Probability of cancer of the skin boost 672 people affected by actinic keratosis

This study aims to assess the prevalence of illicit use of stimulants and attention deficit hyperactivity disorder (ADHD) among a sample of medical students at the main universities in Riyadh, Saudi Arabia and their motivation for use. We examine the association between the use of stimulants and the students' academic performance. We also look into the possible adverse consequences of illicit stimulant use among students. The competitive nature of medical school might place the students at a higher risk of using stimulant drugs illicitly. Acquiring these stimulants illegally has become easier since the diagnosis and treatment of ADHD have risen. We are unaware of any other study exploring the prevalence of and motivation for illicit use of stimulants among medical students in Riyadh. A cross-sectional web-based survey was the study design we chose as we were targeting medical students in three governmental medical colleges in Riyadh, Saudi Arabia. The total sample population of 1,177 participants was divided into the three following groups no previous use of stimulant drugs (Group 1), illicit use (Group 2), and medical use (Group 3). Of the 1,177 medical students, 29 (2.46%) were found to be using stimulants illicitly; 39 (3.31%) were using the stimulants medically as they had been diagnosed with ADHD. The ability to prolong study time was reported as the most common motive for illicit use by many students. The present study contributes to the literature by casting light on this serious issue in Riyadh. More educational effort is needed to promote awareness about the adverse effects of ADHD drugs and their illicit use among students. Copyright © 2020, Alrakaf et al.Acute appendicitis is a mimicker of a wide range of gastrointestinal and genitourinary pathologies. The diagnosis becomes more challenging when it is associated with intestinal malrotation. A rare case of left-sided acute appendicitis with asymptomatic undiagnosed intestinal malrotation is reported. A 32-year-old male without known comorbidities presented with left-sided abdominal pain. Abdominal ultrasonography and computerized tomography scans showed intestinal malrotation with acute appendicitis. Exploratory laparotomy and appendectomy with Ladd's band release via midline incision were performed, and the patient had no issues on follow-up. Given the rarity of acute appendicitis associated with intestinal malrotation, an increase in awareness of this anatomical variant is essential among emergency physicians, radiologists, and surgeons for prompt diagnosis and timely intervention. Copyright © 2020, Kharel et al.Objectives Maxillary antroliths are calcified masses found within the maxillary sinus. The aim of this study was to investigate their presence in a sample of Lebanese population by means of digital panoramic radiographs. Material and methods In this study, 500 digital panoramic radiographs of Lebanese adult patients (281 females and 219 males) with a median age of 47.9±18.98 years were included and examined for maxillary antroliths. The statistical analysis of the data found was performed by IBM® SPSS® (IBM, Armonk, NY) version 20.0 for Windows. Results The sample investigated presented only three maxillary antroliths (0.6%). Among these, two were found in female patients and one in male; none of them was bilateral, one on the right side and two on the left side. No statistically significant relationships were observed with patients' gender and age. Conclusion Maxillary antroliths are rare entities detected accidentally on panoramic radiographs utilized frequently in dental clinics. In light of their possible association with chronic sinusitis, dentists should have a complete knowledge of their diagnosis. Copyright © 2020, Aoun et al.BACKGROUND Research has shown that more than 50% of patients have insufficient postoperative pain relief despite the use of multiple pain management modalities. Insufficient pain relief leads to several pathophysiological effects. One of the barriers to optimal pain relief is patient's lack of knowledge regarding the options available for pain management and their potential side effects. In this survey, we evaluated surgical patients' knowledge about postoperative pain and its management in patients undergoing major upper abdominal surgeries at a tertiary care hospital. METHODS AND MATERIAL This was a cross-sectional survey. TG100-115 manufacturer A total of 155 patients (18-60 years of age) scheduled to undergo elective major upper abdominal surgery were included after ethical approval and informed consent. Preoperatively, patients were interviewed through a questionnaire regarding knowledge about postoperative pain and its management. RESULTS The average age of the patients was 42.97 ± 13.05 years. Excellent and good knowledge were observed in 11.61% and 21.94% patients, respectively, whereas fair and poor knowledge were seen in 42.58% and 23.87%, respectively. Inadequate knowledge was more marked regarding analgesic side effects and addiction risk. Education level, history of surgery, and adequate information provision about pain management plan by surgeons preoperatively were significantly associated with a higher level of knowledge about pain and its management (p-value 0.0005, 0.002, and 0.0005, respectively). CONCLUSION A considerable proportion of patients have inadequate knowledge about their postoperative pain and its management, particularly in areas of side effects and addiction risk. Copyright © 2020, Nasir et al.Perforation of a gastrointestinal tract as a complication of intubation is unusual, and only few cases have been reported. Prompt recognition and management of gastrointestinal tract perforation are needed to limit the morbidity and mortality of this condition. We presented a case of an acutely ill patient who developed gastric perforation following difficult intubation to remind clinicians of a life-threatening complication that can develop following a life-saving procedure. Copyright © 2020, Suwanwongse et al.Diaphragmatic hernias (DH) may be congenital or acquired in origin. Those causing obstructive jaundice in the elderly are extremely rare but can occur. These patients may present with painless jaundice, early satiety, and weight loss due to biliary tract obstruction and stomach compression by the hernia. Therefore, clinicians should consider an anatomic anomaly when evaluating patients with jaundice. Here, we report the case of a 71-year-old female, with a medical history of hypertension and chronic obstructive pulmonary disease, who presented with jaundice. The patient was found to have dilation of the common bile duct due to external mechanical compression of abdominal organs from a DH. Because the patient had poor functional status and multiple comorbidities, the risks of surgically correcting the hernia outweighed the benefits. The patient instead received a biliary decompression and stent, and her jaundice significantly improved. Copyright © 2020, Hoang et al.Introduction Due to conflicting data in the literature, there is a continuing debate on whether advanced hypopharyngeal carcinoma patients should be treated with definitive surgery or chemoradiotherapy. The purpose of this study is to evaluate the management and outcomes of advanced hypopharyngeal carcinoma in a tertiary care institution over the last 25 years. Methods An Institutional Review Board (IRB)-approved and HIPPA-compliant retrospective analysis was performed of patients with advanced-stage squamous cell carcinoma of the hypopharynx treated at our institution between January 1994 and December 2018. Data regarding demographics, stage, treatment, and follow-up were collected. Outcomes including median survival and overall survival were calculated using the Kaplan Meier method. All analyses were performed using SPSS v. 24.  Results This study included a total of 103 advanced stage hypopharyngeal cancer patients. The median age for this cohort is 61 years (range 41-88, SD 9.3). Of the total 103 eligible 41.5% vs 18.5%, p = 0.049) and disease-free survival (DFS; 75.3% vs 56%; p = 0.029) were significantly better for patients in the surgery group compared to the chemoradiotherapy group. On multivariate Cox-regression analysis, lymph nodal status (HR = 1.27, CI 1.00-1.62, p = 0.047) and chemoradiation treatment (HR = 1.82, CI 1.00-3.29, p = 0.048) were associated with higher risk of mortality.  Conclusion In our single institutional experience of advanced hypopharyngeal carcinoma management, the five-year overall survival rate was found to be 25.5 % and was the poorest among head and neck cancers. The patients with advanced hypopharyngeal cancer treated with surgery followed by adjuvant radiation or chemoradiation have significantly improved overall survival compared to those treated with definitive chemoradiotherapy. Further research warranted for early detection and better treatment to improve the cure rate in hypopharyngeal carcinoma patients. Copyright © 2020, Vengaloor Thomas et al.Hyperammonemia is a common cause of encephalopathy encountered in an intensive care unit (ICU). Absence of pre-existing liver disease may misguide a clinician and cases of non-cirrhotic hyperammonemia may be missed in ICU leading to life-threatening outcomes such as cerebral edema and herniation. A critical care physician must look beyond liver cirrhosis as a cause of hyperammonemia so that infrequent but potentially reversible causes of encephalopathy are not missed, and patient treatment is not jeopardized. Copyright © 2020, Sharma et al.Pericardiocentesis is a procedure performed to aspirate fluid from the pericardial space. It is most often performed as an acute therapeutic procedure in cases of massive pericardial effusion or pericardial tamponade. Our case describes an unusual complication of pericardiocentesis leading to hemorrhagic pericardial effusion and hemodynamic compromise. Copyright © 2020, Nair et al.Shwachman-Diamond syndrome (SDS) is an autosomal recessive inherited disease of the SBDS gene. It has multi-organ involvement but primarily affects the bone marrow and the pancreas. This disease is more commonly found in males than females, and its earliest manifestation in infancy is pancytopenia, most especially neutropenia. Our article attempts an in-depth analysis of the hepatic and cardiac association in this disease and the severity of this association. For the purpose of this study, we engaged in an in-depth research of critically appraised literature and published articles. We searched for such articles on PubMed and Google Scholar using regular and Medical Subject Headings (MeSH) keywords. We eventually selected 32 articles from the search results and carefully read through and analyzed them. These articles showed the usual age of diagnosis of SDS to be at infancy (before age one), with a predominantly median survival age of 35 years. All the published articles we reviewed showed some hepatic and cardiac associations with SDS, but the extent of the associations varied. Even though most hepatic involvements were found to be benign, some severe cases led to fibrosis and hepatic failure. Although there is no particular consensus as to the exact outcome of cardiac involvement, the few cases we reviewed showed that cardiac association could be a severe complication and could even be fatal. Most of the cases reported in the literature had been diagnosed at autopsy. Copyright © 2020, Lawal et al.