FibroScan as a surveillance marker post-cavopulmonary anastomosis for single-ventricle physiology.

Purpose: Single-ventricle physiology encompasses a group of congenital cardiac malformations with only one functional ventricle. The Fontan procedure is the final palliation of this pathway and has its complications. One of these is Fontan-associated liver disease (FALD).

Mental Health Symptoms and Service Use in Depressed and Anxious Minors at the Onset of COVID-19 in a County Clinic Serving a Predominantly Hispanic Population.

Objective: The study's primary aim was to compare the utilization rates of services by minors with depression/anxiety in a county mental health clinic before (from December 1, 2019, to March 15, 2020) and during the COVID-19 pandemic (from March 16 to June 30, 2020). The secondary aim was to study demographics and psychiatric symptomatology.

Methods: Service utilization rates were estimated.

The House Cup: Using Longitudinal Gamification to Improve Didactic Attendance.

Objective: Determine if a point-based attendance system combined with longitudinal gamification is feasible and improves didactic session attendance and learner perceptions at our internal medicine residency.

Methods: A prospective before-after cohort study. Weekly attendance was tracked from June 2022 through April 2023 at our university-affiliated internal medicine residency program.

"Postponing it Any Later Would not be so Great": A Cognitive Interview Study of How Physicians Decide to Initiate Goals of Care Discussions in the Hospital.

Background: There are missed opportunities to discuss goals and preferences for care with seriously ill patients in the acute care setting. It is unknown which factors most influence clinician decision-making about communication at the point of care.

Objective: This study utilized a cognitive-interviewing technique to better understand what leads clinicians to decide to have a goals of care (GOC) discussion in the acute care setting.

An outcome of emergency vascular surgery performed by general surgeons; our experience in a university hospital of Pakistan and can they substitute vascular surgeons?

Objective: To measure the outcome of emergency vascular surgery performed by general surgeons, and to identify preventable causes of mortality.

Methods: The retrospective study was conducted at the General Surgery Department of Mayo Hospital, King Edward Medical University, Lahore, Pakistan, and comprised data between January 2014 and May 2019 related to cases regardless of age and gender that required emergency vascular surgery after diagnosis by a consultant surgeon at the surgical emergency. The cases were analysed from admission till discharge.

Diagnosis of Cutaneous Chromoblastomycosis and Its Response to Amphotericin B Therapy: A Case Report.

Cutaneous chromoblastomycosis is a chronic subcutaneous fungal disease of the skin caused by , especially by , ,and species affecting the skin, lungs, intestines, stomach, and central nervous system. It is treated using itraconazole in mild cases and amphotericin B in severe cases. A six-year-old female child presented to the Dermatology Outpatient Department with pigmented brown to blackish tanned plaques and verrucous lesions on the face and extremities.

An Unusual Presentation of Crohn's Disease and Primary Sclerosing Cholangitis.

Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory gastrointestinal bowel disorders that may affect any part of the alimentary tract. Classically, these two diseases have hallmark associations, such as UC with primary sclerosing cholangitis (PSC). We present a case of a healthy 21-year-old white female with concomitant CD and PSC, complicated by a biliary stricture requiring stent placement.

Toxic Epidermal Necrolysis Secondary to Metronidazole.

Hypersensitivity reactions occur when a host exhibits an inappropriate or exaggerated response to allergens. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are examples of such exaggerated responses to various drugs or illnesses. Both conditions affect the skin and mucosal surfaces of the oral cavity, urethra, and conjunctiva to varying degrees.

Successful treatment of recurrent hepatic encephalopathy with revision of transjugular intrahepatic portasystemic shunt and embolisation of splenorenal shunt.

We present a case of 64-year-old US veteran who developed recurrent hepatic encephalopathy (HE) following transjugular intrahepatic portasystemic shunt (TIPSS) procedure. The patient had a history of metabolic syndrome and cirrhosis due to non-alcoholic steatohepatitis. He had undergone sleeve gastrectomy 1 year earlier with preoperative TIPSS placement.

Comparison of the outcome of mesh hernioplasty under local anaesthesia in patients with age less than 60 years VS more than 60 years in terms of wound complications and urinary retention.

Objective: To compare the outcome of mesh hernioplasty performed under local anaesthesia in relatively young and older patients regarding wound complications and urinary retention.

Methods: This comparative study was conducted at Mayo Hospital, Lahore, Pakistan, from 17th Feb 2017 to 17th feb 2018, and comprised patients who underwent mesh hernioplasty. Demographic profile was noted and the patients were divided into <60 and >60 age groups.

The longitudinal impact of COVID-19 pandemic on neurosurgical practice.

Objective: This observational cross-sectional multicenter study aimed to evaluate the longitudinal impact of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical practice.

Methods: We included 29 participating neurosurgeons in centers from all geographical regions in the Kingdom of Saudi Arabia. The study period, which was between March 5, 2020 and May 20, 2020, was divided into three equal periods to determine the longitudinal effect of COVID-19 measures on neurosurgical practice over time.

Safety and Efficacy of Hydroxychloroquine in COVID-19: A Systematic Review and Meta-Analysis.

Background: During the initial phases of the coronavirus disease 2019 (COVID-19) epidemic, there was an unfounded fervor surrounding the use of hydroxychloroquine (HCQ); however, recently, the Centers for Disease Control and Prevention (CDC) has recommended against routine use of HCQ outside of study protocols citing possible adverse outcomes.

Methods: Multiple databases were searched to identify articles on COVID-19. An unadjusted odds ratio (OR) was used to calculate the safety and efficacy of HCQ on a random effect model.

Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study.

Objective: Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality.

Methods: A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic.

Ventricular Dyssynchrony based on echocardiographic variables and exercise tolerance After right ventricular pacing: Impact of alternative septal lead locations.

Objective: We investigated the impact of alternative locations of right ventricular (RV) pacing on left ventricular function and its relation to exercise capacity.

Methods: Fifty patients who received a single lead pacemaker were divided according to RV pacing site into group 1 "high septum" (n = 15), group 2 "mid-septum" (n = 25), and group 3 "low septum" (n = 10) using a documented fluoroscopic method. Dyssynchrony parameters were obtained using different echocardiographic parameters.

Effect of dietary tryptophan supplementation on growth performance, immune response and anti-oxidant status of broiler chickens from 7 to 21 days.

Background: This study was conducted to investigate the optimum dietary level of tryptophan (Trp) supplementation at which broiler chickens have better growth with efficient immune system and anti-oxidant status.

Method: One hundred and twenty (n = 120) 1-day-old broiler chicks were fed a common commercial diet from days 1 to 7. On day 7, the chicks were randomly divided in three treatment groups, that is, Trp 0.

Design and training effects of a physical reality simulator for minimally invasive mitral valve surgery.

Objectives: Minimally invasive mitral valve surgery (MIMVS) through an endoscopic right minithoracotomy is a well-established yet complex procedure that has a challenging learning curve. We have developed a simulator for MIMVS and evaluated its short- and long-term training effects.

Methods: Trainees without simulator experience or training in MIMVS were divided into 2 groups (10 students and 10 residents) and participated in a 5-day training course after initial instruction.

Minimally invasive versus conventional extracorporeal circulation circuits in patients undergoing coronary artery bypass surgery: a propensity-matched analysis.

Objectives: Minimally invasive extracorporeal circulation circuits provide several advantages compared to conventional extracorporeal circulation circuits. We compared the results of a minimally invasive extracorporeal circulation system with those of conventional extracorporeal circulation system, in patients undergoing isolated coronary artery bypass grafting.

Methods: We identified 753 consecutive patients who underwent coronary artery bypass grafting at our centre between October 2014 and September 2016.

Complex Valve Surgery in Elderly Patients: Increasingly Necessary and Surprisingly Feasible.

Objectives: The increasing proportion of elderly patients in cardiac surgery poses additional challenges for the clinical management and leads to a higher operative risk due to multiple comorbidities of these patients. We reviewed the outcome of patients who were 75 years and older and underwent complex multiple valve surgery at our institution.

Methods: A retrospective review was performed to identify patients who were 75 years and older and underwent multiple valve surgery between January 2011 and May 2016 at our institution.

Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery.

We analyzed the long-term results of two surgical techniques (beating versus non-beating) for isolated tricuspid valve (TV) surgery.The long-term results of 92 consecutive patients who underwent isolated TV surgery were analyzed. We compared patients with beating heart (BH) surgery (n = 48) with patients undergoing arrested heart (AH) surgery (n = 44).

Surgical treatment for isolated tricuspid valve endocarditis- long-term follow-up at a single institution.

Background: Systematic long-term data on tricuspid valve (TV) endocarditis are limited. The aim of this study was to investigate the outcome of surgery for isolated TV endocarditis.

Methods And Results: A total of 637 patients who underwent TV surgery between June 1996 and September 2012 at Hannover Medical School were retrospectively investigated.

Pacemaker dependency after isolated aortic valve replacement: do conductance disorders recover over time?

Objectives: Permanent pacemaker (PPM) implantation is required in 3-8% of all patients undergoing aortic valve replacement (AVR). Our aim was to evaluate long-term PPM dependency and recovery of atrioventricular (AV) conduction disorders during follow-up in these patients.

Methods: Since January 1997, a total of 2106 consecutive patients underwent isolated AVR at our institution.

Inhibition of cell division in mouse B-cell hybridomas: an overlooked property of 2-mercaptoethanol and its impact on in vitro antibody production.

Thiol 2-mercaptoethanol (2-ME) has been reported to enhance growth in lymphocytes by various investigators. Some have used 50 μM for growing hybridomas in vitro. Concentrations of 50 and 5 μM in 5% FBS supplemented D-MEM were tested to determine their effects on the growth of 5 monoclonal antibody secreting mouse B cell hybridomas and the myeloma Sp2/O-Ag14.

The first fifty consecutive Bentall operations with a prefabricated tissue-valved aortic conduit: a single-center experience.

Background And Aim Of The Study: Composite replacement is the standard treatment for the repair of aortic aneurysm with aortic valve pathology. With improved long-term durability and no requirement for long-term anticoagulation, tissue-valved conduits have become increasingly popular. Herein are reported the results achieved with 50 consecutive 'Bentall' operations, using the first commercially available prefabricated stentless tissue-valved conduit (Vascutek BioValsalva).

Aortic root reoperation: a technical challenge.

Background And Aim Of The Study: It is well known that aortic root re-replacement presents a formidable technical challenge. Thus, the study aim was to describe the authors' experience with this high-risk cohort.

Methods: Between August 1996 and January 2009, a total of 26 patients (mean age 51 years; range: 16-72 years) underwent aortic root re-replacement surgery at the authors' institution.