The hand portion that sustains injuries most frequently is the fingertip. For a practical and aesthetically acceptable result, flap repair can be required if replantation of a fingertip amputation is not feasible. This work examines frequently used reconstruction methods, emphasizing technical nuances and potential issues and how to prevent them

Monoclonal gammopathies encompass a spectrum of disorders characterized by the abnormal proliferation of plasma cells, leading to the production of monoclonal immunoglobulins. Waldenström macroglobulinemia (WM) is a rare, indolent lymphoproliferative disorder characterized by the presence of an IgM monoclonal gammopathy, bone marrow infiltration by lymphoplasmacytic cells, and clinical features such as hyperviscosity, lymphadenopathy, and hepatosplenomegaly. Recent advances in understanding the pathogenesis of WM have led to the development of novel therapeutic strategies, including targeted therapies and immunomodulatory agents, which have significantly improved outcomes for patients. This article provides an overview of the current understanding of WM pathophysiology, clinical presentation, diagnostic approach, and recent advancements in its management.

If a couple cannot conceive and carry out a baby we speak of “infertility Infertility ,as an unwanted condition, that has been well known since ancient times. However, the first known gynecologic medical text, the Kahoun papyrus (2200-1950 B.C), describes infertility as a disruption in the continuity between the reproductive organs and the digestive tract.

The contemporary landscape of burn care and rehabilitation stands at the nexus of medical innovation and interdisciplinary collaboration. This article delves into the tangledweb of implications arising from the integration of plastic surgery within the rehabilitative continuum for victims of extensive burn injuries. Through a comprehensive exploration of cutting-edge surgical techniques, patient outcomes, and the symbiotic relationship between plastic surgery and rehabilitation, this discourse aims to illuminate the transformative potential of reconstructive interventions. By elucidating the dynamic interplay between surgical innovation and rehabilitative strategies, our investigation seeks to contribute to the evolving paradigm in the holistic management of victims enduring the aftermath of severe burns

The intervertebral disc in human being is a complex structure and is made up of fibrous and cartilaginous tissues. It is characterized as tension-resisting structure whileit allows limited range of motion in axial, bending or rotational posture. Degenerative process of this structure present with clinical morbidity to the patients and possess great challenges to the clinicians while offering care for disc’s pathology.Degeneration begins with imbalance of homeostasis maintained by content of nucleus pulposus and annulus fibrosus. Numerous factors; genetic, mechanical and nutritional, can initiate and or accelerate this degeneration process which ultimately alter the biomechanics of the spine.The aim of this review is to give an overview on the degeneration process, causes and factors influencing disc degeneration, themechanisms of degeneration and the changes resulted from intervertebral disc degeneration

Sildenafil (viagra) has become one of the top selling over the counter product for the treatment of male erectile dysfunction.(1) We report a case of 34year male patient admitted in our ICU with history of severe headache followed by sudden loss of consciousness after ingestion of two tablets of sildenafil(50mg) land up intracerebral bleed and died. There aremany cases in the literature reporting intracerebral or subarachnoid haemorrhage associated with use of sildenafil while sexual contact

Background:Electrical storm, a life-threatening condition marked by recurrent ventricular arrhythmias, demands a multimodal approach for effective management. Wepresent a case of acute heart failure in a rural setting, complicated by electrical storm, where COVID-19-related delays in referrals to tertiary health services are prevalent.Case Illustration:A 55-year-old male with a history of hypertension and previous cardiogenic shock presented with monomorphic ventricular tachycardia. Synchronized cardioversion was followed by intravenous amiodarone, but recurrent episodes persisted. Referral to a tertiary hospital revealed non-significant coronary disease, and ambulatory medication was prescribed.Discussion:Electrical storm, often linked to structural heart disease, requires a complex management algorithm addressing hemodynamics, recurrent shocks, and potential triggers. Psychological considerations are crucial.In rural settings lacking advanced cardiac facilities, adherence to advanced cardiac life support (ACLS) guidelines is vital before referral.Conclusion:In resource-limited rural settings, adhering to ACLS guidelines allows effective initial management of electrical storm cases. While advanced therapies are optimal in tertiary hospitals, timely interventions in rural settings significantly impact outcomes, compensating for the lack of advanced cardiac facilities.

Introduction: Wounds result from the disruption of cellular and anatomical continuity in living tissues due to external factors. Calotropis gigantea, also known as crown flower or giant milkweed (or "biduri" in Indonesia), is a small tree or shrub with white or purple flowers, widely used in traditional remedies. Its properties, including antimicrobial, cytotoxic, and wound-healing activities, have prompted this literature review to assess its efficacy in wound healing. Method: A thorough analysis of scientific findings and research conducted in the last 10 years, specifically after January 1, 2014, was undertaken. Data were collected from reputable databases, such as PubMed, Web of Science, and ScienceDirect. After applying publication limitations, three manuscripts were selected as the final outcomes of the review process. Result: The analysis of multiple studies reveals that C. giganteapossesses wound healing properties attributed to phytochemical constituents like flavonoids, tannins, alkaloids, and saponin. These constituents play vital roles in each stage of wound healing, including the inflammatory reaction, proliferation, and remodeling stages. Additionally, C. giganteapromotes wound healing, leaving minimal scar residues. Conclusion:Calotropis giganteahas demonstrated its ability to enhance wound healing through various mechanisms, including astringency, antibacterial activity, promotion of homeostasis, facilitation of collagen synthesis, enhancement of re-epithelialization, and stimulation of cell proliferation via its phytochemical constituents. However, due to the scarcity of recent studies, the plants true efficacy in wound healing remains unclea

malfunction in human melanogenesis called melasma causes the epidermis to become hyperpigmented in certain regions of the body gradually. It significantly affects physical appearance, results in psychological and physiological distress, and diminishes those impacted individuals quality of living. In order to restrict blood loss, tranexamic acid (TA), a plasmin inhibitor, is used for stopping unusual fibrinolysis. It works by permanently inhibiting lysine binding sites on plasminogen molecules, which prohibits plasminogen activator (PA) from converting plasminogen to plasmin.It seems sense that tranexamic acidmighthave an impact on keratinocyte association and function because plasminogen is additionally found in human epidermis basal cells and owing to the fact that PA has been shown to be produced by cultivated human keratinocytes. A comprehensive review of the literature demonstrates that although TA is administered bytopical, oral, and intradermal injection as well as utilized as an adjuvant therapy Added to the laser therapy to treat melasma, its effectiveness has not been sufficiently proved. To fully understand the function of TA in the management of melasma, additional investigation is required

Introduction:The scrotum is a covering of skin that covers and protects the testicles. Although it is not common, some bacterial infections of this skin can extend to deep tissues and produce a severe entity known as Fourniers gangrene. Clinical case:A 62-year-old male patient arrives at the Emergency Department due to increased scrotal volume with extension to the perineal region associated with purulent discharge and fever for one week. The patient has type 2 diabetes mellitus of 10 years duration, with poor control despite consuming oral hypoglycemic agents. He has also had high blood pressure for two years, managed with Losartan 50 mg/day. They observed secretion from perianal fistula drainage and uncomplicated external hemorrhoids. Laboratories: Glucose 260 mg/dL, BUN 23 mg/dL, Urea 49.5 mg/dL, Cr 1.50 mg/dL, Leukocytosis 33.39 x 109/L, Hb 9.9 g/dL, Hct. 30.3%. Discussion:The management of Fourniers gangrene includes both pharmacological measures, such as the use of antibiotic therapy and surgical management. Autologous partial skin graft is one of the most used techniques due to its safety and versatility and the extensive availability of donor areas. The process consists of obtaining a portion of skin taken from a donor area, preferably the thighs, which is obtained with a dermatome, after which the graft is meshed, increasing its extension and increasing the surface to be covered. As for negative aspects, there is possibly an unaesthetic result and possible retractions. Despite this, most authors point to a good result with this technique.

Background:Hypertrophic scars and keloids represent two distinct forms of abnormal wound healing, characterized by excessive fibrous tissue formation. Despite their prevalence, the pathophysiological mechanisms underlying their development and persistence remain incompletely understood. This literature review synthesizes current clinical and molecular insights into hypertrophic scars and keloids, aiming to highlight differences in their etiology, pathogenesis, and therapeutic responses.Methods:A comprehensive review of the literature was conducted, focusing on articles that provided significant insights into the clinical manifestations, genetic predispositions, molecular pathways, and treatment strategies related to hypertrophic scars and keloids. Experimental studies and clinical trials were included to encompass awide range of data sources.Results:Hypertrophic scars are confined to the original wound boundary and may regress over time, whereas keloids extend beyond the wound margins and do not regress. Clinically, hypertrophic scars and keloids differ in their appearance, texture, and predilection sites. At the molecular level, these differences are underscored by distinct profiles of cytokine expression, growth factor activity, and extracellular matrix composition. Genetic studies have identified several predisposing factors, including specific gene mutations and polymorphisms. Treatment strategies vary; however, intralesional corticosteroids remain the first-line treatment for both conditions. Emerging therapies targeting specific molecular pathways offer potential for improved outcomes.Conclusion:Hypertrophic scars and keloids are complex conditions with distinct clinical and molecular characteristics. Understanding these differences is crucial for developing targeted and effective therapies. Future research should focus on unraveling the genetic basis of these conditions and exploring novel therapeutic targets. Enhanced knowledge of the pathogenic mechanisms will facilitate the advancement of personalized medicine approaches in the management of hypertrophic scars and keloids.

When the abdominal cavitys material migrates to the hernial sac (HSV) and the HSV/abdominal cavity volume ratio exceeds 25%, systemic alterations known as "loss of domain" occur, resulting in an estimated 5–30% of cases of post-incisional ventral hernia. Usage ofbotulinum toxin appears to be a secure way to do a tension-free repairon treatment for hernias with loss of dominance

Introduction: Oral lesions range from innocuous to possibly dangerous, including oral cancer, which is the worlds 16th most common malignancy. Early detection of oral cancer can enhance a patients life expectancy by a decade, emphasizing the need of diagnostic instruments like VELScope. VELScope is a portable device that employs blue light to examine oral tissue, exposing natural fluorescence and emphasizing aberrant regions that would otherwise be invisible without the use of specialized equipment. Objectives: This review looks at the possibility of the VELScope for identifying oral lesions, since it has the potential to be a future dental diagnostic tool. Method: We began with 88 findings and reduced them down to 33 research regarding VELScope technology published in the previous five years. Following screening, we chose ten articles using the same criteria for all research. Results: VELScope uses fluorescence to identify both obvious and concealed oral lesions, which is especially useful when collagen loss occurs in normal tissues. While using autofluorescence requires knowledge, it assists in analyzing margins in probable pre-malignant oral conditions. VELScope, despite its limitations, has promise for early cancer diagnosis as technology develops. Conclusion: When utilized for early diagnosis, VELScope helps to reduce oral cancer mortality, reaching an 83% 5-year survival rate. While it has limits, continuous technical improvements have the potential to improve its accuracy, making it a vital tool for accurate early diagnosis and lowering oral cancer mortality.

Pyogenic liver abscess is a rare clinical entity, having a reported incidence of 1.1/100,000 to 3.6/100,000 people in western countries, and with a reported mortality between 5.6-10%, however, this mortality can increase upto 22% if there are multiple abscesses. The prevalence of acute cholecystitis is reported at 0.8-3.8%; Only 2% of all patients with cholelithiasis will present a gallbladder perforation, and the reported mortality in these cases has been reported between 12 to 16%. The most common site of perforation is the gallbladder fundus because it is the most distal portion, which leads to having less blood flow. Its clinical presentation is not specific, and the ultrasound is usually the first imaging tool for diagnosis. Treatment will depend on the clinical condition of each patient. Here we present an 88-year-old female case successfully treated with laparoscopic cholecystectomy and liver abscess drainage despite hemodynamic instability

The primary cause of rhinoplastys difficulty is the fact that every move made during the procedure has both planned and unforeseen consequences. This reports objective is to examine the research and provide an update on rhinoplasty dynamics. Surgeons doing rhinoplasty operations need to keep reevaluating the dynamics of different movements as the procedures procedures advance.

Background:Incidences of nosocomial infections in COVID-19 patients admitted to the intensive care unit (ICU) have become a common occurrence. Hospital-acquired infections (HAI) present increased mortality, cost-of-care, especially relevant in multidrug resistant (MDR) infections. Our study aimed to assess the clinical implications associated with HAI-infected COVID-19 patients.Patients and Methods:We conducted retrospective single-centred study on ICU-admitted adult COVID-19 patients for a year i.e., 2021-22 at a tertiary Indian institute and collated data of HAI epidemiological, clinical and microbiological reports.Results: Rate of HIA at our centre was estimated to be 10.29% and the mortality rate was 40.4%. 10 different organisms(Bacteria: 8, Fungi: 2) were detected in HAI, of which the incidence of Gram-negative infections (GNI) was highest i.e., 60% and that of Gram-positive infections (GPI)/Fungi (Fungi infected) were 20% each. Mortality was highest among GPI (36.67%), FI (13.46%), followed by and GPI (7.69%). Tocilizumab treatment decreased the risk of survivability with no significant difference in the treatment outcomes.Conclusion:This study provides a comprehensive picture of nosocomial infections characteristics among COVID-19patients and provides insights regarding the impact of treatment on the outcome of these patients with suggestions for strategies. We found that critically ill patients with COVID-19 are at a high risk of developing HAI, especially MDR mediated CLABSI and CAUTI. Clinicians must therefore be cautious and mindful during implementing protocols for management of infectious complications with COVID-19 patients

Back ground: Pulmonary candidiasisis a fungal airway infection caused by the genus candida species, often in immunocompromised patients, and it spreads through hematogenous or other diseases. This case report aims to inform that the disease is rare in immunocompetent patients and difficult to diagnose.Methods: Through a medical record search, a 40-year-old Indo-Chinese man complained of chest pain, cough, shortnessof breath, and a lump in the neck.A history ofpulmonary tuberculosis wascompleted after six months of treatment with no diabetes mellitus. Then, wheezing and rhonchi were heard during the physical examination of the lungs. When a contrast HRCT (high resolution computed tomography) examination was performed, fibrocalcification with a tree in a bud was found in the bilateral superior lobes of the lung, solid mass in the distal bronchus with atelectasis and enlarged paratracheal nodules. Then, a fungal culture of the right BAL (bronchoalveolar lavage) sample was found candida-non albican.Conclusion:Pulmonary candidiasis is not only common in immunocompromised patients but also in immunocompetent conditions; diagnosis using HRCT with contrast and fungal culture from BAL

Introduction: The rural worker, in his work activity, uses the extensor muscles of the lumbar spine in a large number of his actions, and when the abdominal muscles reduce their strength and an imbalance occurs between the flexor and extensor muscles of the trunk, whichcan result in a backache. Objective: To demonstrate the correlation between the work activity of rural workers and low back pain. Methods: This study constitutes a systematic review, classified as exploratory and descriptive. The preparation of the research was a bibliographical search in electronic databases on methods associated with RSL (Systematic Literature Review) and the applications of SMARTER ( Simple Multi-Attribute Rating Technique using Exploiting Rankings ). Results: A comprehensive systematicsearch of the literature yielded a total of 852 articles referring to the correlation between low back pain and rural workers, of which 14 articles were eligible to be included in this systematic review. Conclusion: The conclusion of this study highlightsthe importance of integrated and personalized approaches to reduce the risks and impacts of this condition on the health and well-being of rural workers

One prevalent fibroproliferative hand disorder is Dupuytrens disease (DD). Observation, non-operative management, and operative management are the three types of DD management. Percutaneous needle fasciotomy (PNF), open fasciotomy (OF), injections of Clostridium collagenase histolyticum (CCH), limited fasciectomy (LF), and dermofasciectomy are examples of operative therapies (DF). A overview is given of the many approaches to treating DD. This page outlines the many DD treatment methods, their advantages and disadvantages, and procedural guidelines

Long QT Syndrome (LQTS) is a hereditary or acquired cardiac disorder characterized by delayed ventricular repolarization, predisposing affected individuals to life-threatening arrhythmias. While extensively studied in the pediatric population, there is a paucity of comprehensive research focusing on the clinical implications and prognostic markers of LQTS in adults. This article aims to elucidate the association between Long QT Syndrome and the heightened risk of sudden death in adult patients, exploring pertinent clinical correlates and potential prognostic factors.A systematic literature review was conducted to identify relevant studies published between 2000 and 2024, utilizing databases such as PubMed, MEDLINE, and Cochrane Library. Eligible articles were critically appraised for methodological quality and relevance to adult populations with Long QT Syndrome. Data extraction encompassed demographics, genetic predispositions, clinical presentations, electrocardiographic findings, and outcomes, focusing on the incidence of sudden death.Preliminary findings underscore the significance of a prolonged QT interval as a critical marker for adverse cardiovascular events in adults with Long QT Syndrome. Additionally, the study examines the impact of genotype-phenotype correlations, gender-related differences, and the influence of comorbidities on the risk of sudden death. Furthermore, potential therapeutic interventions and risk stratification strategies will be discussed in light of recent advancements in the field.This review aims to bridge the existing knowledge gap regarding Long QT Syndrome in the adult population, emphasizing the need for heightened clinical awareness, risk stratification, and targeted interventions to mitigate the risk of sudden death in affected individuals. The synthesis of current evidence will contribute to a more nuanced understanding of the complex interplay between Long QT Syndrome and adverse outcomes in adults, facilitating the development of tailored therapeutic approaches and improved patient outcomes.

Background:In the diagnosis of diabetic foot, in addition to the inflammatory biomarkers that have been widely interested and used, for example procalcitonin, C-reactive protein (CRP), ESR, leukocyte count, neutrophil count, Fibrinogen and Monocytes are considered as biomarkers in this study. possible.Methods:Aprospective study was designed to examine the utility of fibrinogen and monocytes in estimating disease severity in patients with DFU (Diabetic Foot Ulcer). The severity of DFU was assessed using the Wagner criteria distinguishing between patients with diabetic foot without ulcer (WDFU) and with non-infected diabetic foot ulcer (NIDFU) or with infected ulcer (IDFU). In this study the AA also wanted to correlate HbA1c to the concentration of Fibrinogen and the appearance of DFU, as well as the level of lymphocytes and monocyte precursors of macrophages in the evolution of ulcerated and non-ulcerated diabetic feet.Results:Mean blood fibrinogen values were significantly higher in patients with DFU grade ?2 compared to those with DFU grade =1 (424.4±138.8 mg/dL versus 395.3±130.0 mg/dL; p=0.091). Fibrinogen values were correlated with CRP levels, neutrophils, ESR and leukocyte count. Monocytes presented a significant difference between non-diabetic patients with ulcer and without ulcer (0.41 vs0.29 k/L; p=0.000) and between the diabetic without ulcer (WDFU) and non-diabetic without ulcer (NDWU) groups (0.39 vs0.29 k/L; p=0.000). The Procalcitonin (PCT) value was <0.5 ng/dl, therefore it had no diagnostic significance. Only 1% of the values found were higherthan 0.5 with an average of 1.04 ng/dl (range: 0.52-2.5).Conclusions:Neither monocytes nor HbA1c can be considered biomarkers for the risk of ulcer formation in the diabetic foot, but only as biomarkers of type 2 Diabetes Mellitus. Differently, fibrinogenemia, its pre/post intervention ratio, the angle and the k value of thromboelastography (TEG), have a clinical significance on the risk of onset and development of ulcerated diabetic foot.The cut-off for ulcer formation for both the pre/post intervention ratio of fibrinogenemia and monocythemia is 1.10,with a sensitivity of 84.1% and a specificity of 24.5% for fibrinogen and 93.8% and 14.8% for monocytes.

Objective To explore the scope of building emergency medical security mechanism in urban paved road environment, and to provide reference, sample data and improvement suggestions for building emergency medical security mechanism in such specific environment. Methods The data of rescue personnel deployment, rescue materials allocation, rescue force monitoring, actual rescue situation, emergency plan and relevant regulations setting, training and other aspects of the emergency medical security mechanism in March and April 2023 were collected, and the data were analyzed. Results (1) The hiking distance was 40km and the road conditions were urban paved roads. There were 1150 official trekkers and 65 people were treated medically. (2) The most common symptoms of outdoor hiking included skeletal muscle injury (19.48%), foot skin and soft tissue injury (18.17%), fever (2.61%) and diarrhea (0.61%). (3) In March, 18.36% of the core medical team members and 20.41% of the first aid volunteers who underwent systematic training took up the task of supporting hiking activities. In April, the core medical team personnel who undertook the task of supporting hiking activities accounted for 1.23% of the total number of the security team, and the first aid volunteers who underwent systematic training accounted for 37.04%. (4) According to local conditions, the multi-vehicle rescue and transport mode was adopted, which was combined with the modified commercial rescue vehicle (42.86%) with the on-board emergency medical unit (EMU) and the ordinary ambulance (28.57%). (5) More than 700 pieces of 34 kinds of medical materials and 40 sets of mobile communication equipment, which were put into use after the feasibility study of the expert group and the technical group, guaranteed the competition from the hardware level. Conclusion The construction of emergency medical support mechanism in outdoor walking sports needs to pay attention to environmental characteristics, operation mode of support team, personnel and adaptability training, equipment and deployment of medical support materials, deployment and cooperation of communication and transport capacity, reasonable support plan and other factors. Medical volunteers who have been systematically trained can undertake part of outdoor medical rescue work. Pre-activity training and regular re-training of medical volunteers can ensure the safety of outdoor activities.

Introduction:Women with heart failure (HF) tend to experience a greater symptom burden and lower quality of life, possibly due to phenotypic differences and unique gender-associated risk factors. Despite evidence on the effects of cardiac rehabilitation programs (CRP)in the general population, there is underrepresentation of women in these programs. Additionally, the impact of CRP on cardiorespiratory variables obtained through cardiopulmonary exercise testing (CPET) and health-related quality of life (HRQoL) in womenwith HF remains unknown.Objective:To assess the impact of a CRP on cardiorespiratory fitness (CRF) in cardiorespiratory variables obtained through CPET and HRQoL in women with HF.Methods:A quasi-experimental study included HF patients who completed a CRP from June 2019 to December 2023. The CRP involved nutritional assessment, psychosocial evaluation, educational sessions, and concurrent training. It comprised 30 minutes of aerobic resistance training at 65-80% of heart rate reserve (HRR) and 30 minutes of strength training at 30-50% of 1-repetition maximum (1RM), with a frequency of 3 sessions per week for 4 to 6 weeks. CPET was conducted at the beginning and end of the program, analyzing cardiorespiratory variables. HRQoL was assessed using the SF-36 questionnaire. Gains in CRF and HRQoL at the end of the program in both men and women were analyzed.Results:Out of 217 included patients, 29.9% were women. At the programs onset, women showed lower exercise tolerance than men (workload 5.4±2.57 METs vs.6.62±2.53 METs) and worse HRQoL (62.03%±18.37 vs. 68.38%±18.37). However, post-intervention, they optimized their CRF (%predicted VO2 [%VO2p] initial 56.62%±20.11 vs final 80.12%±30.32, p=<0.001). Significant improvements in cardiorespiratory variables were observed in both cases: delta METs-load 3.02, p=<0.001, delta peak oxygen consumption (VO2peak) 1.83 ml/kg/min, p=<0.001, delta oxygen pulse (PO2) 1.21, p=0.021, delta cardiac power output (CPO) 1917, p=0.004, with a rightward shift in ventilatory thresholds and improvement in HRQoL (62.03%±18.37 vs. 78.81%±12.9, p=<0.001) post-CRP. The only variable with no significant changes in either case was VE/VCO2slope (delta -0.51, p=0.736). Additionally, in women with reduced left ventricular ejection fraction (<50%), variables with no significant improvement included CPO (delta 959.22, p=0.283) and time to recovery of VO2kinetics (TRCVO2) (delta -0.74, p=0.957). In patients with preserved left ventricular ejection fraction (=50%), variables with no significantchange included PO2(delta 1.08, p=0.173), TRCVO2(delta 26.82, p=0.099), and the first ventilatory threshold (VT1) (delta 0.09, p=0.504). Program attendance was 87.5% in both groups.Conclusion:Implementing a CRP in women with HF resulted in significantimprovements in all evaluated cardiorespiratory variables (except for VE/VCO2slope) and quality of life. These findings support the importance of ensuring womens access and participation in cardiac rehabilitation programs. Addressing existing barriers is crucial to maximize the long-term benefits of CRP in the female population with HF.

Background:Infertility is defined as failure to be pregnant after 12 months of unprotected intercourse. This condition affects millions of individuals worldwide. It is not only a personal problem, causing stress and anxiety amongst individuals and couples, but it has become a community issue. One in every 6 couples will experience infertility in their lifetime. It is affecting both male and female reproductive systems, with causes ranging from hormonal imbalances to obstructive disorders. Despite its prevalence, fertility care is unequal and, for those in low and middle-income countries, virtually non-existent and a long overdue topic for global attention and action. Method:We followed a systematic approach to select articles related to recent developments in female fertility and reproductive medicine. Keywords such as “female fertility” and “advanced reproductive medicine” were used for getting targeted articles. We used only peer-reviewed articles published from 2019 to 2024. Only high-quality data was extracted for general public information. Result:Our findings show that Assisted Reproductive Technologies (ART), microfluidic devices, and innovations like CoQ10 therapieshave significantly improved fertility treatment outcomes. AI-driven personalized medicine has enhanced accessibility and effectiveness, democratizing fertility care. Stem cell therapy and platelet-rich plasma techniques are another breakthrough in reproductive medicine. Conclusion:It is concluded that medical advancements have revolutionized reproductive medicine. There is now a ray of new hope for those couple who are experiencing infertility. The future promises further improvements in success rates and patient experience with continued progress

Objective:Since patients with implantable cardiac devices tend to develop chronotropic incompetence (CI) associated with the effect of the device itself or the pharmacological effect of the underlying disease, CI could act as a limiting factor in improving exercise tolerance in patients undergoing cardiac rehabilitation program, since an increase in HR is a crucial part in improving cardiac output as a central component of oxygen consumption (VO2). However, it has been observed that there could be other factors contributing to the improvement in exercise tolerance in these patients regardless of the presence of CI. The aim of this research is to clarify the effect of chronotropic incompetence on the improvement in exercise capacity in patients with implantable cardiac devices after a phase II cardiac rehabilitation program (CRP). Methods:Quasi-experimental study applied to patients with implantable cardiac devices (ICDs, CRT, pacemakers) undergoing a supervised concurrent CRP, lasting 4-6 weeks, at an intensity between 65-80% of heart rate reserve (HRR), associated with kinesiotherapy sessions (with strength and endurance training and other biomotor qualities) and interdisciplinary intervention, education, and counseling. CI was calculated using the chronotropic response index, and METs-load measurement was performed at the beginning and at the end of the intervention. Results:Forty patients with a mean age of 61.4 years were included, mostly male (29) 72.5%, (23) 57.5% diagnosed with heart failure, and regarding the type of device, pacemakers (20) 50%, implantable cardioverter-defibrillator (ICD) (12) 30%, and cardiac resynchronization therapy with defibrillator (CRT-D) (20) 8%, of the total patients (35) 87.5% presented chronotropic incompetence and only (5) 12.5% with normal chronotropic response at the end of the intervention. A significant decrease in the chronotropic response index from 0.70 to 0.47 (p <0.001) and a significant increase in METs-load from 5.47 to 9.35 (p <0.001) were found. The value of the differential between initial and final METs (delta-METs) was obtained for both groups, observing a significant increase between initial and final METs in favor of patients with CI (3.8 Vs 3.5, p<0.012) at the end of the intervention. A significant moderate negative correlation (r=-0.395, Spearman, p<0.012) was determined between the degree of CI and final METs-load.Conclusions:It was observed that patients with implantable cardiac devices undergoing a CRP show an increase in exercise tolerance measuredin METs, with an inversely proportional correlation to chronotropic incompetence

Our vision is to develop an AI-based software which is capable of analyzing frontal PA chest X-rays for disease diagnosis, detection, and prediction through the analysis of several different X-ray manifestations and findings which are inter-correlated to arrive to afinal result. We utilize state of-the-art AI, thereby facilitating in empowering of the world through our med-tech ecosystem. It is being developed with the intention of enhanced cardiopulmonary care, bridging the gaps in healthcare, by giving conclusive and comprehensive diagnosis at lower costs and reducing the number of unnecessary diagnostic tests which, often, serve as the main cause of the delay between diagnosis and treatment.Why X-rays? X-rays have been chosen as the input because it is Non-invasive mode of diagnostic test, affordable, accessible and has much lesser radiation exposure compared to other imaging methods of CT, MRI, PET

Thromboangiitis obliterans known as Buergers disease is a nonatherosclerotic, progressive inflammatory disease that affects small and medium arteries in the upper and lower extremities.Strong relationship was found between the development of this disease and the patients history of smoking. We reported a case of 50-year-old male with progressive pain in fingers of right legwith darkened ulcer. Open lumbar sympathectomy is a procedure that is rarely performed nowadays, but progressive pain in buergers disease patients can be managed with this procedure. The aimof sympathectomy is to reducesympathetic response causingvasodilation effect which will reduce rest pain.

Introduction: Choking in babies is not only a health issue, but also a source of anxiety for parents and caregivers, as it can lead to serious consequences, including serious injuries and, in extreme cases, death. Objective: Offer a thorough analysis of the existing literature on this critical topic.Methods: This study constitutes a systematic review, classified as exploratory and descriptive. The preparation of the research was a bibliographical search in electronic databases on methods associated with RSL (Systematic Literature Review) and the applications of SMARTER (Simple Multi-Attribute Rating Technique using Exploiting Rankings). Results: A comprehensive systematically search of the literature yielded a total of 423 articles referring Im the main causes of choking in children under 1 year of age, of which 11 articles were eligible Im be included in this systematic review.Conclusion: Continued research and public education efforts are important in mitigating the risks associated with choking in infants. Implementing evidence-based prevention strategies is crucial to ensuring the safety and well-being of newborns and young infants

BACKGROUND:Elderly is a person who has reached the age of more than 60 years old. Elderly generally experiences a decreased in oral hygiene, number of teeth, mucosal sensitivity of the oral cavity and xerostomia. Xerostomia can cause the decreased in oral hygiene and cause an increase in bad breath (halitosis). OBJECTIVES:The purpose of this study is to provide information about halitosis score in elderly. METHODS:This was descriptive research with cross sectional approach. The numbers of subject were 30 and obtained by quota sampling. Data collection was done by anamnesis and by measuring halitosis score, using Tanita breath checker. Tanita breath checker is an innovative palm-sized monitor that able to detect and measure the presence of volatile sulfur compound (VSC) by displaying the level of halitosis.RESULTS: Distribution of halitosis frequency in elderly based on gender were more female than male. Distribution of halitosis frequency in elderly based on halitosis score showed that there were fourteen subjects with a halimeter score of 2 while other scores were less than fourteen subjects. Halitosis frequency distribution based on anamnesis, subjects who had bad breath complaints were more than those who did not have bad breath. Conclusions: Based on the results, it can be concluded that halitosis in elderly were caused by many factors, such as dental caries and the habit of the subject who liked to eat smelly foods

Introduction:Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular events and heart failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a novel class of antidiabetic agents with potential cardiovascular benefits.This systematic review aims to evaluate the impact of SGLT2 inhibitors on reducing cardiovascular events and heart failure hospitalizations in patients with T2DM.Aims:The review aims to comprehensively evaluate the impact of SGLT2 inhibitors on reducing cardiovascular events, including MACE, and HF hospitalizations in patients with T2DM. Methods: A comprehensive literature search was conducted in major electronic databases like PubMed, Google Scholar and Science Direct to identify relevant studies. Studies investigating the cardiovascular outcomes of SGLT2 inhibitors in T2DM patients were included. Data extraction and quality assessment were performed independentlyby three reviewers using predefined criteria.Results:A total of 17 studies met the inclusion criteria and were included in the review. The analysis of clinical trials, including EMPA-REG OUTCOME, CANVAS Program, and DECLARE-TIMI 58, demonstrated significant reductions in MACE and HF hospitalizations with SGLT2 inhibitors compared to placebo or standard care. Real-world evidence from studies such as the CVD-REAL and EASEL studies further supported these findings, showing consistent cardiovascular benefits of SGLT2 inhibitors in routine clinical practice. The findings suggest that SGLT2 inhibitors are associated with a reduction in cardiovascular events, including myocardial infarction, stroke, and cardiovascular mortality, as well as a decreased risk of heart failure hospitalizations in patients with T2DM. Conclusion:This systematic review provides evidence supporting the cardiovascular benefits of SGLT2 inhibitors in T2DM management. The findings underscore the importance of considering these agents as part of comprehensive cardiovascular risk reduction strategies inT2DM patients. Further research is necessary to explicate the mechanisms underlying these benefits and optimize their clinical use

Central nervous system (CNS) relapse in diffuse large B-cell lymphoma (DLBCL)is a rare but serious complication associated with poor outcomes. The prevalence of CNS relapse in DLBCL varies widely in the literature, ranging from 1% to 30%, depending on several risk factors and diagnostic methods. This article provides a comprehensive review of the current literature on the prevalence of CNS relapse in DLBCL, focusing on risk factors, diagnostic approaches, and treatment strategies. Understanding the epidemiology and clinical characteristics of CNS relapse in DLBCL is crucial for thedevelopment of effective preventive and therapeutic strategies.

The paper explores the transformative impact of digital media on epidemiological surveillance. We are aiming to highlight innovative technologies such as Artificial Intelligence (AI), Internet of Things (IoT), Blockchain, and Wearable Devices role in collecting surveillance data. Through predictive modeling, image recognition, and Geographic Information Systems (GIS), the integration ofdigital tools has revolutionized disease detection, outbreak prediction, and resource allocation aiding in overall data surveillance system. Cases including Arogya Setu, BlueDot, and HealthMap illustrate the efficacy of AI-driven surveillance during the COVID-19 pandemic. Challenges persist, necessitating a holistic approach encompassing technological advancement, regulatory frameworks, and ethical considerations to optimize the benefits of digital surveillance while safeguarding privacy and equity

The quadricuspidaortic valve (QAV) is a rare anatomical variation, and the estimated incidence is lower than 0,05% of all congenital heart diseases (1). It is usually found as an isolated alteration, however, it may be associated with other concomitant cardiac anomalies (2).In this case report, an atypical presentation of the QAV was observed, with a lot of clinical dissociation versus complementary exams of excellent accuracy for the diagnosis.

Background: Antenatal care (ANC) serves as a critical component of maternal healthcare, providing pregnant women with essential medical services, information, and support to ensure a healthy pregnancy and childbirth. Objective: The aims of this study was to examine the impact of rural and urban mothers awareness gained through antenatal care of which mothers admitted in the labour ward and postnatal wards of Pabna Medical College Hospital for child birth.Methodology: A descriptive type of cross-sectional study was conducted among systemic randomly selected 442 postnatal mothers. Among them 241 mothers were selected from rural and 201 mothers from urban area. Data were collected by face to face interview through structured questionnaire from January to October 2022.Results: The mean age of rural mothers was 24.82 ± 4.03 years and 24.68 ±4.5 years of urban mothers. From the rural areas, 91.3% respondents know about meaning of antenatal care. On the other hand in urban areas 97.5% respondents know about meaning of antenatal care.It was found that in case of rural areas, 83.8% respondents replied that mother’s condition after child birth was good and in case of urban areas 88.1% respondents replied that mother’s condition after child birth was good. In rural areas 89.7%respondents replied that babies condition after birth was good and in urban areas 92.6% respondents replied that babies condition after birth was good.Conclusion: The awareness gained through antenatal care plays a pivotal role in promoting maternal and neonatal health by facilitating early detection and management of complications, promoting healthy behaviors, and empowering women to make informed decisions about their health and the health of their newborns.

Background: Dispensary services are a crucial part of the health care delivery system.Patients’ satisfaction is an important indicator to measure the quality of dispensary services of a health care organization. Objective: Aim of this study was to assess the level of patients’ satisfaction regarding dispensary services at secondary level hospitals. Methodology: A descriptive type of cross-sectional study was conducted among purposively selected 349 respondents at Munshigonj General Hospital and Narsingdi 100 Bedded Zilla Hospital. Data were collectedby face to face interview through semi-structured questionnaireand observational checklist from January to December 2022. Results: Atotal of 349 respondents were included in this study. Majority of the respondents (69.6%) were highly satisfied for the services with the labeling on the medicine packets. Most of the respondents (85.1%) were dissatisfied regarding the instructions for adverse reaction of drugs, advice about proper storage of medicine (85.1%), waiting space (67.9%).Conclusion: Ensure availability of drugs, distributing medicine as per local demand, increasing the number of posts of pharmacists and number of counters will improve the quality of dispensary service

Introduction:Biomedical waste (BMW) management is not just a legal need, but also a social responsibility. Utilizing the skills and knowledge of nursing practice, nurse can enhance proper BMW management while minimizing complications related to infectious wastes. Methods:A descriptive type of cross sectional study was conducted among 297 nurses working in Dhaka Medical College and Hospital and Shaheed Suhrawardy Medical College and Hospital, in Dhaka city. Data were collected with a pretested semi-structured questionnaire and practices were assessed by observational checklist. Results: Majority (58.6%) of the participants were belongs to age group 25-35 years. Only 4% had right knowledge about six types color coding bin for BMW storage according to national guidelinefor BMW management. Regarding practice 56% did not store waste in designated color coded bin, 53% recapped used needle, 93% didn’t practice needle cutter, 47% not wear PPE. About barriers of BMWM 64% of respondents opined for inadequate nursing and support staff, of them 41% were well-trained, 35% stated that dedicated place for temporary storage. Conclusion: Most of the nurses had knowledge of BMW and its management but less practice due to the unavailability of sufficient trained staff, logistics, designated places etc

Worldwide, acute ischemic stroke continues to be the primary cause of death and disability, requiring ongoing improvements in treatment approaches. With an emphasis on current advancements in collateral evaluation, thrombolytic therapy, endovascular thrombectomy, and neuroprotective treatment, this review examines novel treatments for acute ischemic stroke. To find relevant research published in the past five years, a thorough search of academic databases was carried out. The inclusion criteria for the inclusion of articles on innovative therapeutics and their implications for managing acute stroke were methodological rigor and direct relevance. With an emphasis on the effectiveness and safety of Tenecteplase, the review emphasizes the crucial role that collateral circulation plays in forecasting patient response to reperfusion treatments and the changing landscape of thrombolytic drugs. Furthermore, the treatment of acute strokes has been transformed by developments in endovascular thrombectomy, which provides better functional results for patients with major artery occlusions. Additionally, neuroprotective drugs have potential as complementary treatments, especially when used in combination with reperfusion procedures. Novel treatments for acute ischemic stroke provide fresh chances to improve patient outcomes and lower stroke-related morbidity and death. To provide equal access to improved stroke care, solve outstanding difficulties, and enhance treatment regimens, further research is required