As I approach the conclusion of my residency in Obstetrics and Gynecology (OBGYN), I reflect on the profound impact of Intrapartum Ultrasound (IPUS) on my clinical skills. While the widespread use of IPUS hasn't been definitively shown to improve perinatal outcomes [1,2], its promise in enhancing clinical skills and confidence is undeniable.
Pelvic Inflammatory Disease (PID) is commonly caused by Sexually Transmitted Infections (STIs); however, non-STI pathogens contribute to only 15% of cases. Polymicrobial infections can lead to severe PID owing to bacterial synergy. The identification of bacteria is crucial for guiding antibiotic treatment.
Low Frequency Ultrasound Debridement (LFUD) is a less painful, less traumatic method of wound debridement by imploding pulsatile ultrasound shockwaves to a selected wound bed along with a wound irrigation solution. Apart from wound debridement, LFUD is capable of biofilm disruption and wound contraction.
This case report summarises the treatment failure with upadacitinib as sequential rescue therapy in the setting of steroid and dose-intensified infliximab refractory acute severe ulcerative colitis. This patient proceeded to have a colectomy and end ileostomy.
Small Cell Lung Cancer (SCLC) is notorious for its aggressively proliferative nature. Although early metastasis is well-documented in SCLC, metastasis to the nasopharynx is exceedingly rare. We present the case of a 63-year-old male with a history of SCLC of the lung treated with Chemo Radiation Therapy
Lower limb wounds with exposed implants, tendons or extensive degloving with large soft tissue defects pose a significant challenge for the reconstructive surgeon. Kerecis® (Kerecis, Isafjordur, Iceland) is a piscine aceullar dermal xenograft derived from decellularized Icelandic codfish skin, MatriDerm®
Publications report more on this than on the benefits for the indications of pelvic floor prolapse and severe urinary incontinence. Plastic meshes have been in use for almost 20 years. A follow-up study of Perigee implantations was carried out in 2015 by the Charité/Berlin in a dissertation (Annett Buchheim-Zieb).
The peripheral trigeminal neuralgia mainly serves as a pain originated from the central nervous system, and the mechanism of the central pain that related to dental implant surgery is still unclear. However, persistent, and uncontrollable neuropathic pain following dental implant placement is uncommon.
We present the case of a 53-year-old male with a family history of Polycystic Kidney Disease (PKD) and a 20-year diagnosis of PKD who refused surgical treatment and opted for alternative medicine. After a month on hemodialysis, he presented to the emergency department with chest pain, dyspnea, somnolence, desaturation, hypotension, abdominal pain, and gross hematuria.
Numerous studies of intra-articular hip dis- orders have been performed, many revealing anterosuperior joint pathology. However, we have encountered hip injuries in less common locations in American Football players.
For children, traumatic brain injury can lead to persistent cognitive, neurobehavioral, intellectual, academic, and personality problems. Injury severity is a strong predictor of long-term outcomes, with environmental factors playing a less consistent role.
Bibliometric analysis and visualization tools were used to determine the development trend of intraarticular injection in arthroscopic treatment over the past 20 years, to guide researchers to explore new directions and hotspots in the field in the future.
Opportunistic infections, like Pneumocystis Jirovecii Pneumonia (PJP), in a patient with HIV has devastating outcomes if not properly treated, as the development of a spontaneous pneumothorax is a complication that is difficult to manage.
Retrospective review of the trauma registry of admitted patients >12 years-old from 1995-2009 at a level-one trauma center in an academic tertiary-care hospital. Included were sports and recreation activities such as roller-skating, basketball, football; excluded were motorized activities and sporting utilizing firearms.
Identify patients with temporal bone fractures and longitudinally follow their hearing results and hearing outcomes. IRB approval was obtained. Retrospective systematic review of the trauma database of a regional institution, level 1 trauma center identifying patients diagnosed with temporal bone fracture from January 2015-January 2020.
ACTA2 mutations are causative for familial thoracic aortic aneurysms. Additionally, a specific ACTA2 missense mutation (Arg179His) causes severe cerebrovascular disorders and may lead to a high risk of intraoperative complications. However, outcomes of aortic arch reconstruction for this mutation remain underreported.
Percutaneous Transluminal Angioplasty (PTA) is an effective method for treating arteriovenous fistulas stenosis. In our blood purification center, we found 4 patients with poor blood flow. Ultrasound or X-ray angiography found that the proximal radial artery was occlusive, and the fistula was mainly supplied with blood from the distal radial artery. We did not open occlusive radial artery.
Metastases to the spleen are rare owing to various protective anatomical and physiological features of the spleen itself. Often it occurs in conjunction with widespread disseminated disease and treatment is encompassed as part of the overall systemic treatment rather than targeted towards the splenic metastasis itself.
Libman Sacks endocarditis is a cardiac manifestation of erythematous systemic lupus which often goes unnoticed but can lead to valvular surgery in certain complications, we report the case of a patient with systemic lupus erythematosus and Libman-Sacks endocarditis that progressed rapidly to severe mitral insufficiency that needed surgery.
While Breast Implant-Associated Anaplastic Lymphoma (BIA-ALCL) was first recognized by the WHO in 2016 there has been limited information on this implant associated cancer due its limited incidence worldwide. Despite the lack of literature beyond case series and reports, the association.
A Traumatic Brain Injury (TBI) is an injury to the brain that is expected to cause permanent loss of brain function beyond the brain stem level. Efficient coordination and communication are crucial in facilitating the transfer of patients to higher levels of care.
We present a relatively rare case of ST Elevation Myocardial Infarction (STEMI) noted with left bundle pacing. Pacemaker implantation with left bundle pacing has been implemented in the electrophysiology community over the past few years as a way of creating a relatively narrow pacing QRS morphology due to the location of the pacing lead near the left bundle in the interatrial septum.
Small-Bowel Obstruction (SBO) represents a common surgical emergency entailing considerable morbidity and financial costs. Intraperitoneal adhesions are the leading cause of SBO, with postoperative adhesions responsible for most cases (60-80%).
Solitary Fibrous Tumor (SFT) is a rare type of soft tissue tumor that typically exhibits benign clinical characteristics. SFT of the oral cavity is a rare condition. The differential diagnosis can be challenging due to the histomorphologic diversity and clinical similarity to other mesenchymal tumors.
We describe a clinical case where a pregnant woman with twin gestation was given Tranexamic Acid (TXA) after delivery of her two neonates but was found to have a third fetus during placenta removal. Tranexamic acid is an antifibrinolytic agent that has been widely studied for its potential in reducing Postpartum Hemorrhage (PPH) [1].
In this case report we described a a case of ultra-rare Mullerian anomaly associated with renal agenesia in a syndromic framework of Herlyn-Werner-Wunderlich syndrome in a 15 years old patient who complained dysmenorrhea and abdominal pain.
Warty Dyskeratoma (WD), also known as isolated Darier's disease or focal acantholytic dyskeratosis, is a rare mucocutaneous anomaly and is known as a benign solitary tumor of the skin, vulva, oral cavity. The size of many oral lesions associated with the virus is smaller than 1 cm. An example of such a lesion might be given as squamous papilloma.
Compartment syndrome, defined by escalated pressure within a muscle compartment, can result in ischemia, potential tissue necrosis, and nerve damage, predominantly impacting the lower extremities.
Primary liposarcoma of the mediastinum accounts for less than 1% of all mediastinal tumors and 2% of all liposarcomas, making them exceedingly rare. When they do occur, they typically originate in the posterior mediastinum.
There is no consensus on induction therapy in heart transplantation, although interleukin-2 receptor blockers (basiliximab), thymoglobulin, and steroids are used. In Mexico, there is no experience in the use of thymoglobulin as an induction in heart transplantation.
Type II endoleaks occur frequently following Endovascular Aortic Repair (EVAR), which, in most cases, does not require any treatment. However, managing persistent endoleaks that enlarge the aneurysm sac can be challenging and may require less invasive measures (endovascular interventions).
ASD is a multi-factorial disorder in nature with genetic mechanisms, immune dysregulations and neurofunctional alterations as pathogenic mechanisms. SCN2A, encoding the neuronal voltage-gated Na+ channel NaV1.2, is one of the most commonly affected loci linked to ASD.
Auricular seroma is an uncommon, non-inflammatory, and benign condition affecting the auricle. Synonyms for auricular seroma include auricular pseudocysts, cystic chondromalacia, endochondral pseudocyst, intracartilaginous cyst, and benign idiopathic cystic chondromalacia.
A gastrinoma is a rare and potentially deadly tumor. Gastrinomas can be difficult to detect at first given that affected patients can present with nonspecific symptoms such as anemia, weight loss, and diarrhea, leading to a large list of differentials.
The effectiveness of core muscle strengthening in treating Low Back Pain (LBP) is well-established. The laxity or defect of the important portion of core muscle groups, transverse abdominis muscle, as seen in ventral hernia could be a contributing factor for core weakness and instability and thereafter results in LBP.
Gastric adenocarcinoma is the most common type of gastric cancer in the United States. Multiple factors can predispose a patient to develop such a malignancy, including having a history of Helicobacter pylori infection, tobacco use, alcohol use, specific genetic mutations, and being of Asian or Hispanic descent.
Gastric Mucosal Ischemia (GMI) following left hepatectomy is a rare post operative complication, never described in literature. The presented image illustrates the uncommon postoperative complication of Gastric Mucosal Ischemia (GMI) following Liver Resection (LR).
Exophytic pancreatic cancer is an extremely rare subtype of pancreatic cancer that has not been strictly defined but is based on morphological origin. Herein, we reported a 69-year-old man who presented with an unexplained elevation of CA199.
Nasal bleeding frequently leads to admissions to the Emergency Department (ED), with anterior nasal packing being a common treatment approach. Our patient was transferred to the ED from a nursing home due to epistaxis, which was already initially managed by nasal packing.
A preterm male newborn, treated in the neonatal intensive care, presented with mild abdominal distension and enlarged inguinal hernias, in his second week of life. Plain radiographs showed pneumoscrotum and a falciform ligament sign.
Intraosseous Hemangiomas or Primary Intraosseous Hemangiomas (PIH) are slow-growing innocuous blood vessel tumors that make up less than 1% of all bone malignancies [1-4].
Behçet's Disease (BD) is an uncommon systemic vasculitic disorder, that can affect multiple organ systems. Arterial and venous aneurysmal and occlusive manifestations can occur.
Laparoscopic adjustable banding was previously considered to be the safest and least invasive technique in bariatric surgery in the mid-1990s.
Germ cell tumors rarely present in the anterior mediastinum. We report a case of 43-year-old female who presented to the hospital with cough and chest pain. Computed tomography imaging showed a 7.8 cm right anterior mediastinal mass with extension to the right upper lung.
To assess the effectiveness of a three-dimensional (3-D) printed head and neck model printed from our residency's small 3D printer for the medical education and training of residents in nasopharyngoscopy. Survey based study. Resident education classroom.
Minoxidil, a drug that is widely used for hair loss treatment, is considered a safe medication. While there are minor side-effects such as scalp irritation or systemic effects like tachycardia, it is rarely associated with severe ocular complications.
Residual Cyst (RC) is an odontogenic inflammatory pathology that appears at the site of a previous odontogenic inflammatory lesion. In this report, we present a 65-year-old male, with a history of pulpal pathology in tooth 2.5, which was extracted and treated with dental implants. He currently refers pain in the upper left maxilla with great peri-implant probing depth and marginal bone loss.
Gallbladder volvulus, or torsion, is rare and occurs when the gallbladder twists on its longitudinal axis by more than 180 degrees, causing occlusion of the cystic vessels and duct. The first report of gallbladder volvulus was described in 1898 by Wendel and was associated with cholelithiasis [1].
A 13-year-old male presented to the emergency department following an episode of gagging while eating grilled chicken. He reported significant odynophagia and globus sensation. He had no symptoms of airway compromise.
Primary colorectal lymphoma is a rare cause of intestinal obstruction that is usually diagnosed late due to the presentation of non-specific symptoms. It is more common in males and older age groups. Diagnosis usually occurs after operative intervention through biopsy of the mass.
This article shows the long-term success of surgical debridement and antibiotic-loaded cement spacers, as an alternative to amputation, in a 32-year-old male diabetic Type I patient with Osteomyelitis (OM) of first metatarsal base and medial cuneiform of the left foot.
Non-Alcoholic Fatty Liver Disease (NAFLD) is a frequent cause of abnormal liver function tests and can be easily diagnosed in patients with obesity, hyperlipidemia, hypertension and diabetes mellitus. NAFLD is associated with insulin resistance and has always be treated as a part of metabolic syndrome.
An 88-year-old female patient presented to the emergency department with a 12-hour history of mildly painful right inguinal bulge. She admitted to intermittent nausea but denied vomiting or fever. Physical examination revealed slightly distended abdomen with normal bowel sounds, and a non-reducible right groin bulge measuring 5x5 cm associated with skin erythema.
Atraumatic Splenic Rupture (ASR) is rare relative to traumatic cases, being referred to as a spontaneous rupture in the presence of a histologically proven normal spleen. ASR carries with it a risk of mortality which has been reported to be as high as 12.2%, given the life-threatening potential a prompt diagnosis and subsequent management is critical.
The examination of certain patients in consultation, due to their young age, lack of collaboration or associated pathologies can be very complicated or insufficient. In cases of suspected diagnosis, an examination under sedation in the operating room is necessary.
Anaplastic thyroid carcinoma is a very rare type of undifferentiated thyroid carcinoma. Mostly, the ATC is diagnosed in advanced stage when local and distant metastases are detected. Multimodal approach and personal treatment managed by a multidisciplinary team of specialist is recommended in all ATC cases.
We present a case of alcohol induced pain in the setting of a mediastinal mass with significant lymphadenopathy. A diagnosis of Hodgkin lymphoma (HL) was made. The alcohol induced pain resolved, correlating with post-chemotherapy treatment response on positron emission tomography/ computed tomography (PET/CT) imaging.
This retrospective study at Landspítalinn University Hospital in Iceland investigates reoperation rates and reasons for fixation failure in hip fracture cases. In our cohort, we evaluated the effectiveness of various surgical techniques and their association with reoperations.
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