Navigating Extrapulmonary Tuberculosis: A Case Series from a Tertiary Care Facility Highlighting Rare Presentations, Diagnostic Challenges, Drug Resistance, and Therapeutic Complexities.

Background: Extrapulmonary tuberculosis (EP-TB) constitutes one-fifth of all tuberculosis (TB) cases. EP-TB mimics common infections which pose diagnostic dilemma, requires extensive diagnostics that culminate into therapeutic delay often resulting in irrational and empirical institution of antitubercular therapy (ATT) in challenging cases. This supplemented by poor treatment compliance resulted in emergence of Drug-resistant (DR) strains of EP-TB which further impedes the path to recovery.

Malignant Ventricular Arrhythmia With Apical Biventricular Noncompaction.

Ventricular tachycardia (VT) arising from the right ventricle outflow tract is the most common cause of VT in children with a structurally normal heart. It often presents as a monomorphic VT that is usually amenable to ablation during an electrophysiology (EP) study. VT in children is typically idiopathic and benign but carries a risk for the degeneration of the arrhythmia into ventricular fibrillation or can result in sudden cardiac death.

Tolerability and Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists in Lung Transplant Recipients: A Single Center Report.

Introduction: Diabetes and obesity increase risk of death after lung transplantation. Optimal treatment of diabetes and obesity may improve post-transplant outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are FDA-approved to treat diabetes and obesity and demonstrate improvement in renal and cardiovascular outcomes in the general population.

On being on the same page: Predictors of gastroenterologist-patient misalignment in inflammatory bowel disease.

Objectives: This study explored the prevalence and degree of misalignment between gastroenterologists and people with inflammatory bowel disease (IBD) and investigated communication features related to misalignment.

Methods: A mixed-methods approach incorporated qualitative and quantitative analyses of consultations and post-consultation patient and doctor interviews. Gastroenterologists at two Australian teaching hospitals and IBD patients participated in this study.

Unraveling Alpha-Gal Syndrome: A Case Study of a Rare Meat Allergy.

Allergies are a very common pathology and their manifestations consist of a spectrum of presentations, ranging from minimal discomfort like a runny nose to lethal reactions like anaphylaxis and death. Meat allergy is not a very common form of allergy, even though there is a relatively high level of meat consumption. One of the rare forms of non-primate mammalian meat allergy is alpha-gal syndrome (AGS).

A Survey of the Estimated Cost of Surgical Consumable Items Within Trauma and Orthopaedic Departments.

Introduction The impact of the current economic and environmental climate, both nationally and globally, is further straining the NHS. This has led to scrutiny of high-expenditure areas, including consumables. Clinician's knowledge surrounding health economics is sparse, and we conducted this survey to assess cost-awareness within the Trauma and Orthopaedic (T&O) departmental staff.

Regioselective Pyridine to Benzene Edit Inspired by Water-Displacement.

Late-stage derivatization of drug-like functional groups can accelerate drug discovery efforts by swiftly exchanging hydrogen-bond donors with acceptors, or by modulating key physicochemical properties like logP, solubility, or polar surface area. A proven derivatization strategy to improve ligand potency is to extend the ligand to displace water molecules that are mediating the interactions with a receptor. Inspired by this application, we developed a method to regioselectively transmute the nitrogen atom from pyridine into carbon bearing an ester, a flexible functional group handle.

Exposure to thiourea during the early stages of development impedes the formation of the swim bladder in zebrafish larvae.

Thiourea, a widely used agrochemical, is known to inhibit the activity of thyroid peroxidase, a key enzyme in the biosynthetic pathway of thyroid hormones. Thyroid insufficiency compromises the basal metabolic rate in warm-blooded organisms and embryonic development in vertebrates. In this study, we looked for developmental defects by exposing the zebrafish embryos to an environmentally relevant dose of thiourea (3 mg/mL).

Community-based study to describe the epidemiology of dengue infection in a large cantonment during one transmission season.

Background: Dengue is one of the most important vector-borne disease in India. It has been linked to monsoons when mosquitoes breed profusely in containers. No study exists in Armed Forces wherein a community-based sero-survey has described the epidemiology of dengue.

Surveillance MRI is associated with improved survival in patients with primary sclerosing cholangitis.

Background: The benefits of regular surveillance imaging for cholangiocarcinoma in patients with primary sclerosing cholangitis (PSC) are unclear. Hence, we aimed to evaluate the impact of regular magnetic resonance cholangiopancreatography (MRCP) on outcomes of patients with PSC in Australia, where the practice of MRCP surveillance is variable.

Methods: The relationship between MRCP surveillance and survival outcomes was assessed in a multicenter, retrospective cohort of patients with PSC from 9 tertiary liver centers in Australia.

Health Drink Poisoning - An Unusual Case of Bottle Gourd Toxicity.

Bottle gourd, popularly known as "Lauki" is a commonly used vegetable throughout the world including India. Its juice is considered a "health tonic" for chronic ailments by practitioners of alternate therapy and nutritionist. It is essential for emergency physicians to be aware of this toxicity, especially in tropical countries like India, where alternate therapy practices are prevalent.

Association of Inflammatory Markers With Disease Progression and the Severity of COVID-19.

Introduction In December 2019, there was a massive outbreak of viral pneumonia, which had a high case fatality rate. Genetic sequencing of the virus showed similarity with severe acute respiratory syndrome coronavirus (SARS-CoV). It was later named novel coronavirus 2019 while the disease it caused was given the nomenclature of COVID-19.

Older adult drug overdose: an application of latent class analysis to identify prevention opportunities.

Background: Older adult overdose death rates have increased significantly in recent years. However, research for prevention of drug overdose death specific to older adults is limited. Our objective is to identify profiles based on missed intervention points (touchpoints) to inform prevention of future older adult unintentional overdose deaths.

Purulent Bacterial Pericarditis: Rare Yet Lethal.

Bacterial pericarditis is a rare phenomenon that progresses rapidly and carries high mortality. Patients presenting with new pericardial effusions are often evaluated for concomitant rheumatologic, oncologic, and infectious diseases. We present a complex case of purulent pericarditis with pneumopericardium.

Impact of heart failure on COVID-19 patients: An insight from nationwide inpatient sample.

Background: Patients with COVID-19 have been reported to experience adverse cardiovascular outcomes, such as myocarditis, acute myocardial infarction, and heart failure. Among these complications, heart failure (HF) has emerged as the most common critical complication during exacerbations of COVID-19, potentially leading to increased mortality rates and poorer clinical outcomes. We aimed to investigate the in-hospital outcomes of COVID-19 patients with HF.

Assessment of the alpha 7 nicotinic acetylcholine receptor as an imaging marker of cardiac repair-associated processes using NS14490.

Background: Cardiac repair and remodeling following myocardial infarction (MI) is a multifactorial process involving pro-reparative inflammation, angiogenesis and fibrosis. Noninvasive imaging using a radiotracer targeting these processes could be used to elucidate cardiac wound healing mechanisms. The alpha7 nicotinic acetylcholine receptor (ɑ7nAChR) stimulates pro-reparative macrophage activity and angiogenesis, making it a potential imaging biomarker in this context.

Efficacy of topical in the healing of extraction sockets: A split-mouth clinical trial.

Background: The healing process after dental extraction is influenced by various factors, and finding effective strategies for promoting wound healing and reducing postoperative discomfort remains a challenge. This study aimed to evaluate the effectiveness of topical gel in reducing pain and promoting wound healing after dental extraction, with the secondary objective of assessing the occurrence of dry sockets. The study was a split-mouth randomized controlled trial conducted at the oral and maxillofacial surgery department over 3 months.

An Update from the Benchmark Survey of phactMI™ Member Companies on Providing Medical Information in the Digital Space.

Objective: The Pharma Collaboration for Transparent Medical Information (phactMI™) benchmarking survey of 32 pharmaceutical companies describes the use of technology by Medical Information Departments.

Methods: A survey was distributed to phactMI™ member companies in June 2022 and included 79 closed and open-ended questions. The survey's six sections included demographics, chatbot, social media, instant messaging applications, websites, and technology.

The Role of a Pharmacy Administration and Leadership Rotation within Postgraduate Year Two Critical Care Residency Training.

Introduction: The job of a critical care pharmacy specialist has evolved to include quality improvement and administrative tasks. As such, the American Society of Health-System Pharmacists (ASHP) highlights specific goals and objectives to ensure post-graduate year two (PGY2) critical care residents are sufficiently trained to perform these tasks. The PGY2 critical care pharmacy residency leadership at the University of Kentucky sought to develop a four-week learning experience entitled, "Critical Care Administration / Medication Use Quality & Outcomes," as a unique rotation to capture these requirements and activities.

Quad-port MIMO antenna with high isolation characteristics for sub 6-GHz 5G NR communication.

A four-port MIMO antenna with high isolation is presented. The antenna is primarily envisioned to cover the n48 band of Frequency Range-1 (FR-1) with TDD duplex mode. The engineered antenna has electrical dimensions of 90 × 90 × 1.

Musings from a Bent Arrow: The Road from Private Practice to Academics.

This biographical article takes the reader on the unlikely journey of a small-town dermatologist, Robert T. Brodell MD, from private practice to academics. It is designed to demonstrate that the road less traveled may be of interest to many other "regular" dermatologists in private practice… particularly those who enjoy teaching.