Quinnchilders9534

Technology integration in teaching is an evolving concept in modern medical education like other study disciplines in India. The domain of medical science education is presently deficient of deploying technology-based practices. Currently, majority of medical schools and colleges continue to choose traditional wet laboratory dissections over new virtual dissections which are being followed in institutions such as All India Institute of Medical Sciences (AIIMS) and handful of other governmental as well as private medical schools of India like AIIMS Rishikesh, AIIMS Jodhpur, Government Medical College Vimsar, Burla, Odisha, GSL Medical College Rajahmundry, Andhra Pradesh, Yennapoya University Mangalore, Dutta Megha Medical College, GMC Chindwara Madhya Pradesh, Symbiosis Institute Pune and Apollo Medical College Chitoor. Not to mention, as the current push for technology integration increases, it is likely that a large number of Indian academic scholars will begin seeing virtual dissections as beneficial to their classroom. This article is protected by copyright. All rights reserved.BACKGROUND Nasal nitric oxide (nNO) is a potential biomarker of chronic rhinosinusitis (CRS), and correlates well with endoscopic and radiologic severity of disease. However, the long-term profile of nNO as a biomarker is not established in literature. The objectives of our study were to examine whether nNO can maintain this correlation in a 5-year follow-up following endoscopic sinus surgery (ESS) and to investigate whether nNO value can be used to prognosticate revision rates in patients with CRS. METHODS We enrolled CRS patients 5 years after initial ESS at our institution. Patients underwent initial ESS at our institution between January 2013 and January 2015. Patients prospectively had the following measurements at baseline, 1-month, 6-month and 5-year post-ESS nNO levels, Lund-Kennedy Endoscopy Score (LKES), and Sinonasal Outcome Test-22 (SNOT-22) score. We also compared the nNO levels between patients who underwent revision ESS and those who did not. RESULTS There were 32 patients included in the study with 8 patients undergoing revision ESS during the 5-year follow up. nNO levels were elevated at 1-month, 6-month and 5-year post-ESS compared to baseline. A significant negative correlation between nNO and LKES was found at 5-year post-ESS. nNO levels were significantly reduced at baseline and 6-month post-ESS in the revision cohort compared to non-revision cohort despite having comparable radiologic severity. CONCLUSION nNO may serve as a non-invasive long-term biomarker to monitor sinus disease severity and to prognosticate patients with CRS. This has implications for potential integration into clinical practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.AIM We aimed to evaluate whether patients with malignant biliary obstruction (MBO) could benefit from balloon dilation before the placement of self-expanding metal stent (SEMS) for palliative biliary drainage. METHODS Consecutive patients who underwent ERCP with SEMS placement for palliative management of MBO were retrospectively included. Comparative analyses were performed on decreased serum bilirubin levels, post-procedural adverse events, patency duration, stent dysfunction and survival time between the groups. RESULTS A total of 221 patients underwent palliative endoscopic SEMS implantation for MBO were included from January 2014 to June 2018. Dilation increased the percentage of decreased serum bilirubin (37.0% vs 14.3%, P = 0.001) and there was a decreaseing trend of the incidence of post-procedural cholangitis (2.5% vs 7.8%, P = 0.075), while the rates of other adverse events such as pancreatitis and bleeding were not increased. The patency duration of the SEMS and survival time were not significantly different in patients with or without dilation. However, temporary endoscopic nasobiliary drainage (ENBD) after SEMS insertion could also achieve short-term efficacy. Patients with ENBD but without dilation showed similar short-term outcome as compared to patients with dilation but without ENBD. CONCLUSIONS Dilation with small caliber balloon catheter before SEMS insertion is a safe and effective approach for MBO. Balloon dilation could improve the short-term efficacy of SEMES, while the long-term outcomes were not obviously affected. The short-term effect of stricture dilation could be replaced by ENBD. However, further studies are essential to confirm the current results. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.PURPOSE To compare the risk of haemorrhagic complications in elective macular surgery between patients with no antithrombotic (AT) treatment (defined as patients with no history of AT therapy or who discontinued AT therapy) and patients who continued AT treatment during the surgery. METHODS E-case report forms were prospectively recorded in a database before vitreoretinal surgery and 1 month after. Data on patient characteristics, surgical techniques, haemorrhagic complications and antithrombotic status were collected. Patients with retinal detachment, proliferative diabetic retinopathy and previous retinal haemorrhage were excluded. RESULTS A total of 748 procedures (single procedure in one eye per patient) were performed between January and May 2019. Among them, 202 patients (27.0%) were treated with antithrombotic therapy at the time of surgery 19.5% with antiplatelet agents (n = 146), 6.3% with anticoagulants (n = 47) including 3.2% (n = 24) patients treated with novel oral anticoagulants, 0.8% (n = 6) with anticoagulants and antiplatelet agents, and 0.4% (n = 3) with heparin. Overall, 92 patients (12.3%) developed one or more haemorrhagic complications, of which 63 (11.5%) and 29 (14.4%) were in the non-AT and AT group, respectively. The multivariate logistic regression model showed no difference between AT treatment groups regarding ocular bleeding complications (odds ratio [OR] 1.2, 95% confidence interval (CI) [0.7-2.2], p = 0.54). CONCLUSION No cases of uncontrolled or severe perioperative haemorrhage in patients continuing antithrombotic agents were reported in this selected population. For the majority of the patients taking antiplatelets or anticoagulants, these agents could be safely continued during macular surgery. © 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.Severe fever with thrombocytopenia syndrome (SFTS) virus is an emerging zoonotic virus in East Asia. However, SFTS virus (SFTSV) has not been reported to cause clinical infection in companion dogs to date. We report the case of a 4-year-old companion dog that presented with fever, vomiting, leukocytopenia and thrombocytopenia at a veterinary hospital in the Republic of Korea. It was diagnosed with SFTS, which was confirmed using real-time reverse transcription PCR, sequencing and an indirect immunofluorescence assay, and recovered after supportive care. Further studies are required to investigate SFTSV infection in companion animals, living in close contact with humans, as well as animal-to-human transmission. © 2020 The Authors. Veterinary Medicine and Science Published by John Wiley & Sons Ltd.OBJECTIVE To describe survival and six-month outcomes (residence, community supports) in the very old (≥80 years) admitted to intensive care in Waitemata District Health Board, New Zealand. METHODS Hospital records of patients 80 years and over admitted from August 2015 to June 2017 were reviewed. RESULTS One hundred and seventeen patients were admitted (median age 83). Standard ICU risk scores predicted survival to hospital discharge. Patients admitted electively were more likely to survive to discharge than emergency ICU/HDU admissions (P = .007). Ninety-two (79%) survived to hospital discharge, and 84 (72%) survived to 6 months. Eighty-four were discharged home (91% of survivors), and 79 were living at home at 6 months (94% of survivors). Community supports increased from admission (34, 29%) to 6 months later (34, 43% of community dwellers). Forty-four (47.8% surviving to discharge) were readmitted within 6 months. CONCLUSION Most patients are alive at discharge and 6 months, with a majority requiring no formal supports. © 2020 AJA Inc.INTRODUCTION Microdissection testicular sperm extraction (micro-TESE) is a procedure commonly utilized to harvest spermatozoa in severe male factor infertility. We have developed a technique involving a mini tunica albuginea incision with superficial tissue dissection (mini-incision micro-TESE). The modification is designed to reduce potential tissue injury, and we studied its effectiveness to harvest spermatozoa in men with cryptozoospermia and non-obstructive azoospermia. MATERIALS AND METHODS We performed a retrospective analysis of 103 infertile men with NOA and cryptozoospermia who underwent a mini-incision micro-TESE between March 2015 and August 2018 at the OVO fertility clinic. We consider the mini-incision micro-TESE procedure successful when at least five spermatozoa are identified in the micro-biopsies obtained from the superficial tissue exposed by the 1-cm mini-incision. https://www.selleckchem.com/products/t0901317.html If no spermatozoa are identified through the mini-incision, we can easily extend the incision to the standard micro-TESE. RESULgenesis in men with cryptozoospermia and NOA. © 2020 American Society of Andrology and European Academy of Andrology.AIMS/INTRODUCTION Liraglutide and empagliflozin suppress cardiovascular events. However, reports on their long-term combined use with insulin therapy or direct comparisons of these drugs are limited. MATERIALS AND METHODS This open-label, parallel-group, randomized controlled trial compared the effects of liraglutide and empagliflozin combined with insulin therapy in type 2 diabetes patients. Adult type 2 diabetes outpatients undergoing stable insulin therapy with glycated hemoglobin levels of 7.0-9.5% were enrolled. Subjects received 0.9 mg/day liraglutide or 10 mg/day empagliflozin for 24 weeks. The primary endpoint was the change in glycated hemoglobin levels from week 0 to 24. Body composition was assessed by dual energy X-ray absorptiometry. RESULTS Sixty-four insulin-treated patients were randomized to receive liraglutide or empagliflozin. We analyzed 61 patients (30 liraglutide and 31 empagliflozin) who could be followed-up. Liraglutide induced greater changes in glycated hemoglobin and glycated albumin than empagliflozin (glycated hemoglobin, -1.24 ± 0.15% vs. -0.35 ± 0.11%, p less then 0.0001; glycated albumin, -4.4 ± 0.6% vs. -2.4 ± 0.5%, p less then 0.01). Body weight (-1.3 ± 0.4 kg vs. -1.5 ± 0.3 kg, p=0.69) or body fat mass/lean tissue mass; urinary albumin excretion [(median, IQR) -5.3 [-60.6, 9.9] mg/g-creatinine vs. -12.9 [-70.8, -2.0] mg/g-creatinine, p=0.23]; and frequency of hypoglycemia did not differ significantly between the groups over 24 weeks. There were no cases of study discontinuation owing to adverse effects. CONCLUSIONS Liraglutide addition to ongoing insulin therapy effectively reduced glycated hemoglobin and glycated albumin levels than empagliflozin in patients with inadequately controlled type 2 diabetes. This article is protected by copyright. All rights reserved.