International Journal of Research in Medical Sciences
Not a member yet
9900 research outputs found
Sort by
Goblet cell adenocarcinoma of the appendix: a rolling stone for long
Get PDFAppendiceal goblet cell adenocarcinoma (GCA) is a rare and aggressive epithelial neoplasm comprising goblet-like mucinous cells primarily and variable neuroendocrine cells. It is an amphicrine neoplasm with features of epithelial and neuroendocrine tumours, but behaves aggressively like an adenocarcinoma variant. GCA has undergone multiple name changes in the past; therefore, there have been inconsistencies in nomenclature, classification, reporting, and understanding of the pathology of the disease. Although it typically presents with features of acute appendicitis, it may sometimes present with subtle symptoms of gastrointestinal discomfort. In late stages, they may present with intestinal obstruction or as a metastatic ovarian mass. Diagnosis is possible only on histopathologic examination, which reveals goblet cell infiltration in sheets, singly scattered form, complex cribriform pattern, discrete clusters, and tubules. Our case report aims to increase awareness about GCA and its differential diagnosis and emphasise the need for a larger, elaborate study to bring consistency in GCA reporting. We report a rare case of metastatic high-grade appendiceal GCA in a 65-year-old female presenting with complete intestinal obstruction
The evolving role of nurses in extracorporeal membrane oxygenation therapy
Get PDFNurses managing extracorporeal membrane oxygenation (ECMO) have shifted from operating under a perfusionist-led framework to assuming full responsibility for ECMO care. This transition reflects a growing demand for sustainable, team-based ECMO delivery models. To review the evolving role of nurses in ECMO therapy, with emphasis on clinical responsibilities, education, training and leadership, this narrative review synthesizes findings from original studies and program evaluations describing nurse-led ECMO models, nursing competencies and educational initiatives. Nurses now monitor circuits, adjust settings, manage anticoagulation and lead emergency responses. Structured training programs, simulation exercises and competency validation have facilitated this role expansion. Studies report improved ECMO capacity, patient safety and program efficiency. Nurse-led ECMO models enhance resource use, team integration and care quality. Investment in training and interprofessional collaboration is vital for sustaining and expanding nursing roles in ECMO programs.
Penile strangulation by a plastic bottle neck: a novel technique for non-metallic foreign body removal
Get PDFPenile strangulation is a rare urological emergency requiring immediate intervention to prevent ischemia, necrosis, and functional loss. We reported a 35-year-old male who presented with penile incarceration caused by a rigid plastic bottle neck. The patient’s unsuccessful self-removal attempts partially fragmented the object. A novel extraction technique using a Gigli saw guided over an artery forceps under local anaesthesia enabled safe removal without significant complications. A multidisciplinary approach involving surgical, urological, and psychiatric evaluation ensured complete recovery. This report highlights a simple, low-cost, and reproducible technique for managing non-metallic penile constricting objects and underscores the importance of early intervention and holistic care in such emergencies
Primary neuroendocrine tumor of liver-a rare case report
No full textThe primary neuroendocrine tumor of the liver (PNET) is an exceptionally rare diagnosis, representing only 0.3% of all neuroendocrine tumors (NET). Due to its infrequency, accurate differentiation from other hepatic masses and exclusion of occult primary NETs are imperative. Establishing a definitive diagnosis of liver PNET often requires a comprehensive follow-up to rule out alternative primary causes. The liver is a frequent site for neuroendocrine metastases, and notably, primary neuroendocrine liver tumors typically demonstrate a more favorable prognosis compared to hepatocellular carcinoma and other malignant hepatic lesions. This paper reports on the case of a 74-year-old female patient who presented with pain in the right upper quadrant of the abdomen for two months. Following a triphasic CT scan and liver mass biopsy, the diagnosis of PNET was confirmed based on biopsy reports and immunohistochemistry (IHC). The patient underwent multimodality treatment; however, further intervention was deferred due to the patient's poor general condition. Instead, the patient was placed on the best supportive care.
Basal cell carcinoma in a patient at two rare sites: a case report
Get PDFBasal cell carcinoma (BCC) is a locally aggressive cutaneous tumor frequently linked to aberrations in the Hedgehog signaling pathway. It typically occurs on sun-exposed areas; however, rare presentations in non-sun-exposed sites have been documented. A 61‐year‐old female presented with a five-year history of a non-healing ulcer on the right leg. Initially misdiagnosed as Lupus vulgaris, repeated biopsies revealed features consistent with infiltrative BCC and, subsequently, a morpheaform subtype with squamous differentiation. In addition, metastasis was noted in the inguinal region. Radiological studies and histopathological evaluations confirmed the diagnosis. This case underscores that BCC may present at atypical, non-sun-exposed sites and can demonstrate local aggressive behavior with regional metastasis. Early recognition and prompt surgical management are essential to prevent further local invasion and metastasis
Role of ultrasonography in the diagnosis of acute appendicitis in emergency cases
Get PDFBackground: Acute appendicitis remains one of the most common surgical emergencies worldwide, demanding prompt and accurate diagnosis to prevent complications such as perforation or peritonitis. While computed tomography (CT) offers high diagnostic accuracy, ultrasonography (USG) serves as a safer, more accessible alternative, particularly in emergency and resource-limited settings. This study aimed to evaluate the diagnostic accuracy of ultrasonography in acute appendicitis by correlating USG findings with histopathological results among patients presenting with suspected appendicitis in the emergency department.
Methods: A prospective observational study was conducted on 54 patients aged 8–60 years with clinical suspicion of acute appendicitis. All patients underwent graded compression ultrasonography using high-frequency linear and convex probes. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated using histopathological findings as the gold standard.
Results: The appendix was visualized in 79.6% of patients. USG diagnosed appendicitis in 41 of 43 positive scans, with 2 false positives and 4 false negatives. The overall diagnostic performance of USG was sensitivity 91.1%, specificity 77.8%, PPV 95.3%, NPV 63.6%, and accuracy 88.9%. Common sonographic findings included a non-compressible tubular structure >6 mm (75.9%), periappendiceal fat stranding (64.8%), and Doppler hyperemia (51.9%). Accuracy was higher in non-obese patients (92.3%) compared to obese individuals (81.8%), and pediatric cases showed superior sensitivity (95%).
Conclusions: Ultrasonography is a reliable, non-invasive, and efficient first-line imaging modality for diagnosing acute appendicitis in emergency settings. It demonstrates high sensitivity and accuracy comparable to CT when performed by skilled radiologists. Incorporating Doppler assessment and adopting a staged USG-CT approach in equivocal cases can further enhance diagnostic confidence while minimizing unnecessary radiation exposure.
Titagen® for total wellness: results from a randomised, placebo controlled clinical study on adults for osteoarthritis, improvement in skin, nail and health
Get PDFBackground: Fish collagen has been vital in functional food with natural bioactive compounds to offer potential therapeutic benefits. Titan biotech limited (TBL) has studied Titagen® as a nutraceutical to evaluate improvement in in adults looking to improve skin, hair, nail health and osteoarthritis.
Methods: Two randomised, double blinded, placebo controlled clinical studies were conducted on Titagen® of TBL. 48 adults were studied in each of the studies for a period of 90 days. Study 1 (SHN study) was conducted on adults looking to improve skin, hair and nail health with Titagen® dose of 5g per day for 3 months-assessed, using assessments and questionnaire to evaluate skin improvement, hair growth and nail health. Study 2 (OA study) was conducted on adults with osteoarthritis with Titagen® dose of 10 g per day for 3 months-evaluated using assessments and questionnaires.
Results: Results showed that Titagen® was better than placebo with statistically significant results in skin health (59.72% vs -51.39), 60 second hair comb test (27.15% vs 2.35%), hair health (18.06% vs -43.06%), nail health (62.50% vs -33.33%), Western Ontario and McMaster universities arthritis index (WOMAC) parameters (39.73% vs 1.72%), pain VAS (70.86% vs 4.21%), quality of life questionnaire (20.83 scores vs 7.31 scores), global impression of change scale results (2.75 vs 4.40). There were no adverse events related to Titagen® and is deemed safe for daily consumption.
Conclusions: The clinical studies proved 5 g Titagen® for 90 days improved skin, hair and nail health, 10 g Titagen® for 90 days reduced pain, stiffness in joints and improved quality of life living with osteoarthritis
Relationship between QRS duration on admission electrocardiogram and angiographic severity of coronary artery disease in patients with acute anterior myocardial infarction
Get PDFBackground: Early risk stratification in myocardial infarction (MI) is crucial, but the prognostic role of admission electrocardiography (ECG) findings remains underexplored. This study evaluated the relationship between QRS duration and severity of coronary artery disease (CAD) in acute anterior MI (AMI).
Methods: A cross-sectional study was conducted at the Department of Cardiology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from November 2019 to October 2020. One hundred patients with first anterior MI, admitted within 12 hours of chest pain onset and treated with thrombolysis, were enrolled. Patients were stratified into two groups: QRS≤100 ms (normal) and QRS >100 ms (prolonged). CAD severity was assessed using Gensini score, with ≥36 indicating moderate-to-severe disease.
Results: Patients with prolonged QRS duration were significantly more likely to have severe CAD, with an eightfold higher risk compared to those with normal QRS (95% CI: 3.2-19.3; p<0.001).
Conclusions: Prolonged QRS duration on admission ECG is strongly associated with severe CAD in acute anterior MI, suggesting its value for early risk stratification
Diabetic myonecrosis: a rare complication of poorly controlled diabetes
Get PDFDiabetic myonecrosis is a rare complication of poorly controlled diabetes that can be overlooked. This case report describes a 58-year-old man with type 2 diabetes who presented with severe pain and swelling in his right anterolateral thigh for one month. Despite antibiotics, his symptoms persisted. Laboratory tests revealed a normal white blood cell count, elevated blood glucose levels, an elevated erythrocyte sedimentation rate, and elevated C-reactive protein levels. Magnetic resonance imaging revealed diffuse oedema in the anterior thigh muscles, strongly suggesting muscle necrosis. The patient was diagnosed with diabetic myonecrosis based on clinical presentation, basic investigations and imaging findings. He was managed with rest, pain control, and improved glycemic control. This case highlights the importance of considering diabetic myonecrosis in patients with poorly controlled diabetes who present with acute muscle pain and swelling. Early recognition and appropriate management are crucial for avoiding unnecessary interventions and improving outcomes. Increased awareness of this complication is needed among clinicians to ensure prompt diagnosis and treatment
Occupational brucellosis in a veterinary assistant following exposure during management of bovine dystocia: a case report
Get PDFBrucellosis remains a significant occupational zoonosis in India, particularly affecting workers in the veterinary and livestock sectors who frequently interact with infected animals and reproductive tissues. The disease is caused by gram-negative intracellular coccobacilli of the genus Brucella, with B. abortus being the predominant species associated with bovine brucellosis. Veterinary personnel performing high-exposure procedures such as dystocia management, placentectomy and handling of aborted materials face the greatest risk due to the heavy bacterial load present in reproductive tissues. We describe a case of acute brucellosis in a 34-year-old veterinary assistant who developed undulant fever, arthralgia, generalized myalgia, malaise and sacroiliac pain after unprotected exposure to reproductive secretions during manual management of bovine dystocia in a herd experiencing multiple late-term abortions. Herd screening revealed widespread Brucella abortus positivity. Initial evaluation showed leukopenia and a false-positive Widal test, leading to misdiagnosis as enteric fever. Persistent fever and musculoskeletal symptoms led to further investigation, and Brucella IgM ELISA returned strongly positive, confirming acute infection. The patient received WHO-recommended therapy with doxycycline and rifampicin for six weeks, resulting in full recovery without relapse over three months of follow-up. This case highlights the occupational risks faced by veterinary personnel, diagnostic challenges caused by nonspecific symptoms and serological cross-reactivity, and the critical need for strengthened biosafety practices and One-Health–oriented surveillance systems to reduce the burden of brucellosis in endemic regions