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and Importance Steroids induced psychosis is one of major adverse effects of corticosteroids therapy especially in patients with disease causing low serum albumin level like nephrotic syndrome. The literature review about this adverse effects is lesser in children than adults population. The management is done by tapering dose of steroids in aid of immunosuppressive drug with an antipsychotics drug.
Here we present a case of 14 years old female child known case of nephrotic syndrome secondary to Focal segmental glomerulosclerosis with steroids induced psychosis who is managed by tapering dose of prednisolone with Tacrolimus as immunosuppressive and Quetiapine as antipsychotic.
The prevalence of steroids induced psychosis is higher in our locality which is still unreported due to lack of detailed history and proper diagnosis and it is manageable if early diagnosis and treatment is initiated. Thus, proper counselling to parents about the adverse effect of steroids therapy and timely follow up will prevent Nepalese children from this illness.
The prevalence of steroids induced psychosis is higher in our locality which is still unreported due to lack of detailed history and proper diagnosis and it is manageable if early diagnosis and treatment is initiated. Thus, proper counselling to parents about the adverse effect of steroids therapy and timely follow up will prevent Nepalese children from this illness.
Traumatic brain injury (TBI) is a major cause of death and disability worldwide that imposes a significant burden on both individuals and their families. Many of the symptoms experienced by patients with TBI are thought to be mediated by the neuroinflammatory process that occurs after the primary injury. Therefore, the present study aimed to determine the effect of diphenhydramine HCl (DPM) on serum levels of the inflammatory cytokine tumor necrosis factor-α (TNF-α) after TBI.
This was an experimental study with a pre- and post-test control group design. A total of 10 adult Wistar rats were divided into 2 groups, the DPM group and the placebo group. The effect of DPM on serum levels of TNF-α was evaluated at 30min, 2h, and 24h after the induction of experimental TBI in the rats using Marmarou's weight-drop model.
TNF-α levels in the DPM group significantly decreased from 0min to 24h after TBI (p=0.004). In the placebo group, TNF-α levels significantly increased from 0min to 24h after TBI (p<0.001). Post hoc analysis found that TNF-α levels in the DPM group decreased significantly from 30min to 2h and from 2h to 24h after TBI (p=0.019 and p=0.005, respectively).
The results of this study suggest that administration of DPM causes a reduction in serum levels of TNF-α, indicating that DPM has a significant anti-inflammatory effect in experimental rats after TBI.
The results of this study suggest that administration of DPM causes a reduction in serum levels of TNF-α, indicating that DPM has a significant anti-inflammatory effect in experimental rats after TBI.
In low-income nations like Ethiopia, the rate of obstetric death in intensive care units is significant. The indications of admission are Preeclampsia/Eclampsia, postpartum hemorrhage, and puerperal sepsis but, patient outcomes subsequent to intensive care unit admission are sparse. The aim of this study is to assess factors associated with obstetrics mortality in Intensive Care unit.
A hospital based unmatched case control study was conducted on obstetrics patients admitted to Addis Ababa Public hospital's intensive care unit from October 2018 to November 2020. Multivariable logistic regression analysis was done; Odds Ratio and Confidence Interval (OR and 95% CI) were computed using SPSS version 26. P value<0.05 was taken as statistically significant.
Obstetrics mortality in intensive care unit was high and accounts 27% from the total intensive care unit admission. Severe pre-eclampsia AOR 6.33; 95% CI 2.25-17.79, puerperal sepsis AOR 4.51; 95% CI 1.68-12.15, age ≥35 years AOR 4.09; 95% CI 1.42-11.7ommended that all pregnant women should have antenatal care so that preeclampsia and maternal comorbidities will be early diagnosed and treated.
To assess the impact of %PEP on liver indicators and lipid profile two years after BS.
The prevalence of weight gain in the adult population continues to increase, 57.8% of the world's adult population will be overweight or obese by 2030.
This is a retrospective cohort and descriptive study, performed by consulting the database of an Obesity and Digestive Surgery Clinic in the city of Santa Maria - (Rio Grande do Sul, Brazil). The study included 351 patients (284 women, 67 men), aged at least 18 years, who underwent bariatric surgery from March 2014 to March 2016. The following data were obtained from the patients' medical records Weight, height, age, sex, associated morbidities, biochemical parameters. The data were described by mean and standard deviation, median and interquartile range, count, and percentages.
The results showed a significant reduction in excess loss, triglycerides (TG) and low-density lipoprotein (LDLc) cholesterol variables in the prospective period, while high-density lipoproteieded to clarify the impact of %PEP on liver indicators and lipid profile two years after SB.
A re-nonunion after failed intramedullary nailing for a nonunion of the humeral shaft and a peri-implant distal humeral fracture with an ununited humeral shaft are rare cases. Therefore, no consensus has been established regarding the treatment strategies.
Case 1 An 84-year-old woman presented with humeral shaft re-nonunion after intramedullary nailing. The images revealed callus formation and loosening of the implant, suggesting a lack of mechanical stability. Nail removal and helical plating were performed. One year postoperatively, bony union was achieved. Case 2 A 59-year-old woman presented with a peri-implant distal humeral fracture with an ununited humeral shaft after nailing. Nail removal and helical plating were performed using a minimally invasive plate osteosynthesis (MIPO) technique. The distal humeral fracture was fixed with plates. One year postoperatively, bony union was achieved.
Imaging findings in Case 1 indicated that nonunion was caused by a lack of mechanical stability. In Case 2, s enables the minimal length of distal humeral plate fixation.
Right-sided colonic diverticulitis (RCD) and left-sided colonic diverticulitis (LCD) are considered distinct diseases. However, separate guidelines for RCD do not exist. Since the establishment of RCD management would first require evaluation of disease characteristics and recurrence patterns, this study has aimed to investigate the differences in the clinical characteristics between RCD and LCD and the recurrence patterns of RCD.
Patients admitted for colonic diverticulitis between January 2012 and August 2020 were retrospectively reviewed. Clinical characteristics and recurrence rates in RCD and LCD patients, and predictors for recurrence and the recurrence patterns of RCD were analyzed.
In total, 446 colonic diverticulitis patients (343 RCD, 103 LCD) were included in this study. RCD patients were more likely to be male, younger, taller, heavier, smoke, drink alcohol, have better physical performance scores, lower modified Hinchey stages and better initial laboratory findings. LCD patients were more lous drainage are more likely to experience a disease recurrence, suggesting nonsurgical management may be insufficient.
Appendicitis is one of the most prevalent abdominal emergencies globally. Despite the fact that acute appendicitis is a clinical diagnosis, preoperative imaging investigations are often conducted. Other disorders that might mimic acute appendicitis can occur in the appendix. The aim of this paper is to describe the histopathological findings of all appendectomy specimens.
A retrospective study of 940 cases of appendectomy that were performed between 2010 and 2017at King Abdulaziz University Hospital, Jeddah, Saudi Arabia were reviewed. The main outcome measured in this study is to describe the histopathological findings of all appendectomy specimens. The secondary outcomes measured in this study were the disease incidence in relation to age, and gender. Moreover, the accuracy of imaging diagnostic tools were also evaluated.
This study included 940 participants who underwent an appendectomy procedure. The patients' mean age was 23.4 years (±12.2), with a 32 male to female proportion. The incidence in malnal management beyond appendectomy. The clinical details, radiological investigations including CT scan and histopathological diagnoses are required for better management in cases of appendicular lesions.
Histopathological evaluation after common procedures, such as appendectomy, is essential to avoid missing other pathologies in the appendix. Surgeons should be aware of the uncommon histopathology findings as some disorders call for additional management beyond appendectomy. The clinical details, radiological investigations including CT scan and histopathological diagnoses are required for better management in cases of appendicular lesions.
The syndrome of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) is one of the most common inherited mitochondrial disorders.
A 33- year-old male was admitted due to edema, urinary retention, and reduce urinary output. The medical history included a pigmentary retinopathy (PR) at age of 22 and uveitis at age of 30, which were both treated with prednisolone. At age of 32, unapparent bilateral sensorineural hearing loss (SNHL) and symmetric basal ganglia calcifications were observed in neurologic study, and received prednisolone for the diagnosis of migraine and undefined vasculitis. Also, he described a right transient ischemic stroke (TIA) in the past 4 months. His family history included a dead brother, who had nearly similar components. Physical exam on admission corresponded with parkinsonism. The status points to MELAS but the genetic test was not available. Additional tests were applied, excluding all other disorders. Lactate was normal in serum and CSF. Kidney teuide the diagnosis of these conditions to reduce the delay of diagnosis and ineffective treatments.The rise in the cases of acute hepatitis of unknown aetiology in the paediatric population is a public health concern worldwide and investigations to ascertain the exact cause of this outbreak are being carried out extensively by the concerned authorities. BX471 In early April 2022, the World Health Organisation (WHO) issued a warning on acute hepatitis of unknown origin in children. Since then, there have been continuing additional reports of the cases globally. The recent cases of acute hepatitis of unknown aetiology are more prevalent in children aged less then 10 years, are more clinically severe, and a high percentage of infected individuals develop acute liver failure in contrast to the previous cases. The aetiology of this disease and its complete pathogenesis is still unclear. This review critically focuses on the current leading hypothesis and provides comprehensive information regarding this recent outbreak that can help in handling the situation by a better understanding of its aetiology.
