Two case reports of triple ectopic: Literature review of incidence, risk factors and management of recurrent ectopic pregnancy.

Ectopic pregnancy is a gynaecological emergency. While its identification and management are monumental, it also impacts the patient's future fertility. Ectopic pregnancy is one of the leading causes for maternal deaths in the first trimester.

A Retrospective Study of Routine Preoperative Blood Grouping and Saving in Laparoscopic Surgeries: A Minimally Utilized Expenditure.

Introduction Patients scheduled for laparoscopic cholecystectomy and laparoscopic appendicectomy typically undergo routine preoperative blood grouping and saving (G&S). Despite the low incidence of blood transfusion in this context, the acquisition and processing of G&S samples incur a cost of £31 ($40) per sample. This study aims to review blood transfusion usage in these procedures to determine whether routine G&S sampling is clinically necessary or represents an avoidable expense.

Advancements in Pancreatic Cancer Detection: Integrating Biomarkers, Imaging Technologies, and Machine Learning for Early Diagnosis.

Artificial intelligence (AI) has come to play a pivotal role in revolutionizing medical practices, particularly in the field of pancreatic cancer detection and management. As a leading cause of cancer-related deaths, pancreatic cancer warrants innovative approaches due to its typically advanced stage at diagnosis and dismal survival rates. Present detection methods, constrained by limitations in accuracy and efficiency, underscore the necessity for novel solutions.

Recurrence of Statin-Induced Necrotizing Myopathy: A Learning Point.

Statin-induced myopathy remains a significant adverse event associated with statin use. Insufficient literature exists studying the recurrence of statin-induced myopathy in patients who have been re-exposed to statins. In this case report, we present the case of an elderly woman who developed immune-mediated necrotizing myopathy secondary to simvastatin and eventually improved with statin cessation and corticosteroids.

Challenges and Opportunities in Developing Tailored Pain Management Strategies for Liver Patients.

Chronic liver illnesses pose a substantial worldwide health challenge, with various causes that span from viral infections to metabolic problems. Individuals suffering from liver problems frequently face distinct difficulties in pain control, requiring a customized strategy that takes into account both the fundamental disease and the complexities of liver function. The liver, a vital organ responsible for metabolic control and detoxification, is pivotal in multiple physiological processes.

A Case of Antisynthetase Syndrome Initially Presented With Interstitial Lung Disease Mimicking COVID-19.

In this case report, we present a case of antisynthetase syndrome which is a rare disease that can be easily missed, if not specifically looked for in adults, whose initial presentation is combination of myopathic and respiratory symptoms. In clinical practice, patients presenting with coronavirus disease 2019 (COVID-19) symptoms, whose computed tomography (CT) imaging is consistent with COVID-19, were accordingly isolated and treated as COVID-19 awaiting reverse transcription polymerase chain reaction (RT-PCR) results. However, there are many COVID-19 mimics on chest CT, which can make the CT-based diagnosis of COVID-19 unsafe.

Lafora Body Epilepsy: A Challenging Diagnosis.

Lafora body disease (LBD) is a progressive myoclonic genetic epilepsy syndrome characterized by the presence of Lafora inclusion bodies within neurons and other cells. It is a complex neurodegenerative disease presenting in adolescence with seizures, myoclonus, and rapid cognitive decline. Diagnosis is often challenging requiring a thorough history including family history, identification of Lafora bodies in apocrine sweat glands of axillary skin, and specific DNA sequencing.

Subclavian vessel injury from chest-drain malposition in the treatment of a pneumothorax in the presence of a lateral third open clavicular fracture.

We report the unorthodox injury of the subclavian vessels by the malposition of a chest drain, for the treatment of a pneumothorax in the presence of a lateral third open fracture of the left clavicle. This case presents the first report of a ruptured subclavian vein and cephalic vein after the insertion of a chest drain for a pneumothorax. A systematic search performed in MEDLINE, EMBASE, Cochrane Library, and Web of Science found no similar cases documented in the literature.

Antegrade insertion of a retrograde intramedullary femoral nail for treatment of a subtrochanteric pathological femoral shaft fracture in a patient with pre-existing coxa vara.

We report the unorthodox use of a retrograde intramedullary nail via antegrade technique for the treatment of a subtrochanteric pathological femur fracture in the presence of significant coxa vara. No similar use has been documented previously in literature. A standard approach to the proximal right femur was performed and standard antegrade technique used to introduce a guide wire into the proximal femur after which the femoral shaft was reamed.

The flexibility and convenience of using a standard orthopaedic table in peri-articular knee fractures: Allowing ligamentotaxis and improving imaging accessibility.

Tibial plateau and distal femoral fractures are common injuries presenting a significant operative challenge. Complexity of the fracture often needs multi-planar surgical access. A combined two-staged procedure is frequently suggested both in supine and prone position to address this issue.

A case of etanercept (anti-TNF agent) induced granulomas on the lids.

Sarcoid-like granulomas are a rare adverse effect of TNF-α inhibitors that are becoming increasingly reported in the literature. A retrospective study in France estimated this adverse effect to occur in 0.04% patients.

Comparative Analysis of Rural Health Demographics in 2 East African Communities During Medical Camps: Volunteers' Perspectives'.

Aims And Objectives: To compare of basic health and social demographics observed during 4-day medical camps in 2 rural communities in Zambia and Malawi to determine any significant differences or similarities.

Method: About 12 and 10 local and international volunteers at medical camps (at a temporary rural health post or community hall) in rural Zambia and Malawi respectively treated 488 patients in total, with basic health and social demographic data collected and results analyzed.

Results: The mean age of patients seen in Malawi and Zambia were 34.

An international genome-wide meta-analysis of primary biliary cholangitis: Novel risk loci and candidate drugs.

Backgrounds & Aims: Primary biliary cholangitis (PBC) is a chronic liver disease in which autoimmune destruction of the small intrahepatic bile ducts eventually leads to cirrhosis. Many patients have inadequate response to licensed medications, motivating the search for novel therapies. Previous genome-wide association studies (GWAS) and meta-analyses (GWMA) of PBC have identified numerous risk loci for this condition, providing insight into its aetiology.

Urinary symptoms in pregnant women in their third trimester-a cross-sectional study.

Introduction And Hypothesis: Urinary symptoms are common in pregnancy. Our study aims to understand the extent of these symptoms in a cohort of pregnant women in the third trimester and their impact on quality of life (QOL) from the women's perspective.

Methods: A single-centre cross-sectional study of self-reported urinary symptoms of pregnant women in the third trimester conducted from August 2018 at the Diana Princess of Wales Hospital, Northern Lincolnshire, and Goole NHS Foundation Trust, Grimsby, UK.

Semi-quantitative analysis of F fluorodeoxyglucose uptake in the assessment of disease activity and therapeutic response in rheumatoid arthritis: An institutional experience.

F fluorodeoxyglucose (F-FDG) positron emission tomography (PET) can be used to image synovial inflammation in patients with rheumatoid arthritis (RA). Recently, clinical application of novel therapies for RA, such as tumor necrosis factor-α (TNF-α) inhibitor and anti-interleukin-6 receptor antibody, has been introduced. The radiological assessment of disease activity changes of patients who underwent these therapies will help the clinicians to obtain more information about the patients and to decide drug withdrawal or change of medication.

A Single Centre Randomised Control Study to Assess the Impact of Pre-Operative Carbohydrate Loading on Women Undergoing Major Surgery for Epithelial Ovarian Cancer.

Objective Historically, patients have fasted before elective surgery to ensure an empty stomach to avoid aspiration. A fasting-induced catabolic state however may adversely influence recovery after surgery. Our study was designed to test the effect of oral carbohydrate loading on clinical parameters in patients undergoing major surgery for advanced-stage ovarian cancer.

Prophylactic Bilateral Salpingo-oophorectomy in BRCA2 Mutation with Incidental Finding of Serous Tubal Intraepithelial Carcinoma (STIC) and Subsequent Diagnosis of Primary Peritoneal Carcinoma (PPC): A Case Report and Review of Current Literature.

A major effort to prevent serous cancer in genetically susceptible women with breast cancer susceptibility gene (BRCA) mutations has recently introduced the practice of risk-reducing prophylactic salpingo-oophorectomy. A small number of those who undergo prophylactic salpingo-oophorectomy will be found to have occult carcinomas. The majority of these appear to originate in the fallopian tube, reinforcing the theory that a significant proportion of high-grade serous carcinoma pelvic tumours have a fimbrial origin.

Lopinavir/ritonavir use in Covid-19 infection: is it completely non-beneficial?

Covid-19 infection caused by the novel coronavirus SARS-COV-2 continues to be a major global health challenge. Till date, no drug has been approved for the treatment of this infection. A number of medications have been proposed and there are ongoing clinical trials around the world to find a suitable treatment.

Correlation Between Urodynamic and Clinical Diagnoses in Classifying the Type of Urinary Incontinence in Women.

Urodynamic tests are considered the gold standard for investigating and managing patients with urinary incontinence symptoms. The objective of this review is to determine the correlation between urodynamic and clinical diagnoses in identifying the type of urinary incontinence in pre and postmenopausal women. This is a retrospective review of 116 women with urinary incontinence symptoms that were evaluated clinically initially and then investigated further with urodynamic tests.

Outcome of surgery in neck of femur fracture patients with poor pre-fracture mobility.

Background: Hip fractures are common with a UK incidence of over 70,000 cases and total healthcare costs of over £2 billion per year. Mortality rates of 10% at 30 days and up to 30% at 1-year have been reported. We wanted to assess the outcome of hip fracture surgery in patients with reduced pre-fracture mobility as this has not been exclusively studied previously.

Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees.

Background: To prepare for surgery, surgeons often recur to surgical videos, with YouTube being reported as the preferred source. This study aimed to compare the evaluation of three surgical trainees and three senior surgeons of the 25 most viewed laparoscopic appendectomy videos listed on YouTube. Additionally, we assessed the video conformity to the published guidelines on how to report laparoscopic surgery videos (LAP-VEGaS).