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Thyroid Imaging Reporting and Data System (TIRADS) in Stratifying Risk of Thyroid Malignancy in a Tertiary Care Hospital
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A Rare Case of Direct Invasion of Inferior Vena Cava by Renal Cell Carcinoma
Full text linkThere has been a global increase in the incidence of renal cell carcinoma (RCC) during the last two decades. Metastatic RCC can spread to the lung, bone, lymph nodes and liver. RCCs tend to invade the vascular system, with the involvement of the renal vein and extend into the inferior vena cava (IVC). The venous invasion changes the staging and prognosis of the disease. We present a case of a 60-year-old male patient who incidentally discovered a right renal mass on ultrasound. A contrast-enhanced computed tomography (CECT) was performed in our institute which showed a mass involving the mid and lower pole of the right kidney, causing distortion of renal architecture. The mass was directly infiltrating into the inferior vena cava with no evidence of thrombosis or invasion into the renal vein. Our case highlights the importance of standard preoperative imaging to assess IVC invasion for optimum surgical planning
Peritoneal Mesothelioma Mimicking Ovarian Malignancy: The Critical Role of Immunohistochemistry in Diagnosis – A Case Report
Full text linkPeritoneal mesothelioma is a rare and aggressive cancer that may mimic other intra-abdominal malignancies, making the diagnosis challenging, particularly epithelial ovarian cancer. Immunohistochemistry (IHC) plays a vital role in distinguishing malignant mesothelioma from other cancers with overlapping features. This case highlights the importance of a comprehensive IHC workup in differentiating between mesothelial and ovarian neoplasms. We present a 74-year-old female who initially presented to the ED with neurological symptoms due to venous sinus thrombosis diagnosed by CT scan and MRV. This reflects that the patient's initial presentation was neurological, seizures, and hemiparesis due to venous sinus thrombosis, which may have been a paraneoplastic phenomenon associated with the malignancy. This unique presentation has been highlighted as an important aspect of the case. Further imaging revealed an intrabdominal mass with raised CA 125, initially raising the suspicion of ovarian malignancy. An omental biopsy and the IHC profile revealed positive staining for CK7, calretinin, and WT1, while CK20, Ber-EP4, and PAX8 were negative, supporting a diagnosis of malignant mesothelioma. Genomic profiling with BAP1 mutation provides an additional approach to confirm the diagnosis.
This case has given an appropriate insight into the role of comprehensive IHC in differentiating the peritoneal mesothelioma from mimicking pathologies and guiding appropriate therapies
Association of Down Syndrome (DS) with Morphology and Anomalies of Teeth: A Concise Narrative Review
Full text linkTrisomy 21 causes Down syndrome (DS), a genetic condition marked by unique dental and craniofacial abnormalities. These abnormalities significantly impact oral function, appearance, and overall quality of life. An example of this tendency is seen in cases where DS children erupt their first molar at 8 years and 9 months as opposed to the average rise in age between 6 and 8 years. The most prevalent kind of consequence for individuals with DS who have unfavourable diseases of the middle part of their faces is facial deformities. This review investigates the relationship between DS and dental anomalies, with a focus on tooth morphology, number, eruption patterns, and structural defects. It seeks to summarise existing studies, point out knowledge gaps, and emphasise therapeutic implications for oral healthcare. Databases like PubMed and Google Scholar were used to assess peer-reviewed literature. Included were studies on dental abnormalities in DS, such as hypodontia, microdontia, delayed eruption, enamel hypoplasia, and malocclusions, that were published between 2000 and 2025. A characteristic of DS is dental abnormalities, which call for specialist oral therapy to address both functional and cosmetic issues. Improving results requires multidisciplinary care, individualised treatment programs, and early diagnosis and action. General colonisation, dental health, and other medical issues are all positively impacted by dental surgery. In contrast to simpler cognitive subjects, IQ might occasionally demonstrate a reduced ability to handle more complicated cognitive activities. To investigate genetic causes and create focused management plans, more
research is required
Development of Practice Guidelines for Peripartum Depression in Primary Healthcare
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The Study on Awareness of Empowering Minds: The Role of Psycho-Education in Mental Health
Full text linkMental health disorders pose a significant public health challenge in Pakistan, with high prevalence rates and adverse impacts on individual well-being and societal functioning. This abstract highlights key findings from available research on mental disorders and mental health prevention in Pakistan, drawing upon relevant studies to inform future interventions and policy initiatives. Studies have identified common mental health disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD) among the population, with intimate partner violence emerging as a significant risk factor for psychological distress. Psychological distress is also associated with physical morbidity, highlighting the interconnectedness of mental and physical health outcomes. Preventive interventions, including awareness campaigns, community-based programs, and access to mental health services, are essential to address the burden of mental illness and reduce stigma. These initiatives aim to promote early detection, increase help-seeking behavior, and provide timely support to needy individuals. However, further research and collaborative efforts are necessary to develop culturally appropriate interventions that address the unique challenges faced by individuals and communities in Pakistan and improve overall mental health outcomes
Misinterpretation of Prescription Leading to Acute Methotrexate Toxicity: An avoidable Accident
Full text linkBackground: Low-dose oral methotrexate (MTX), as used for several dermatological and rheumatological indications, is generally a safe medication. Overdose of MTX may cause acute toxicity, which results in oral mucositis, skin ulceration, and pancytopenia.
Case Presentation: A 40-year-old man presented with a 3-day history of oral mucosal ulceration along with pustular eruption, painful bullae, and skin erosion. He also had a passage of black, tarry stool for 2 days. Another patient, a 50-year-old female presented with oral mucosal ulceration and per-rectal bleeding. Both were recently started on low-dose oral MTX for seronegative arthritis. Misinterpreting the physician’s prescription, they took MTX daily instead of weekly. Their blood count revealed a variable degree of pancytopenia. They were treated with intravenous or oral Leucovorin, along with other supportive therapy. Patients started responding within a few days after treatment and were discharged after a week.
Conclusion: Proper education of the patient regarding the dosage is fundamental for prescribing MTX and reducing the chance of developing toxicities. MTX-induced acute toxicity is a medical emergency requiring prompt and proper intervention
The Impact of Dentistry on Global Health: Challenges and Research Priorities
Full text linkEven though oral health has improved worldwide, there are still many obstacles to overcome, especially in high-income and low-income countries' underprivileged groups. For many people, having access to basic dental healthcare is still an asset rather than a right. The July 2019 release of the oral health issue in The Lancet sparked a buzz and raised awareness of dental services and oral health issues. To close the gap connecting dental studies and health worldwide and to make oral health a top concern in public health discourse globally, there is still more work to be done.
Based on Shiffman's approach, we propose the creation of an international oral health network to promote systemic improvements and impact health policy. Four major areas of challenge—problem means, position, alliance building, and governance-have emerged from our experience in the field of global health. We provide these challenges to include stakeholders, in addition to seeking external validation.
How well our profession handles these issues will influence our success concerning the Sustainable Development Goals and beyond
Transforming Patient Care to Reduce Mortality Rates: A Comprehensive Review
Full text linkThis review article addresses the critical and enduring challenge of high patient mortality rates that plague healthcare systems globally. Despite the advent of numerous quality improvement initiatives and significant technological advancements in medicine, mortality rates have shown little to no substantial improvement. In the United States alone, over 250,000 deaths per year are estimated to be preventable. The article delves deep into the intricacies and complexities of healthcare delivery systems, highlighting the systemic issues that contribute to these disheartening statistics. It proposes a comprehensive, multi-faceted approach aimed at transforming the very fabric of healthcare delivery. The article meticulously discusses key components essential for initiating and sustaining quality improvement. These components include the adoption of evidence-based practices to standardize care, the importance of care coordination especially during transitions, the role of health information technology in facilitating quality care, and the often-overlooked aspect of patient and family engagement in healthcare decisions. Additionally, the article underscores the necessity of a robust quality assurance infrastructure for monitoring performance and implementing targeted interventions. Moreover, the article doesn't shy away from examining the formidable challenges and barriers that healthcare providers and policymakers face in implementing these sweeping changes. It emphasizes the indispensable role of strong, committed leadership and a multidisciplinary team in overcoming these obstacles. By synthesizing current literature, this review aims to serve as a comprehensive guide and a call to action for healthcare providers, policymakers, and various stakeholders. The ultimate goal is to galvanize these key players into committing to tangible improvements in patient outcomes and a significant reduction in preventable mortality rates
