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  • Castro Sanford posted an update 8 hours, 50 minutes ago

    In men, the mean age at diagnosis of papillary TC was 46.98 ± 15.4 years, while in female patients, it was 39.02 ± 12.8 years (p-value = 0.0001). We did not find a trend toward smaller tumours in the more recent years in comparison to the early years (r = -0.083, p-value = 0.168). Conclusions TC is diagnosed at a younger age and larger sizes in Saudi Arabia in comparison to other countries. A gender difference was only noted with papillary TC in regard to the age of diagnosis. There was no trend toward smaller sizes of TC over the years.In-stent restenosis (ISR) arising in bare-metal stents and drug-eluting stents is difficult to manage. Herein, we report a case of ISR. Our patient had a history of percutaneous coronary intervention and presented with exaggerated angina symptoms despite being on antianginal medication. Prexasertib mouse ISR was diagnosed with coronary angiography. In a clinical setting, it is treated with repeat revascularization of the blocked vessel with a re-stent placement or surgical approach.Dentures are accidentally ingested foreign bodies, especially in the geriatric population. They get frequently lodged in the esophagus because of their larger size, rigidity, and pointed edges. But, it is unusual for a denture to remain asymptomatic in the esophagus for a decade. We report a case of 45-year-old female who presented with the complaints of progressive dysphagia for six months. Endoscopy revealed an impacted denture in the mid-esophagus. The patient recollected that she lost her denture 13 years back and was unaware that she swallowed it. Right thoracotomy and esophagotomy were done to remove the impacted denture. The esophagotomy site was buttressed with vascularised intercostal muscle flap.The dexterity of computer systems to resemble and mimic human intelligence is artificial intelligence. Artificial intelligence has reformed the diagnostic and therapeutic precision and competence in various fields of medicine. Artificial intelligence appears to play a bright role in medical diagnosis. Computer systems using artificial intelligence help in the assessment of medical images and enormous data. This research aims to identify how artificial intelligence-based technology is reforming the art of medicine. Artificial intelligence empowers providers in improving efficiency and overall healthcare. Newer machine learning techniques lead the automatic diagnostic systems. Areas of medicine such as medical imaging, automated clinical decision-making support have made significant advances with respect to artificial intelligence technology. With improved diagnosis and prognosis, artificial intelligence possesses the capability to revolutionize various fields of medicine. Artificial intelligence has its own limitations and cannot replace a bedside clinician. In the evolving modern medical digital world, physicians need to support artificial intelligence rather than fear it replacing trained physicians for improved healthcare.Introduction Blood and its products are the most valuable resource in every healthcare institution. Judicial use of these limited resources is necessary and important to maintain sufficient supply. Blood products and its transfusion system are being evaluated by the use of several markers. The use of crossmatch to transfusion ratio (C/T) was first proposed by Boral Henry in 1975. Nowadays, the C/T ratio is being used by researchers to assess transfusion practices. Ideally, (C/T) ratio has to be 1.0 but it has been suggested that a ratio of 2.5 or less would indicate effective blood use. Objective To assess crossmatch to transfusion ratio (C/T ratio), transfusion probability (%T), and transfusion index (TI) in patients of medical and surgical wards. To assess the wastage of blood components/whole blood units. Methods A cross-sectional study was conducted at Mayo Hospital/King Edward Medical University, Lahore, Services Hospital Lahore, and Alkhidmat Blood Bank Surrayya Azeem Hospital between January 2019 and June 2019. Nonprobability convenient sampling was performed and all collected data were entered and analyzed by using statistical package for social sciences (SPSS version 20). Results The total patients who were ordered to arrange blood were 1322 for which overall 2715 crossmatches had been done. Among these crossmatches, a total of 1536 of the donors were bled for from which only 815 units had been transfused to the patients. Overall C/T ratio was found to be 3.33 and the overall wastage was 38.9%. Conclusions Blood transfusion is considered useful in the management of surgical as well as medical patients. Too many units are ordered out of which the majority are wasted due to nonutilization. There is a need for standard operating procedures for transfusion of blood. There shall be regular audits to improve the blood collection, treatment, delivery, and usage practices of this scarce resource.Percutaneous radiofrequency ablation of spinal metastases is an emerging treatment for patients with painful metastatic spine disease. It is typically performed for patients who have not responded to conventional treatments or who have contraindications to radiotherapy. Destruction of the posterior wall of the vertebral body and epidural disease may be considered relative contraindications for radiofrequency ablation. This is due to the difficulty in achieving satisfactory ablation balanced against the risk of neural injury. We describe a case of metastatic melanoma with an expansile lytic metastasis and epidural tumour extension at the L4 vertebral body level resulting in severe central canal stenosis. This was successfully treated with percutaneous radiofrequency ablation and vertebral augmentation. The patient reported significant pain relief post-procedure and follow-up MRI at two months demonstrated local tumour regression, epidural disease resolution and improved spinal canal dimensions. To the best of our knowledge, this is the first report of epidural disease resolution from metastatic melanoma following radiofrequency ablation and emphasises the potential benefits of ablation therapy even in the presence of canal stenosis and epidural metastatic disease.

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