Discharge against medical advice in pediatrics: a 10-year retrospective analysis in a tertiary care center.

Background: There is still limited data on Discharge Against Medical Advice (DAMA) in the pediatric population. Most research comes from low-and middle-income countries, where the financial burden associated with medical care is often an important reason to leave a healthcare facility prematurely. Discharge against medical advice in the children's population is considered a significant issue that may lead to an increased risk of morbidity and mortality.

Efficacy and safety of semaglutide: real-world tertiary care experience from Saudi Arabia.

Background: Semaglutide, a glucagon-like peptide-1, is an effective antidiabetic drug promoting weight loss and providing cardiovascular protection. The original trials did not include participants from Saudi Arabia; hence, the study's findings are expected to be useful.

Objectives: Explore the efficacy, safety, and favorable effects of once-weekly subcutaneous semaglutide (1 mg) in patients with type 2 diabetes and those who received it as an off-license prescription without having diabetes.

Sperm morphology value in assisted reproduction: dismantling an enigma and key takeaways for the busy clinician.

The ideal morphology of the sperm cell was initially described based on the characteristics of sperm able to migrate through the endocervical canal assuming these had the best fertilization potential. Sperm morphology assessment has moved over the years toward stricter criteria based on the findings from studies that underline its value in successful reproductive outcomes. While treatment options are clear for some conditions related to abnormal sperm morphology, the value of sperm morphology in assisted reproduction requires further investigation.

A Paradigm Shift in Renal Cell Carcinoma: Recognizing Hypoglycaemia as a Significant Paraneoplastic Syndrome.

Recurrent hypoglycaemia is a rare paraneoplastic syndrome associated with several cancers, including renal cell carcinoma (RCC). Here we present a curious case of a patient with type 2 diabetes mellitus (T2DM) who had numerous hospitalisations due to recurrent hypoglycaemia. A well-defined lesion at the lower pole of the right kidney and bilateral pyelonephritis were found during imaging investigations.

Comparison of Ropivacaine and Bupivacaine in Intraperitoneal Instillation for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Randomized Controlled Trial.

Introduction Laparoscopic cholecystectomy, despite its several advantages, is sometimes associated with discomfort due to pain in the immediate postoperative period. Effective management of this pain is critical for enhancing recovery, minimizing complications, and facilitating early discharge. The use of local anesthetics for intra-abdominal analgesia, specifically bupivacaine and ropivacaine, has been investigated as a means to improve postoperative pain control.

An Unusual Case of Esophageal Perforation Following C5-C7 Anterior Cervical Corpectomy and Fusion Managed Surgically With Esophageal Repair and Long-Segment Cervical Fusion.

Anterior cervical corpectomy and fusion (ACCF) is frequently the surgical management for myelopathy, radiculopathy, and cervical spine trauma. Although esophageal perforation is an uncommon complication, it remains a serious concern. This report details the case of a 50-year-old female who underwent a C6 corpectomy with C5-C7 ACCF due to degenerative pathology and subsequently developed an esophageal perforation that required revision surgery and surgical repair of the perforated esophagus.

Utility of Intranasal Tapentadol in Redefining Postoperative Pain Management in Total Knee Arthroplasty: A Prospective Observational Study.

Introduction Effective strategies to minimize postoperative pain following total knee arthroplasty (TKA) are essential to improve functional outcomes. This study aimed to evaluate the effectiveness and safety of tapentadol nasal spray as a form of patient-controlled analgesia (PCA) for postoperative pain management after TKA. The intranasal route was chosen for the study as intranasal tapentadol has been shown to have superior pain reduction as compared to intravenous tapentadol.

Exploring Gonadal Functions in Patients With Alcoholic Liver Disease: A Correlative Analysis With Disease Severity.

Background and objective Alcoholic liver disease (ALD) encompasses a spectrum of liver conditions caused by excessive alcohol consumption, including fatty liver, alcoholic hepatitis, and cirrhosis. Both phenotypical and biochemical changes in gonadal hormones are observed across these stages. This study aimed to evaluate the clinical, biochemical, and hormonal abnormalities in patients with varying degrees of ALD and to assess their correlation with disease severity.

Recurrent Osteosarcoma Presenting as Hepatic Metastasis: A Case Report.

Osteosarcoma is a malignant tumor, derived from primitive bone-forming mesenchymal cells, and its aggressive nature often leads to significant morbidity and mortality, with amputation being routinely performed in localized cases. Post-amputation morbidity has a significant impact on the quality of life of the affected individuals. The tumor frequently metastasizes to the lungs and bones, and widespread disease remains the leading cause of most patient deaths.

The First Case Report of a Homozygous Consensus Acceptor Splice Variant in the NUP214 Gene Associated With Fetal Hydrops and Arthrogryposis Multiplex.

The gene encodes a nuclear pore complex protein (nucleoporin, 214 kilodaltons) which plays a critical role in messenger RNA export to the cytoplasm and import of substrates from the cytoplasm. Biallelic mutations in the gene have been associated with susceptibility to acute infection-induced encephalopathy type 9 (ILAE9) (Online Mendelian Inheritance in Man (OMIM), 114350), an autosomal recessive disorder. Herein, we describe for the first time, a fetus with hydrops and arthrogryposis multiplex with a homozygous novel consensus splice site variant in the NUP214 gene, chr9:g.

Large Renal Calculus in a Patient With Crossed Fused Ectopic Kidney Managed With Percutaneous Nephrolithotomy: A Case Report.

Congenital anomalies are not regularly seen in day-to-day practice. Crossed fused renal anomalies are even rarer. A 50-year-old female patient presented with right-sided pain in the abdomen with intermittent episodes of burning micturition.

A Tribute to the Legendary Physician and Politician: Dr. Bidhan Chandra Roy.

This comprehensive review article examines the profound and multifaceted impact of Dr. Bidhan Chandra Roy (1 July 1882 to 1 July 1962) on the political landscape and healthcare system of post-independence India, with a particular focus on West Bengal. Dr.

Evaluation of Functional and Radiological Outcomes of Long Bone Fractures in Non-union Treated With Nail and Plate With Osteo-Periosteal Flaps.

Objective: To evaluate the functional and radiological outcomes of long bone fractures in non-union cases treated with nail and plate with osteo-periosteal flaps.

Methods: This prospective study included 20 patients with non-union long bone fractures treated at Dr. DY Patil Medical College, Pimpri, Pune over a two-year period.

Supportive and Palliative Care Needs of the Older Adults with Stroke and Neurological Diseases: An Estimation using data from Longitudinal Ageing Study in India.

Objectives: The prevalence and burden of neurological diseases are high among the older age group. Stroke and other neurological diseases significantly impair functional capacity and lead to poor quality of life. This study aims to provide a national-level estimate for palliative and supportive care needs among older Indian adults with stroke and other neurological diseases.

Interpretation of testicular biopsy for infertility: a practical guide.

Testicular biopsies are often performed in men with unexplained infertility and azoospermia to ascertain the status of spermatogenesis. Testicular pathology is one of the primary causes of male infertility. However, infrequent exposure among pathologists and a lack of uniform reporting terminology pose diagnostic challenges and variability in interpretation.

A retrospective analysis of tacrolimus pharmacokinetic in Saudi paediatric patients in early post-liver transplantation period.

Background: Tacrolimus is an essential immunosuppressive medication in paediatric patients' post-liver transplantation. Achieving tacrolimus target concentration in early post-transplantation is crucial to minimise the risk of acute rejection; however, this is challenging due to inter- and intra-patient variability in tacrolimus metabolism and clearance. Therefore, our study aims to describe tacrolimus trough concentration variability and pharmacokinetics in paediatric post-liver transplantation during the first two weeks post-transplantation.

Aging and cancer: Clinical role of tumor markers in the geriatric population (Review).

Aging, with the progressive deterioration and functional decline of several organ systems, is highly heterogeneous for both between and within individuals. Tumor markers are widely used in clinical practice as a screening test for individuals >50 years of age. More specifically, caring for elderly patients is a public health concern, given the incidence of cancer and its related mortality and morbidity.

Robert Koch: From Anthrax to Tuberculosis - A Journey in Medical Science.

The pioneering German physician and microbiologist Heinrich Hermann Robert Koch (1843-1910) made pivotal contributions to the field of bacteriology, significantly advancing the germ theory of disease. His groundbreaking research in identifying the causative agents of anthrax, tuberculosis, and cholera revolutionized medical science and public health. Koch's development of essential microbiological techniques, such as using agar for bacterial cultures and introducing the Petri dish, transformed laboratory practices.