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To compare postoperative astigmatism and visual outcome following phacoemulsification versus Manual Small Incision Cataract Surgery (MSICS) seen at tertiary care center
No full textPurpose: To compare postoperative astigmatism and visual outcome following phacoemulsification versus Manual Small Incision Cataract Surgery (MSICS) seen at a tertiary care center. Method: A total of 100 patients were enrolled in this retrospective study. Group A included 50 patients undergoing phacoemulsification surgery and group B included 50 patients undergoing MSICS. The outcome was evaluated in both techniques in terms of astigmatic profile and visual outcome at post-operative day 1 and 3 months.Results: The mean age was 60 ± 1.84 years in the phacoemulsification group and 61 ± 1.25 years in the MSICS group. In the phacoemulsification group, 60% were male patients as compared with 40% female patients while MSICS group included 62% female patients and 38 % male patients. The initial visual recovery on the first postoperative day was better in the patients who underwent phacoemulsification, with the uncorrected visual acuity better than or equal to 6/18 in 94% of the patients, whereas the percentage was 72% in the MSICS group. At three months, 80% of the patients in the MSICS group had uncorrected visual acuity better than or equal to 6/18 versus 88% of the patients in the phacoemulsification group. The mean astigmatism was 0.808 ± 0.39D in the phaco group and 1.565 ± 0.51D in the MSICS group, p-value significant (0.0001).Conclusion: Both phacoemulsification and MSICS achieved comparable and excellent visual outcomes. However, MSICS appears to be more advantageous than phacoemulsification in terms of speed, cost and independence from technology and appears to be more suitable for mass surgery especially in developing countries.</p
Gastrointestinal stromal tumor revealed by hemorrhagic shock
No full textGastrointestinal Stromal Tumors (GISTs) are rare tumors of the digestive tract. The small intestine is the second most frequent localization of GIST after the stomach. We report a case of the ileal stromal tumor. The patient was admitted with a picture of hemorrhagic shock due to massive rectal bleeding. The fiberscope performed after stabilization was not objectified at the origin of the document while the CT scan objectified a mass of tissue density at the level of the right iliac fossa. Given the increasing evolution with the recurrence of patients to a target of a laparotomy for diagnostic and therapeutic purposes objectifying the tumor of the right iliac fossa at the expense of the ileum. The surgical procedure consisted of a major segmental resection of the tumor with ileo-ileal anastomosis. The anatomopathological study confirmed the diagnosis of the stromal tumor with good evolution. Through a general review of the literature, we have described the various clinical, para-clinical, anatomopathological, prognostic, and current therapeutic aspects specific to these tumors.</p
Secukinumab Associated Choroidal Neovascularization
No full textA previously healthy 38-year-old woman with non-radiographic spondyloarthritis (nrSpA) developed juxta-foveal Choroidal Neovascularization (CNV) in the right eye three months after starting treatment with the anti-IL-17A inhibitor secukinumab. As there was no sign of ocular inflammation, no known association with CNV and this rheumatic disease, and other etiologic etiologies were excluded, this biologic agent was the suspected cause. Drug discontinuation and treatment with bevacizumab resulted in full suppression of the neovascular activity. IL-17 has a purported etiologic role in ocular neovascular diseases. The onset of this process in a patient receiving anti-IL-17 therapy suggests a possible causative role requiring further clarification.</p
Breastfeeding and women living with HIV: Is it possible to move beyond the avoidance?
No full textThe risk of mother-to-infant transmission of HIV 1 during breastfeeding ranges from 10% to 15% in the absence of maternal Antiretroviral Therapy (ART) and infant Antiretroviral (ARV) prophylaxis. WHO guidelines 2016 recommend women living with HIV and fully supported for ART adherence should breastfeed for at least 12 months and up to 24 months or longer. Anyway, in high-income settings, women living with HIV are suggested to avoid breastfeeding, regardless of maternal viral load or antiretroviral therapy status. The advantages of breastfeeding in low and middle-income settings are well recognized. This brief narrative review aims to summarize existing evidence on mechanisms and risk factors for HIV transmission during breastfeeding and the possible prevention strategies in the context of ART adherence. </p
The benefits of Heart Rate Variability (HRV) in the assessment of health and exercise performance
No full textThe purpose of this brief report is to stimulate further interest and to raise awareness in relation to the usefulness of assessing cardiac autonomic nerve function using heart rate variability (HRV). The paper outlines the mechanisms associated with HRV and the relationships between HRV, health, and athletic performance. The paper then summarizes the potential benefits of HRV in the assessment of health and exercise adaptations. The paper also provides suggestions about the practical implications of HRV measurement during data collection. We hope that the content provides useful information for the application of HRV for health evaluation and training adaptations. In addition, we hope the paper will provide a better understanding of how HRV measurements can be interpreted and used. Finally, the paper provides practical applications that are effective in the assessment of health and athletic training program outcomes.</p
Prevalence of Psychopathology in Bariatric Surgical Candidates with Type 2 Diabetes Mellitus: Systematic Review
No full textIntroduction: Bariatric surgical candidates confer an elevated risk of psychopathology. Prior reviews highlight the vulnerability and bidirectionality of psychopathology in people with Type 2 Diabetes Mellitus (T2DM). Despite this, current evidence for the rates of psychopathology in people with T2DM pre and post-bariatric surgery has yet to be systematically reviewed.Objective: To perform a systematic review of the prevalence of psychopathology in adults with Type 2 Diabetes Mellitus pre and post-bariatric surgery. Results: Seven studies fulfilled the inclusion criteria, from 45,576 studies on the digital search of databases. Conclusions: Scant evidence exists which specifies cohorts of bariatric surgical patients with T2DM and rates of psychopathology. Further research is warranted to understand the risks, measures, and potential interventions for this subgroup.</p
Intellectual property safe – First-to-File and First-to-Invent system
No full textAll countries use the First-to-File system. An inventor may feel very tense about the time race and the physical and cyber security of his intellectual properties. Biomedical researchers and inventors are particularly vulnerable since most of them may not possess enough IT knowledge to maintain cyber security. An Intellectual Property Safe System to protect the initial draft and/or prototypes is suggested.</p
Hinduism and Prosthodontic Treatment: A Review and a Clinical Report of a Hindu Menopausal Woman
No full textHinduism is one of the world’s most populous religions. A matter in everyday dentistry is the use of products and materials that could limit dental treatment options because of religion. Menopause is a specific and critical period in a woman’s life when dental restorations or other dental procedures are needed. Some menopausal women face difficulty when performing dental care due to restrictions concerning their religion or vomiting symptoms. Religion and a hypersensitive vomit reaction in menopause may prevent the dental provider from choosing extended or complicated dental, mainly prosthodontic, treatment plans including bone grafts and dental implants, and consequently, these parameters can affect menopausal women’s quality of life.The purpose of this article is to review the current literature and to report a case of a 60-year-old Hindu menopausal woman, partially edentulous with an exaggerated vomiting reaction, focusing on successful clinical management using a simple but effective table salt technique for the gag reflex and proper fixed and removable prostheses design, as also to discuss how Hinduism affects the dental treatment plan, especially prosthodontic, because some products and their consistency used in dental implants and prosthodontics, are usually not acceptable due to this religion, affecting also menopausal womens’ quality of life.Because of the shift of population globally, the scientific community faces patients of different religions, faiths, traditions, and beliefs, and has to adjust socially to new conditions.</p
An unusual presentation of a secondary extramedullary plasmacytoma
No full textPlasma cell dyscrasias are a group of entities characterized by neoplastic proliferation of a single clone of plasma cells, typically producing a monoclonal Immunoglobulin [1].</p
Surgical treatment of spinal tumors with modified laminoplasty: Preliminary study
No full textObjective: We aimed to present our experience with a modified laminoplasty technique that allows stabilization of the spine without instrumentation during tumor surgery. Methods: This retrospective study was performed in the neurosurgery department of a university hospital and data were collected from the medical files who were treated surgically for spinal tumors. The same surgical team operated on the patients using the same procedure without any instrumentation for stabilization of the spine. Demographic and clinical data were collected. It was checked whether radiological and clinical instability developed at the 6th and 12th months postoperatively.Results: Our series comprised 41 patients (20 females, 21 males) with an average age of 47.122±20.33 (range: 11 to 86 years). The most common complaints detected in this series were diminution of motor power in lower extremities (20,47.62%), radicular pain (9,21.43%), and hypoesthesia (2,4.76%). The most frequent sites of involvement were L1-L2 (5,11.90%), L2 (4,9.52%), and T5-T6-T7 (2,4.76%), respectively. Histopathologically, schwannoma (8,19.94%), ependymoma (7,16.64%), meningioma (6,14.28%), and metastatic carcinoma (5,11.90%). The distribution of tumors was intradural and extramedullary (27,64.28%), intradural and intramedullary (13,30.95%), and extradural and extramedullary (2,4.77%), respectively. Conclusion: Our results imply that stability of the spinal cord can be preserved without fixation or instrumentation during surgical procedures for spinal tumors. However, longer periods of follow-up, as well as prospective, controlled, multi-centric trials on larger populations, are warranted to evaluate the safety and efficacy of the novel technique. </p