A 16-year-old male presented with constipation, acute retention of urine and abdominal swelling associated with pain. Per-rectal examination revealed painful growth in lateral and anterior wall of rectum 4cm from anal verge. X-ray erect abdomen was done which showed Indistinct bowel gas pattern suggestive of Intestinal obstruction. Diversion transverse colostomy was done in view of acute intestinal obstruction. Investigations revealed large well defined exophytic heterogenous lesion arising from lateral wall of rectum with normal CEA levels. Biopsy revealed small round blue cell tumour which was positive for Pan CK and CD99. He was planned for 6 cycles of Neoadjuvant chemotherapy (NACT) with VAC IE followed by reassessment for local therapy followed by adjuvant chemotherapy with 8 cycles of VAC IE. He received 6 cycles of VAC IE and Definitive radiation therapy 45Gy in 25 fractions by 3DCRT. After completion of radiation therapy, he received 8 more cycles of VAC IE in TATA memorial hospital. We present this case report, due to the rarity of Extraosseous Ewing’s sarcoma (EES)of the rectum.

STS represents a heterogenous group of malignancies with varying pathological grades, sites of origin and histologies. In the olden days, treatment consisted of resections and amputation which led to significant detriment in quality of life(QoL) and structural functions . Here we present a case of 49 year old patients who came with complaints of painless, progressive swelling in the right upper arm. He underwent WLE followed by intraoperative brachytherapy catheter application. He was then planned for HDR brachytherapy 34 Gy in 10 fractions 4 days following surgery. He tolerated the treatment well, the surgical scar healed by primary intention with no complication during or after the procedure. It can be concluded that brachytherapy in soft tissue sarcoma is a feasible option and an effective modality in the treatment of extremity soft tissue sarcoma with adequate local control.

STS represents a heterogenous group of malignancies with varying pathological grades, sites of origin and histologies. In the olden days, treatment consisted of resections and amputation which led to significant detriment in quality of life(QoL) and structural functions . Here we present a case of 49 year old patients who came with complaints of painless, progressive swelling in the right upper arm. He underwent WLE followed by intraoperative brachytherapy catheter application. He was then planned for HDR brachytherapy 34 Gy in 10 fractions 4 days following surgery. He tolerated the treatment well, the surgical scar healed by primary intention with no complication during or after the procedure. It can be concluded that brachytherapy in soft tissue sarcoma is a feasible option and an effective modality in the treatment of extremity soft tissue sarcoma with adequate local control.

Achalasia is a rare chronic esophageal disease that affects the relaxation function of the lower esophageal sphincter (LES) and peristaltic motility of the esophagus. Surgical treatment, especially laparoscopic esophageal myotomy, has been shown to be highly effective in relieving symptoms and improving esophageal function. Although there are different surgical approaches, the choice of treatment should be based on the experience of the surgeon and the individual characteristics of the patient. Long-term follow-up and consideration of complementary measures are crucial to achieve optimal results in the management of achalasia

Ovarian carcinomas are the most fatal among malignancies of female reproductive tract. The most prevalent type of ovarian cancer, high grade serous carcinoma, has a complex mechanism of carcinogenesis and a poor outcome. However, in recent years, increasing evidence has suggested that tubal fimbriae lesions may be precursor lesions for ovarian high grade serous carcinoma. Here we report a case of high grade serous carcinoma ovary arising from fallopian tube in a 60 year old post menopausal woman.

Tamaka Swasa is described as one of the five varieties of swasa mentioned in various Ayurvedic classics like Charaka Samhita, Susruta Samhita, Astanga Hrdaya, Madhava Nidana etc. In classics various single/multiple herbs and minerals has been well establish in the practice of Ayurveda. In the present study an open clinical trial has been made in 100 (one hundred) patients of bronchial asthma with an attempt to explore the efficacy of polyherbal formulation in the management of bronchial asthma. The polyherbal formulation is prepared in coarse powder and made it into kwath (decoction) form by boiling 10 gms in 200ml of water for 5-10 minutes or more till concentrated by evaporation to 50 ml. The decoctions is then keep for cooling for some time and is advice to take twice daily preferably after food continuously for three months. The result after completion of the treatment in all sign and symptoms following inclusion and exclusion criteria is seen to be so satisfactory and encouraging and further no adverse or side effect was observed in any of the patient in the entire study.

Background: One of the strong bands of tissue that help connect your thigh bone (femur) to your shinbone (tibia) can be torn or sprained, and this is known as an anterior cruciate ligament (ACL) injury (tibia). Objective: To assess the demographic status of patients with ACL injury in tertiary hospital Bangladesh. Methods: This prospective observational study was carried out at National Institute of Traumatology and Orthoapedic Rehabilitation, Dhaka from January 2019 to December 2020. A total case of 30 in group 1 (Hamstring tendon) and 30 in group 2 (Peroneus longus tendon) is included in the study according to inclusion and exclusion criteria. Results: Mean age was 25.45 ± 0.93 years with male pre-dominance (96.67%). In both groups male patients were mostly common, group-1, 93.33% and group-2, 100%. Right knees were affected more (58%) in comparison to left knees (42%). The cause of injury which was mostly sports-related injuries (78.33%) and the injury was more common among students (43.33%). Conclusion: From our study we can say that, young age people and male patients were mostly affected. In addition to that, right knee was mostly injured and sports-related injuries were common among students.

The rapid intubation sequence (RISS) in children is a fundamental procedure used in emergency situations and pediatric critical care to ensure a safe airway and establish effective mechanical ventilation. This study aims to provide a comprehensive and up-to-date review of SIR in children, focusing on key aspects related to its clinical application. The essential steps of SIR in children are reviewed in detail, including pre-preparation, administration of sedative and muscle relaxant agents, induction of anesthesia, laryngoscopy, insertion of the endotracheal tube, confirmation of proper tube position, and subsequent respiratory support. Anatomic and physiologic differences between children and adults are highlighted, and specific considerations to be taken into account when performing SIR in this vulnerable population are described. In addition, the different drugs used for sedation and muscle relaxation in pediatric RDS are discussed in depth, highlighting dosages, pharmacologic effects, and potential associated complications. The importance of careful selection of appropriate agents and doses based on the childs age, weight, and clinical condition is discussed. It also addresses the use of specific medical equipment in pediatric RDS, such as pediatric laryngoscopes, adapted endotracheal tubes, pediatric videolaryngoscopy devices and capnographs, highlighting their relevance in the accurate visualization of the airway and confirmation of adequate intubation. Finally, the importance of adequate training, clinical expertise and multidisciplinary collaboration in the successful performance of SIR in children is highlighted. Emphasis is placed on the need for continuous monitoring and meticulous evaluation throughout the procedure, as well as the implementation of strategies to minimize risks and potential complications.

Background According to World Health Organization, an estimated 700000 to 1 million new cases and 26000 to 65000 deaths occur annually from Kala-azar. In the countries of South-East Asia region, Kala-azar occurs mainly in three countries- India, Bangladesh and Nepal. The disease occurs in agricultural villages where houses are frequently constructed with mud walls. Even people residing in endemic areas have poor practices for its prevention. Methods A descriptive cross-sectional study was conducted among 150 community people of Katahari Gaupalika, Morang. Simple Random sampling technique was used for the selection of three wards among seven wards, probability proportionate was used for the selection of the population from the ward. The desired sample was selected purposively. Data were collected from face-to-face interview techniques using a structured questionnaire. Statistical analysis was done by using SPSS 16 version. Results It is found that nearly two-thirds of the respondents (63.3%) had moderate awareness, more than one-fifth (22%) of the respondents had adequate awareness while (14.7%) of the respondents had inadequate awareness of Kala-azar. Similarly, more than half (55.3%) had moderate preventive practice, (25.3%) had inadequate preventive practice and nearly one-fifth (19.3%) had adequate preventive practice. The mean score for awareness and practice was 16.633 and 5.54 respectively. Conclusion The study was conducted to assess the level of awareness of Kala-azar. This concluded moderate awareness of respondents on Kala-azar which suggested that there is still a need to improve the awareness of the respondents particularly on its causative agent, preventive measures and complication. However, to improve their awareness to an adequate level, awareness-raising programs focusing on preventive practice should be conducted.

The present study aims to provide a detailed and accurate summary of reconstructive aesthetic hand surgery in medical terms. This specialized surgical intervention comprehensively addresses the functional and aesthetic alterations affecting the hand, through complex and personalized techniques.Aesthetic reconstructive hand surgery is indicated in a variety of clinical situations, including hand trauma, congenital malformations, degenerative diseases, soft tissue defects, tumors and post-surgical reconstruction. Each case requires a thorough and personalized evaluation to determine the most appropriate surgical approach and to achieve satisfactory results.The anatomical complexity of the hand, consisting of bones, joints, tendons, muscles, nerves and blood vessels, requires in-depth knowledge on the part of the surgeon. The multidisciplinary approach, in collaboration with specialists in plastic surgery, orthopedic surgery, occupational therapy, physiotherapy and rehabilitative medicine, is crucial to the success of the intervention.Aesthetic reconstructive hand surgery seeks to restore hand function, improve aesthetic appearance and ultimately improve patients quality of life. The focus is on repair and reconstruction of affected tissues, correction of deformities, stabilization of joints, revision of scars, and optimization of hand shape and contour

Methotrexate, inhibitor of a dihydrofolate reductase, is a chemotherapeutic treatment applied in many kinds of tumors as an anti-metabolite. also, Methotrexate applied to treat different other disorders, including diseases of autoimmunity, such as psoriasis, rheumatism, vasculitis and ulcerative colitis and Crohn’s disease. However, Methotrexate induces toxic effects on neurons, kidney toxicity, and liver damage, also Methotrexate have been associated with elevation risk of hepatic injury, fibrosis and cirrhosis. Methotrexate work as a dihydrofolic acid analog that binds to the dihydrofolate reductase enzyme that prevent the synthesis of tetrahydrofolic acid, that is essential synthesis of DNA. Although folic acid combine with Methotrexate therapy to prevent hepatotoxic effects, folic acid may reduce therapeutic effects of Methotrexate so recent research focus incorporation of new agent to counteract Methotrexate induced hepatotoxicity that include vitamin B12, vitamin E, N-acetylcysteine, melatonin, Erdosteine, inulin, Ferulic acid, Human placental extract, Natural plant extract (flavonoids). These agents are promising to counteract Methotrexate induced hepatotoxicity.

Blau syndrome is an extremely rare genetic disease characterized by a multisystemic clinical presentation affecting the skin, joints, eyes and nervous system. It is an autosomal dominantly inherited disease caused by mutations in the NOD2/CARD15 gene. This disease predominantly affects children, although adult-onset cases have been reported. The epidemiology of Blau syndrome is limited due to its low prevalence, with fewer than 200 cases reported worldwide. Diagnosis is based on clinical evaluation and molecular genetic testing to identify mutations in the NOD2/CARD15 gene. Treatment focuses on symptom control and reduction of inflammation, using non-steroidal anti-inflammatory drugs, corticosteroids and, in more severe cases, immunosuppressive agents. Multidisciplinary collaboration between different medical specialties is essential for the comprehensive management of patients. Although advances have been made in the understanding of Blau syndrome, more research is still needed to elucidate its pathophysiology, epidemiology and therapeutic options.

Introduction: The mesenteric cyst is a rare type of abdominal tumor in the adult and pediatric population1, the mesothelial cysts are more frequent in young women 2,3, there are mainly 3 forms of clinical presentation4. The asymptomatic clinical presentation is the most frequent and is diagnosed incidentally in complementary tests or surgeries5. Clinical case: A 38-year-old woman diagnosed with a mesocolon-dependent mesenteric cyst of mesothelial origin at the splenic angle level, the triphasic abdominopelvic CT scan reported an 11x11 cm cyst with a volume of 403 cc, the biopsy reported a simple mesothelial cyst. Complete removal of the tumor was performed using a laparoscopic approach. Conclusion: The treatment of choice for tumors of the mesentery is the complete removal of the tumor, the mere aspiration of its contents or partial resection is doomed to recurrence 6.

Eosinophilic colitis is a rare disease. It is part of the eosinophilic gastroenteritis, characterized by eosinophilic infiltration of the tissues that affects any segment of the digestive tract, but more frequently the stomach and small intestine and rarely the colon in isolation.

Waldenstrom macroglobulinemia is a rare hematological malignancy which accounts for only about 1% of the diagnosis. It is unique among B cell malignancies that usually produce a large amount of immunoglobulin M(IgM). Some patients may be symptomatic commonly fatigued due to anemia, bleeding or neurologic complaints, while others may be asymptomatic. There is a greater proportion of men and are diagnosed in their mid-60s. Here we report a case of a 58-yearold male who presented with increased fatigability. Routine blood investigation showed anemia with raised ESR and reversal of albumin globulin ratio.Bone marrow study was done to rule out multiple myeloma,which showed hypercellular marrow predominantly composed of atypical mononuclear cells with variable morphology from lymphocytes to plasma cells.Serum electrophoresis was adviced which revealed elevated serum

Background: The news of pregnancy is usually a happy one in a family and the birth of a new baby marks the peak of the experience. However, many times this happy beginning is clouded by pain and sorrow when serious maternal morbidity or mortality occurs. The major cause of maternal death is Primary postpartum haemorrhage. The introduction of active management of the third stage of labour has significantly reduced the incidence of maternal mortality but the risk of PPH is not entirely eliminated, hence, the need for a near ideal uterotonic agent that will better prevent or control PPH. Carbetocin promises to be a veritable tool in this regard and this case series was designed to showcase our experience with the drug. Aim: The aim was to analyze our experiences with Carbetocin during caesarean section in preventing PPH. Methodology: This was a case series of 15 women who had caesarean delivery in 3 different hospitals in Enugu under cover of Carbetocin. An extensive literature search was also done to unravel the extent of use and reported efficacy or otherwise of Carbetocin compared with our own experience. Relevant data was collated using a proforma and the result was analyzed using SPSS version 25.0 Results: The result from the study showed that out of the fifteen subjects analyzed, 5(33.3%) were less than 30 years while 10(66.7%) were more than 30 years and that 14(93.3%) of them were Igbo, whereas only 1(6.7%) was Yoruba. Seven of them (46.7%) were primipara, 1(6.7%) was para-4 or more and the rest were either between para-2 or para-3. Intra-operatively 12(80%) had no uterine fibroid and 3(20%) had one or more uterine fibroids. It also revealed that 6(40%) were delivered at a gestational age of 38 weeks, 3(20%) at 37 weeks and 1(6.7%) each at 35 weeks and 40 weeks. Only 1(6.7%) had need for additional uterotonics whereas the remaining 14(93.3%) had no need for additional uterotonics during and after the surgery. There was no record of any side-effects in any of the subjects. Prolonged labour and placenta previa with previous caesarean delivery topped the list of indications each having 3(20%) whereas breech presentation and previous caesarean deliveries were 2(13.3%) each; the others constituted the remaining 5(33.3%) each. The mean estimated blood loss was 335.33ml±140.80 (p-value= 0.001 and CI= 4.68-8.26), the average pre-operative packed cell volume (PCV), 34.2%±2.73 whereas the mean post-operative PCV was 30.93%±2.21(p-value = 0.001 and CI= 2.55-3.90). There were no side-effects recorded in any of the subjects. Conclusion: Carbetocin is an efficacious uterotonic agent and is very effective in preventing uterine atony and PPH during caesarean deliveries with minimal and tolerable side-effects.

Introduction:Reactivation of herpes simplex virus (HSV)-1 can cause recurrent herpes labialis. This is a lesion that clinically consists of multiple vesicles that can break into erosive areas covered with crusts on the vermilion and surrounding skin. The lesions may recur, be triggered by systemic factors including; stress, menstruation, and local stimuli such as injury; sun exposure, and are usually preceded by prodromal symptoms. Case: a 44-year-old woman came to the Department of Oral Medicine at the Dental and Oral Hospital of the University of Jember with complaints of small blisters and peeling on the outer right corner of her mouth. The patient has had these complaints since 3 days, feels pain especially when eating and talking accompanied by not feeling well. The patient had experienced the same illness several years ago and relapsed again when experiencing stress and fatigue. The patient has no history of allergies, either to drugs or food. Treatment: Topical antiviral drugs are given in the form of 5% acyclovir cream and supportive therapy in the form of multivitamin tablets. Conclusion: Recurrent Herpes labialis caused by HSV-1 can be treated with topical antivirals drugs and multivitamin tablets.

Introduction:Reactivation of herpes simplex virus (HSV)-1 can cause recurrent herpes labialis. This is a lesion that clinically consists of multiple vesicles that can break into erosive areas covered with crusts on the vermilion and surrounding skin. The lesions may recur, be triggered by systemic factors including; stress, menstruation, and local stimuli such as injury; sun exposure, and are usually preceded by prodromal symptoms. Case: a 44-year-old woman came to the Department of Oral Medicine at the Dental and Oral Hospital of the University of Jember with complaints of small blisters and peeling on the outer right corner of her mouth. The patient has had these complaints since 3 days, feels pain especially when eating and talking accompanied by not feeling well. The patient had experienced the same illness several years ago and relapsed again when experiencing stress and fatigue. The patient has no history of allergies, either to drugs or food. Treatment: Topical antiviral drugs are given in the form of 5% acyclovir cream and supportive therapy in the form of multivitamin tablets. Conclusion: Recurrent Herpes labialis caused by HSV-1 can be treated with topical antivirals drugs and multivitamin tablets.

One in three Indonesian children is stunted. The presence of stunting in Indonesia, particularly in the city of Subulusssalam, was consistent with the practice of feeding sick infants and children. The aim of this study analyzed infant and young child feeding practices in the study area Pulo Belen, Sultan Daulat District, Subulusssalam City. Qualitative study design A rapid evaluation procedure with a sample of mothers with children aged 6-18 months and older and health care workers: the head of public health center and nutritionist. Data collection method used focus group discussion and in-depth interview. Data analysis used content analysis to obtain detailed information related to the deployment of PMBA, or MP-ASI. As a result, PMBA practice in Pulo Belen villages of all ages was associated with 7 out of 36 informants who provided complementary feeding early and 1 out of 36 informants who started complementary feeding late, indicated that 4 of 36 people misreported the texture of complementary foods. 7 of 36 respondents did not offer supplements, 4 of 36 respondents gave her MP-ASI immediately, and most of her MP-ASI was given in response to positive. In addition, most information about her maternal FPIC was obtained from health care providers, all of whom supported her correct FPIC practice. The presence of balanced training with MP-ASI demonstration methods and the formation of community groups to support breastfeeding and complementary feeding can support the correct implementation of PMBA in Pulo Belen Village, Subulussalam city.

Caries is a tooth surface disease characterized by demineralization caused by acids produced by bacteria during the metabolism of sugar food. Molars are the primary teeth that are most prone to caries. One of the causes of caries is poor dental and oral hygiene. Preschoolers have a lower awareness of and adherence to oral hygiene, increasing the risk of caries. The objective of this study was to examine the caries description of primary molars as well as the effect of dental health education on dental and oral hygiene in preschooler. This study was pre-experimental, with a one-group pretest-posttest design model and a purposive sampling technique. The sample size was 66 children aged 4 to 6 years who attended five preschool facilities in the agro-industrial environment in Arjasa District. SPSS was used to analyze data obtained from objective examinations and questionnaires. The findings included the distribution of primary molars with the most caries-free category in the maxillary first and second primary molars, the distribution of caries in primary molars with the category of enamel caries spread evenly across all maxillary and mandibular primary molars, the distribution of caries in primary molars with the categories Dentin and pulp caries were most common in mandibular first and second primary molars, and the provision of dental health education could improve dental and oral hygiene in preschooler.

Acute lymphoblastic leukemia (ALL) is a malignant neoplasm of immature lymphoid progenitor cells, characterized by an uncontrolled and excessive proliferation of these cells in the bone marrow and other hematopoietic organs. This disease primarily affects children and young adults, and is characterized by the presence of abnormal immature lymphoblastic cells in the blood and bone marrow.1 Splenic infarction, on the other hand, is a rare but potentially serious complication associated with various medical conditions. It refers to necrosis or death of splenic tissue due to interruption of adequate blood supply through the splenic arteries.2

Psoriasis is a chronic, immune-mediated inflammatory skin disorder that affects 2-3% of the population worldwide. Current therapies, including biologic agents, often have adverse effects and incomplete efficacy. Recent studies suggest that the PI3K/AKT/FOXO signalling cascade and interleukin-1 ß play a crucial role in the pathogenesis of psoriasis. Hyperbaric oxygen therapy, a safe and well-tolerated procedure, has been suggested as a potential treatment for psoriasis due to its ability to increase tissue oxygenation and reduce inflammation. This review article summarizes the current understanding of the pathophysiology of psoriasis and the potential benefits of hyperbaric oxygen therapy as a treatment modality. The authors suggest that hyperbaric oxygen therapy may modulate the PI3K/AKT/FOXO signalling cascade, reduce interleukin-1 ß levels, and improve skin oxygenation, leading to the attenuation of psoriatic plaques. Further clinical studies are needed to confirm the safety and efficacy of hyperbaric oxygen therapy in psoriasis treatment.

Meckels diverticulum is the most common congenital malformation of the gastrointestinal tract. This is a true diverticulum as it contains all the layers of the intestinal wall. It is usually asymptomatic and discovered as an incidental finding during surgery for another cause. In adults, its complication is rare and clinically indistinguishable from an appendiceal condition. It has a risk of complications ranging from 2 to 40%, the most frequent being gastrointestinal bleeding, intestinal obstruction and acute abdomen (diverticulitis or diverticular perforation). We present the clinical case of a 21-year-old male with an initial diagnosis of perforated appendicitis who, upon undergoing exploratory laparoscopy, found diffuse peritonitis secondary to Meckels diverticulum perforation. This patient underwent laparoscopic surgery for intestinal resection of the segment where the diverticulum was located and an end-to-end enteroanastomosis coupled with an appendectomy, due to presenting intense abdominal pain, cramping/oppressive in the lower hemiabdomen, evidence of peritoneal irritation, alteration of the formula white in laboratory studies and findings suggestive of appendicitis and perforation in the abdominal cavity in imaging studies. Therefore, it is concluded that in cases of acute abdomen, the differential diagnosis of Meckels diverticulum should be taken into account in those patients who present symptoms related to its complications.

Microbial biofilms are collections of grouped microbial cells enmeshed in an extracellular polymeric substances (EPS) matrix that they have self-assembled. Biofilms are resistant to harsh environments and can serve as "protective clothing" for bacteria by shielding them from ultraviolet (UV) radiation, extreme temperatures, pH ranges, high salinity, high pressure, inadequate nutrition, antibiotics, etc. Research on biofilms in recent years has mostly concentrated on biofilm-associated illnesses and methods for eradicating microbial biofilms.

Basal cell carcinoma is the most common malignant neoplasm of the skin in humans, originating from the basal cells of the epidermis and its adnexa. It is characterized histologically by the uncontrolled proliferation of cells that show similarity to normal basal cells. Chronic exposure to ultraviolet (UV) radiation is considered the main risk factor in its development, and sun-exposed skin, such as the face and upper extremities, is the most common location for the appearance of this disease. The clinical presentation of basal cell carcinoma can vary, with different subtypes including nodular, superficial, sclerodermiform and pigmented, among others. Each of these subtypes exhibits distinctive clinical features, such as raised lesions with well-defined borders, flat plaques, fibrous or sclerotic appearance, pigmentation, and presence of ulcers. Variability in clinical appearance can make early and accurate diagnosis difficult, highlighting the importance of a thorough evaluation and consideration of biopsies to confirm the diagnosis. Although basal cell carcinoma tends to have slow local growth and low metastatic capacity, it can cause significant cosmetic and functional damage when it invades surrounding tissues. Therefore, prompt treatment is essential to prevent complications and limit disease progression. Complete surgical excision, using techniques such as Mohs surgery, is the primary approach in the management of basal cell carcinoma. In addition, additional therapeutic modalities such as radiotherapy, photodynamic therapy and topical application of chemotherapeutic agents may be considered in selected cases.

Conservative treatment of chronic kidney disease, apart from simply treating symptoms and associated complications, consists in slowing chronic kidney disease progression, in order to improve patient and family quality of life, to postpone the need for renal replacement therapy and to reduce the treatment costs. Slowing chronic kidney disease progression involves therapeutic strategies, aiming to avoid/treat malnutrition and inflammation, correct anemia, treat mineral bone disorders of CKD and correct vitamin, mineral and microelement’s deficit. This review aims to shed light to the rationale behind these strategies through evidence from clinical studies and the recent guideline recommendations for use of ketoanalogues, essential aminoacids, calcium, Vit D3, iron, Vit B12, folates and unsaturated fatty acid supplements.

Multiple sclerosis is an autoimmune disease that demyelinates the nerves, the damage to the nerves interrupts communication between the brain and the body. Although it is a disease that has no cure, it has been studied for a long time to try to find a treatment to stop the progression of the disease. Currently there are many drugs that can help reduce the effects caused by the disease, but it is necessary to evaluate which one is given because of the adverse effects that these may have, even so, the research of new treatments has not stopped until finding one that benefits completely or its risks are minimal.

This case report is about a woman in her fourth decade of life who, after a fight, went into a nervous-depressive crisis and decided to consciously ingest the herbicide paraquat. The patient is from a rural community and after 6 hours she decided to go to a tertiary level hospital located in the nearest city due to the persistence of her discomfort, In the emergency room she reported having consumed about 300 milliliters of paraquat, the e?ects were not immediate, but after 5 hours she began with asthenia, adynamia, sialorrhea, she was hospitalized for 10 days presenting the three phases described, starting with the gastrointestinal phase, the hepatorenal phase where on the fourth day after ingestion there was a peak elevation of hepatic transaminases and azo levels and the pulmonary phase causing a type of pulmonary lesion, since the alveolar spaces were filled with microhemorrhages, In this third level hospital, support care, hydration and medication were provided according to the literature, but despite the excessive amount consumed and the high mortality rate of this type of intoxication, it had an unfavorable end..

this literature review article, the topic of flaps in reconstructive surgery will be addressed in detail, focusing on their definition, indications, complications and management. The epidemiology of flaps and their significance in clinical practice will be explored. The methods used for the implementation of flaps will be discussed, highlighting the importance of preoperative planning and surgical techniques. In addition, the complications associated with flaps will be discussed and a comprehensive discussion on the advantages and challenges of their use in reconstructive surgery will be presented. A conclusion summarising the key aspects of this review will be provided

Pancreatic cyst is a pathological condition characterized by the presence of a fluid-filled cavity or sac within the pancreatic tissue. It can arise from various etiologies, including chronic pancreatitis, acute pancreatitis, pancreatic duct obstruction, and benign or malignant pancreatic lesions. Histopathological classification of pancreatic cysts reveals distinct subtypes such as pseudopapillary cysts, serous cysts, mucinous cysts, solid cysts, and intraductal papillary mucinous neoplasms, each exhibiting unique characteristics that influence clinical management. Diagnosis of pancreatic cysts relies on a combination of imaging modalities including ultrasound, computed tomography, magnetic resonance imaging, as well as blood tests and, in selected cases, biopsy. Treatment of pancreatic cysts depends on several factors, including size, location, and associated symptoms. Small asymptomatic cysts are often managed with regular surveillance, while symptomatic, large, or worrisome cysts may necessitate more aggressive interventions such as percutaneous drainage or surgical intervention. Targeted pharmacological therapy may be considered in specific cases.

Prostatic sarcoma is a rare and aggressive disease that accounts for less than 1% of all diagnosed malignant prostate tumors. It mainly affects older men and its epidemiology is still not well defined due to the lack of comprehensive registries. The clinical presentation of prostatic sarcoma is variable, with urinary symptoms, pelvic or lumbar pain and systemic symptoms. Diagnosis requires a comprehensive evaluation including clinical history, physical examination, prostate biopsy and imaging studies. Treatment is individualized and multidisciplinary, including surgery, radiotherapy, chemotherapy and targeted therapies. However, due to the rarity of this disease, evidence on the efficacy of different treatments is limited. More research is needed to better understand prostatic sarcoma, develop more effective therapeutic strategies and improve outcomes for affected patient

Background: According to the Ministry of Health data, cancer prevalence is growing internationally and in Saudi Arabia, particularly colorectal cancer (CRC). We also noticed several individuals with a spectrum of different clinical presentations of gastro intestinal symptoms among adults in our routine primary health care (PHC) practice. Methodology: A 379 person cross-sectional research was undertaken among PHC participants from June 2021 to December 2022. SPSS was used to enter and evaluate data. Statistical tests such as basic proportions, chi square test for categorical data, risk variables relationship with CRC, and logistic regression analysis were used. The current study found that nearly half of the individuals (50.9%) had strong CRC knowledge of common symptoms. Dietary variables, fast meals, and greasy foods were cited by nearly two-thirds of the study group (69.5%) as potential causes of CRC. Furthermore, two-thirds (68.6%) were aware of the CRC screening test. Regression analysis was used, and a significant correlation was found between risk variables of fast-food intake, daily red meat consumption, and physical inactivity with CRC knowledge (P - 0.026, 0.012, and 0.004, respectively). Conclusions: According to the findings, primary health care attendants have a low level of CRC awareness. Almost one-third (35.6%) of persons will have a FOBE test for CRC. There is a need to raise knowledge of risk factors and CRC screening, as well as to strengthen current awareness programs. More research is needed to back up the current study findings in our population

Cleft of lip and palate are the most common serial congenital anomalies to affect the orofacial region. Its occurrence can be isolated or together in various combination and/or along with other congenital deformities. In addition to aesthetic disfigurement, a child with cleft lip and/or palate suffers functional morbidity such as restricted maxillofacial growth, speech anomalies, swallowing and feeding difficulties, hearing loss and/or recurrent ear infections. Although not generally life-threatening, living with a cleft evoke a significant health burden. The management of patients with cleft lip and cleft palate is very complex and requires a multidisciplinary team with several treatment interventions This article aims to review the primary care physicians in literature knowledge about cleft lip and palate.

De Quervains tenosynovitis is a common condition that affects the tendons of the thumb at the wrist. In this literature review article, a comprehensive overview of the surgical treatment of this disease is presented. Aspects related to epidemiology, clinical significance, definition, diagnosis, surgical techniques and indications, complications are addressed and a discussion on the results and effectiveness of treatment is offered. Based on the available evidence, it is concluded that surgical treatment of de Quervains tenosynovitis is an effective and safe option in selected cases that do not respond to conservative measures.

Introduction - Mucormycosis is a life threatening invasive fungal infection that mostly occurs in immunocompromised patients. Aim of our study is to analyze the management of mucormycosis in rhinoorbital mucormycosis cases and dire requirement for more than one surgical intervention for their management. The limitations of first surgery, progressive nature of disease, and difficult anatomical regions were the areas to address in most of our patients in this series. Methodology - Our case series consists of 34 confirmed cases of mucormycosis using standard staining and histopathological confirmation on biopsy. The study group being subjected to complete modern diagnostic, CT, MRI scrutinization. Detailed follow up with serial endoscopies, post-surgery. Re confirmation of residual on progressive mucormycosis disease condition being subjected to repeat of these investigative tools and confirmation with PET scan. Results – Total of 34 patients were included in our study majority of them were diabetic. Only 3 patients underwent single stage debridement however 34 patients underwent debridement in two successive stage and two patients required third surgery for disease clearance. Conclusion – Repeated surgical debridement is must for complete disease eradication in case of rhinoorbitocerebral mucormycosis. Also, medical management can prolong the survival of patients with disease in areas which are inaccessible by surgical clearance. Serial radiography with CT, MRI and PET scan are not only contributary but mandatory.

This study discussed the characteristics of patients with the incompatible crossmatch results in 2017- 2021 at Indonesian Red Cross of Sidoarjo. This study was conducted due to the differences, and no study has been conducted regarding the characteristics of adult blood transfusion patients with incompatibility at Indonesian Red Cross of Sidoarjo. The type of study was quantitative descriptive. The sampling technique was the total sampling technique. The data collection technique was documentation through reports from Indonesian Red Cross of Sidoarjo. The results of the study showed that the results of the incompatible crossmatch test were 76 patients with various kinds of incompatible, mainly in the major incompatible of 58 patients (76.40%). The gender most experienced incompatible was female, with 54 patients (71%). Patients who carried out the crossmatch test were mainly 36-45 years old, with 47 patients (62%). The incompatible blood request required blood component PRC 76 (100%). The cause of the most incompatibility case was anemia, with 49 patients (64.46%).