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Hyperglyceridemia induced pancreatitis in pregnancy accounts for 4% of all cases of acute pancreatitis. Though rare, hypertriglyceridemia induced pancreatitis may lead to fatal maternal and fetal complications, even maternal death. Its management during pregnancy remains a challenge for many physicians. Management options are limited in pregnancy. In the refractory cases, management options and timing of delivery is debatable. Here we report a case of hyperglyceridemia induced pancreatitis and the challenges faced in the management.

Introduction: Immune checkpoint inhibitors (ICI) have significantly improved cancer treatment outcomes, but cardiovascular complications such as ICI-associated myocarditis are a major concern. Diagnosing myocarditis requires integrating biomarkers, electrocardiogram (EKG), cardiac imaging, and endomyocardial biopsy. We present a case illustrating these diagnostic challenges, involving a female patient treated with pembrolizumab who developed fatal acute myocarditis mimicking infiltrative cardiomyopathy.Case report: A 54-year-old woman with mucosal melanoma, treated with pembrolizumab, was hospitalized in May 2023 due to dyspnea and elevated troponin levels. Initial cardiac workups were normal, but subsequent tests revealed borderline cardiac magnetic resonance imaging findings. In late May 2023, the patient was admitted with worsening dyspnea, elevated NT-pro-BNP, and severe hyperlactatemia. Imaging and endomyocardial biopsy confirmed acute myocarditis with atypical presentation, mimicking infiltrative cardiomyopathy. Despite aggressive immunosuppressive therapy, the patient’s condition deteriorated, resulting in cardiogenic shock and death seven days post-admission.Conclusion: This case underscores the diagnostic and management challenges of ICI-associated myocarditis, particularly with atypical presentations. It highlights the need for vigilant, comprehensive monitoring and further research to improve diagnostic and therapeutic strategies for managing these severe side effects in patients undergoing ICI therapy.

Background/aim: Amitriptyline belongs to class of known as tricycline antidepresant (TCA) that is being used to treat anxiety and depressive states. It may help improve mood and feelings of well-being, relieve anxiety and tension, help to improve sleep and increase energy level. The study investigated the effect of amitriptyline on learning and memory using eighteen (18) healthy Swiss mice of both sexes weighing 16 – 25 g. Method: The animals were divided into three (3) groups consisting of six (6) animals each. Group 1 served as the control group, Group 2 was administered with amitriptyline at a dose of 3 mg/kg body weight dissolved in 3 mls of distilled water, and used to test for learning, while Group three was also given similar administration like Group 2, but used to test for memory. All the animals were tested for learning and memory performance using Novel object recognition task and Morris water maze test. Results: The results obtained from the Novel object recognition task showed that there was a significant decrease (p < 0.05) in total object approach in acquisition trial of amitriptyline treated group when compared to the acquisition trial of the control group. There was a significant decrease (p < 0.05) in retention trial of amitriptyline group when compared to retention trial in the control group. There was a significant decrease (p < 0.05) in total duration exploring objects in acquisition trial of amitriptyline treated group when compared to the acquisition trial of the control group. There was a significant increase (p < 0.05) in total duration exploring objects in retention trial of amitriptyline treated group when compared to the retention trial of the control group. There was a significant decrease (p < 0.05) in the index of habituation of amitriptyline treated group when compared to the control group. The index of discrimination showed a significant increase (p < 0.05) in amitriptyline treated group when compared to the control group and a significant decrease (p < 0.05) in amitriptyline group when compared to the control group. In the Morris water maze test, Day 1 – 3 were for acquisition training, day 4 – 6 reversal training, day 7 the probe trial day and day 8 the visible platform day. During acquisition training in the Morris water maze test, there was no significant difference in Swim latencies in day 1 and 2. However in day 3, there was a significant increase (p < 0.05) in swim latency of group compared to control group and a significant decrease (p < 0.05) in swim latency of amitriptyline treated group compared to the control group. During reversal training in day 1, 2 and 3, there was no significant difference in swim latency among the three groups. Results for the retention quadrant in the probe trials showed a significant decrease (p < 0.01) in amitriptyline group when compared to the control group. Conclusion: Results suggest that amitriptyline impairs learning and memory functions.

Background: Stunting is a condition of growth and development disorders in children under 5 years of age who appear shorter than their age caused by nutritional deficiencies. The stunted growth and development of children can be influenced by deficiencies in the intake of macronutrients such as protein and micronutrients such as calcium, phosphorus, zinc, and vitamin D. One nutrient that is relevant to current dental health research is vitamin D. Objective: This review article will further analyze the relationship between vitamin D deficiency and Porphyromonas gingivalis bacterial lipopolysaccharide in stunting children. Literature review: Vitamin D deficiency can cause various problems related to the oral cavity such as a decrease in salivary flow rate, buffer capacity, and salivary content such as protein. A decrease in salivary flow rate causes secretory Immunoglobulin A (IgA) to decrease, thus disrupting the colonization of normal microflora in the oral cavity. Reduced vitamin D levels can potentially increase the number of Porpyhromonas gingivalis bacteria and also lipopolysaccharides (LPS), thus inhibiting the proliferation and differentiation of alveolar bone cells. Conclusion: Therefore, lack of micronutrient intake such as vitamin D deficiency can trigger the growth of Porphyromonas gingivalis bacteria and an increase in bacterial products such as lipopolysaccharides, especially in stunted children. 

Background: Tuberculosis (TB) is a significant global health problem, and extrapulmonary TB can present with no specific clinical or radiographic findings. Genito-urinary TB is often associated with elevated tumor markers and can be misdiagnosed as ovarian/fallopian tube carcinomas, especially in elderly female patients, as genitourinary TB commonly affects women of reproductive age.Objective: We present a rare case of genito-urinary TB in an elderly female patient who was initially misdiagnosed with ovarian cancer with metastasis.Case presentation: An 83-year-old woman with a medical history of diabetes and hypertension presented with complaints of abdominal distension. Diagnostic imaging revealed lesions in the ovaries and omentum and tumor markers were elevated, leading to a suspicion of ovarian cancer with metastases to the omentum. The patient underwent a diagnostic laparotomy and surgical removal of ovaries, fallopian tubes, and the lesion of the greater omentum. However, no malignancy was found during the morphological evaluation. Further histopathological examination confirmed the final diagnosis of genito-urinary tuberculosis, and the patient received anti-TB drugs. The postoperative period was uneventful, and tumor marker levels decreased.Conclusion: As the clinical presentation of genito-urinary TB can mimic ovarian cancer, a histopathological examination should be performed for differential diagnosis, thereby reducing the possibility of inaccurate treatment. This case report highlights the importance of considering genito-urinary TB as a differential diagnosis in elderly female patients presenting with elevated tumor markers, abdominal distension, and suspected genital malignancy. It is crucial to carefully evaluate these cases and explore the possibility of genital TB as an alternative diagnosis, given the overlapping clinical presentation. This highlights the importance of a comprehensive diagnostic approach that includes considering TB in addition to malignancy, even in the context of elderly female patients.

With each passing year a new record for global emissions is set (1) and policymakers and utility companies must embrace all avenues for decarbonization of energy. Universal adoption of electrification for every building and home by 2050 (2) is not practical, a balance must be struck between an equitable transition to cleaner energy supplies and ensuring uninterrupted, safe delivery of energy to utility customers. Renewable Natual Gas (RNG) is a molecule-for-molecule replacement of traditional geological natural gas with tangible life cycle emissions reductions. California continues to lead the way, initially starting with the low carbon fuel standard (LCFS) which aimed to reduce the carbon intensity of transportation fuel, and subsequently, Senate Bill 1440, which established RNG procurement goals including 12% RNG by 2030 (3). Other States are starting to adopt similar changes such as Oregon’s Senate Bill 98 and Colorado’s Senate Bill 21-264. As utilities attempt to transition the energy network, they must never compromise system safety and reliability. Recognizing that raw biogas has dangerous levels of contaminants of concern (COC) and must be conditioned to pipeline quality, its important utility companies better understand the methods with which methane is extracted and the testing protocols used to confirm performance. This paper highlights the equipment, processes, and testing regime National Grid and its partner the New York City Department of Environmental Protection (NYC DEP) deployed as part of its Newtown Creek RNG project, which successfully began injecting RNG into the NYC gas distribution network in October 2022.

Introduction: A 17 years old male patient was treated at the University orthodontic department. He had the chief complaint of unaesthetic appearance of his teeth, mostly for anterior crowding. The pretreatment records showed a Class II skeletal relation, moderate upper and lower anterior crowding, 0.5mm of overbite and 2mm of overjet. Materials and Methods: It was suggested Osteogenic Accelerated Orthodontics (OAOTM), the treatment option was very attractive to the patient although it required a surgical procedure and a more expensive type of treatment. Results: The overall treatment time was 6 months, facial balance was improved and the final occlusal relationships from the functional and aesthetics perspective were good. Conclusion: OAOTM is a good alternative to reduce extractions rate as it increases the scope of tooth movement and strengthen the periodontal tissues thru bone grafting, although these claims require more scientific data to be validated.

It was pyrite from Congo which conducts electricity but cannot store it as the existing event of catalytic nanomotors. Herewith provided discussion and description from nanodiamond contained in meteorite to alkylation reaction any catalytic nanomotors proposed to enhance the built-in DNA-wave biocomputer.We found chondrite meteorites in primitive types of space rock.

The term open bite is referred as no contact between anterior or posterior teeth. The complexity of open bite is attributed to a combination of skeletal, dental and habitual factors. Etiology of open bite can be attributed to genetics, anatomic and environmental factors. However, the tendency toward relapse after conventional or surgical orthodontic treatment has been indicated. Therefore, open bite is considered one of the most challenging dentofacial deformities to treat. The aim of this article is to emphasize that early etiological diagnosis, dentofacial morphology and classification are essential to the successful outcome of the technical intervention. Failure of tongue posture adaptation subsequent to orthodontic and/or surgical treatment might be the primary reason for relapse of open bite. Prolonged retention with fixed or removable retainers is advisable and necessary in most cases of open bite treatment. The treatment of open bite remains a tough challenge to the clinician; careful diagnosis and timely intervention with proper treatment modalities and appliance selection will improve the treatment outcomes and long-term stability. 

Concussion diagnosis is a clinical categorization that often rests primarily on symptom reporting. However, diagnostic criteria require certain signs and symptoms to be either ruled in or ruled out.