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.

Evaluating duloxetine for pruritus and psychiatric comorbidities in lichen simplex chronicus.

The use of antidepressant medications in the treatment of lichen simplex chronicus (LSC) also known as neurodermatitis, is not well-documented in the literature. The primary aim of our study is to evaluate the impact of duloxetine 30 mg on the quality of life in patients with LSC, focusing on both pruritus and psychopathological aspects. The secondary aim is to investigate the relationship between LSC and anxiety and depression.

Comparison of Mesotherapy and Transcutaneous Electrical Nerve Stimulation (TENS) in the Management of Chronic Non-Specific Low Back Pain: A Randomized Clinical Trial.

Unlabelled: Introduction-Aim: Chronic low back pain affects 80% of individuals at some point in their lives and has significant socioeconomic impacts. This study aims to compare the efficacy of mesotherapy with transcutaneous electrical nerve stimulation (TENS) in treating chronic low back pain.

Methods: A randomized bicentric study was conducted at the Military Hospital of Tunis and the Multidisciplinary Military Polyclinic of Mefeteh Saadallah between August 2023 and June 2024.

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Aim: To elaborate Tunisian recommendations for the therapeutic management in current practice of patients with spondyloarthritis who are candidates for treatment with a biological agent.

Methods: Following the standardized procedures of the INEAS (Instance Nationale de l'Evaluation et de l'Accréditation en Santé) and in collaboration with the LITAR (Tunisian League against Rheumatism), a systematic review of the literature, carried out by 6 rheumatologists, based on the questions individualized by the working group (15 expert rheumatologists), served as the basis for the working meetings, with determination of the strength of the recommendations and the degree of agreement of the experts. The recommendations were validated by an independent reading group comprising 19 experts from various related specialties.

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Aim: To develop good practice recommendations (GPR) for the therapeutic management of patients with spondyloarthritis (SpA), including psoriatic arthritis.

Methods: Following standardised procedures, a systematic review of the literature was carried out on non-pharmacological and non-biological pharmacological treatments for SpA. The review was based on questions defined by a working group of 15 rheumatologists.

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Unlabelled: Advancements in understanding SpA have greatly improved patient quality of life through early detection and effective treatment. However, non-specialist physicians often face challenges in identifying the early symptoms of SpA.

Aim: This study aims to assist healthcare practitioners in the early detection of SpA and to streamline management strategies by employing a standardized assessment protocol for adult patients with SpA.

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This framework was developed under the auspices of the Tunisian League Against Rheumatism (LITAR), coordinated by a project leader. The primary objective is to formulate recommendations for the management of spondyloarthritis, grounded in the development of questions structured according to the PICO model. This model defines four essential elements of a clinical question: P: Patient or Population or Problem, I: Intervention (the proposed action), C: Comparison (between diagnostic tests, treatments, etc.

INDEPSO-ISPSM consensus on peritoneal malignancies - Enhanced recovery after surgery in cytoreductive surgery (CRS) with/without hyperthermic intraperitoneal chemotherapy (HIPEC).

Background: The role of enhanced recovery after surgery (ERAS) in cytoreductive surgery and/or Hyperthermic Intraperitoneal Chemotherapy HIPEC) is evolving, with promising results that improve patient outcomes. This consensus exercise was carried out to address and standardize components of the ERAS protocol pertinent to the Indian context.

Method: The modified Delphi method was employed with two rounds of voting.

Altered circadian rhythmicity of the QT interval predicts mortality in a large real-world academic hospital population.

Objective And Rationale: Small studies have shown that the QT interval follows a circadian rhythm. This finding has never been confirmed in a large real-world hospital population and the clinical meaning of disrupted rhythmicity remains unknown.

Methods: In this cohort study, all consecutive adult patients with at least one 12-lead ECG acquired between 1991 and 2021 were considered.

Trichohepatoenteric Syndrome: A Report of Two Children From Bahrain With a Novel Mutation and a Literature Review.

Trichohepatoenteric syndrome (THES) is a rare genetic disorder inherited in an autosomal recessive manner. THES primarily leads to neonatal enteropathy, typically manifesting as severe, persistent diarrhea, distinctive facial features such as frontal bossing and a broad flat nasal bridge, woolly and fragile hair, immunodeficiency resulting in recurrent infections, failure to thrive (FTT), and liver complications including fibrosis or cirrhosis. This multisystem disorder is linked to mutations in the tetratricopeptide repeat domain 37 (TTC37) gene, also known as superkiller complex (SKIC) protein 3, responsible for THES type 1, and the Ski2-like ribonucleic acid (RNA) helicase (SKIV2L) gene, also known as SKIC2, responsible for THES type 2.

Effect of preoperative hair removal vs. no removal on surgical site infections: a systematic review and meta-analysis.

Background: The practice of preoperative hair removal has been debated regarding its role in Surgical Site Infection (SSI) prevention. This study aimed to compare the different hair removing modalities and investigate the effect of preoperative hair removal on SSI rates.

Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines.

Transcatheter closure of paravalvular leakage through multiple approaches after surgical mechanical valve replacements: A retrospective study.

Background: Transcatheter closure of percutaneous paravalvular leak (PVL) is a technically challenging procedure, especially after surgical mechanical valve replacements (SMVR), as the risk of interference with the prosthetic valve discs and the complex interventional techniques required for mitral PVL closure. Our study was designed to review the results with transcatheter closure of PVL after SMVR.

Methods: From January 2018 through December 2023, a total of 64 patients with PVL after SMVR underwent transcatheter closure with the help of preoperative 3-dimensional printing model and simulator for image evaluation.

Uncommon retroperitoneal mass in a young adult: A rare case report of retroperitoneal schwannoma and review of diagnostic challenges.

Introduction And Importance: Retroperitoneal schwannomas are extremely rare, benign tumors originating from Schwann cells in peripheral nerve sheaths, with few reported cases. Their deep location and nonspecific symptoms make preoperative diagnosis challenging, often requiring imaging and surgical resection for confirmation. This case highlights an uncommon presentation of retroperitoneal schwannoma in a young patient, emphasizing its rarity.

The association of HLA-DRB1 allele group but not HLA-B or ERAP1-rs7063 gene polymorphisms with atopic dermatitis.

Atopic dermatitis (AD) is one of the most common dermatoses. According to current data 2.6 % of the world's population suffer from AD.

Visual Improvement Following Stereotactic Radiosurgery for Orbital Apex Vascular Tumor.

Orbital apex lesions represent a clinical challenge since they are difficult to remove surgically and may induce significant functional defects. The orbital apex is an area of convergence of neurovascular elements passing through the various local osseous foramina and the congestion of several critical anatomical structures in a confined space increases the risk of intraoperative complications. Radiotherapy is an alternative treatment option in such cases but may also induce radiation toxicity.

Pulmonary hydatid cyst misdiagnosed as lung cancer.

Hydatid disease is endemic in Tunisia. Whereas uncomplicated pulmonary hydatid cysts are easily diagnosed on radiological findings, complicated and atypical forms may be misdiagnosed and confused with other pulmonary lesions, mainly lung malignancies. We report a case of a 47-year-old woman, who presented with a 3-month history of hemoptysis.

Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study.

Objectives: We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.

Study Design: An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.

Methods: A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection.

Current and emerging bone resorption inhibitors for the treatment of osteoporosis.

Introduction: Osteoporosis is a metabolic skeletal disease characterized by low bone mass and strength, and increased risk for fragility fractures. It is a major health issue in aging populations, due to fracture-associated increased disability and mortality. Antiresorptive treatments are first line choices in most of the cases.

The Impact of Hepatic Hydrothorax on the Outcome of Liver Cirrhosis: A Comparative Study.

Hepatic hydrothorax (HH) is a severe cirrhosis complication requiring early diagnosis and appropriate management. This study aimed to assess the impact of HH on the disease severity and mortality of cirrhotic patients and compare their clinical and biological profiles with those of patients without HH. This retrospective study involved 155 patients diagnosed with cirrhosis, of whom 31 had HH.

Therapeutic Consequences and Prognostic Impact of Multimorbidity in Heart Failure: Time to Act.

: In heart failure (HF) with reduced ejection fraction (HFrEF), the early diagnosis and proper treatment of comorbidities (CMs) are of fundamental relevance. Our aim was to assess the prevalence of CMs among real-world patients requiring hospitalisation for HFrEF and to investigate the effect of CMs on the implementation of guideline-directed medical therapy (GDMT) and on all-cause mortality (ACM). : The data of a consecutive HFrEF patient cohort hospitalised for HF between 2021 and 2024 were analysed retrospectively.

From Molecular to Radionuclide and Pharmacological Aspects in Transthyretin Cardiac Amyloidosis.

Amyloidosis is a rare pathology characterized by protein deposits in various organs and tissues. Cardiac amyloidosis (CA) can be caused by various protein deposits, but transthyretin amyloidosis (ATTR) and immunoglobulin light chain (AL) are the most frequent pathologies. Protein misfolding can be induced by several factors such as oxidative stress, genetic mutations, aging, chronic inflammation, and neoplastic disorders.

Tailgut Cyst-Gynecologist's Pitfall: Literature Review and Case Report.

Retrorectal cystic hamartomas ("Tailgut cysts") are rare developmental cysts that appear in the retrorectal space, arising from aberrant remnants of the post-anal primitive gut in case of an incomplete embryogenetic involution. We present the case of a 30-year-old woman with a history of chronic lower abdominal pain. Other digestive symptoms, like rectal fullness, constipation, pain on defecation, rectal bleeding or genitourinary obstruction symptoms, were not associated.