European Journal of Medical and Health Sciences 2022-01-06T08:59:24-05:00 Editor-in-Chief Open Journal Systems European Journal of Medical and Health Sciences The Forgotten Ganglion: Ganglion Sublinguale 2021-09-29T07:16:01-04:00 Birsen Ozyurt <p>This study is aimed to reming the presence of ganglion sublinguale. Currently, 4 parasympathetic ganglion have been mentioned in head and neck region. Although contemporary anatomy textbooks report the ganglion submandibulare, the ganglion sublinguale has not been described in these texts. However, the ganglion sublinguale was reported by earlier researchers. Recently, Takezawa and Kageyama showed a seperate sublingual gaanglion, related to the sublingual gland [1]. This information was supported by descriptions in 19th century anatomy textbooks. A thorough understanding of the ganglion sublinguale is very important for anatomy education and oral surgical procedures.</p> 2022-01-25T00:00:00-05:00 Copyright (c) 2022 Birsen Ozyurt A Prospective Study Regarding the Need for Repeat Potassium Testing in ED Patients with Hemolysis-Associated Pseudo-Hyperkalemia 2021-12-16T16:22:26-05:00 David Salo Patrick Hinfey Devansh Pandey Renae Bernard Randy Gill Frederick Fiesseler <p><em>Objectives:</em> Many ED patients who have hyperkalemia (HK) with evidence of hemolysis have pseudohyperkalemia (PHK) and may not require repeat potassium (K) testing, though ED physicians often redraw levels. We sought to determine if a set of patients with PHK could be determined who would not require repeat K draws based on lab and medication/co-morbid conditions.</p> <p><em>Methods: </em>This was a prospective IRB-approved study at an 85,000 patient/yr inner-city ED. Data was analyzed to determine whether repeat K draws were necessary in patients with HK plus hemolysis who had normal renal function (NFR) defined by either Cr or GFR and to determine factors that might lower retest threshold and prevent unnecessary repeat K testing. Normal renal function was defined as Cr <u>&lt;</u> 1.3 or GFR <u>&gt;</u> 60 (calculated by the Modification of Diet in Renal Disease (MDRD) equation:. HK was defined as K &gt; 5.3 mEq/L. ED patients with K draws showing HK plus hemolysis with repeat metabolic panel performed within 12 hours were eligible.</p> <p><em>Results: </em>300 patients had HK with hemolysis with repeat testing during the study period. Four were excluded due to missing/incomplete data. Two patients had renal failure and were excluded. 238 had repeat K sent prior to, or without specific HK treatment and were further analyzed. The median age was 60, range 76, IQR 46-75. 153/238 (64.2%) were female, 200/238 African-American (84%), 169/238 (71%) had normal GFR while 182/238 (76.8%) had normal Cr. Twenty-four of the 238 (10%) had persistent HK on the 2<sup>nd</sup> lab draw. Factors on univariate analysis associated with HK on repeat testing were age, gender, diuretic use, PVD, DM, and abnormal BUN, Cr or GFR. Binary logistic regression showed abnormal Cr, age and PVD as significant predictors of persistent HK. ROC curves of Cr and age were generated and further analysis showed Cr &gt;1.4, age &gt; 63, or PVD would have identified 22/24 cases of persistent hyperkalemia (the two patients showing persistent hyperkalemia had potassium levels that did not require treatment). This resulted in a decreased need for retesting in 53.7% of patients.</p> <p><em>Conclusion: </em>By using 3 variables: Cr &gt;1.4, age &gt; 63, and history of PVD, 115/214 (53.7%) of patients with initial HK with hemolysis would not require repeat blood draw for potassium testing, while 2/24 patients with persistent HK would have been missed. These 2 patients had marginally elevated potassium that would not have required treatment. Since some variables reported to be associated with hyperkalemia were not present or were present in low numbers, physicians may need to repeat testing on select or sicker patients who they suspect may have true HK, however up to 50% of patients will not require such testing.</p> 2022-01-27T00:00:00-05:00 Copyright (c) 2022 David Salo, Patrick Hinfey, Devansh Pandey, Renae Bernard, Randy Gill, Frederick Fiesseler SARS-CoV-2 Direct Real Time PCR without RNA Extraction: Appropriate Method or Not? 2021-11-30T23:06:16-05:00 Spandan Chaudhary Disha Patel Kavisha Vyas Pooja Chaudhary Prathana Singhania Juhi Patel Ekta Jajodia Nilay Dave Shiv Patel Ramachandiran Sivaramakrishnan Mayank Patadiya Tushar Sonagara Ashish Hirpara Neeraj Arora <div> <p class="Abstract"><span lang="EN-US">Real time PCR (RT-PCR) detection method is the widely used for COVID-19 virus detection. This includes sample collection in viral transport medium (VTM), viral RNA extraction followed by detection of virus using fluorescence dye-based system using RT-PCR machine. Several studies have demonstrated a new method which replaces the extraction step by a simple method involving DTT and Proteinase-K and heat treatment. ICMR and few other governing bodies have approved such protocols but are they appropriate in clinical context? In present study, we tried to evaluate one such protocol by using ICMR and WHO approved COVID-19 detection protocol (of CoviPath™ COVID-19 RT-PCR Kit) by replacing RNA extraction step. We used 228 clinical COVID-19 samples for studying method which includes 176 positive (CT values from 14 to 23; 24 to 31 and 32 to 37 were considered as high, moderate and low positive respectively) and 52 negative nasopharyngeal and oropharyngeal swabs samples. We got 100% concordant results with negative samples and 92% concordant and 8% non-concordant results for positive samples. Non-concordant results are with low positive samples. Low level of positivity in the samples could indicate the initial/end stage of COVID-19 disease. If they are at the initial stage, they can be the potential carrier and spread the disease. Authors believe that direct methods can be used for screening bit not for diagnosis of COVID-19 disease.</span></p> </div> 2022-01-27T00:00:00-05:00 Copyright (c) 2022 Spandan Chaudhary, Disha Patel, Kavisha Vyas, Pooja Chaudhary, Prathana Singhania, Juhi Patel, Ekta Jajodia, Nilay Dave, Shiv Patel, Ramachandiran Sivaramakrishnan, Mayank Patadiya, Tushar Sonagara, Ashish Hirpara, Neeraj Arora Normal Chest X-Ray in Patients with Pulmonary Embolism May Involve Increased Risk of Massive Pulmonary Embolism 2022-01-06T08:59:24-05:00 Hatice Kilic Habibe Hezer Berker Ozturk Muhammed Sait Besler Huseyin Cetin Hatice Canan Hasanoglu Aysegul Karalezli <div> <p class="Abstract"><em><span lang="EN-US">Purpose:</span></em><span lang="EN-US"> Chest radiography is normal in approximately 20-40% of acute pulmonary embolism (PE) patients without cardiopulmonary disease. The aim of this study was to determine whether there is any difference between the patients with normal chest X-ray and those with pathological findings in terms of clinical severity and prognosis. </span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Methods:</span></em><span lang="EN-US"> 178 of PE patients were included in the study. 110 patients had no parenchymal pathology, whereas group 1 (n = 110); group 2 (n = 68) had various pathological parenchymal findings in 68 patients. Clinical and radiological parameters were compared between these groups. Following the diagnosis of PE, the cases were recorded in the fifth year.</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Results:</span></em><span lang="EN-US"> In 178 participants; those with normal chest X-ray (group 1), with parenchymal pathological findings on the chest X-ray (group 2); echocardiographic systolic pulmonary artery pressure (sPAP) (p = 0.68), gender (p = 0.9) and thrombus type (p = 0.41) were similar.</span></p> </div> <div> <p class="Abstract"><span lang="EN-US">The patients in group 1 were not different in terms of central thrombus detected in computed tomography pulmonary angiogram compared to the patients in group 2; however, the chest radiograph of the patients in group 1 had no parenchymal pathology. Central thrombus group 1, group 2, respectively; 97 (89.0%), 53 (77.9%), p = 0.07.</span></p> </div> <div> <p class="Abstract"><span lang="EN-US">There was no significant difference between the two groups in terms of mortality which was followed up in fifth year (p &gt; 0.05).</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Conclusions:</span></em><span lang="EN-US"> Normal chest X-ray in PE can determine mortality and may involve increased risk of massive PE.</span></p> </div> 2022-01-04T00:00:00-05:00 Copyright (c) 2022 Hatice Kilic, Habibe Hezer, Berker Ozturk, Muhammed Sait Besler, Huseyin Cetin, Hatice Canan Hasanoglu, Aysegul Karalezli Variation between Initial and Final Diagnosis as A Predictor of Adverse Obstetric Outcome among Post-Natal Women at Bungoma Hospitals, Kenya 2022-01-06T08:59:22-05:00 David Nandebe Wafula Bernard Wesonga Maximilla Wanzala Nathan Shaviya Rose A. M. Nyang’au <p>Despite diagnosis being an important part of clinical or medical consultations, the diagnosis might fail leading to adverse effects. This is a global problem, where developed and developing countries go through. In sub-Saharan Africa, variations between initial diagnosis and final diagnosis lead to diagnostic errors with high maternal mortalities. In Kenya, a lot of measures have been put in place but still, variation in diagnosis appear to have become rampant. Bungoma county is one of the counties with a high mortality ratio, especially for pregnant women attributed to the variation between initial and final diagnosis. Therefore, it was crucial to investigate the variation between initial and final diagnosis in relation to obstetric outcomes at hospitals in Bungoma County. The cross-sectional research design was used (Bungoma and Webuye hospitals). Systematic sampling was used to obtain 384 respondents after proportionate allocation to each hospital, and purposive sampling to select 8 health care workers as key informants. Data was collected using a structured questionnaire and an interview guide. The pre-test was done with validity established through crosschecking and reliability calculated using the Cronbach method (0.89). Using a statistical package for social sciences version 25, descriptive and inferential statistics was run where chi-square and odds ratio was used to determine the influence between variables, significance and prediction. The study revealed a variation between initial diagnosis and the final diagnosis was 20.8% while diagnostic errors were significant predictors of obstetric outcomes among post-natal mothers at level five with a p-value of 0.045 at a significance of 5%(P=0.045). Demographic characteristics showed no relationship with obstetric outcomes (P=0.54&gt;0.05). Matched diagnostic had no variations (N=327, M=1.00, SD=0.000); while unmatched diagnostic had variations (N=327, M=1.82, SD=.384). There was a relationship between diagnostic errors and obstetric outcome (ꭓ2 (1) = 251.86, p&lt; .001). An association between diagnostic error with unsafe obstetric outcomes was significant at the odds ratio of 2.03(OR 2.03, 95% CI 1.31–2.16). The study demonstrates that a correct diagnosis is a viable strategy in preventing unsafe obstetric outcomes and by extension minimizing morbidity and mortality among pregnant women. The study concluded that there was a variation between initial diagnosis and final diagnosis which had an adverse obstetric outcome. it was recommended to build capacities for the health workers in order to address increased diagnostic errors.</p> 2022-01-04T00:00:00-05:00 Copyright (c) 2022 David Nandebe Wafula, Bernard Wesonga, Maximilla Wanzala, Nathan Shaviya , Rose A. M. Nyang’au Therapeutic Plasma Exchange in Guillain Barre Syndrome: An experience of Bangabanhu Sheikh Mujib Medical University, Bangladesh 2022-01-06T08:59:18-05:00 Sheikh Saiful Islam Jannatul Ferdous Ashraful Hoque Atiar Rahman <p><em>Background:</em> Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh.</p> <p><em>Materials and Methods:</em> A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume.</p> <p><em>Results:</em> Out of 50 cases there were 43 (86%) male and 7 (14%) female. Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE &amp; 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered.</p> <p><em>Conclusion: </em>The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.</p> 2022-01-05T00:00:00-05:00 Copyright (c) 2022 Sheikh Saiful Islam, Jannatul Ferdous, Ashraful Hoque, Atiar Rahman Prevalence, Knowledge and Treatment of Systemic Arterial Hypertension in A Campaign Day 2021-11-01T18:07:38-04:00 Elizabeth do Espirito Santo Cestario Anderson Aparecido Santim Beatriz Beretta Alves Beatriz Pereira Alcarde Beatriz Sanches Rodrigues Catarina de Souza Nascimento Fernanda de Almeida Spósito Lauane Carolina Maciel Fernandes Letícia Fernandes Garcia Roberta Bonamim Fiorilli Vinicius Cardoso de Leão Vinicius Cavallari <div> <p class="Abstract"><span lang="EN-US">Hypertension affects 1.4 billion of the world population, being considered the main cause of cardiovascular diseases and, therefore, an important cause of premature and preventable mortality worldwide. It is associated with complications such as atherosclerotic coronary artery disease, congestive heart failure, stroke, intracerebral hemorrhage, and chronic kidney disease. Given this prevalence and risk, strategies were created to control the disease, such as changes in lifestyle and use of medications. However, non-adherence to treatment is a frequent concern and it is associated with adverse results and an increased number of complications. Therefore, the present study aims to present the incidence of arterial hypertension in the population of a city in the inland part of São Paulo, relating it to its risk factors, adherence to treatment and disease control. The objective is evaluating the incidence and rate of uncontrolled systemic arterial hypertension on a campaign day in a city in the inland part of São Paulo. The method is observational, cross-sectional, descriptive, population-based study, random sample of 545 individuals, 231 women and 314 men, collected in a city in the northwest of São Paulo on a campaign day. The study showed a prevalence of 46.24% for hypertensive patients, with 88.9% adherence to treatment and pressure loss of 34.23%. Among the analyzed hypertensive patients, there was a higher incidence among the elderly, obese, and people with diabetes mellitus. Regarding adherence and disease control, better results were noted among patients with complications such as AMI and thrombotic events, and less adherence among obese, alcoholics and smokers. The results of the present study are consistent with literature data, showing that even with knowledge of the disease, part of the population does not have adequate treatment, showing the need for integrated health policies for early diagnosis, distribution and treatment regulation, and actions to improve lifestyle.</span></p> </div> 2022-01-13T00:00:00-05:00 Copyright (c) 2022 Elizabeth do Espirito Santo Cestario, Anderson Aparecido Santim, Beatriz Beretta Alves, Beatriz Pereira Alcarde, Beatriz Sanches Rodrigues, Catarina de Souza Nascimento, Fernanda de Almeida Spósito, Lauane Carolina Maciel Fernandes, Letícia Fernandes Garcia, Roberta Bonamim Fiorilli, Vinicius Cardoso de Leão, Vinicius Cavallari Sexual Relationship, Power and Safe Sex Practices among Female Bar Workers in Kinondoni Municipality, Dar es Salaam, Tanzania 2021-11-24T01:22:39-05:00 Mangi Job Ezekiel Judith Narlis Metta Idda Hubert Mosha <p><em>Background:</em> HIV and AIDS continue to challenge the health sector and economies in low and middle-income countries. Effectiveness condom use in preventing transmission of HIV is jeopardized due to recent reported decline in condom use. Alcohol serving venues are meeting points for sex partner which is a significant determinant of risk sexual practices while gender inequities impose challenges to women in negotiating safe sex.</p> <p><em>Methods:</em> Cross sectional exploratory study was conducted which deployed a qualitative method in data collection. Purposive sampling was used to select fourteen study participants. In-Depth Interview guide was used to gather information from female bar workers on perceptions and experiences in sexual relationships that are initiated following their interaction with male customers in alcohol serving settings and their negotiation for safe sex. This study explored sexual relationship power of Female Bar Workers (FBWs) in safe sex negotiations as they interact in alcohol serving venues in Kinondoni municipality in Dar es Salaam, Tanzania. Data was analysed manually by using thematic approach.</p> <p><em>Results:</em> Negotiation ability and sexual relationship power continue to be a key determinant of safe or unsafe sexual practices in sexual relationships of female bar workers. Although power to negotiate and make decisions towards safe sex was widely reported by female bar workers when they engage in casual sexual relationships, such power is outweighed by their own willingness to engage in multiple sexual relationships to supplement their meagre incomes.</p> <p><em>Conclusion:</em> Health promotion should continue to focus on behaviour change interventions with consideration of gendered roles and power in sexual relationships.</p> 2022-01-13T00:00:00-05:00 Copyright (c) 2022 Mangi Job Ezekiel, Judith Narlis Metta, Idda Hubert Mosha 4th National Sero Survey of India: Vaccine Generated Antibodies Enhancement 2021-11-05T21:44:28-04:00 Zameer Shervani Deepali Bhardwaj Roma Nikhat Aiman Ibbrahim Intazam Khan Umair Yaqub Qazi Ankira Agarwal Adil Ahmed Khan Sadia Hasan Abdullah Sherwani <div> <p class="Abstract"><span lang="EN-GB">The results of the fourth COVID-19 national serosurvey (June-July 2021) </span><span lang="EN-GB">of India </span><span lang="EN-GB">have been analysed. </span><span lang="EN-GB">M</span><span lang="EN-GB">uch needed data of </span><span lang="EN-GB">vaccine </span><span lang="EN-GB">generated antibodies have been </span><span lang="EN-GB">reported</span> <span lang="EN-GB">world first as recorded in Indian population on the ground in real. </span><span lang="EN-GB">More than two-third</span><span lang="EN-GB">s</span> <span lang="EN-GB">of </span><span lang="EN-GB">(67.6%) Indian population developed antibodies against the infection. This include</span><span lang="EN-GB">s</span><span lang="EN-GB"> natural immunity build up </span><span lang="EN-GB">due to infection</span><span lang="EN-GB"> and vaccine generated antibodies</span><span lang="EN-GB">.</span> <span lang="EN-GB">Eleven</span><span lang="EN-GB"> states: </span><span lang="EN-US">Madhya Pradesh, Rajasthan, Bihar, Gujrat, Chhattisgarh, Uttarakhand, Uttar Pradesh, Andhra Pradesh, Karnataka, Tamil Nadu, and Odisha ha</span><span lang="EN-US">d</span><span lang="EN-US"> sero positivity of &gt;67.6%</span><span lang="EN-US">which was </span><span lang="EN-US">the national average. </span><span lang="EN-US">Ten </span><span lang="EN-US">other states registered &lt; 67.6% </span><span lang="EN-US">seroprevalence </span><span lang="EN-US">were: Punjab, Telangana, Jammu and Kashmir, Himachal Pradesh, Jharkhand, West Bengal, Haryana, Maharashtra, Assam, and Kerala. </span><span lang="EN-US">Single dose vaccination of </span><span lang="EN-US">24% </span><span lang="EN-US">population </span><span lang="EN-US">added 19% seroprevalence in </span><span lang="EN-US">the </span><span lang="EN-US">population whereas 13% full vaccination increased 28% </span><span lang="EN-US">individuals registered</span><span lang="EN-US"> antibodies. The highest (90%) seroprevalence was registered </span><span lang="EN-US">among</span> <span lang="EN-US">the individuals </span><span lang="EN-US">who have taken both vaccine doses followed by HCWs (85%)</span><span lang="EN-US">.</span> <span lang="EN-US">S</span><span lang="EN-US">eroprevalence</span><span lang="EN-US"> in </span><span lang="EN-US">85-90% </span><span lang="EN-US">population might be the </span><span lang="EN-US">threshold </span><span lang="EN-US">for </span><span lang="EN-US">herd immunity which </span><span lang="EN-US">delayed or possibly </span><span lang="EN-US">stopped the third COVID-19 wave in India.</span></p> </div> 2022-01-19T00:00:00-05:00 Copyright (c) 2022 Zameer Shervani, Deepali Bhardwaj, Roma Nikhat, Aiman Ibbrahim, Intazam Khan, Umair Yaqub Qazi, Ankira Agarwal, Adil Ahmed Khan, Sadia Hasan, Abdullah Sherwani Obstetric Safety and Quality at Istishari Arab Hospital: Where Are We Now and How Can We Improve 2021-09-25T19:40:25-04:00 Raneem Abd Alrhim Shahenaz Najjar Sami Smerat <div> <p class="Abstract"><em><span lang="EN-US">Background:</span></em><span lang="EN-US"> Indicators for tracking progress in maternal and newborn health have been recommended by a number of global monitoring initiatives. Quality of care is increasingly recognized as an important aspect of maternal and newborn health, particularly in the labor and delivery and immediate postnatal period.</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Objectives</span></em><span lang="EN-US">: The purpose of this study is to estimate the frequency of obstetric complications. Furthermore, in 2018, Istishari Arab Hospital assessed the safety and quality of obstetrical procedures. Identifying risk factors that contributed to adverse events in the obstetric department.</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Methods: </span></em><span lang="EN-US">A retrospective study is dependent on the use of electronic medical records from inpatient hospitals. Research was conducted in the field of inquiry in an electronic database, as well as related studies. Maternal morbidity and adverse outcomes were identified using diagnosis and procedure codes from the International Classification of Diseases, 10th Revision (ICD-10-CM) within the health information system. Aside from the paper files. SPSS was used for descriptive, univariate, and multivariate analysis.</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Results</span></em><span lang="EN-US"> This study included 418 women, with 62.2 percent of them having their babies delivered by CS. The average age of the women in this study was 27.84.8 years, with 58.1 percent of them coming from Ramallah. Following a multivariate analysis using logistic regression, our study discovered a positive correlation with P-value 0.05 between educational level and prior CS on one side and surgical site infection on the other. Furthermore, our study found a link between the rate of CS on one side and maternal age, diabetes, hypertension, and gynecological factors on the other (prematurity, multiple gestation).</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Conclusion:</span></em><span lang="EN-US"> Regardless of the number, patients with a lower education level or a history of CS have a higher risk of surgical site infection and other complications. By focusing on these factors and increasing awareness and education, we may be able to reduce obstetric complications in the future.</span></p> </div> 2022-01-19T00:00:00-05:00 Copyright (c) 2022 Raneem Abd Alrhim, Shahenaz Najjar, Sami Smerat, Marah Abu Muhsen A Surgical Approach to Giant Cell Tumor of Lower End of Tibia with Curettage and Reconstruction by Bone Grafting Harvested from Left Iliac Crest and K-wire Fixation: A Case Report 2022-01-06T08:59:15-05:00 Pravakar Tripathy Mahesh Chand Bansal Rahul Upadhyay <p><em>Introduction:</em> Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT is usually found in the long bones around the knee or in the distal radius but distal end of tibia, proximal humerus, vertebrae of young adults are unusual location. We report a case of GCT of the distal end of tibia, with a secondary aneurysmal bone cyst, in a 26-year-old female. Based on our review of the medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst (ABC) in distal end of tibia is less typical with challenging task for full tumor resection and restoration of ankle function to normal.</p> <p><em>Case Summary:</em> 26 year old female presented with pain&amp;swelling over left ankle since last six month. Biopsy was suggestive of GCT with ABC of lower third tibia. We managed this case with intralesional curettage using phenol and burr and bone graft harvested from left iliac crest for reconstruction of defect along with kwire fixation to achieve optimum anatomical restoration.</p> <p><em>Conclusion:</em> In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Here Intra-articular GCT is managed with extended intralesional curettage with phenol. Bone graft plays a role of agent for reconstruction of the defect and kwire for anatomical reduction.</p> 2022-01-05T00:00:00-05:00 Copyright (c) 2022 Pravakar Tripathy, Mahesh Chand Bansal, Rahul Upadhyay A Case Report: Methotrexate and Etoposide as Adjuvant Therapy on Patient with Hydatidiform Moles that Have Growing Rapidly Becomes Gestational Trophoblastic Neoplasia 2021-10-23T00:01:44-04:00 Supriyono <p>A hydatidiform mole is a type of placental abnormality that is associated with gestational trophoblastic disease (GTD). It can be complete or partial mole. They are typically considered benign, but they are also premalignant, with the potential to become malignant and invasive to other organs (gestational trophoblastic neoplasia/GTN). Management of the hydatiform moles is curettage therapy and suction, which aims to therapy and diagnostic. Follow-up post evacuation of moles must be tight with serum hCG and clinical examination. When there is evidence of vaginal bleeding and an increase in serum hCG, chemotherapy must be used as an adjuvant. This case report intends to persuade clinicians that adjuvant therapy with chemotherapy combination-based Methotrexate/MTX and etoposide can recover and eliminate vaginal bleeding disorders. On her first pregnancy, a woman of 27 years old develops a complete hydatiform mole. The curettage and suction procedure were then performed twice. She also receives chemotherapy in three series of single MTX and three series of MTX plus Etoposide. Following this therapy, the patient recovers, normal hCG level and has no vaginal bleeding problems.</p> 2022-01-07T00:00:00-05:00 Copyright (c) 2022 Supriyono Management and Outcome of Bilateral Elastofibroma Dorsi: 3 Cases Report and Review of Literature 2021-12-14T14:43:38-05:00 S. Karti A. Jalal A. Chfiri M. Diouri <p>Elastofibroma dorsi is a rare soft tissues benign tumor with very slow evolution, seen predominantly in females and elderly, It mostly occurs in the infrascapular region, and can be bilateral. The diagnosis is based on clinical presentation and imaging features but pathological study after excision is necessary for confirmation. We present the cases of 3 patients with bilateral elastofibroma dorsi to clarify the clinical features, radiological and therapeutic modalities to improve management, along with a literature review.</p> 2022-01-19T00:00:00-05:00 Copyright (c) 2022 S. Karti, A. Jalal, A. Chfiri, M. Diouri Chronic Ruptured Abdominal Aortic Aneurysm 2021-11-30T10:39:22-05:00 Sohaib Bin Nawaz <div> <p class="Abstract"><span lang="EN-US">Chronic rupture of Abdominal Aortic Aneurysm is a rare presentation although AAA and its frank rupture is well known phenomenon. Chronic rupture of AAA can be misdiagnosed due to non-specific presentation and absence of haemorrhagic shock. This case report discusses the presentation scenarios as well radiologic findings which may help diagnose a Chronic Ruptured AAA (CR-AAA) and will be helpful in prompt recognition and early management of the situation.</span></p> </div> 2022-01-19T00:00:00-05:00 Copyright (c) 2022 Sohaib Bin Nawaz Parsonage Turner Syndrome Following COVID-19 Vaccine 2021-11-29T09:31:47-05:00 Sohaib Bin Nawaz Wathsala A. Raigam <div> <p class="Abstract"><span lang="EN-US">Parsonage Turner Syndrome (PTS) presents with sudden onset arm pain followed by motor weakness and can be associated with surgery, infection, or vaccination. This case discusses an incidence of PTS following COVID-19 vaccination where symptoms resolved on their own progressively and extensive investigations ruled out cerebrovascular accident or vascular aetiology, and diagnosis of PTS was made. Incidence of such adverse effects is rare and awareness among clinical community can lead to recognition and prompt management of such cases.</span></p> </div> 2022-01-19T00:00:00-05:00 Copyright (c) 2022 Sohaib Bin Nawaz, Wathsala A. Raigam