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The classical form of GPA is characterized by the involvement of the upper respiratory tract, sinuses, lungs, and kidneys. Autoimmune disorders may develop secondary to hematopoietic stem cell transplant (HSCT). In our case, the patient was diagnosed with GPA, which is likely one of the autoimmune complications after HSCT.Miliary tuberculosis (TB) represents a rare escalation of TB stemming from the hematogenous dissemination of Mycobacterium tuberculosis . Common extrapulmonary infection sites include the lymphatic system, musculoskeletal system, and central nervous system. The nonspecific motif of clinical symptoms involving joint pain, fever of unknown origin, and night sweats make the diagnosis of disseminated TB quite challenging. Long-term outcomes remain bleak. Untreated miliary TB is estimated to be fatal within one year. Here, we present a case of miliary TB in a 21-year-old male with a remote exposure history who was not immunocompromised.A patient with a three-month history of persistent delusions of infestation presented to the emergency department with suicidal ideation secondary to complaints of worsening pruritus. Routine investigations failed to disclose any underlying organic cause for her pruritic sensations. The patient ascribed these to a parasitic infestation acquired following a brief stay at her maternal aunt's residence. Following a thorough psychiatric assessment and collateral history obtained from her aunt, it became clear that both the patient and her aunt held similar delusions of infestation. Her aunt was found to be the main inducer. The patient was admitted, successfully treated with low-dose quetiapine, and eventually deemed fit for discharge. Delusional parasitosis and folie à deux are both rare conditions that may sometimes co-occur.

To investigate the reliability and educational value of YouTube videos of minimally invasive complete mesocolic excision with right hemicolectomy procedures.

We searched YouTube with theterms "Laparoscopic and Robotic Complete Mesocolic Excision with Right Hemicolectomy" on January 12, 2021.To assess the reliability of the videos, we evaluated nine steps in each videoand scored the videosbased on the key steps they contained. The videos were divided into three groups according to the source of the upload. The total number of views, length, time since upload, and the number of likes, dislikes, and comments were recorded for each video. Narration, the use of descriptive subtitles, and the upload status by an expert surgeon were also examined.

Sixty-eight videos were included in the study. A positive significant correlation was identified between the comprehensiveness score (CS) and the number of views (p=0.025). The CSs of the videos accessed from academic channels, as well as those accessed from journals, congress, and association channels, recorded higher CSs than those obtained from the personal channels of consultants (p=0.003). It was also found that CSs were higher in the videos of expert surgeons (p<0.001) and narrated videos (p<0.001).

Not all YouTube videos on this subject have reliability and educational value. Surgical videos on YouTube may be evaluated by a video review commission formed by academic institutions, surgical associations, or expert surgeons, and videos suitable for education could be brought together and published via a free channel.

Not all YouTube videos on this subject have reliability and educational value. Surgical videos on YouTube may be evaluated by a video review commission formed by academic institutions, surgical associations, or expert surgeons, and videos suitable for education could be brought together and published via a free channel.Urinothorax is a rare cause of pleural effusion, which is seen in patients with obstructive uropathy, blunt trauma, or ureteric injury during abdominal surgical procedures. Clinical symptoms may include dyspnea, chest pain, cough, fever, abdominal pain, and decreased urine output. Diagnosis is made by thoracentesis, which would reveal fluid with a urine-like odor, and pleural fluid analysis, which would show if fluid is transudative in nature with a pH lower than 7.30. Pleural fluid to serum creatine ratio of more than 1 is diagnostic for this condition. In our case, the patient underwent percutaneous nephrolithotripsy with a stent placement three days before presentation to the hospital. learn more She was diagnosed with urinothorax, which led to further investigations, and she was found to have persistent hydronephrosis. Her condition improved after her underlying hydronephrosis was addressed with stent placement. She was discharged home in stable condition.Video-assisted thoracoscopic surgery (VATS) is considered the standard procedure for surgical resection in non-small-cell lung cancer (NSCLC). However, there is still lingering speculation on its adequacy of lymph node (LN) dissection or sampling and the long-term survival benefits when compared to open thoracotomy. Given the above, we conducted a systematic review comparing VATS and thoracotomy in terms of their oncological effectiveness in resection. We explored major research literature databases and search engines such as MEDLINE, PubMed, PubMed Central, Google Scholar, and ResearchGate to find pertinent articles. After the meticulous screening, quality check, and applying relevant filters according to our eligibility criteria, we identified 16 studies relevant to our research question, out of which one was a randomized controlled trial, one meta-analysis, and 14 were observational studies. The study comprised 44,673 patients with NSCLC, out of whom 15,093 patients were operated by VATS and the remaining 29,580 patients by thoracotomy. The results indicate that VATS is equivalent to thoracotomy in total LNs (N1 + N2) and LN stations dissected. However, a thoracotomy may achieve slightly better mediastinal lymph node dissection (N2) in terms of assessing a greater number of mediastinal lymph nodes and nodal stations. This may be attributed to a better visual field during mediastinal nodal clearance by an open approach. Also, nodal upstaging was consistently more common with an open approach. In terms of long-term outcomes, both overall survival and disease-free survival rates were similar between the two groups, with VATS offering a slightly better survival benefit. Irrespective of the increased rates of nodal upstaging by an open approach, we conclude that VATS should be considered a highly efficient alternative to thoracotomy in both early and locally advanced NSCLC.An immunocompetent 45-year-old Cuban-American man presented with worsening knee pain and swelling despite antibiotic therapy. On physical examination, the patient was ill-appearing, cachectic, with a protuberant abdomen and massive splenomegaly. In addition, he had a 10 cm area of peripheral hyperemia with central necrosis in the medial left knee that was non-tender and non-fluctuant. Initial lab work demonstrated pancytopenia, hyponatremia, hypoalbuminemia, and anemia of chronic inflammation. Peripheral smear showed microcytic, hypochromic red blood cells with mild anisopoikilocytosis. and leukopenia with slight left shift and metamyelocytes. Bone marrow biopsy demonstrated amastigotes and kinetoplasts within white blood cells and extracellular space consistent with leishmaniasis. Centers for Disease Control and Prevention (CDC) testing with PCR returned positive for Leishmaniasis infantum. The patient received two courses of amphotericin B lipid complex (ABLC) with a 28-day course of miltefosine, which resulted in clinical improvement. This case illustrates the unique pathology that can affect immigrants and highlights the need to increase health provider awareness of foreign pathologies in areas with large migrant populations.Aims and objective This study describes postmortem and histopathological findings to understand the internal progression of methanol poisoning. The study also aims to examine clinical, biochemical, and histological changes seen with methanol poisoning. Materials and methods The study describes the methanol poisoning tragedy that occurred in February 2019 in the Haridwar district of Uttarakhand. Ninety-one patients were admitted to the hospital, four were brought dead, four died within a few hours of admission (designated as early deaths), and four died between 10 and 45 days of hospitalization (designated as late deaths). A medicolegal autopsy was performed on all 12 deaths. Gross external and internal findings were noted, and routine viscera and blood were preserved and sent to Uttarakhand's Forensic Science Laboratory (FSL) to estimate methyl alcohol. A section of the optic nerve was taken from the optic chiasma for histopathological examination. Data were collected retrospectively from records. All data wed. Severe metabolic acidosis leading to the respiratory failure was the cause of death in early deaths. Cerebral and pulmonary edema consequent upon septicemic shock was the cause of late deaths. A case with the most extended survival duration showed cerebral edema with intracerebral hemorrhage. Cirrhotic liver, along with features of renal failure, was an additional internal finding in late deaths. Optic nerve histopathology showed no demyelination or axonal necrosis; however, mild edematous changes were evident. Conclusions Methanol poisoning is one of the manmade disasters in the developing world. There are various adverse effects of different organs and organ systems inside the body. Timely intervention and diagnosis can save several lives. The organ-directed meticulous autopsy can help autopsy surgeons in establishing the diagnosis and thus help the judiciary in delivering justice to the sufferers.Pseudocirrhosis can result in cirrhosis-like symptoms of portal hypertension and is observed mostly in patients with breast cancer; however, its cause is unclear. Herein, we report a case of pseudocirrhosis in a 76-year-old woman with metastatic breast cancer. The patient developed irregular contours of the liver, resembling cirrhosis, and esophageal varices during chemotherapy for breast cancer with liver metastases. Although intrahepatic metastasis was absent on imaging, a liver biopsy showed cancer cell infiltration consistent with the fibrotic area, which was similar to fibrosis seen in liver cirrhosis. Endoscopic ligation was performed for the varices; however, the patient's worsening liver function made it difficult to continue chemotherapy. Clinicians should be alert to the possibility of pseudocirrhosis developing in patients with metastatic breast cancer undergoing chemotherapy. Since pseudocirrhosis is a life-threatening complication, non-invasive markers for early diagnosis are needed.

Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by SARS CoV-2 that emerged in Wuhan, China, and has rapidly spread worldwide. The mortality rate of critically ill COVID-19 patients is high.

To assess the severity, different clinical symptoms, and comorbidities of COVID-19 pneumonia in vaccinated vs. non-vaccinated patients.

In this single-center, cross-sectional study, 142 patients with COVID-19 were enrolled. The clinical characteristics, comorbidities, severity, and outcomes were also assessed.

Of the 142 patients, 92 (64.8%) were males, with a mean age of (56.00±14.81) years. Among them,62 (43.7%) wereaged above 60 years. Of these, 92 (64.7%) had comorbidities. The patients were divided into two groups unvaccinated and those who received at least one dose of the vaccine within six months. The demographic characteristics of the two groups were similar exceptfor gender. In the vaccinated group, most of the patients were males. Most patients in the non-vaccinated group had a severe illness, whereas most patients in the vaccinated group had mild to moderate disease.