Introduction: Wound dressing is a fundamental aspect of modern healthcare, encompassing a diverse range of materials and techniques aimed at optimizing the healing process while safeguarding against infection and further injury. By understanding the specific benefits of different types of wound dressings, healthcare professionals can optimize the healing process and improve patient outcomes

The second most frequent type of non-melanoma skin cancer is cutaneous squamous cell carcinoma (cSCC). We present the case of a squamous cell carcinoma of the scalp with surgical management and the importance of the Ying-yang flap. Ying-Yang flaps" are employed when there is stress on the incision, especially on the scalp and lower extremities

Wereporta40-year-oldfemalewithcoloncancer,initsfirstsessionoftreatmentwithcapecitabine/oxaliplatin,whopresentedaneventofacutecoronarysyndrometypemyocardialacuteinfarctionwithSTinferiorelevationinthefirst30daysafterinitiationofadjuvanttreatment,angiographicallywithoutlesionsandechocardiographicallypresentedimpairedventricularfunction.Thiscasereportillustratesmyocardialdamageinducedbyantimetabolitesinanacutemanner

Endomyocardialfibrosis (EMF) is characterized by fibrosis of the endomyocardium of one or both ventricles and atrioventricular valves. Progressive fibrosis leads to irreversible restrictive cardiomyopathy, progressing to heart failure (HF), thromboembolic phenomena, and arrhythmias. It is one of the main complications of chronic eosinophilic leukemia (CEL), resulting from intense eosinophilic infiltration into cardiac tissue. This case is of a 34-year-old male patient with past medical history of CEL, who developed EMF and severe heart failure, NYHA (New York Heart Association) IV, and underwent endocardectomy and mitral and tricuspid valvuloplasty. After the procedure, he improved to NYHA II, initiated cardiovascular rehabilitation, and returned to daily activities

Background:The effect of lung cancer and its various treatments on the overall well-being can be substantial. This study seeks to examine the correlation between quality of life and baseline hemoglobin (Hb) levels in lung cancer patients who are receiving chemotherapy.Method:This study involved 30 patients with non-small cell lung cancer (NSCLC) who underwent platinum-based chemotherapy. Baseline Hb level were collected from medical records. The patients quality of life was assessed using interviews utilizing the EORTC QLQ-LC13 questionnaire.Result:Baseline Hb levels and pain relief after medication score was positively correlated (r=0.559, p=0.001). Baseline Hb levels and difficulty swallowing score was negatively correlated (r=-0.386, p=0.035). Determined cut-off point for the total score was 303.5. However, the correlation between Hb levels and overall quality of life was insignificant (r=-0.096, p=0.615).Conclusion:According to the quality of life indicators in the questionnaire, there is a notable association between lower baseline Hb levels and reduced effectiveness of pain relief medication, as well as an increase in difficulty swallowing. However, the underlying cause for this correlation is unclear. On the other hand, the correlation between baseline Hb levels and the overall scores of quality of life in the questionnaire was not found to be significant.

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare and inflammatory disorder characterized by fever, neutrophilia, and tender, erythematous skin lesions. The pathogenesis of Sweet syndrome involves an exaggerated immune response, with evidence suggesting a role for cytokines, particularly granulocyte colony-stimulating factor (G-CSF). Clinical manifestations vary widely, but commonly include abrupt onset of painful, raised plaques or nodules, often on the upper limbs, face, or neck. Histopathological examination reveals dense neutrophilic infiltrates in the dermis without evidence of vasculitis.Diagnosis is primarily clinical, supported by histopathology and exclusion of other similar conditions. Treatment typically involves corticosteroids, which often lead to rapid resolution of symptoms. However, relapses are common, necessitating long-term management strategies. This review aims to provide a comprehensive overview of the pathogenesis, clinical manifestations, diagnosis, and management of Sweet syndrome, highlighting recent advancements and areas requiring further research.

Pulmonary embolism (PE) presents significant healthcare challenges and potentially life-threatening consequences, demanding a nuanced approach to management. This systematic review aimed to critically evaluate available pharmacological and nonpharmacological interventions for PE, analyzing their efficacy and safety in patients with cardiac comorbiditie, ranging from traditional anticoagulants like warfarin to novel direct oral anticoagulants (DOACs) or thrombolytic therapies is commercially available options with varying benefits and limitations. Nonpharmacological interventions, including catheter-directed therapies and embolectomy, provide alternative avenues, especially when thrombolysis is contraindicated despite advancements, and gaps persist, particularly in reconciling efficacy with safety profiles and optimizing resource allocation. Addressing these challenges necessitates a multidisciplinary approach, integrating clinical expertise with evidence-based practices. By exploring these interventions intricacies and implications, this review aims to inform clinicians, researchers, and policymakers, fostering improved care pathways and better outcomes for patients facing the complex landscape of PE management

Discoid lupus erythematosus(DLE) is a chronic inflammatory skin condition that can lead to disfiguring scarring and pigmentary changes. This review article provides an overview of the epidemiology, pathogenesis, clinical manifestations, and treatment options for DLE. Special considerations in the management of DLE, including the role of photoprotection, topical and systemic therapies, and the importance of multidisciplinary care, are discussed. The impact of DLE on quality of life and psychosocial well-being is also addressed. A better understanding of the complexities of DLE can aid clinicians in providing comprehensive care to patients with this challenging condition.

ntroduction: Businesses and organizations in the current period strive to thrive in a fiercely competitive environment by attracting a maximum number of consumers. Purpose: This review study seeks to examine the definition of quality in health care with the goal of promoting health. Materials and Methods: The methodology employed involved doing a comprehensive literature search of review and research studies in internationally recognized databases such as Medline, Pubmed, and Cinahl. The articles were excluded based on the criterion that they were written in a language other than English.Results: The concept of health is intricate, making it challenging to establish a precise and unambiguous definition of excellence in healthcare. Quality in healthcare is an essential focus for scientists, organizations, and healthcare personnel, as well as for individuals who receive these services. Conclusions: Undoubtedly, quality in health services is an increasingly demanding first-priority need.

ntroduction: Leukodystrophies are a rare geneLcdisease characterized by damage of the myelin sheath. They represent a large number of diseases that are heterogeneous by their clinical and physiopathological aspects. Material and Methods: We report 12 cases of leukodystrophies collected at the Neuropediatric Unit of Abderrahim Harouchi Mother and Child Hospital CHU Ibn Rochd, Casablanca, Morocco. Results: The average age of diagnosis was 2 years and 9 months, with a predominance of females (sex raLo:0.33). Consanguinity was found in 5 cases. The onset symptomatology was dominated by psychomotor regression, found in 8 paLents, and seizures in 4 paLents. Motor signs were in the foreground: pyramidal syndrome in 5 cases, hypotonia in 4 cases, tetraparesis in 1 case, dysarthria in 1 case. The lumbar puncture, carried out in 4 paLents, revealed hyperproteinorachy in 3 cases, glycorachy and cytological study were normal. We noLced a decreased level of Aryllsulfatase A in 6 cases. Imaging was performed in all paLents and showed diffuse white ma]er demyelinaLon.MRI allowed us to classify our cases and showed 7 cases of metachromaLc leukodystrophy, 1 case of cavitary leukodystrophy, 1 case of Refsum disease, 1 case of Canavan disease, 1 case of Cockaynes syndrome and 1 case of adrenoleukodystrophy. The electroneuromyogram showed a decrease in nerve conducLon velociLes in 2 cases. Molecular study was performed in one paLent finding a hyccin mutaLon. Conclusion: The diagnosis of leukodystrophies is o_en difficult because of their clinical heterogeneity. The partnership of clinicians with geneLcists may be the key point to improve diagnosis and therapeuLc management

Endocardial fibroelastosis(EFE) is a rare and enigmatic myocardial disease characterized by the abnormal accumulation of collagen and elastin fibers in the endocardium, predominantly affecting the left ventricle. This comprehensive review aims to elucidate the pathogenesis, clinical manifestations, diagnostic modalities, and management strategies of EFE. EFE typically presents in infants and young children, although adult cases have been reported. The etiology of EFE remains elusive, with theories implicating genetic, infectious, and autoimmune factors. Clinically, EFE may manifest with symptoms of heart failure, arrhythmias, or sudden cardiac death. Diagnosis often involves echocardiography, cardiac magnetic resonance imaging, and endomyocardial biopsy. Management strategies for EFE are primarily supportive, focusing on the management of heart failure symptoms and arrhythmias, with advanced cases necessitating heart transplantation. This review provides a comprehensive overview of EFE, highlighting the challenges in diagnosis and management and underscoring the need for further research to elucidate its pathogenesis and improve outcomes.

Sepsis is a severe acute infection that can lead to organ failure and mortality in 30-50% of patients. It ranks among the top 10 causes of mortality in the United States and has increased significantly since the 1970s. Postoperative sepsis, the primary type of sepsis, accounts for almost one-third of all sepsis cases.Postoperative sepsis is a major cause of illness and deathfor hospitalized patients, often leading to multiple organ failure and mortality. A study found that patients aged 18 years or older who have undergone surgical interventions and have been hospitalized for at least 4 days after the operation have a higherlikelihood of developing sepsis. The most prevalent complication after radical gastrectomy for stomach cancer is postoperative infection, which occurs through leukocyte depletion in transfusion patient.Being male or over 65 significantly increased the likelihood of having postoperative sepsis. Sex hormones significantly influence the bodys response to sepsis, and elderly individuals may be more susceptible due to deterioration of immune system function and age-related immunosenescence. Chronic renal illness, diabetes, and chronic heart failure have the highest risks of developing postoperative sepsis, ranked first, second, and third, respectively.Dysfunctions in the cardiovascular and hematological systems also have the highest probability of leading to the development of postoperative sepsis. These findings suggest potential areas for future research to decrease the impact of the disease.

Introduction:El síndrome hemofagocítico es una enfermedad grave caracterizada por un estado de hiperinflamaciónsistémica con sobreproducción de citoquinas. Puede responder a causas genéticas (primario) o desencadenarse por infecciones, fármacos, neoplasias o enfermedades autoinmunes. Con una mortalidad incrementada. Se presenta el caso de un paciente con VIH que desarrolló síndrome hemofagocítico en internamiento. Case presentation:Presentamos el caso de un paciente masculino portador de Inmunodeficiencia humana, el cual desarrolló síndrome hemofagocítico con linfadenopatíasy reporte de biopsia concluyendo la sospecha sindromática. Conclusiones:Nuestro reporte de caso refleja la el abordaje clínico y bioquímico del síndrome hemofagocítico, en quien la realización de un diagnóstico histopatológico fue determinante para reflejar la causa de la enfermedad en cuestión, denotamos la importancia de la sospecha clínica en situaciones infrecuentes relacionadas con el paciente con inmunodeficiencia.

Minimally invasive surgery (MIS) is a groundbreaking approach for treating Crohns disease (CD), affecting approximately 100-300 per 100,000 people. In 2015, an estimated 3.1 million people were diagnosed with Inflammatory Bowel Disease (IBD). Our researchaims to consolidate previous evidence on MIS techniques, including laparoscopic techniques and robotic-assisted surgery, and compare them to traditional surgical techniques in managing CD. The practical benefits of MIS are evident in comparative studies, which consistently show that laparoscopic approaches result in shorter hospital stays and faster recovery than open surgery. MIS also demonstrates significant long-term benefits, particularly in reducing the mortality rate. Even pediatric CD patients have shown improved outcomes with laparoscopic-assisted surgery, experiencing fewer postoperative complications and better recovery. MIS applications include Laparoscopic ileocolic resections, a key MIS technique, offer comparable outcomes to other therapies like open ileocolic resection but with the added advantages of lower costs and long-term disease control. This cost-effectiveness of MIS techniques is a significant advantage. Techniques like intracorporeal anastomosis and trans colonic specimen removal havefurther improved postoperative recovery and cosmesis. Strictureplasty is another MIS technique, is particularly beneficial for CD patients with strictures due to its ability to preserve intestinal length and function. Lastly,

Reconstructing the chest wall following substantial surgical removal is a challenging task for thoracic, oncologic, and reconstructive surgeons. Common indications include breast cancer, radionecrosis, and malignancies affecting fascia, muscle, and sometimes the ribs. Skin grafts are not a favorable choice due to their thinness and unsuitability of the recipient site. Over the past 30 years, a wide range of flaps have been created to achieve sufficient covering and protection of intrathoracic structures.TheTai and Hasegawa technique, developed in 1974, involves using a transverse fasciocutaneous flap taken from the same side of the body in the thoracoabdominal region. Davis and McCraw made modifications to this technique in 1977, and Brown and Vasconez in 1975 revealed the presence of musculocutaneous perforator branches originating from subcostal, intercostal, and lumbar arteries. Baroudi introduced a contralateral thoracoabdominal fasciocutaneous flap in 1978.In the 1980s, muscular and musculocutaneous flaps became widely accepted as the best method for reconstructing the chest wall. However, there have been limited comparison studies published, making it difficult to determine whether musculocutaneous flaps are preferable than fasciocutaneous flaps. Deo etal. (2019) proposed that the fasciocutaneous "thoracoabdominal" flap should be considered as the primary choice.The extended cutaneous thoracoabdominal flap is a straightforward and efficient surgery that can be completed in a single step. It is generallysafe and rarely results in tissue death, and its generous mobility and "back-cut" incision facilitate advancement and rotation. However, it has drawbacks such as the inability to carry out an instant breast reconstruction and the presence of lengthy scarson the abdominal wall

ntroduction: Eosinophilic gastroenteritis (EGE) is a rare disorder characterized by eosinophilic infiltration of the stomach and small intestine. Its clinical manifestations depend on the extent, location, and depth of the inflammatory infiltrate. The pathogenesis remains unclear, but it may be related to food allergy or other hypersensitivity reactions in some patients. Untreated cases can cause intestinal stricture or perforation, making timely diagnosis and intervention essential.Clinical case: A 13-year-old male adolescent was hospitalized due to symptoms suggesting intestinal obstruction or alterations in intestinal motility. Medical imaging revealed significant gastric distension and delayed gastric emptying. An endoscopic study showed a “snake-skin” pattern, duodenitis due to food stasis, a2 cm ulcer, and stenosis in the duodenum. The biopsy confirmed EGE with significant irregular eosinophilic infiltration of the lamina propria. A panendoscopy was performed after steroid treatment without being able to assess the site of stenosis and perform pneumatic dilation. After completing the immunomodulatory management, a contrast-enhanced abdominal tomography was performed showed a significant decrease in the intestinal lumen, therefore an exploratory laparotomy with a lateral to lateral jejune-jejunal anastomosis was performed. Discussion: EGE is a rare inflammatory disorder characterized by eosinophilic infiltration of the stomach and small intestine. Symptoms are based on the affected gastrointestinal tract segment. In this case, our patient presented intestinal obstruction symptoms with endoscopic biopsies and a histopathological study confirmed eosinophil infiltration. Treatment typically involves identifying potential triggers and corticosteroids to reduce inflammation and symptoms. However, in this case, a decrease in the intestinal lumen was observed, therefore an elective surgical resection was performed. Conclusion: Eosinophilic gastroenteritis is a rare disorder that requires strong clinical suspicion to be diagnosed, which is why its knowledge is important. In this case, gastrointestinal symptoms, radiological and endoscopic images, in addition to the histopathological report, were key tools for integrating the diagnosis. Although management with steroids and immunomodulators was not successful, surgical management became an appropriate option as definitive treatment.

Introduction:Motororsensorynerveinjuryisamajorsurgicalandclinicalchallenge,oftenwithdisappointing results and impairing sensory and motor function. Now there are some studies tolooking for ways to accelerate nerve regeneration. Platelet-rich fibrin (PRF) is made from anautologous platelet concentrate that contains progenitor cells that are essential for the healingprocess, along with neurotrophic factors and several growth factors. Additionally, PRF can bemanufacturedinthemembraneformthatcanbewrappedaroundnervesintheformoftubeswhichtubulation has many advantages such as guiding growth within the tubular shape to improveregenerative capacity.Methods:Thissystematicreviewandmeta-analysiswasconductedasperthePreferredReportingItems for Systematic Review and Meta-Analysis (PRISMA) guidelines. A systematic, detailedsearch was carried out by the authors in the electronic databases, including PubMed, Cochrane,ResearchGate,Elsevier,andPRSJournal.Studieswereselectedandcomparedbasedonoutcomemeasures like Morphometric (Axon Area and Myelin Sheath Thickness) and Electrophysiologic(Amplitude and Nerve Conduction Velocity). Statistical analysis was performed using a random-effectmodel,pooledstandardmeandifferenceandI2heterogeneity.Result:Fourrandomizedstudieswithanalyzed4parameters,thoseareMorphometric(AxonAreaandMyelinSheathThickness)andElectrophysiologic(AmplitudeandNerveConductionVelocity).Pooled analysisfor the outcomelikeMyelin Sheath Thickness, Axon Area, andAmplitude showed a significant result in groups with PRF. Pooled analysis for outcome of NerveConduction Velocity showed no significant difference between the groups with PRF and withoutPRF(SMD:0.01;95%CI:-0.64.0.65)withP= 0.99.Conclusion:ThisMeta-analysisshowsthatPRFmembraneasnerveguidanceconduitispromising method and can improve function outcome in nerve repair specially in MorphometricandElectrophysiologicparametersbutoutcomeofNerveConductionVelocityshowednosignificantinthis study.

It is important to recognize that this clinical case demonstrates that carriers can remain asymptomatic, there may be changes recognizable in the ophthalmological examination. The clinical onset of Leber hereditary optic neuropathy (LHON) usually occurs inyoung adulthood (ages 18-30) and is divided into subacute (<6 months from onset) and dynamic (6-12 months) stages. It is caused by a mitochondrial mutation that is transmitted from mothers to children. It is the most common inherited mitochondrial disorder, but it is considered a rare disease. It usually causes severe vision loss in both eyes. The classic presentation of LHON is that of a young adult male who develops a severe, painless, acute or subacute unilateral vision loss, followed by a similar vision loss in the fellow eye two to three months later (although rarely the delay can be much longer). In most cases, it starts affecting only one eye and, within a few weeks or months, affects the second eye. It can all be seen with the loss of the pupils ability to react to light. Complete blindness is rare among patients suffering from this disease.

Emerging evidence suggests that vaping can significantly impede wound healing, with prevalence rates of current e-cigarette use varying between 3.3% and 11.8%. This study aims to investigate the impact of vaping on wound healing, particularly in acute wounds encountered in plastic surgery settings. Electronic cigarettes (e-cigarettes), comprising a rechargeable battery and an atomizer or heating element, typically contain flavored liquids with or without nicotine as humectants. Skin wounds heal through overlapping inflammatory, proliferative, and remodeling phases. Chemical constituents of e-cigarettes, including propylene glycol (PG), vegetable glycerin (VG), nicotine, flavoring agents, and contaminants, hinder wound healing by inducing osmotic effects, cellular toxicity, vasoconstriction, reduced oxygen supply, impaired angiogenesis,cytotoxicity, and modulation of inflammatory responses. Similar to conventional cigarettes, e-cigarettes may compromise wound healing through a multifaceted mechanism, although they may offer a comparatively less harmful alternative.

Background: Maternal health is a critical component of public health worldwide, reflecting a societys commitment to the well-being of its women and children. The provision of obstetric services, encompassing antenatal care, delivery and postnatal care, plays a pivotal role in reducing maternal mortality and ensuring positive birth outcomes. However, the quality and accessibility of obstetric services are influenced by various factors, including healthcare infrastructure, staffing levels and healthcare policies.Objective: To determine obstetric service delivery trends and healthcare staffing at a teaching hospital in southwest NigeriaMethodology: This study utilized a retrospective cohort design to examine the utilization of maternity care services among women at Ekiti State University Teaching Hospital, Nigeria. Data spanning from January 2016 to December 2023 were collected from obstetric records.Analysis was done using Statistical Package for Social Sciences (SPSS) version 20.Results: a total of 9,855 deliveries were recorded, with 4,145 Caesarean sections and 5,767 spontaneous vaginal deliveries, giving a Caesarean section rate of 42%. Overall, there seems to be some fluctuations in the total number of deliveries over the years, with the highest number observed in 2019 (1482) and the lowest in 2021 (868). The number of consultants, senior residents, junior residents, house officers, nurses and other support staff varied over the years, with different staffing levels observed ineach year.Conclusion: this study contributes to a better understanding of obstetric service delivery trends and healthcare staffing dynamics, offering valuable insights for healthcare resource allocation and policymaking. The findings underscore the importance of monitoring caseloads and staffing levels to ensure quality maternal and infant healthcare delivery.

Background:The Health Promoting Family Approach involves a comprehensive perspective that extends beyond the conventional medical approach. It recognizes the intricate relationships among family dynamics, social and cultural backgrounds, and health habits. In this approach, families are seen not just as passive participants in health initiatives, but as influential contributors who play a pivotal role in molding health behaviors, mindsets, and ways of life.Material/Method:The research methodology involved descriptive bibliometric analysis using data gathered from international publications sourced from the Scopus database (accessible in www.scopus.com). The analysis was conducted using VOSViewer version 1.6.18 and R-Studio version 4.3.2, facilitating bibliometric analysis. Information regarding the study, focusing on the "health promoting family approach" keyword. Result:The results of bibliometric analysis show that publication trends from 1972 to 2024 have increased. Some of the most frequently used keywords by the authors include: human, female, male, health promotion, public health, family, qualitative research, mental health, and health. The journal BMC Public Health publishes the most articles about the Health Promoting Family Approach, with a total of 49 articles. The highest number of writer collaborations is from the United States. And the paper by Lobstein is the most globally cited document with a total of 3022 citations. Conclusion: Trend in publications on the Health-Promoting Family Approach, particularly concerning mental health, from 1972 to 2024, has shown an increasing trajectory, indicating a growing interest and relevance in this topic. Authors from developed countries such as the USA and the United Kingdom have contributed the most to these publications.

ntroduction: Breast cancer (carcinoma mammae) is a malignancy originating from breast tissue, either from its ductal or lobular epithelium.Objective:This study aim to find out the characteristics of Breast Cancer at Margono Soekarjo Hospital in Purwokerto to determine the breast cancer therapy policies.Methods:This study utilized a descriptive retrospective design with the research subjects being patients with carcinoma mammae who underwent anatomical pathology and immunohistochemistry examinations at Prof. Dr. Margono Soekarjo Regional General Hospital from 2020 to 2023.Result:The characteristics age of patients with Carcinoma Mammae are divided into 76 patients (30,9%) between 50-59 years old, followed by the 40-49 age group with 68 patients (27,6%). A total of 178 (72.4%) patients are ductal type, followed by 35 patients (14,2%) are lobular type. A total of 92 patients (37,4%) are grade 2 of Ca Mammae, followed by 83 patients (33,7%) are grade 3. A total of 95 patients (38,6%) are Luminal B sub type, followed by 69 patients (28%) are Her2 Enriched.Conclusion:The majority of breast cancer patient are aged 50 –59 years with Invasive Ductal Carcinoma type, grade 2 and Luminal B Subtype.

Introduction: Antimicrobial treatment in burn patient include systemic and topical antibiotic care should be carefully deliberated to prevent the development of resistant organismsMethods: This literature review was compiled using information from numerous open access web databases. Data were compiled and analyzed.Results and Discussions: To prevent antibiotic resistance and prevent infection, the best prophylactic antibiotics for burn patients are topical antibiotics. However, for the treatment of patients with extensive burns or those with antibiotic resistance, especiallyantibiotics for gram-positive bacteria, systemic antibiotics can be used for treatment.Conclusion: The use of antibiotics in patients with burns can be adjusted to the patients needs. surgeons may consider its use to prevent antibiotic resistance in patients

Aim/Objective:The purpose of this study was to determine how intense exercise effect the blood pressure, heart rate and the extent upto, which the cardiac remolding may occur in elite athletes.Location of Study: This study was conductedin the Department of Physiology, Army Medical College, along with the Armed Forces Institute of Cardiology (AFIC) in Rawalpindi.Methodology: There were 40 control participants and 40 elite endurance athletes. Clinical tests were performed on all the subjects to rule out an underlying medical condition or disease. Auscultatory method was used to measure the heart rate before exercise and immediately after exercise, Similarly theblood pressure was examined before and within 3 minutes after the physical activity. The left ventricular end-diastolic internal diameter (LVIDd), diastolic posterior wall thickness (PWTd), diastolic interventricular septal thickness (IVSTd), and left ventricular mass (LVM) were measured by echocardiography and determined using the Devereux formula. Before breakfast, the participants engaged in maximum physical activity on an electronicergometer cycle until they were exhausted.Results: It was observed thatwhen compared to the control group, the heart rates and blood pressure of athletes were noticeably lower. In contrast, LVIDd, IVSTd, PWTd, and LVM were higher in athletes than in healthy controls...Conclusion:The long term athletic training causes remodeling of the heart with increased dimensions of the left ventricle which reduces the heart rate and blood pressure in endurance trained athletes

Type 2Diabetes Mellitus is a heterogenousgroup of disorders characterized by variable degree of insulin resistance, impaired insulin secretion and excessive hepatic glucose production. Diabetic thrombocytopathy is a condition that affects the platelet function in diabetic individuals. The aim ofthis research is to study the platelet parameters in type 2 diabetics. Method: In this cross sectional study we studied fasting blood sugar level, post prandial blood sugar, HbA1c and platelet parameters in relation with HbA1c and blood sugar levels in 115 patients of type 2 diabetes mellitus.Results: Present study shows that there is statistically significant correlation between BSL (Fasting) ,BSL (Post prandial) and HbA1c; BSL (Post Prandial) and Plateletcrit and no statistically significant correlation between the other platelet parameters and HbA1c, fasting blood sugar level and post prandial blood sugar level in type 2 diabetics

Seborrheickeratosis(SK)andBowendisease(BD)aredifferententitiesindermatopathology.Differentiatingbetweenthesetwoisimportantandcansometimesbeachallengeforthepathologist,whomayneedtorelyoncomplementarytechniques.Toobtainareliabledistinction,severalimmunohistochemistrymarkershavebeenexploredsuchasp16andKi67,beingpositiveinBowendiseaseandnegativeinSeborrheickeratosis.Ki-67isanon-histoneproteinassociatedwithribosomesandawell-knownmarkerofcellularproliferation,overexpressedinBowendisease.Inaddition,ithasbeenrelatedtoagreaterexpressionofantigensassociatedwiththegrowthanddifferentiationofkeratinocytes.P16isatumorsuppressorgenethatinhibitscyclin-dependentkinases4and6.Hisinactivationleadstoaunregulatedproliferationofthecellcycle.AgreaterexpressionwasfoundinBowenDiseasecomparedtoSeborrheicKeratosis.Immunohistochemistryallowsthedistinctionbetweenentitiesthatmaybeappearsimilarbothclinicallyandhistopathologically.Thisisofutmostrelevancesincepropertreatmentdependsonaprecisediagnosis

Non-smokers, particularly adolescents, face significant public health risks from e-cigarette use due to immediate health hazards, the potential for initiating tobacco use, and insufficient data on critical health outcomes, including wound healing. This study investigates vapings impact on chronic wound healing, emphasizing e-cigarette chemical components. E-cigarettes contain common constituents: 1) Base liquids: Propylene glycol (PG) and vegetable glycerin (VG), 2) Nicotine, 3) Flavoring chemicals and additives, 4) Trace contaminants and toxins. Chronic wounds exhibit persistent inflammation, impaired proliferation, delayed remodeling, and environmental factors (e.g., ischemia, infection, trauma). E-cigarette components impair wound healing: VG induces osmotic effects and cellular toxicity, nicotine causes vasoconstriction, reduced oxygenation, and impaired angiogenesis. Flavoring chemicals contribute to cytotoxicity and modulate inflammatory responses, while contaminants like heavy metals induce oxidative stress and inflammation. Despite e-cigarettes lower harm compared to traditional cigarettes, their effects on chronic wound healing remain poorly understood. Further research is essential to elucidate smokings precise impact on chronic wound healing.

nomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) syndrome is a rare congenital cardiac anomaly characterized by the abnormal origin of the left coronary artery from the pulmonary artery instead of the aortic root. This anomaly results in compromised myocardial perfusion, particularly under conditions of increased oxygen demand, leading to myocardial ischemia, left ventricular dysfunction, and potentially severe complications such as mitral regurgitation, heart failure, and sudden cardiac death. The pathophysiology of ALCAPA involves a complex interplay of coronary artery steal phenomenon, collateral vessel development, and ventricular remodeling. Early diagnosis is critical, often achieved through echocardiography, cardiac MRI, or coronary angiography, which helps in planning surgical intervention. The mainstay of treatment is surgical correction to re-establish a dual coronary artery system, with techniques including direct reimplantation of the anomalous coronary artery into the aorta or the creation of an intrapulmonary tunnel. This article provides a comprehensive review of the current understanding of ALCAPA syndrome, emphasizing its pathophysiology, clinical presentation, diagnostic modalities, and surgical management, along with outcomes and prognostic factors.

Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare inherited heart disorder characterized by fibrofatty replacement of the right ventricular myocardium, leading to ventricular arrhythmias and an increased risk of sudden cardiac death. This review aims to provide a comprehensive overview of ARVD, including its pathophysiology, clinical manifestations, diagnostic criteria, and management strategies. The pathogenesis of ARVD involves genetic mutations affecting proteins of the cardiac desmosome, leading to myocardial cell death and fibrofatty replacement. Clinical presentation varies widely, ranging from asymptomatic individuals to those with palpitations, syncope, or sudden cardiac arrest. Diagnosis is challenging and relies on a combination of clinical, electrocardiographic, imaging, and histopathologic findings. Management involves risk stratification for sudden cardiac death, lifestyle modifications, antiarrhythmic medications, and, in select cases, implantable cardioverter-defibrillator placement or catheter ablation

Burn injuries are a significant cause of admissions to burn and plastic surgery units.One treatment modality for burn injury patients is hyperbaric oxygen therapy (HBOT). HBOT exposes patients to high concentrations of oxygen at increased atmospheric pressure levels. It can enhance burn wound healing by promoting cellular response, inflammatory cytokines, neovascularization, and collagen formation.This review explores the role of HBOT in enhancing burn wound healing, particularly in plastic surgery. We gathered and analyzed information from various web databases, using specific keywords related to burn wound injuries and HBOT. Inclusion criteria encompassed open-access journals and articles relevant to the subject matter.This review revealed that despite some controversial findings and the absence of treatment guidelines for burn patients,HBOT can complement other modalities. Side effects may include neurological and ophthalmic toxicity, as well as mild effects such as nausea and gastrointestinal disturbance.In conclusion, HBOT serves as an adjunctive therapy for promoting wound healing, including in burn patients. Evidence suggests its effectiveness in plastic surgery, potentially reducing hospital stays, costs, and recovery times. Further prospective randomized controlled trials with larger sample sizes and blinding are necessary to address remaining controversies and evaluate the full benefits of HBOT

Ortnerssyndrome, also known as cardiovocal syndrome, is a rare clinical entity characterized by left recurrent laryngeal nerve palsy secondary to cardiovascular pathology. Initially described in the context of left atrial enlargement due to mitral stenosis, the syndrome has since been associated with various cardiac and thoracic abnormalities, including aortic aneurysms, pulmonary hypertension, and congenital heart defects. This review aims to provide an in-depth analysis of Ortners syndrome, encompassing its etiological factors, pathophysiology, clinical manifestations, diagnostic approaches, and therapeutic strategies. We also discuss the historical evolution of the syndromes understanding and highlight contemporary advancements in its diagnosis and management. Enhanced awareness and timely recognition of Ortners syndrome are crucial for appropriate intervention and improved patient outcomes.

Cesarean section (CS) delivery involves surgically delivering the fetus through an incision in the abdominal and uterine walls. Attention to wound care is essential to prevent infections, a common impediment to CS wound healing, with infection rates significantly higher compared to vaginal delivery. Several factors, including age, nutrition, mobilization, infection, circulation, oxygenation, medications, and wound conditions, influence surgical wound healing. Electronic cigarettes (e-cigarettes), popular for their perceived harm reduction, flavors, and ease of use, deliver flavored nicotine doses via aerosolization through battery-powered devices. Studies link e-cigarettes to proinflammatory responses, increased cytotoxicity, and weakened immune defenses during the perioperative period, heightening surgical risks and impeding healing. This review aims to synthesize evidence on vapings impact on CS wound healing, focusing on e-cigarette chemical components

Introduction: Good communication is thecornerstone of quality healthcareand it should be patient centered. Communication skills is taught and assessed with surrogates in undergraduate training. This study aimed to determine the effectiveness of communication skills taught in undergraduate period in reality.Methodology: It was a combined qualitative and quantitative methods. For qualitative assessment, phenomenology was used. Informal focus group semi-structured interview was done to groups of interns who had completed internship at medical wards. The responses were analyzed interpreted and classified; thematic analysis was done.For quantitative assessments, open ended questions were set by experts in medical education. The questions were answered anonymously; they were grouped into samethemes. This study was approved by ‘Hospital Research and Ethics Committee’ of No(1) Defence Services General Hospital. Informed consent was taken from each intern.Results: A total 20 interns were included. Four themes were formed after thematic analysis: (1) the extent of applicability of communication skills they were taught in undergraduate days;(2) self-admitted confidence and degree of satisfaction; (3) the challenges/gaps they faced in reality; and (4) their suggestions on undergraduate teaching to fill the gaps. All interns admitted that the communication skills they taught was 100% applicable in practice. And they were confident out of proportion to their medical experience. They were satisfied with communication skills they were taught in undergraduate days. The challenges faced were as follows; difficulty in understanding volume and clarity of language when dealing with some nationality; low education level of patients leading to difficulty in understanding the information they have given; difficulty in getting trust from patient being youngest doctor in the team; and, taking long time due to emotional reaction of patient in breaking bad news. They admitted that theyneed to fill their knowledge gaps to answer the questions raised by patients particularly in explanation of diagnosis and management. They realized the importance of facial expression and tone of voice to express sympathy and empathy especially in breaking bad news. To improve communication skills in practice, they suggested to teach with real patients with real scenario. Conclusion: Teaching communication skills in undergraduate period was effective. The interns had good self-reported confidence. The interns need more training and self-directed learning. The Published On: 30May2024 Effectiveness of Teaching Communication Skills in Undergraduate Curriculum at Defence Services Medical Academy Myanmar: Mixed Qualitative and Quantitative Study 996Volume 04 Issue 05 May 2024 Corresponding Author:Khin Phyu Pyarchallenges faced by interns were acceptable/logical. We should find better teaching method/media in undergraduate teaching to promote communication skills.

Introduction: Monogenic obesity is characterizedby a mutation in a single gene, which directly influences metabolism, appetite control or other biological pathways associated with body weight regulation. Objective: To provide practical insights for healthcare professionals working with affected children to improve health outcomes and quality of life. 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 systematic search of the literature yielded a total of 4125 articles referring to the incidence of obesity and overweight in adolescents, of which 20 articles were eligible to be included in this systematic review. Conclusion: With a continued and coordinated effort, it is possible to significantly improve health outcomes for these children, preparing them for a brighter future.