Romerotruelsen2064
Malignancy associated pericardial effusion is a serious condition and testifies to poor prognosis. Cardiac tamponade can be the first presentation of underlying adenocarcinoma of the lung. We present a 78-year-old female with no known history of any malignancy, who presented with symptoms of abdominal and respiratory pathology. The physical exam findings were significant for a possible cardiac tamponade. Computed tomography (CT) of the abdomen and chest confirmed moderate bilateral pleural effusions, large pericardial effusion, left upper lobe mass, possible lymphangitic spread of carcinoma in the left lung, and adenopathy in the mediastinum. The echocardiography findings further confirmed tamponade. Cardiology and pulmonary medicine were taken on board for a possible malignancy associated pleural effusion leading to cardiac tamponade. Pericardial fluid analysis showed atypical cells suggestive of malignancy. Transbronchial biopsy confirmed moderately differentiated invasive adenocarcinoma. Positron emission tomography (PET) scan revealed metastatic spread to the mediastinum and right hilum with possible pleural metastatic disease seen posteriorly in the left hemithorax. The patient was discharged home with oncology follow up for chemotherapy.Objective The effectiveness of the flipped classroom is currently debated due to conflicting results from different studies. It is therefore important to evaluate its usefulness each time it is applied in a new setting. Thus, this study was conducted with the objective of evaluating the effectiveness and acceptability of the flipped classroom in undergraduate medical education at the College of Medicine, Alfaisal University. Methods This was a quasi-experimental study consisting of development and administration of a flipped classroom with one group of students receiving the flipped classroom (FG) and the other group with the traditional lecture-based teaching (LG). We compared the pre-university enrolment Cumulative Grade Point Average (CGPA), preceding progress test results and previous semester performance for the two groups, which showed no statistical difference. Results Since the FG had received the video lecture while the LG had not, there was a clear statistical difference between the groups with FG showing better performance in pre-test scores. The post-test performances were marginally not statistically different between FG and LG groups. Conclusion Our results did not show any long-term benefit of a flipped classroom in terms of retention of knowledge as manifested by grades obtained in midterm and final examinations. It was also not received positively by the students.Background Birth asphyxia is a major cause of early neonatal death and leads to severe consequences such as epilepsy, cerebral palsy, and developmental delay. This study aims to determine the correlation between dyselectrolytemia and the degree of hypoxic-ischemic encephalopathy (HIE) and to find out major risk factors contributing to the severity of HIE and neonatal death. Methods In this prospective cohort study (n=150), term babies weighing ≥ 2.5 kg at birth, with the diagnosis of birth asphyxia, admitted in a medical college in Odisha state from September 2014 to August 2016 were included. Clinical findings, biochemical parameters, treatment, and outcome of HIE babies were recorded. Result The majority of the asphyxiated babies were having moderate HIE (HIE II) (57.33%), whereas mild and severe stages were seen in 15.33%, and 27.34% of babies, respectively. Factors like prolonged labor (87.8%) and meconium-stained liquor (63.4%) were mostly attributed to the severe degree of birth asphyxia (p less then y and long-term neurological sequelae.Plasmodium vivax (P. vivax) is the most common cause of malaria in Pakistan. Several cases of severe malaria due to P.vivax have been reported from Pakistan and India, however morphological characteristics of the parasite have been mainly ignored. We present two cases of P. vivax mono-infection, which were characterized by multiple infected red blood cells, similar to that seen in Plasmodium falciparum, as observed under microscopy. Both cases were confirmed as mono-infection of P.vivax on Giemsa stained thick and thin films, malaria rapid diagnostic test (RDT) and Polymerase Chain Reaction (PCR). Morphology on peripheral blood smear remains the gold standard for diagnosis of malaria and mimicking morphological features leads to misdiagnosis and mismanagement of patients.Gout is one of the most common diseases affecting men globally due to the spread of unhealthy dietary habits, kidney disease, and the use of diuretics. It is characterized as having monosodium crystals depositions in the synovial fluid, which causes an inflammatory response and painful joints. Most of the time, it can be found affecting the first metatarsophalangeal joint or other large joints in concurrence with other disorders. Tamoxifen chemical Non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, and steroids have been known to suppress such events in most cases without the need for any surgical intervention. We present a case of a 44-years-old medically free healthy male who presented with a case of gouty arthritis in the second distal interphalangeal joint. Initially, colchicine treatment was given along with NSAIDs, but symptoms failed to subside. After a persistent increase of swelling and pain, the surgical evacuation was sought to reduce the pain and exclude any other causes of arthritis. Histopathology report confirmed the presence of monosodium urate crystals without any signs of infection. In conclusion, surgical intervention of gouty arthritis can be beneficial in cases of persistent pain and increasing rate of swelling despite the medicinal trial, especially in unusual cases of gouty arthritis such as gout of the second metatarsophalangeal joint.The association of polycythemia vera (PV) and localized prostate cancer is uncommon. PV is one of the myeloproliferative neoplasms that is characterized by an increased red cell mass and uncontrolled formation of blood cells owing to an acquired mutation in Janus kinase-2. PV has numerous complications and could raise the hazard of other tumors. Here, we report an extremely rare association of localized prostate cancer in a 62-year-old male with PV. He was treated by CyberKnife surgery and completed four doses of goserelin and radiotherapy, his follow up Magnetic Resonance Imaging (MRI) four months after completion of treatment showed no recurrence, and the PV was treated with hydroxyurea 500 mg twice per day and repeated phlebotomies, when needed, to keep his hematocrit level under 45%.