during storage. In this study, a hot ethanol extract was prepared using a device Soxhlet, and water extract hot as well as a cold ethanol extract and cold-water extract aqueous extract three concentrations (25% - 50% - 75%) of plant extracts were used on the tested fungi. All extracts showed an effect on the tested fungi. The concentrations of (75% - 50%) of the extracts had an effect on the tested fungi, while most concentrations of 25% of the extracts did not record any effect on the tested fungi. The hot ethanol extract of the Artemisia herba-alba plant was more effective than the other extracts. Aspergillus sp. was recorded with the highest inhibitory zone (0.73 mm).
Hepatic Angiomyolipoma Mimicking Hepatocellular Carcinoma: Another Rare Case Report
Published on: 11th February, 2025
Epithelioid angiomyolipomas (AML) are uncommon mesenchymal neoplasms, belonging to the group of perivascular epithelioid cell neoplasms (PECOMA). Hepatic PECOMA is even rarer. It’s difficult to diagnose in preoperative by imaging, especially when the fatty component is scant or absent. The gold standard for the diagnosis is histologic examination coupled with an immunohistochemical study. Positive HMB45 immunostaining of the myoid cells is a major diagnostic feature. Herein, we report a particular case of hepatic angiomyolipoma in a middle-aged woman with no significant medical past history. The preoperative diagnosis was difficult given the absence of specific clinical manifestations, even the radiologists considered high suspicion of hepatocellular carcinoma. The final diagnosis has been made by post-operative histology coupled with an immunohistochemistry study.
GELS as Pharmaceutical Form in Hospital Galenic Practice: Chemico-physical and Pharmaceutical Aspects
Published on: 10th February, 2025
This work aims to describe the chemical-physical properties of various GELS used as galenic forms in hospital pharmacy practice. After an overview of the excipients and method used three preparations are reported. LAT GEL is used as an anesthetic in an emergency (pediatry ) in treating little Traumatic lacerations of the skin and scalp, calcium gel is used as an antidote for fluoride acid burns, and Lidocaine viscose 2% oral gel is used in some pathological conditions like severe esophagitis in onco - hematological patients after radiotherapy or chemotherapy. The galenic role in the situation of some drug shortages was also analyzed.
Lymphoscintigraphic Investigations for Women with Lower Limb Edemas After One Pregnancy
Published on: 11th February, 2025
Lower extremity edema is one of the most common complaints among pregnant patients. Lymphatic origin to these edemas is rarely considered and few cases of lymphedema after pregnancy have been reported and documented in medical literature. We describe here a series of 15 cases where the diagnosis of lymphedema was established by lymphoscintigraphy. Dermal reflux was observed in ten of the 15 patients (66%), popliteal lymph nodes in 11 (73%), and the edematous limb(s) were said to be abnormal in all but one case which showed only functional asymmetry at rest and limited vascular reflux in a calf.
Unmasking Renal Complications of Immunotherapy: A Case of Nivolumab-induced FSGS
Published on: 7th February, 2025
Immune Checkpoint Inhibitors (ICPIs), while revolutionizing cancer therapy through potentiation of anti-tumour responses via targeted blockade of T-lymphocyte inhibitory receptors, are associated with immune-related adverse events (irAEs), including diverse renal manifestations. This report presents a case of a 69-year-old male with urothelial carcinoma who developed Acute Kidney Injury (AKI) and nephrotic-range proteinuria following initiation of nivolumab, an anti-PD1 antibody, necessitating renal biopsy to clarify the aetiology. The biopsy revealed Focal Segmental Glomerulosclerosis (FSGS) with endotheliopathy, suggesting a direct ICPI-induced glomerular injury. This case underscores the need for heightened awareness of ICPI-associated glomerular disease, alongside more common renal adverse events such as Acute Interstitial Nephritis (AIN), and for the need for renal biopsy in such cases. While the incidence of ICPI-associated AKI is approximately 17%, and AIN is a more frequent finding, FSGS and other glomerular pathologies should also be considered. Current treatment for such renal events involves discontinuation of the ICPI agent and initiation of immunosuppression with glucocorticoids. The management of these cases requires prompt detection, timely diagnosis, and often interdisciplinary collaboration, thus highlighting the need for more case reports, research, and better treatment strategies.
Unveiling the Impostor: Pulmonary Embolism Presenting as Pneumonia: A Case Report and Literature Review
Published on: 5th February, 2025
Pulmonary Embolism (PE) can present with symptoms resembling pneumonia, creating a diagnostic challenge, particularly in patients with comorbidities. We report the case of a 67-year-old male who presented with cough, hemoptysis, shortness of breath, fever, and pedal edema. Initially diagnosed with consolidation based on chest X-ray findings, he was treated with antibiotics. However, persistent symptoms prompted further evaluation, leading to the diagnosis of PE with pulmonary infarction and deep vein thrombosis on computed tomography pulmonary angiography and Doppler ultrasound. This case highlights the need to consider PE in the differential diagnosis of consolidation, particularly in high-risk individuals, to avoid delays in appropriate management.
Fostering Pathways and Creativity Responsible for Advancing Health Research Skills and Knowledge for Healthcare Professionals to Heighten Evidence-Based Healthcare Practices in Resource-Constrained Healthcare Settings
Published on: 5th February, 2025
Globally, evidence-based healthcare practices are the most dependable framework for effective healthcare decisions and practices. In all nations, financial resources, people, and time are always insufficient. Healthcare professionals should recommend healthcare interventions that have been proven to be safe, effective, and affordable. All healthcare professionals must be creative to be involved in the creation and compilation of trustworthy evidence to support the decrease in morbidity and mortality of communicable and non-communicable diseases, particularly in developing nations. Regretfully, most developing nations still exhibit weaknesses and barriers to promoting health research and evidence-based healthcare. Evidence indicates that developing countries contribute 1% - 2% of health research activities to address global health problems and challenges. As a result, many individuals in these nations continue to have below-average health conditions. The lack of creativity, innovation, and motivation to gain health research competencies for healthcare professionals causes all these issues. Creativity and innovation are the foundations for the effective implementation of evidence-based healthcare. Surprisingly, no researchers have explored how creativity and innovation heighten evidence-based healthcare practices. The primary objective of this project will be to foster pathways and explore the creativity that advances health research abilities among healthcare professionals to improve evidence-based healthcare practices in resource-limited healthcare settings.
Chaos to Cosmos: Quantum Whispers and the Cosmic Genesis
Published on: 4th February, 2025
Quantum fluctuations, usually arising from the inherent uncertainty in the quantum fields, are pivotal in understanding the universe at both the small and large scales. Even though fluctuations are usually unobservable and rather small, they give significant observable effects during specific epochs under specific conditions. During the early epochs of the universe, the fluctuations were scaled, resulting in the primordial density perturbations that gave rise to the large-scale structure of the universe and the observed inhomogenities. In this paper, we study the basic origin, structure, evolution, and imprints of fluctuations during the inflationary period resulting in large-scale structure formation. We use the Mukhanov-sasaki formalism to model scalar perturbations, embedding the theoretical results into observations. Theoretical predictions show an almost scale-invariant power spectrum with stringent constraints on the inflationary parameters. It further states that in the very early universe, the inflatons that are quanta of the primordial field were highly filled in the degenerate quantum state. This carries large potential energy that results in an exponential expansion of the universe. During post post-inflationary period the inflaton dominated the Universe’s energy density; they interact among themselves and due to non-linear effects, these inhomogeneities grow which amalgamate into spatially distinguishable patches in our observable universe. Our understanding projects us towards the fact that fluctuations play a pivotal role in understanding the structure formation at micro, macro, and far-macro scales. This study also addresses the significance of quantum fluctuations in cosmic evolution and manifests the enduring relevance in addressing some of the profound mysteries of our universe.
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