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Mucinous cystadenoma is a rare tumour of the appendix. It accounts for only 0.4% of the gastrointestinal tract malignancies and is reported rarely in the literature. Therefore, surgical management is not yet established. Here we report the case of a 65-year-old female who presented with a dragging sensation and a feeling of a mass in the right iliac fossa. Her computed tomography (CT) suggested formation of an abscess in the parietal peritoneum. She was scheduled for laparotomy and upon exploration, a mass was found arising from the tip of the retroperitoneal appendix. The whole of the appendix was studded with mucoid material. Right hemicolectomy was performed and histopathology of the appendix showed mucinous cystadenoma with no evidence of malignant changes. The recovery was uneventful and the patient was discharged on the fourth post-operative day. The unusual presentation of retroperitoneal pseudomyxoma without any intraperitoneal pathology prompted us to report this case.We report a case of mixed germ cell tumour, which presented with acute kidney injury in an unmarried 22-year-old Asian girl. The case demonstrated that an aggressive approach with multidisciplinary teamwork ascertained outstanding clinical outcome. The patient was successfully managed fertility-sparing surgery and three cycles of Bleomycin, Etoposide and Cisplatin (BEP) therapy. The patient's pathophysiology returned to normal within weeks and she was declared tumour-free. Furthermore, three-year follow up scans and biomarkers were evident for tumour negativity.Small bowel malignancy (SBM) is a rare malignancy in the gastrointestinal tract. Duodenum is the most commonly involved segment and the most common histological subtype is adenocarcinoma (40%). Due to a lack of screening tools and vague symptoms, its clinical detection is very challenging. A 27-year-old man presented at the surgical emergency of Lahore General Hospital in February 2019 with non-specific gastrointestinal symptoms (vomiting, abdominal pain), for which he had previously visited the hospital multiple times. Later, on further workup, he had been diagnosed as a case of intussusception on CT scan. On exploration, he had an impassable stricture in the jejunum. Resection anastomosis of the jejunum was done, but later, on histopathology it turned out to be adenocarcinoma. Adenocarcinoma of the small bowel is a rare entity, and, particularly in Pakistan, the available literature is limited. SBM should be included in the differentials of patients with vague abdominal symptoms. Future studies for the evaluation of new investigations and treatment modalities should be encouraged to improve the overall outcome of the patients.Hypertrophic olivary degeneration is a kind of trans-synaptic degeneration, caused by the interruption of dentato rubro olivary pathway. Magnetic resonance imaging (MRI) has been the best modality to show the signals of olivary nucleus hypertrophy. It appears on T2-weighted magnetic resonance imaging as hyper-intensities. Here we present a unique case of a 27-year-old male with traumatic brain injury causing multiple intracranial haemorrhages and functional impairment, which was revealed on computerised tomography. Tracheotomy and thoracic drainage were performed immediately. Anti-infection therapy, brain protection, and comprehensive arousal therapy were part of the intervention along with a comprehensive rehabilitation programme including occupational therapy, balance training, coordination, bed mobility training, and strengthening exercises. A holistic diagnostic approach can reduce the chances of misdiagnosing post-traumatic Hypertrophic Olivary Degeneration cases. We concluded that a comprehensive physical rehabilitation programme and medical treatment works best to heal the lesion and its resulting traumatic symptoms in cases of Hypertrophic Olivary Degeneration cases.Foreign body (FB) ingestion is common in children; however, management varies based on the object ingested, its location and clinical presentation. Urgent intervention is needed if any warning signs are present. We describe the case of a four-year-old child who presented with acute onset of life-threatening upper gastro intestinal bleeding. He had no other significant previous or present complaint, and results of lab workup were inconclusive. Endoscopic evaluation revealed a sharp and hard object which was removed. Post-operative period, duration of hospitalization and subsequent follow up were uneventful. Through this report, we wish to draw the attention of healthcare providers to the dangerous effects of FB ingestion and also emphasise that FB ingestion should be considered in differential diagnosis when unexplained upper GI haemorrhage symptoms occur acutely.Although body fluid adenosine deaminase (ADA) level is useful for diagnosing tuberculosis but little is known about joint fluid ADA level in tuberculous (TB) arthritis. This study aimed to evaluate the diagnostic value of synovial fluid ADA (SF-ADA) in TB arthritis. Of 43 patients enrolled, nine had confirmed TB arthritis. Fourteen had non-TB septic arthritis, and 20 patients had non-infectious etiologies. The SF-ADA levels were significantly elevated in patients with TB arthritis compared to those with non-infectious origin (P 76 U/L with negative ordinary bacterial culture results is highly suspicious for TB arthritis.This study aimed to assess the level of retention of knowledge regarding calculation of drug dose among undergraduate nursing students studying at a private school of nursing. This was a pre- and post-comparison design conducted at the Aga Khan University, Pakistan, from August 2017 to September 2019. All the students enrolled in Bachelor of Science in Nursing (BScN) (Class of 2019) were included in the study. Mean test scores of 141 fourth year BScN students were compared with their own performance in the second year. Mean scores on mathematics and drug dosage calculation test decreased significantly from 21 in second year to 17.97 in the final year of studies. Modifications in assessments as well as curriculum are suggested to improve retention of dose calculation skills among undergraduate nursing students.The majority of relatives of cancer patients in Pakistan request their clinicians to adopt a "do not tell approach" while counselling the patients regarding their disease. The current study aimed to assess patients' understanding of their disease and how they would prefer the physicians to deliver news about cancer diagnosis and its management plan. selleck chemicals llc This was a cross-sectional study in which both patients and their immediate relatives were interviewed. The study enrolled 55 patients with six different types of cancers. The study showed that 35 (65.5%) patients did not know the stage of their illness at the time of diagnosis, while 40 (72.7%) patients did not know the current stage of their disease. In 22 (40%) cases, the patient's family knew the diagnosis ahead of the patient, and 19 (86.3%) families asked the clinicians to hide the diagnosis from the patient. This study, which used a scoring questionnaire, demonstrates that specialist oncologists for breaking the bad news, family counselling, helping patients to figure out how to inform others, giving the news directly to the patient and the effects of cancer on daily life are preferred areas to communicate with cancer patients.The current review was planned to assess updated knowledge about gout and to highlight the various areas which need to be focussed upon for better healthcare. Relevant articles published in English language were reviewed by utilising various databases including Google Scholar, Springer Link, Science Direct and MEDLINE. Data revealed a precipitating number of gout cases from the developed countries, while the developing countries on the other hand were found to be faced with an even higher threat. The risk factors and pathophysiology of gout are immaculate and clearly established. Hence, appropriate measures can be explored and worked on to pinpoint diagnosis, and economical treatment. In order to lessen the elevated global health burden along with revolutionising the patient's quality of life, an immediate action is required in certain aspects, like the adoption of a healthy modified lifestyle, a reduction in exposure to risk factors, robust prophylactic measures, bettering awareness, and an approach to early diagnosis followed by optimal treatment protocols.Aquaporins are transcellular proteins that majorly consist of a tetrametric hour-glass-like structure. Aquaporins have a definitive function in transpositioning of water and solutes across cell membranes. The current review was planned to provide information regarding structure, expression and functions of aquaporins in the human body, and to generate a comprehensive summary of physiological and pathophysiological correlations related to aquaporins and their therapeutic implications. Absence or mutations of different aquaporins are believed to be linked to clinical diseases, including Sjogren's syndrome, nephrogenic diabetes insipidus, liver dysfunction and obesity. Modern therapeutic techniques are utilising aquaporins in gene therapy for Sjogren's syndrome and cholestasis. The narrative review aims at providing a comprehensive description of localisation, function, abnormal clinical conditions and therapeutic implications of aquaporin proteins.Atopic dermatitis mostly starts with children in early life. Besides the aetiological factors, like environmental, dietary or medical exposures, gut-skin axis microbiome studies have an impact to investigate and to understand the relation between the gut microbiome and changes to the skin microbiom as well as resulting skin diseases like atopic dermatitis. Infants start forming their microbiome in early life and some studies suggest that this phase has a crucial role in AD development. Balanced bacterial composition is important to maintain healthy skin as the gut microbiome dysbiosis may result in dramatic shifting in the skin microbiome that gives better chance for some bacteria, such as staphylococcus aureus, to prevail which has been reported to contribute to AD development. Among several factors, immunological activity has a strong relation to microbiome, changed composition and AD development. Supplements of prebiotic and probiotic could be a positive treatment approach. More studies regarding the gut-skin axis microbiome in general and diseases associated with microbiome, such as AD, are needed.Behaviourism is the underpinning learning theory of many teaching and assessment tools utilised to enhance the effectiveness of learning. Feedback, reinforcements, motivation, learning outcomes and objectives are a few among many which are implied by the medical teachers while teaching both basic and clinical sciences to students. The claim of behaviourism being redundant or dead is not based on realities. The behaviourist approach is and will remain the most powerful theory to be implied in educational processes for gaining successful outcomes.

To gain an enhanced understanding of the prognostic importance of 14-3-3ξ levels in cancer patients.

The meta-analysis and systematic review was conducted in October 2019. Two reviewers independently reviewed Web of Science, Embase and PubMed databases to identify published studies using relevant key words. The correlation between the level of 14-3-3ξ and cancer patient survival was assessed based upon pooled hazard ratios and 95% confidence intervals derived from the selected studies. Data was analysed using STATA 12.

Of the 244 studies initially identified, 22(9%) were included, and they comprised 2,676 patients. Elevated 14-3-3ξ level correlated significantly with poorer overall survival (hazard ratio 1.93; 95% confidence interval 1.42-2.61) in cancer patients. With respect to disease-free survival, the pooled hazard ratio for cancer patients expressing high levels of 14-3-3ξ was 1.89 (95% confidence interval 1.56-2.30). Patients with elevated 14-3-3ξ expression also exhibited reduced cancer-specific survival (hazard ratio 3.