Reviewing the Possible Rare Reasons for Normal Parathyroid Hormone, Vitamin D and Serum Calcium Levels in a Patient With Severe Osteoporosis and Radiologic Parathyroid Adenoma: A Case Report.

Literature evidence describing a seeming de novo occurrence of severe osteoporosis accompanied by the presence of parathyroid adenoma with normal serum parathormone level (PTH), normal serum vitamin D, and serum calcium levels is rare; hence, this case report. In the absence of raised parathormone levels and the demonstration of the presence of parathyroid adenoma, the hypothesis that the authors were left with was that could certain forms of parathyroid adenoma express factors or active substances with severe osteoclastic activity. Or, could certain expressed PTH molecules in parathyroid adenoma scenarios prove difficult to assay using conventional study methods? We have reviewed the literature in a bid to provide answers to these possible uncommon scenarios.

Rhabdomyolysis in a Patient With a Possible Mitochondrial Pathogenic Variant in the Peri-operative Period: A Case Report.

Mitochondrial disorders are often underrecognized as potential causes of rhabdomyolysis, a condition characterized by acute muscle breakdown that can lead to local and potentially systemic complications, with the possibility of being life-threatening. Accounts of rhabdomyolysis as a peri-operative complication associated with mitochondrial disorders are rare; therefore, this study is noteworthy. We describe a case of rhabdomyolysis that occurred during the peri-operative period in a middle-aged male with Charcot-Marie-Tooth (CMT) disease-like peripheral neuropathy.

Orthopaedic Telemedicine Clinics: A Patient Satisfaction Survey of 522 Patients.

Background The COVID-19 pandemic necessitated the rapid adoption of telemedicine across medical specialties, including orthopedics. This study aimed to assess patient satisfaction with orthopedic telemedicine consultations and analyze the efficiency and limitations of this approach during the pandemic. Methods A cross-sectional survey was conducted involving 522 patients who underwent telephone consultations for orthopedic care between May 2020 and January 2021.

Routine 36-week scan: prediction of small-for-gestational-age neonate.

Objectives: First, to compare the predictive performance of routine ultrasonographic estimated fetal weight (EFW) at 31 + 0 to 33 + 6 and 35 + 0 to 36 + 6 weeks' gestation for delivery of a small-for-gestational-age (SGA) neonate. Second, to compare the predictive performance of EFW at 36 weeks' gestation for SGA vs fetal growth restriction (FGR) at birth. Third, to compare the predictive performance for delivery of a SGA neonate of EFW < 10 percentile vs a model combining maternal demographic characteristics and elements of medical history with EFW.

Reviewing the Rare Association Between Progestogen-only Implant and Pulmonary Embolism in a Woman with Multiple Cardiovascular Risk Factors: A Case Report.

Pulmonary embolism (PE) is a recognized complication of hormonal contraceptive use, but the risk associated with progestogen-only implants in women with multiple cardiovascular (CV) risk factors remains uncertain. We present the case of a woman in her early forties with multiple CV risk factors, including obesity, obstructive sleep apnoea, and hypertension, who developed bilateral PE while using a progestogen-only implant. This case highlights the potential increased risk of PE in women with multiple CV risk factors using progestogen-only implants, warranting further investigation and cautious clinical decision-making.

Early Operative Risk Assessment Using the Modified Mannheim Peritonitis Index in Patients With Generalised Peritonitis at a Tertiary Hospital in Abuja, Nigeria.

Introduction The use of validated prognostic scoring tools in resource-poor environments has been hampered by the cost of procuring and maintaining devices, such as arterial blood gas analysers, to measure critical physiological derangements. Attempts need to be made to adapt these applicable risk stratification tools so they can be easily adopted in developing countries like Nigeria.  Aim This study assessed the usefulness of a modified Mannheim peritonitis index (mMPI) as a risk stratification tool in predicting surgical outcomes in managing patients with generalised peritonitis in Abuja, Nigeria.

Case Series of Abdominal Actinomycosis: An Old Diagnostic Conundrum.

Abdominal actinomycosis is a rare disease caused by the bacteria. We report a case series of two similar cases with a mismatch between the initial differential diagnosis, the radiological findings, the surgical findings, and the actual histological result. The first case is a 25-year-old woman with a month's history of right-sided abdominal pain.

Challenges in Diagnosing and Managing Hurler Syndrome: A Case Report.

This case report details a 12-year-old male diagnosed with Hurler syndrome, a rare autosomal recessive disorder caused by a deficiency in the enzyme alpha-L-iduronidase. The patient exhibited typical symptoms, including developmental delays, ocular clouding, and distinctive skeletal deformities, along with mild cognitive abnormalities. Despite the presence of traditional clinical signs and elevated urine heparin and dermatan sulfate levels confirming the diagnosis, access to advanced treatments such as enzyme replacement therapy was severely limited due to socioeconomic constraints and a lack of diagnostic facilities in the region.

The Use of 3D Printing in Fetal Surgery for Surgical Planning: A Scoping Review.

: We sought to identify in which clinical scenarios 3D printed models are used to plan for fetal surgeries as well as the main purpose and the imaging method utilized for the models. In addition, we describe benefits and shortcomings of the models, as well as potential future improvements. : In this scoping review, data were collected retrospectively from scientific databases (PubMed, Embase, Cochrane CENTRAL, CINAHL, Scopus, and the Web of Science platform) and screened by title, abstract, and full text against strict criteria.

Improving the Accuracy of the Gynaecology Handover Process: An Effective Quality Improvement Project at a University Hospital in the United Kingdom.

Objectives The objective of this study was to introduce a new system of handover in the gynaecology department and ensure its effectiveness with dynamic improvement measures. This was launched as a quality improvement project in a district general hospital in the United Kingdom. The primary aim was to start and consolidate a new system of a separate gynaecology handover in the presence of consultants, registrars (incoming and outgoing), senior house officers (incoming and outgoing) and gynaecology nurses.

Impact of COVID-19 pandemic on the elderly in the United Kingdom: A review study.

The coronavirus disease 2019 (COVID-19) pandemic has significantly altered the lives and lifestyles of several older populations in the United Kingdom. It was important to note how it has affected their physical, mental, and social health and well-being during the first wave of the Covid-19 pandemic. To study the impact of the Covid-19 pandemic and the imposed restrictions on the day-to-day lives of the elderly population in the United Kingdom.

Convergent ablation for persistent atrial fibrillation: A UK multicentre perspective.

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide and remains a major cause of morbidity and mortality. Unfortunately, a significant proportion of patients have persistent AF, for which conventional catheter ablation is less effective. However, convergent ablation has emerged in recent years as a hybrid treatment targeting both the epicardium and endocardium in a multidisciplinary joint cardiothoracic and electrophysiology procedure, with promising efficacy outcomes in recent studies.

Cost Awareness of Anaesthetic Consumable Items Among the National Health Service (NHS) Staff and the Financial Impact on the NHS.

Background The financial burden of running the National Health Service (NHS) is high. Staff members should be aware of the cost of the equipment they use to enable efficient use of resources, reduce waste, and control spending. However, limited financial education at undergraduate and junior stages has contributed to relatively poor knowledge among healthcare workers at all levels.

The use of venous blood gas in assessing arterial acid-base and oxygenation status - an analysis of aggregated data from multiple studies evaluating the venous to arterial conversion (v-TAC) method.

Background: Several methods exist to reduce the number of arterial blood gases (ABGs). One method, Roche v-TAC, has been evaluated in different patient groups. This paper aggregates data from these studies, in different patient categories using common analysis criteria.

Patients' Preferences for Cytoreductive Treatments in Newly Diagnosed Metastatic Prostate Cancer: The IP5-MATTER Study.

Background And Objective: Cytoreductive treatments for patients diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) confer incremental survival benefits over systemic therapy, but these may lead to added toxicity and morbidity. Our objective was to determine patients' preferences for, and trade-offs between, additional cytoreductive prostate and metastasis-directed interventions.

Methods: A prospective multicentre discrete choice experiment trial was conducted at 30 hospitals in the UK between December 3, 2020 and January 25, 2023 (NCT04590976).

Analgesia for emergency laparotomy: a systematic review.

Poorly controlled pain is common after emergency laparotomy. It causes distress, hinders rehabilitation, and predisposes to complications: prolonged hospitalisation, persistent pain, and reduced quality of life. The aim of this systematic review was to compare the relative efficacies of pre-emptive analgesia for emergency laparotomy to inform practice.