Indian Journal of Medical Sciences
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Item Pulmonary paragonimiasis: Close mimic to pulmonary tuberculosis in endemic regions(Scientific Scholar, 2024-04) Sharma, S; Agrawal, G; Labru, V; Bhatt, AP; Ahmed, S; Bhatt, R.We, hereby, report a case of pulmonary paragonimiasis in a patient from an endemic region who was misdiagnosed with pulmonary tuberculosis as the clinical features of both diseases are the same. The subtle clue such as eosinophilia, food habits, and travel history can help us diagnose parasitic infections. Pulmonary paragonimiasis with coughing up rusty brown sputum is the most common presentation of the disease. Praziquantel is mainstay of treatment.Item A case of a 44-year-old lady presenting with Sheehan’s syndrome(Scientific Scholar, 2024-04) Bhandari, R; Paudyal, R; Khanal, A; Pandey, G.Because of ischemic necrosis following postpartum hemorrhage, patients with Sheehan’s Syndrome may exhibit different degrees of anterior pituitary insufficiency. They can report a variety of obscuring clinical signs and symptoms even many years after the postpartum hemorrhage, which could lead to a delay in diagnosis and an increase in mortality and morbidity. We report a case of a 44-year-old G3P3L3 lady who presented with this syndrome with history of postpartum hemorrhage 5 years back during the birth of her last child.Item Integration of hyperthermic intraperitoneal chemotherapy with cytoreductive surgery for ovarian cancer in Iraq: Navigating challenges in a resource-limited setting(Scientific Scholar, 2024-12) Mahmood, AS; Shakir, AA; Sabri, S.In Iraq, the application of hyperthermic intraperitoneal chemotherapy combined with cytoreductive surgery is a novel therapeutic strategy for ovarian cancer with peritoneal carcinomatosis. This study at the Arby Private Hospital represents the pioneering use of this modality in a resource-limited setting. It evaluates procedural effectiveness, elucidates the systemic challenges within the healthcare framework, and identifies the imperatives for medical training enhancement. The findings illuminate the clinical viability and outline necessary strategies for broader integration of advanced therapies into the Iraqi health-care paradigm, emphasizing a pressing need for policy and infrastructural reforms to elevate oncologic care.Item Florid vascular proliferation due to focal necrotizing enterocolitis in infancy: A case report(Scientific Scholar, 2024-12) Ozturk, S; Erdogan, Duzcu S; Boran, C; Ozturk, H.Vascular anomalies rarely emerge in the gastrointestinal tract. The most prevalent benign vascular lesions include angiodysplasia, Dieulafoy’s lesion, vascular ectasia, vascular malformations, and hemangiomas. Florid vascular proliferation (FVP) is also a rare benign vascular lesion associated with intussusception in adults. In infants, there are only a few cases in literature. Although FVP usually presents as a mass in the intestine, it is a non-neoplastic lesion and is thought to occur due to a reactive process. In this study, we present a case of FVP due to an attack of focal necrotizing enterocolitis in a 10-month-old infant.Item Gestational diabetes mellitus: Awareness, risk factors, perceived effects, and lifestyle intervention among pregnant women in a Nigerian tertiary health institution(Scientific Scholar, 2024-04) Chikeme, PC.Objectives: To assess the awareness, risk factors, perceived effects, and level of awareness of lifestyle interventions for the prevention of gestational diabetes mellitus (GDM) as well as the association between educational background and the level of awareness of GDM. Materials and Methods: A cross-sectional survey of 244 antenatal women was carried out using a validated self-administered questionnaire containing five sections with sections A to E bordering on demographics, awareness of GDM, risk factors, perceived effects on pregnancy, and lifestyle interventions towards prevention from May through August 2021. Data were analyzed using descriptive statistics of frequencies, percentages, means, and standard deviation. The chi-square test was used to assess the association between educational background and level of GDM awareness. Results: Out of 244 respondents who showed awareness of GDM, 212 (86.9%) had an understanding of what GDM is, 212 (86.9%) knew the risk factors, 227 (93.0%) agreed that they knew the effects, 191 (78.3%) knew about lifestyle interventions. Despite the positive responses, disparities exist in their levels of awareness of each alleged variable. There was an association between educational background and level of awareness of GDM with a P-value of 0.0001 (<0.05). Conclusion: The majority of antenatal women were aware of GDM, risk factors, effects, and lifestyle interventions with diverse degree levels. Less than half were fully aware of the risk factors, and the effects on pregnancy. Regular health/medical professional visits were the most acceptable lifestyle intervention for the prevention of GDM. There was a significant association between education and the level of awareness of GDM. Thus, the government is to enact strong policies that will favor female education as education is a strong determinant of awareness of disease conditions.Item The orthopedics and sports medicine research in India from 2013 to 2022: Comparison with South Asia, European Union, China, and USA(Scientific Scholar, 2024-12) Hassan, W; Duarte, AE.Objectives: In the present study, we explored the research progress in Orthopedics and Sports Medicine within India and South Asia from 2013 to 2022. Materials and Methods: In November 2023, the data were retrieved from Scopus databases. Key indicators such as the number of publications, citations, citations per paper, field-weighted citation impact (FWCI), and distribution across journal quartiles were analyzed. Results: While India demonstrated a substantial contribution to the field, comparative analysis revealed it lags behind China, Europe, and the USA in both quantity and quality of research output. Specifically, India (6,498) and South Asia (6,983) exhibit lower scholarly outputs as compared with China (30,350), European Union (EU) (105,228), and the USA (100,041). Citations per publication reveal gaps, with the USA leading (17), followed by the EU (15.5), China (7.7), and India (7.6). FWCI placed the USA at 1.22, EU at 1.2, and lower values were noted for South Asia (0.74), India (0.70), and China (0.69). Conclusion: The distribution across quartiles indicated that India and South Asia’s comparatively lower emphasis on Q1 (21.30% and 21.72%, respectively), while the EU, China, and the USA demonstrated higher proportions (49.29%, 27.07%, and 53.05%). Conversely, in Q4, India and South Asia (15.04% and 14.87%) have higher concentrations, signaling a potential area for improving research quality. Recommendations include increased funding, interdisciplinary collaboration, investment in advanced technologies, and a focus on high-impact journals.Item Association of serum iron and serum calcium levels in children with febrile seizures(Scientific Scholar, 2024-04) Gupta, H; Sharma, B; Verma, M; Singh, VK; Verma, R.Objectives: The current case–control study was conducted to investigate the relationship of iron deficiency anemia and calcium levels with febrile seizures (FSs) in children. Materials and Methods: The study included 200 children ranging in age from 6 to 60 months. One hundred cases had FSs, including simple FSs and rest; 100 controls had a short history of febrile illness (<3 days) without seizures. A statistical analysis of the data was carried out using Statistical Package for the Social Sciences version 23. Results: The mean weight, height, and head circumference of cases and controls are 9.73 ± 2.51 kg and 10.63 ± 3.34 kg, 79.66 ± 11.08 cm and 85.43 ± 15.55 cm, and 46.37 ± 2.79 cm and 46.83 ± 3.72 cm, respectively. As per the Indian Academy of Pediatrics, 27% of cases and 37% of controls had protein energy malnutrition (PEM). In cases and controls, the mean hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width values were 9.23 ± 1.30 and 10.78 ± 1.60 gm/dL, 68.83 ± 8.86 and 78.59 ± 9.82 fl, 25.40 ± 3.47 and 28.50 ± 3.60 pg, and 18.73 ± 1.77 and 16.44 ± 1.76, respectively, and are statistically significant. Patients had lower serum ferritin levels than controls. The mean blood calcium levels in cases and controls were 9.13 ± 0.64 and 9.05 ± 0.93 mg/dL, respectively (P = 0.507). Iron deficiency anemia was found in 26% of cases and 7% of controls (P value <0.001). Hypocalcemia was reported in only 18% of patients and 23% of controls (P = 0.38). Conclusion: There is a clear correlation between FSs and iron deficiency. The majority of data suggests that hypocalcemia is unlikely to be the cause of FSs. Early detection and intervention of iron deficiency in children could help in the prevention and recurrence of FSs.Item A deep dive into chickenpox epidemiology and outbreaks: A retrospective study in a tribal-dominated district of Western India(Scientific Scholar, 2024-04) Khan, V; Sanghai, AA; Zala, D; Babariya, MJ; Das, V.Objectives: This retrospective observational study conducted in the district of Dadra and Nagar Haveli, Western India, over the past 9 years aimed to comprehensively investigate the epidemiology of chickenpox. The objectives were to analyze demographic and clinical characteristics, examine temporal trends, identify outbreak locations, assess outbreak intensity and duration, determine laboratory-confirmed cases, and provide insights for public health interventions. Materials and Methods: The study employed a retrospective approach, gathering data on chickenpox cases in the region. Demographic information, clinical profiles, and outbreak details were analyzed. Temporal variations and seasonal trends were assessed. Laboratory confirmation was achieved through serology and molecular methods. Locations of outbreaks were identified, and their characteristics were evaluated. Results: The study revealed that the 6–10 age groups were most vulnerable, with mild-to-moderate symptoms predominantly observed. Significant variations in cases occurred year round, with peaks between November and February. Out of 25 recorded outbreaks and three early warning signals, Aganwadis, play schools, and schools were common outbreak locations. Most outbreaks were low intensity, and laboratory confirmation identified Clade-1 Varicella-Zoster virus as the causative agent. Conclusion: These findings provide essential insights for public health officials. Identifying the vulnerable age group and high-risk locations allows for targeted vaccination campaigns. Moreover, the study underscores the need for continuous monitoring and surveillance to detect outbreaks early and mitigate their spread effectively, emphasizing the importance of proactive prevention and control measures for chickenpox in the region.Item Effect of depot medroxyprogesterone acetate on cardiometabolic risk factors among women of reproductive age in Rwanda: A prospective cohort study(Scientific Scholar, 2024-04) Kantarama, E; Uwizeye, D; Uwineza, A; Muvunnyi, CM.Objectives: Depot medroxyprogesterone acetate (DMPA) injectable contraceptive is a widely used hormonal method that offers reversible and effective birth control for women worldwide. However, various studies have raised concerns regarding its potential association with increased cardiovascular disease risk, attributed to its influence on cardiometabolic risk factors. While previous studies have primarily focused on lipid profile, weight gain, blood pressure, and blood glucose, important aspects such as central obesity, glycated hemoglobin (HbA1C), and systemic inflammation have remained under- investigated. Thus, this study aimed to explore the influence of DMPA injectable contraceptives on lipid panel, HbA1C, visceral fat deposition, blood pressure, and inflammatory markers among women of childbearing age in Rwanda. Materials and Methods: The study was a prospective cohort and recruited an equal number of DMPA users (45) as the study group and users of non- hormonal (NH) contraceptives (45) as the control group. We recruited participants from two selected family planning centers in Kigali and collected data at baseline, 6 months, and 12 months. We measured the waist circumference, blood pressure, lipids profile (high-density lipoprotein cholesterol [HDL], low-density lipoprotein cholesterol [LDL], total cholesterol [TC], and triglycerides [TG]), HbA1C, and high-sensitivity C-reactive protein (hs-CRP). We run the Mann–Whitney to compare the median (MD) change between DMPA and NH users. Data were presented as MD (interquartile range), with a significance level of 5%. Results: After a follow-up of 12 months, DMPA users experienced a significant increase in waist circumference, TG, LDL, TC, hs-CRP, and HbA1C (P < 0.05), whereas they experienced a significant decrease in HDL than controls (P < 0.05). However, our data did not indicate a significant difference in blood pressure changes between DMPA and NH users (P > 0.05). Conclusion: The effect of DMPA injectable on cardiometabolic parameters was minimal in the first 6 months of use; however, it manifested statistically significant at 12 months of follow-up. It is recommended to initiate a follow-up with users at least 12 months of use and repeat every 6 months to check the status of cardiometabolic markers and intervene where necessary.Item Peritoneal dialysis-related peritonitis from Burkholderia pseudomallei infection (Melioidosis) of northeast Thailand(Scientific Scholar, 2024-12) Waramit, S.Objectives: Melioidosis is an uncommon cause of peritonitis in patients with end-stage renal disease who are receiving continuing peritoneal dialysis. This study aims to investigate the prevalence and outcome of peritoneal dialysis-related peritonitis due to Burkholderia pseudomallei infection. Materials and Methods: A retrospective cohort study of melioidosis infection between 2018 and 2022, peritoneal dialysis-related peritonitis in cases with end-stage renal failure was collected. The patients’ demographics, clinical characteristics, and treatments were described. Results: Of the 194 cases diagnosed with peritoneal dialysis-related peritonitis, there were 7 patients (3.6%) with melioidosis peritonitis. The patients’ mean age was 51.1 ± 9.44 years old, range of 40–65. Diabetes (5 cases, 71.4%) and hypertension (7 cases, 100%) were the most common co-morbidities. Six cases (85.7%) had fever, 5 (71.4%) had hazy dialysate, and everyone had abdominal pain as clinical signs. Associated septicemia was observed in 5 (71.4%) cases. As part of their antibiotic therapy, meropenem was given to 1 (14.3%) and ceftazidime to 6 (85.7%) cases. Six cases (85.7%) received intravenous antibiotics, whereas 1 (14.3%) case received both intravenous and intraperitoneal routes. The catheters were removed; then, hemodialysis sessions of 5 (71.4%) cases were initiated. Hemodialysis mode was switched permanently in 3 (42.9%) cases and temporarily in one case, thereafter, peritoneal dialysis was resumed. 3 (42.9%) cases died. No significant relations were found about risk factors between survivor and non-survivor group (P < 0.05). Conclusion: Peritoneal dialysis-related peritonitis due to melioidosis is uncommon. However, it may be accompanied by catheter loss and can be lethal if untreated as systemic melioidosis.Item A case of tuberculosis of adrenal gland presenting as acute adrenal insufficiency following initiation of anti-tubercular therapy(Scientific Scholar, 2024-12) Vijayakumar, B; Meganathan, A; Ranganathan, SD; Paulchamy, B.Adrenal tuberculosis is one important cause of acute or chronic adrenal insufficiency in developing countries like India. There are many random cases in literature describing various clinical situations of adrenal tuberculosis presenting with adrenal insufficiency, especially after initiation of anti-tubercular therapy. A 43-year-old male recently diagnosed patient with pulmonary tuberculosis and chronic coronary syndrome was admitted for acute decompensated heart failure with pulmonary edema. He was taking fixed dose combination anti-tubercular therapy. During admission, he had hyponatremia (serum sodium 96 mEq/L) and during treatment, he developed hypotension and shock, which were appropriately treated. Due to ischemic hepatitis, anti-tubercular treatment (ATT) was modified to streptomycin, ethambutol, and ofloxacin regimen to avoid further hepatotoxicity. Hyponatremia and shock recovered. Rifampicin and isoniazid were restarted. He again developed easy fatigability, nausea, vomiting, and hypotension. Suspecting adrenal insufficiency, fasting serum cortisol, and adrenocorticotropic hormone (ACTH) were done, which revealed a low serum fasting cortisol and high ACTH. Computed tomography abdomen showed enlarged left adrenal gland with calcifications. He was started on prednisolone 2 mg/ kg/day with full dose fixed dose ATT, following which his symptoms resolved.Item A comparative analysis of two antigen retrieval techniques: Microwave oven and pressure cooker for immunoexpression of estrogen and progesterone receptors in breast cancer tissue(Scientific Scholar, 2024-04) Kaur, R; Somal, PK; Sancheti, S.Objectives: Antigen retrieval (AR) is an important step in Immunohistochemistry (IHC) which is used to unmask the antigenic sites and facilitate antigen-antibody binding. Adequate fixation of tissue is necessary to achieve consistent demonstration of tissue antigens that can be masked by the chemical process involved in formalin fixation and tissue processing. Out of the various methods of AR, heat-induced epitope retrieval (HIER) methods have greatly improved the quality and reproducibility of IHC. In this study, a comparison of the two most commonly used HIER methods-pressure cooker and microwave oven was done on thirty cases of breast carcinoma. Materials and Methods: Appropriate tumor sections were taken and subjected to manual IHC testing for estrogen receptor (ER) and progesterone receptor (PR) receptors in each case. The results were divided into technique and microscopy-based. The parameters assessed on microscopy were uniformity of nuclear staining, quality of nuclear staining, internal control staining, presence of background staining, and Allred score. The sensitivity and specificity and positive and negative predictive values for each method were calculated. Results: The parameters assessed on microscopy were comparable for both methods. Using a microwave oven, the sensitivity and specificity for ER and PR were 94% and 100%, respectively. Using a pressure cooker, the sensitivity, and specificity for ER were 94% and 100%, respectively, and for PR were 88% and 100%, respectively. On technical aspects, the pressure cooker method offers the advantage of being more convenient due to the possibility of simultaneous handling of more slides and being more time efficient. Conclusion: Both the AR methods had comparable results on microscopy. However, the pressure cooker has the benefit of being both time and money efficient from a technical standpoint.Item A declining trend of hepatitis A and hepatitis E at tertiary care hospital in South Gujarat(Scientific Scholar, 2024-12) Gandhi, TN; Patel, SS; Chaudhary, A; Nakrani, K.Objectives: Hepatitis A virus (HAV) and Hepatitis E virus (HEV) both are spread through the fecal-oral route and cause acute viral hepatitis (AVH) and pose a major public health problem in India. This study was done to find out the proportion of positivity of HAV and HEV in patients with AVH and its seasonal trend. Materials and Methods: A retrospective study was carried out at Surat Municipal Institute of Medical Education and Research Medical College, Department of Microbiology, Surat, Gujarat. Result of 3615 blood samples of suspected AVH patients of the past 5 years (January 2018–December 2022) were taken from hospital data records. The enzyme-linked immunosorbent assay method was used to test serum samples for immunoglobulin M (IgM) HAV and IgM HEV antibodies for HAV and HEV, respectively. All samples were evaluated for liver function as well. Results: The positivity of HAV and HEV was 15.13% and 10.26%, respectively. The coinfection rate was 2.07%. HAV and HEV both affected males more than females. Among pregnant females, HEV infection had more positivity (6.77%) than HAV, which had 1.08% positivity. HAV and HEV infections had a seasonal trend, with the highest infection rate in the monsoon. Conclusion: The declining trend of cases of HAV and HEV was found in Surat city of south Gujarat which indicates increased awareness about hepatitis among people and better public health management by the civic authorities.Item Demographic profile, spectrum, awareness, and cost of renal replacement therapy of chronic kidney disease patients in a public tertiary care center in Rajasthan, India(Scientific Scholar, 2024-12) Jhorawat, R; Meena, RK; Kularaj, SS; Sharma, SK; Beniwal, P; Gupta, R; Agarwal, D; Malhotra, V.Objectives: Chronic kidney disease (CKD) is widely recognized as the leading cause of death worldwide. Diabetes and hypertension are common risk factors. This is the only study on CKD from Rajasthan that highlights basic CKD profiles in patients attending public tertiary care centers. Materials and Methods: This observation study included diagnosed cases of CKD attending nephrology outpatient department (OPD) from January to December 2020. Data regarding the cause of CKD, its stage, mode of renal replacement therapy (RRT), and direct cost of medication were collected. The state runs various schemes, including free dialysis facilities for all, below-poverty level cards (below poverty line [BPL] cards, which had complete free treatment), and state health cards Bhamasha Swasthya Bima Yojana (BSSY) under the government scheme. Results: A total of 252 patients were included in the study. Patients on dialysis were highest, followed by stage V and stage IV CKD, representing 33.73%, 18.65%, and 17.86%, respectively. Hypertension was the predominant cause of CKD, representing 29.37% and CKD (u) prevalence in our study was 14.68%. The direct cost of treatment at CKD stages I, II, III, IV, and V were Rs. 520 ($6.93), Rs. 2435.71 ($32.48), Rs. 3400 ($45.33), Rs. 3405.57 ($45.41), and Rs. 4815.97 ($64.21) per month, respectively. The monthly medicine cost of treatment on hemodialysis was Rs. 6730.60 ($89.74), Rs. 30,278 ($403.71) on peritoneal dialysis, and Rs. 5021.74 ($66.96) on renal transplant. BPL card holders were 8.33%, 39.68% had BSSY card, 16.27% had Insurance, and around one-third (35.71%) were without support. Conclusion: Age, socioeconomic status, and geographical location affect CKD etiology. The accessible dialysis facility, insurance, and government policies affect the selection of the RRT.Item Does the size of unifocal papillary thyroid carcinomas affect the status of the cervical lymph nodes?(Scientific Scholar, 2024-04) Rezkallah, EM; Mahmoud, Y; Mekhaeil, K; Hanna, RS.Objectives: Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy in humans. Cervical lymph node (LN) involvement is one of the major prognostic factors in disease recurrence and morbidity. Despite central lymph node dissection (CLND) is recommended in the case of involved LNs, prophylactic neck dissection is still controversial due to the potential complications associated with this procedure. The aim of the current review is to assess the correlation between the sizes of unifocal PTC with cervical LN involvement, which could help to choose the best treatment plan for patients with PTC. Materials and Methods: We performed a retrospective review for all patients who had unifocal PTC in our department from 2013 to 2019 with a minimum of 3 years of follow-up. SPSS software was used to calculate this correlation. Results: Fifty-nine patients (38 females and 21 males) were included in our study with an average age of 45.4 ± 17 years of age. Out of 17 patients (28.8%) with microcarcinomas, six of them (10.2%) had cervical LN involvement, whereas of the 42 patients (71.2%) with macrocarcinomas, 17 of them (28.8%) had cervical LN metastasis. The correlation between the tumor size and the number of metastatic LNs in our study was weakly positive (r = 0.332, P < 0.05). Conclusion: The decision regarding CLND should be selected on an individual base as even small micro PTC could metastasize to the local LNs.Item Epidemiology and outcomes of drug-resistant tuberculosis cases notified in a low-resource district in Kerala, India 2017–2021 – A 5-year retrospective analysis(Scientific Scholar, 2024-12) Vaman, RS; Kalyanasundaram, M; Amina, TP; Murhekar, MV.Objectives: Kasaragod district reports the highest drug-resistant tuberculosis (DR-TB) case notification rates in Kerala. We conducted a cross-sectional study in Kasaragod to describe the DR-TB cases notified from January 2017 to December 2021 and to identify the factors associated with unfavorable treatment outcomes in DR-TB patients. Materials and Methods: We analyzed the programmatic data from the “Nikshay portal” (a web-based patient management information system for [TB] under the National TB Elimination Program), DR-TB treatment cards, and treatment registers available with the district TB center for all the DR-TB patients notified during the study period. We described the DR-TB cases by year, local self-government area (the local administrative setup), age, gender, income level, and treatment outcomes. We compared sociodemographic, anthropometric, and clinical factors among the DR-TB patients with favorable (cured and treatment completed) and unfavorable (died, lost to follow-up, and treatment failure) treatment outcomes. Results: From January 2017 to December 2021, 128 DR-TB cases were notified from Kasaragod. Annual notification rates varied from 1.4 to 3.4/100,000 population with the highest notification in 2019. The proportion of new TB cases notified tested for drug sensitivity rose from 22% in 2017 to 86% in 2021. Seven of 41 local self-government areas had not notified DR-TB cases during 2017–2021. The notification was higher in inter-state border areas and the coastal belt of the district. The notification of DR-TB cases was highest among the 45–59 age group (17/100,000), followed by the 60 above group (11/100,000). Males and those living below the poverty line had higher notification rates. Among the outcomes evaluated 118 DR-TB patients, 89 (75.4%) had favorable outcomes, whereas the remaining 24.6% had unfavorable outcomes (death 18 [15.3%], loss to follow-up 7 [6%], and treatment failure 4 [3.4%]). Age more than 45 years adjusted odds ratio (aOR) 3.1 (95% confidence interval [CI] 1.1–8.8), income category below the poverty line aOR 6 (95% CI 1.2–28.6), admitted at least twice during treatment aOR 9.2 (95% CI 2.8–30.3), and body mass index at diagnosis <18.5 kg/m2 aOR 3 (95% CI 1.1–10.3) were found to be significantly associated with unfavorable treatment outcomes. Conclusion: DR-TB notifications have increased in the Kasaragod district from 2017 to 2021, with a high burden among males aged 45 years and above. The favorable treatment outcome is better than the national and state average. Regular monitoring and follow-up of multidrug-resistant patients with low incomes, above 45 years, and underweight may improve the final treatment outcomes.Item Respiratory complications of neurological diseases(Scientific Scholar, 2024-08) Aldurah, M; Aractingi, R; Al Bardan, H.Objectives: This study aims to raise awareness toward early diagnosis, effective treatment, and prevention of respiratory complications in patients with neurological diseases. The goal is to improve patients’ overall condition and reduce mortality rates. Materials and Methods: This study is a prospective observational study conducted at Damascus Hospital, Damascus, Syria, from October 2022 to March 2023. It includes (100) patients diagnosed with neurological diseases who developed respiratory complications. Their ages ranged from 18 to 89 years, with an equal gender distribution. Data analysis was performed using SPSS statistics version 19. Results: This study revealed that cerebrovascular accidents cause aspiration pneumonia. The most frequent chest X-ray and thoracic computed tomography findings showed pulmonary densities and infiltrates. Subsequently, arterial blood gas results showed type 2 respiratory failure. Many patients experienced regression of respiratory complications, and the mortality rate was low, indicating the efficacy of treatments. Conclusion: Respiratory complications significantly contribute to mortality in patients with neurological diseases. The study emphasizes the importance of early diagnosis and preventive measures such as elevating the patient’s bed and periodic suctioning of secretions. Placing patients in specialized neurological intensive care units for tailored treatment is advised.Item Rare presentation of gastric glomus tumor in a 28-year-old female with gastritis(Scientific Scholar, 2024-08) Mubarak, A; Alshaikh, SA; AlKhuzaie, J; Ali, N.This case report describes a rare presentation of a gastric glomus tumor in a 28-year-old Bahraini female patient who was previously diagnosed with gastritis and was on proton-pump inhibitor therapy for the past 3 years. The patient presented with symptoms of anemia and coffee ground vomiting, which led to further investigation and the eventual diagnosis of a glomus tumor in the stomach. Glomus tumors are uncommon neoplasms derived from the glomus body, a specialized arteriovenous structure involved in thermoregulation. Although they typically occur in the extremities, glomus tumors can rarely be seen in visceral organs, including the stomach. This case emphasizes the importance of considering unusual etiologies in patients with atypical presentations, even in those with pre-existing gastrointestinal conditions.Item Unraveling the quivering dance: Trichomoniasis(Scientific Scholar, 2024-08) Rajan, A; Kapil, N.This case report delves into an atypical presentation of trichomoniasis in a previously healthy 56-year-old female. Presenting with burning micturition and pruritus, the patient’s urine microscopy revealed characteristic twisting motility of Trichomonas vaginalis, confirming the diagnosis. Treatment with metronidazole resulted in prompt symptomatic improvement. This case underscores the importance of recognizing diverse presentations of Trichomoniasis for accurate diagnosis and timely intervention.Item Uses, benefits and future of artificial intelligence (AI) in orthopedics(Scientific Scholar, 2024-08) Nathan, L; Muthusamy, V.The use of artificial intelligence (AI) technology in healthcare is estimated to grow at 47.6%/year. AI applications in orthopedics are used for diagnostics, predictive models, medical image analysis, and risk prediction. This review aims to provide an understanding of AI applications used in orthopedics, their benefits, future applications, and challenges to be overcome.