bluuebunny/crossref_metadata_2025 huggingface dataset:
Autoimmune response and myocarditis associated with COVID-19 vaccination
Authors:   Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi ‘an, China., Han Tuo , Wu Haoyu ,   Department of Cardiology, People’s Hospital of Shaanxi Province, Xi ‘an, China., Zhang Yan ,   Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi ‘an, China., Wang Cong-xia ,   Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi ‘an, China.
Published: September 2022

Recently, there have been numerous reports of suspected myocarditis cases following vaccination against Corona Virus Disease 2019 (COVID-19), although the exact mechanism behind it is still unclear [1,2]. Shaw KE and colleagues reported four cases of acute myocarditis that were temporally related to the receiving of COVID-19 vaccine based on their Cardiac Magnetic Resonance (CMR) imaging findings [3]. Among them, two patients with previous COVID-19 infection developed symptoms after the first dose, while the other two patients with no previous COVID-19 infection developed symptoms after the second dose. Therefore, the authors argued that there might be a potential immune-boosting mechanism flowing prior immune exposure or priming.
Epstein-Barr virus-associated lymphoproliferative disorder of donor origin after heart transplantation
Authors:   Cardiovascular Research Institute Basel, Basel, Switzerland, Barkhudaryan Anush , Pfister Otmar ,   Cardiovascular Research Institute Basel, Basel, Switzerland, Drexler Beatrice ,   Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland., Mueller Christian ,   Cardiovascular Research Institute Basel, Basel, Switzerland, Zhou Qian ,   Division of Cardiology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
Published: September 2022

Post-Transplant Lymphoproliferative Disorder (PTLD) represents a group of lymphomas, which may develop after solid organ transplantation and decrease the survival of transplant recipients. The main challenge of treatment is to achieve disease remission by avoiding the risk of allograft rejection. This report describes a successful treatment of PTLD in an adult patient who underwent allogeneic stem cell transplantation as a child and cardiac transplantation as a young adult. We present the case of a 33-year-old female, who was diagnosed with a Diffuse Large B-Cell Lymphoma (DLBCL) triggered by Epstein - Barr virus (EBV) 8 months after receiving orthotopic heart transplantation from an EBV-positive donor. The patient was treated with R-CHOP chemotherapy followed by maintenance therapy with rituximab, resulting in complete morphologic and metabolic remission of the lymphoma. The echocardiographic examinations and routine endomyocardial biopsies performed during and after chemotherapy did not reveal any signs of cardiac allograft rejection. The patient was asymptomatic on Heart Failure (HF) therapy and continued to remain in complete remission after the cancer treatment. This case underlines the importance of timely surveillance and treatment of seronegative patients after receiving EBV-positive donor organs. Keywords: post-transplant lymphoproliferative disorder; EpsteinBarr virus; immunosuppression; cardiac transplantation; chemotherapy
Surgical outcome of septorhinoplasty using spreader graft in patients with nasal obstruction: An institutional study
Authors:   ENT, Consultant, SKS Hospital, Salem, Tamil Nadu, India., Ponnusamy Sabarirajan , Lade Himani ,   ENT, Professor, Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India., Sharma Akriti ,   ENT, Assistant Professor, Department of Otorhinolaryngology, SGT Medical College, Hospital & Research Institute, Village Budhera, Gurugram, Haryana 122505, India., Shareef PK Mohammed ,   ENT, Consultant, Aster MIMS, Kottakal, India., Bhardwaj Rohit ,   ENT, Assistant Professor, Department of Otorhinolaryngology, Army college of medical sciences and Base Hospital, Delhi cantt-10, India.
Published: September 2022

Nasal obstruction is one of the most common complaints of patients in the ENT OPD. The most common causes of nasal obstruction include septal deviation, turbinate hypertrophy, nasal masses and nasal valve narrowing. The nasal valve pathology is often overlooked and attributed wrongly to other factors such as adeviated septum or hypertrophy of turbinates even at the level of tertiary facility [1]. The under addressed problem of internal nasal valve remains a diagnostic and surgical challenge.
Is that a berry?
Authors:   First year, Orthopedic Resident, Oman Medical Specialty Board, Muscat, Oman., A Hala , E Stephen ,   Senior Consultant, Vascular Surgery, Sultan Qaboos University Hospital, Muscat, Oman., R Sameer ,   Consultant, Radiology, Sultan Qaboos University Hospital, Muscat, Oman, M Mohammed ,   Consultant, Orthopedics, Sultan Qaboos University Hospital, Muscat, Oman.
Published: September 2022

A 55-year-old male, smoker, with no other comorbidities, was referred to our hospital with signs and symptoms of acute left lower limb ischemia, which was not salvageable. He underwent an Above Knee Amputation [AKA] to avoid sepsis and relieve pain. He was discharged on therapeutic dose of Rivaroxaban as he had a past history of unprovoked venous thromboembolism. Post AKA, his stump wound was healthy. Two weeks post-op he reported to the emergency with history of swelling and pain on the stump edge. Upon examination, there was 2 by 2 cm collection on the lateral edge of his stump wound. Under local anesthesia, the collection was drained. This was thought to be an infected hematoma. He started regular physiotherapy once the incision site healed.
COVID-19 treatment of pediatric cases: Advantages vs disadvantages
Authors:   Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran., Madani Sedigheh , Shahin Sarvenaz ,   Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran., Malekpour Mohammad-Reza ,   Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran., Rezaei Negar ,   Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Published: September 2022

COVID-19 became the most challenging health, economic, and social problem of the entire world from the beginning of 2020. Despite the first insight about COVID-19 in children, more critical involvement of children was observed. However, World Health Organization has not approved any preventive drug or curative antibiotic for COVID-19 infection [1], and reports on COVID-19 pharmacological treatment in children are limited. Pediatricians have concerns about the effect of common pharmacological treatments of COVID-19 in pediatric cases. Safety and efficacy of pharmacological treatments in hospitalized children are controversial.
Emphysematous cystitis in a renal transplant recipient
Authors:   AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015, Paris, France., Devars Emilie , Guinebert Sylvain ,   AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015, Paris, France., Henon Olivier ,   AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015, Paris, France., Bodard Sylvain ,   AP-HP, Hôpital Necker Enfants Malades, Service d’Imagerie Adulte, F-75015, Paris, France.
Published: September 2022

Emphysematous cystitis is a rare entity characterized by gas inside the bladder and in its wall on CT, the gold standard to establish the diagnosis. Few renal transplant recipients have reported few cases, and none of them had associated diabetes over the last ten years. We report the case of a 64-year-old female who had a history of type 2 diabetes mellitus and who presented emphysematous cystitis nine years after her kidney transplant for chronic interstitial nephropathy. Abbreviations: CBEU: cytobacteriological examination of urine.; CT: Computed Tomography; CECT: Contrast-enhanced computed tomography; CBEU:Cytobacteriological examination of urine
Art and pediatric orthopaedics: Pieter Bruegel and children’s games
Authors:   University of Arizona College of Medicine – Phoenix, 475 N 5th St., Phoenix, AZ 85004, USA., N Vij , M Belthur ,   University of Arizona College of Medicine – Phoenix, 475 N 5th St., Phoenix, AZ 85004, USA., MV Belthur ,   Phoenix Children’s Hospital, Department of Orthopedics, Main Building, Clinic B, 1919 E , Thomas Rd, Phoenix, AZ 85016, USA.
Published: September 2022

Pieter Bruegel’s “The Children’s Games” demonstrates a wide age range of children participating in a known therapeutic and preventative measure --outdoor play. An interpretation of captivating oil-onwood masterpiece in the context of recent pediatric and pediatric orthopedic literature is given. Keywords: art; outdoor play; vitamin D; parent-children relations; pediatric orthopedics.
Chronic venus ulcer pain reduction and full recovery by an autologous blood clot: A case study
Authors:   Wound Management and Tissue Viability Nurse, (West Midlands, UK) Graft-In International, Limassol, Cyprus., Dimitriou Elena
Published: September 2022

Introduction: Venous Leg Ulcers (VLU) can be associated with severe pain, having a tremendous effect on the ulcer treatment and eventually the patient’s quality of life. Dressing removal and procedures are the main cause for VLU pain, however, background pain is common in chronic wounds, with numerous patients needing analgesics to manage the pain. ActiGraft is an autologous whole blood clot, created by the patient’s own peripheral blood, at a point of care to treat cutaneous wounds. ActiGraft mimics the Extracellular Matrix (ECM) by creating a protective scaffold, that promotes the acceleration of the wound healing process. Case study: We here by describe a case study of a 63-year-old patient who exhibits a 1-year-old VLU, that went under advanced treatments previously with no improvement. This was the result of the deterioration of a simple scratch that extended to a spreading wound, covering a large area of the shin. The patient experienced high pain levels and consumed large amounts of analgesics during the past year of his life, with no significant relief. The patient suffered severe pain and was unable to sleep for more than a 3 hour period, every single night. ActiGraft weekly application was able to change the pain form during the first treatment and followingly reduce the pain levels with a constant decrease in wound pain with every application. ActiGraft treatment was able to promote the healing process, achieving a complete wound healing after receiving 16 weeks of constant treatment. Discussion: Pain associated with VLU has a major effect on the patient’s quality of life and can significantly impact the ability to efficiently treat the ulcer. ActiGraft treatment progressed the wound toward complete healing and reduced the pain level from the wound, suggested to have an anti-inflammatory effect, which contributes to the reduction of pain levels and initiating the natural wound healing process. Conclusion: ActiGraft was found to have a significant effect in reducing wound pain levels, having an impact on the patient’s quality of life, and also progressing hard-to-heal wounds toward complete healing. This synergetic effect establishes ActiGraft as an effective wound healing product in patients with multiple comorbidities, who are suffering from severe background pain related to their wound. Keywords: VLU; autologous blood clot; pain.
Renal cell carcinoma, MiTF/TFE3 family translocation-associated subtype
Authors:   Gulbransen Lab, Michigan State University College of Osteopathic Medicine, USA., Chow Aaron , Shaker Nada ,   Department of Pathology, The Ohio State University Wexner Medical Center. Columbus, Ohio, USA., Parwani Anil V ,   Department of Pathology, The Ohio State University Wexner Medical Center. Columbus, Ohio, USA.
Published: September 2022

A 20-year old male presented with right flank pain and hematuria. Initial workup for nephrolithiasis by CT imaging revealed a right renal lower pole mass. Biopsy of the renal mass revealed “clusters of spindle cells and mature fat” with no malignant cells found. Subsequent MRI imaging confirmed the presence of the mass, with concern for an infiltrative process. Therefore, the patient underwent a robotic-assisted right nephrouretectomy that revealed a Micropthlamia Family of Transcription Factor (MiTF) translocation tumor involving the Xp11.2 TFE3 transcription factor, without lymph node involvement. The patient remains asymptomatic without evidence of abdominopelvic or intrathoracic metastatic disease or lymphadenopathy two years post nephrouretectomy
Indirect inguinal hernia of the urinary bladder
Authors:   Department of Surgery, Edward via College of Osteopathic Medicine, Spartanburg, SC, USA., Hopper Wade , Forte Matthew ,   Regional Medical Center, Orangeburg, SC, USA.
Published: September 2022

An 83-year-old man was diagnosed with stage IIIA follicular small cleaved cell lymphoma in June 2021. Treatment with rituximab x4 weekly was initiated. Routine CT scanning was obtained in August 2021 to determine response to treatment. A right-sided indirect inguinal hernia was encountered at this time which had not been present upon prior examinations. The hernia sac was found to contain a significant anterior extension of the urinary bladder. An enlarged prostate was also observed measuring 6.2 cm transversely. The patient experienced no lower urinary tract symptoms at this time. Surgical repair of the hernia was deferred because the patient self-reported minimal discomfort and minimal functional restriction due to the hernia.
An uncommon association of L-asparaginase with gastrointestinal vascular congestion
Authors:   Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), National University Health System, Singapore., Choong Shi Hui Clarice , Teo Winnie ZY ,   Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), National University Health System, Singapore., Yap Eng Soo ,   Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), National University Health System, Singapore.
Published: September 2022

A 71-year-old Chinese female was admitted with nasal symptoms and biopsy of her right nasal mass confirmed extra-nodal Natural Killer/T (NK/T) cell lymphoma. She was commenced on combination chemotherapy regime consisting of Prednisolone, Vincristine and L-asparaginase. Six days after initiation of chemotherapy, she developed an acute onset of generalized 2 abdominal distension with large amount of ascites. A Computed Tomography scan of her abdomen and pelvis showed stomach and proximal small bowel oedema and non-specific hyper densities within her duodenum. A pushed enteroscopy and colonoscopy subsequently showed a highly oedematous gastrointestinal tract, making it extremely challenging to scope. Multiple biopsies of her stomach corpus and fundus were acquired which revealed vascular congestion of the gastric body-type mucosa, with no malignancy involved, demonstrating a rare association of gastrointestinal vascular congestion with L-Asparaginase. Keywords: L-Asparaginase; extra nodal nk/t cell lymphoma; vascular congestion; hypercoagulable state.
An unusual case of empyema with septicaemia secondary to eggerthella lenta
Authors:   Darul sehat Hospital, St-19, KDA Scheme, Abul Asar Hafeez Jalandhari Rd, Block 15 Gulistan-e-Johar, Karachi City, Sindh, Post code 75290, Pakistan., Hussain A B M Arad , Hamdallah Hanady ,   Senior Lecturer, Chester Medical School, University of Chester, Bache Hall, Chester, CH2 1BR, UK., Ponnuswamy Aravind ,   Senior Lecturer, Chester Medical School, University of Chester, Bache Hall, Chester, CH2 1BR, UK.
Published: September 2022

Eggerthella lenta is an anaerobic, non-spore-forming, nonmotile, gram-positive bacillus commensal in human intestine. It causes genitourinary tract infection, abscess, and wound infection but can lead to disseminated life-threatening septicemia. Risk factors to develop infection secondary to E. Lenta are immunocompromised and elderly patients with pre-existing co-morbidities such as cancer and diabetes mellitus.
Right ventricular myxoma: An incidental finding on CT chest lung screen
Authors:   Department of Medicine, Reading Hospital, Reading, PA 19611, USA., DeBoer, DO Rebecca , Reggio Christopher ,   Department of Medicine, Reading Hospital, Reading, PA 19611, USA., Sandhu Charnjeet ,   Department of Cardiology, Reading Hospital, Reading, PA 19611, USA., Fraga Julian Diaz ,   Department of Cardiology, Reading Hospital, Reading, PA 19611, USA.
Published: September 2022

With the rise in screening modalities, incidental findings increase. We present a case of a computed tomography (CT) chest lung cancer screen that resulted in the diagnosis of a right ventricular (RV) myxoma. Echocardiogram and cardiac magnetic resonance imaging (CMR) led to this diagnosis.
Periodontal wound healing: An absolute literature review
Authors:   Post Graduate, Department of Periodontology, Peoples Dental Academy, Bhopal, Madhya Pradesh, India., Srivastava Vishakha , Dwivedi Shivani ,   Professor, Department of Periodontology, Peoples Dental Academy, Bhopal, Madhya Pradesh, India., Sharma Srashti ,   Post Graduate, Department of Periodontology, Peoples Dental Academy, Bhopal, Madhya Pradesh, India.
Published: September 2022

Periodontal healing is a complex process requiring coordinated responses involving gingival epithelium and connective tissue, periodontal ligament, cementum and alveolar bone. The understanding of this process is necessary to visualize the outcome of different periodontal procedures which inhibits the further progression of periodontal disease and restore the lost periodontal structures. The periodontal regeneration is the ideal response for long-term success of the tooth. The newer approach to periodontal regeneration involves the use of biological mediators like attachment proteins, enamel matrix proteins, growth factors and bone morphogenetic proteins which enhances the regenerative potential of the host tissues by providing favourable signals for proliferation and migration of the periodontal ligament cells towards the affected root surface. Keywords: wound healing; regeneration; reattachment; inflammation; granulation; growth factors.
Trastuzumab-related sarcoidosis in patient with breast adenocarcinoma: Case report and review of the literature
Authors:   Departamento de Saúde, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil., PO Oliveira , RC Vitorino ,   Acadêmico de Medicina, Departamento de Saúde, Escola Bahiana de Medicina e Saúde Publica, Salvador, Bahia, Brazil., LA Da Cruz ,   Oncologista, Grupo Baiano de Oncologia (GBO), Feira de Santana, Brazil., RC Silva ,   Membro, Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, Salvador, Bahia, Brazil., EG Dos Santos-Junior ,   Professor de Cardiologia, Departamento de Saúde, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil., RG Figueiredo ,   Professor de Pneumologia, Departamento de Saúde, Programa de Pós-Graduação em Saúde Coletiva (PPGSC-UEFS), Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil.
Published: September 2022

Introduction: Sarcoidosis is a complex systemic granulomatous disease of unknown etiology, characterized by the formation of non-caseous granulomas. It has a biphasic age pattern, with higher incidence in young adults as well as in older people. Trastuzumab is a monoclonal antibody that inhibits the Human Epidermal Growth Factor Receptor (HER2) and there are few reports in the literature concerning sarcoidosis or sarcoidosis-like reactions induced by cancer immunotherapy. Case report: We reported a peculiar association between sarcoidosis and trastuzumab immunotherapy in a 38-year-old woman with breast cancer. Multiple well-defined lung nodules in a perilymphatic distribution were seen in association with opacities that tended to merge to form nodular images with irregular outlines, the so-called galaxy sign, in the posterior part of the upper left lobe. Conclusion: Herein, we also briefly review the role of neoplasic factors in sarcoidosis and immunopathological triggers to the development of granulomas in patients under trastuzumab therapy. Keywords: sarcoidosis; breast cancer; neoplasis; monoclonal antibody; trastuzumab
The SARS-CoV-2 manifestations within the oral cavity
Authors:   Department of Immunology, School of Public Health, Tehran University of Medical Sciences. Tehran, Iran., Jadali Zohreh
Published: September 2022

The COVID-19 pandemic that began on 31 December 2019 is considered as the world’s most deadly infectious disease of the century. COVID-19 is predominantly a respiratory disease, but it can really affect any organ in the body. This capability depends on several factors such as the method that is utilised by the virus for cell entry. The virus binds to Angiotens in Converting Enzyme 2 (ACE2) receptors which are present in many cell types and tissues including salivary glands and oral mucosal epithelia [1]. It is therefore not surprising that several tissues in the oral cavity could be a target of SARS-CoV-2 infection. Patients with COVID-19 show wide range of oral manifestations, that has become a major concern for the dental and oral health specialists. The majority of oral health conditions in patients with COVID-19 are: aphthous-like ulcers, herpes-like lesions, fungal infections, glossitis/depapillation/geographic tongue, parotitis and angular cheilitis. These signs and symptoms can be detected in different anatomical subsites of the oral cavity such as oral mucosa, tongue, palate, gingiva and lips [1]. Brandão et al. have shown that older patients with severe form of disease tend to have more severe and widespread oral lesions [2].
A rare coexistence of ankylosing spondylitis and SCD: Pitfalls and challenges during THA
Authors:   Founder and Chairman, Shalby Hospital, Ahmedabad, India., Shah Vikram I , Pachore Javahir A ,   Director of Hip Surgery and Head of Department of Orthopaedics, Shalby Hospital, Ahmedabad, India., Patil Jayesh ,   Senior Consultant Joint Replacement, Shalby Hospital, Ahmedabad, India, Rajani Darshan ,   Resident, Department of Orthopaedics, Shalby Hospital, Ahmedabad, India., M Shetty Gautam ,   Consultant Orthopaedic Surgeon, Knee and Orthopaedic Clinic, Mumbai, India
Published: September 2022

The co-existence of Ankylosing Spondylitis (AS) and Sickle Cell Disease (SCD) is extremely rare, and the case of such a patient undergoing Total Hip Arthroplasty (THA) has never been reported. We present a case report of a 39-year-old male with co-existing AS and SCD who underwent staged bilateral THA with good clinical and radiographic outcomes at 5 years follow-up. Co-existing AS and SCD can present unique intraoperative surgical challenges in patients undergoing THA as seen in our patient, and the establishment of perioperative management guidelines may help prevent complications. Keywords: ankylosing spondylitis; sickle cell disease (SCD); total hip arthroplasty (THA); hip.
Full mouth rehabilitation with immediate loading implants
Authors:   Professor of Restorative Dentistry, Dental Implant Consultant, Faculty of Dentistry, Sana’a University, Sana’a, Yemen., I Al-kholani Abdulwahab , A Al-Maghreby Soumia ,   Professor, Abdulwahab Al-kholani Dental Center, Sana’a, Yemen.
Published: September 2022

Implant-supported fixed prosthodontics are successful treatment modalities that can be used for full mouth rehabilitation. According to the patient’s wishes, great concern was given to the esthetic and function. The purpose of this study is to report the clinical outcomes of fullmouth rehabilitation using flapless implant placement and immediate loading prosthesis in patients with the complete destruction of permanent dentition in which 16 single piece implants were placed in the extraction sockets eight implants in each jawand functionally loaded with both maxillary and mandibular fixed prosthesis. This is considered an ideal method and gives successful treatment results, with a significant improvement of oral function, esthetic, and quality of life. Keywords: immediate loading implant; full-mouth rehabilitation; implant-supported fixed prosthodontics.
Acute motor weakness of lower extremity after a novel balloon-inflatable catheter for percutaneous epidural adhesiolysis and decompression: A case report
Authors:   Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha university School of Medicine, Inhang-ro 27, Jung-gu, Incheon, 22332, Korea, Yang Chun Woo , Kim Na Eun ,   Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha university School of Medicine, Inhang-ro 27, Jung-gu, Incheon, 22332, Korea, Kwon Hye Rim ,   Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha university School of Medicine, Inhang-ro 27, Jung-gu, Incheon, 22332, Korea, Lee Sunhee ,   Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha university School of Medicine, Inhang-ro 27, Jung-gu, Incheon, 22332, Korea, Park Ji Sung ,   Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha university School of Medicine, Inhang-ro 27, Jung-gu, Incheon, 22332, Korea, Kim Byung Gun ,   Department of Anesthesiology and Pain Medicine, Inha University Hospital, Inha university School of Medicine, Inhang-ro 27, Jung-gu, Incheon, 22332, Korea
Published: September 2022

Background: As our population ages and the rate of spine surgery continues to rise, the use of epidural lysis of adhesions has emerged as a popular treatment for spinal stenosis and disc herniation. Percutaneous Epidural Adhesiolysis (PEA) causes pain by preventing the release of increased spinal nerve movement and nerve sensitivity due to nerve compression. PEA and decompression with a newly developed inflatable balloon catheter have been widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. Case presentation: A 64-year-old female patient who had lower back pain and right buttock pain radiating to the leg caused by an L4- L5 severe spinal stenosis underwent PEA and decompression using a Zigzag-motion Inflatable Neuroplasty (ZiNeu®, JUVENUI, Seoul, Korea) catheter. After the procedure, the patient complained of acute motor weakness in the right leg. After conservative treatment, motor weakness and paresthesia gradually improved over time. At the follow-up visit after 3 weeks, there were no signs of motor or sensory abnormalities. Conclusions: Practitioners should be aware that these complications can occur at any time, and a skilled practitioner should undertake the procedure. Keywords: cute motor weakness; percutaneous epidural adhesiolysis and decompression; spinal stenosis. Abbreviations: HIVD: Herniated Intervertebral Disc; MRI: Magnetic Resonance Imaging; NRS: Numeric Rating Scale; ODI: Oswestry Disability Index; PEA: Percutaneous Epidural Adhesiolysis.
Psychological effects of burnout among health workers
Authors:   Department of Psychology, University of Ghana, Legon-Accra, Ghana., Yeboah Elizabeth , Arboh Francisca ,   Department of Management Science and Engineering, Jiangsu University, Jiangsu, China., Quainoo Eric Atta ,   Faculty of Education, Beijing Normal University, Beijing, China.
Published: September 2022

Stress and burnout among human service professionals have been considered by researchers as an endemic affecting the quality-of-service delivery within the profession. A cross-sectional survey research method through a quantitative approach was used in exploring the psychological effects of burnout among health professionals. Through stratified and simple random sampling procedures, 150 health workers (90 from Korle-Bu Teaching Hospital and 60 from Ridge Hospital) were sampled and responded to a standardized burnout questionnaire designed by Maslach (Maslach burnout inventory 2008). Frequencies, percentages, means, standard deviation, and t-test were used to analyze the data. The findings of the study rejected the hypothesis that experienced doctors will experience less burnout than inexperienced doctors. Again, the finding of the study indicated that there is an age barrier when it comes to burnout, thus, younger health workers experience burnout more than older health workers. The outcome of the study further rejected the fact that there is a correlation between gender and the level of burnout. The study concluded that as burnout was closely related to age and experience as a more source of stress and burnout among doctors, management and staff of the health institution must consider appropriate measures to alleviate job stress and burnout. Keywords: Stress; Burnout; Health workers.
Remodelled multiple linear regression equation for stent size calculations of left anterior descending artery (LAD-proximal) dimensions with single vessel disease
Authors:   Department of Anatomy, Yenepoya Medical College, Karnataka, India., A Divia Paul , SM Ashraf ,   Department of Cardio Vascular Sciences, Sahakarana Hrudayalaya, Pariyaram Medical college, Kerala, India., Das Ranajit ,   Yenepoya Research Centre, Yenepoya University, Deralakatte, Mangalore -575018, Karnataka, India., Prabhu Ashwini ,   Yenepoya Research Centre, Yenepoya University, Deralakatte, Mangalore -575018, Karnataka, India.
Published: September 2022

Purpose of research: To validate the Multiple Linear Regression Equation (MLR) of predicted dimensions of left anterior descending coronary artery (LAD-o, p) and left circumflex artery (LCx-o, p) by remodelling the equation based on the percentage of stenosis present in the artery segments. This helped us to go forward with an objective to explore the possibility of explaining the relationship with a MLR formula, to estimate the reference diameter of a stenosed coronary artery when the other two arteries are normal. Materials and methods: Patients who undergo Percutaneous Coronary Angioplasty (PCI) procedure were included from single study centre of South India after obtaining the ethical clearance through proper channels. Total n=104 cases who have undergone PCI in LAD-p were studied prospectively. Informed consent was obtained. Exclusion criteria’s were post CABG and post PCI patients. The parameters assessed and categorized were coronary artery measurements of non-diseased segments from Single Vessel Diseased Coronaries (SVD) after excluding the diseased segments. Results and conclusions: The initial participant predicted equation for LAD-p was remodelled after validation by considering the difference between stent size estimated (calculated) and stent reduction category. Participant predicted equation: LAD-p=1.092+0.302*LMCA+0.379 * LCx-p. F (2,101) = 1340, p<0.0001; with an R2 of 0.9637. Age and gender had no significant change while taking in to consideration for remodelling (p =0.17). PCI was found to be safe and effective in our routine clinical setting during the validation of the estimated MLR formula and was valuable in detecting the artery diameter in stenosed SVD of LAD-p. Keywords: Percutaneous coronary angioplasty; Multiple linear regression equation; Left anterior descending artery; Single vessel diseased coronaries; Stenting strategies.
Unclassified testicular sex cord-stromal tumors in children
Authors:   Urologist, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Azucena Lirio Armas Alvarez , Angel Alois Osorio Manyari ,   General Surgeon, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Cruz Santiago Moreno Pérez De la ,   Urologist, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Irache Abaigar Pedraza ,   Urologist, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Juan José Camacho Monge ,   Urologist, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Victoria Pérez Holgado ,   Pathologist, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Pedro Pérez Cidoncha ,   Chief of the Pathology Department, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain., Andrés López de Alda González ,   Chief of the Urology Department, Hospital de Don Benito-Villanueva de la Serena, Badajoz, Spain.
Published: September 2022

We report a case of 12-year-old boy diagnosed with an unclassified sex cord stromal testicular tumor after a mild testicular trauma and the unclear ultrasound finding of a testicular mass. Physical examination was significant for a mass in the right testis. Scrotal magnetic resonance revealed an 8 millimeters nodular lesion suggestive of a Leydig cell tumor. Tumor markers were negative. The patient underwent a right radical orchiectomy plus implantation of a testicular prosthesis. Tumor cells expressed inhibin, WT 1, CD 56, CD99, vimentin and actin. Pathological diagnosis was unclassified sex cord stromal tumor confined to the testis. Metastatic workup by CT was negative. Unclassified sex cord-stromal tumors are infrequent and show an indeterminate differentiation of tumor cells that cannot be characterized with light microscopy towards Leydig, Sertoli, granulosa or theca cells. Immunohistochemistry helps in the differential diagnosis.Due to the risk of malignancy, local recurrence and uncertain biological behavior, radical orchiectomy is recommended, and a metastatic workup should be performed. Keywords: children; orchiectomy; sex cord-stromal tumor; scrotal ultrasound; testicular tumor
Thoracoscopic removal of a posterior mediastinal parathyroid adenoma
Authors:   Thoracic Surgery Department, Abderrahmen Mami University Hospital, Ariana, Tunisia, Zribi Hazem , Dahmane Mariem Hadj ,   Thoracic Surgery Department, Abderrahmen Mami University Hospital, Ariana, Tunisia, Bouassida Imen ,   Thoracic Surgery Department, Abderrahmen Mami University Hospital, Ariana, Tunisia, Abdennadher Mahdi ,   Thoracic Surgery Department, Abderrahmen Mami University Hospital, Ariana, Tunisia, Sellem Dorra Ben ,   Nuclear Medicine Department, Salah AZAIEZ Institute, Tunis, Tunisia., Dridi Amira ,   Anesthesiology and Reanimation Department, Abderrahmen Mami University Hospital, Ariana, Tunisia., E Mazni Faouzi ,   Department of Anatomical Pathology, Abderrahmen Mami University Hospital, Ariana, Tunisia., Marghli Adel ,   Thoracic Surgery Department, Abderrahmen Mami University Hospital, Ariana, Tunisia
Published: September 2022

Ectopic Parathyroid Adenomas (EPA) can occur in many anatomical locations and the most frequent one was the mediastinum region. Traditionally, the adenoma resection has been performed through conventional thoracotomy or sternotomy. Recently, a few cases of thoracoscopic excision of mediastinal adenoma were reported. We report here the case of a successful exclusive thoracoscopic removal of a mediastinal parathyroid adenoma. A 58-year-old female patient presented with bilateral renal stones and fatigue. Biology results showed elevated serum calcium and parathyroid hormone levels. The diagnosis of primary hyperparathyroidism caused by solitary EPA in lateralesophageal region was confirmed by imaging tools. The patient underwent successful thoracoscopic resection. He was discharged on the 2rd postoperative day. Keywords: primary hyperparathyroidism; parathyroid adenoma; mediastinum; thoracoscopic excision.
A case of accidental dental prosthesis ingestion
Authors:   Intensive Rehabilitation Unit S AnnaInstitute, 88900, Crotone, Italy., Pugliese Maria Elena , Battaglia Enrico ,   Sapienza University of Rome, 00161, Rome, Italy
Published: September 2022

A sixty years old patient was admitted to our intensive rehabilitation department after a right nucleo-capsular hemorrhagic stroke. He was affected by hypertension, paroxysmal atrial fibrillation, recent infective pneumonia. The day after admission missing of upper fixed dental prosthesis was noticed during neurological evaluation. The patient was asymptomatic with normal oxygen saturation while breathing in ambient air. An urgent chest x-ray was performed. Displaced dental prosthesis at hypo-pharynx tract was noticed. Endoscopic extraction of the foreign body was performed without complications and the patient was able to continue his rehabilitative course.
Caseous calcification of the mitral annulus presenting with symptomatic complete heart block
Authors:   Associated Professor of Cardiology, Shiraz University of Medical Science, Non-Communicable Diseases Research Center, Iran., Hossein Nikoo Mohammad , Danesh Sina ,   Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran., Abtahi Firoozeh ,   Cardiology Department, Cardiovascular Research Center Shiraz University of Medical Sciences, Iran.
Published: September 2022

Mitral Annular Calcification (MAC) could even be a chronic, degenerative process of the fibrous support structure of the mitral valve [1,2]. MAC is usually visualized on echocardiography as an echo-dense shelf-like structure with an irregular, lumpy appearance involving the mitral valve annulus, with associated acoustic shadowing. within the Cardiovascular Health Study [3], MAC was quantified as mild (focal, limited increase in echodensity of the mitral annulus), moderate (marked echodensity involving one third to a minimum of 1 half the ring circumference), or severe (marked echodensity involving quite half the ring, or with intrusion into the left ventricular [LV] inflow tract).
Roseomonas gilardii bacteremia: A case report and literature review
Authors:   Sentara Albemarle Medical Center Elizabeth City, North Carolina, USA., Hussain Ali , Hussain Munawwar ,   UAMS Medical Center Little Rock, Arkansa, USA., Aron Upasana ,   Sentara Albemarle Medical Center Elizabeth City, North Carolina, USA., Tahir Hassan ,   Lake Cumberland Regional Hospital Somerset, Kentucky, USA.
Published: September 2022

Bacteremia is a known complication of long-term central venous catheters and one of the most common reasons for removal. Usually, the infection happens after contamination from the skin during handling and rarely from the environmental organism. Roseomonas gilardii is a non-fermentative, oxidative Gram-negative coccobacillus. Roseomonas has been described in the literature as a rare opportunistic pathogen to cause bacteremia in the immunocompromised host. Herein, we report the case of a 67-year-old male who presented to ER with fever, nausea, and vomiting. He has been diagnosed with Roseomonas gilardii bacteremia from port infection in a small community hospital.
Severe lymphedema mass of the right forearm
Authors:   Wyckoff Health Medical Center, Brooklyn, New York, USA., Landa Eric
Published: September 2022

Lymphedema can be divided into primary and secondary lymphedema depending on the underlying cause. It is a common instance often seen after breast surgery with resulting lymphedema of the adjacent upper extremity. Here we present an astonishing case of 56 year old women who presented with a massive lymphedema mass in the right forearm which had chronically increased in size post chemotherapy treatment for right sided breast cancer and mastectomy of the same breast 20 years ago.
Analysis of clinical characteristics of subacute combined degeneration on three cases of delayed diagnosis
Authors:   Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu 215006, China., Tang Anqi , Li Tan ,   Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu 215006, China., Ding Qianqian ,   Department of Neurology, Suzhou Wuzhong People’s Hospital, 61 Dongwu North Road, Suzhou, Jiangsu 215128, China., Wang Zhi ,   Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu 215006, China., Liu Yuan ,   Department of Neurology, Suzhou Ninth People’s Hospital, 2688 Ludang Road, Suzhou, Jiangsu, 215200, China., Cai Xiuying ,   Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu 215006, China.
Published: September 2022

Purpose: Subacute Combined Degeneration (SCD) is a kind of neurodegenerative diseases which is easy to be misdiagnosed because of some promiscuous symptoms and atypical laboratory test results. The prognosis would be poor if patients had clinical symptoms of myelopathy for a long time. Therefore, doctors should combine pre-existing conditions, clinical symptoms and correlated laboratory examinations to make definite diagnosis quickly and accurately. Case report: Three middle-aged patients aged from 41 to 63, one male and two females were diagnosed SCD with progressive ascending numbness in four limbs or both legs. For some reason, none of them got the right diagnosis in the first place. In case 1, blood cell analysis revealed a decrease in three series including white blood cells, platelets and hemoglobin. In case 2, the blood cell analysis of the patient did not show signs of anemia at all. While the initial clinical symptom in case 3 was just a mild psychiatric symptom. Although their final diagnosis were clear, the failure not to take SCD into consideration at the first time was worthy of reflection. Fortunately, their neurological status improved after vitamin B12 supplementation. Conclusion: Usually, some confusing symptoms and a typical laboratory may make SCD easy to be misdiagnosed. Early diagnosis and treatment are critical to the prognosis. Thus, the clinicians must capture the related clinical characteristics. Keywords: subacute combined degeneration; vitamin b12 deficiency; clinical characteristics.
The social effects and potential value of combination of Chinese herbal medicine with internet hospitals during the COVID-19 epidemic
Authors:   Department of Traditional Chinese Medicine, The Affiliated Bao’an Hospital of Shenzhen, Shenzhen, 518100, China., Huang Chao , Huang Weixuan ,   Department of Traditional Chinese Medicine, The Affiliated Bao’an Hospital of Shenzhen, Shenzhen, 518100, China., Liu Haosheng ,   Department of Traditional Chinese Medicine, The Affiliated Bao’an Hospital of Shenzhen, Shenzhen, 518100, China., Chen Zhaoxin ,   Department of Traditional Chinese Medicine, The Affiliated Bao’an Hospital of Shenzhen, Shenzhen, 518100, China., Sun Ying ,   Department of Traditional Chinese Medicine, The Affiliated Bao’an Hospital of Shenzhen, Shenzhen, 518100, China., Shen Weizeng ,   Department of Traditional Chinese Medicine, The Affiliated Bao’an Hospital of Shenzhen, Shenzhen, 518100, China.
Published: September 2022

Background and objective: The diagnosis and treatment of other common and chronic diseases under circumstances of COVID-19 epidemic is very serious. This study aimed to summarize and assess the social effects and potential value of combination of Internet hospital with Chinese herbs on the patients suffering from common and chronic diseases. Methods: We collected and evaluated daily data including manner seeing a doctor online, ages, gender, pattern of payment, and way getting the medicine. In addition, number of diseases diagnosed, areas of Chinese herbs delivered, and composition and quantity of these drugs were also computed. Results: Physicians in Internet hospital provided online medical services to 1888 visitors daily through image-text consultation and video interrogation. The diseases included insomnia, distention and fullness, emmeniopathy. The Chinese herbs prescribed were delivered by SF-Express to Guangdong and outside, especially in Shenzhen. The prescriptions were up to 599. Six kinds of scented teas comprised by Chinese herbs were produced and extensively sold in and around Shenzhen through this Internet platform. Conclusions: The combination of Internet hospital with TCM is very promising, contributing to control of COVID-19 epidemic and producing new industries which drive economic recovery. Keywords: COVID-19; internet hospital; traditional chinese medicine; chronic diseases; epidemic.
Appendicitis in a drain-site hernia
Authors:   ST3 General Surgery, North Lincolnshire and Goole NHS Trust, England., Ashmore Christopher , Miller Andrew ,   Honorary Associate Professor of Colorectal Surgery, University Hospitals of Leicester NHS Trust, England., Couch Daniel ,   ST8 Colorectal surgery, University Hospitals of Leicester NHS Trust, England.
Published: September 2022

A 73 year old woman underwent a Hartmann’s procedure for stricturing ulcerative colitis of the sigmoid colon. Following the procedure, she developed a tender, ruborous lump in the right lower quadrant, at the site of a recently removed silicone (Blake) abdominal drain. Computed tomographic images revealed herniation of the vermiform appendix in to the tract created by the abdominal drain. A diagnosis was made of acute appendicitis secondary to herniation of the vermiform appendix. The patient was managed conservatively with antibiotics, permitting the formation of an appendico-cutaneous fistula. Keywords: appendicitis; abdominal drains; drain-site hernia; vermiform appendix; complications.
Correlation analysis of TCM syndrome characteristics and high risk factors of patients with colorectal polyps in Shenzhen: A case retrospective study
Authors:   Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Shenzhen University (People’s Hospital of Shenzhen Baoan District), Shenzhen 518100, China., Sun Ying , Huang Chao ,   Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Shenzhen University (People’s Hospital of Shenzhen Baoan District), Shenzhen 518100, China.
Published: September 2022

Objective: To analyze the characteristics of Traditional Chinese Medicine (TCM) asthenia- and sthenia-syndrome and its correlation with high-risk factors in patients with colorectal polyps in Shenzhen through case retrospective study Methods: 296 eligible patients hospitalized were collected in the Department of TCM in People’s Hospital of Shenzhen Baoan District from January 2016 to June 2021, and diagnosed with intestinal polyps, and divided into deficiency-syndrome, sthenia-syndrome and Asthenia-Syndrome Accompanied With Sthenia-Syndrome (ASASS). In addition, the correlation between syndromes and hyperglycemia, hypertension, hyperlipidemia and hyperuricemia was also analyzed. Results: There were 37 patients with ASASS, among which deficiency of vital energy and blood stasis accounted for the highest proportion. For patients with ASASS, the age difference among different syndromes was statistically significant (P<0.05). The proportion of patients with hypertension and sthenia of liver yang was significantly higher than that of other syndromes (P<0.05). Conclusion: Patients with colorectal polyps in Shenzhen area are mainly deficiency of vital energy and phlegm-wetness, and the pathological factors involve phlegm-dampness, blood stasis and stagnation of vital energy. Age and hypertension should be considered in the treatment of ASASS. Keywords: colorectal polyps; TCM syndrome; asthenia-syndrome accompanied with sthenia-syndrome; deficiency of vital energy; Shenzhen.