Simonsenkrog0219

Varicocele is a common condition, estimated to be present in 15% of the general male population. It consists of abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus of the spermatic cord. In adults, varicocele repair may be considered in cases of scrotal pain, or of infertility associated with impaired sperm parameters. Microsurgical varicocelectomy is currently a common method for varicocele repair. Superficial penile vein thrombophlebitis has been previously reported to occur after microsurgical varicocelectomy but has not been well recognized as a possible complication of this surgery. We present three cases of superficial penile vein thrombophlebitis after microsurgical varicocelectomy. Diagnosis on this condition was based on physical examination, mainly a palpable cord-like structure along the involved vein, without overlying redness. Signs and symptoms of superficial penile vein thrombophlebitis resolved after a 4-8-week course of aspirin at the dose of 325 mg daily. Awareness of this possible post-operative complication and its possible management could be helpful to the clinicians involved in the care of patients with varicoceles.Group B Streptococcus (GBS) is a rare but increasingly recognized cause of invasive disease in nonpregnant adults, particularly in the United States. Invasive GBS can take on many forms and may involve virtually any organ system. This case report describes the presentation, diagnosis, and management of a middle-aged male with GBS bacteremia and endocarditis. A 59-year-old Caucasian male with a history of a heart murmur presented to the emergency department (ED) with two weeks of intermittent fevers, chills, rigors, and back pain. He had also become increasingly agitated and confused over this time. His heart murmur was discovered years prior during a work physical examination but was not investigated further. On arrival, he was afebrile but hypotensive and tachycardic. Physical examination revealed petechiae at the bilateral inferior palpebral conjunctivae as well as a grade 2 holosystolic murmur heard best at the apex. Abnormal laboratory findings included leukocytosis, transaminitis, elevated ferritin, and fections. Otherwise healthy patients with invasive GBS should undergo a comprehensive workup for potential underlying chronic illnesses. In the proper clinical context, conjunctival petechiae should elicit concern for infective endocarditis as they are present at a rate similar to that of Janeway lesions, splinter hemorrhages, and Roth spots.Bardet-Biedl syndrome (BBS), also known as Laurence-Moon-Bardet-Biedl syndrome, is a unique autosomal recessive genetic disorder that involves multiple organ systems with an incidence under 1/100,000 in Europe and the USA. We present a case of a 27-year-old male with BBS and a past medical history of hypertension. He was diagnosed with BBS when he was a child. His physical examination showed polydactyly in the feet. MEDICA16 His renal ultrasound showed the left kidney with a double collecting system and measured 1.9 × 6.1 × 3.6 cm and extended from the left upper quadrant to the left lower quadrant. His CT of the abdomen showed a horseshoe-shaped kidney with right moiety. Renal abnormalities in BBS have been identified recently. BBS is also associated with various cardiac manifestations such as patent ductus arteriosus, cardiomyopathies, and valvular diseases. BBS requires multidisciplinary management and a close follow-up with a nephrologist to decrease morbidity and mortality. Genetic and molecular mapping of this disorder will aid the understanding of congenital renal ciliopathies.Dermatophytes are fungi that invade and proliferate over structures containing keratin. The potassium hydroxide (KOH) mount is a commonly performed investigation to detect the presence or absence of fungal elements. This study is an attempt to semi-quantify the KOH mount done for dermatophytosis and to validate the Hyphal Index (HI). HI is determined by the number of fungal elements present in the mount, in a method similar to the bacillary index in leprosy. This simple semi-quantification assessment is proposed as a prognostic tool in the management of dermatophytosis.

A hospital's performance regarding the management of hip fractures is based on six key performance indicators (KPIs) which are recorded onto the National Hip Fracture Database (NHFD). The aim of this study was to assess the overall impact of coronavirus disease 2019 (COVID-19) on the management and outcomes of hip fracture patients against a similar period in 2019 by utilizing the KPIs.

Retrospective data collection of hip fracture patients during a six-week (pre-COVID) period in 2019 and a six-week (COVID-19) period in a single orthopedic unit. The following parameters were compared; patient age, time to theater, surgeon operating time, total time in the operating room, time from ward to recovery, time from hospital presentation to theater, and total time from presentation to hospital discharge.

Some 38 patients in the pre-COVID-19 period vs. 27 patients with hip fractures in the COVID-19 period were included in the study. Time from diagnosis to theater and surgeon operating time were similar in both groups. The mean length of stay was 9.3 days vs. a mean of 31.34 days (p = 0.0004) in the COVID-19 and pre-COVID-19 groups respectively. A 30-day mortality was 22.2% (n = 6) in the COVID-19 group vs. 5.3% (n = 2) in the pre-COVID-19 group.

Our study demonstrates that the combination of surgical stress and COVID-19 leads to higher mortality rates. Our hospital's structural reorganization during the pandemic has shown progress in achieving important KPIs and improved short-term outcomes for hip fracture and trauma patients.

Our study demonstrates that the combination of surgical stress and COVID-19 leads to higher mortality rates. Our hospital's structural reorganization during the pandemic has shown progress in achieving important KPIs and improved short-term outcomes for hip fracture and trauma patients.Chronic lymphocytic leukemia is the most common blood cancer in adults. A major cause of morbidity and mortality associated with this cancer stems from opportunistic infections. Similar to many cancers, the inherent effects of battling a raging disease along with the many treatment options causing immunosuppression to lend to the likelihood of obtaining secondary infections. As it is important for physicians to note the ever-increasing secondary complications, which can manifest in the long-term management of immunosuppressed patients, we present a case of an 86-year-old Caucasian female with stable chronic lymphocytic leukemia who developed intermittent presentation of lung abscesses due to growth of atypical Mycobacterium species. With the advent of new treatment options, there has been an increased rate of drug-resistant organisms, lending for the need for more awareness to the severity of these secondary complications and for better options in preventing their occurrence.Median arcuate ligament syndrome refers to anatomical compression of the celiac artery and/or ganglion by fibrous attachments of the median arcuate ligament. It typically presents as a vague constellation of abdominal symptoms that are often initially attributed to various other gastrointestinal pathologies; thus, it can be very difficult to diagnose. We present a case of median arcuate ligament syndrome in a 68-year-old woman, whose diagnosis and treatment were delayed by many years as her symptoms were taught to be the result of functional abdominal pain syndrome, ultimately corrected by laparoscopic decompression of the celiac axis. This case demonstrates that surgical decompression of the celiac axis is an effective treatment for median arcuate ligament syndrome and the importance of continuing to reassess the clinical picture of patients labeled with functional abdominal pain syndrome.Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP) with various hydroxychloroquine (HCQ) doses against a placebo among healthcare personnel (HCP) with high-risk exposure to coronavirus disease 2019 (COVID 19). Methods A phase II, randomized, placebo-controlled trial was conducted including 200 subjects with no active or past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (antibody testing and reverse transcription-polymerase chain reaction (RT-PCR) were taken at the time of enrollment). Subjects of experimental groups one to three received HCQ in various doses and the control group received a placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and by the end of week 12 with RT-PCR or serology testing (COVID-19 IgM/IgG antibody testing). Results Out of the total participants, 146 reported exposure to a confirmed COVID-19 case in the first month, and 192 were exposed by week 12 of the study. Moreover, the precautionary use of personal protective equipment (PPE) significantly varied; initially more than 80% of the exposed HCPs were not ensuring PPE being used by the patients treated by them, which gradually developed over time. Mild treatment-related side effects were observed among the interventional and placebo arm patients. There was no significant clinical benefit of PrEP with HCQ as compared to placebo (p>0.05). Conclusion It is concluded that the PrEP HCQ does not significantly prevent COVID-19 among high-risk HCPs.The Impact of Covid -19 Pandemic on Orthopedic trauma practice An experience at a tertiary care center in Northern India Introduction COVID-19 pandemic and associated lockdown have had drastic effects on the health care system. To dedicate all the staff, residents, interns to covid care and accommodate the escalated inflow of infected persons, most hospitals had to restructure their departments. The orthopedic department was no exception. The present study aimed to evaluate trends in orthopedic trauma cases during two waves of the Covid -19 pandemic.

In this retrospective observational study, the period of lockdown during the first wave of Covid (March 24, 2020, to May 31, 2020 (Period 2)) and the second wave in 2021 was compared with a similar nine weeks interval in 2019 before COVID -19 (Period 1). Demographic details and epidemiological parameters of trauma were collected and compared.

The number of admissions declined from 8.2 admissions/day to 2.3/day and 2.71/day in periods 2 and 3, respectively. Roadside accidents in 73.37% of patients in period 1 reduced to 30.43% and 59 36.2% in period 2 and 3, respectively. After soft tissue injuries, fractures around the hip joint dominated the pattern of injury during the lockdown, while polytrauma significantly decreased compared to the pre-covid era. More than 80% of patients during lockdown were treated conservatively.

Evaluation of differences in injury patterns and method of treatment during distinctive situations arising due to the COVID-19 pandemic will help to judicially plan and formulate protocols for more effective management of patients if similar events arise again.

Evaluation of differences in injury patterns and method of treatment during distinctive situations arising due to the COVID-19 pandemic will help to judicially plan and formulate protocols for more effective management of patients if similar events arise again.