International Journal of Medical and Surgical Sciences

Giant Solitary Pulmonary Fibrous Tumor: Case Report

Mon, 01 Jul 2024 00:00:00 +0000

The giant pulmonary solitary fibrous tumor is a mesenchymal tumor of rare fibroblastic differentiation, preferably intrathoracic and intraoral. Not associated with specific risk factors. Non-specific clinical presentation and slow growth. The present case is of a 54-year-old patient with dyspnea on medium exertion with the presence of abolished left vesicular murmur. He developed refractory hypoglycemia leading to Doege Potter syndrome. A total occupying mass was evident in the left chest on computed axial tomography. A modified approach was performed by sternotomy plus left thoracotomy to improve exposure and hemodynamic control with access to the tumor’s nutritional vessels and total tumor excision. Histopathology revealed a heavier tumor reported in the medical literature. Microscopy presence of mesenchymal neoplasia composed of spindle-shaped and oval cells and positive immunohistochemistry of giant solitary pulmonary fibroma.

Case Reports on Anatomical Variations of the Hepatic Arteries: Implications for Laparoscopic Cholecystectomy and Surgical Safety

Tue, 02 Jul 2024 00:00:00 +0000

A laparoscopic surgeon’s understanding of embryology, anatomy, and potential anatomical variations of the bile duct is crucial for safely performing gallbladder removal using this minimally invasive technique. In conducting two medical-legal autopsies, we identified a previously undocumented anatomical variant where the liver’s blood supply originates from the common hepatic artery, branching into a trident formation to form the right, left, and cystic hepatic arteries. Notably, the right hepatic artery is situated within Calot’s triangle, whereas the cystic artery is located anomalously outside the triangle. This anatomical anomaly poses significant surgical risks, including the potential for morbidity and mortality due to ischemic necrosis of the liver from vascular injury. The success of laparoscopic surgery under these circumstances relies heavily on the surgeon’s expertise in managing an atypical surgical field, adherence to a culture of safety, and a critical approach to safety in laparoscopic cholecystectomy.

Protective Effects of Tigernut (Cyperus esculentus) on Bisphenol A- Induced Testicular Toxicity in Wistar Rats

Abraham Abigail , Idaguko Chika Anna — Mon, 22 Jul 2024 00:00:00 +0000

Bisphenol A (BPA) have been reported to induced reprotoxicity in rats. This study was conducted to find out the ameliorative properties of aqueous extract of Cyperus esculentus (tigernut) on BPA induced testicular toxicity in Wistar rats.

Methods: Twenty male rats were divided randomly into 4 groups (n=5): group A: (Control); group B: Bisphenol A (BPA) (25 mg/kg b.w/day); group C: tigernut (200 mg/kg b.w); group D: (25 mg/kg of BPA+ 200 mg/kg of tigernut extract. 25 mg/kg of BPA was dissolved in 0.2 ml of olive oil as vehicle and administration was given by oral gavage for 4 weeks. The body weights were measured. Blood were collected for the testosterone (T) and luteinizing hormone (LH) assays; the epididymis were processed for sperm count, sperm motility, sperm viability and sperm abnormality test; while the testes were harvested for histology

Results: There was a significantly (p < 0.05) decreased in body weight; reduced (sperm count, motility, viability, serum testosterone and luteinizing hormone) in BPA compared with control group. These parameters however increased significantly (p < 0.05) in tigernut (200mg) and BPA + tigernut (200mg) compared with BPA. Also, histological examination showed widened interstitial spaces, some distorted seminiferous tubules, degeneration of basement membrane, scanty Leydig cells, fewer spermatozoa and vacuolation While BPA + tigernut (group D); showed improved testicular architecture (preserved interstitial spaces and interstitial cells. restoration of the loss of the basement membrane and closely packed seminiferous tubules with well-arranged germinal epithelium. Supplementation with tigernuts following BPA administration produces a reversal of the deleterious effect of BPA on the testis.

Pediatric Patients with Acute Lymphoblastic Leukemia in Honduras: Demographic Characteristics, Clinical Features, and Laboratory Findings.

Wed, 17 Jul 2024 00:00:00 +0000

Approximately 90% of confirmed cancer cases annually are reported in low to middleincome countries. In Honduras, the incidence of pediatric cancer has been steadily increasing, accompanied by a higher cancer mortality rate attributed to diagnostic errors, limited access to healthcare, and management challenges. Diagnostic pitfalls, such as failure to recognize signs of malignancy, inadequate assessment of persistent symptoms, and misinterpretation of diagnostic tests, significantly impede effective cancer care. This retrospective case study collected data from 68 pediatric patients diagnosed with Acute Lymphoblastic Leukemia (ALL) at the Honduran Social Security Institute in Tegucigalpa between January 2015 and December 2022. Data retrieval encompassed demographic features, clinical characteristics, and laboratory findings. We used SPSS Statistics version 29.0.2.0 to perform all statistical analysis. The cohort comprised patients of equal gender distribution, with 42.6% (N: 29) belonging to the age group of 1 to 4 years. The hospital diagnosed an average of 8.5 cases each year. Fever was the most prevalent symptom, affecting 80.9% of patients (N: 55). Hemoglobin levels were below 10 mg/dL in 67.6% of patients, with 33.8% exhibiting levels below 7 mg/dL (N: 23) and equal proportion falling within the 7-10 mg/dL range (N: 23). Platelet levels were below 150,000/μL, with 48.5% experiencing severe thrombocytopenia (platelet levels <50,000/μL). Additionally, most patients presented phosphorus levels exceeding 4.5 mg/dl (N: 33, 48.5%), along with elevated LDH levels surpassing 500 U/l (N: 34, P: 50%). The presence of persistent fever should trigger suspicion of cancer, necessitating thorough assessment. Implementing guidelines outlining common symptoms and referral protocols could significantly reduce mortality in Honduran children with ALL.

Could glycated hemoglobin be considered a marker of inflammation in patients with diabetes mellitus?

Pablo Aguirre-Villegas, Adriana Pedreañez — Mon, 26 Aug 2024 00:00:00 +0000

La fisiopatología de la diabetes incluye la persistencia de un estado inflamatorio de bajo grado caracterizado por el incremento de citocinas proinflamatorias, proteínas de fase aguda y alteraciones en la respuesta inmunitaria que conllevan al desarrollo de complicaciones macrovasculares y microvasculares. Los mecanismos involucrados en la activación del estado inflamatorio no están totalmente esclarecidos, pero se sabe que la hiperglucemia juega un rol determinante. La hemoglobina glicada es en la actualidad el marcador biológico por excelencia utilizado para evaluar la evolución de los niveles de glucemia en los pacientes diabéticos debido a su formación irreversible y acumulativa, proporcionando información retrospectiva sobre el equilibrio glucémico durante dos a tres meses anteriores a su medición. Sin embargo, poco se conoce sobre su asociación con la respuesta inflamatoria en estos pacientes. El objetivo de esta investigación es recopilar evidencias que permitan establecer una asociación entre los niveles de HbA1c y el estado inflamatorio en pacientes con diabetes mellitus, lo que permitiría considerar a la HbA1c no sólo como una medida fiable para evaluar el control glucémico retrospectivo. Sino además, como un biomarcador asociado al estado inflamatorio y por consiguiente al riesgo de desarrollar complicaciones propias de esta enfermedad.