Malignant pleural mesothelioma: The disdained member of thoracic oncology!

Pleural mesothelioma is a very aggressive malignancy that arises from the pleural mesothelial cell lining and is linked strongly to prior asbestos exposure. The ban on asbestos has helped to lower the incidence, but in developing countries like India, it is expected to rise. It has an extended latency period usually progressing over decades and presents with nonspecific symptoms.

Carotid Stump Syndrome: Rare Cause of Recurrent Stroke Post-Ipsilateral Carotid Occlusion - A Case Report.

Carotid stump is blind remnant of occluded proximal segment of the internal carotid artery (ICA) that can become the potential source of embolism. Carotid stump syndrome is a potentially treatable cause of recurrent ischemic events in the carotid territory in the setting of occlusion of the ipsilateral ICA. It is thought to be caused by turbulent blood flow in the patent stump of the occluded ICA causing microemboli migrating in the brain through external carotid-ophthalmic anastomotic channels and retrograde flow.

Atmospheric deposition of microplastics in an urban conglomerate near to the foothills of Indian Himalayas: Investigating the quantity, chemical character, possible sources and transport mechanisms.

The global apprehension regarding the ubiquitous presence of microplastics (MPs) and their associated health risks underscore a significant challenge. However, our understanding on the occurrence and characteristics of this emerging class of pollutants in the different environmental compartments remains limited. For instance, despite housing approximately 20-25% of the global population, the evidence of the atmospheric MPs in Indian Subcontinent is exceedingly rare.

Success of Insulin Infusion Transitions in Moderate to Severe Diabetic Ketoacidosis With Transition Anion Gap of Less Than or Equal to 12 mEq/L Versus Greater Than 12 mEq/L.

Patients with diabetic ketoacidosis (DKA) are transitioned from intravenous (IV) to subcutaneous (SQ) insulin upon DKA resolution. Although an anion gap (AG) ≤12 mEq/L is recommended before transition to SQ insulin, there are limited data to support this threshold. To compare the rates of successful transitions to SQ insulin in patients with DKA with an AG ≤ 12 mEq/L versus > 12 mEq/L.

Clinical and Radiographic Evaluation of Different Glass Ionomer Restorative Materials in Primary Molars: A Comparative Randomized Clinical Trial.

Aim: The study aimed to evaluate and compare the clinical and radiographic success rate of Ketac Universal (3M), GC 9 EXTRA (GC), and Cention N (Ivoclar) restorative materials in primary molars.

Materials And Methods: The study was conducted as randomized clinical trial in children aged 3-8 years old, out of which a total of 75 primary molars were selected in 43 patients who met the inclusion criteria. The sample size was further divided into three groups of restorative materials, which included group I-Ketac Universal ( = 25), group II-GC 9 EXTRA ( = 25), and group III-Cention N ( = 25).

Simultaneous Integrated Boost (SIB) Versus Sequential Boost in Anal Cancer Patients: A Single-Center Experience.

Purpose: Concurrent chemoradiation is the standard of care for the treatment of anal cancer. Radiation can be delivered by sequential or simultaneous integrated boost (SIB) approach. The present study was conducted to compare the treatment outcomes and toxicity profile of patients with anal cancer treated with sequential boost and SIB approach.

Synovial Sarcoma of Cheek: A Rare Case Report with Review of Literature.

Synovial sarcomas are a rare entity in the head and neck region. We present a rare case of a 50 year old female presenting with a painless mass over right cheek since one year which gradually increased in size since past two months. Imaging was done which revealed a mass lesion in soft tissue of right cheek deep to the masseter muscle with no obvious involvement of the adjacent part of maxilla and mandible.

Strategic Utilization of Dantrolene in a Case of Severe Acute Generalized Tetanus.

Tetanus is a life-threatening, vaccine-preventable disease caused by an endotoxin produced by . We report a case of severe tetanus in an adult male with a history of intravenous drug use. The patient presented with a 1-day history of inability to open his jaw and a right lower extremity necrotic wound.

Effect on SARS-CoV-2 viral load using combination therapy with casirivimab/imdevimab and remdesivir.

Evidence suggests that SARS-CoV-2 viral load is an independent predictor of disease severity and mortality. A 61-year-old woman presented with severe COVID-19 and was treated with casirivimab/imdevimab and remdesivir. Quantitative nasopharyngeal (NP) viral loads were trended throughout the treatment course.

Evaluation of Unfractionated Heparin Dosing by Antifactor Xa During Targeted Temperature Management Post Cardiac Arrest.

Purpose: To evaluate unfractionated heparin (UFH) dosing guided by antifactor Xa levels during targeted temperature management (TTM) post-cardiac arrest.

Methods: Single-center, retrospective, observational study between January 1, 2014 and September 1, 2020. Patients initiated on TTM post-cardiac arrest and UFH were evaluated for inclusion.

Impact of ketamine versus fentanyl continuous infusion on opioid use in patients admitted to a surgical-trauma intensive care unit.

Objective: Ketamine has been shown to decrease opioid utilization as an adjunct, but limited evidence is available on ketamine as a primary analgesic strategy.

Design: A retrospective chart review.

Patients And Participants: Mechanically ventilated adult patients (≥18 years) in the surgery-trauma intensive care unit (STICU) with continuous infusion ketamine or fentanyl with concomitant propofol for at least 12 hours were screened for inclusion.

Comparison of Patiromer to Sodium Polystyrene Sulfonate in Acute Hyperkalemia.

Patiromer and sodium polystyrene sulfonate (SPS) are cation-exchangers approved for the treatment of chronic hyperkalemia. Data regarding their efficacy acutely is lacking. Despite this, both drugs are frequently used in the emergent setting.

Evaluation of aerosolized epoprostenol for hypoxemia in non-intubated patients with coronavirus disease 2019.

Objectives: Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) frequently present with a febrile illness that may progress to pneumonia and hypoxic respiratory failure. Aerosolized epoprostenol (aEPO) has been evaluated in patients with acute respiratory distress syndrome and refractory hypoxemia. A paucity of literature has assessed the impact of aEPO in patients with SARS-CoV-2 receiving oxygen support with high flow nasal cannula (HFNC).

Polysomnography in AF patients without prior diagnosis of obstructive sleep apnea reveals significant sleep abnormality: A strong case for screening in all patients with atrial fibrillation?

Background: Obstructive sleep apnea (OSA) and atrial fibrillation (AF) are known to often coexist together. However, whether all patients with AF should be screened for sleep abnormalities is not clear. No previous study has examined the association of asymptomatic OSA with AF.

Establishing a diagnostic reference level of radiation dose in coronary angiography and intervention: A prospective evaluation.

Introduction: Invasive Coronary Angiography (CAG) leads to significant radiation exposure to the patients. Guidelines suggest that a local landmark or Diagnostic Reference Level (DRL) for these procedures should be established for every region and country. This study attempts to create a DRL for a tertiary care hospital, acting as an interim DRL for the country/region.

Usefulness of thrombolysis in cardiac arrest secondary to suspected or confirmed pulmonary embolism.

Acute pulmonary embolism (PE) is a form of venous thromboembolism associated with significant morbidity and mortality. Massive PE, characterized by hemodynamic instability, has been reported as a common cause of cardiac arrest. Thrombolytic agents have therefore been identified as a potential rescue therapy to restore circulatory perfusion.

Intravascular shockwave lithotripsy as a treatment modality for symptomatic mesenteric ischemia.

Chronic mesenteric ischemia has traditionally been treated with either open surgical revascularization or endovascular therapy. Endovascular surgery has typically been preferred due to the lower rates of peri-procedural and post-procedural morbidity, yet this comes at the expense of long-term durability. Intravascular shockwave lithotripsy is a technique utilized to modify intimal and medial calcified plaque in order to improve vessel expansion and patency.

Effect of Adjunctive Dexmedetomidine in the Treatment of Alcohol Withdrawal Compared to Benzodiazepine Symptom-Triggered Therapy in Critically Ill Patients: The EvADE Study.

Objective: This study evaluated the safety and efficacy of adjunctive dexmedetomidine for alcohol withdrawal syndrome (AWS) treatment compared to symptom-triggered benzodiazepine therapy.

Methods: This single-center, retrospective, cohort study evaluated patients admitted to an intensive care unit (ICU) with AWS. Patients were divided into 2 groups: adjunctive dexmedetomidine or symptom-triggered therapy (control).

Spectrophotometric Evaluation of Color Change in Tooth Enamel Defects Using Resin Infiltrate: An Study.

Aim: To analyze the comparative change in pretreatment and posttreatment ** values of color in initial nonpitted white spot lesions of fluorosed teeth after resin infiltration with DMG-Icon spectrophotometrically with VITA easy shade.

Materials And Methods: A total of 30 maxillary and mandibular permanent anterior teeth with mild, nonpitted white spot lesions (atleast one) of fluorosis [till grade IV of Thylstrup and Fejerskov (TF) index] in patients between 6 years and 14 years of age were included in the present study. Shade of selected tooth and its white spot lesion area was recorded using VITA 3D shade guide, both pre and postoperatively, i.

The acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a prevalent cause of acute respiratory failure with high rates of mortality, as well as short- and long-term complications, such as physical and cognitive impairment. Therefore, early recognition of this syndrome and application of well-demonstrated therapeutic interventions are essential to change the natural course of this entity and bring about positive clinical outcomes. In this article, we review updated concepts in ARDS.

Hemifacial microsomia managed by distraction osteogenesis: A clinicoradiological report.

Hemifacial microsomia (HFM) is a congenital malformation in which there is hypoplasia of hard and soft tissues on one side of the face. It is considered the second most common congenital syndrome of the head-and-neck region. The hypoplasia manifests in all the structures derived from the first and second branchial arches and therefore, growth and development of these structures is affected in this condition.

A cross-sectional study to analyze the clinical subtype, contact sensitization and impact of disease severity on quality of life and cost of illness in patients of hand eczema.

Background: The high incidence, chronicity, frequent recurrences and severity of hand eczema leads to a massive impact on the quality of life. Despite great medical and socioeconomic importance, there is a paucity of data that addresses the cost of illness and economic factors associated with hand eczema. Most of the studies have originated from Europe and none have been reported from India.