DNA and RNA Methylation in Rheumatoid Arthritis-A Narrative Review.

Rheumatoid arthritis (RA) is a progressive autoimmune disease leading to structural and functional joint damage and, eventually, to physical disability. The pathogenesis of the disease is highly complex and involves interactions between fibroblast-like synoviocytes (FLSs) and immune cells, which stimulate the secretion of pro-inflammatory factors, leading to chronic inflammation. In recent years, studies have demonstrated the importance of epigenetics in RA.

SWEET'S SYNDROME ASSOCIATED WITH PHEOCHROMOCYTOMA: A RARE CASE REPORT AND REVIEW OF LITERATURE.

Background: Sweet's syndrome (SS) or acute febrile neutrophilic dermatosis is a dermatological illness that can be described by tender erythematous plaques or nodules and acute onset fever. The etiology is multifactorial and is not fully understood. SS is separated in three subclasses: classical, malignancy-associated, and drug-induced.

Social determinants of financial stress and association with psychological distress among young adults 18-26 years in the United States.

Introduction: Financial stress (FS) during young adulthood may have lasting effects on financial security, physical health, and overall wellbeing. This study examines the burden, social determinants and mental health consequences of experienced FS among young adults in the United States, based on objective measures of financial stress.

Methods: We studied young adults aged 18-26 years using pooled data from the 2013-18 National Health Interview Survey.

Nontraumatic right diaphragmatic hernia with malrotated left liver lobe incarceration: An unusual case report with literature review.

Diaphragmatic hernia is an unusual finding, especially in emergency settings and in the absence of trauma. Imaging plays a crucial role, with various CT signs of diaphragmatic rupture having been described, including the "dangling diaphragm," "absent diaphragm," "collar sign," "hump sign," "fascia sign," and "dependent viscera sign". We report an unusual case of a 53-year-old woman who presented with exertional dyspnea and asthenia.

Factors Influencing the Achievement of the Critical View of Safety in Laparoscopic Cholecystectomy: A Prospective Observational Study in Yemen.

Background The critical view of safety (CVS) is a critical technique to minimize the risk of bile duct injuries (BDIs) during laparoscopic cholecystectomy (LC). This study evaluated the rate of CVS achievement and examined factors influencing its success. Methods This prospective study included 97 patients undergoing LC.

Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation.

Background: Abelacimab is a fully human monoclonal antibody that binds to the inactive form of factor XI and blocks its activation. The safety of abelacimab as compared with a direct oral anticoagulant in patients with atrial fibrillation is unknown.

Methods: Patients with atrial fibrillation and a moderate-to-high risk of stroke were randomly assigned, in a 1:1:1 ratio, to receive subcutaneous injection of abelacimab (150 mg or 90 mg once monthly) administered in a blinded fashion or oral rivaroxaban (20 mg once daily) administered in an open-label fashion.

Standardized measurement of the piriformis muscle and the proximal portion of the sacral nerve roots using transvaginal ultrasound.

Objective: To identify the sonomorphological appearance and to measure the thickness of the piriformis muscle (PM) and the proximal portion of the sacral nerve roots S1-S3 in healthy premenopausal women.

Materials And Methods: This prospective multicentric observational study included a consecutive series of women undergoing transvaginal sonography (TVS) at two tertiary gynecological referral centers. Standardized assessment of the pelvic organs was performed followed by an attempt to visualize the right and left PM and sacral nerve roots S1-S3 at their origin in proximity to the sacral neuroforamen.

Incidence and complication rate of arthroplasty in Perthes disease management: A systematic review and meta-analysis.

Background: Perthes disease presents a challenge in orthopedic management, often necessitating surgical intervention such as arthroplasty. This meta-analysis systematically evaluated the rate of occurrence and complications associated with arthroplasty in Perthes disease.

Methods: A comprehensive search was conducted across PubMed, Web of Sciences, Scopus, and Cochrane Library databases to identify relevant studies.

Efficacy and Safety of Tranexamic Acid in the Management of Gastrointestinal Bleeding: A Systematic Review.

Lower gastrointestinal bleeding (LGIB) is a challenging and potentially life-threatening medical condition that often necessitates prompt intervention. In the quest to improve patient outcomes, one therapeutic agent has garnered significant attention - tranexamic acid (TXA). The basic aim of the study is to systematically review the role of TXA in LGIB.

Enhancing Thromboembolic Risk Prediction in Non-valvular Atrial Fibrillation: The Critical Role of Transesophageal Echocardiography (TEE).

Introduction Atrial fibrillation (AF), the most common cardiac arrhythmia, poses challenges in predicting thromboembolic risk. While the CHADS-VASc (congestive heart failure, hypertension, age ≥ 75 years (doubled), type 2 diabetes mellitus, previous stroke, transient ischemic attack, or thromboembolism (doubled), vascular disease, age 65-74 years, and sex category) score remains essential, its limitations include failure to identify left atrial (LA) thrombus in some patients. Transesophageal echocardiography (TEE) provides superior detection of LA thrombi and thrombogenic factors compared to transthoracic echocardiography (TTE), improving risk stratification, especially in intermediate-risk groups.

Managing Arrhythmias in Cardiogenic Shock: Insights Into Milrinone and Dobutamine Therapy.

Shock is a state of inadequate perfusion that affects vital organs. Cardiogenic shock (CS) predisposes patients to various arrhythmias. The adverse effect depends on intervention and pharmacogenomics.

Chemical Burns Caused by Topical Silver Nitrate in Umbilical Granuloma Treatment: A Case Report.

An umbilical granuloma (UG) is one of the most common umbilical anomalies seen in infants, mostly due to delayed cord separation. It is usually treated with silver nitrate; however, topical application of silver nitrate can cause chemical burns, creating concern among parents. We present a similar case in a two-month-old baby boy with a giant UG, which was treated with topical silver nitrate application, producing significant chemical burns around the umbilicus and on the anterior abdominal wall.

Emerging role of ultrasound guided interventional management in cervicogenic headache.

The objective of this mini review is to discuss the role of musculoskeletal ultrasound (MSK US) in identification and treatment of pain generators in cervical spine in patients presenting with cervicogenic headache (CEH). CEH is a secondary headache arising from cervical nociceptive structures emerging from facet joints, intervertebral discs, nerves, muscles, fascia and ligaments. It presents a complex challenge in clinical management.

An examination of autopsies in a 400 bedded government hospital in Jhelum. An insight into the sudden cause of death and costs associated with autopsy in young government personnel.

Objective: To explore the different causes of sudden death among serving government employees.

Methods: The audit study was conducted at the Pathology Department of a tertiary care hospital Combined Military Hospital (CMH) Jhelum, Pakistan, and comprised data of all autopsies between January 2017 and June 2021. Sampling was done by non probability purposive sampling technique which requires no statistical method calculation.

Assessment of chronic ankle instability: are functional scores relevant enough?

Introduction: A poorly treated acute ankle sprain can rapidly progress to chronic instability, with varying degrees of disability secondary to weakness of the ankle stabilizers. The aim of our study was to evaluate functional scores and physical tests in the assessment of eversion and proprioception deficits after non-surgical treatment of chronic ankle instability. Our hypothesis was that these functional scores and physical tests are suitable and sufficient for assessing the functional aspect of an unstable ankle.

Small intestinal metastasis of cutaneous melanoma in an elderly woman: Survival benefits of surgery and novel targeted therapies - A case report.

Introduction And Importance: Cutaneous malignant melanoma, originating from melanocytes, is a highly metastatic cancer with an incidence rate of 0.9 per 100,000. The gastrointestinal tract is a common site of metastasis, with the small intestine being particularly affected.

Evaluating the Effectiveness of Shockwave Lithotripsy vs Ureteroscopic Lithotripsy for Treatment of Renal Stones: A Prospective Cohort Study.

Background: Renal stones are a prevalent condition requiring effective treatment strategies. This study evaluates the comparative effectiveness of shockwave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) in treating renal stones in a Pakistani cohort, focusing on stone clearance, recurrence, and complications.

Methods: This prospective cohort study involved 250 patients aged 18-55 diagnosed with renal stones.

Anatomic and Functional Reconstruction of the Abdominal Wall in Prune Belly Syndrome: A Case Report.

Prune belly syndrome (PBS), or Eagle-Barrett syndrome, is a rare congenital disorder marked by abdominal wall muscle deficiency, urinary tract anomalies, and cryptorchidism, causing significant abdominal wall laxity and functional impairment. This case report discusses an innovative approach to abdominal wall reconstruction in a 19-year-old male patient with PBS and associated conditions, including chronic renal failure and spina bifida. Previously, he underwent distal ureterectomy and vesicoureteral reimplantation at the age of two years to correct urinary tract dilation and bilateral orchiopexy.

Exploring Neurohormonal Modulation by Acetazolamide in Heart Failure.

Background Heart failure (HF) is commonly managed by addressing water and sodium (Na) balance, with arterial circulation playing a major role in influencing renal Na and water excretion. Recently, chloride (Cl) has been recognized as an important factor in HF, associated with volume regulation and its modulation of renin-angiotensin-aldosterone system (RAAS) activity through macula densa signaling, which impacts Na retention and neurohormonal activation. Acetazolamide, a carbonic anhydrase inhibitor, can enhance decongestion in HF by increasing urinary Na and Cl excretion when added to loop diuretics, a mechanism supported by prior studies demonstrating improved urine output and decongestion.

Elective Sternotomy With Fluoroscopic Guidance for the Removal of a Residual Implantable Cardioverter Defibrillator Lead: A Case Report and Literature Review.

Infectious myocarditis (IM) and infective endocarditis (IE), sometimes associated with infection of the surrounding mediastinal tissue or embolic complications caused by residual implantable cardioverter defibrillator (ICD) lead material embedded in the ventricle, present a significant challenge for cardiac surgeons due to the difficulty of precisely locating the old intracardiac pacing lead remnants because of the heart's continuous movement. We present the case of successful two-stage elective sternotomy extraction of two residual defibrillator leads, one trapped in the left innominate vein, easily removed after veinotomy without cardiopulmonary bypass (CPB), and the other embedded intramyocardially in the inferior wall of the right ventricle, successfully removed under CPB after fluoroscopic guidance. The patient was discharged four weeks post-operation without complications.

Prevalence and associated factors of herbal medicine use among breast cancer patients: a cross-sectional study in Morocco.

Background: Despite advances in modern medicine, an increasing number of breast cancer (BC) patients are turning to complementary and alternative medicine, such as phytotherapy. Instead of being prescribed by breast medical oncologists, patients are often seeking out phytotherapy themselves. They typically resort to herbal medicine as an alternative treatment to alleviate symptoms and side effects and enhance their quality of life during cancer treatment.

Effectiveness of Acetazolamide in Patients With Heart Failure: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis evaluated the efficacy and safety of acetazolamide as an adjunctive diuretic therapy in acute heart failure (AHF) patients. A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Embase, Cochrane Library, and Scopus, identifying seven studies (five randomized controlled trials and two observational studies) that met the eligibility criteria. The analysis revealed that acetazolamide significantly enhanced mean natriuresis (mean differences (MD) 52.

Superior mesenteric artery syndrome in a pediatric patient: A rare case report and literature review.

Introduction And Importance: Superior mesenteric artery (SMA) syndrome, or aorto-mesenteric clamp syndrome, is a rare condition where the third portion of the duodenum is compressed between the aorta and the superior mesenteric artery. This syndrome often affects adolescents and young adults, with predisposing factors including significant weight loss, anatomical variations, and spinal deformities. Early diagnosis and intervention are critical for managing symptoms and preventing complications.