Use of Aerosolized Prostacyclins in Critically Ill Patients and Association With Clinical Outcomes.

Unlabelled: Aerosolized prostacyclins are frequently used in patients with severe acute respiratory distress syndrome and refractory hypoxia. Previous studies have shown improvement in oxygenation with use of pulmonary vasodilators such as iloprost and epoprostenol; however, there is no head-to-head comparison between these agents.

Objectives: To compare the effects of inhaled epoprostenol and inhaled iloprost in critically ill patients with refractory hypoxia.

A second hit? Pulmonary arterial hypertension, mutation, and exposure to prescription amphetamines.

The second hit hypothesis in pulmonary hypertension refers to the development of pulmonary vascular disease in individuals at risk, after an additional exposure or "hit" to factors with potential injury to the pulmonary circulation, such as drugs or toxins. We here present a case of severe pulmonary hypertension diagnosed during the third trimester of pregnancy, in a patient with familial history of pulmonary hypertension, found to have a heterozygous mutation in the gene, who also had chronic exposure to prescription amphetamines. We hypothesize that exposure to prescription amphetamines could act as a second hit of pulmonary vascular injury in individuals at risk of pulmonary vascular disease.

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield.

Since the endobronchial ultrasound bronchoscope was introduced to clinical practice, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the procedure of choice to sample hilar and mediastinal adenopathy. Multiple studies have been conducted in the last two decades to look at the different technical aspects of the procedure and their effects on the final cytopathological yield. In addition, newer modes of ultrasound scanning and newer tools with the potential to optimize the selection and sampling of the target lymph node have been introduced.

Assessment of knowledge and practices about breastfeeding and weaning among working and non-working mothers.

Objective: To assess the knowledge and practices of working and non-working mothers regarding breastfeeding and weaning.

Methods: This cross-sectional study involving working and non-working mothers was conducted from May 2015 to May 2016 at different hospitals of Karachi. Data was collected from women who had at least one child aged below 5 years and who had previously breastfed their child.

Perforated sub-hepatic appendix; rare presentation of a common disease.

An elderly gentleman presented to our emergency with a 10-day history of right upper quadrant pain and nausea with associated tenderness on examination. His white cell counts were raised with predominant neutrophils with ultrasound evidence of a heterogeneous sub-hepatic collection, not associated with fever, diarrhoea or vomiting. He had a similar episode 3 weeks ago, which resolved with antibiotics.