Complicated Colonic Diverticulitis Presenting as Vaginal Bleeding: An Unusual Presentation.

Colonic diverticula are small outpouchings from the colonic lumen secondary to mucosal herniation through the colonic wall. Clinical presentation usually involves an acute or subacute onset of abdominal pain typically localized in the left lower abdominal quadrant as well as nausea, low-grade fever, bowel habit changes, and elevated inflammatory markers. We present a case of complicated colonic diverticulitis with vaginal fistula with eventual formation of abdominal abscess, presenting as vaginal bleeding and pelvic pain.

Does Treatment for Depression With Collaborative Care Improve the Glycemic Levels in Diabetic Patients with Depression? A Systematic Review.

Diabetes is a chronic disease with a high prevalence in the United States. If not treated adequately, it can have serious complications. Furthermore, when depression affects concomitantly, adherence to treatment can be decreased.

Migrainous Infarction and Cortical Spreading Depression.

Migraine is a very common disorder of the nervous system. It shares similar physiological processes with stroke. Migrainous infarction is a rare complication of migraine with aura.

Frequency of Hepatorenal Syndrome Among Patients With Cirrhosis and Outcome After Treatment.

Introduction Hepatorenal syndrome is the third most common cause of admissions among patients with liver cirrhosis and has a high mortality rate. It is a progressive deterioration of renal function in a patient with acute or chronic liver failure. The only definite curative treatment of choice for hepatorenal syndrome is liver transplantation.

Bariatric Surgery and Type 2 Diabetes Mellitus: Assessing Factors Leading to Remission. A Systematic Review.

Type 2 Diabetes Mellitus (T2DM) is a health problem of paramount proportions and is associated with significant morbidity and mortality. Our study aims to review data published on the effects of different types of bariatric surgeries on T2DM remission, compared to lifestyle and medical intervention (LMI) exclusively, along with a comprehensive finding of numerous preoperative factors that lead to remission. We used PubMed, PubMed Central (PMC), and MEDLINE to search for literature.

Faculty Feedback Program Evaluation in CIMS Multan, Pakistan.

Faculty feedback program (FFP) at CMH Multan Institute of Medical Sciences (CIMS) was conducted for obtaining feedback for basic medical sciences faculty and evaluated to highlight its weaknesses for future improvement. The evaluation design was utilization-focused evaluation (UFE) keeping in mind its two essential elements. First element is the primary intended users (PIU) of the evaluation, namely the college faculty and students which were clearly identified and personally engaged to investigate intended use of the evaluation.

Psychosocial predictors of antenatal stress in Pakistan: perspectives from a developing country.

Objective: Antenatal stress is highly prevalent globally and is associated with adverse physical and psychiatric morbidities and adverse neonatal outcomes. However, the burden of antenatal stress and its psychosocial predicators have not been explored in context of the Pakistani sociocultural environment. The present study explores the prevalence of antenatal stress and its association with gender of offspring, socioeconomic background, cultural beliefs, and access to healthcare in the province of Punjab, Pakistan.

Relationship of Major Depression with Body Mass Index and Salivary Cortisol.

Introduction Depression is one of the most incapacitating psychiatric diseases that disturb life of millions of people round the globe. Its major causes include stressful life events, bereavement, social abuses or certain biological and genetic factors with complex causal mechanisms. Higher salivary cortisol levels for a long period lead to dyslipidemias which increase body mass index (BMI), elevate adiposity and waist-to-hip ratio (WHR).

Association of breastfeeding status with risk of autism spectrum disorder: A systematic review, dose-response analysis and meta-analysis.

Current evidence indicates that nutritional status in newborns, especially the duration of breastfeeding, plays a key role in the pathogenesis of autism spectrum disorder. We aimed to systematically review and meta-analyze relevant studies with findings of an association between autism spectrum disorder and breastfeeding patterns, and undertook an extensive dose-response analysis to interpret the results more accurately. Ten electronic databases and manual search of reference lists were used to identify relevant studies in September 2018.

Gastrosplenic Fistula without Malignancy Management in a 16-Year-Old Boy.

Gastrosplenic fistula is a very rare entity, most commonly occurring as a distinctive complication of splenic or gastric malignancies, most notably diffuse large B cell lymphoma (DLBCL). Benign gastric ulcer, splenic abscess, and Crohn's disease have also been reported as possible causes. We report a nonmalignant case of 16-year-old male with a gastrosplenic fistula of unclear etiology.

Fine mapping of MRT9 locus through genome wide homozygosity mapping in a consanguineous Pakistani family.

Intellectual disability (ID) or Mental Retardation (MR) is a broad term, which occupies several medical directions. It is extremely heterogeneous and has about reported 25,000 genes of which half of the genes expression have been found in the brain. Intellectual disability causes severe disability and has a worldwide prevalence of around 2% while autosomal recessive form of ID causes almost 25% of all non syndromic (NS) ID cases.

2D:4D digit ratios in males and females and its correlation with simple reaction time: A cross sectional Study at Combined Military Hospital (CMH), Lahore, Pakistan.

A cross-sectional study was conducted on 86 medical students between the ages of 18 to 25 years studying at the Combined Military Hospital (CMH) in Lahore, Pakistan. They were assessed for height, weight, digit length of the 2nd and 4th fingers of both hands and reaction time (response time to auditory stimulus as measured by BIOPAC). Of the 86 students, 42 (49%) were male and 44 (51%) were female, with a mean age of 19.

Can aging be slowed down?

Aging is a complex process, with genetic and environmental influences, that unfolds over time. The rate at which skin aging proceeds is predictable, although many persons appear older or younger than their chronologic age. This is especially evident in rare genetic disorders such as Hutchinson-Gilford progeria syndrome in which persons suffer from a premature aged appearance and in neotenic complex syndrome in which children appear to be "frozen in time," remaining physically and cognitively similar to an infant or toddler despite increasing age.

Perception of Preparedness of Health Care Professionals in Case of a Nuclear, Chemical, Biological Attack/Emergency in a Tertiary Care Hospital.

Background With the growth of global terrorism and rapid advancements in the field of science, the threat of a nuclear, biological, and chemical (NBC) attack remains imminent. This study assesses perceptions of preparedness of health care professionals in case of an NBC attack/incident in a tertiary care hospital. Patients and methods We conducted a descriptive, cross-sectional study of 200 health care workers (including nurses and doctors) in a tertiary care hospital, from October 2018 through December 2018.

Exposure to violence and its association with symptoms of aggression: A cross sectional study among medical students of Karachi, Pakistan.

Objective: To explore the experience of violence and its association with symptoms of aggression among medical students.

Methods: The cross-sectional study was conducted from January 5 to 14, 2018, at Dow University of Health Sciences, Karachi, and comprised medical students who were interviewed using a self-reporting questionnaire that had three sections: demographics, the Aggression Questionnaire, and the Exposure to Violence Scale. Data were analysed using SPSS 20.

Retraction: An Overview of the Pathology and Emerging Treatment Approaches for Interstitial Cystitis/Bladder Pain Syndrome.

[This retracts the article DOI: 10.7759/cureus.3321.

Retraction: Systemic Lupus Erythematosus: An Overview of the Disease Pathology and Its Management.

[This retracts the article DOI: 10.7759/cureus.3288.

Retraction: Neurogenic Stunned Myocardium: A Literature Review.

[This retracts the article DOI: 10.7759/cureus.3129.

Evaluating the collection, comparability and findings of six global surgery indicators.

Background: In 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates.

An Overview of the Pathology and Emerging Treatment Approaches for Interstitial Cystitis/Bladder Pain Syndrome.

Our article will discuss bladder pain syndrome (BPS), which is the presence of chronic suprapubic pain to bladder filling accompanied by other urinary symptoms, such as frequency, urgency, discomfort with filling, and relief with emptying of the bladder in the absence of infections or other pathology. It is mostly seen in females and occurs in 0.06%-30% of the population.

Managing Chronic Pain in the Elderly: An Overview of the Recent Therapeutic Advancements.

A majority of the elderly suffer from chronic pain that significantly alters their daily activities and imposes an enormous burden on health care. Multiple comorbidities and the risk of polypharmacy in the elderly make it a challenge to determine the appropriate drug, dosage, and maintenance of therapy. Opioids are the most commonly used agents for this purpose in the elderly.

Systemic Lupus Erythematosus: An Overview of the Disease Pathology and Its Management.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with varied natural history and multisystemic involvement. The pathogenesis is multifactorial and complex precipitating the formation of autoantibodies. One of the main factors in SLE is the interaction between environmental triggers and genetic factors.

The Neurocognitive Effects of Ghrelin-induced Signaling on the Hippocampus: A Promising Approach to Alzheimer's Disease.

The communication between the gastrointestinal tract and the central nervous system (CNS) allows for certain peptide hormones to influence neurocognitive function. Ghrelin, also known as the 'hunger hormone,' has the unique ability to enter the CNS and interact with the growth hormone secretagogue receptor (GHS-R) within the hippocampus. Upon interaction with ghrelin, a conformational change in the receptor causes an increase in transcription factors to foster a wide array of physiologic changes in response to caloric deprivation.

The Prevention and Management of Contrast-induced Acute Kidney Injury: A Mini-review of the Literature.

Contrast-induced acute kidney injury, also called contrast-induced nephropathy, is one of the main causes of acute renal failure/acute kidney injury (AKI) in hospitalized patients within 48 to 72 hours of contrast media administration during various radiologic procedures. Several factors can be responsible for contrast-induced acute tubular necrosis (ATN); however, patient and procedure-related factors play the lead role in determining the development of contrast-induced nephropathy. There is no definitive treatment and hydration remains the mainstay preventive strategy.

American Heart Association High Blood Pressure Protocol 2017: A Literature Review.

Hypertension is the most prevalent clinical symptom arising from various cardiovascular disorders. Likewise, it is considered a precursor or sequelae to the development of acute coronary artery disease and congestive heath failure (CHF). Hypertension has been considered a cardinal criterion to determine cardiovascular function.