Review of Web-Based Toolkits for Health Care Practitioners Working With Women and Girls Affected by or at Risk of Female Genital Mutilation/Cutting.

Increased migration has given rise to more advocacy efforts against female genital mutilation or cutting (FGM/C), legislation that criminalizes the practice, and guidance to the health sector for managing care of affected groups. More women and girls who have been cut or who are at risk of FGM/C are migrating from regions where it is common to countries where it is not and interacting with health professionals and other community practitioners in these host countries. Despite numerous studies on the negative health impacts of FGM/C, little is known about toolkits on FGM/C that providers can use in their prevention and response efforts.

Coincident remission of ankylosing spondylitis after autologous stem cell transplantation for multiple myeloma.

Introduction: Ankylosing spondylitis is an autoimmune disease with chronic inflammation of the spine and sacroiliac joints that is commonly treated with immunosuppressants including disease-modifying antirheumatic drugs and anti-tumor necrosis factor alpha therapy.

Case Report: A 75-year-old female with active ankylosing spondylitis on treatment with etanercept was referred to us for newly diagnosed IgG kappa free light chain multiple myeloma. After failing induction with revlimid, bortezomib, and dexamethasone, she was initiated on carfilzomib.

Impact of Body Mass Index on Gastrointestinal Disorders: A Cross-sectional Study in a Pakistani Population.

Background:  The prevalence of obesity is on the rise globally. Pakistan ranks ninth out of 188 countries in terms of obesity. Literature regarding any potential role of obesity in gastrointestinal manifestations is limited.

Assessing Self-Perceived Interprofessional Collaborative Competency on Advanced Pharmacy Practice Experiences Through Interprofessional Simulations.

To implement and assess the impact of Doctor of Pharmacy (PharmD) students participating in a required interprofessional (IP) simulation during an advanced pharmacy practice experience (APPE). Fourth-year PharmD students completing APPEs were required to participate in one of three IP simulations during the 2016-2017 academic year to improve their interprofessional teamwork and collaboration skills. Pharmacy student self-perception of IP competence was measured by the Interprofessional Collaborative Competency Attainment Survey (ICCAS), administered in a retrospective pre-/post-test design.

Outcome of Heart Disease in Syrian Refugee Children: Insights into Crisis.

Background: There are many challenges facing Syrian refugee children with heart disease. In this report, we present the spectrum, management, and outcome of heart disease in Syrian refugee children over six-year period, highlighting challenges in management and availability of funding.

Methods: Data on Syrian refugee children with heart disease diagnosed between 2012 and 2017 were collected.

Effects of Life style factors on the symptoms of gastro esophageal reflux disease: A cross sectional study in a Pakistani population.

Background &objective: Gastro esophageal reflux disease (GERD) broadly includes the whole spectrum of reflux disease symptoms like heartburn or acid regurgitation to endoscopic, reflux esophagitis or Barrett's esophagus. Our aim therefore was to study the association between Gastroesophageal reflux disease symptoms and various lifestyle factors.

Methods: A descriptive cross-sectional study was carried out in the outpatient department of Darul Sehat Hospital, Zubaida Medical Center and Liaquat National Hospital & Medical College, Karachi, Pakistan from January 2018 to October 2018.

High variability of tibial slope measurement methods in daily clinical practice: Comparisons between measurements on lateral radiograph, magnetic resonance imaging, and computed tomography.

Background: Tibial slope measurements are important in guiding clinical decisions in the field of orthopedic surgery. However, there are multiple techniques across different medical imaging modalities and little is known about its impact on result and validity of the measurement. Therefore, the purpose of this study was to compare tibial slope measurements from lateral radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) scans in order to better assess the clinical significance of measured tibial slope values.

Current and future cholera vaccines.

Cholera remains a major global public health problem that is primarily linked to insufficient access to safe water and proper sanitation. Oral Cholera Vaccine (OCV) has been recommended as an additional public health tool along with WASH in cholera endemic countries and in areas at risk for outbreaks. The new generation OCV is safe and offers good protection in older children and adults while limited protection in younger children less than five years of age has been observed.

A new methodologic approach for clinico-pathologic correlations in invasive placenta previa accreta.

Background: The development of new management strategies for women presenting with placenta accreta spectrum requires quality epidemiology data, which have so far been limited by the high variability in clinical and histopathologic data confirming the diagnosis at birth.

Objective: To evaluate the role of a new methodologic approach for the correlation of clinical and pathological data for women with a history of prior cesarean delivery diagnosed prenatally with placenta previa accreta.

Materials And Methods: A modified pathologic technique for gross examination of hysterectomy specimens with placenta in situ consisting of intraoperative examination, immediate postoperative examination, and guided histologic sampling was used prospectively in a cohort of 24 patients with singleton pregnancies complicated by placenta low-lying/placenta previa accreta.

Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case.

An 80-year-old man who was previously diagnosed with Philadelphia+ B cell-acute lymphoblastic leukaemia (B-ALL) in remission post-allogeneic matched unrelated donor peripheral blood stem cell transplant. Five years later, he was found to have unilateral testicular relapse of Philadelphia+ B-ALL proven by pathology after radical orchiectomy. Bone marrow aspirate and biopsy did not show evidence of leukaemia.

MTHFR and F5 genetic variations have association with preeclampsia in Pakistani patients: a case control study.

Background: To study the role of single nucleotide variants (SNVs) of genes related to preeclampsia in Pakistani pregnant women.

Methods: After ethical approval and getting informed consent; 250 pregnant women were enrolled and equally divided into two groups (125 preeclamptic cases and 125 normotensive pregnant women). Demographic details and medical history were recorded, and 10 ml blood sample was obtained for DNA extraction.

The femoral posterior fan-like extension of the ACL insertion increases the failure load.

Purpose: To examine the role of the posterior fan-like extension of the ACL's femoral footprint on the ACL failure load.

Methods: Sixteen (n = 16) fresh frozen, mature porcine knees were used in this study and randomized into two groups (n = 8): intact femoral ACL insertion (ACL intact group) and cut posterior fan-like extension of the ACL (ACL cut group). In the ACL cut group, flexing the knees to 90°, created a folded border between the posterior fan-like extension and the midsubstance insertion of the femoral ACL footprint and the posterior fan-like extension was dissected and both areas were measured.

Efficacy and Safety of Canagliflozin in Patients with Type II Diabetes Mellitus Inadequately Controlled on Triple Drug Therapy.

Objective: Canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, has been associated with HbA1c reduction and weight loss in a broad range of patients with type 2 diabetes mellitus (T2DM). This analysis evaluated changes in HbA1c and body weight in patients who were inadequately responding to maximum dose of three oral hypoglycemic agents and reluctant to take insulin therapy.

Methods: In this open label interventional single arm study, patients aged 18 to 65 years (N=118) received Canagliflozin 100 mg for in addition to an ongoing triple drug oral hypoglycemic agents (OHA) regimen for a period of 12 weeks.

Paravertebral Mass and Diffuse Lymphadenopathy in a Patient with Pyruvate Kinase Deficiency: Malignancy or Alternative Etiology?

Extramedullary hematopoiesis is common in chronic hemolytic anemias such as pyruvate kinase deficiency. It is commonly associated with hepatosplenomegaly or lymphadenopathy; however, it can rarely also present as a mass in the chest, abdomen, or paraspinal region. Here, we present a case of an adult patient with pyruvate kinase deficiency and history of splenectomy.

A Case of Secondary Sclerosing Cholangitis in the setting of Non-Hodgkin's Lymphoma.

Sclerosing cholangitis represents a spectrum of cholestatic liver disease characterized by inflammation, fibrosis, and stricture of the bile ducts. A 67-year-old Caucasian female with a history of breast cancer in remission, presented with jaundice and an exophytic mass at the base of the tongue. Laboratory data revealed cholestasis with alkaline phosphatase 953 U/L, total bilirubin 7.

Vitamin C deficiency: rare cause of severe anemia with hemolysis.

Historically known to be a disease of sailors and soldiers in the seventeenth and eighteenth century, scurvy is a rare nutritional deficiency in the developed world, but it can still be seen among the alcoholics and the malnourished. We present a case of a 39-year-old alcoholic male who presented with progressive fatigue and diffuse purpuric rash with scattered ecchymosis for 2 months. Blood work was remarkable for hemoglobin of 9.

Optic Nerve Sheath Diameter Assessment in Patients with Intracranial Pressure Monitoring.

Background Optic nerve sheath diameter (ONSD) has been found to have good correlation with intracranial pressure (ICP) measurements. Here, we aim to determine if the correlation between ONSD and ICP persists throughout the acute phase of neurologic injury through the evaluation of patients with ICP monitoring. We also aim to determine if the ONSD assessments at different depths (3, 6, or 9 mm) and a ratio of the ONSD and eyeball transverse diameter (ETD) are better correlated with ICP than the well-studied ONSD assessment at 3 mm beyond the globe.

Respiratory muscle testing in amyotrophic lateral sclerosis: a practical approach.

In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure and death. Non-invasive positive pressure ventilation (NIPPV) appears to reduce lung function decline, thus improving survival and quality-of-life of patients affected by the disease. Unfortunately, clinical features and timing to start NIPPV are not well defined.

Mimicking Active Biopolymer Networks with a Synthetic Hydrogel.

Stiffening due to internal stress generation is of paramount importance in living systems and is the foundation for many biomechanical processes. For example, cells stiffen their surrounding matrix by pulling on collagen and fibrin fibers. At the subcellular level, molecular motors prompt fluidization and actively stiffen the cytoskeleton by sliding polar actin filaments in opposite directions.