Cholecysto-colonic fistula after xanthogranulomatous cholecystitis: Surgeon’s nightmare
Published on: 9th February, 2021
OCLC Number/Unique Identifier: 8998604264
Xanthogranulomatous cholecystitis is a rare benign inflammatory disease of gallbladder that may be misdiagnosed as carcinoma of the gallbladder intraoperative or in pre-operative imaging. Intramural accumulation of lipid-laden macrophages and acute and chronic inflammatory cells is the hallmark of the disease. The xanthogranulomatous inflammation can be very severe and can spill over to the neighboring structures like liver, bowel and stomach resulting in dense adhesions, abscess formation, perforation, and fistulous communication with adjacent bowel [1-3]. Cholecysto-colic fistula is a rare and late complication of gallstones roughly found 1 in every 1,000 cholecystectomies.
Clinical featuresThe clinical features are variable and non-specific. Patients with cholecysto-colonic fistula often present with symptoms of acute cholecystitis and preoperative diagnostic tools often fail to show the fistula. Hence most cases it is an on table diagnosis.
ManagementTreatment involves closing the fistula and performing an open or laparoscopic cholecystectomy.
Treatment of antibiotic-resistant bacteria by nanoparticles: Current approaches and prospects
Published on: 8th June, 2022
Antibiotic-resistant bacteria are emerging pathogens whose resistance profiles generate a serious health crisis by holding their impact on human health. Misuse of antibiotics has directed the emergence of microbes immune to presently accessible drugs. Pathogenic bacteria become resistant by employing various mechanisms, such as; antibiotic modification, target site alteration, and biofilm formation, increasing the time they spend in the intracellular environment where antibiotics are unable to succeed at therapeutic levels. Due to this, attempts are being made to develop new alternative nanoantibiotics as a promising approach to treat multidrug resistance disease-causing bacteria. Accordingly, there is considerable contemporary attention to the use of nanoparticles (NPs) as antibacterial agents against different pathogens and as target drug delivery toward specific tissues therefore microbes are eliminated by the biocidal properties of nanoantibiotics. Additionally, the utilization of nanoencapsulation systems can help to beat the issues of, those with toxicity natures, and target drug delivery problems. This review encompasses the antibiotic resistance prevalence, mechanisms, and therefore the use of nanoparticles as antibacterial and drug delivery systems to overcome the antibiotic resistance challenges of bacteria. Overall, this review paper provides a conceptual framework for understanding the complexity of the matter of emergence of antibiotic resistance bacteria even for brand spanking new synthesized antibiotics. Therefore the availability of such knowledge will allow researchers to supply detailed studies about the applications of nanoparticles in the treatment of multidrug-resistant bacteria.
Curettage is a risk factor for marginal umbilical cord insertion
Published on: 2nd July, 2020
OCLC Number/Unique Identifier: 8628672442
Objective: To identify the risk factors for marginal cord insertion (MCI).
Material and Methods: This case-control study was carried out between 1st February and 30th June 2019. Singletons with and without MCI at delivery were recruited. Main variables analyzed included maternal age, parity, number of previous dilatation and curettage (D&C) or manual vacuum aspiration (MVA), time interval between each procedure and conception, cord insertion. Fisher’s exact test, t-test and logistic regression were used to compare data from both groups.
Results: We found 60 cases of MCI (4.1%). The significant (p < 0.05) risk factors for MCI were past-history of D&C (aOR 5.97, 95% CI 1.95-18.25) particularly when conception occurred ˂ 5 months after D&C (OR 10.5, 95% CI 1.36-81.05), fetal female sex (aOR 3.82, 95% CI 1.41-10.32), parity ≥ 4 (aOR 2.63, 95% CI 1.05-12.71) and past-history of MVA (aOR 2.06, 95% CI 1.23-8.76).
Conclusion: Women should be advised to conceive at least five months after D&C.
Effect of Pesticides on Human Health
Published on: 14th August, 2023
The demand for pesticides has increased in today’s world of expanding population in order to boost crop productivity and eliminate undesirable plants (weeds) that grow alongside the primary crop. Along with the various benefits, it is also used in animal farms to get rid of pests. This has an impact not only on humans but also on animals and the environment. The usage of pesticides has increased, and occasionally some of them linger in the food products they are applied to, a condition known as pesticide residue. This residue is linked to human health and can result in a variety of diseases and disorders. In the current environment, even pesticides that are marketed as benign have negative long-term effects and exacerbate issues like bioaccumulation and bio-magnification. To avoid food contamination with pesticides, different methods like crop rotation, organic farming, and integrated pest management should be used as alternatives. Today, it is essential for all pesticide users to be aware of the risk and proper handling of these pesticides. New methods of pest management should be fostered in the realm of development.
Patellar fractures in children
Published on: 19th November, 2019
OCLC Number/Unique Identifier: 9269418298
We describe a rare case of patellar fracture in a seven year old girl. The case was reviewed for various aspects such as clinical diagnosis, imaging tests and most suitable treatment.
Prevalence of PTSD symptoms in children: The cost of the inadequate mental health system in Pakistan
Published on: 15th June, 2022
Post-Traumatic Stress Disorder (PTSD) is a disorder that affects not only military veterans but also the general public specifically children. They may replay the event and its aftermath, avoid talking about it, have low self-esteem, and be unable to develop meaningful connections. Mentally sick individuals in Pakistan frequently face an obstacle, as discussing mental health is taboo. Mentally ill people are publicly humiliated in Pakistan, and sufferers are occasionally referred to as “pagal.” Even parents ignore the symptoms of their children.
Treatment of autoimmune hemolytic anemia with erythropoietin: A case report
Published on: 20th November, 2019
OCLC Number/Unique Identifier: 9269420484
In this article, we describe the case of a fifty-year-old patient with autoimmune hemolytic anemia (AIHA) with constitutional symptoms, jaundice, unquantified fever and progressive dyspnea. The patient had history of smoking and Hepatitis A and following a physical exam she was found in a regular condition, icteric but with no other further signs. Her laboratory tests revealed hemolytic anemia with a hemoglobin of 8.5 g/dL, an increase of total and indirect bilirubin, an elevated ferritin, a decreased transferrin and haptoglobin and a positive result for direct Coomb’s test. Considering this, an immune profile was ordered finding a negative result of ANAs and ENAs and a decrease of complement C3 and C4. The patient was diagnosed with AIHA and as an initial step a corticosteroid treatment was administrated however the patient showed no clinical nor chemical improvement. At her third day of hospitalization, she was unstable hemodynamically requiring transfer to Intensive Care Unit (ICU) to optimize management. After 24 hours on ICU, due to persistence of deterioration of the patient, it was decided to manage with erythropoietin (EPO). In the following days, the patient showed a rise in her hemoglobin and an overall improvement made possible the transfer to hospitalization service. The AIHA is an uncommon disease and is not the first option that comes to mind with these symptoms, currently there are not controlled studies to the treatment due to its complexity and the heterogeneity of the results. We strongly support the use of EPO in refractory cases of this pathology.
Foley catheter balloon tamponade as a method of controlling iatrogenic pulmonary artery bleeding in redo thoracic surgery
Published on: 20th November, 2019
OCLC Number/Unique Identifier: 9269426092
Background: Pulmonary artery bleeding secondary to iatrogenic injury is a troublesome intraoperative complication. The likelihood of encountering this complication is significantly higher in redo surgery for a number of reasons, including distortion of anatomical structures, adhesions and loss of tissue planes. Significant blood loss, although rare, remains a concern, and can occasionally be life-threatening. When significant bleeding from the pulmonary artery occurs, it can be a challenging situation to manage.
Case Report: A 65 year old female was undergoing redo thoracic surgery in the setting of a completion lobectomy for biopsy-proven primary adenocarcinoma of the lung. Iatrogenic injury to the pulmonary artery resulted in significant bleeding that could not be managed by gaining proximal control due to dense adhesions. The novel decision to utilize a Foley catheter for balloon tamponade was taken, in order to provide sufficient haemostasis for definitive surgical repair of the defect to be undertaken
Conclusion: The increased technical difficulties of redo thoracic surgery are well recognised. We describe the first case of Foley catheter balloon tamponade being utilized in the context of iatrogenic pulmonary artery bleeding during thoracic surgery.
Delayed penile prosthesis implantation in the delayed presentation of ischemic priapism
Published on: 6th February, 2020
OCLC Number/Unique Identifier: 8541455754
Priapism is currently defined as a prolonged painful erection without sexual stimuli, if priapism persists > 36 hours, conservative treatment does not lead to detumescence.
The most common etiologies are: medications into corpora cavernosa, anti-psychotics, anti-hypertensives, hematological disorders (chronic myeloid leukemia).
The Penile prosthesis is the choice treatment for restoring the erectile function after the failure of the conservative treatment.
But the corporal fibrosis makes it very difficult, with high risk of complications [1].
Endometriosis as a risk factor for colorectal cancer
Published on: 12th August, 2020
OCLC Number/Unique Identifier: 8667860684
Endometriosis is a common benign disease in women of reproductive age, it has been associated with an increased risk of various malignancies that is defined by certain histological criteria mainly 80% in ovary and 20% in extragonadal sites such as intestine, rectovaginal septum, abdominal wall, pleura and others; the greatest risk for colorectal cancer is women with adenomyosis or endometriosis; Several genetic alterations have been found in the risk of endometriosis associated with cancer; The symptomatology, imaging and endoscopic characteristics simulate other inflammatory and malignant lesions that make the preoperative diagnosis of extragonadal endometriosis difficult. This is a review of the knowledge about endometriosis and its potential risk of malignancy, particularly with colorectal cancer
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