Percutaneous coronary intervention (PCI) has got more benefit as compared to redo CABG in terms of morbidity & mortality in patients presented with degenerated CABG grafts. We report a case of post CABG patient treated successfully with multiple PCI to SVG grafts- 35 years follow up.

Spirituality is a subjective term that differs between individuals. There is existing literature comparing the experiences of African American men and broader groups at historically black colleges and universities (HBCU) and predominately white institutions (PWI) as it relates to spirituality. However, there is little or lacking research that focuses on the experience of African American women. This literature review will document the effectiveness spirituality has on the academic success of African American Women. More research must be done to address the correlation between African American female’s student success and spirituality.

Exceptional neoplasia with perivascular clear cell and epithelioid cell differentiation are diverse and constituted by angiomyolipoma, clear cell “sugar tumour” of pulmonary and extra pulmonary sites, clear cell myomelanocytic tumour of falciform ligament or ligamentum teres and lymphangioleiomyomatosis on account of distinctive histological manifestations. Variable genetic and malignant biological behaviour is exemplified within perivascular epithelioid cell tumours.

Averrhoa bilimbi belongs to the Oxalidacea family of fruits. It was introduced from tropical America but is now pantropic and is cultivated in many Asian countries including the Philippines. Its nutritional and medicinal values are well known, however, due to its high oxalate content, excessive intake can lead to acute kidney injury (AKI). We report a case of AKI after ingestion of kamias (Averrhoa bilimbi) juice. Consent was granted by the patient to share her case with the intent of raising public awareness regarding the dangers of consuming high quantity of Averrhoa bilimbi fruit.

Less than 50 cases of anaplastic lymphoma kinase (ALK) re-arrangement-associated renal cell carcinoma (ALK-RCC) been reported in the literature. ALK-RCC does affect children who have sickle cell trait and also adults with no evidence of sickle cell trait or sickle cell disease. ALK-RCC may be diagnosed incidentally or in individuals who have typical symptoms that simulate those or more common renal tumours.. Diagnosis of ALK-RCC does depend upon histopathology examination, immunohistochemistry studies as well as electron microscopy studies of nephrectomy / biopsy specimens of the kidney lesion that that show: typical pathology examination features of ALK-RCC as described within the text. Immunohistochemistry studies in ALK-RCC tend to show positive staining for: ALK, PAX8, INI1 (Intact), AE1/AE3, CAM5.2, CK7, EMA, LMWCK, P53, +Vimentin, CD10 (this tends to be variable), AMACR (this tends to be variable), and TFE3 (within the majority of the tumour cells). Majority of ALK-RCCs have been localized tumours at the time of initial diagnosis, but some cases of locally advanced tumours or tumours associated with metastases have been reported. There is no consensus opinion on the treatment of ALK-RCC but nephrectomy has been undertaken in most cases with good short term and medium term; nevertheless metastases and death have been reported. Response to utilization of to ALK inhibitor alectinib, as well as ALK Translocation Renal Cell Carcinoma does respond to Crizotinib. Improvements in the outcome of ALK-RCC could possibly be achieved through routine screening of sickle cell trait individuals, routine pre-operative per-cutaneous radiology imaging guided biopsies of all renal lesions, small localized tumours could be treated by (a) partial nephrectomy, or (b) radical nephrectomy, (c) cryotherapy, (d) radiofrequency ablation, (e ) irreversible electroporation plus / minus adjuvant therapy (radiotherapy, chemotherapy or ALK inhibitor plus or minus immunotherapy.