Morganmontoya5631

Background and objective The head of the humerus articulates with the glenoid cavity (GC) to form the shoulder joint. Understanding the various shapes and sizes of GC is important not only to analyse the stability of the glenohumeral joint but also to design prostheses for shoulder arthroplasty. Morphometric data on GC among the North Indian population is scarce. Hence, the aim of this study was to provide morphological and morphometric data on GC among the North Indian population. Methods This study was conducted in the department of anatomy of two medical colleges using undamaged dry scapulae. The shapes of GC and supero-inferior (SI) and maximum anteroposterior diameters above and below the notch were recorded. Statistical analysis and Student's t-test were carried out to identify statistically significant differences in diameters of the two sides of GC. Results The most common and least common shapes of GC were pear and inverted comma shapes respectively. The mean SI glenoid diameter was 33.6 ± 3.2 mm. The mean of H1 and H2 diameter was 23.6 ± 3.1 and 15.3 ± 2.1 mm respectively. The mean GC indices on the right and left sides were 72.16 and 68.14 respectively. In all of the above measurements, bilateral differences were not statistically significant (p-values of ˃0.05). Conclusions The morphometric data on GC may be used to design prostheses for shoulder arthroplasty among the North Indian population. The information is also useful in detecting various pathological conditions of the shoulder like rotator cuff disease, osteochondral defects, and Bankart lesions.Biplane fluoroscopy in a hybrid operating room (OR) is commonly used for neuroendovascular and hybrid open/endovascular cases. The image quality is far superior to most C-arm fluoroscopy machines in the regular OR. This advantage can be particularly useful for upper and mid-thoracic percutaneous screw placement because the C-arm visualization in the regular OR is suboptimal due to shoulders absorbing the majority of the photons on lateral fluoroscopy. A 31-year-old man was ejected following a motor vehicle accident and sustained a T7 burst fracture with anterior translation on T8 and spinal cord transection. Following stabilization in the intensive care unit, the patient was taken to the biplane hybrid OR for percutaneous pedicle screw fixation. The patient had percutaneous instrumentation and fixation of T5-T10, and sequential reducers were also used to re-align T7 and T8. The use of biplane fluoroscopy enhanced safety and visualization. The patient tolerated the procedure well without complication. We believe this is an unrealized and underutilized function of a biplane hybrid OR that bears further investigation and study.Lung damage in coronavirus disease 2019 (COVID-19) pneumonia may be so severe that management with lung-protective ventilation, neuromuscular blockade, and proning cannot sustain life. Extracorporeal membrane oxygenation (ECMO) may allow patients with acute respiratory distress syndrome (ARDS) to undergo a period of lung recovery before being transitioned back to mechanical ventilation. A successful outcome requires both timely initiation of ECMO before development of irreversible organ injury from severe ARDS and selection of patients with adequate physiologic reserve. We present a 40-year-old healthy male patient with severe COVID-19 pneumonia not responsive to more conservative options for ARDS management. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) rescue therapy was instituted and after 34 days he was successfully decannulated and eventually discharged from the hospital in good condition. Despite needing ECMO for longer than what is reported in most case reports and series involving patients with COVID-19 pneumonia, our patient made a complete recovery. He was also followed up in an outpatient setting and seen to be doing well. With appropriate patient selection and timely initiation of ECMO, many patients stand to benefit from this treatment. Ensuring that therapy be delivered to these patients when the need arises requires meticulous planning and provision of the appropriate resources. In addition, inflammatory markers may serve as a further guide to decision-making in patients already on ECMO as has already been indicated in the literature.Ethylene glycol is a colorless, odorless, sweet-tasting liquid commonly found in antifreeze, as well as in industrial agents. It is regarded as one of the toxic alcohols. Ethylene glycol poisoning usually occurs due to ingestion, and its toxicity is mediated by its metabolites, glycolic acid, and oxalate. These metabolites can cause neurological symptoms, gastrointestinal symptoms, and/or renal failure if not diagnosed and treated promptly. The diagnosis can be very challenging as the test used to detect ethylene glycol in the blood may not be readily available or due to an inaccurate history. The treatment of ethylene glycol poisoning consists of supportive care, sodium bicarbonate, and the use of an antidote (ethanol or fomepizole) which inhibits alcohol dehydrogenase and thereby prevents the formation of toxic metabolites. Patients with advanced poisonings may also require dialysis. The diagnosis is usually suggested by a high anion gap metabolic acidosis and an elevated osmolal gap in the setting of a suspected ingestion. Rarely, the osmolal gap may be close to normal which can delay the diagnosis or lead to a misdiagnosis. We report a case of ethylene glycol ingestion with a near-normal osmolal gap.Background Some models based on clinical information have been reported to predict which patients have Coronavirus Disease-2019 (COVID-19) pneumonia but have failed so far to yield reliable results. We aimed to determine if physicians were able to accurately predict which patients, as described in clinical vignettes, had, or did not have this infection using their clinical acumen and epidemiological data. Methods Of 1177 patients under investigation for COVID-19 admitted, we selected 20 and presented them in a vignette form. We surveyed physicians from different levels of training ( less then 5, and five or more years after graduation from medical school) and included non-medical participants as a control group. We asked all participants to predict the result of the PCR test for COVID-19. We measured the accuracy of responses as a whole, and at three stages of the pandemic associated with a growing incidence of COVID-19 in the community. We calculated the inter-rater reliability, sensitivity, and specificity of the clinical prediction as a whole and by pandemic stage. Results Between June 8 and August 28, 2020, 82 doctors and 20 non-medical participants completed the survey. The accuracy was 58% (59% for doctors and 52% for non-medical, p=0.002). The lowest accuracy was noted for cases in the pandemic middle stage; years of post-graduate training represented no difference. Of the 2040 total answers, 1176 were accurate and 864 inaccurate (349 false positives and 515 false negatives). Conclusion The influence of symptomatic positivity, confirmation bias, and rapid expertise acquisition on accuracy is discussed, as the disease is new, time after graduation made no difference in the response accuracy. The limited clinical diagnostic capacity emphasizes the need for a reliable diagnostic test.Pregabalin is a gamma-aminobutyric acid (GABA) derivative that was commercially approved by the Food and Drug Administration (FDA) in 2004. It is commonly used in the treatment of diabetic neuropathy, peripheral neuropathy, and spinal cord injury. We present the case of a 36-year-old Caucasian male double lung transplant recipient who presented with an 18-month history of fatigue and muscle weakness. He had elevated creatinine kinase level and his muscle biopsy showed evidence of drug-induced myopathy that improved after the cessation of pregabalin. We present a case of drug-induced myopathy as a rare complication of pregabalin therapy in a double lung transplant recipient.Introduction The number of octogenarian invasive breast cancer cases is projected to increase, as there is a significant increase in life expectancy. However, no specific treatment guideline has been established so far for this vulnerable group of patients. The aim of the present study was to evaluate the treatment outcomes of octogenarians diagnosed with early and locally advanced invasive breast cancer, to compare those who underwent surgery with conventional treatment and those who did not, and to reveal the potential social factors that may affect their therapy outcomes. Material and methods A total of 78 patients aged 80 and over were included in the study. There was a significant relationship between a patient's social milieu and treatment status (p less then 0.001). The relationship between receiving endocrine therapy or surgical treatment was also significant (p = 0.029). Results The surgical treatment rate was 90.9% in survivors, which was significantly lower in those who passed away (37.8%, p less then 0.001). According to the log-rank test results, life expectancy was significantly longer in operated patients than in non-operated ones (p less then 0.001). The median survival length was 62 months (range 33.8-90.2) in operated patients 80 years of age and above and 19 months (range 16.3-21.7) in non-operated ones. The surgical treatment frequency was 15.30 times (range 4.86-48.21) higher in patients living with family than in patients living alone or in a nursing home. Conclusion Thus, the social milieu of the patients, especially the place of residence, had a major impact on the treatment of the elderly (octogenarians) patients with breast cancer. Surgery and endocrine therapy as an adjuvant treatment were tolerable and had positive impacts on survival.Background Depression is a highly prevalent disorder globally and locally in Saudi Arabia. Individuals with chronic conditions are more liable to develop depression. limertinib Keratoconus is a chronic progressive corneal disorder that markedly affects the vision and quality of life, making its sufferers liable to developing depression. Methods This is a descriptive cross-sectional study that was conducted using 9-item Patient Health Questionnaire (PHQ-9) to screen for depression among adults aged between 18 and 60 years old only. The participants in this study are patients who have been previously diagnosed with keratoconus by their ophthalmologists. The structured questionnaire was distributed using Google Forms through various social media platforms. After extracting the data, it was revised, coded and then analyzed using the Statistical Packages for Social Sciences (SPSS), version 21 (IBM Corp., Armonk, NY). Results A total of 330 keratoconus patients living in Saudi Arabia were recruited in this study. The modal age group was 31-40 years old (44.5%), and the male to female ratio was 32. The most frequently reported concurrent eye diseases of the patients were astigmatism (48.5%) and myopia (36.7%). The prevalence of depression among patients with keratoconus was 40.6% (n = 134). The use of corrective contact lens (includes both hybrid and rigid lens) in both eyes contributed to a significantly higher depression rate among its wearers compared to users in one eye and non-users (p less then 0.001). Conclusion Depression is highly prevalent among keratoconus patients. This is especially true among corrective contact lens wearers of both eyes. Keratoconus is associated with depression regardless of disease severity and socio-demographic characteristics.