Fourth Decade Of Life Research Articles

Giant Epididymal Cyst in the Right Testicle: Case Report and Literature Review.

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.

Bilateral Idiopathic Neuroretinitis.

Neuroretinitis (NR) is a rare inflammatory condition characterized by sudden vision loss, optic disc edema and macular star appearance predominantly affecting individuals in their third and fourth decades of life. This paper describes the case of 33-year-old Caucasian man with no significant medical history complaining of decreased vision for about a week. The ophthalmological exam revealed best-corrected visual acuity (BCVA) for the right eye (RE) of 0.8 (decimal notation) and of 0.9 for the left eye (LE). Intraocular pressure (IOP) was 20 mmHg in RE and 18 mmHg in LE. Slit-lamp examination of both eyes (OU) showed no evidence of intraocular inflammation in the anterior chamber or vitreous cavity. Examination of the posterior pole of the right eye showed bilateral papilledema with an incomplete macular fan pattern. Despite extensive laboratory tests, including serologic and imaging investigations, a definitive etiology remained unclear. It is very important to differentiate NR from other optic nerve disorders, requiring careful clinical evaluation and observation of the evolution of symptoms.

Primary Mediastinal Large B-cell Lymphoma – A Case Report

AbstractPrimary mediastinal large B-cell lymphoma (PMBL) is an uncommon and aggressive subtype of non-Hodgkin large B-cell lymphoma that affects patients in the third and fourth decades of life. The objective of the present report is to describe the case of a male patient admitted to the emergency room with symptoms of dyspnea associated with signs of superior vena cava syndrome. The imaging exams revealed two masses in the mediastinum; the definitive diagnosis, established through an anatomopathological examination and immunohistochemistry, was of PMBL, and the patient was referred for chemotherapy.

6457 You Are Never Too Old For Pheo

Abstract Disclosure: M. Masumy: None. B. McAdams: None. P. Mikkilineni: None. Introduction: Pheochromocytomas (PCC) are a rare neuroendocrine tumor derived from chromaffin cells. The incidence is estimated at 8 in 1 million individuals with no sex or ethnic predilection. It is estimated that 0.05-0.2% of hypertensives may have PCC. Its incidence generally peaks between the third and fifth decades of life. The classic PCC symptoms are headaches, hypertension, palpitations, pallor and tachycardia. However, most patients may not present with these symptoms, and may go undiagnosed. Untreated PCC can have significant morbidity and mortality such as MI, CVA, and hypertensive crises. The current standard of evaluation for PCC includes obtaining serum metanephrines, then if significantly elevated, obtaining CT imaging. Oftentimes, surgical resection is the treatment of choice, but PCC may recur, thus regular follow up is needed. We present a case of PCC in an elderly patient who developed symptoms over a year. Case presentation: A 72-year-old Caucasian female with diabetes presented to the emergency department with palpitations, severe headache, flushing and hypertension. She began experiencing these spells several months earlier with increasingly difficult to manage hypertension. She also had a CVA and NSTEMI earlier in the year. Her blood pressure regimen included amlodipine 20 mg, valsartan 160 mg, and carvedilol 12.5 mg bid. Despite this her blood pressure was uncontrolled. She also had palpitations and unease up to an hour after taking valsartan. Due to her symptoms; PCC was suspected. Serum metanephrines were obtained with her normetanephrines measured at 3334.7 pg/ml and metanephrines were 475.6 pg/ml, these were significantly elevated and thus an abdominal CT scan was done. On CT, she was found to have a 4.9 cm x 4.4 cm left adrenal mass with a density of 31 Hounsfield units. Her symptoms, labs and imaging were strongly indicative of PCC and she was referred to surgery. Her previous blood pressure medications were discontinued, and doxazosin was titrated to a goal SBP of 120 mmHg. Then metoprolol was added to attain a goal heart rate below 70 bpm. She then underwent a successful laparoscopic left adrenalectomy. She is now on 5mg of amlodipine for her blood pressure and metformin for her diabetes. She will be having regular follow ups to monitor for pheochromocytoma recurrence. Conclusion: Though pheochromocytoma is a rare entity that affects individuals primarily in the third and fourth decade of life, it may also occur in elderly patients. In patients with difficult hypertension, screening with metanephrines may be indicated if these are significantly elevated CT imaging should be obtained. When obtaining CT imaging, Hounsfield units are important in characterizing PCC. Achieving adequate alpha blockade before beta blockade is also essential pre-surgery for the best outcome. Even after surgery, patients will require lifelong follow up to monitor for recurrence. Presentation: 6/1/2024

Evaluation of Periapical Granuloma and Radicular Cyst Regarding the Age, Gender and The Lesion Size

Background: Apical periodontitis (AP) is a common infectious disease characterized by inflammation and bone destruction in the periapical tissues due to microbial infection in the dental pulp . AP is the most frequent inflammatory lesion related to teeth, distinguished by a direct pathway to the bone marrow without epithelial barriers if the dental pulp becomes necrotic and infected. Materials and methods: Thirty paraffin embedded tissue blocks of radicular neck resected samples of 18 preapical granulomas and 12 radicular cysts were processed histopatholgically. Results: the mean patients’ age was 34.37 ± 2.95 years; fifteen patients were aged bellow 30 years and 15 patients were equal or above 30 years. The mean lesions size was significantly higher among patients with radicular cysts than preapical granuloma (5.07 ± 1.35 vs. 0.94 ± 0.21; p=0.048. granulomas lesions were slightly higher among females in age group 30-39 years ( 25% vs. 10%), and the radicular cysts lesions were higher among females in all age group as compare to male patients Conclusions: Lesions size was significantly higher among patients with radicular cysts than that of preapical granuloma. A peak incidence between the third and fourth decades of life and predominance among female

Cemento-ossifying fibroma: an extensive fibro-osseous lesion involving paranasal sinuses

Cemento-ossifying fibroma (COF) is a fibro-osseous lesion arising from cells of the periodontal ligament. This tumor typically occurs in individuals during their third and fourth decades of life, with a predilection for women. COF primarily affects the maxillofacial region, most commonly the mandible. Its localization in the paranasal sinuses and skull base is unusual. However, we present a rare case of COF involving the right paranasal areas of the maxillofacial region in an 18-year-old female. Computed tomography (CT) revealed an expansile lesion measuring 52.45×32×74.29 mm involving the right maxillary sinus, expanding into both the anterior and posterior choanae. The patient underwent endoscopic sinus surgery (ESS) with preservation of adjoining vascular structures. Clinical, radiographic, and histologic features are presented, and differential diagnosis is discussed.

Challenges and opportunities in transitional care process in Behçet's syndrome.

Behçet's syndrome (BS) is a rare chronic multi-systemic inflammatory disorder that usually involves adults between third and fourth decades of life, while pediatric and juvenile onset are relatively rare. BS young patients (YP) often develop a full-blown disease late after onset, requiring careful diagnostic workup and regular follow-up while they grow up. In this regard, the purpose of transitional programs is to ensure continuous high-quality care to YP with chronic conditions, providing them with the skills necessary to become independent and empowered adults able to chronically self-manage their disease. EULAR/PReS released the first set of standards and recommendations for transitional care (TC) of YP with juvenile-onset rheumatic diseases, but the appropriate timing for transition, the tools to evaluate patients' readiness, and indicators of transition plans effectiveness still need to be identified. Although little is known regarding TC in BS, it is easy to assume that BS YP will benefit from developmentally and disease-specifically appropriate transition plans, which may promote continuity of care, improve perceived quality of life and prevent poor disease outcomes. This perspective article discusses the key concepts and the goals of TC, addressing the potential challenges and opportunities of TC for YP with BS in clinical practice.

NAD+ Metabolism and Mitochondrial Activity in the Aged Oocyte: Focus on the Effects of NAMPT Stimulation.

The ovary experiences an age-dependent decline starting during the fourth decade of life. Ovarian aging is the predominant factor driving female reproductive aging. Modern trend to postpone childbearing age contributes to reduced fertility and natality worldwide. Recently, the beneficial role of NAD+ precursors on the maintenance of oocyte competence and female fertility affected by aging has emerged. Nevertheless, age-related changes in NAD+ regulatory network have not been investigated so far. In this context, our goal was to investigate changes induced by the aging process in the expression level of genes participating in NAD+ biosynthetic and NAD+ consuming pathways and in the cellular bioenergetics in the mouse oocyte. From Ingenuity Pathway Analysis (IPA) it emerged that aging caused the downregulation of all cellular pathways for NAD+ synthesis (Kynurenine pathway, Preiss-Handler pathway and NAD+ salvage pathway) and deeply influenced the activity of NAD+-dependent enzymes, i.e. PARPs and SIRTs, with effects on many cellular functions including compromised ROS detoxification. Considering that NAMPT, the rate-limiting enzyme of NAD+ salvage pathway, was deregulated, aged oocytes were matured in the presence of P7C3, NAMPT activator. P7C3 improved spindle assembly and mitochondrial bioenergetics and reduced mitochondrial proton leak. Moreover, P7C3 influenced gene expression of NAD+ regulatory network, with Sirt1 as the central node of IPA-interfered target gene network. Finally, P7C3 effectively counteracted oocyte alterations induced by exposure to oxidative stress. Our study contributes to establish effective NAD+ boosting interventions to alleviate the effects of advanced maternal age on fertility and explore their potential in redox-related fertility disorders.

Perforated Peptic Ulcer in Lagos. Risk Factors and Management Outcome

Abstract Background: Complications of peptic ulcers, such as bleeding, gastric outlet obstruction, and perforation, can be life-threatening and may require surgical intervention. Perforated peptic ulcer (PPU) presents mostly as a surgical emergency and is one of the leading causes of secondary peritonitis with significant morbidity and mortality. The clinical outcome of surgical treatment of peptic ulcers varies due to the varying patterns of presentations and interventions between countries. There are few documented series on PPU in Nigeria. This paper reviews the management outcome of PPU in our institution. Materials and Methods: A retrospective review of the available medical records of patients managed for PPU between February 2008 and February 2023 was conducted. All patients had a single anterior peptic ulcer perforation managed by a modified Graham’s patch. Data analysis was performed using IBM SPSS for Windows, Version 23 (IBM Corp., Armonk, NY, USA). Results: There were 107 PPU patients comprising 93 males and 14 females. The mean age of all patients was 41 years. The peak prevalence of PPU was found among patients aged 30–39 years. Delayed presentation was recorded in about half of the patients. Ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) was the most common risk factor for PPU. Among the 93 documented cases, perforated gastric ulcers (71 cases) were found in a much higher proportion than duodenal ulcers (22 cases). Large ulcer (10–30 mm) was the main perforation size category found in 47 out of 83 recorded PPU cases. PPU size was not associated with the incidence of complications or mortality. The median duration of hospital stays was 13 (1–19) days. Surgical site infection was the most common complication after surgery. Conclusion: PPU is present in our predominantly male patients in their fourth decade of life. Ingestion of NSAIDs is a major risk factor. Duodenal ulcers were the predominant type seen in our patients. Documented perforated ulcer sizes in our patients are predominantly in the large category. Surgical site infection, systemic sepsis, and superficial wound infection were major complications in our patients.

Prevalence and Clinico-pathologic Profile of Biopsied Gingival Lesions from 2 Thai Dental Schools.

Gingiva can be afflicted by several pathological entities apart from gingivitis and periodontitis. There have been limited number of studies on gingival lesions, especially from Thailand. Aim: To analyze the prevalence and distribution of biopsied gingival lesions from Chulalongkorn and Rangsit Dental Schools, Thailand. Biopsy records of the participating institutions from 1995 to 2020 were reviewed for gingival lesions. The demographic data, site of lesions and diagnoses were collected. Data were analyzed by descriptive statistics. From a total of 16,207 biopsies, 1,589 cases (10.2%) were diagnosed in the category of gingival lesions. The mean age ± SD of the patients was 42.3 ± 18.6 years with the highest prevalence being in the fourth decade of life (17.4%). A male-to-female ratio was 0.48:1. The most common location was the posterior mandible (27.4%). Regarding the type of gingival lesions, non-neoplastic lesions (88.5%) outnumbered neoplastic lesions (11.5%). The most common lesion was pyogenic granuloma, followed by irritation fibroma and peripheral ossifying fibroma. Among the neoplastic lesions, squamous cell carcinoma was the most prevalent lesion followed by papilloma and lymphoma. Gingival lesions mostly occur in the fourth decade of life and have a predilection for female patients. The majority of the lesions are located in the posterior mandible. Non-neoplastic lesion, especially the reactive subtype, is the most prevalent group and pyogenic granuloma is the most common gingival lesion. Data from this study represent biopsied gingival lesions from Thailand which may be different from those of other countries. Key words:Gingival lesions, prevalence, demographic, clinico-pathological correlation, gingival biopsy.

Correlation of Clinical and Electrophysiological Criteria in the Diagnosis of Guillain-Barré Syndrome: A Prospective Observational Study.

There are many criteria for diagnosing Guillain-Barré syndrome (GBS), and the yield of these diagnostic criteria varies. Each criterion requires some laboratory data and nerve conduction studies (NCS). Although supportive laboratory data are reassuring when present in suspected cases of GBS, when absent, they can potentially cause further delay in diagnosis and treatment. There is no gold standard test for the diagnosis of GBS, and there are multiple diagnostic criteria for GBS to date. The aim of the study is to know the sensitivity of different criteria, clinical and electrophysiological, for the diagnosis of GBS and to study the clinical spectrum and electrophysiological spectrum of GBS in our cohort of patients. We studied a total of 43 cases who presented with one or more of the following symptoms: relatively symmetrical and progressive flail-type weakness of more than one limb, with or without ataxia and/or ophthalmoplegia, and were diagnosed with GBS according to clinical criteria at the time of admission to Government Stanley Medical College Hospital. GBS mimics were ruled out. In all patients, the demographic data, cerebrospinal fluid (CSF) analysis (if done), and electrophysiological findings fitting into the diagnostic criteria of National Institute of Neurological Disorders and Stroke (NINDS), Dutch, and Brighton criteria were recorded. The need for assisted mechanical ventilation, neurology intensive care unit (NICU) stay, any complications, and treatment outcome details were recorded in a structured proforma. Most of the patients in our study were in their fourth decade of life, with a mean age of 41.37 years, similar to previous studies from India. Men are more frequently affected compared to women, similar to what has been observed in most studies done previously worldwide. In our study, electrophysiological criteria by Dutch criteria (87.5%), Brighton criteria (87.5%), and NINDS criteria (85.6%) had low sensitivity compared to the clinical criteria. In the present study, electrophysiological criteria proposed by the NINDS, Dutch, and Brighton criteria are less sensitive compared to clinical criteria in diagnosing GBS at early stages. Clinical criteria alone may be useful in resource-poor countries and at peripheral healthcare systems where NCS are not always readily available.

A Study on Clinical and Immunological pattern of Systemic Lupus Erythematosus patients in a Tertiary care Hospital – A Retrospective Study

Introduction Systemic Lupus Erythematosus (SLE) is a Chronic Multisystem Autoimmune disorder that exhibits a wide spectrum of clinical and immunological abnormalities ranging from localized cutaneous involvement to life-threatening systemic involvement. The heterogeneity of SLE manifestations is due to an interplay of genetic, environmental, and hormonal influences[1]. Onset occurs commonly in women of reproductive age, in the third and fourth decades of life, with a Male: Female ratio of about 1:10. The clinical course of the disease is unpredictable with periods of remission and flares.

Jejunal Perforation Due to Histoplasmosis Regarding a Case.

Histoplasmosis is an increasing infection that mainly affects immunocompromised individuals such as patients with HIV/AIDS, with the disseminated form, especially gastrointestinal, being common in this population. The clinical presentation ranges from asymptomatic to symptoms that mimic other abdominal diseases. Jejunal perforation due to histoplasmosis, although rare, has been reported in a few cases, typically in men living with HIV in their fourth decade of life. We present the case of a 34-year-old male, with a history of HIV and colonic histoplasmosis who presented with acute abdominal pain requiring exploratory laparotomy and intestinal resection due to jejunal perforation, with histological confirmation of histoplasmosis in the resected intestinal segment.

Patient-reported outcomes and functional assessments of patients with Alkaptonuria in a 3-year Nitisinone treatment trial

Alkaptonuria is a rare disorder of tyrosine catabolism caused by deficiency of homogentisate 1,2-dioxygenase that leads to accumulation of homogentisic acid (HGA). Deposition of HGA-derived polymers in connective tissue causes progressive arthropathy of the spine and large joints, cardiac valvular disease, and genitourinary stones beginning in the fourth decade of life. Nitisinone, a potent inhibitor of the upstream enzyme, 4-hydroxyphenylpyruvate dioxygenase, dramatically reduces HGA production. As such, nitisinone is a proposed treatment for alkaptonuria. A randomized clinical trial of nitisinone in alkaptonuria confirmed the biochemical efficacy and tolerability of nitisinone for patients with alkaptonuria but the selected primary outcome did not demonstrate significant clinical benefit. Given that alkaptonuria is a rare disease with slow progression and variable presentation, identifying outcome parameters that can detect significant change during a time-limited clinical trial is challenging. To gain insight into patient-perceived improvements in quality of life and corresponding changes in physical function associated with nitisinone use, we conducted a post-hoc per protocol analysis of patient-reported outcomes and a functional assessment. Analysis revealed that nitisinone-treated patients showed significant improvements in complementary domains of the 36-Item Short-Form Survey (SF-36) and 6-min walk test (6MWT). Together, these findings suggest that nitisinone improves both quality of life and function of patients with alkaptonuria. The observed trends support nitisinone as a therapy for alkaptonuria.

Epilepsy in inmate patients seen in a high complexity reference hospital in Colombia: A cross-sectional study.

To describe the sociodemographic and clinical characteristics of imprisoned patients with epilepsy seen at Samaritana University Hospital (HUS) in Bogotá D.C., between January 2017 and November 2020. Cross-sectional cohort study of inmate patients over 18 years of age seen at HUS between January 2017 and November 2020, with a discharge diagnosis of epilepsy. A descriptive univariate analysis of patient sociodemographic and clinical characteristics was carried out. Overall, 92 patients were included, 95.7% were males with a median age of 32 years (IQR: 26-44); 65% were assessed in the outpatient clinic; median hospital length of stay was 2 days (IQR: 0) and 7.6% required admission to the intensive care unit; 75% had focal onset epilepsy, 63.04% with undetermined etiology 31.52% with structural causes. Polytherapy was found in 53.3%, valproic acid being the most frequently used antiseizure medication in 59.78%; lack of adherence was reported in 15.22% and inadequate seizure control in 81.52%; status epilepticus occurred in 5.34%. A total of 31 EEG recordings and 53 brain images were performed, of which, 29% and 39.62%, respectively, were abnormal. Non-epileptic paroxysmal events were diagnosed in 5.34%, while organic or psychiatric comorbidities were found in 25%, and the use of psychoactive substances was documented in 17.39%. Upon discharge, 93.47% had no disability, and only 45.65% returned for outpatient follow-up. The clinical profile was of men in the fourth decade of life with focal onset epilepsy characterized by high seizure frequency, most of whom were receiving antiseizure medication, with a high proportion of polytherapy. The results are a point of departure for prospective studies designed to identify points to intervene and improve healthcare for inmates with epilepsy. Inmates are a vulnerable proportion of persons with epilepsy. In this group there are significant differences compared to the general population, especially with greater psychiatric comorbidity and worse control of epileptic seizures due to difficulties in accessing medical care, antiseizure medication and diagnostic tests. We found that the most characteristic population is made up of men in the fourth decade of life with a high frequency of seizures, most of whom were receiving multiple antiseizure medication This study is the first of its kind in Latin America and it is an initial approach to epilepsy in inmates.

Characteristics of blunt and penetrating trauma among victims of physical violence: A retrospective study

BackgroundA significant number of referrals to the emergency departments is due to violence and conflict leading to serious injuries and death. The increasing number of such cases highlights the urgent need for investigating victimization of physical violence.AimThe purpose of this study was to determine the frequency of demographic and clinical characteristics in victims of violence and classify them based on penetrating or blunt trauma.MethodsThe data of the patients who had been the victims of violence in 2020 were extracted from the Trauma Registry System(TRS) of the Guilan Road Trauma Research Center(GTRC). All analyses were performed using SPSS software version 24. The significance level was considered less than 0.05.ResultsThere was a significant difference in the type of violence-related trauma in different age groups (P < 0.001), based on sex (P = 0.002), and marital status (P = 0.012). A significant difference also existed between the trauma type and clinical variables including smoking (P = 0.032), history of alcohol drinking (P = 0.005), and other substance use (P = 0.002), the anatomical location of injury (P < 0.001) and therapeutic interventions (p < 0.001(.ConclusionMost of the clients of the violence suffered from blunt trauma, the severity of which was mild, and they were treated supportively without the need for surgery. Blunt trauma was seen more in women, divorcees, over 40 years and non-smokers. Penetrating trauma was observed more in lower limb injuries and alcohol and amphetamine users. Prevention programs and educational interventions should be programmed for the society long before men alcohol and amphetamine abusers reach their fourth decade of life. Accurately recording the type of physical violence, and the weapon used, and determining the injury severity score in TRS can lead to more reliable results in researching the field of violence issues.

Pulmonary Alveolar Microlithiasis in a Young Man Undergoing Lung Transplantation: A Case Report.

Pulmonary alveolar microlithiasis is a rare disease characterized by the deposition of microliths in the alveoli, attributed to mutations in the solute carrier family 34 member 2 (SLC34A2) gene. Diagnosis is often incidental to chest imaging, most frequently occurring between the second and fourth decades of life. The disease follows a progressive course and manifests with a clinical-radiological dissociation. No effective treatment is known except for lung transplantation.We report on a 28-year-old Hispanic male patient with no relevant personal or family history, presenting with progressive exertional dyspnea and intermittent dry cough. He was referred for evaluation by pulmonology due to abnormal findings on chest x-ray. High-resolution computed tomography revealed diffuse lung opacities caused by multiple microcalcifications, suggesting pulmonary alveolar microlithiasis with additional signs of pulmonary hypertension. Throughout his clinical course, he experienced a decline in functional class with severe impairment in pulmonary function tests. He underwent transplant evaluation, and the procedure was performed, with reported complications including airway stenosis, which were managed. Despite these challenges, the patient eventually showed positive progress and maintained an adequate functional class.Pulmonary alveolar microlithiasis is a rare disease with a chronic clinical course and variable manifestations. Its progressive deterioration leads to chronic respiratory failure. A high index of suspicion is required when evaluating characteristic radiological findings and conducting relevant differential diagnoses. No specific treatment guidelines are available, and lung transplantation emerges as the only effective therapy, as illustrated in the described patient.

Demographic profile of thyroid malignancies in a tertiary care centre in South India

: Thyroid carcinomas were significantly on the rise all over the world, with 5.86 lakh new cases and 43,664 deaths reported in 2020. In this study, we focused on a detailed analysis pertaining to the incidence and demographic profile of all histological types of thyroid malignancies. : All cases of thyroid carcinomas reported in the department of Pathology at a tertiary care center in South India from January 2016-December 2020 were included in this study. The demographic profile and patient details were obtained from the medical records section. Pathology reports of the included cases were retrieved, and associated factors were analysed. : Out of the 98 cases included in the study, 16 cases (16.3%) were below 30 years of age, 44 cases (44.9%) were 30-50 years of age and 38 cases (38.8%) were above 50 years of age. The mean age was 45.78. Female preponderance was noted, with 66 cases (67.3%) being females and 32 cases (32.65%) were males. The histopathology results revealed 90 cases (91.8%) to be papillary carcinoma, 1 case (1.02%) of medullary carcinoma, 1 case (1.02%) of Insular carcinoma, 5 cases (5.102%) of follicular carcinoma and 1 case (1.02%) of anaplastic carcinoma. Most of the cases were classified as T1 tumours (45.91%) under the TNM classification. 24 cases (24.49%) were graded as N1 (Metastasis to regional nodes). 3 cases (3.06%) exhibited distant metastasis. Majority of the cases (71.42%) were samples from a total thyroidectomy procedure. : In our demographic study, we have noted that thyroid carcinomas have a peak incidence in the fourth decade of life with a female preponderance. Majority of the cases were noted to be papillary carcinomas in histological type. Understanding the histopathology and TNM staging of thyroid carcinomas is crucial for the selection of appropriate treatment modalities, predicting patient prognosis and clinical outcomes.

Intestinal Intussusception in Adults: A Diagnostic Challenge

Intussusception, a rare cause of intestinal obstruction in adults, accounts for only 1% of obstruction cases and 5% of all intussusceptions. Its global incidence is 1-3 cases per million per year. Early identification is challenging, which can lead to significant morbidity and mortality. In adults, intussusception is often associated with benign or malignant lesions, with primary adenocarcinoma being the principal cause. Preoperative diagnosis can be complex, and computed tomography (CT) is considered the preferred imaging modality. Most cases require surgical intervention, and the decision on whether to reduce before resection depends on the type and location of the lesion. Both laparoscopic and open surgeries are valid options, depending on clinical conditions and the surgical team's experience. We present the case of a patient in their fourth decade of life with a 15-day history, who presented to the emergency room with symptoms of intestinal obstruction secondary to intussusception. An emergency laparotomy was performed, revealing intussusception from the ascending colon to the transverse colon with a neoplastic-looking lesion in the cecum. A right radical hemicolectomy with intestinal diversion was performed. Histopathological examination revealed a moderately differentiated grade 2 adenocarcinoma.

Advances in Systemic Lupus Erythematosus Treatment With Monoclonal Antibodies: A Mini-Review.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems. It is characterized by the production of abnormal antibodies that attack healthy cells and tissues. The disease presents a wide range of symptoms and severity, from mild to severe. Diagnosis can be complex, but the classification criteria of the American College of Rheumatology (ACR) help to facilitate it. Incidence and prevalence vary considerably worldwide, mainly affecting adult women between the third and fourth decades of life, although it can also occur in childhood. The prognosis of SLE has improved over time, but there is still a risk of irreversible organ damage. Treatment is individualized for each patient and is based on immunosuppression and the use of corticosteroids. Biological therapies, such as monoclonal antibodies, have emerged as a more specific alternative. Methotrexate, antimalarials, glucocorticoids, immunosuppressants, and monoclonal antibodies are some of the medications used to treat SLE. New therapeutic strategies are currently being developed, such as targeted therapies, immunomodulators, and biological agents. Treatment adherence, monitoring, and regular follow-up are important aspects of SLE management. This article aims to describe the characteristics of the new monoclonal antibody therapies that exist for the management of SLE.