Background: Coronary Heart Disease (CHD) remains a leading cause of morbidity and mortality globally, with a significant impact on public health systems, especially in developing countries.

Background: Immediate postoperative complications following general anesthesia are critical considerations in surgical care, impacting patient recovery and healthcare resource utilization. This retrospective observational study aimed to investigate the prevalence and characteristics of immediate complications among patients in the postoperative ward at Sir Salimullah Medical College Hospital in Dhaka, Bangladesh.

Introduction: Osteoporosis is a metabolic bone condition characterized by decreased bone mineral density and deterioration of the microarchitecture of bone tissue, resulting in fragile bones susceptible to fractures. Diabetes mellitus (DM) is a chronic metabolic disease characterized by persistent hyperglycemia resulting from defects in insulin secretion or action.

Background: Studies show that the cytotoxic effect of black cumin seed extract and oil can reduce the viability of lung cancer cells including VEGF and increase the Hb of cancer patients. This study aims to compare Hb and VEGF levels between lung cancer patients undergoing chemotherapy with black cumin (Nigella sativa) and those undergoing standard chemotherapy.

Background: HIV/AIDS continues to be a major public health issue worldwide, particularly in developing countries where resources for prevention and treatment are often limited. In Bangladesh, the prevalence of HIV/AIDS is relatively low compared to global averages, but the potential for spread remains a significant concern.

The De Winters electrocardiographic pattern, which is present in only 2% of cases of acute myocardial infarction, is an electrocardiographic pattern with a high risk of complications since acute occlusion of the anterior descending artery must be considered. Early recognition and appropriate therapy are what improve the prognosis in this patients.

To present a case assisted at the Pereira Rossell Hospital Center of a very rare injury, its evolution, as well as an update on the diagnostic and therapeutic measures for this type of injury. Clinical case: A 12-year-old adolescent with no significant personal history who suffered a fall from a horse with direct trauma to the right elbow and no other trauma. Physical examination at the emergency room revealed a painful and swollen right elbow, no skin lesions, and no distal neurovascular alterations were found. Diagnosis was confirmed after requesting a CT scan of the elbow, which showed a supracondylar fracture. The fracture line divided the capitellum and was directed medially. A closed reduction maneuver and medial approach without arthrotomy were performed to identify the ulnar nerve. Three medial and one lateral Kirschner needles were placed. A brachypalmar splint was made. The Kirschner needles were removed at 6 weeks. Follow-up at 3 months after the injury.

A 32-year-old man presented with nephrotic syndrome due to membranous nephropathy, secondary to systemic lupus erythematosus (SLE). During intensive immunosuppressive therapy with corticosteroid and cyclophosphamide, the patient developed confusion, fits (lupus cerebritis), pancytopenia and rapidly rising serum creatinine (end stage renal failure). Plasmapheresis and rituximab therapy did not make improvement. Later, the patient had gastro-intestinal bleeding, ARDS secondary to bacterial pneumonia, fits and succumbed. Multiple cerebral hemorrhages, consolidation and bilateral small kidneys were found in autopsy.

Drop foot is characterized by presenting gait alterations due to the inability to dorsiflex the ankle. Neurological and muscular etiology can cause foot drop. Tendon transfer surgery represents the gold standard of surgical treatment. Clinical case: 15-year-old female patient with a history of congenital common peroneal nerve paralysis. The first surgical stage is performed on the left foot, tendon transfer is performed with the classic Barrs technique, the posterior tibial tendon is disinserted by crossing the interosseous membrane and inserting in a lateral cuneiform. The second surgical procedure was performed 9 months after the first surgery with tendon transfer of the right foot, the procedure began with the classic Barrs technique, with insertion of the posterior tibial tendon in the medial cuneiform of the right foot and fixation with the use of a biotenodesis screw.

Background: Coronary pseudoaneurysms (CPAs) are rare but significant complications of percutaneous coronary interventions (PCIs), trauma, or infections. They pose a considerable risk due to potential rupture and thromboembolism. While surgical repair has been the traditional approach, percutaneous methods have emerged as viable alternatives.

A 31-year-old patient presents to our service with fever of unknown origin. During his approach, it is discovered that in an event of anaphylactic shock, a central venous catheter was placed, leaving the metal guide for 2 years. This was the cause of endocarditis, so he went to cardiac surgery where the metal wire was removed, with proper evolution.

Toxic epidermal necrolysis (TEN) is a rare, life-threatening dermatologic emergency characterized by extensive keratinocyte apoptosis, resulting in widespread epidermal detachment and mucosal involvement. Its pathogenesis is primarily linked to an immune-mediated response triggered by certain medications. This report presents a case of a 45-year-old female who developed TEN following administration of an antibiotic regimen. The patient exhibited progressive skin detachment affecting over 30% of the body surface area, with concurrent ocular and oral mucosal involvement. Despite initial delays in diagnosis, aggressive management with fluid resuscitation, prompt drug discontinuation, and systemic immunosuppressants led to stabilization and eventual recovery. This case highlights the importance of early recognition, the need for a multidisciplinary approach, and the challenges in managing complications such as secondary infections and multi-organ dysfunction. Additionally, we discuss the diagnostic criteria, therapeutic options, and the role of emerging therapies, providing a comprehensive overview for clinicians facing similar cases.

Introduction: Migraine headache is a neurovascular disorder characterized by primary chronic headache pain, with attacks lasting between 4 to 72 hours. Plastic surgery interventions such as targeted nerve decompression and Botox injections can provide better results.

Pelvic fractures occur frequently due to traffic accidents and high-energy. Pregnant women are susceptible to trauma, with one in 12 pregnancies complicated by such incidents, making trauma the leading cause of non-obstetric maternal deaths during pregnancy. Pelvic fractures during pregnancy pose significant risks, potentially leading to adverse pregnancy outcomes such as preterm delivery, placental abruption, fetal distress, and even maternal or fetal death. The physiological changes that occur during pregnancy, including increased blood volume and altered cardiovascular dynamics, further complicate the management of pelvic trauma in pregnant patients. Prompt and appropriate management of pelvic trauma in pregnant patients is essential to optimize outcomes for both the mother and the fetus. Initial evaluation and stabilization of the mother take precedence, with close attention to airway, breathing, and circulation. Diagnostic imaging, including pelvic X-rays and, when feasible, body CT or MRI, aids in assessing the extent of pelvic injury and identifying associated injuries. Definitive treatment of pelvic fractures may involve a combination of surgical fixation, bed rest, traction, and pelvic slings, depending on the severity of the injury. The timing and approach to delivery in pregnant patients with pelvic fractures require careful consideration, with vaginal delivery being a viable option in many cases, provided that the pelvic architecture remains intact.

Introduction: Bifurcation technique angioplasty remains one of the most challenging procedures in interventional cardiology, up to 10% of patient with STEMI present with a bifurcation as the culprit lesion. Coronary artery perforation is a known complication of percutaneous coronary intervention and complex coronary anatomy is often posed as a risk factor. Interventional and surgical manage

Ten studies comprising 1,389 HCC patients were included. The Barcelona Clinic Liver Cancer (BCLC) staging system, reported in 5 studies, revealed a predominance of intermediate to advanced stages (B and C) at diagnosis. Child-Pugh scores, available for 7 studies, indicated variability in liver function, with Child-Pugh A ranging from 12.0% to 85.7%. Hepatitis B virus (HBV) infection was the primary etiological factor, with prevalence ranging from 53.8% to 84.0%. Hepatitis C virus (HCV) infection was less common (1.0% to 25.21%). Non-viral etiologies represented a substantial proportion, reaching up to 37.4% of cases. The mean age at diagnosis ranged from 52.43 to 63.1 years.

This article describes the clinical, histological, radiological characteristics, and treatment of unicystic ameloblastoma by presenting a clinical case of an 11-year-old patient, over a period of 2 years of clinical control and follow-up, in which histopathological diagnosis and radiographic control play a crucial role in diagnosis and the choice of an appropriate treatment plan. In this case, the patient underwent marsupialization, and after 4 weeks, enucleation in the mandibular symphysis and parasymphysis, along with odontectomy under general anesthesia. A treatment success rate of 100% without recurrence was achieved, and postoperative follow-up every 6 months was recommended.

Boutonniere disease is a hand injury causing extension lag or restriction in the proximal interphalangeal joint and hyperextension in the distal interphalangeal joint. This condition often arises from direct laceration or closure damage to the central tendon, rheumatoid arthritis, osteoarthritis, Dupuytren contracture, pulley injury, burns, and other conditions. Surgical management for Boutonniere deformity relies on the expertise of the attending physician and involves both non-surgical and surgical options. In acute cases, conservative therapy should be pursued, while in chronic cases, conservative management may be advised. Surgical intervention is used to transform excessive extension force of the distal interphalangeal joint into extension force of the proximal interphalangeal joint. This is necessary to heal an open rupture of the central tendon. Surgical techniques for chronic deformity are complex due to variables and hand surgeons expertise. There is no definitive surgical therapy for persistent buttonhole deformity, but several approaches have been documented in case studies. These include terminal tenotomy, collateral band surgery, central tendon surgery, tendon transfer and grafting, stepwise extension mechanism readjustment surgery, and arthrodesis. Central tendon surgery addresses the central tendon, where injured tissue transforms into scar tissue, resulting in delayed extension of the proximal interphalangeal joint. Tendon transfer or grafting have been documented for rotator cuff mechanism rehabilitation, but no definitive guidance exists for these techniques. Curtis treatment introduced a sequential therapy approach for traumatic buttonhole deformity, which involves splinting, excising the transverse reticular ligament, resecting and lengthening the collateral ligament, and repositioning the core tendon. Arthrodesis may be applicable in cases of advanced arthritis, coronal plane deformity, functional impairment, or elderly patients. There are no definitive indications for surgical interventions for persistent buttonhole deformity, and outcomes may be variable or inferior. Understanding the deformity, its progression, and patients functional constraints is crucial for effective treatment

Defense is the ability to fend off an attack .The oral cavity has several defense systems that can fend off different types of injuries. A variety of mechanical, chemical, and antigenic stresses are continuously applied to gingiva;some of these challenges are temporary, while others are ongoing. his study will go over various defense mechanism the gingiva uses to protect and prepare itself from the harsh environment. Defense e is ability to withstand the attack;the mouth cavity has many defense system that protect it from injuries.A vast range of mechnaical, chemical, and antigenic obstacles are continuously faced by gingiva. This study will go over the several defense mechanism how gingiva will protect from the harsh environmental.

Introduction: In addition to nursing, the nurse gives the patient medical attention by giving injections and managing medications. She helps the physician with diagnosis and therapy. The advancement of technology and rising demands for health care have changed the meaning of this profession. Nursing models that emphasize the practical application of learned information demonstrate the evolution of this profession. The purpose of this study was to outline the responsibilities, skills, and role of the nursing profession in raising the standard of patient care. Material and method: The literature analysis method is used in this work. The information utilized in the work is derived from scientific journals and publications that have been released in compressed form. Results: The analysis of the gathered scientific data demonstrated that nurses have a major influence on both the standard of medical care and the smooth operation of the entire institution. Healthcare facilities are part of organizations where a patient life and health are directly impacted by the quality of care provided. As a result, everyone on staff should prioritize the patients care, especially the nurses who spend a lot of time getting to know them and meeting them first. Patients look to nurses for medical expertise above all else, but they also expect safety, trust, and appropriate communication. Conclusions: The nursing field has seen significant change in recent years, necessitating a variety of actions from those working in it to advance their careers. Additionally, patient expectations are evolving. Success depends on getting their feedback and meeting their needs. A happy customer will undoubtedly employ the facilitys services once more.

Introduction: In addition to nursing, the nurse gives the patient medical attention by giving injections and managing medications. She helps the physician with diagnosis and therapy. The advancement of technology and rising demands for health care have changed the meaning of this profession. Nursing models that emphasize the practical application of learned information demonstrate the evolution of this profession. The purpose of this study was to outline the responsibilities, skills, and role of the nursing profession in raising the standard of patient care. Material and method: The literature analysis method is used in this work. The information utilized in the work is derived from scientific journals and publications that have been released in compressed form. Results: The analysis of the gathered scientific data demonstrated that nurses have a major influence on both the standard of medical care and the smooth operation of the entire institution. Healthcare facilities are part of organizations where a patient life and health are directly impacted by the quality of care provided. As a result, everyone on staff should prioritize the patients care, especially the nurses who spend a lot of time getting to know them and meeting them first. Patients look to nurses for medical expertise above all else, but they also expect safety, trust, and appropriate communication. Conclusions: The nursing field has seen significant change in recent years, necessitating a variety of actions from those working in it to advance their careers. Additionally, patient expectations are evolving. Success depends on getting their feedback and meeting their needs. A happy customer will undoubtedly employ the facilitys services once more.

Antibiotic resistance (ABR) is one of the priority problems around the world which affects the evolution of infectious diseases and leads to economic losses with a considerable impact on increased mortality and morbidity in low-resource countries. One of the bacteria most involved in resistance is Pseudomonas aeruginosa. It is a bacteria belonging to the ESKAPE group, for which there is an urgent and critical need for antibiotic development. The circulation of this bacteria in several countries has been the cause of many infections affecting all ages, patients and healthcare staff, and has promoted the spread of resistance in environmental and animal health. To investigate the determinants of resistance in Pseudomonsa aeruginosa, the aim of this work was to assess the correlation between biofilm, Cell Surface Hydrophobicity (CSH) and antibiotic resistance in clinical isolates of Pseudomonas aeruginosa circulating in Yaounde.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, accounting for approximately 1% of all gastrointestinal cancers. They primarily arise from the interstitial cells of Cajal in the gastrointestinal wall and can occur throughout the digestive tract, most frequently in the stomach. While symptomatic cases often present with gastrointestinal bleeding, obstruction, or abdominal pain, large tumors can remain asymptomatic for long periods, leading to incidental detection. This case report discusses an 80-year-old woman with a 20-year history of a painless upper abdominal mass, initially presenting without gastrointestinal symptoms, obstruction, or constitutional complaints. Imaging suggested a large GIST, and after surgical resection, histopathology confirmed an epithelioid GIST of the stomach. This case highlights the unusual asymptomatic course of a large gastric GIST and discusses the potential complications, such as rupture, obstruction, and pressure effects, that can arise from tumors of this size, underscoring the importance of early detection and management.

We present the case of a 30-year-old male patient with loss of visual acuity in the left eye. The imaging study detected a lesion of high suspicion of tumor in the left eye. Enucleation of the left eye was performed, confirming the diagnosis of choroidal melanoma by histopathological study. Subsequently, the disease progressed with neoplastic activity in the lungs, liver, lymph nodes and central nervous system. A case description is provided along with a bibliographic review, focusing on the approach and prognostic factors in patients with metastatic disease.

Shones syndrome, a rare congenital heart disease, encompasses a complex array of obstructive lesions within the left heart. First described in 1963, this syndrome typically presents with a combination of supravalvular mitral ring, parachute mitral valve, subaortic stenosis, and coarctation of the aorta. The intricate nature of these anomalies presents significant diagnostic and therapeutic challenges. This review aims to elucidate the pathophysiological mechanisms underlying Shone syndrome, provide a detailed account of its clinical manifestations, and discuss current management strategies, including surgical and medical interventions. Through an in-depth analysis of existing literature, we seek to enhance understanding and improve outcomes for patients afflicted with this multifaceted condition.

Gallbladder polyps (GP) are projections of the mucosa toward the light, most of them are benign caused by cholesterol deposits, focal adenomatosis, or hyperplastic lesions secondary to a local infection. It has an estimated prevalence of 5% of the world population. Cholesterol polyps are usually formed by an asymptomatic process, rarely obstructive jaundice or cholangitis due to the blockage of distal bile ducts by detached fragments of polyps. A small number of patients may be symptomatic; cholesterolosis and adenomatosis can also cause chronic dyspeptic abdominal pain, nausea, and vomiting. Ultrasound is the main imaging modality to diagnose polyps of the gallbladder, endoscopic ultrasonography can be a useful tool in patients with clinical pictures suggestive of vesicular pathology and non-invasive imaging studies, and inconclusive. In a patient aged less than 50 years with GP, the likelihood of malignancy is minimal and does not require cholecystectomy. However, those with a size greater than or equal to 10 mm should be resected by cholecystectomy for high risk of malignancy, and those with a size less than 10 mm should be submitted to ultrasound monitoring, observing the risk characteristics during follow-up, to provide timely treatment.

Infective endocarditis (IE) is a severe and life-threatening condition characterized by infection of the endocardial surface of the heart, primarily affecting the heart valves. Despite advances in diagnostic techniques and antimicrobial therapies, IE remains associated with significant morbidity and mortality due to its complex pathogenesis and clinical variability. This article reviews the most recent developments in the pathophysiology, diagnostic criteria, and management strategies of infective endocarditis. Key issues such as microbial etiology, including common pathogens like Staphylococcus aureus and Streptococcus species, are discussed alongside less frequent organisms and their association with specific patient populations. The article emphasizes the importance of early diagnosis using advanced imaging modalities, such as echocardiography and PET-CT, and laboratory findings, particularly blood cultures. We explore both medical and surgical management strategies, highlighting the role of antibiotic therapy and the indications for valve surgery. A focus is given to the management of complex cases, including prosthetic valve endocarditis and infections in immunocompromised patients. The article aims to provide clinicians with a comprehensive understanding of the evolving landscape of infective endocarditis and its implications for patient outcomes.

Epidermoid cysts, also known as epidermal cysts, keratin cysts, epithelial cysts, or sebaceous cysts (although this term is no longer widely used), are benign lesions frequently seen in clinical practice. These cysts arise from epidermal cells trapped beneath the skins surface. The most common complication is cyst rupture, which can lead to significant inflammation and even a granulomatous response. This article presents the clinical case of a male patient with a ruptured epidermoid cyst that triggered a granulomatous reaction, treated with surgical excision and reconstruction using a Limberg flap. Proper surgical management is crucial in such cases to prevent long-term complications and ensure optimal healing.

Objective: Describe the causes of biliodigestive bypass reoperation in our center. Material and methods. Retrospective, descriptive and observational study. Results. A total of 64 records were reviewed. 53.1% of the patients underwent reintervention after biliodigestive bypass surgery, in some cases on more than one occasion to the same patient, thus making a total of 61 biliodigestive bypass reintervention surgeries. in unity. The most frequent causes for reintervention were stenosis with a frequency of 70.4%, lithiasis 22.9%, anastomotic dehiscence 4.9% and bilioma 1.6%. In patients who had a diagnosis of stenosis in their first reoperation, it was associated with subsequent reinterventions being for the same diagnosis, with a value of p = 0.087. Conclusions. Any attempt at bile duct repair by inexperienced surgeons or in non-specialized centers should be avoided, in addition to early referral of patients. Avoid instrumentation before bile duct reconstruction due to its possible complications. The surgical technique of hepaticojejunostomy is essential for reducing postoperative complications and better long-term results.

The notion of feminine aesthetics has evolved, significantly shaped by cultural and geographical influences. The primary areas of emphasis are the buttocks and breasts, particularly in Latin America. Consequently, gluteal fat grafting has more significance. This paper is to examine the outcomes of this treatment and its difficulties, propose a categorization for buttock morphology, and standardize the regions designated for fat grafting. The operation is safe with a low complication rate when fat grafting adheres to the subcutaneous plane, resulting in high patient satisfaction.

The World Health Organization (WHO) reports that over 11 million individuals get burns annually, resulting in 180,000 fatalities. A burn is a condition resulting by heat, chemical agents, electrical currents, or other forces that inflict tissue damage. Burns primarily impact the skin, however they may also include deeper structures, including bones and muscles. Upon combustion, the skin forfeits its primary functions, including protection against the external environment, infections, moisture evaporation, and thermal regulation. Based on the burns stage, the patients health, and the burns etiology, it is essential to choose the most suitable therapy. Personalization and interdisciplinary teamwork are essential for the effective therapy of burn victims. This thorough study compiles and examines the existing treatment modalities, emphasizing current advancements in topical therapies, wound debridement, dressings, skin grafting, nutritional support, pain management, and scar tissue therapy.

Squamous cell carcinoma (SCC) is a prevalent form of skin cancer arising from the squamous cells of the epidermis. This malignancy primarily affects areas of the body exposed to ultraviolet radiation, but it can also develop in mucosal regions and internal organs. The pathophysiology of SCC involves a complex interplay between genetic mutations, environmental factors, and immune system dysregulation. Clinically, SCC presents with varied manifestations, ranging from indolent, well-differentiated lesions to aggressive, invasive tumors. Diagnostic techniques encompass a range of modalities, including dermoscopy, histopathological examination, and molecular profiling. Treatment strategies for SCC are multifaceted, involving surgical excision, radiation therapy, and emerging immunotherapies. This article aims to provide a detailed overview of SCC, focusing on its pathogenesis, clinical features, diagnostic approaches, and therapeutic options, highlighting recent advancements and ongoing research in the field.

Endometrial cancer is the most common malignancy of the female reproductive system, with increasing incidence rates. While pelvic lymph node metastases occur in approximately 21% of cases, cutaneous metastases are rare, representing only 0.8% of instances. This case report describes a 40-year-old female patient with a soft tissue tumor in the right thigh, initially suspected of having metastatic endometrial carcinoma. The patient had a history of dysmenorrhea and hypermenorrhea, and presented with a progressively enlarging lesion. Imaging revealed a hypoechoic mass with vascular characteristics, leading to an incisional biopsy. Pathological analysis indicated malignant neoplastic tissue suggestive of genitourinary origin, likely endometrial. This case underscores the rarity of cutaneous metastases from endometrial adenocarcinoma and highlights the importance of considering internal malignancies in patients with unusual skin lesions.

Breast reconstruction is recommended for patients diagnosed with breast cancer who require mastectomy, are candidates for breast-conserving surgery, or have genetic mutations necessitating prophylactic mastectomy. Reconstruction can be immediate or delayed, depending on patient preference and completion of cancer treatments like chemotherapy or radiotherapy. Immediate reconstruction involves placing a tissue expander or implant at the time of mastectomy, while delayed reconstruction can occur weeks or years later. Reconstruction techniques include the use of implants or autologous tissue, such as skin, fat, or muscle from areas like the abdomen, back, or thighs. Autologous reconstruction offers a natural result but requires two surgical sites and poses higher risks of complications. Flap procedures like TRAM and DIEP are commonly used, with careful consideration of patient comorbidities. The final stage of reconstruction involves nipple and areola reconstruction, typically using tattooing methods.

Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA) is a complex clinical entity characterized by the onset of autoimmune or inflammatory responses following exposure to adjuvants, substances that enhance immune responses. One of the most studied triggers of ASIA is breast implants, which are commonly composed of silicone. While breast implants are generally considered safe, a subset of patients may develop systemic symptoms collectively termed as "Breast Implant Illness" (BII), now recognized within the broader spectrum of ASIA. This review provides a thorough analysis of the pathophysiology, clinical presentation, diagnostic challenges, and management options for ASIA associated with breast implants. We aim to elucidate the underlying mechanisms of immune dysregulation and inflammatory responses induced by silicone and explore the latest evidence-based therapeutic approaches, including explantation surgery and immunosuppressive therapies. Our review underscores the need for heightened clinical awareness and further research into ASIA, as early recognition and intervention can significantly improve patient outcomes.

Staghorn lithiasis, characterized by renal calculi that extensively occupy the renal collecting system, poses significant medical challenges due to high morbidity and mortality rates. Traditionally attributed primarily to recurrent urinary tract infections caused by urease-producing bacteria, recent studies indicate a shift toward an increased prevalence of metabolic stones. This change may be linked to rising obesity and metabolic syndrome rates. Historical perspectives emphasized struvite stones, associated with infections, but emerging data reveal a notable proportion of calcium phosphate and mixed stones, suggesting a complex interplay between metabolic factors and infection. Analysis of stone composition in patients has shown that metabolic abnormalities are common, emphasizing the need for comprehensive evaluations beyond infectious risk. Understanding this evolving etiology is crucial for guiding treatment and improving patient outcomes.

Small bowel diverticulosis is a rare condition, with an incidence ranging between 0.3% and 1.3% in the general population. Although it is typically asymptomatic, it can lead to severe complications such as perforation, diverticulitis, bleeding, and intestinal obstruction. These cases require rapid and accurate diagnostic evaluation, with computed tomography and ultrasound being essential due to the lack of established diagnostic protocols. We present the case of a 61-year-old woman with a history of colonic diverticulosis, who developed abdominal pain, fever, melena, and septic shock. Imaging revealed an intestinal perforation, confirmed by exploratory laparotomy, which identified jejunal diverticulosis with perforation. A resection of 90 cm of the small intestine was performed with a primary anastomosis. The patient recovered well in the intensive care unit. This case highlights the importance of early diagnosis and surgical intervention in small bowel diverticulosis complications, a condition that, though uncommon, can be potentially serious.

Acute myocardial infarction (AMI) and diabetic ketoacidosis (DKA) are two critical conditions that can coexist with significant morbidity and mortality. AMI is a leading cause of cardiovascular death, while DKA is a severe complication of uncontrolled diabetes mellitus, characterized by hyperglycemia, metabolic acidosis, and ketonemia. The convergence of these conditions presents unique challenges in diagnosis and management, as the metabolic disturbances of DKA can exacerbate myocardial ischemia and contribute to poor clinical outcomes. This article aims to explore the pathophysiological interplay between AMI and DKA, focusing on their shared risk factors, metabolic derangements, and the impact of hyperglycemia and ketosis on myocardial oxygen supply and demand. Furthermore, we discuss the clinical presentation, diagnostic strategies, and therapeutic approaches tailored to this dual pathology. Early recognition and prompt intervention are crucial to improving prognosis in patients with coexisting AMI and DKA. Multidisciplinary management involving cardiologists, endocrinologists, and intensivists is essential to mitigate the adverse outcomes of this complex clinical scenario.

Introduction: Cystic intratesticular lesions can occur in the second and fourth decades of life and are typically identified via ultrasound. Testicular cysts, usually under 2 cm, result from epididymal-lymphatic obstruction or hormonal changes. Larger lesions with sperm and lymphocytes are spermatoceles. Epididymal cysts are asymptomatic but can cause discomfort or pain, sometimes requiring surgery. Clinical case: A 38-year-old male with no chronic diseases presented with a giant tumor in the right testicle, experiencing pain and hypersensitivity. Physical examination and ultrasound revealed an irregular, painful testicular tumor and a right epididymal cyst. A right epididymal tumor excision was performed successfully. Discussion: Testicular cysts are benign and represent 20-40% of benign testicular tumors. They may arise due to idiopathic, infectious, or traumatic causes with no established risk factors. Diagnosis is often incidental and involves physical examination and imaging techniques like ultrasound. Management is conservative for asymptomatic cases, while symptomatic cases may require surgical intervention that involves careful separation of the cyst from the adhered area. Conclusion: An epididymal cyst is a common pathology in males worldwide, occupying up to 40% of the masses in the testes at the time of a urological assessment. It is a collection at the testicular level of hyaline content and usually measures < 2 cm. They are generally asymptomatic, but when their size exceeds 2 cm or causes symptomatology, it is important to know the therapeutic options that can be offered to patients. In the case of our patient, as it is an epididymal cyst with a diameter of 5 cm and with additional symptomatology, the ideal management was surgical resection, showing adequate evolution in the postoperative follow-up.

Background: Methicillin-resistant S. aureus (MRSA) is a major healthcare burden and is classified as healthcare-associated (HA-MRSA) and community-associated (CA-MRSA). While HA-MRSA is clinically feared, CA-MRSA is often considered less pathogenic. This case report highlights the serious course of illness due to CA-MRSA infection and provides a treatment strategy for the management of such cases. Case description: A 41-year-old male presented with fever and breathlessness for five days. Upon admission, he was provided empirical treatment for atypical infections and vasopressor support for hypotension. His condition deteriorated, necessitating ventilator support. Although the initial tracheal Bio Fire test indicated MRSA, his clinical manifestations did not match MRSA pneumonia symptoms; however, CA-MRSA was confirmed within 12 h. Skin legions developed within 16 h and progressed gradually from ecchymosis, petechial, and palpable purpura to bullous lesions over 72 h. The antibiotic regimen was modified and optimized with the addition of Clindamycin, Vancomycin, and Meropenem–Colistin. Owing to high IL-6 levels, dual vasopressor support, and acute kidney failure, he was started on early (within 12 h) continuous renal replacement therapy (CRRT) with CytoSorb filter (for 3 days) for cytokine removal. IL-6 levels decreased after two days of CytoSorb use. Subsequently, the patient stabilized with reduced dependence on vasopressor and ventilator assistance. Discussion: Early diagnosis of CA-MRSA and management with CRRT using CytoSorb may help improve patient outcomes. To our knowledge, this is the first report of clinical management of CA-MRSA with CytoSorb therapy in India that resulted in positive outcomes.

Laparoscopic surgery has revolutionized the field of surgery, offering significant improvements in patient outcomes such as reduced recovery times, pain, and hospital stays compared to traditional open surgery. However, safety concerns arose with its introduction, prompting the need for advancements in technique and equipment. This article explores critical safety improvements in laparoscopic surgery, simulating a patient’s perioperative journey. Key topics include the importance of team briefings, proper patient positioning, ergonomics, optimal laparoscopic setup, safe port insertion techniques, pneumoperitoneum management, instrument handling, and hemostasis. The review highlights the ongoing need for research and consensus in patient safety practices within laparoscopic surgery.