Delayed Presentation of Severe Blunt Liver Trauma Following a 12-Foot Fall: A Case Report of a Grade 4 Hepatic Injury With a Concurrent Grade 1 Renal Injury.

The delayed presentation of a 15-year-old female with a complex Grade 4 liver injury and a concurrent Grade 1 renal injury sustained from a fall exemplifies the heightened vulnerability of adolescents to blunt hepatic trauma. Unlike typical presentations where symptoms like abdominal pain and internal bleeding appear immediately, this case emphasises the potential for delayed manifestation, posing unique challenges for diagnosis and management. This case, managed at a leading trauma centre, underscores the distinct challenges compared to adult cases due to adolescents' larger space available for the organ and immature livers. While presenting more management complexity than typical splenic injuries, prompt intervention with emergency laparotomy and hepatic packing proved crucial for the patient's successful outcome. This case emphasises the critical role of early identification, vigilant monitoring, and strict activity restrictions post-operatively for optimal adolescent liver trauma management and serves as a reminder of the spectrum of potential injuries, including bile duct and vascular damage alongside contusions and haematomas.

Association of latent autoimmune diabetes of adults with type 3 polyglandular autoimmune syndrome-a diagnostic challenge.

Autoimmune polyendocrine syndromes (APS) encompass m ultiple e ndocrin e gland ins ufficiencies asso ci ated wit h auto immune disease. This c as e report underscores the importance of recognising the association between latent auto immune di a betes of ad ults (LADA) and type 3 polyglandular syndrome. A 42-year-old man belonging to R awalpi ndi, Pakistan, p resented to th e out patient department (OPD) of Ali Medi cal Centre, Islamab ad, i n Januar y 2023 with the complaints o f e xtreme thirs t and frequent urination. The patient reported consistently raised app etite an d eating four to five meals a day along with abrupt weight loss, dry mouth, fatigue occasional dizziness, an d dyspnoea. He was diagno s ed with type 3 polygla ndular syndrome w ith associat io n of LADA. Daily administration of 10 units of glargine insulin, along with six units of rapid-acting insulin, was prescribed. The patient's H bA1c level reduce d in a few months afte r succe ssive follow-up. Patients who exhi bit uncontrol led diabe tes despite dietar y and oral hypoglycaemic management should be further investigated for multiple au toimmune endocrine disorders.

Dual Energy X-ray Absorptiometry Scanning for Osteoporosis Detection: Analysis of Patients at a Tertiary Care Hospital.

INTRODUCTION: Dual-energy X-ray absorptiometry (DEXA) scanning is a rapid and accurate noninvasive procedure utilized to measure bone mineral density (BMD) and diagnose osteoporosis. The primary objective of this study was to assess the prevalence of osteoporosis in different regions of the body using DEXA scanning in patients attending a tertiary care private hospital. Additionally, we aimed to raise awareness about approved diagnostic methods for osteoporosis. METHODOLOGY: For this retrospective study, a sample size of 384 participants was determined. The selection of participants was based on convenience sampling, considering their availability and accessibility. Data were collected from adult patients aged 18 years and above who underwent DEXA scanning. The information was compiled using Microsoft Excel, obtained from the patient's treating physicians, and evaluated by two medical graduates. Statistical analyses were performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY). RESULTS: The findings unveiled an overarching osteoporosis prevalence of 38.5%, accompanied by distinctive figures of 38.7%, 8.9%, and 38.4% in the lumbar, hip, and forearm regions, respectively. Furthermore, the occurrence of osteopenia was found in 33% of participants in the lumbar region, 35.1% in the hip region, and 39.7% in the forearm region. Additionally, no significant association was found between gender and overall osteoporosis prevalence, suggesting that the susceptibility to osteoporosis did not significantly differ between genders. Moreover, the study emphasized the variations in bone density across different skeletal regions, with the forearm region displaying the lowest mean T-score and Z-score. CONCLUSIONS: The results of this study on osteoporosis prevalence in the lumbar, hip, and forearm regions indicate varying rates among these skeletal sites. Notably, both male and female patients demonstrated an equal susceptibility to developing osteoporosis. Interestingly, the forearm region emerged as the most common site for osteoporosis in males (34.6%), while the lumbar region was the most common in females (41.6%).

Microstructural examination and corrosion behavior of selective laser melted and conventionally manufactured Ti6Al4V for dental applications.

The selective laser melting of Ti6Al4V would induce definite changes in the microstructure that may affect its corrosion properties. Microstructural examination showed the formation of relatively thin beta (ß) lamella in selective laser melted (SLM) Ti6Al4V compared to wrought Ti6Al4V. X-ray diffraction analysis (XRD) analysis confirmed the presence of alpha and beta phases in both SLM and wrought Ti6Al4V. However, the higher concentration of the ß phase in SLM Ti6Al4V compared to wrought Ti6Al4V was evident in the microstructure. As candidate dental implant materials, the corrosion behavior of both SLM and wrought Ti6Al4V was assessed in artificial saliva (AS) and deionized water (DI) containing various species i.e. fluoride (F), calcium chloride (CaCl2) and lactic acid (LA). Electrochemical impedance spectroscopy and potentiodynamic polarization analysis was carried out to estimate the corrosion behavior of SLM and wrought Ti6Al4V at room temperature. SLM Ti6Al4V offered better corrosion resistance than wrought Ti6Al4V in all solutions at pH > 6. However, wrought Ti6Al4V comparatively presented high corrosion resistance in AS + LA, DI + CaCl2 and DI + LA solutions (pH < 6). The lower dissolution rate of SLM Ti6Al4V (at pH > 6) was attributed to larger ß content in the microstructure compared to wrought Ti6Al4V.