International Journal of Medical and Surgical Sciences

Chronic granulomatous intestinal disease: case report

Tue, 24 Sep 2024 00:00:00 +0000

Chronic intestinal granulomatous disease is a disorder that directly compromises the entire immune system. The estimated incidence is one in a million inhabitants. Among the associated risk factors, the presence of chronic and recurrent infections stands out. In the present case, it is a 39-year-old female patient with a history of intestinal obstruction and endometriosis, who presents abdominal pain in the left abdomen and recurrent abdominal pain without an identifiable cause. Laboratory tests revealed leukocytosis and mild neutrophilia. The tomography showed intestinal dilation at the jejunoileal level without transition zones, and the serological tests were negative. Exploratory laparoscopy was performed and the presence of tumor implants was found in the omentum, extending to the abdominal, uterine, intestinal, and peritoneal regions, as well as sallow fluid at the abdominal level. Tumor markers are normal. Histopathology details fungal colonization with eosinophilic necrosis and presence of granulomas, negative immunohistochemistry for Aspergillus and negative Lowestein-jensen culture. Antifungal and antituberculous treatment was started, with a decrease in symptoms and improvement in the clinical picture.

Syncope as a clinical presentation of cardiac lymphoma: a case report

Fri, 11 Oct 2024 00:00:00 +0000

Primary cardiac lymphoma, an extremely rare type of B-cell non-Hodgkin lymphoma, has an incidence of approximately 0.02-2% among malignant cardiac tumors. It is frequently associated with manifestations such as cardiac rhythm disturbances, refractory pericardial effusion and cardiac masses. Definitive diagnosis is achieved by biopsy, being essential to rule out hematogenous dissemination with PET-CT. The literature indicates a predominance of right chamber involvement and survival that varies significantly according to left ventricular involvement and the presence of arrhythmias. Therapeutic options are not well defined, but chemotherapy such as R-CHOP has shown efficacy, although the prognosis is generally poor due to complications such as disease progression, arrhythmias and sepsis. This case underscores the importance of considering cardiac lymphoma in patients with unexplained cardiac symptoms, highlighting the need for a multidisciplinary and specific diagnostic and therapeutic approach.

Effect of Orijin Bitters, Aqueous Extracts of Hibiscus Sabdariffa and Zingiber Officinale Roscoe on the Kidney of Adult Wistar Rats

Sarah I. David, Godfrey Duru, Abigail Abraham, Samuel Victor Ita — Fri, 22 Nov 2024 00:00:00 +0000

Orijin bitters, Hibiscus sabdariffa and Zingiber officinale roscoe have been reported to possess various medicinal properties. The aim of the study is to evaluate their effects on the kidney of adult wistar rats. Methodology: thirty rats were randomly divided into 6 groups, each having 5 rats. Group 1 received distilled water, group 2, 70cl/70kg/bw orijin bitters, group 3, orijin bitters and 200mg/kg/bw Hibiscus sabdariffa calyx aqueous extract, group 4, orijin bitters and 500mg/kg/bw Hibiscus sabdariffa calyx aqueous extract, group 5, orijin bitters and 200mg/kg/bw officinale rhizome aqueous extract, group 6, orijin bitters and 500mg/kg/bw Zingiber officinale rhizome aqueous extract over a 21- day period. After administration, the rats were sacrificed and the kidney harvested for biochemical and histological analysis. Results: Orijin bitters altered renal function, indicated by elevated level of malondialdehyde and decreased level of superoxide dismutase, catalase and glutathione, along with histopathological changes such as glomerular atrophy and tubular degeneration compared to the control. The result was not statistically significant (P < 0.05). Conversely, aqueous extracts of Hibiscus sabdariffa calyx and Zingiber officinale rhizome exhibited antioxidant properties, reducing oxidative stress and mitigating renal damage compared to the orijin bitters group only. Although the result was not statistically significant (P < 0.05). Conclusion: Orijin bitters may have nephrotoxic effects, while Hibiscus sabdariffa and Zingiber officinale may offer protective benefits, due to their antioxidant properties.

From Anatomy to Algorithm: Scope of AI-Assisted Diagnostic Competencies in Health Sciences Education

Iván Suazo Galdames — Thu, 21 Nov 2024 00:00:00 +0000

The article explores the evolution of medical knowledge from its anatomical and functional foundations to the integration of advanced technological tools, focusing on the impact of artificial intelligence (AI) on the development of diagnostic competencies. Initially, medical training relied on direct observation and clinical judgment based on anatomical and surgical knowledge. Subsequently, the inclusion of physiology and pathology enabled a functional understanding of the human body, transforming diagnosis into a systematic skill supported by objective data such as laboratory tests and medical imaging. The integration of AI in recent decades has revolutionized this process, offering unprecedented capabilities to analyze complex clinical data. Tools such as machine learning algorithms and predictive systems have enhanced diagnostic precision, allowing for the identification of previously unnoticed patterns. This data-driven approach strengthens physicians’ ability to correlate clinical symptoms and signs with specific pathological entities. However, the incorporation of AI presents challenges in medical education. Future physicians must combine learning traditional clinical foundations with mastering advanced technologies, all while maintaining an ethical and patient-centered approach. Furthermore, excessive reliance on technology and biases inherent in algorithms underscore the need to balance technological innovation with human clinical judgment. The article highlights that medical education must adapt to include critical competencies such as digital literacy, ethical reasoning, and critical thinking. AI-based simulators and educational platforms are playing a key role in preparing physicians for a more digitized clinical environment, while research remains essential to ensure transparency and fairness in these technologies.

Subjective and objective evaluation of nasal obstruction in patients treated at the Hospital de Clínicas, Paraguay

Fri, 27 Sep 2024 00:00:00 +0000

Nasal obstruction is characterized by insufficient airflow and increased resistance in the nasal cavities, affecting patients’ quality of life and sleep. This study aims to compare the efficacy of medical and surgical treatment in patients with Nasal obstruction, using subjective evaluations (NOSE and VAS scales) and objective evaluations (active anterior rhinomanometry). This is an experimental and prospective longitudinal study conducted at the Hospital de Clínicas, Paraguay. Forty patients with Nasal obstruction were included, divided into medical treatment (nasal corticosteroids) and surgical treatment (turbinoplasty, septoplasty, or both) groups. Pre- and post-treatment evaluations were performed using the NOSE and VAS scales, and active anterior rhinomanometry. The sample included 52.5% men and 47.5% women, with an average age of 32.18±11.59 years. The main cause of Nasal obstruction was chronic rhinitis (62.5%). Treatments showed significant improvements in subjective and objective evaluations. In the medical group, VAS improved by 2.63 points in women and 2.00 in men, while the surgical group showed more pronounced improvements. The NOSE also showed significant reductions, especially in patients undergoing combined turbinoplasty and septoplasty. Active anterior rhinomanometry reflected an increase in overall nasal flow in all treated groups. Both medical and surgical treatments are effective in improving Nasal obstruction, with greater benefits observed in surgical treatments. Subjective and objective evaluations are valuable and complementary tools for assessing treatment in patients with Nasal obstruction. These results highlight the importance of a comprehensive evaluation in the management of Nasal obstruction.