Malignant Insulinoma: Diagnostic Difficulties and Treatment Strategies in a Case of Persistent Hypoglycemia.

Hypoglycemia in non-diabetic individuals is a rare but critical condition that often signals an underlying pathology. Insulinoma, a rare neuroendocrine tumor of the pancreas, is a key differential diagnosis. As the most common functional pancreatic neuroendocrine tumors, insulinomas originate from pancreatic islet cells and are predominantly benign.

Association of Palliative Care Consultation in Patients With Heart Failure With Preserved Ejection Fraction With Symptom Burden and Health Care Use.

Background: Guidelines recommend palliative care (PC) for patients with heart failure. However, little research has been performed assessing the effect of PC consultation in patients with heart failure with preserved ejection fraction (HFpEF).

Objectives: The purpose of this study was to investigate the impact of PC consultation on symptom burden and health care utilization among individuals with HFpEF during the last 3 years of their lives.

Bilateral Anti-VEGF on Same-Day-Investigation on Safety in Retinopathy of Prematurity: A Multicenter Retrospective Study.

Purpose: To report an incidence of procedure-related complications in preterm infants with retinopathy of prematurity (ROP) treated with intravitreal anti-VEGFs injection in both eyes on the same day.

Design: Retrospective, multicenter case series.

Subjects: Preterm infants with ROP treated with anti-VEGF bilaterally on the same day.

The Impact of Donor Body Mass Index on Safety and Outcomes in Living Donor Liver Transplantation: An Analysis of the National United States Database.

Background: The prevalence of obesity is rising in the general population. Donor obesity (body mass index ≥30 kg/m) may potentially reduce the donor pool and impact outcomes in living donor liver transplantation (LDLT).

Methods: We utilized the national transplant database to investigate the impact of donor obesity on donor and recipient outcomes.

The Potential Utilization of Machine Perfusion to Increase Transplantation of Macrosteatotic Livers.

Background: The demand for liver transplantation has led to the utilization of marginal grafts including moderately macrosteatotic livers (macrosteatosis ≥30% [Mas30]), which are associated with an elevated risk of graft failure. Machine perfusion (MP) has emerged as a technique for organ preservation and viability testing; however, little is known about MP in Mas30 livers. This study evaluates the utilization and outcomes of Mas30 livers in the era of MP.

Full Thickness Macular Hole in Aesthetician Occurring Due to Accidental Self-exposure to Cosmetic Laser Machine Trying to Take Special Precautions Against COVID-19.

A 25-year-old aesthetician was operating Q-switch pulse (SPECTRA) cosmetic laser machine of 1,064 nm wavelength, for the purpose of skin bleaching. The probe suddenly slipped over the plastic sheet that had been placed to avoid COVID-19 exposure after which she complained of sudden loss of vision. She was diagnosed as having vitreous hemorrhage in her right eye and was treated conservatively for one month.

Fulminant amoebic colitis co-infection in a patient with COVID-19.

A woman in her 80s who presented with sudden abdominal pain and bloody stool associated with fever, dry cough and malaise, was found to be COVID-19 RT-PCR positive with fulminating necrotising amoebic colitis. She underwent right extended hemicolectomy with ileostomy and survived despite an unpredictable post-operative course, the need for aggressive intensive care and other major risk factors, and was discharged home after the twentieth day of her presentation.This case summarises the survival of a geriatric patient diagnosed with two lethal complications - amoebic colitis and COVID-19 respiratory infection with the aid of prompt surgical intervention and appropriate critical care.

Successful Weaning From Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) After Initiation of Inhaled Epoprostenol in a Neonate With Refractory Persistent Pulmonary Hypertension of the Newborn (PPHN).

Despite improvements in the medical management of persistent pulmonary hypertension of the newborn (PPHN), a significant number of patients persist with inadequate gas exchange and are treated with extracorporeal membrane oxygenation (ECMO). Prolonged time to weaning ECMO can increase mortality risk. Therefore, multiple therapies are utilized for pulmonary hypertension treatment, including pharmacotherapy with pulmonary vasodilators, to improve the prognosis of these critical patients.

Long-term outcomes of laparoscopic longitudinal pancreatojejunostomy and modified Frey's procedure for patients of chronic pancreatitis: A 10-year experience.

Introduction: To mitigate the morbidity associated with open procedures for chronic pancreatitis (CP), there is a paradigm shift towards the laparoscopic approach. However, since these procedures are technically demanding, literature is still limited. We present our experience and long-term outcomes in the management of CP with laparoscopic surgical procedures.

COMBINED HAMARTOMA OF THE RETINA AND RETINAL PIGMENT EPITHELIUM AT PEDIATRIC AGE: Surgical Versus Conservative Approach.

Purpose: To report outcomes of pediatric patients with combined hamartoma of the retina and the retina pigment epithelium followed up conservatively or after pars plana vitrectomy.

Methods: This retrospective multicenter study included 62 eyes of 59 pediatric patients with combined hamartoma of the retina and the retina pigment epithelium from 13 different international centers with an average age of 7.7 ± 4.

Initial experience of radiofrequency ablation for the treatment of advanced haemorrhoidal disease.

Introduction: The ideal approach to the management of haemorrhoidal disease (HD) remains to be elucidated. A procedure that returns the anal cushions to their normal size without destroying them or damaging the surrounding tissues is sought. Radiofrequency ablation (RFA) overcomes many of the disadvantages of the previously described repairs and may be a valuable alternative in the management of advanced HD.

Post-Expansion and end of treatment outcomes of semi-rapid maxillary expansion with a modified removable appliance.

Context: Maxillary expansion is the mainstay therapy for maxillary transverse deficiency. There has been a constant search for the most effective yet biologically friendly method of maxillary expansion, alternatives being, slow, rapid and semi rapid.

Aims: The purpose of this study was to explore the outcome of palatal expansion achieved using a removable plate and low continuous forces brought about by a semi rapid screw activation protocol.

Optimal timing of laparoscopic cholecystectomy post-endoscopic retrograde cholangiography and common bile duct clearance: A prospective observational study.

Background: The treatment of patients with cholelithiasis with common bile duct (CBD) stones is CBD clearance with cholecystectomy. While traditional teachings advocate waiting for 4-6-week post-endoscopic retrograde cholangiography (ERCP) with CBD clearance, recent studies favour an early laparoscopic cholecystectomy (LC). Hence, this study was conducted to evaluate the optimal timing of LC post-ERCP.

Management of pancreatic trauma in urban India: A multicenter study.

Background: Pancreatic trauma occurs in 0.2-2% of patients with blunt trauma and 1-12% of patients with penetrating trauma. The mortality and morbidity rates range from 9 to 34% and 30-60% respectively.

A Comparative Study of Desarda's Versus Lichtenstein's Technique for Uncomplicated Inguinal Hernia Repair.

Purpose Since mesh-related long-term morbidity like chronic groin pain and vas entrapment in patients with an inguinal hernia is a concern, tissue-based repairs should be revaluated. There have been few prospective studies comparing the outcomes of Lichtenstein's technique and Desarda's technique for the repair of uncomplicated inguinal hernias. So, we conducted this prospective study comparing the two techniques.

Comparison of RetCam and Smartphone-Based Photography for Retinopathy of Prematurity Screening.

This study aimed to compare the clinical performance between a smartphone-based fundus photography device and a contact imaging device for retinopathy of prematurity (ROP) screening. All patients were first examined with binocular indirect ophthalmoscopy (BIO), which served as the reference standard. The patients were then assessed by two devices.