Unveiling Complexity: A Case Report of Catastrophic Antiphospholipid Syndrome With Coronary Occlusion and a Concomitant Patent Foramen Ovale Shunt.

Antiphospholipid syndrome (APLS) and systemic lupus erythematosus (SLE) are rare autoimmune disorders that afflict a small percentage of the global female population. The complexity of these conditions is further exacerbated by their propensity to give rise to recurrent thrombosis and obstetric morbidity, thereby posing intricate challenges for clinicians and patients alike. One of the most concerning aspects of these diseases is the heightened risk they confer for accelerated atherosclerosis, which can ultimately culminate in the development of acute coronary syndrome (ACS).

Outcome of Atrial Fibrillation Ablation in Cancer Patients: A Review.

Atrial fibrillation (AF), a cardiac arrhythmia, exhibits a heightened prevalence among individuals diagnosed with cancer, notably prominent in cases of lung and gastrointestinal malignancies. Robust evidence from extensive studies underscores this association, emphasizing its clinical significance. However, the precise mechanistic underpinnings and specific risk factors linking cancer and AF remain a subject of incomplete understanding.

Comparative Analysis of Oral Ondansetron, Metoclopramide, and Domperidone for Managing Vomiting in Children With Acute Gastroenteritis.

Background Acute gastroenteritis (AGE) is a major health concern in pediatric populations because of its associated vomiting, which worsens dehydration and the severity of illness. Objective The purpose of the research was to compare the relative effectiveness of oral ondansetron in treating AGE in children's vomiting when compared to oral domperidone and oral metoclopramide. Methodology A clinical investigation involving 120 pediatric patients diagnosed with AGE was conducted in Pakistan from November 2022 to April 2023 using a single-blind randomized design and convenience sampling.

A rare case of perforating chest wall including pericardial sac with penetrating trivial injury: A case report and literature review.

Unlabelled: Perforating chest wall injuries involving the pericardial sac in pediatric patients are exceedingly rare and pose a unique clinical challenge. Thoracic trauma in the pediatric population remains a significant cause of morbidity and mortality. We present a case of an 8-year-old boy with an acute history of a sharp injection needle embedded in his chest wall presented with severe chest pain and diaphoresis.

Cannulation Strategies in Type A Aortic Dissection: Overlooked Details and Novel Approaches.

Aortic dissection type A is a life-threatening condition that frequently necessitates surgical intervention. This review focuses on central aortic cannulation, arch branch vessel (ABV) cannulation, and proximal arch cannulation as key techniques during aortic surgery. It discusses innovative solutions for addressing these challenges.

The Impact of Artificial Intelligence on Optimizing Diagnosis and Treatment Plans for Rare Genetic Disorders.

Rare genetic disorders (RDs), characterized by their low prevalence and diagnostic complexities, present significant challenges to healthcare systems. This article explores the transformative impact of artificial intelligence (AI) and machine learning (ML) in addressing these challenges. It emphasizes the need for accurate and early diagnosis of RDs, often hindered by genetic and clinical heterogeneity.

Effectiveness of community pharmacist-led interventions in osteoarthritis pain management: A cluster-randomized trial.

Background: Community pharmacists contribute in osteoarthritis management via evidence-based pain management services. However, their roles and impacts on osteoarthritis management in low- and middle-income countries have yet to be explored.

Objective: This study aims to evaluate the effectiveness of community pharmacist-led educational intervention and medication review among osteoarthritis patients.

Comparing the Effectiveness of Intravenous Tissue Plasminogen Activator and Dual Antiplatelet Therapy in Patients With Minor Stroke: A Meta-Analysis.

The aim of this study was to compare the outcomes between dual antiplatelet therapy (DAPT) versus intravenous tissue plasminogen activator (IV t-PA) in patients with minor stroke. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Two authors independently conducted online database searches using PubMed, Web of Science, and EMBASE to identify articles published in English language from inception to September 5, 2023.

Atrial Fibrillation Ablation in Patients With Chronic Kidney Disease: A Review of Literature.

Atrial fibrillation (AF) is a common arrhythmia among patients with chronic kidney disease (CKD), which leads to increased cardiovascular complications. Catheter ablation (CA) has emerged as an effective and safe treatment for AF in CKD patients. CA offers tailored treatment strategies and presents a safer alternative with fewer adverse outcomes than anti-arrhythmic agents.

Neutropenic enterocolitis in aplastic anemia - a case report from Nepal.

Introduction And Importance: Neutropenic enterocolitis (NE) is a life-threatening necrotizing enterocolitis, particularly in neutropenic patients.

Case Presentation: We are presenting a case of a 22-year-old male who presented chief complaints of abdominal pain, reddish black stool, abdominal distention, and low-grade fever with laboratory and bone marrow findings suggestive of aplastic anemia. Computed tomography scan of the abdomen and pelvis with contrast was used to establish the diagnosis of necrotizing enterocolitis.

An Infrequently Encountered Cause of Hemoptysis.

Mitral stenosis (MS) is not a common entity in modern-day medicine, especially in developed countries, as the most common etiology is still rheumatic fever. MS can present mainly with a wide range of cardiac symptoms. However, infrequently, MS can cause extra-cardiac symptoms as well.

Disseminated adrenal histoplasmosis in an immunocompetent adult from Nepal: a case report.

Introduction: Histoplasmosis is caused by the environmental fungus . In immunocompromised patients, histoplasmosis can present as a disseminated infection that can involve the liver, lymph nodes, lungs, and adrenal glands. Disseminated histoplasmosis affecting the adrenal glands in an immunocompetent individual is a rare infection.

Severe acute organophosphate poisoning managed with 2-month prolonged atropine therapy: a case report.

Introduction And Importance: Organophosphate (OP) poisoning is a common and potentially fatal condition that requires prompt and aggressive treatment with atropine, oximes, and supportive care. We report a rare case of OP poisoning that needed high doses of atropine and intensive care for 60 days.

Case Presentation: A 39-year-old male ingested 200 ml of chlorpyrifos, an OP compound, and presented with vomiting and epigastric pain.

Granulomatosis with polyangiitis mimicking COVID-19 pneumonia: A case report.

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a necrotizing vasculitis characterized by small-to-medium-sized vessel involvement and the presence of antineutrophil cytoplasmic antibodies (ANCA). We present a case of a 26-year-old Asian woman who was transferred to our center from a nearby hospital, where she presented with shortness of breath, tested positive for COVID-19, and was being managed for COVID-19 pneumonia. She also had hemoptysis, skin lesions, and left foot numbness.

The outcome of Radial Neck Fracture Treated with Closed/ Open Reduction and Retrograde Kirschner Wires Fixation in the Paediatric Age Group.

Background Radial neck fractures in children are rare injuries, representing 1 to 5% of all elbow pediatric fractures. Most of them are non-displaced or slightly displaced and treated conservatively. Severely displaced or angulated radial neck fractures (Judet type III and IV fractures or O'Brien type III radial neck fractures) requires surgical treatment.

Correlation of Conductive Hearing Impairment With Sizes of Adenoids in the Pediatric Age Group: An Observational Case-Control Study.

Introduction: When adenoids enlarge and elicit symptoms it is referred to as symptomatic adenoids, which is a preventable cause of hearing loss and nasal obstruction in the pediatric age group. This study was done to correlate conductive hearing loss with the size of adenoids and to emphasize the importance of screening in the pediatric age group.

Methods: An observational case-control study was conducted to analyze the degree of hearing impairment in children with adenoid hypertrophy.

Type IV-A choledochal cyst with choledocholithiasis in an adult female: A case report.

A choledochal cyst is a rare congenital anomaly of the biliary system, characterized by bile duct cystic dilatation, typically affecting the common bile duct. Choledochal cysts are generally categorized using the Todani classification system. The typical symptoms are jaundice, abdominal masses, and recurrent abdominal pain.

Emergence of Marburg virus: a global perspective on fatal outbreaks and clinical challenges.

The Marburg virus (MV), identified in 1967, has caused deadly outbreaks worldwide, the mortality rate of Marburg virus disease (MVD) varies depending on the outbreak and virus strain, but the average case fatality rate is around 50%. However, case fatality rates have varied from 24 to 88% in past outbreaks depending on virus strain and case management. Designated a priority pathogen by the National Institute of Allergy and Infectious Diseases (NIAID), MV induces hemorrhagic fever, organ failure, and coagulation issues in both humans and non-human primates.

Level and Trend of Child Health and Nutrition Status in Nepal: Evidence from Demographic and Health Survey (1996-2016).

Background: Child health and nutrition are key indicators of the country's socioeconomic development and quality of life. The purpose of the paper was to examine the level, trend, and socio-demographic differences of selected child health and nutrition indicators and to provide policy recommendations for improvement.

Methods: Desk review was conducted to compile secondary information on child health and nutrition status published in the Nepal Demographic and Health Survey reports prepared by Ministry of Health and Population from 1996 to 2016.

Systemic Venous Congestion Reviewed.

Accurate determination of intravascular volume status is challenging in acutely ill patients. Favorable patient outcome is vital to correctly identify intravascular volume depletion and avoid systemic venous congestion. Most of the conventional means of hemodynamic monitoring in the acute healthcare setting are geared toward addressing the cardiac output and maintaining an optimum mean arterial pressure.

Gastric organoaxial volvulus: A lethal twist and a rare cause of acute abdomen.

Organoaxial gastric volvulus is a rare clinical condition. We present a 55 years old man with an acute episode of melena and hematemesis with moderate epigastric pain which was unresponsive to analgesics. Initially, the patient was misdiagnosed and treated symptomatically for other gastrointestinal conditions but later contrast-enhanced abdominal CT scan revealed gastric organo-axial volvulus, which was associated with a right hiatal hernia.

Clarithromycin-induced acute liver injury in a patient with positive : a case report and review of the literature.

Introduction And Importance: While 14-day triple therapy with clarithromycin is a common approach for eradicating infection, it is essential to note that this treatment does not come without potential side effects.

Case Presentation: We present the case of a 34-year-old male who presented to the emergency department with severe vomiting and abdominal pain. Subsequent evaluation revealed that the patient had developed drug-induced liver injury (DILI).

A Comprehensive Management of Neck Hematoma in Post-Thyroidectomy Patient for Papillary Thyroid Cancer: A Case Report.

A post-thyroidectomy hematoma is a rare, potentially fatal surgical complication that may present as hoarseness, dysphagia, and difficulty in breathing, which could progress to complete airway obstruction and, ultimately, death. The treatment for a neck hematoma is emergent surgical drainage. While certain precautions can be taken to prevent this complication, such as the cessation of any anticoagulants prior to surgery, it is still a feared complication of thyroidectomy with an increasing prevalence.

The Interplay between Obstructive Sleep Apnea, Chronic Obstructive Pulmonary Disease, and Congestive Heart Failure: Time to Collectively Refer to Them as Triple Overlap Syndrome?

Background And Objectives: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and chronic obstructive pulmonary disease (COPD) are independently linked to an increase in cardiovascular disease (CVD). Only a few studies have been published linking the association between overlap syndrome and congestive heart failure (CHF). This review highlights the interplay between overlap syndrome (OSAHS-COPD) and CHF.