Non-linear ground deformation detection and monitoring using time series InSAR along the coastal urban areas of Pakistan.

Conventional geodetic methods rely on point measurements, which have drawbacks for detecting and tracking geologic disasters at specific locations. In this study, the time series Interferometric Synthetic Aperture Radar (InSAR) approach was incorporated to estimate non-linear surface deformation caused by tectonic, shoreline reclamation, and other anthropogenic activities in economically important urban regions of Pakistan's southern coast, which possesses around 270 km. The shoreline is extended from the low-populated area on the premises of the Hub River in the west to the highly populated Karachi City and Eastern Industrial Zone, where we collected the Sentinel-1A C-band data from 2017 to 2023 to address urban security and threats to human life and property. The main advantage of opting for the non-linear persistent scatterer interferometric SAR (PSInSAR) approach for this study is that it exposes minute movements without any prior consideration of conventional monitoring techniques, making it valid in continuously varying regions. An average vertical displacement range of - 170 to + 82 mm per year was found, which was used to investigate the potential correlation with the most effective causative parameters of deformation. The densely populated areas of the study area experience an annual subsidence of 170 mm, and the less populated western region experiences an uplift of 82 mm annually. Land deformation varies along the coast of the study area, where the eastern region is highly reclaimed and is affected by erosion. Groundwater table-depleting regions experienced high levels of land subsidence, and tectonic activities controlled vertical displacement in the region. Major variation was detected after an earthquake occurred along fault lines. This study was designed because a non-linear approach is required to address ground movement activities acutely, and it will make it possible to plan surface infrastructure and handle issues brought on by subsidence more effectively.

Elevated lipoprotein(a) levels: A crucial determinant of cardiovascular disease risk and target for emerging therapies.

Cardiovascular disease (CVD) remains a significant global health challenge despite advancements in prevention and treatment. Elevated Lipoprotein(a) [Lp(a)] levels have emerged as a crucial risk factor for CVD and aortic stenosis, affecting approximately 20 of the global population. Research over the last decade has established Lp(a) as an independent genetic contributor to CVD and aortic stenosis, beginning with Kare Berg's discovery in 1963. This has led to extensive exploration of its molecular structure and pathogenic roles. Despite the unknown physiological function of Lp(a), studies have shed light on its metabolism, genetics, and involvement in atherosclerosis, inflammation, and thrombosis. Epidemiological evidence highlights the link between high Lp(a) levels and increased cardiovascular morbidity and mortality. Newly emerging therapies, including pelacarsen, zerlasiran, olpasiran, muvalaplin, and lepodisiran, show promise in significantly lowering Lp(a) levels, potentially transforming the management of cardiovascular disease. However, further research is essential to assess these novel therapies' long-term efficacy and safety, heralding a new era in cardiovascular disease prevention and treatment and providing hope for at-risk patients.

Neuro-computing solution for Lorenz differential equations through artificial neural networks integrated with PSO-NNA hybrid meta-heuristic algorithms: a comparative study.

In this article, examine the performance of a physics informed neural networks (PINN) intelligent approach for predicting the solution of non-linear Lorenz differential equations. The main focus resides in the realm of leveraging unsupervised machine learning for the prediction of the Lorenz differential equation associated particle swarm optimization (PSO) hybridization with the neural networks algorithm (NNA) as ANN-PSO-NNA. In particular embark on a comprehensive comparative analysis employing the Lorenz differential equation for proposed approach as test case. The nonlinear Lorenz differential equations stand as a quintessential chaotic system, widely utilized in scientific investigations and behavior of dynamics system. The validation of physics informed neural network (PINN) methodology expands to via multiple independent runs, allowing evaluating the performance of the proposed ANN-PSO-NNA algorithms. Additionally, explore into a comprehensive statistical analysis inclusive metrics including minimum (min), maximum (max), average, standard deviation (S.D) values, and mean squared error (MSE). This evaluation provides found observation into the adeptness of proposed AN-PSO-NNA hybridization approach across multiple runs, ultimately improving the understanding of its utility and efficiency.

The Use of 2-Octylcyanoacrylate Dressing in Reducing the Risk of Superficial Surgical Site Infections in Colorectal Stoma Surgery: A Retrospective Cohort Study.

BACKGROUND: Superficial surgical site infection (SSI) is a common morbidity following bowel resection surgery involving stoma formation with clinical and financial implications. The study aimed to evaluate the role of topical skin adhesive, 2-octylcyanoacrylate (Dermabond®) (2-OCA) in reducing wound infections following colorectal stoma surgery. METHODS: We performed a retrospective, single-centre, cohort study using clinical notes. All patients, over the age of 18, undergoing bowel resection either elective or emergency, with stoma formation over five years from January 2015 to December 2019 were included. The primary endpoint was SSI, defined by the clinical manifestation of inflammation including pain, erythema, and discharge, regardless of the microbiological culture results. Patients received either 2-OCA glue as wound dressing or standard firm adhesive wound dressing e.g. Opsite. RESULTS:  Overall, 604 patients were included in the study. The median age was 67; 187 (31%) patients received Dermabond (Group 1) and 417 (69%) received standard care (Group 2). A total of 288 (47%) patients were female, 134 (22%) had body mass index (BMI) greater than 30, 87 (14%) were diabetic, and 90 (15%) were smokers. A total of 279 (46%) patients had an American Society of Anesthesiologists (ASA) score of 3 and 4; 282 (47%) patients went through emergency surgery, 279 (64%) patients underwent dirty surgery, and 220 (35%) patients developed SSI. BMI greater than 30 compared to < 30 (OR: 2.32, 95% CI: 1.54-3.49, p<0.0001), diabetes compared to no diabetes (OR: 0.54, 95% CI: 0.32-0.92, p<0.0241), dirty surgery compared to clean surgery (OR: 2.26, 95% CI: 1.51-3.37, p<0.0001) and standard care, no 2-OCA glue use compared to the use of 2-OCA glue (OR: 1.52, 95% CI: 1.03-2.24, p=0.0343) were associated with SSIs.  Conclusion: Our study demonstrates that there is an association between 2-OCA and reduced SSIs in bowel resection surgery involving stoma formation when compared to standard methods of wound dressing. Further randomised clinical trials are recommended to strengthen this evidence and demonstrate causation.

Pedunculated gluteal mass.

Forceful compression made a small papule grow into this 3.5 × 4.5-cm mass.

Landslide detection and inventory updating using the time-series InSAR approach along the Karakoram Highway, Northern Pakistan.

Karakoram Highway (KKH) is frequently disrupted by geological hazards mainly landslides which pose a serious threat to its normal operation. Using documented inventory, optical imagery interpretation, and frequency-area statistics, the features of slope failure, the spatial distribution, and their link to numerous contributing factors have all been effectively explored along the KKH. An updated inventory for the area was recreated using the interferometric synthetic aperture radar (InSAR) persistent scatterer (PS) technology to further investigate millimetre-accurate measurements of slope deformation (Vslope). Utilizing the PS approach, Sentinel-1 data from Jan 2018 to Jan 2022 were processed by which we obtained a deformation rate (VSlope) that varies between 0 and 364 mm/year. A total number of 234 landslides were cited from the literature and classified while 29 new potential landslides were detected and several pre-existing landslides were redefined by the InSAR approach, which was incorporated to generate an updated landslide susceptibility model with 86.6% of prediction precision in the area under curve method. As previous studies done by applying the InSAR technique incorporated a short span temporally and they missed some highly deforming zones like Budalas and Khanabad landslides, contain mean velocities > 50 mm/yr, which we studied individually in this work. In this study, a comprehensive application of the InSAR technique to assessing its performance in detecting and analysing landslides has been applied. The deformation velocity (Vslope) model shows high displacement in some regions, which needed to be further investigated by geoscientists, and the updated developed landslide inventory and susceptibility map can be used for land use planning and landslide mitigation strategies.

Management of Acute Appendicitis During the COVID-19 Pandemic: A Single-Centre Retrospective Cohort Study.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, the management of acute appendicitis shifted towards non-operative management in the United Kingdom (UK). The open approach was recommended over the laparoscopic approach due to the risk of aerosol generation and subsequent contamination. The aim of this study was to compare the overall management and surgical outcomes of the patients treated for acute appendicitis before and during the COVID-19 pandemic. MATERIALS AND METHODS: We performed a retrospective cohort study at a single district general hospital in the UK. We compared the management and outcome of the patients diagnosed with acute appendicitis before the pandemic, from March to August 2019, and during the pandemic, from March to August 2020. We looked at the patient demographics, methods of diagnosis, management, and surgical outcomes for these patients. The primary outcome of the study was the 30-day readmission rate. Secondary outcomes included length of stay and post-operative complications. RESULTS: Over the period of six months, a total of 179 patients were diagnosed with acute appendicitis in 2019 (Pre-COVID-19 pandemic, from March 1, 2019, to August 31, 2019) versus 152 in 2020 (during the COVID-19 pandemic, from March 1, 2020, to August 31, 2020). For the 2019 cohort, the mean age of the patients was 33 (range 6-86 years), 52% (n=93) were female, and the mean BMI was 26 (range 14-58). For the 2020 cohort, the mean age was 37 (range 4-93 years), 48% (n=73) of the patients were female, and the mean BMI was 27 (range 16-53). At the first presentation, in 2019, 97.2% of the patients (174 out of 179) received surgical treatment compared to 70.4% (107 out of 152) in 2020. Three per cent of the patients (n=5) were managed conservatively in 2019 (two out these failed conservative management) as compared to 29.6% (n=45) in 2020 (21 of these failed conservative management). Pre-pandemic, only 32.4% (n= 57, ultrasound (US) scan: 11, computer tomography (CT) scan): 45, both US and CT: 1) of the patients received imaging to confirm the diagnosis as compared to 53.3% during pandemic (n=81, US scan: 12, CT scan: 63, both US and CT: 6). Overall, the CT to US ratio increased. We found that during 2019, 91.5% (n=161/176) of the patients who received surgical treatment went through laparoscopic surgery as compared to only 74.2% (n=95/128) in 2020 (p<0.0001). Postoperative complications occurred in 5.1% (n=9/176) of the surgical patients in 2019 as compared to 12.5% (n=16/128) in 2020 (p<0.033). The mean length of hospital stay in 2019 was 2.9 days (range 1-11) versus 4.5 days in 2020 (range 1-57) (p<0.0001). The 30-day readmission rate was 4.5% (8/179) versus 19.1% (29/152) (p<0.0001). The 90-day mortality rate was zero for both cohorts. CONCLUSION: Our study shows that the management of acute appendicitis changed due to the COVID-19 pandemic. More patients went through imaging, especially CT scans for diagnosis and received non-operative management with antibiotics only. The open surgical approach became more common during the pandemic. This was associated with longer lengths of hospital stay, more readmissions, and an increase in postoperative complications.

Bioengineering liver tissue by repopulation of decellularised scaffolds.

Liver transplantation is the only curative therapy for end stage liver disease, but is limited by the organ shortage, and is associated with the adverse consequences of immunosuppression. Repopulation of decellularised whole organ scaffolds with appropriate cells of recipient origin offers a theoretically attractive solution, allowing reliable and timely organ sourcing without the need for immunosuppression. Decellularisation methodologies vary widely but seek to address the conflicting objectives of removing the cellular component of tissues whilst keeping the 3D structure of the extra-cellular matrix intact, as well as retaining the instructive cell fate determining biochemicals contained therein. Liver scaffold recellularisation has progressed from small rodent in vitro studies to large animal in vivo perfusion models, using a wide range of cell types including primary cells, cell lines, foetal stem cells, and induced pluripotent stem cells. Within these models, a limited but measurable degree of physiologically significant hepatocyte function has been reported with demonstrable ammonia metabolism in vivo. Biliary repopulation and function have been restricted by challenges relating to the culture and propagations of cholangiocytes, though advances in organoid culture may help address this. Hepatic vasculature repopulation has enabled sustainable blood perfusion in vivo, but with cell types that would limit clinical applications, and which have not been shown to have the specific functions of liver sinusoidal endothelial cells. Minority cell groups such as Kupffer cells and stellate cells have not been repopulated. Bioengineering by repopulation of decellularised scaffolds has significantly progressed, but there remain significant experimental challenges to be addressed before therapeutic applications may be envisaged.

Environmental Contamination With SARS-CoV-2 in a Hospital Setting.

Background The coronavirus disease 2019 (COVID-19) pandemic is a global concern and has changed the way we practice medicine in acute hospital settings. This is particularly true with regard to patient triage, patient risk assessment, use of personal protective equipment, and environmental disinfection. Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily through inhalation of respiratory droplets generated through talking, coughing, or sneezing. There is, however, a potential risk that respiratory droplets settling on inanimate surfaces and objects in the hospital environment could provide a reservoir for nosocomial infections in patients and pose a healthcare risk to medical staff. Indeed, there have been previous reports of healthcare-associated outbreaks in hospitals. Several authors have argued that the risk of transmission via fomites may be insignificant. It is, however, not clear what proportion of SARS-CoV-2 infections are attributable to direct contact with fomites; a few reports have indicated possible transmission via this route. Environmental contamination with SARS-CoV-2 in healthcare institutions has been shown to vary according to the function or service provided by a unit or department. Information that identifies hospital areas that have a propensity for higher environmental burden may improve the practice of infection control and environmental cleaning and decontamination in healthcare institutions. This study aimed to investigate environmental SARS-CoV-2 contamination in the clinical areas of patients with COVID-19 infection. Methodology We conducted a cross-sectional study performing swabbing of frequently touched surfaces, equipment, and ventilation ducts in five specific clinical areas of Peterborough City Hospital which is part of the North West Anglia NHS Foundation Trust. The five clinical areas that were chosen for swabbing were the Emergency Department (ED), Intensive Care Unit (ICU), Isolation Ward, Respiratory Ward, and a Gastroenterology Ward that was serving as a receiving ward at the height of the second COVID-19 infection wave in the United Kingdom. Surfaces to be swabbed were divided into the patient zone, doctor zone, and nursing zone. Swabs from the chosen surfaces were collected on two consecutive days. A total of 158 surface swabs were collected during the second wave of the COVID-19 pandemic. SARS-CoV-2 RNA was detected by reverse transcription polymerase chain reaction. Results The most contaminated clinical areas were the three receiving wards where 12% (11/96) of the swabs were positive. Inside the patient rooms, these surfaces included bed rails and controls, bedside tables, television screens, remote control units, and the room ventilation system. Outside the patient room, these surfaces included mobile computers and computer desk surfaces in the doctors' offices. All swabs taken from the ED and ICU were found to be negative. Conclusions Our study confirms the potential infection risks posed by environmental contamination with the SARS-CoV-2 virus. This highlights the importance of adequate environmental cleaning for proper infection control and prevention in healthcare settings.

Frequency Of Ventricular Septal Rupture As A Complication Of Acute St-Elevation Myocardial Infarction In Patients Presenting To A Tertiary Care Hospital.

Background: Nearly one-third of the world's population dies from cardiovascular disorders, the majority of which are caused by stroke and coronary artery problems and 80 percent of these fatalities occur in impoverished countries. This study was conducted to determine the frequency of ventricular septal rupture in patients with acute ST-elevation myocardial infarction presenting to cardiology unit Hayatabad Medical Complex Peshawar. Methods: This was descriptive cross sectional research study at the Department of Cardiology, MTI-Hayatabad Medical Complex, Peshawar, from January to July 2020. Detailed history was obtained including duration of symptoms, co-morbidities present and occupation. A thorough clinical examination was done for signs of heart failure and ventricular septal rupture. Patients' demographics, clinical and laboratory parameters were recorded on a pro forma. All the data was analyzed statistically by using SPSS version 24.0. Results: A total of 179 patients were included in our study. Ventricular Septal Rupture (VSR), was recorded in 7 (3.9%) patients having Acute ST elevation of MI. In our study age, obesity, reperfusion therapy, location of MI and history of previous shock were observed to be non significantly (p˂0.05) associated with high incidence of Ventricular Septal Rupture in patients having Acute ST elevation of MI. Conclusion: According to our findings, individuals with PI-VSR have a significant risk of acute-phase death. Furthermore, a significant incidence of acute-phase fatalities has been related to female gender and severe cardiac failure upon admission.

The Role of Preoperative Imaging in the Detection of Lateral Lymph Node Metastases in Rectal Cancer: A Systematic Review and Diagnostic Test Meta-analysis.

BACKGROUND: Different techniques exist for the imaging of lateral lymph nodes in rectal cancer. OBJECTIVE: This study aimed to compare the diagnostic accuracy of pelvic MRI, 18 F-FDG-PET/CT, and 18 F-FDG-PET/MRI for the identification of lateral lymph node metastases in rectal cancer. DATA SOURCES: Data sources include PubMed, Embase, Cochrane Library, and Google Scholar. STUDY SELECTION: All studies evaluating the diagnostic accuracy of pelvic MRI, 18 F-FDG-PET/CT, and 18 F-FDG-PET/MRI for the preoperative detection of lateral lymph node metastasis in patients with rectal cancer were selected. INTERVENTIONS: The interventions were pelvic MRI, 18 F-FDG-PET/CT, and/or 18 F-FDG-PET/MRI. MAIN OUTCOME MEASURES: Definitive histopathology was used as a criterion standard. RESULTS: A total of 20 studies (1,827 patients) were included out of an initial search yielding 7,360 studies. The pooled sensitivity of pelvic MRI was 0.88 (95% CI, 0.85-0.91), of 18 F-FDG-PET/CT was 0.83 (95% CI, 0.80-0.86), and of 18 F-FDG-PET/MRI was 0.72 (95% CI, 0.51-0.87) for the detection of lateral lymph node metastasis. The pooled specificity of pelvic MRI was 0.85 (95% CI, 0.78-0.90), of 18 F-FDG-PET/CT was 0.95 (95% CI, 0.86-0.98), and of 18 F-FDG-PET/MRI was 0.90 (95% CI, 0.78-0.96). The area under the curve was 0.88 (95% CI, 0.85-0.91) for pelvic MRI and was 0.83 (95% CI, 0.80-0.86) for 18 F-FDG-PET/CT. LIMITATIONS: Heterogeneity in terms of patients' populations, definitions of suspect lateral lymph nodes, and administration of neoadjuvant treatment. CONCLUSIONS: For the preoperative identification of lateral lymph node metastasis in rectal cancer, this review found compelling evidence that pelvic MRI should constitute the imaging modality of choice. In contrast, to confirm the presence of lateral lymph node metastasis, 18 F-FDG-PET/MRI modalities allow discarding false positive cases because of increased specificity. PROSPERO REGISTRATION NUMBER: CRD42020200319.

Landslide Susceptibility Mapping Using Machine Learning Algorithm Validated by Persistent Scatterer In-SAR Technique.

Landslides are the most catastrophic geological hazard in hilly areas. The present work intends to identify landslide susceptibility along Karakorum Highway (KKH) in Northern Pakistan, using landslide susceptibility mapping (LSM). To compare and predict the connection between causative factors and landslides, the random forest (RF), extreme gradient boosting (XGBoost), k nearest neighbor (KNN) and naive Bayes (NB) models were used in this research. Interferometric synthetic aperture radar persistent scatterer interferometry (PS-InSAR) technology was used to explore the displacement movement of retrieved models. Initially, 332 landslide areas alongside the Karakorum Highway were found to generate the landslide inventory map using various data. The landslides were categorized into two sections for validation and training, of 30% and 70%. For susceptibility mapping, thirteen landslide-condition factors were created. The area under curve (AUC) of the receiver operating characteristic (ROC) curve technique was utilized for accuracy comparison, yielding 83.08, 82.15, 80.31, and 72.92% accuracy for RF, XGBoost, KNN, and NB, respectively. The PS-InSAR technique demonstrated a high deformation velocity along the line of sight (LOS) in model-sensitive areas. The PS-InSAR technique was used to evaluate the slope deformation velocity, which can be used to improve the LSM for the research region. The RF technique yielded superior findings, integrating with the PS-InSAR outcomes to provide the region with a new landslide susceptibility map. The enhanced model will help mitigate landslide catastrophes, and the outcomes may help ensure the roadway's safe functioning in the study region.

Effects of different acetylsalicylic acid doses on body organs, histopathology, and serum biochemical parameters in broiler birds / Efeito de diferentes doses de ácido acetil salicílico nos orgãos corpóreos, histopalogia e parâmetros bioquímicos sorológicos em frangos de corte

The poultry industry suffers from various diseases or stresses. In poultry, apart from being antipyretic, acetylsalicylic acid (ASA) is widely used to cope with different issues including heat stress, and respiratory and digestive orders. This study evaluated the beneficial and toxic effects of ASA at different dose levels in broiler birds. To evaluate these toxic and beneficial effects it is necessary to examine the physical and serum biochemical parameters as well as the histopathological changes with tissue sections taken from broiler birds under experimental trial. This study was conducted on 60 one-day-old broiler chicks purchased from a local market in Faisalabad. Chicks were reared for the first 14 days under similar conditions. On the 15th day, birds were randomly divided into 4 groups (1-4) with 15 birds in each group. Group 4 was kept as control, while groups 1, 2, and 3 were treated with ASA at the dose of 300, 600, and 1200 mg/L of drinking water for 21 days. There were 3 samplings performed at 21, 28, and 35 days post-treatment. The live body weight and carcass weight were noted on each sampling. All the visceral organs were recorded for gross pathological changes. The serum samples were collected for biochemical evaluation. Histopathology of all the visceral organs was performed to observe the microscopic changes. A significant (P<0.05) increase in live body weight at a 300mg/L dose was noted after the first 2 samplings. A significant (P<0.05) increase in the relative organ weight was recorded at 1200 mg/L. The groups treated with ASA 600 and 1200 mg/L showed increased (P<0.05) AST, ALT, and creatinine levels from that of the control group. The group treated with 1200 mg/L of ASA showed increased (P<0.05) urea, serum total protein, and albumin level in all the samplings. Histopathological changes revealed swollen hepatocytes, increased sinusoidal spaces in the liver, congestion and abnormal glomerular spaces in the kidney, congestion and alveolar disruption in the lungs, and generation of villi and cellular degeneration in the intestine in a high-dose group. The study concluded that ASA at a low dose can be used for a long time in broilers and has a growth promontory role, while high-level doses cause hepatorenal toxicity.(AU)

A indústria avícola é afetada por diversas doenças ou estresses. Particularmente devido às aves serem antipiréticas. O ácido acetil salicílico (AAS) é largamente utilizado com diferentes objetivos que incluem o controle do estresse calórico, bem como a atividade respiratória e digestiva. O propósito deste estudo foi a avaliação dos efeitos benéficos e tóxicos do emprego de diferentes dosagens do AAS em frangos de corte. As variáveis analisadas foram: exame físico, parâmetros bioquímicos, bem como as alterações histopatológica em seções de tecidos colhidas das aves em um ensaio experimental. O estudo foi conduzido em 60 frangos de corte com um dia de idade adquiridos em um mercado local de Faisalabad que foram recriados nos primeiros 14 dias em idênticas condições. Então no 15º dia as aves foram distribuídas randomicamente em quatro grupos identificados pelos números 1 a 4, com 15 aves em cada grupo. O grupo 4 foi mantido como grupo controle e os grupos 1, 2 e 3 foram tratados com AAS, respectivamente, nas doses de 300, 600 e 1200 mg/L de água de bebida, durante 21 dias. Foram realizadas três amostragens nos dias 21, 28 e 35 pós-tratamento. O peso vivo corpóreo e da carcaça foi registrado em cada amostragem. Em todos os órgãos viscerais foi analisada a presença de alterações patológicas. As amostras de soro sanguíneo foram colhidas para a avaliação bioquímica. O exame histopatológico de todos os órgãos viscerais foi realizado para a observação de alterações microscópicas. A partir da segunda amostragem foi observado um aumento significante (p<0,05) no peso corpóreo na dosagem de 300mg/L. Um significante aumento no peso relativo dos órgãos foi registrado na dosagem de 1200 mg/L. Os grupos tratados com dosagens de 600 e 1200 mg/L de AAS, apresentaram aumento significante dos níveis de AST, ALT e de creatinina quando comparados ao grupo controle. O grupo tratado com 1200 mg/L de AAS apresentou um aumento significante (P,0,05) de uréia, proteína sérica total e de albumina em todas as amostragens. No grupo de alta dosagem foram observados alterações histopatológicas constituídas por aumento dos hepatócitos, aumento dos espaços sinusoidais no fígado, congestão e anormalidades nos espaços glomerulares nos rins, congestão e ruptura alveolar nos pulmões, degeneração das vilosidades e celular nos intestinos A conclusão obtida foi que em frangos de corte uma baixa dosagem do AAS pode ser utilizada por um período de longa duração, apresentando um efeito promotor do crescimento, contudo as doses elevadas determinam toxicidade hepática e renal.(AU)

Strangulated Amyand's hernia: management during the COVID-19 pandemic.

Amyand's hernia, presence of the appendix within an inguinal hernial sac, is a rare condition. We report a case of a 68-year-old woman who presented during the COVID-19 pandemic with an acute right groin pain due to a tender incarcerated inguinal hernia. Cross-sectional imaging confirmed an Amyand's hernia. She proceeded to open appendectomy via the inguinal canal and primary suture repair of her inguinal hernia. Patient was discharged the following day. Surgical management of Amyand's hernia varies depending on the resources, clinical findings and personal experience. In our opinion and experience, open hernia reduction, appendectomy and primary tissue repair repairs the most effective and appropriate approach especially during the COVID-19 pandemic.

Generalized pruritic blisters and bullous lesions.

In a patient with no history of skin disease, a recent change provided a clue to his condition.

A case of successful surgical management of primary retroperitoneal mucinous cystadenoma.

Primary retroperitoneal mucinous cystadenoma (PRMC) is a rare tumour. It was first reported in 1965, and since then, less than 100 cases have been reported. It is cystic in nature and most commonly affects the female population. It becomes symptomatic in later stages due to its mass effect, making the diagnosis challenging in its early asymptomatic stage. We report a case of a 32-year-old female who presented with abdominal pain and a mass in left iliac fossa. Diagnostic imaging revealed a large cystic lesion in retroperitoneum. A midline laparotomy was performed, and a complete surgical excision was accomplished without any spillage. Surgical histology confirmed the diagnosis of PRMC. The patient was discharged on postoperative day 2. There was no evidence of tumour recurrence on repeat imaging at 90-day follow-up. Surgical approach, with complete resection and without any spillage, remains the most effective and appropriate treatment for this tumour.

Painful, slow-growing recurrent nodules.

The patient's mother and son had similar lesions. Histopathology revealed an uncommon diagnosis.