Comprehensive Medical History Research Articles

Fracture of Stieda Process with Posterior Ankle Impingement Syndrome: A Case Report

Ankle impingement syndromes, prevalent among athletes, result in significant pain and limited joint mobility. Using imaging techniques (such as radiographs, CT, MRI, and ultrasound) not only assists in diagnosis but also helps in understanding the anatomical cause of the impingement, directing therapeutic injections, and pre-surgery planning. This article presents a case of a 36-year-old female with a two-year history of chronic ankle pain, associated with recurrent swelling and decreased mobility who underwent a radiographic imaging and MRI revealing a fracture of the Stieda process as a cause of posterior ankle impingement (PAI) syndrome. The diagnosis of ankle impingement syndromes mainly depends on comprehensive clinical examination and patient's medical history, but MRI was proved crucial for diagnosing syndromes affecting the posterior areas and excluding other causes of ankle pain.

Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study

Background: The influence of medical and dental factors on jaw clicking within the South Australian population remains unexplored, and there is a lack of research on the impact of occlusal therapy on dynamic jaw movement parameters in this population. Purpose: This study investigated the potential significant associations between specific aspects of patient histories, occlusal therapy, and self-reported or observed jaw clicking in a population from the state of South Australia. Methods: Seventy individuals aged 18 to 65 participated in a cross-sectional study. Data collection included comprehensive medical, social, and dental histories, followed by evaluations of jaw function. Twenty-six out of the seventy individuals reported jaw clicking. Electrognathography assessed maximum mouth opening, surface electromyography evaluated masticatory muscle function, and joint vibration analysis measured individual joint vibration amplitudes and integrals. Logistic regression models analysed overall variable effects, while sub-models focused on predictors related to occlusal therapy, specifically orthodontic intervention. Independent t-tests and Mann–Whitney U tests compared jaw functions between participants who received occlusal therapy and those who did not. Results: The number of third molars extracted, vitamin D deficiency, and self-reported mental health disorders (R2 = 0.414, p = 0.048) emerged as significant predictors for jaw clicking. Factors associated with occlusal therapy showed no significant association with jaw clicking (R2 = 0.59, p = 0.027). Furthermore, there were no significant differences observed in mouth opening (t-stat = −0.439, p = 0.662), muscle activity, and joint vibration analysis between participants who underwent occlusal therapy and those who did not. Conclusions: Within the selected study population and limited sample size, the number of third molars extracted, vitamin D deficiency, and self-reported mental health disorders were associated with jaw clicking.

Exploring Information-Gathering Techniques in Medical and Dental Interviews for Child Abuse and Neglect: A Comprehensive Scoping Review of Existing Gaps

AbstractHealthcare providers may regularly encounter victims of suspected child abuse or neglect. Conversations during medical evaluations and examinations may yield essential information and reliable accounts of a child’s experiences of abuse. However, knowledge of appropriate communication skills when interacting with suspected child abuse victims and information gathering techniques have not been well explored in healthcare providers. This scoping review assesses the state of the literature concerning medical interviewing in cases of child abuse and explores the communication and information gathering techniques used by healthcare providers when interacting with suspected child abuse victims. Ten studies were included in the analysis, collectively revealing a limited body of knowledge on information gathering techniques in child abuse cases in healthcare settings. Collecting a comprehensive medical history has emerged as a crucial tool for guiding medical examinations and assessments. The findings also highlight the absence of standardised guidelines for healthcare professionals to gather information from victims of child abuse. This review did not identify any studies that investigated the information gathering skills of oral healthcare providers in the context of child abuse. Further research is needed, and the creation of standardised protocols aimed at improving information gathering techniques within healthcare settings for cases of child abuse could prove beneficial. Improved communication and information gathering techniques can significantly contribute to the management of suspected cases of child abuse, safeguarding the well-being of vulnerable children.

Approaches to medication history taking in different hospital settings: A scoping review.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. A comprehensive medication history can contribute to safe therapy. Many approaches aiming to improve medication history taking require significant human resources. To design an efficient process that delivers high-quality medication histories, the individual requirements and resources of a given setting need to be considered. We aimed to provide an overview of existing approaches to medication history taking and their performance in different settings to potentially support the selection of an appropriate procedure. We searched 3 literature databases (PubMed/MEDLINE, CINAHL, PsycINFO) for publications on approaches to medication history taking and analyzed them with regard to their key components as well as the setting, patient population, assessed outcomes, and efficacy. In total, 65 publications were included and analyzed. The majority of the reported approaches relied on involvement of dedicated staff (n = 43), followed by process-oriented interventions (eg, checklists; n = 15) and information technology (IT)-guided interventions (n = 11). A mean (SD) of 6 (2.9) outcomes were described in each study. Medication discrepancies were reported in 89% of all studies, yet about 75 different descriptions of this outcome were used, making it difficult to compare study results. Only 11 studies applied a sample size calculation and statistical tests. Of those, 10 reported a positive effect of their respective intervention on the quality of medication histories. Most approaches focused on pharmacy staff, which are associated with considerable cost and resources. Therefore, IT-based approaches and patient engagement should be investigated as cost-effective alternatives and tested for superiority in the same setting. Reporting guidelines and standardized methodology are needed to improve the comparability of such studies.

Renal tubular necrosis associated with anagrelide administration: a case report.

A 62-year-old female patient with essential thrombocythemia experienced rapid renal dysfunction and was subsequently referred to our hospital. Further investigations did not reveal any significant abnormalities except for a slight increase in urinary β2-microglobulin levels. A renal biopsy was performed to investigate the cause of her renal dysfunction, revealing acute tubular necrosis, interstitial edema, and arteriosclerosis. No significant glomerular lesions were observed. Immunofluorescence staining and electron microscopy showed no abnormalities. She had been using anagrelide for 4years, and her dosage was increased from 2.0 to 3.0mg/day 10months before her initial admission. Her renal function began to deteriorate 2months after the anagrelide dosage increase. Although 0.625mg of bisoprolol was initiated for tachycardia 3months after the anagrelide dosage adjustment, we suspected that the acute tubular necrosis was associated with anagrelide administration. After transitioning from anagrelide to hydroxyurea and discontinuing bisoprolol, her renal function improved. This case suggests the importance of considering anagrelide as a potential cause of renal dysfunction in patients using this medication. Therefore, renal biopsy, combined with a comprehensive medical history, is crucial for evaluating the etiology of renal injury in such cases.

Punctal Atresia As a Clinical Indicator of Systemic Genetic Anomalies

ABSTRACT Background Punctal atresia or agenesis (PA) is a rare congenital anomaly characterized by the absence or closure of the tear duct puncta, potentially linked to systemic genetic anomalies. The necessity of a genetic workup based solely on the presence of PA remains uncertain. This study investigates a cohort of PA patients, examining the prevalence and types of associated syndromes. Methods A retrospective medical records review of all patients diagnosed with PA at the Children’s Hospital of Philadelphia between 2009–2023 was conducted, analyzing medical histories and genetic testing results. Primary outcomes included the prevalence of systemic syndromes, while secondary outcomes focused on the variety of associated syndromes. Results Forty-four patients were included, of which 31 were male (70%) with a mean ± SD age 3.3 ± 3.3 years. Overall, 87 puncta in the study cohort were affected, and 26 cases (59%) were bilateral. Systemic abnormalities or genetic syndromes were identified in 19 patients (43%), with the most common being Ectodermal Dysplasia and Down syndrome. Additional rare syndromes were demonstrated. No significant association was found between systemic abnormalities and gender, bilaterality, or the number of puncta involved. Conclusions A high incidence of systemic syndromes (43%) was observed in the study cohort. In individuals with PA who also exhibit extraocular disease, systemic evaluation and genetic workup should be considered. Syndromic diagnoses identified in our cohort also include: Branchio-oto-renal syndrome, 22q11.2 deletion syndrome, 1q21.1 microdeletion syndrome, NF1, monosomy 4q and trisomy 6q, which represent novel associations. The lack of correlation between PA’s phenotypic severity and systemic abnormalities highlights the need to obtain a comprehensive medical history and consider a systemic workup in PA patients.

PDE5is-naïve versus non-naïve patients at first investigation for erectile dysfunction-findings from a long-term, real-life cross-sectional study.

Phosphodiesterase 5 inhibitors (PDE5is) represent a first-line pharmacological therapy for erectile dysfunction (ED). Men could obtain PDE5is for recreational purposes without any proper medical prescription. We aimed to analyze clinical characteristics of patients who already used any PDE5i for ED without previous formal medical prescription. Data from 2012 heterosexual, sexually active men seeking first medical help for ED at our outpatient clinic between 2005 and 2022 were analyzed. All patients were assessed with a comprehensive sexual and medical history and completed the International Index of Erectile Function (IIEF) at baseline. Comorbidities were scored with the Charlson comorbidity index (CCI). Thereof, according to exposure to any PDE5i before their first visit, patients were subdivided into: PDE5i-naïve and non-PDE5i-naïve patients. Descriptive statistics tested the sociodemographic and clinical characteristics of both groups. A logistic regression model predicted the likelihood of being PDE5i-naïve at the baseline. Linear regression analysis (LRA) estimated the likelihood of being PDE5i-naïve versus non-PDE5i-naïve over the analyzed timeframe. Lastly, local polynomial regression models graphically explored the likelihood of being PDE5i-naïve at the first clinical assessment over the analyzed timeframe, and the sensitivity analyses tested the probability of being PDE5i-naïve at baseline. Overall, 1,491 (70.9%) patients were PDE5i-naïve and 611 (29.1%) were non-PDE5i-naïve at the first assessment. PDE5is-naïve patients were younger, with a lower prevalence of CCI ≥ 1 and of normal erectile function (EF) than non-PDE5i-naïve men (all p<0.05). Multivariable logistic regression found that patients with lower BMI (OR: 0.99), higher IIEF-EF scores (OR: 1.02), lower rates of severe ED (OR: 0.94), and who had been assessed earlier throughout the study timeframe (OR: 1.27) were less likely to be PDE5i-naïve at baseline. Univariate LRA revealed that younger patients (Coeff: -0.02), with lower CCI (Coeff: -0.29) and higher alcohol intake per week (Coeff: 0.52) were more likely to be PDE5i-naïve over the analyzed timeframe. Moreover, for the same IIEF-EF score, patients with higher CCI had lower probability of being PDE5i-naïve. Self-prescription of PDE5is is an attitude presents in the general population, despite this phenomenon has decreased overtime. Current data outline the importance to keep promoting educational campaigns to promote PDE5is as effective and safe medicinal products, while avoiding their improper use.

Ekalusugan: An Intelligent health observation system using Internet of Things

- In today's technological landscape, the Internet of Things (IoT) has ushered in a multitude of applications, with wearable technology and smart healthcare standing out as paramount. Amidst this backdrop, we present "eKalusugan," an innovative intelligent health monitoring system harnessed by IoT. Traditional health observation systems often fall short in catering to the needs of sick patients, a concern this study addresses through an insightful exploration of challenges and innovative remedies. Our work also delves into the evaluation of a prototype observation system, gauging user acceptance based on its novel features. Employing a mixed-methods approach, encompassing both a comprehensive questionnaire and in-depth interviews, we engaged five (5) medical experts, thirty (30) healthcare providers, and eighty (80) patients from diverse locales. This collaborative effort yielded invaluable insights into the existing gaps, such as inadequate sickness monitoring, role ambiguity, and the struggle to maintain comprehensive medical histories under the conventional model. To surmount these limitations, our proposed solution boasts two pivotal facets. First, we advocate for leveraging IoT's capabilities to streamline the creation of an intelligent health observation system. Second, we emphasize the necessity of a user-centric approach, rendering the system significantly more intuitive for medical professionals and patients alike, in stark contrast to conventional methods. Our findings underscore the potency of the eKalusugan system, with respondents lauding its functionality (rated 4.62), reliability (rated 4.52), usability (rated 4.68), and performance (rated 4.70) as either excellent or good (with an average rating of 4.59). Encouragingly, our study indicates that the envisaged system could potentially gain traction at the behest of governmental health agencies, paving the way for its integration in monitoring the well-being of sick individuals. In this era where the confluence of IoT and healthcare beckons transformative progress, eKalusugan shines as a testament to the possibilities that emerge when cutting-edge technology aligns with human well-being

Medical History and Preoperative Coagulation Profile as Predictors of Outcomes in Elective Spinal Surgery: A Meta-Analysis

In patients with unremarkable medical history, comprehensive preoperative hemostasis screening in elective neurosurgery remains debated. Comprehensive medical history has shown to be noninferior to coagulation profile to evaluate surgical outcomes. This study aims to evaluate the predictiveness of preoperative coagulation screening and medical history for surgical outcomes. Databases were searched until April 2023 for observational cohort studies that reported preoperative hemostasis screening and clinical history prior to elective neurosurgical procedures. Outcomes of interest included postoperative transfusion, mortality, and complications. Pooled relative risk ratios (RRs) were analyzed using random-effects models. Out of 604 studies, 3 cohort studies met our inclusion criteria, adding a patient population of 83,076. Prolonged partial thromboplastin time (PTT; RR=1.42, 95% confidence interval [CI]=1.14, 1.77, P=0.002), elevated international normalized ratio (INR; RR=2.01, 95% CI=1.14, 3.55, P=0.02), low platelet count (RR=1.58, 95% CI=1.34, 1.86, P<0.00001), and positive bleeding history (RR=2.14, 95% CI=1.16, 3.93, P=0.01) were associated with postoperative transfusion risk. High PTT (RR=2.42, 95%CI=1.24, 4.73, P=0.010), High INR (RR=8.15, 95% CI=5.97, 11.13; P<0.00001), low platelet count (RR=4.89, 95% CI=3.73, 6.41, P<0.00001), and bleeding history (RR=7.59, 95% CI=5.84, 9.86, P<0.00001) were predictive of mortality. Prolonged PTT (RR=1.53, 95% CI=1.25, 1.86, P=<0.0001), a high INR (RR=3.41, 95% CI=2.63, 4.42, P=< 0.00001), low platelets (RR=1.63, 95% CI=1.40, 1.90, P=<0.00001), and medical history (RR=2.15, 95% CI=1.71, 2.71, P=<0.00001) were predictive of complications. Medical history was a noninferior predictor to coagulation profile for postoperative transfusion, mortality, and complications. However, our findings are mostly representative of elective spinal procedures. Cost-effective alternatives should be explored to promote affordable patient care in patients with unremarkable history.

Prenatal exposure to environmental toxins and comprehensive dental findings in a population cohort of children.

Environmental toxins are known to have many impacts on growth and development in humans, starting in utero. Alterations in amelogenesis, caused by chemical and physical trauma that occur during the antenatal, perinatal and postnatal time periods, may result in developmental defects in deciduous and permanent tooth enamel, as demonstrated in animal studies. These defects can be clinically visible and result in a variety of morphological and functional problems in the dentition. Since enamel does not remodel after formation, it may serve as a permanent record of insults during organ development.Our primary purpose was to investigate any possible relationship between intrauterine exposure to endocrine disrupting chemicals (phenols and phthalates) and developmental defects in enamel in children, while also accounting for fluoride exposure. Our secondary purpose was to report descriptively on findings from comprehensive dental examinations performed on 356 children that were drawn from the general paediatric population. A cohort of children from the Utah Children's Project (N = 356) that had full medical exams, comprehensive medical and family histories and available biospecimens were given extraoral and intraoral examinations. They also completed an oral health questionnaire. Standardized intraoral photographs were taken of the teeth and viewed by standardised examiners and the dental observations were recorded for a full inventory of findings, including: tooth morphology, caries, restorations, colorations, attrition, erosion, fractures and hypomineralization. Perinatal maternal urine samples were assessed for the concentration of fluoride, phenols and phthalates, including bisphenol A (BPA).Pairwise statistical analyses were done to correlate the dental findings with one another and with the presence of environment chemicals found in the urine samples. Hypomineralization was the most common finding (96% of children; 37% of deciduous teeth, 42% of permanent teeth), consistent with molar incisor hypomineralization (MIH) described in other human populations. No consistent correlations were seen between dental findings and the presence of phenols and phthalates in prenatal urine, but the number of samples available for the assessment was limited (n = 35).In conclusion, we found a high proportion of dental hypomineralization in a population based paediatric cohort, but did not find an association with prenatal exposure to phenols and phthalates.

Medconnect (Android App): Linking Doctors, Patients, and Prescriptions Digitally

Abstract: Medconnect, an innovative Android application, emerges as a transformative platform within the healthcare sector, seamlessly bridging the communication gap between doctors, patients, and pharmacies. This application introduces a novel approach to managing prescriptions digitally, ensuring accuracy, enhancing medication adherence, and streamlining the healthcare experience. With functionalities like e-prescriptions, real-time appointment scheduling, and a comprehensive medical history database, Medconnect prioritizes patient care and data security. The integration of advanced technologies facilitates a more efficient healthcare delivery system, reduces the potential for prescription errors, and promotes a collaborative environment between healthcare providers and patients. By embodying the principles of accessibility, reliability, and user-centric design, Medconnect stands at the forefront of digital healthcare innovation, promising a future where managing health and wellness is more integrated and intuitive.

Excellence in Surgical Care: A Review of Preoperative and Postoperative Management

A retrospective study aimed to analyze and identify the main components involved in patients' preoperative and postoperative management, recognizing the importance of knowledge in approaching the complexities inherent to surgical procedures. Search was conducted in the PubMed, Embase, SCOPUS, Web of Science, and Google Scholar databases to identify relevant studies. Patients with compromised organic functional reserve, when undergoing surgical procedures, often face an increased risk of morbidity and mortality. In this context, obtaining a comprehensive medical history and a meticulous physical assessment are crucial in decision- making. Laboratory tests are recommended only when clinical findings justify their performance. This review highlights fundamental aspects, including surgical indication, clinical history, physical examination, surgical risk assessment, continuous use medications, sedation approaches, antibiotic prophylaxis, unique preparations, and postoperative care. In conclusion, this comprehensive literature review significantly contributed to the in-depth and wellfounded understanding of the preoperative preparation and postoperative care of patients with surgical pathologies within a scientifically validated context.

A Single-Center Study on the Clinical Profiles and Ultrasonographic Assessments of Living Kidney Donors in the Marathwada Region of Maharashtra.

Living donor kidney transplantation plays a vital role in renal replacement therapy, particularly in India, where a substantial increase in kidney transplants has been observed. Thorough assessments of living kidney donors are crucial, focusing on parameters such as kidney size and glomerular filtration rate (GFR). Despite the importance of GFR in donor assessments, there is a noticeable lack of data on normal GFR ranges in the Indian population. This study aims to address the gap in knowledge by establishing a reference range for GFR in healthy kidney donors from the Marathwada region of Maharashtra. The research also explores the clinical profiles and ultrasonographic features of living kidney donors. A retrospective analysis was conducted at the Mahatma Gandhi Mission (MGM) Medical College and Hospital in Aurangabad, involving 134 living kidney donors. Inclusion criteria encompassed healthy donors with a BMI of less than 30 kg/m², while donors with uncontrolled hypertension, diabetes, microalbuminuria, or a measured GFR below 70 mL/min/1.73 m² were excluded. Comprehensive medical histories, demographic parameters, and ultrasonographic assessments were conducted, with GFR measured using 99M technetium diethylenetriamine pentaacetate scans. The study reveals that the majority of donors were females (80.6%), and the highest number fell within the 41-50 age group. Parents constituted the primary donor category (68.7%), reflecting a familial inclination toward organ donation. Ultrasonographic assessments indicated larger kidney sizes compared to other studies, suggesting regional or population-specific differences. The mean GFR for the right and left kidneys, as well as the total GFR, was within the expected range. The negative correlation between age and GFR emphasizes the need to consider age in donor assessments. The findings emphasize the unique features of this population, including a higher average age, female preponderance, and larger kidney sizes. The study contributes to the understanding of living kidney donors' profiles in the region and highlights the importance of individualized assessments in the donor selection process.

Machine Learning Oriented Heart Disease Prediction using Clinical Data with Genetic Factors: A Overview

Abstract: The critical global health concern of heart disease is to focus on improving its prediction accuracy through the integration of clinical data and genetic factors using machine learning. The primary aim is to develop a highly accurate predictive model that can revolutionize heart disease diagnosis and enhance healthcare outcomes. Machine learning, a branch of artificial intelligence, offers the potential to create systems that can learn from historical data and make informed predictions, particularly in the medical field. The research measures the likelihood of patients being diagnosed with cardiovascular heart disease based on a range of medical attributes, including age, gender, chest pain, and fasting sugar levels. A dataset from Kaggle, comprising comprehensive patient medical histories and attributes, is leveraged, utilizing 14 medical attributes to predict heart disease risk. The research incorporates four unique machine learning algorithms, namely Logistic regression, Support Vector Machines (SVM), Decision Trees, and Random Forest Classifier, to classify individuals into two groups: those who are susceptible to heart disease and those who are not. The research endeavours to significantly enhance heart disease prediction accuracy, providing a promising avenue for personalized healthcare and early detection. Through the synergy of clinical and genetic data and the capabilities of machine learning, it aims to contribute to more precise risk assessment, timely treatment, and ultimately better outcomes for individuals at risk of heart disease.

Current clinical profiles of acute respiratory tract infections in children between 2 months to 5 years

Background: The nascent respiratory tract of infants is highly vulnerable to frequent infections, thereby making acute respiratory infections a major risk factor for under five years morbidity and mortality. The clinical presentation of acute respiratory tract infections (ARTI) is however ambiguous and varied depending on a plethora of factors. The aim was to delineate the respiratory disease profiles of children aged 2 months-5 years in Western Maharashtra. Methods: The present cross sectional analytical study was conducted on 249 children aged between 2 months-5 years consulting the Pediatric wards and OPD with complaints of fever with cough, cold, breathlessness, and chest pain. A comprehensive medical history was procured, followed by general and systemic examinations. Infections were assessed and x-ray was taken for all the patients. Data was analyzed using statistical software R version 4.0.3 and Microsoft Excel. Results: The male:female ratio in the study was 137:112. Cold (80.72%) and cough (74.3%) were the most widely experienced symptoms among patients, while chest pain (0.8%) was the least common. Among 249 cases, upper respiratory tract infection (URTI; 60%) was more predominantly noted than lower respiratory tract infections (LRTI; 44.8%). Nasopharyngitis (34.14%) and tonsillopharyngitis (6.83%) were the commonly prevalent types of URTI whereas pneumonia and bronchiolitis were the most recurrent types in the LRTI. Conclusions: Practitioners must consider the possibility of acute URTI more closely and must not be quick to disregard common symptoms such as cold and cough. Misdiagnosis or delayed diagnosis can severely hamper the prognosis of ARTI in young children. Hence, keeping abreast of the current clinical profiles exhibited by ARTI is of paramount importance for practitioners and the general population in the fight against under 5 mortalities.

Multi-Instance Contingent Fusion for the Verification of Infant Fingerprints

It is imperative to establish an automated system for the identification of neonates (1–28 days old) and infants (29 days–12 months old) through the utilisation of the readily accessible 500 ppi fingerprint reader. This measure is crucial in addressing the issue of newborn swapping, facilitating the identification of missing children, monitoring immunisation records, maintaining comprehensive medical history, and other related purposes. The objective of this study is to demonstrate the potential for future identification of infants using fingerprints obtained from a 500 ppi fingerprint reader by employing a fusion technique that combines multiple instances of fingerprints, specifically the left thumb and right index fingers. The fingerprints were acquired from babies who were between the ages of one day and six months at the enrolment session. The sum-score fusion algorithm was implemented. The approach mentioned above yielded verification accuracies of 73.8%, 69.05%, and 57.14% for time intervals of 1 month, 3 months, and 6 months, respectively, between the enrolment and query fingerprints.

Prosthetic rehabilitation of unilateral midfacial defect resulting from flap related complication: A case report of clinical challenges and their solutions.

Composite defects of the head and neck region after oncologic resection are challenging and require reconstruction of several layers, including the intraoral lining, osseous reconstruction of the mandible or maxilla and soft tissue/skin coverage. Management of complications resulting from flap failure is a challenging task from a technical and aesthetic perspective that can have a substantial social and psychological impact on those affected. This clinical report describes prosthetic rehabilitation of a lateral midfacial defect and the clinical challenges encountered and their solutions in a patient with carcinoma of gingivobuccal complex who underwent composite bite resection, reconstruction and adjuvant radiation therapy. A conventional approach that employed an acrylic substructure and silicone (one-piece) prosthesis was implemented to address the cutaneous cheek defect taking into account history of recent radiotherapy and comprehensive medical history. The delivered prosthesis effectively restored the lost facial contour and concealed the facial defect, contributing to aesthetics and improving the patient's quality of life.

Clinico-etiological profile of chronic liver disease in females: A cross-sectional observational study in Eastern Indian set-up

Abstract Background: There are notable distinctions in the epidemiology, progression, symptoms, and treatment responses observed between males and females with chronic liver disease (CLD). Women tend to exhibit a higher prevalence of acute liver failure, autoimmune hepatitis, benign liver lesions, primary biliary cirrhosis, and toxin-induced liver injury compared with men. This study investigated the clinical and pathological characteristics of CLD in female patients admitted to a tertiary healthcare facility in eastern India. Materials and Methods: An observational cross-sectional study was conducted involving adult female patients meeting the criteria for CLD. Comprehensive medical histories were obtained, physical examinations were conducted, and various investigations were performed, including complete blood count, liver function tests, urea, creatinine, and electrolyte levels. Additionally, all cases underwent whole abdomen ultrasound, with selected cases undergoing further viral profiling and upper gastrointestinal workups. The collected data underwent statistical analysis. Results: Among the 80 cases of CLD examined in our study, 62.5% fell within the age range of 41–60 years. Metabolic dysfunction associated with steatohepatitis (MASH) and hepatitis C were identified as the primary causes of CLD, collectively accounting for 50% of all cases. Specifically, 25% of cases were attributed solely to hepatitis C, whereas another 25% were attributed solely to MASH. Additionally, two cases presented with a combination of MASH and hepatitis C. Pallor and jaundice were the most frequently observed clinical findings. Notably, autoimmune hepatitis tended to occur in younger females, whereas MASH was more prevalent in those aged over 51 years. Conclusion: There are distinctions based on gender concerning the causes, advancement, natural course, complications, and outlook of CLD cases. Therefore, it is essential to consider gender-specific traits when diagnosing and treating CLD in females.

FNDC5 genetic polymorphism in patients with peripartum cardiomyopathy.

Late in pregnancy or soon after delivery, peripartum cardiomyopathy (PPCM) which is an uncommon type of cardiomyopathy, can develop. To assess the association between the level of irisin expression and (FNDC5) (rs3480) gene polymorphism with peripartum cardiomyopathy. This is a case control study included a thirty female patients with new-onset PPCM and sixty healthy females at the at the peripartum period in same time window for PPCM as a control. For each patient, comprehensive medical history was taken, full clinical assessment was done, ECHO., FNDC5 (rs3480) & Irisin assay. The left ventricle end diastolic dimensions &left atrium diameters were statistically significant higher in patients' group than controls' group (P=0.000 for all), Also left ventricular ejection fraction (%) was statistically significant lower in patients than controls and as regards irisin, its Mean ±SD was lower in patient group than control group (8.44±1.1 vs 10.65±2.31) with (p <0.001) which is considered a significant difference statistically. Irisin level was lower in peripartum cardiomyopathic patients when compared with normal individuals and regarding its genotype, the homotype A/A was higher than homotype G/G.

Procena odnosa između nivoa TWEAK-a u serumu i stepena vaskularne uključenosti kod pacijenata sa stabilnom anginom pektoris

Introduction: This study investigates the relationship between serum TWEAK levels and the degree of vascular involvement in patients with stable angina pectoris, offering insights beyond conventional cardiovascular risk factors. Materials and Methods: This study involved 88 patients (33 women, 55 men) diagnosed with stable angina pectoris. Patients were classified based on angiographic findings. Comprehensive demographic and medical history data were collected, and morning blood samples were analyzed, focusing on TWEAK and IL-6 levels. To assess the severity of coronary artery lesions, a modified version of the Gensini scoring system was employed. Results: Analyses revealed no significant correlation between TWEAK levels and the severity of coronary artery disease. Although some variations in biochemical markers were observed based on gender and diabetic status, these differences did not exhibit a statistically significant relationship with the degree of vascular involvement. Conclusion: The findings indicate that serum TWEAK levels do not have a significant association with the severity of vascular involvement in patients with stable angina pectoris. These results highlight the limited efficacy of TWEAK as a sole biomarker in assessing the severity of coronary artery disease, emphasizing the complexity of its role.