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About 77.5% of the cases were identified to have a deficiency. Teaching points were identified and presented in Week 4 meetings in 80.9% of the cases that had a deficiency. The residents provided a positive response and said that the process improved their quality of patient care (98%), professionalism (95%), systems-based practice, practice-based learning (90%), medical knowledge (88%), and interpersonal and communications skills (87%). Discussion This resident-driven, novel, and innovative model can be a successful teaching methodology for Internal Medicine residents to augment Patient Safety and Quality Improvement and could be implemented in residency programs irrespective of the size and specialty.Background and objective The aim of this study was to investigate whether the maximum inspiratory and expiratory pressure are correlated with the apnea-hypopnea index (AHI) in patients with obstructive sleep apnea syndrome (OSAS). Methods Fifty-two patients with OSAS were divided into two groups (AHI, events/hours less then 30, n=28, versus ≥30, n=24). For each patient, anthropometric characteristics, spirometry parameters, maximum inspiratory (MIP) and expiratory pressure (MEP), and cardiopulmonary function (CPF) parameters (oxygen uptake at rest (VO2), carbon dioxide output (VCO2), heart rate (HR), minute ventilation (VE), tidal volume at inspiratory (TVin) and expiratory (TVex), breath frequency (f β), end-tidal carbon dioxide pressure (PETCO2), end-tidal oxygen pressure (PETO2), and mean arterial pressure (MAP)) in sitting position for three minutes were recorded. The independent t-test was used to measure the differences between groups (events/hours less then 30 versus ≥30) and Pearson correlation analysis was used for statistical comparison between parameters. Results Results showed differences between groups (AHI, events/h ≥30 versus less then 30) in MIP (102.0±18.3 versus 91.1±12.1 % of predicted, p=0.013) and CPF parameters TVin (0.8±0.2 versus 0.7±0.1, L, p=0.047), PETCO2 (34.6±4.2 versus 31.4±3.7, mmHg, p=0.007), and MAP (88.4±6.5 versus 82.9±6.2, mmHg, p=0.003). Pearson correlation analysis between respiratory muscle strength (MIP and MEP) and polysomnography (PSG) parameters, MIP is related to AHI (r=.332, p=0.016) and desaturation index (r=.439, p=0.001), as well as MEP to percent of REM sleep stage (r=-.564, p less then 0.001). Conclusion The data from the present study support that maximal inspiratory pressure relates to the severity of AHI and intermittent breath-holding during sleep increases the inspiratory muscle strength.Epithelioid sarcoma is a rare soft tissue sarcoma. It is a slow-growing neoplasm, which usually presents as a painless mass in the extremities and typically grows along deep dermal and subcutaneous planes. In contrast to other types of sarcoma, it has a strong tendency for nodal metastasis and local metastasis adjacent to the primary lesion within the affected limb. In this article, we present a case of chronic traumatic ulcer in the upper extremity in an adolescent male that was subsequently diagnosed as epithelioid sarcoma, which is a very unusual mode of presentation of this particular tumour. The patient was treated with wide local excision and reconstruction with a free flap. Histopathological examination and immunochemistry studies confirmed the diagnosis and the patient underwent radiotherapy post-operatively as a part of the treatment regime. His post-treatment period was unremarkable, and he was put on regular surveillance to monitor the development of any signs of disease recurrence. Patients with epithelioid sarcomas often present late due to the slow-growing nature of the tumour. Unusual presentations like this will further delay the diagnosis and treatment, which will eventually worsen the prognosis. Awareness of such presentations can encourage primary care physicians to make early referrals to experts, which, in turn, may help the patients get early treatment and have a better prognosis.Transtibial pull-out repair is routinely performed to treat medial meniscal posterior root tear (MMPRT). However, data on the postoperative histological evaluation of the repaired medial meniscus posterior attachment after the procedure is scarce. In this report, we present a histological evaluation of the harvested specimen of a patient who underwent unicompartmental knee arthroplasty (UKA) approximately two years and six months after MMPRT transtibial pull-out repair. The patient was a 75-year-old female. Her X-ray showed Kellgren-Lawrence classification grade II and her MRI revealed MMPRT. Arthroscopic transtibial pull-out repair was performed two months after the onset, and her condition was fine two years after the operation. However, her knee pain gradually worsened, and UKA was performed two years and six months after the initial surgery. The medial meniscus posterior root was continuous from the resected tibia. Tissue specimens were prepared and evaluated. There were Sharpey's fiber-like tissues in the tibial bone tunnel. The medial meniscus posterior attachment showed a four-layer structure of ligaments, uncalcified fibrocartilage, calcified fibrocartilage, and subchondral bone zone. The structures were observed 2,000 ㎛ medially from the bone tunnel. Benzylpenicillin potassium cost The results revealed that the reconstructed graft after a transtibial pull-out repair for the medial meniscus posterior root showed different histological findings compared with the native posterior root and similar to the anterior root of the medial meniscus.In this case report, we highlight a patient with catatonia secondary to schizoaffective disorder, depressive type. This patient developed a bilateral deep venous thrombosis progressing to a saddle pulmonary embolism without any predisposing factors to hypercoagulability other than immobility and obesity. The goal of this case report is to increase monitoring and prophylactic treatment for deep venous thrombosis in patients with catatonia, retarded type.Pilonidal sinus (PNS) is a clinically diagnosed condition caused by hair entrapment underneath the skin leading to a granulomatous reaction and the formation of a tract. PNS is commonly found in the sacrococcygeal area (natal cleft). However, this is a rare case presentation of a male patient with PNS located at the back of his neck region as there were only four similar conditions reported in the literature review. The patient was first managed medically as a case of hidradenitis suppurativa by the dermatology department. Later on, when the treatment failed, he was treated surgically as a case of PNS with an excellent outcome. The patient was seen at the outpatient clinic one week after surgery. The wound was healed completely and totally recovered.