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Thyroid Nodules
No full textOver the last few years, the prevalence of thyroid nodules has increased. There are multiple reasons: true increase in incidence and increase in investigations with better technology. Finding a nodule in the thyroid does lead to a flurry of investigations. 
Medical mystery: Deposition of calcium oxalate and phosphate stones in soft tissues
No full textCalcinosis cutis (CC) [1] is an unusual disorder characterized by calcium-phosphate deposition into cutaneous and subcutaneous tissues. There are five subtypes: dystrophic, metastatic, idiopathic, iatrogenic and calciphylaxis.Calciphylaxis or calcifying panniculitis is defined as small vessel calcification mainly affecting blood vessels of the dermis and subcutaneous fat. Despite the predominance of cases in patients with ESRD, calciphylaxis can also be found in patients with normal renal function and normal levels of calcium and phosphate. These cases are often referred to as nonuremic calciphylaxis (NUC), a heterogeneous category with several associations. Literature reveals an association with hyperparathyroidism (28%), malignancy (22%), alcoholic liver disease (17%) and connective tissue diseases (11%) while obesity, liver disease, high-serum calcium (Ca) × phosphorus (P) levels, combined therapies of calcium salts with vitamin D, warfarin and corticosteroids have been observed to increase the likelihood of this disease [2]. The lesions in both nonuremic and uremic calciphylaxis tend to be indistinguishable from each other, initially presenting as tender subcutaneous plaques that progress into nonhealing ulcers with overlying black eschar. Skin changes often begin with a livedo reticularis pattern that can progress to livedo racemes and ultimately retiform purpura.In our clinical case, we describe a patient with multiple risk factors for calciphylaxis, intense widespread calcification (vessels, tendons, joints) and cutaneous calcific stone of calcium and phosphate oxalate not elsewhere described before
Abnormal uterine bleeding and severe anemia cause the life-threatening condition
No full textThe World Health Organisation (WHO) defines anemia as a global public health problem. It is a medical condition in which the number of red blood cells or the hemoglobin concentration within them is below the physiological range. We present a case of a 40-year-old woman with Abnormal Uterine Bleeding (AUB) accompanied by malaise, weakness, and tachycardia. The patient reported heavy menstrual bleeding for the past 14 days. Speculum examination revealed that the bleeding was from the uterus. There were no pathological findings during a gynecological and transvaginal ultrasound examination. A complete blood count performed at the time of her arrival showed a low hemoglobin level of 24 g/L, a low hematocrit level of 7,4%, a mean corpuscular volume of 98,7 fL and a number of red blood cells 0,75 x 1012/L. Due to the severity of the anemia, she was given 6 units of red blood cell transfusion, 2 fresh frozen plasmas and tranexamic acid accompanied with calcium carbonate. The curettage was performed. The pathohistological finding was endometrium in proliferation. Afterward, the hemoglobin level increased to 90 g/L. Their past medical history revealed that she abused alcohol. On an abdominal CT scan, Alcohol-Related Liver Disease (ARLD) was confirmed. We should keep in mind that coagulopathy could be the underlying cause of abnormal uterine bleeding and that anemia must be analyzed for successful treatment. A multidisciplinary approach to anemia caused by AUB is required in cases of severe anemia
Colorectal cancer: physical activity, obesity and consumption of foods a case-control study in the east of Algeria
No full textPurpose: To evaluate the role of dietary components, physical activity, smoking and Obesity in colorectal cancer.Materials and methods: With a population-based case-control study, 49 colorectal cancer patients and 72 controls were interviewed with uniform questionnaires. Conditional logistic regression was used for multivariate analysis of colorectal cancer. A total of 121 pairs of case controls were interviewed.Results: Relationship between body mass index (BMI) and colorectal cancer was shown in this study, obesity was shown in 21 patients (42.86) before cancer and in 0% of patients during colorectal cancer. Physical activity was a significant risk factor p < 0.0001. Malnutrition was noted in 48 patients (97. 96%) according to Brachial muscular circumference in patients with colorectal cancer (p = 0.002). Daily consumption of sugar Khi² of Wald (5.423) and butter Khi² of Wald (7.694) is higher in cases than in controls. During that time, high daily consumption of pasta (p = 0.018) and vegetables (p = 0.045) was a protective factor for colorectal cancer.Conclusion: Colorectal cancer in Algeria was related to dietary and environmental factors. The research results support the colorectal cancer etiological hypothesis of deficiency vegetable and high consumption of lipids and sugar. Obesity and lack of physical activity were also correlated with colorectal cancer
Determination of the in vivo activity of leaves extract of Zanthoxylum Chiloperone var. Angustifolium (Tembetary hú) orally and intralesionally administered to BALB/c mice experimentally infected with Leishmania
No full textNatural products are becoming increasingly important as an unlimited source for obtaining chemical substances with possible pharmacological potential. Current existing drugs for the treatment of cutaneous leishmaniosis produce major side effects; therefore the search for new drugs is justified. The stem bark of Zanthoxylum chiloperone var. Angustifolium Engl. (Rutaceae) is traditionally used in Paraguay for its antiparasitic properties. The leaf extract was evaluated for the first time to determine its leishmanicidal activity in BALB/c mice infected with amastigote forms of Leishmania amazonensis (PH8). The mice were treated orally with the extract at three concentrations (100, 50 and 10 mg/mL), intralesional (50 mg/mL), and subcutaneously using glucantime as a control (100 mg/mL). The percentage of decrease in parasite load was measured and with intralesional 50 mg/kg a reduction of 72% occurred, with the reference drug (Glucantime) a reduction of 62% was obtained with the same oral dose a reduction of 50%, while with an oral dose of 10 mg/mL the percentage of reduction was 55%. When the oral dose was increased to 100 mg/mL, the reduction percentage of the parasitic load was only 16%. These results indicated that the leaf extract of Z. chiloperone var. angustifolium Engl. at low oral concentrations (50 and 10 mg/mL) had very good activity against L. amazonensis, and it was even more efficacious intralesionally at 50 mg/mL but at the oral dose of 100 mg/kg has very reduced antiparasitic activity. This study showed the efficacy of the extract leaves of Z. chiloperone in reducing the parasite load in an in vivo test, so its use as a potential leishmanicidal could be suggested to develop and evaluate new drugs for the oral treatment of leishmaniosis disease with fewer side effects and lower cost
Neglected percutaneous rod extrusion following posterior occipitocervical instrumentation: a case report
No full textPurpose: The extrusion of implant material is a rare complication but has been reported in several cases following anterior cervical spine surgery. A posterior spontaneous percutaneous rod extrusion after rigid occipitocervical (OC) instrumentation (screw and rod construct) has not been reported yet. The authors discuss potential complications after cervical spine surgery and its clinical management.Methods: This is a case report of a 56-year-old patient after posterior OC spine surgery with initially unobserved implant failure and posterior percutaneous rod extrusion. The implant failure with a missing rod has been documented 4 years later during a routine follow-up visit.Results: At the four-year follow-up, the asymptomatic patient presented with a stable occipitocervical junction and an improved range of motion after generalized sepsis with an epidural spinal abscess, decompression and posterior OC instrumentation. A computed tomography scan of the implant failure of a broken rod was noticed two years postoperatively. The patient failed to return to the clinic. For years postoperatively he returned to the clinic and the broken rod could not be detectable in-situ on the X-rays anymore. Conclusion: The posterior percutaneous rod extrusion following an OC instrumentation not noticed by the patient, is a very rare complication that has not been described in the literature yet. Once seen back in the clinic, the patient unexpectedly reported an improved ROM without neck pain. Usually, revision surgery or implant removal is recommended if an implant failure is documented
Post-harvest assessment of infectious fruit rot on selected fruits in Lafia, Nasarawa State Nigeria
No full textThe post-harvest health and microbial safety of plant products and foods continue to be a global concern to farmers, consumers, regulatory agencies and food industries. A study was carried out to evaluate the pathogenicity of fungi associated with post-harvest rot of oranges, watermelons and bananas in Lafia, Nasarawa State, Nigeria. Healthy fruits inoculated with fungal spores obtained from rotted fruit tissues were incubated at ambient temperature conditions and observed daily for the appearance and development of tissue rot. Oranges and Watermelons had the highest number of fungal isolates (3) compared to banana (2). Fungi belonging to the genus Curvularia were the most isolated (37.50%), followed by both Aspergillus and Colletotrichum (25.00% respectively) and lastly Alternaria (12.50%). The highest tissue rot diameter of sweet orange (2.40 cm) was induced by Alternaria sp. followed by Curvularia geniculate (1.40 cm) and lastly Colletotrichum sp. (1.28 cm). The highest rot of banana fruit tissues was produced by A. niger (3.90 cm), followed by Curvularia geniculate (3.40 cm). Aspergillus sp. produced the highest tissue rot diameter on watermelon fruits (1.93 cm), followed by Colletotrichum sp. (1.30 cm) and lastly Curvularia geniculate (1.20 cm). Differences in the susceptibilities of different fruits to rot by fungal pathogens were significant (p ≤ 0.05). There is need for improved handling of fruits after harvest to prevent losses due to bacterial and fungal rots in the study area
Harmonic oscillation picture of the free electron Zitterbewegung in vacuum
No full textAs shown e.g. in ref.[1] Zitterbewegung (trembling motion) of the free Dirac electron is generated if transitions between positive and negative energy states occur. Here we treat this effect in a single-mode configuration using a density matrix method. As compared with more elaborate conventional treatments, this method allows an easy estimate of the amplitude of the motion. The result is by predicted spreads of the free electron charge
Effectiveness of different cord care interventions on omphalitis prevention among neonates in Nakuru County Hospital, Kenya
No full textBackground: Sepsis among newborns is common and a major cause of neonatal deaths in developing countries. Annually, about 4 million neonatal deaths occur around the world. Of these, more than 30% are caused by infections majority of which start as umbilical cord infections. Topical umbilical cord care can reduce omphalitis (umbilical cord infection) and neonatal mortality among newborns.Objective: This study aimed to compare the incidence of omphalitis in different cord care interventions (Dry, Chlorhexidine, and Alcohol) in Nakuru County, Kenya. Methodology: A randomized controlled trial was carried out between July 2018 and June 2019. A total of 540 newborns were randomly assigned to receive 1 of 3 cord care regimens; twice cord cleansing with 4% chlorhexidine (Group 1), twice cord cleansing with 70% alcohol (Group 2), and dry cord care (Group 3) as control. Results: The risk of omphalitis was significantly reduced in the chlorhexidine group than in dry and alcohol cord care groups. The incidence of omphalitis was 1.95 times more likely to occur among the dry cord care group [AOR = 1.95; 95% CI = 1.13-3.38; p = 0.017] compared to the chlorhexidine group. Similarly, babies in the alcohol group were nearly 2 times more likely to develop omphalitis [AOR = 1.98; 95% CI = 1.15-33.40; p = 0.014] compared to those in the chlorhexidine group.Conclusion and recommendation: Chlorhexidine topical cord care significantly reduces the risk of umbilical infection in neonates when compared to both topical alcohol application and dry cord care approach. It should be recommended to be used topically for the prevention of omphalitis in our setup
ACE2 and TMPRSS2 polymorphisms and the development of COVID-19: a review of the literature
No full textSARS-CoV-2 is a virus that has a positive-sense, single-stranded RNA genome that encodes 4 structural proteins, the main one being the S protein (Spike) responsible for mediating with ACE2 and TMPRSS2 for entry into the host cell. The study of single nucleotide polymorphisms (SNPs) of ACE2 and TMPRSS2 can elucidate their possible intervention in the action of the protein, its activity, and the gene expression of encoding these enzymes, which may increase susceptibility to viral infection. From this, literature searches were carried out until December 2021, listing 11,820 publications for literary analysis on the described genetic variations of these protein structures, as well as their relation and influence on the pathology. It was possible to conclude that there is a great influence exerted by genetic variability in ACE2 and TMPRSS2 increasing the ability of the virus to bind to the host cell and the development of COVID-19 with complications.