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The coronavirus disease (COVID-19) is a global pandemic. COVID-19 is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which was identified at the end of 2019 in a cluster of pneumonia cases in Wuhan, China. It has likely affected everyone in the world either directly or indirectly, financially or through social isolation measures. There are now many publications about its etiology, epidemiology, investigations, and clinical presentation. Therefore, the medical community has a much better understanding of the disease as compared to a few months ago. There is no effective, safe treatment for COVID-19. There are many guidelines, clinical trials, and information on various media platforms that hinder the tracking of developments in this rapidly evolving situation. In this review, we provide a detailed update on various emerging treatment options and analyze the results of recent trials. This review also discusses current progress on finding a COVID-19 vaccine.Intravenous drug use has become a worldwide public health hazard and continues to affect all strata of our society. It has been associated with a multitude of severe infectious complications, such as hepatitis B, hepatitis C, human immunodeficiency virus, and endocarditis, though others such as skin and soft tissue infections are also extremely common. Rectus sheath abscess remains a rare medical condition. Here we report a 62-year-old man, who used heroin daily, presenting with an abdominal swelling with pain for two weeks. CT of the abdomen revealed a large left-sided rectus sheath abscess. Intravenous antibiotics were started and the abscess drained. #link# The patient responded favorably to treatment. While managing complications of injection drug abuse, apart from the medical management, interventions to treat addiction assume prime importance. Rehabilitation, needle exchanges, and injection hygiene remain key to battling this malady.A tenosynovial giant cell tumor (TGCT) is a benign lesion whose presence in Hoffa's pad has rarely been reported. This unique case report discusses a 33-year-old female patient who presented with swelling and pain in her left knee. Clinical and MRI findings were used to make the diagnosis, which was confirmed on a histopathological basis. The patient had a large tumor (5 × 3 × 3 cm) in Hoffa's fat pad, which was diagnosed as TGCT and managed with open resection due to its size. At follow-up after 20 months, the patient was asymptomatic, and there was no local recurrence of the tumor.Introduction Polarized light (PL) has been used in pathology for multiple reasons, including the demonstration of foreign bodies, the evaluation of crystals, and the demonstration of fibrosis. We incidentally found that yellow-gold polarization routinely occurs surrounding desmoplastic scar tissue abutting the invasive glands of colonic adenocarcinoma. We hypothesized that evaluating the use of polarized light over a series of invasive adenocarcinomas of the large intestine might produce evidence of its utility. Methods Large intestinal resections with invasive adenocarcinoma were reviewed with yellow-gold polarized light microscopy by two surgical pathologists postoperatively between January 2017 and March 2019. Specimens were examined under yellow-gold polarized light to evaluate invasion from the submucosa into the muscularis propria, from the muscularis propria into pericolic fat, and to the serosa. The diagnosed location, T stage, history of radiotherapy, mucinous features, and grade were recorded. Photocisely staged pathological colorectal cancer specimens.Cryptococcosis is a major life-threatening fungal infection in patients with severe HIV infection and other immunocompromised states. Lung and central nervous system (CNS) are the most commonly involved organs in disseminated cryptococcosis. Others include skin, prostate, medullary cavity of bones, eyes, heart, liver, etc. Pulmonary cryptococcosis may be misdiagnosed because of comparatively nonspecific clinical and radiological features. [https://www.selleckchem.com/products/brm-brg1-atp-inhibitor-1.html compound library inhibitor] report the case of a 61-year-old male patient who is a known case of gastroesophageal reflux disease (GERD), myasthenia gravis, and steroid-induced diabetes mellitus. He was diagnosed with gangrenous cholecystitis at another institution but refused surgery. At our hospital, he experienced loss of consciousness in the out-patient department (OPD) and was therefore admitted for further evaluation where he was found to have pulmonary cryptococcosis and pancytopenia. Pulmonary cryptococcosis is usually found in HIV-positive immunosuppressed patients. However, sometimes it is also seen in HIV-negative patients, and they tend to have a good prognosis with adequate treatment.Atypical hemolytic uremic syndrome (aHUS), defines as non-Shiga toxin HUS, is thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, consumptive thrombocytopenia, and renal impairment. aHUS is associated with high morbidity and mortality, necessitating the need for an early diagnosis to limit target organ damage. Mutations or autoantibodies against specific complement factors over-activate the complement system forming microthrombi. aHUS has the potential to cause multi-organ system dysfunction, but it predominantly affects the kidneys. aHUS is treated with eculizumab, a terminal blocker of the complement system. Clostridium difficile infection is a rare precipitant of aHUS. We present a case of aHUS associated with Clostridium difficile infection in a 60-year-old female patient that was successfully treated with eculizumab.Introduction Metabolic syndrome (MetS) is defined as a syndrome of truncal obesity, insulin resistance, hypertension, hypertriglyceridemia, and dyslipidemia. It is well known that MetS increases the risk of cardiovascular disease and adverse events. Each of its components is associated with an increased risk of cardiovascular disease, but data on the association with ischemic stroke are scarce. At the international level, a significant body of research has been conducted on this issue, but the situation is very different in Pakistan. Very little data are present on the subject matter. link2 This study is an endeavor in this direction, generating data, that can be used in early identification and developing treatment services for patients with ischemic stroke having MetS. Aims To determine the frequency of MetS in ischemic stroke patients admitted to a tertiary care hospital in Karachi, Pakistan. Methods This six-month observational and cross-sectional study was conducted at Medical Unit I, Jinnah Postgraduate Medicts are truncal obesity, hypertension, and dyslipidemia.Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE). LN often leads to kidney failure, affecting the quality of a patient's life. There are several classical biomarkers that assist nephrologists' daily practice. For more than 50 years, anti-double stranded DNA antibodies and complement components C3 and C4 have been used for LN disease activity evaluation. The major obstacle in the usage of conventional biomarkers is that none of them have both high specificity and high sensitivity. Moreover, an invasive kidney biopsy is still the gold standard for renal involvement detection in SLE patients. Therefore, new non-invasive biomarkers are needed for the early and accurate establishment of LN. Among the promising candidates are long non-coding RNAs (lncRNAs). Their dysregulation appears to have predictive and diagnostic potential. Furthermore, these biomarkers like other conventional biomarkers give insight into the pathogenesis of LN. This review aims to summarize the available information on lncRNAs in SLE patients and to present their future opportunities to add to the conventional biomarkers in the diagnosis and monitoring of LN.Osteomyelitis is an infection of the bone and bone marrow that can be caused by an exogenous source or by hematogenous spread. The hematogenous spread of bacteria usually results in bacteremia with subsequent infection of the bone. The most commonly associated pathogen with this type of infection is Staphylococcus aureus, with other gram-negative organisms, such as Pseudomonas aeruginosa, also frequently encountered. The microorganism Serratia marcescens is a rare and infrequently encountered cause of this condition known to cause nosocomial infections. This organism can be notoriously difficult to treat, with resistance to many commonly used antibiotics. The case presented is one of vertebral osteomyelitis in an intravenous drug user caused by Serratia marcescens with subsequent treatment and management of the condition. This case allows for investigation into the continued management of intravenous drug user infections, with the isolation and treatment of less commonly encountered pathogens.Diabetic ketoacidosis (DKA) is a common complication in patients with type I and ketosis-prone type II diabetes mellitus. A variety of electrolyte derangements are encountered during the presentation and management of DKA. Hypercalcemia has been rarely reported in DKA, particularly when patients develop severe acidosis. However, we describe a patient with DKA and severe hypercalcemia in the absence of severe acidosis. The hypercalcemia quickly corrected back to normal with the treatment of DKA.We report a case of a 73-year-old male with a history of diabetes mellitus, osteomyelitis, methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia who recently completed an extended intravenous course of cefazolin eight days back, and presented with MSSA bacteremia complicated by epidural abscess, endocarditis, and aortic root abscess. Meanwhile, the patient was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription-polymerase chain reaction (RT-PCR). Even with aggressive antibiotic treatment, the patient remained bacteremic and developed endocarditis with a worsening aortic root abscess. link3 We suspect coronavirus disease 2019 (COVID-19) as a cause for the infectious paradox and will discuss the possible mechanisms in this case report.Hemorrhage is a major cause of death globally, yet our options to control the condition have remained limited. The standard intervention for patients suffering from a non-compressible torso hemorrhage (NCTH) typically involves resuscitative thoracotomy (RT) with aortic cross-clamping. Apart from being extraordinarily invasive, the survival rates for this procedure remain low. Over the years, research has surfaced that offers much promise regarding the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in exsanguinating patients. Although this type of procedure is not yet universally recognized as a gold standard, it holds some hope for the development of additional research regarding how we can make use of this advancement to improve survival in trauma patients. Complete REBOA (c-REBOA) has not gained wide acceptance due to the undeniable effects it has on normal physiology, metabolic effects, long-term complications, and mortality. Partial REBOA (p-REBOA) is not yet fully validated by research but could potentially be the answer to our problem. The critical question that we should address at this juncture is as follows how can we improve the survival of patients with an NCTH in the least invasive way possible, while also reducing the feared complications associated with c-REBOA?