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Open Pyelolithotomy in the Presence of a Retro-Renal Colon: A Safe Alternative in Resource-Limited Settings

Adrian R Rhudd,

A retro-renal colon (RRC) is a rare but important anatomical variant to consider when planning percutaneous stone surgery. CT scanning of the abdomen is critical to detect this and to plan the surgical approach to avoid injury to the colon. In this case report, a 38-year-old woman with large obstructing ... Read more >>

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Thoracic Epidural Anesthesia for Modified Radical Mastectomy in a High-Risk Patient: A Case Report With Literature Review

Aarti Srivastava, Shaista Jamil, Ankur Khandelwal, Manish Raj, Shalley Singh,

Surgery is one of the mainstays of treatment in breast cancers. Typically, modified radical mastectomy (MRM) is done under general anesthesia (GA). However, GA is not a reasonable choice in patients with multiple comorbidities and difficult airways. Thoracic epidural anesthesia (TEA) is a reasonable and safe alternative to GA as ... Read more >>

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5-HT1A and 5-HT2A Signaling, Desensitization, and Downregulation: Serotonergic Dysfunction and Abnormal Receptor Density in Schizophrenia and the Prodrome

Sun A Kim,

The significant role of serotonin (5-hydroxytryptamine [5-HT]) in the pathogenesis and early development of schizophrenia has been established by contemporary research through the assessment of structural and pharmacological neuroimaging, blood metabolites, cerebrospinal fluid, genome polymorphisms, and other valid indicators of abnormal serotonergic activity in prodromal, ultra-high-risk, and schizophrenic patient groups. ... Read more >>

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Acute Cholecystitis in a Patient With Situs Inversus Totalis: An Unexpected Finding

Andres Felipe Herrera Ortiz, Juan C Lacouture, Daniel Sandoval Medina, Luis J Gómez Meléndez, Rodolfo Uscategui,

Situs inversus totalis (SIT) has an incidence in the general population of 1/10,000, with a female-male ratio of 1:1.5 without racial predilection. Clinically, SIT by itself tends to be asymptomatic; however, when it is associated with other conditions such as cholecystitis or appendicitis, the diagnosis may represent a challenge due ... Read more >>

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Infrarenal Vena Cava Leiomyosarcoma Treated With Surgical Resection and Vascular Reconstruction

Yosra Malki, Hatim Lazaar, Tariq Bouhout, Badr Serji, Adnan Benzirar, Tijani El Harroudi,

Leiomyosarcoma of the inferior vena cava is a rare malignant tumor with a poor prognosis. We report a case of a 39-year-old woman admitted for a surgical resection of a retroperitoneal mass revealed by pain localised in the right lumbar fossa. Computed tomography of the abdomen revealed a heterogeneous retroperitoneal ... Read more >>

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Akathisia as an Extrapyramidal Side Effect of Fluoxetine

Ijeoma Ajufo, Tajudeen O Basiru,

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is commonly prescribed for major depressive disorder (MDD). Akathisia is one of the well-recognized extrapyramidal symptoms (EPS) of antipsychotics and antiemetics, but also a rare manifestation of antidepressants. There are various documentations of EPS of antidepressants including acute dystonia, Parkinsonism, and tardive dyskinesia. ... Read more >>

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Dermatology Resident Billing and the Impact of 2021 Evaluation and Management Coding Changes

Michael Tassavor, Aatman Shah, Jonathan Ungar,

New billing rules were implemented in 2021 for determining the level of service in outpatient encounters. The purpose of this study was to assess overall dermatology resident billing at our institution and the impact of these rule changes. Billing codes from four months of our resident clinic were extracted from ... Read more >>

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Effect of Smartphone on Hand Performance and Strength in the Healthy Population

Jasraj Kaur Bhamra, Waqar M Naqvi, Sakshi P Arora,

The study aimed to determine the interactive effects of smartphone use on hand grip strength as well as functional hand performance in young people. The evolution of technology smartphone has become our necessity. It has made our lifestyle more comfortable in the form of browsing the internet, important conversation, and source ... Read more >>

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The Perfect Cytokine Storm: Utilization of Lung Ultrasound During Urgent Surgery in an Infant With Multisystem Inflammatory Syndrome in Children and Hemophagocytic Lymphohistiocytosis

Michael A Waterhouse, Anrew Villion, Toni Manougian, Irim Salik,

Reports of children with a temporal association to severe acute respiratory syndrome coronavirus-2 hospitalized with cardiogenic shock or Kawasaki-like disease began emerging in April 2020. In May 2020, the Centers for Disease Control and Prevention published the criteria for what came to be known as multisystem inflammatory syndrome in children, ... Read more >>

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Perceived Barriers to Gynecologic Care by Women Who Use Wheelchairs

Lauren Holt, Madeline H Carney, Lauren Duncanson, Christopher Hazen, Ambuj Kumar, Bri Anne McKeon, Laurie Woodard,

Objective The aim of this study was to evaluate the current barriers associated with gynecologic care as perceived by women who use wheelchairs. Methods This qualitative study evaluated the barriers to gynecologic healthcare as described by female wheelchair users. We recruited English-speaking female participants aged 18 years and older who ... Read more >>

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Progressive Supranuclear Palsy: Improvement in Cognitive-Behavioral Disturbances and Motor-Function Disabilities Following Treatment With Antidepressants and Cholinesterase Inhibitors

Michelle Oyeka, Terngu Ibilah, Jacob Israel, Jose Gavito-Higuera, Ricardo Salazar,

Progressive supranuclear palsy (PSP) is a neurodegenerative disease that usually develops after the sixth decade of life, and the diagnosis is purely clinical except in cases of pathologically confirmed autopsies. A multidisciplinary approach to meet the patients’ complex needs is the current core treatment strategy for this devastating disorder. No medications ... Read more >>

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Incidental Diagnosis of Healed Aortic Abscess Cavity

Shilpa Shree, Vijayanand Palanisamy, Kumar Chidambaram, Vasanthi Vajjiram, Pradeep Ramkoomar,

In infective endocarditis, the perivalvular abscess is a known complication with an incidence of more than 22%-29%, but the primary presentation of a healed aortic abscess without any clinical features of infective endocarditis is very rare. These sorts of cases are scarcely documented throughout literature. We present a successful surgical closure of ... Read more >>

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A Field-Based Study of the Magnitude of Risk Factors and Health Habits in Young Volunteers in the Community

Turki Alsafrani, Abdulkarim W Abukhodair, Osama M Khojah, Essam I Jastania, Rawan Alamri, Abdulhalim J Kinsara,

Objective A field study is more informative in terms of epidemiological data than a hospital-based study. Undiagnosed risk factors may be discovered in an asymptomatic group. This study aimed to estimate if the community was well informed about the risk factors for coronary artery disease and if that affected the ... Read more >>

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Impact of a Multimodal Improvement Strategy to Promote Hand Hygiene at a Hospital in Mauritius

Dooshanveer C Nuckchady,

Introduction Limited data is available on which interventions are likely to improve compliance to hand hygiene, especially in underdeveloped countries. The objective of this study is to explore whether the introduction of a particular bundle of strategies to improve hand hygiene is effective. Material and methods In this pre-post study, ... Read more >>

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Recurrent Hiatal Hernia Resulting in Rightward Mediastinal Shift: Diagnostics in Cardiology and Clinical Pearls

Divy Mehra, Javier Alvarado, Yanet Diaz-Martell, Lino Saavedra, James Davenport,

On radiographic imaging, the finding of a right-sided heart location can be due to multiple etiologies and may be congenital or acquired. We present the case of a 71-year-old male with a self-reported past medical history of hiatal hernia and previously diagnosed dextrocardia. The patient experienced cardiovascular intervention following an ST-elevation ... Read more >>

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Incidental Finding of Right-Sided Idiopathic Spontaneous Acquired Diaphragmatic Hernia

Zain Ali Zaidi, Sameer S Tebha, Sehrish S Sethar, Sakshi Mishra,

Spontaneous acquired diaphragmatic hernia is a rare finding which occurs in the absence of any trauma or surgery. Here, we present the case of an 83-year-old male who presented to the outpatient department complaining of nausea, vomiting, epigastric pain and sensation of fullness, loss of appetite, and occasional episodes of ... Read more >>

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A Rare Case of Intrapulmonary Sequestration With Multiple Feeding Arteries and an Anomalous Pulmonary Vein Draining Into the Azygos Vein

Ramakanth Pata, Nway Nway, Tsering Dolkar, Htun M Aung, Meet Patel,

Pulmonary sequestration is an isolated mass of lung tissue that has no identifiable bronchial communication and that receives its blood supply from one or more anomalous systemic arteries. The feeding vessel is the aorta or its major vessels and venous drainage usually is to the pulmonary veins to the left ... Read more >>

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Cardiogenic Shock Due to Multisystem Inflammatory Syndrome in a Young Adult Female

Amer Muhyieddeen, Mehdia Amini, Damon McEnroe, Felice Lin,

Multisystem inflammatory syndrome in adults (MIS-A) was initially described by pediatricians after reporting a temporal association of a mimicker of Kawasaki disease shortly after the resolution of a COVID-19 illness. Since June 2020, there have been an increased amount of reports of adults and adolescents above the age of 18 presenting with ... Read more >>

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N-Methyl-D-Aspartate Receptor-Negative Autoimmune Encephalitis in a Patient With an Ovarian Teratoma and an Associated Novel Cerebrospinal Fluid Autoantibody

Munir A Chaudhuri, Jason M Lucas, Mona Chandra, Michael Silver,

Autoimmune encephalitis is most commonly caused by autoantibodies against N-methyl-D-aspartate (NMDA) receptors, and the malignancy most often associated with anti-NMDA receptor autoimmune encephalitis is an ovarian teratoma. Here, we describe a case of autoimmune encephalitis caused by a newly discovered cerebrospinal fluid autoantibody that has not been previously described and ... Read more >>

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Atypical Thyroid Function Tests and Thyroid Hormone Resistance

Vishwanath Pattan, Ishita Mehra, Syed Anjum Khan, Rahul Kashyap,

Clinical interpretation of thyroid labs is usually straightforward. However, there are rare instances when the atypical profile of thyroid labs warrants systematic investigation to determine the underlying cause. We report the case of a 90-year-old Caucasian male with a chronic history of atrial fibrillation with chronic pacemaker dependence who presented with ... Read more >>

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Factors for Negative Result in Serum Anti-Helicobacter pylori IgG Antibody Test in Adult Subjects With Nodular Gastritis: A Single-center Study

Kyoichi Adachi, Kanako Kishi, Utae Sakamoto, Tomoko Mishiro, Eiko Okimoto, Norihisa Ishimura, Shunji Ishihara,

Aim: Nodular gastritis has been demonstrated to be strongly associated with Helicobacter pylori infection. The present retrospective study was performed to elucidate factors related to a negative serum antibody test result in adults with nodular gastritis. Materials and methods: We investigated 116 H. pylori-positive subjects endoscopically diagnosed with nodular gastritis ... Read more >>

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Association Between Long-Term Use of Non-steroidal Anti-inflammatory Drugs and Hyperkalemia in Diabetic Patients

FNU Sahil, Jatender Kumar, Gul Raiz, Naila S Bhutto, Hamza Tahir, Zauraiz Anjum, Sidra Naz, Amber Rizwan, Maha Jahangir, Sania Muhammad Shehzad,

Introduction The association between continuous use of nonsteroidal anti-inflammatory drugs (NSAIDs) and hyperkalemia is not consistent in the literature and creates grounds for further large-scale trials, particularly in patients with a chronic disease that affects renal function, such as diabetes mellitus (DM). In this study, we will compare mean serum potassium ... Read more >>

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A Case of Traumatic Cerebrospinal Fluid Rhinorrhea Successfully Treated Using Intravenous Factor XIII Administration

Iori Yasuda, Masahito Katsuki, Norio Narita,

Traumatic cerebrospinal fluid (CSF) rhinorrhea occurs around 2% of severe head trauma. We should find the fistula and surgically seal it or perform conservative therapy with bed rest with/without lumbar spinal CSF drainage. However, the fistula may not be identified, and treatment may sometimes be challenging. Blood coagulation factor XIII ... Read more >>

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The Role of Lateral Internal Sphincterotomy in Haemorrhoidectomy: A Study in a Tertiary Care Center

Shashikanth Vijayaraghavalu, Guru Prasad R, Sathish Rajkumar,

Background Hemorrhoids are a common condition that presents with bleeding per rectum, pain at rest and defecation, mucosal discharge, and prolapse. Surgical hemorrhoidectomy is the treatment method of choice for Grade 3 and Grade 4 hemorrhoids. Hemorrhoidectomy is associated with postoperative pain and no single surgical technique has been proved ... Read more >>

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Clinical Presentation and Management of Endometriosis-Related Hemorrhagic Ascites: A Case Report and Systematic Review of the Literature

Mareesol Chan-Tiopianco, Wei-Ting Chao, Patrick R Ching, Ling-Yu Jiang, Peng-Hui Wang, Yi-Jen Chen,

This study aims to analyze the patient profile and presentation of endometriosis-related hemorrhagic ascites and review its management to raise awareness among gynecologists and improve treatment strategies. We present a case report and engage in a systematic review involving human cases of histologically proven endometriosis with hemorrhagic ascites. Keywords were searched ... Read more >>

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