A Successful Pregnancy Following Intracytoplasmic Sperm Injection in a Breast Cancer Survivor: A Case Report.

This report documents the case of a 36-year-old female diagnosed with stage I invasive ductal carcinoma of the left breast who, alongside her 39-year-old husband, sought fertility assistance at our center due to primary infertility. Having survived cancer twice in the span of their seven-year marriage, the couple faced the challenge of overcoming both the repercussions of cancer treatment and difficulties in conceiving. Initial attempts through three intrauterine insemination (IUI) cycles proved unsuccessful, leading the couple to opt for in vitro fertilization (IVF). The fertility assessment of the husband revealed the presence of several pus cells and a high sperm DNA fragmentation index (DFI). To address this, a medication regimen was administered to improve sperm quality. Concurrently, the female underwent controlled ovarian stimulation (COS) with the anti-estrogen agent letrozole to mitigate the risk of estrogen surges that could compromise her health. Subsequently, oocytes were retrieved from the female, and intracytoplasmic sperm injection (ICSI) was used to facilitate fertilization with her husband's sperm. Following successful embryo development, the patient underwent embryo transfer (ET), resulting in a positive beta-human chorionic gonadotropin (beta-hCG) result, signifying a successful conception. This case report highlights the intricate challenges faced by individuals with a history of breast cancer, emphasizing the delicate balance required in managing infertility in such circumstances. The described approach, involving personalized treatments and meticulous care, underscores the possibility of achieving successful conception for females struggling with fertility issues post-cancer survival. The documented journey serves as a testament to the resilience of individuals facing the dual challenges of cancer survival and infertility, offering insights into the complexities of their reproductive healthcare.

An Unusual High Bifurcation of the Brachial Artery: A Cadaveric Case Report.

The human vascular system exhibits a remarkable degree of anatomical variability, with deviations from conventional arterial branching patterns occasionally encountered. Among these variations, the atypical bifurcation has drawn attention for its infrequent occurrence and potential clinical implications. This study investigates the rare anatomical variation of high bifurcation seen during cadaver dissection in the brachial artery. It emphasizes the relevance of understanding such variations in established vascular anatomy and their clinical implications. Detailed findings from the dissection of the upper limbs, which reveal a high bifurcation in a 40-year-old male cadaver, are presented. The report highlights unique anatomical variations, including a superficial path. The conclusion underscores the rarity of this high bifurcation and its potential impact on medical procedures. It stresses the importance of healthcare professionals being aware of and prepared for such anatomical variations for optimal patient care. In order to manage potential difficulties during medical operations affecting the circulatory system and eventually enhance patient outcomes, it is necessary to understand these deviations.

A Comprehensive Approach to Polycystic Ovarian Syndrome: A Case Report of Successful Intracytoplasmic Sperm Injection Treatment Utilizing the Short Antagonist Protocol and Hatching.

The 29-year-old participant in the case study has been grappling with infertility for the last six years. Following an assessment of her symptoms, hormone profile, and ultrasound results, she received a diagnosis of polycystic ovarian syndrome (PCOS). PCOS is a multifaceted endocrine and metabolic disorder characterized by symptoms such as obesity, insulin resistance, anovulation, and polycystic ovaries. Various factors, including heredity, intestinal dysbiosis, obesity, environmental pollutants, lifestyle choices, and neuroendocrine abnormalities, contribute to the susceptibility of women to PCOS. In planning polycystic ovarian stimulation, it is crucial to consider parameters such as antral follicle count (AFC), luteinizing hormone (LH), and anti-Müllerian hormone (AMH). Careful planning of the gonadotrophin dose is essential to achieve an optimal response during a gonadotropin-releasing hormone antagonist (GnRH-ant) cycle. In our case, the brief antagonist protocol was used, resulting in a favorable outcome with minimal risk of ovarian hyperstimulation syndrome (OHSS). Despite multiple unsuccessful attempts at natural conception, the patient successfully conceived with the help of intracytoplasmic sperm injection (ICSI), leading to a positive pregnancy outcome. In addition to incorporating mechanical hatching to promote implantation, we diligently selected the most beneficial medications for the patient.

Association Between Foramen Rotundum and Trigeminal Neuralgia in the Saudi Population: A Radiological Study.

The trigeminal nerve is responsible for transmitting sensory information from the face, nasal and mouth cavities, and most of the scalp. Trigeminal neuralgia (TN) is a chronic facial pain disorder characterized by spontaneous paroxysmal pain throughout the distribution of the trigeminal nerve. This study investigated the morphological and morphometric variations of the foramen rotundum (FR) and its association with TN through a retrospective radiological analysis. A cohort of 97 participants from King Fahad University Hospital, Saudi Arabia, comprising 57 TN patients and 40 controls, underwent head CT scans for measurement and analysis. The study revealed significant differences in the FR morphology between TN patients and controls, particularly noting narrower FR measurements among TN individuals, especially in females. The right side demonstrated narrower FR dimensions, potentially correlating with the predominant side of pain in TN patients. While the presence of bony spurs was absent in all participants, variations in FR shape, size, and spatial positioning were observed and compared across genders and groups. These findings provide crucial insights into the potential anatomical factors contributing to TN, emphasizing the importance of understanding FR variations in clinical assessment and management of TN cases. Further research focusing on FR morphology and its clinical implications is recommended to enhance understanding and aid medical professionals in addressing TN-related concerns.

Morphometric Parameters of the Ear and Their Sexual Dimorphism in the Eastern Province of Saudi Arabia.

Background The human ear is a distinctive facial feature, revealing valuable information about ethnicity, gender, and age. Anthropometric measures play a crucial role in fields such as forensic medicine, prosthetics, and plastic surgery. The external ear, known for its diversity in structure and individual characteristics, has become a subject of interest in various populations. This study aims to determine the mean values of morphometric measurements for both right and left ears while exploring sexual dimorphism in ear dimensions. Methodology A prospective, observational, cross-sectional study was conducted among 200 volunteers from the eastern province of Saudi Arabia, comprising 98 males and 102 females, at the Department of Anatomy, Institute of Medical Sciences, Imam Abdulrahman Bin Faisal University. Participants were randomly selected from King Fahad University Hospital workers and patients. Using a Vernier caliper and after obtaining consent, various aspects of ear morphology were measured. The study employed statistical analyses such as the volunteers' t-test, Pearson's coefficient of correlation, and linear regression equations. Results In males, the mean total height of the right and left ears was 6.054 ± 0.5394 and 6.044 ± 0.5235 cm, respectively, while for females, it was 5.489 ± 0.4481 and 5.763 ± 4.8446 cm, respectively. The mean widths, heights, and other dimensions of the ears exhibited variations between genders. Conclusions The study provides comprehensive insights into the dimensions and indices of the pinna among the population of the eastern province of Saudi Arabia. The findings confirmed the presence of sexual dimorphism in the ear measurements, consistent with observations in other ethnic groups.

The Potential of Theophylline and Pentoxifylline in Sperm Optimization and Its Intracytoplasmic Sperm Injection Outcomes.

Sperm motility is an essential selection criteria by embryologists at the time of intracytoplasmic sperm injection (ICSI). One method of testing sperm viability is to induce sperm motility by increasing cyclic adenosine monophosphate (cAMP) levels by treating a semen sample with phosphodiesterase inhibitors (PDEIs), such as theophylline and pentoxifylline. It explores the implications of PDEI in medical care, reflecting on its effects in clinical settings and recognizing potential topics for future exploration. This analysis revealed that by incorporating stimulants that activate movements, the time it took to single out sperms was markedly reduced, and consequently, the sperms were safeguarded from a prolonged period of oxidative stress. Furthermore, theophylline was found to advance sperm motility, consequently resulting in several initially immobile spermatozoa displaying rapid progressive motility. Higher fertilization rate, cleavage rate, good quality embryos (grade I), and higher biochemical and clinical pregnancy rates were found with artificial sperm activation (ASA) using pentoxifylline and theophylline. This review emphasizes the need for more research to evaluate the drug's long-term safety and investigate the effects of theophylline and pentoxifylline on postfertilization parameters, such as embryo development, implantation, and pregnancy outcomes. These areas of investigation are important for understanding the complete impact of these agents and to ensure their safe and effective implementation in clinical practice.

Flipped Classrooms in Medical Education: Improving Learning Outcomes and Engaging Students in Critical Thinking Skills.

The flipped classroom (FC) model involves students independently acquiring knowledge before in-person class sessions, during which they engage in active discussions and problem-solving. Various methods to implement FC are quizzes, e-content, case-based learning, problem-based learning, and reading assignments. The advantages of the FC approach included improved student preparation, active participation, and the promotion of critical thinking skills. Some disadvantages identified are technical problems like internet connection, improper planning and preparation, which increases teacher workload, and lack of self-motivation. This review underscores the potential of the FC approach to improve medical education by promoting independent learning, active participation, and deeper understanding. Consideration of factors such as curriculum design, faculty development, technological infrastructure, and student readiness is vital for successfully implementing the FC model. Balancing self-directed study with meaningful face-to-face interactions remains crucial to harnessing the full benefits of this innovative approach. By leveraging technology and student-centered methods, medical educators can create an enriched learning experience that positively influences future healthcare professionals.

A Review of Amelioration of Awareness About Blood Donation Through Various Effective and Practical Strategies.

Blood donations play a crucial role in medical care; however, the global shortage of donors remains and has a serious impact on medical interventions. The challenges involved include the lack of public awareness of the importance of blood donation, the lack of understanding of the process and eligibility criteria for blood donation, and the lack of comprehensive strategies aimed at raising awareness and participation among potential donors, with particular emphasis on the involvement of young people. It is essential to recognize that blood donation delivers significant benefits to donors and recipients, improves overall health, and ultimately saves lives. Various initiatives, such as blood donation camps, dynamic social media campaigns, and strategic networking of medical professionals, have proved effective in promoting blood donation. In particular, in the event of an emergency, the availability of sufficient blood supplies is increasingly essential, underlining the urgent need to establish and maintain a sustainable blood donor network. An in-depth understanding of the motivation and conservation of donors is crucial in this context, as it is known that demographic factors significantly impact the frequency of blood donation. In addition, ethical and legal considerations require careful attention, highlighting the essential role of obtaining informed consent and ensuring the confidentiality of donors throughout the process. As we look ahead to the evolving landscape, it presents a series of formidable challenges. These challenges encompass the critical necessity to broaden and diversify our donor base, thereby extending and varying our sources of financial support for specific initiatives, organizations, or projects. Moreover, we must proactively harness the opportunities presented by emerging technologies and commit ourselves to closing the information gaps within the existing public knowledge sphere. In summary, the review emphasizes the paramount importance of ongoing efforts to strengthen and enrich donors' engagement through customized strategies and educational outreach.

Managing Diabetes Mellitus With Millets: A New Solution.

Diabetes mellitus (DM) is the leading cause of morbidity and mortality, and the disease's prevalence is increasing with each passing day. DM can be prevented and controlled with modifications to the diet, especially by incorporating millet in the diet. Throughout history, eating habits have been recognized for their significant contribution to promoting health and wellness by eating foods rich in nutrients. Millet is an underutilized food crop with many benefits for health, with the most beneficial being low glycemic index, high fiber content, polyunsaturated fatty acids (PUFA), non-acid-forming potential, and gluten-free. In addition to staple food crops, such as wheat, rice, and foxtail millet, millets are still highly nutritious and beneficial and have great potential to help the world combat the food insecurity many countries face today. Millets are in the top positions of recommended dietary charts with their numerous health benefits and antioxidant properties.

The Role of E-Content Development in Medical Teaching: How Far Have We Come?

With the advancements in technology, medical educators are now able to create and deliver content to students through digital platforms. Electronic content (e-content) development has allowed educators to incorporate multimedia, animations, simulations, and interactive elements which support verbal instruction, such as improved expression and comprehension, into their teaching materials. E-content development is a relatively new field, but it is growing very rapidly. Recent findings have indicated that the e-learning sector will likely experience a huge surge in the upcoming years. The Indian government has launched various initiatives for e-content development in medical education. E-content development has great potential and can be used in various learning scenarios. While it initially gained popularity in higher education, it has since been applied to many other sectors, including healthcare. It allows educators to create highly engaging learning experiences that are accessible by all students. Challenges in e-content development include availability of the internet, creating content that is engaging and relevant to a wide range of learners, and access. Still, it is expected that the use of e-content in medical teaching will continue to increase in the future. The future of e-content development in medical teaching is likely to see continued growth and innovation as technology advances and more educators and learners recognize the benefits of online and digital resources.

The Role of Basal Ganglia and Its Neuronal Connections in the Development of Stuttering: A Review Article.

Dysfluent speech has the potential to lower one's standard of living drastically. Although there is a lot of theoretical support for basal ganglia dysfunction in developmental stuttering, there isn't any imaging data to back it up. According to several studies, there is a difference in gray matter volume between people who stammer and those who don't. According to studies, the right inferior longitudinal fasciculus and the uncinate fasciculus have higher fractional anisotropy (FA) than fluent controls. A high fractional anisotropy means good white matter integrity in these areas. In children who stutter, grey matter volume was higher in the Rolandic operculum, middle frontal gyrus, superior temporal gyrus, and inferior parietal lobule. These regions are found to be more active in adults who stammer as their speech fluency improves. Stuttering is previously linked to structural deficiencies in the corpus callosum. However, there are differences in the directionality of the findings between studies, which are unknown. According to current theories, stuttering is caused by a breakdown in the integration of auditory data in speech motor planning, which affects behavior tasks that rely on basal ganglia structures. According to some studies, connectivity in the left inferior frontal gyrus (IFG) and basal ganglia of persons with stuttering (PWS) was significantly reduced. Still, it was more robust in the left supplementary motor cortex (SMC) and premotor cortex (PMC) (primary motor cortex). In the Broca's region, there was also decreased perfusion and spectroscopic indicators of neuronal density. Spontaneous speech is more affected by stuttering than conversation, reading, sentence repetition, or singing. As per the dual process theory of language formation, the basal ganglia are essential for formulaic phrases, but the left hemisphere is important for innovative, freshly constructed sentences. According to current theories on their functional traits and connections to cortical areas of control, the basal ganglia are the complex networks in charge of organizing, initiating, carrying out, and controlling motor behaviors.  Given the distinct neuroanatomical characteristics of people who stutter, more research into this cohort is required to further our understanding of the illness. The primary goal of this review article is to fill in any knowledge voids between the neuroanatomical structure of the basal ganglia and the onset of stuttering.

Simultaneous hemorrhage in intracranial aneurysms and in renal cyst in a case of polycystic kidney disease.

We report an unusual case of simultaneous hemorrhage in intracranial aneurysms and in renal cyst in a case of polycystic kidney disease. A 27-year-old gentleman presented with progressive headache and intermittent vomiting of one month duration. Initial computerized tomography (CT) scan and magnetic resonance imaging/angiography revealed a large mass lesion in the right temporal fossa. Over the previous 15 days, he developed progressive weakness in his left upper and lower limbs, and the headache worsened in severity. A repeat of CT scan showed an evidence of aneurysmal bleed and a large temporal lobe hematoma. The patient underwent urgent evacuation of the intracerebral of hematoma and excision of the redundant aneurysmal sac. The patient made excellent recovery in the post-operative period; however, for him, the pain abdomen was persisting. Detailed work-up with contrast-enhanced abdominal CT scan revealed bilateral multiple cysts in the kidneys with evidence of intracystic hemorrhage on the left side. An extensive search of the literature revealed that this kind of presentation has not been reported previously.

Malignant hemangioendothelioma of occipital bone.

Epithelioidhemangioendothelioma is a rare vascular tumor of bone, and rarely these lesions can present as unique and extremely aggressive tumor. We report a case of highly aggressive epithelioidhemangioendothelioma and discuss the imaging findings. CT brain plain study revealed a poorly-defined, mixed density expansile and lytic lesion involving the occipital bone with extension to the left side with poorly defined trabecula formation. There was significant but irregular enhancement after intravenous administration of contrast material and also marked bone destruction. Microscopic examination of the fine needle aspiration cytology showed a tumor composed of vascular channels lined by plump endothelial cells, which had enlarged hyperchromatic nuclei. In view of the extensive infiltration the patient was submitted for the radiotherapy.

Acute onset progressive hemiparesis in a case of head and neck injury.

Traumatic carotid artery injury is an increasingly recognized complication of severe blunt head or neck trauma in patients with motor vehicle accidents. A 22-year-old male presented after a high-velocity road traffic accident and sustained head, neck and systemic injuries. Initially the patient was neurologically stable and initial CT scan brain was also apparently normal. Few hours after the injury, the patient developed progressive left hemiparesis. MRI of brain was suggestive of acute infarct involving right internal carotid artery territory. In accordance with the literature and as in present case, it would be emphasized that the patients who develop gross neurological abnormalities after blunt trauma to the head or neck, there should be a high index of suspicion of having sustained injury to the carotid arteries.

Traumatic dural sinus thrombosis causing persistent headache in a child.

Dural venous sinus thrombosis following a mild head injury is increasingly recognized. We report case of a 9-year-old male child presented with progressive headache and vomiting following a minor fall. A diagnosis of sinus venous thrombosis was suspected on nonenhancing computed tomography, and that was confirmed with magnetic resonance venography. The child was managed with intravenous fluids, anticoagulation (injection heparin followed by oral anticoagulants-tab coumarin), antiedema measures (mannitol), and antiepileptics (phenytoin) with good outcome.

Mount Fuji sign with concavo-convex appearance of epidural haematoma in a patient with tension pneumocephalus.

Intracranial pneumatocele is a non-infected accumulation of air within the cranial cavity. We report a case of a 22-year-old male who sustained a fracture of anterior cranial fossa following a motor vehicle accident and the imaging findings showed a concave-convex epidural haematoma. Simple traumatic pneumocephalus usually does not require surgical treatment and non-operative management has been advocated for small, asymptomatic convexity extradural haematomas.