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No statistically significant difference in the rate of postoperative hemorrhagic or non-hemorrhagic neurological complications was observed between patients in either age group. Conclusion Age over 65 years was not associated with a higher risk of postoperative hemorrhage in patients who received SCUFH after emergency neurosurgery. SCUFH can be safely used as a chemoprophylactic agent against venous thromboembolism for elderly patients when used within 24 hours after emergency neurosurgery.Rationale Pre-exposure prophylaxis (PrEP) is a highly effective, evidence-based HIV prevention strategy. STC-15 concentration However, its use in the city of Saskatoon, Saskatchewan province of western Canada, is relatively new. Therefore, this study aimed to examine the interest and uptake of PrEP and investigate factors associated with HIV PrEP by high-risk patients. Methods A cross-sectional, self-administered survey of patients attending Saskatoon's Public Health Services Sexual Health Clinic was conducted from October until December 2018. The primary outcome was the interest in taking PrEP to reduce the risk of HIV infection. This outcome was evaluated for its association with potential correlates, which included sociodemographic characteristics, HIV risk perception, prior PrEP awareness, and sexual behaviors/lifestyles. Descriptive, univariate, and multivariate analyses were used to pursue our research objectives. Results One hundred forty-one participants were recruited from a sexual health clinic in Saskatoon. The median on HIV risk, concerns around side effects, and associated blood work with PrEP use.Acute esophageal necrosis (AEN) is a rare clinical finding due to multifocal factors consisting of an ischemic insult to the esophagus, corrosive injury from gastric content, and diminished mucosal defense. It is also referred to as "black esophagus" or acute necrotizing esophagitis. The clinical presentation mainly consists of upper gastrointestinal bleed and abdominal pain. Associated symptoms include nausea, vomiting, and dysphagia. AEN can be diagnosed by esophagogastroduodenoscopy (EGD) with findings of diffuse circumferential black pigmentation in the distal esophagus that classically extends to the gastroesophageal junction. A diagnostic biopsy is not required but recommended. Treatment of AEN is conservative management to maintain hemodynamic stability and treat coexisting medical conditions. Herein, we present the case of a 78-year-old male who initially presented with hematemesis and abdominal discomfort of five-day duration and was subsequently found to have AEN.Acute pancreatitis is one of the most common diagnoses for patients admitted to the hospital with acute abdominal pain and nausea and vomiting. often elevated amylase and lipase support the diagnosis. This case illustrates the importance of recognizing the elevated laboratory findings seen in patients with end-stage renal disease, especially those laboratory findings that aid in making clinical decisions and/or establishing the diagnoses. We present a case of a patient misdiagnosed with recurrent acute pancreatitis due to his recurrent episodes of nausea, vomiting, abdominal pain, and persistently elevated pancreatic enzymes in the setting of end-stage renal disease. It is important for clinicians to recognize that these enzymes are renally eliminated and thus will be elevated as a result of the renal disease, which would limit the use of pancreatic enzymes to establish the diagnosis of acute pancreatitis.We present the case of a 26-year-old male who was found to have human herpesvirus 6 (HHV-6) in his cerebrospinal fluid (CSF) during acute presentation of multiple sclerosis (MS). Paresthesia of the lower extremities was his only symptom during the initial presentation, and workup for MS was not included during this evaluation. A single dose of IV steroids failed to improve his condition, and symptoms became more severe. Upon secondary evaluation, MRI revealed white-matter disease with plaques at multiple levels of the cervical spine and central nervous system (CNS). Lumbar puncture was obtained, and CSF analysis was positive for HHV-6 DNA. After five days of oral steroid treatment and physical therapy for three weeks, his symptoms continued to worsen. MRI at this time demonstrated an increase in the size of previous plaques and new foci of white matter disease. Repeat CSF analysis was negative for HHV-6. The virus' association with relapse of MS has been investigated by many studies. However, there is a lack of literature investigating its role in causing MS disease. In this case report, we highlight the need for further research aimed at determining if HHV-6 is an environmental trigger for MS disease onset.Eosinophilic granulomatosis with polyangiitis (EGPA) or Churg-Strauss syndrome (CSS) is a rare, autoimmune vasculitis usually affecting small and medium-sized blood vessels in its later phases. It is a diffuse, systemic, multisystem disease that is reported to present with gastrointestinal manifestations but very rarely as an acute abdomen secondary to eosinophilic peritonitis. A 28-year-old relatively healthy male with a pre-existing diagnosis of inactive pulmonary sarcoidosis presented to the emergency department with an acute abdomen. After an exploratory laparotomy, multi-specialty involvement, and extensive investigations to exclude other differentials, a diagnosis of EGPA was made. The patient was treated with systemic glucocorticoids initially, followed by a tapering course of steroids and anti-interleukin 5 monoclonal antibodies as maintenance upon remission. EGPA can manifest in a myriad of ways including an acute abdomen, and medical treatment is useful in managing this presentation. Surgeons should be aware of the atypical causes of acute abdomen and should routinely broaden their differential diagnosis to include medical pathologies.Introduction Primary percutaneous coronary intervention (PPCI) in ST-elevation myocardial infarction (STEMI) patients can lead to poor outcomes. Intra-coronary thrombus development due to atherosclerotic plaque rupture and coronary blood flow blockage causes STEMI. Intracranial thrombosis in STEMI patients is fatal. It was our goal to establish how often patients with STEMI underwent PPCI with a high thrombus burden versus a low thrombus burden and to compare the mean monocyte count between the two groups. Material and methods This cross-sectional study was conducted at KRL Hospital Islamabad from October 2021 to March 2022. At a 95% level of confidence, a 5% margin of error, and keeping a population size of 330, a sample size of 178 was obtained using the Raosoft sample size calculator (Raosoft, Inc., Seattle, WA). The non-probability consecutive sampling method was used. All patients with STEMI undergoing PPCI, aged between 18 and 80 years, and presenting within 24 hours of symptoms were included in our stuts was 70.27 ± 3.24, whereas it was 61.89 ± 5.71 in low burden patients. Only five patients had a Thrombolysis In Myocardial Infarction (TIMI) score of 5 while 34.8% of patients arrived in three to six hours and 12.9% arrived in less than three hours. Patients with a high monocyte count have 1.3 times more chances of developing the disease when the monocyte count was high (OR = 1.318, 95% CI = 1.140-1.524). Conclusion Patients with STEMI undergoing PPCI had a higher monocyte count upon admission, which was an independent clinical predictor of a high thrombus burden. Our findings suggest that admission monocyte count may be available for early risk stratification of high-thrombus burden in acute STEMI patients and might allow the optimization of anti-thrombotic therapy to improve the outcomes of PPCI.Rhino-orbital-cerebral mucormycosis (ROCM) is a fulminant, often fatal, angioinvasive fungal infection commonly transmitted through inhalation of fungal spores and traumatic inoculation. While the literature has documented rare cases of infection in immunocompetent patients, the vast majority of case fatalities are noted in immunosuppressed populations. Common predisposing factors to infection include immunosuppressive therapies, hematologic malignancies, and most notably, uncontrolled diabetes. Actinomycosis is a subacute to chronic bacterial infection stemming from non-spore-forming anaerobic/microaerophilic bacteria of the genus Actinomyces. Infection with Actinomyces species has been documented across numerous anatomical sites; however, literature on concurrent infection with ROCM in pediatric patients is sparse. We document a case of a 17-year-old male with uncontrolled type 1 diabetes who presented to the emergency department with combined ROCM and actinomycotic infection of his anterior skull base.Coronary artery ectasia (CAE) is a rare dilation of the lumen in coronary arteries, either localized to one vessel or diffuse in multiple vessels. A 31-year-old white male with no significant past medical or cardiac history, presented with severe sudden onset chest pain, diaphoresis, shortness of breath, and nausea without vomiting. A 12 lead electrocardiogram (EKG) showed an ST elevation in the inferior leads with reciprocal changes, suggestive of myocardial infarction in the right coronary artery (RCA). He was taken directly to the catheterization laboratory for coronary angiography, which identified a mid-RCA thrombus with thrombolysis in myocardial infarction (TIMI)-1 flow, and distal to that in the right posterolateral branch was another thrombus with TIMI-0 flow. Additionally, he was found to have severely diffuse CAE in all of his coronary arteries. Angioplasty successfully restored TIMI-3 flow throughout the RCA. We present this case to discuss the prevention of complications from CAE. There are currently no recommendations on the use of antiplatelet or anticoagulation therapy in patients with CAE.There is a growing body of evidence that coronavirus disease 2019 (COVID-19) is linked with neuropsychiatric complications such as psychosis and delirium in adults. Much less is known about the neuropsychiatric manifestations of this virus in the child and adolescent population. This case series discusses two unique adolescent patients who presented with new-onset mania and psychosis in the context of an otherwise asymptomatic COVID-19 infection, which raises several questions about whether and how the virus precipitates mania and psychosis, whether these symptoms are transient or predisposes patients to a chronic psychiatric disorder, and confounding variables that may have contributed to the symptoms. These questions can then be points for future research and longitudinal follow-up that can better improve our knowledge about the relationship between this complicated virus and how it affects children psychiatrically.Gingival enlargement may manifest as a side effect of medications (calcium channel blockers, anticonvulsants, or immunosuppressants) and may be associated with inflammation, malignancy, or genetic inheritance. This condition has a significant impact on a patient's quality of life and affects their oral health status. This case report describes the management of a 68-year-old gentleman who presented with generalized gingival enlargement and chronic periapical abscess originating from tooth 34, which served as an abutment for a fixed partial prosthesis. The patient's medical history revealed that felodipine, an antihypertensive medication, was prescribed to him. A comprehensive treatment plan was developed to improve the patient's quality of life.