Articles

   Hidradenoma papilliferum is a rare benign neoplasm that occurs in the middle aged female’s anogenital area. We present a 70 years old male patient with a hidradenoma papilliferum on nasolabial fold. The patient had had a skincolored subcutaneous nodule on his nose for 6 months. The histopathological findings showed variously shaped cystic spaces in the tumor, the lumen was surrounded by a single or double layer of cell which showed decapitation secretion. In the English literature, few cases of ectopic hidradenoma papilliferum arising in facial skin has been reported.

   There are about 30,000 to 35,000 genes in a human genome. Different genes are expressed in different tissues of the body (formation of the protein) a process called gene expression or gene function. After the formation of a protein in a cell, proteins are involved in different cellular functions. Glucose molecule is an energy of a cell, but this energy cannot be produced directly because glucose cannot enter in cells without the involvement of different receptors, there is a process called glucose uptake.

   Gastrointestinal stromal tumors (GIST) are the most common subepithelial lesions of the gastrointestinal tract. Treatment of lesions greater than 2 cm in diameter is by laparoscopic wedge resection. We report a 77-year-old man who was diagnosed with a 2.3 cm diameter gastric GIST. He had a thickened mitral valve, severe mitral annular calcification, mild mitral regurgitation and moderate aortic stenosis. One week after undergoing an unsuccessful attempt at laparoscopic endoscopic cooperative surgery (LECS), he was admitted with a fever of 40.2oC.

   Autoimmune encephalitis (AE) is an emerging autoimmune inflammatory neurological disorder in which antibodies are directed against intracellular or cell surface neuronal antigens in central nervous system (CNS). Autoimmune encephalitis (AE) can be subcategorized on the basis of presence of specific autoantibody. Among these Anti-leucine-rich glioma-inactivated 1 limbic encephalitis (anti-LGI1 LE) is a rare entity which presents with rapidly progressive dementia, faciobrachial dystonic seizures (FBDS), refractory hyponatremia and mental disorders [1].

   Kasabach-Merritt Phenomenon (KMP) is a coagulopathy characterized by profound thrombocytopenia due to platelet entrapment within a pre-existing vascular tumor, tufted angioma or kaposiform hemangioendothelioma. It usually occurs in newborns and infants under 6 months of age. Congenital forms are not uncommon, and some diagnoses have even been made in utero. Imaging is used to confirm the diagnosis and look for deep-seated localizations. This syndrome can be life-threatening, with the risk of haemorrhage, coagulopathy, thrombosis, compression and heart failure.

   This study evaluated the effectiveness of disinfecting surfaces using natural products (vinegar, Peganum harmala, and rose water) and common chemical disinfectants (ethanol and hydrogen peroxide) against Escherichia coli, Pseudomonas sp, Bacillus sp, and Staphylococcus sp.

   Recent research has revealed that extracellular vehicles (EVs), also known as exosomes, are crucial for cell-to-cell communication because they may transmit a variety of genetic and metabolic signals. Exosomes can eventually change the tumor environment to encourage tumor progression, such as metastasis and multidrug resistance (MDR). Exosomes can be secreted by either tumor cells or stromal cells, including immune cells. The resistance type that transforms using exosomes is acquired drug resistance.

   Achondroplasia is the most common cause of skeletal dysplasia and thoracolumbar kyphosis is one of the most common spinal disorders in achondroplastic patients. If the thoracolumbar kyphosis progresses despite conservative treatment, or if the kyphosis exceeds 50 degrees, or patients develop neurological deficits relating to the thoracolumbar kyphosis, surgical intervention is indicated.

   Patent ductus arteriosus (PDA) is a congenital cardiovascular disease in which a fetal connection between the aorta and pulmonary artery fails to spontaneously close shortly after neonate birth. If left untreated, PDA might lead to severe cardiac complications and even death. Surgical ligation is the conventional surgical option. Nevertheless, it is an invasive procedure, which instead motivates development of minimally invasive interventional occlusion [1]. In recent years, although open chest and video-assisted interruption are still being adopted, transcatheter occlusion has rapidly become the optimal choice for the occlusion of PDA in eligible patients.

   Depression is a brain disorder characterized by loss of interest, low energy and fatigue. Nowadays many people across the world are facing depression and their life is completely sadness and hopelessness. From every 6 individuals [1] people may be in depression in their life. This brain disorder is a common problem especially in youngsters. India has higher occurrence of depression in the world. Approximately 15 % of depressed patients going to suicide attacks. Intelligent people have higher risk of depression because they feel a lot especially bad behavior of other peoples.

   Widespread use of contemporary antiretroviral therapy (HAART) globally has transformed HIV disease into a chronic illness associated with excess risk for disorders of the heart and circulatory system. The global burden of human immunodeficiency virus-1 (HIV)-associated cardiovascular (CV) disease has tripled over the past two decades and is now responsible for about 2.6 million DALYs per annum with the greatest impact in sub-Saharan Africa and the Asia Pacific regions [1,2]. Current clinical care and research, which were originally dedicated to improving survival, are now focused on ameliorating quality of life and reducing risk of HIV-related CV disease complications.

   Anterior cervical spine surgery (ACSS) is a frequently performed procedure that enhances life quality by reducing pain and improving functionality. A rare but serious complication after ACCS is cervical hematoma, which can lead to acute airway obstruction and subsequent rapid deterioration. Effective management of cervical hematomas requires an astute awareness of the developing signs and proficiency in the techniques involved when issues arise.

   Secondary chronic myelocytic leukemia after treatment of Hodgkin’s lymphoma is a very rare entity. Here we report a case of an 18 years old male patient who presented at our institution for a right palpable cervical mass without any symptoms. On physical exam, he has fixed, non-tender cervical mass. The biopsy of the cervical mass was in favor of a nodular lymphocyte predominant Hodgkin’s lymphoma. He was treated by four cycles of rituximab and13 sessions of radiotherapy. PET scan showed complete remission with a Deauville score of 1.

   Pyogenic granuloma is a relatively common benign vascular lesion of the skin and mucosa whose exact cause is unknown [1]. The lesion usually occurs in children and young adults on the head, neck, extremities, and upper trunk [2]. The localization of the vulva is a relatively rare finding, and a limited number of cases have been reported in the literature [3,4,5]. In this case, we present a female patient in her second trimester a painful mass in right labia majora. It was excised and histopathological reports confirmed it to be a pyogenic granuloma pyogenic of the vulva.

   Antimicrobial resistance is current world wide One Health issues in the areas of human, animal, and environmental fields due to the extensive use and misuse of antimicrobials in the human and animal fields as for growth promotion, prophylaxis and therapeutics. The transfer of antibiotic resistance E. coli from animals to humans is of concern in recent times. The b-lactam antibiotics have been used successfully to treat infections caused by pathogenic E. coli. However, currently, the utility of b-lactams is being challenged severely by a large number of hydrolytic enzymes the b-lactamases expressed by bacteria.1623

   This online-based study examines individual aspects of female masturbation, the links to individual sex variables, and the influences on women’s sexual satisfaction and life satisfaction. Significant correlations of masturbation frequency, age of first masturbation, and orgasmic ability during masturbation were found. It appears that satisfaction with one’s own masturbation experiences, as an overarching variable of masturbation, is related to sexual satisfaction and to life satisfaction. Correlations of the individual sex variables to the overall sexual satisfaction are shown. The individual preferences of masturbation can be transferred to sexual activity with a partner and could therefore increase overall sexual satisfaction.1622

   Zellweger syndrome, also known as Zellweger Spectrum Disorders (ZSD), is a group of rare genetic disorders affecting peroxisome metabolism. Peroxisomes play a crucial role in the catabolism of very long-chain fatty acids and the metabolism of bile acids, among other essential functions.The aim of this article is to examine the clinical features, genetic aspects, underlying pathological mechanisms and recent advances in the diagnosis and management of Zellweger Syndrome.1621

   In secondary healthcare facilities in Bayelsa State, Nigeria, this study analyses the physico-chemical characteristics of the hospital water. Five secondary healthcare facilities in total were chosen at random from the State’s three senatorial regions. DK, CHE, GHS, CTH, and GHK were the labels used for the healthcare facilities. The collection and analysis of water were conducted using conventional field and laboratory techniques.

   The acute scrotum is an emergency. Testicular torsion represents approximately 25% of the causes. The annual incidence of testicular torsion is approximately 1/4000 persons under 25 years, with highest prevalence between 12 and 18 years old. It usually occurs without apparent cause, but it has been associated with anatomical, traumatic, and environmental factors, among others.1619

   Acute myocardial infarction with ST elevation is a common life-threatening condition in emergency medicine, typically managed with percutaneous coronary intervention (PCI) that is followed by observation in a cardiac critical care unit [1]. This procedure usually involves the administration of aspirin, P2Y12 inhibitor and heparin, which poses a risk of bleeding for the patient.1618

   Mechanical circulatory support (MCS) devices are complex and allow blood to bypass the heart or lungs (or both). When blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulants, a thrombus may develop in the device, resulting in device failure or embolic stroke. Therefore, anticoagulation is necessary to prevent blood clots and maintain device functionality. Titrating anticoagulation to prevent bleeding complications and thrombotic events can be difficult, and despite a perfect balance, a thrombosis can still occur [1,2].1617

   A 70-year-old man who was a farmer and had habitual contact with dogs, presented with symptoms of progressive exertional dyspnea, fatigue, productive cough, weight loss, and pleuritic chest pain. Physical examination revealed decreased lung sounds and coarse crackles in the left hemithorax. Laboratory data showed elevated white cell count (Eosinophil count 1600/µl), high C-reactive protein, elevated erythrocyte sedimentation rate, and high serum lactate dehydrogenase and ferritin levels. CT scan revealed lobulated pleural effusion. Thoracentesis was performed and the pleural fluid was semi-clear and yellowish. Further Abdominal ultrasound was performed, which did not show evidence of liver and spleen involvement, also evaluation led to a diagnosis of primary pleural hydatid cyst involvement based on positive hydatid cyst serology tests.1616

   Juvenile xanthogranuloma (JXG) is a benign non- Langerhansian histiocytosis that classically presents as yellowish skin nodules due to accumulation of lipid-laden macrophages. It is usually unique but multiple or even disseminated forms have been described. We report here a new case of diffuse juvenile xanthogranuloma.1615

   Xanthogranulomatous pyelonephritis is a rare chronic pyelonephritis, mostly occurring in adults, with female predominance [1]. This infection is related to a total or partial obstruction of the urinary tracts and induces a loss of renal function by granulomatous destruction of the renal parenchyma. The treatment usually consists of an antibiotic therapy associated with partial or total nephrectomy, regarding the partial or diffuse involvement of the kidney [2].1614

   Rectovaginal fistula is usually caused by obstetric injury commonly resulting from breakdown of the repair of complete perineal tears or from unrecognised injury during forceps or precipitate delivery [1]. MRI is sometimes used if diagnosis is unclear. In some patients, the fistula healed spontaneously within 12 weeks of the injury. But in the majority of cases surgical treatment is necessary by the transvaginal or perineoproctotomy methods [2]. We report a case of a 41-yearold-woman, at three months of postpartum period with no pathological history.1613

   Open-book pelvic fractures are potentially rare and serious, representing around 0.3-8.2% [1] of all fractures, with a high mortality rate estimated at 10.4% [2]. This injury is typical of motorcycle accident or a high-energy accident. This is a consequence of anteroposterior compression of the pelvis responsible for disjunction of the symphysis pubis and the sacroiliac joint, secondary to a complete rupture of the ligament. Often unstable, it is associated with vascular, abdominal, neurological and urinary lesions [3].

   Inter-radicular bone loss, also referred to as periodontal furcal lesions of endodontic origin, presents a significant challenge in endodontic-periodontal treatments, requiring an integrated approach to address both pulpal and periodontal components of the lesion [1]. The intricate connection between the periodontal ligament (PDL) and the root canal system, including accessory canals, facilitates the spread of inflammation or infection from the diseased pulp to the furcation region, leading to bone resorption/loss and compromising tooth health and stability [2].

   Acute thyrotoxicosis and thyroid storm are well recognized sequelae of thyroidectomy in patients with Graves’ disease whose FT4 and FT3 levels remain elevated at the time of surgery and in patients who undergo nonthyroid surgery with unrecognized thyrotoxicosis. When untreated, mortality from thyroid storm has been reported in 8-25% of patients [1-3]. However, thyroid storm has largely disappeared following thyroid surgery because of the routine preparation of thyrotoxic patients with thioamides, iodine, beta receptor blocking agents, or some combination thereof

   A 30-year-old woman came to the hospital with irregular vaginal bleeding that had lasted for two months after a medical abortion. An ultrasound revealed uneven echoes in her uterine cavity. Subsequently, a hysteroscopy was performed, revealing the presence of Retained Products of Conception (RPOC) in the lower uterine segment. The doctor performed hysteroscopic resection of the remaining uterine tissue. However, the patient developed a high fever and severe thrombocytopenia four hours after the surgery. After receiving intensive anti-infection treatment, the patient recovered and was discharged. Through the diagnosis and treatment of this case, we have identified several key points: Firstly, prolonged presence of RPOC may lead to latent infection. Secondly, hysteroscopic fluid dilation can facilitate the entry of bacteria into the bloodstream, potentially causing sepsis.

   The presence of nuchal cord is frequent during delivery and does not usually cause adverse foetal or neonatal outcomes even in case of multiple loops. We report a case of a 30 year-old G3P2 with past history of nuchal cord in her previous pregnancies, one resulting into neonatal death and a previous caesarean section. She delivered through elective caesarean section of a female child with four loops nuchal cord and severe neonatal asphyxia who was rescued in the neonatal intensive care unit. We review the recommendations about the management of multiple loops nuchal cord and highlight the lesson learned.

   Right-sided infective endocarditis accounts for 5-10% of all infective endocarditis cases. Fungal endocarditis represents 1-3% of all of infective endocarditis cases, with Candida spp. being the most common microbiological cause. Primary mural endocarditis is defined by the absence of valvular vegetations together with the presence of vegetations on the endocardial free wall that are not associated with myocardial abscesses, cardiac structural abnormalities, devices, prosthetic material, thrombi or tumors. It constitutes a very rare entity and only 63 cases have been published the literature. C. albicans is the microbiological cause in only nine of these cases, none of which involves the right atrium. We report the case of a frail 84-year-old female patient with a pacemaker presenting with fever. In the transthoracic and three-dimensional transesophageal echocardiograms, a mobile mass was found attached on the free wall of the right atrial base. Blood cultures were positive for C.

   Violence in the work environment of healthcare providers has increased dramatically in the last decade internationally. By insanely violating the personal rights of health professionals, there are attacks on healthcare providers, both from abroad and from the domestic environment, attacks that ultimately have adverse health effects and the performance of healthcare professionals. These effects clearly affect healthcare providers, as it is common for professionals working in an environment of fear and resentment to be unable to perform at their best, to provide inadequate or poor quality care, ultimately affecting patient safety.

   Violence in the work environment of healthcare providers has increased dramatically in the last decade internationally. By insanely violating the personal rights of health professionals, there are attacks on healthcare providers, both from abroad and from the domestic environment, attacks that ultimately have adverse health effects and the performance of healthcare professionals. These effects clearly affect healthcare providers, as it is common for professionals working in an environment of fear and resentment to be unable to perform at their best, to provide inadequate or poor quality care, ultimately affecting patient safety.

   Emissions of formaldehyde were quantified from 20 sites in Urban and West B districts allocated in Urban West Region Zanzibar between August and September 2019. In situ measurement was conducted for two separate sources, wood products and road automotive source. Emissions of formaldehyde were measured by using portable instrument known as air detector. The result shows that there was small level of formaldehyde emitted from both sources. From wood product sources, the emission level of formaldehyde was 0.311mgm-3 (urban district), while at west B district the emission was 0.304 mgm-3. For the case of road automotive sources, the level of formaldehyde was 0.32 mgm-3 Urban district and at west B was 0.331 mgm-3.

   Obsessive-compulsive disorder (OCD) is a chronic and debilitating mental illness characterized by recurrently intrusive, distressing, unwanted thoughts (obsessions) and by repetitive behaviors or mental rituals (compulsions) performed in response to an obsession. Currently, selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) benefit around 60% of OCD patients [1-3].