Artemether-lumefantrine (AL) is the first-line treatment for uncomplicated infection in Colombia. To assess AL efficacy for uncomplicated falciparum malaria in Quibdo, Choco, Colombia, we conducted a 28-day therapeutic efficacy study (TES) following the WHO guidelines. From July 2018 to February 2019, febrile patients aged 5-65 years with microscopy-confirmed mono-infection and asexual parasite density of 250-100,000 parasites/µL were enrolled and treated with a supervised 3-day course of AL. The primary endpoint was adequate clinical and parasitological response (ACPR) on day 28. We attempted to use polymerase chain reaction (PCR) genotyping to differentiate reinfection and recrudescence, and conducted genetic testing for antimalarial resistance-associated genes. Eighty-eight patients consented and were enrolled; four were lost to follow-up or missed treatment doses. Therefore, 84 (95.5%) participants reached a valid endpoint: treatment failure or ACPR. No patient remained microscopy positive for malaria on day 3, evidence of delayed parasite clearance and artemisinin resistance. One patient had recurrent infection (12 parasites/µL) on day 28. Uncorrected ACPR rate was 98.8% (83/84) (95% CI: 93.5-100%). The recurrent infection sample did not amplify during molecular testing, giving a PCR-corrected ACPR of 100% (83/83) (95% CI: 95.7-100%). No 13 polymorphisms associated with artemisinin resistance were identified. Our results support high AL efficacy for falciparum malaria in Choco. Because of the time required to conduct TESs in low-endemic settings, it is important to consider complementary alternatives to monitor antimalarial efficacy and resistance.
Subcapsular liver haematoma in pregnancy, a rare and life-threatening condition, is more commonly associated with severe preeclampsia and haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. The common presenting symptom of subcapsular haematoma is acute-onset upper abdominal pain in patients suffering from preeclampsia; shock is the presenting feature in severe cases of rupture. Here we have discussed a case of subcapsular haematoma associated with HELLP syndrome in a patient who responded to conservative management.
Background: The physical and mental changes created during menopause cause sexual dysfunction, which affects the quality of life, self-esteem, and emotional relationships. Wormwood cream contains tannins, terpenoids, flavonoids, phytosterols, and alkaloids. The purpose of this study is to evaluate the safety and effectiveness of wormwood vaginal cream on the sexual satisfaction and quality of sexual life of postmenopausal women.
Objective: Aim: To evaluate the early postoperative results of surgical treatment of patients with inguinal hernias after laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) using invasive and non-invasive methods of fixation of prosthetic material.
Patients And Methods: Materials and Methods: The study included 76 patients (average age 61,4±15,3 years; 69 [91 %] males, 7 [9 %] females) with primary uncomplicated unilateral inguinal hernias who underwent TAPP. Patients were divided into two groups: group 1 - 52 patients in whom the AbsorbaTack fixation device was used to secure the mesh; group 2 - 24 patients in whom the LiquiBand FIX8 cyanoacrylate adhesive was used.
A 65-year-old woman presented with progressively increasing swelling on the right lateral side of her tongue. Further investigation confirmed it to be a schwannoma. Surgical excision of the tumour was performed, resulting in an uncomplicated postoperative recovery with complete preservation of the tongue function.
The Senhance robotic system (Asensus Surgical, Durham, NC, USA) is an innovative platform for minimally invasive surgery. It enables surgeons to perform precise and cost-effective procedures using reusable instruments and has advanced features such as haptic feedback and eye-tracking camera control. Herein, we present the first application of the "double bipolar method" (DBM) in a Senhance-assisted laparoscopic partial cystectomy utilizing 3 mm Maryland bipolar instruments.
