Condition Of Patient Research Articles

Cutting-edge Advances in Nanocarrier-Facilitated Topical Drug Delivery Systems for Targeted Skin Cancer Therapy: A Comprehensive Review.

Skin cancer is one of the most common and complex types of the disease, resulting in a high mortality rate worldwide. Skin cancer can be treated with chemotherapy, surgery, radiotherapy, etc. In most cases, a patient's condition and the type of skin cancer determine the recommended treatment options. As a result of poor penetration of the drug into stratum corneum or lesions, low efficacy, and higher concentrations of active pharmaceutical ingredients required to achieve a therapeutic effect, the efficacy of skin cancer therapy has been limited. The high dose requirement, as well as poor bioavailability at the site of action, causes skin inflammation, which greatly hinders drug absorption. This review mainly focuses on research on nanocarriers for sitespecific and controlled delivery of therapeutics for skin cancer treatment. The information related to various nanocarriers systems for skin cancer will be illustrated. This also focused on patents, clinical trials, and research carried out in the field of liposomes, niosomes, ethosomes, nanoparticles, microemulsion, nanoemulsions, gels, nanogels, hydrogels, dendrimers, and nanofibers for treating skin cancer. Nanotechnology-based therapy has shown great promise in controlling skin cancer and can be used to deliver drugs more effectively.

Intracranial dissemination of Klebsiella pneumoniae originating from pulmonary infection: a case report

BackgroundMetastatic brain abscesses caused by Klebsiella pneumoniae are extremely rare but life-threatening conditions. To depict a unique case of the middle-aged hypertensive man with an unusual presentation of metastatic brain abscesses originating from a pleural abscess caused by Klebsiella pneumoniae and subsequently leading to loss of consciousness (LOC).Case reportA 52-year-old Iranian man with a history of hypertension presented to the emergency department with a five-day history of worsening cough, high-grade fever, shortness of breath, chest pain, fatigue, and a productive cough. Laboratory tests revealed leukocytosis, elevated C-reactive protein, and respiratory alkalosis. A chest computed tomography scan confirmed pneumonia, and a brain scan revealed multiple hypodense lesions. Despite antibiotic therapy, the patient's condition worsened, leading to confusion, disorientation, and loss of consciousness. Magnetic resonance imaging revealed multiple ring-enhancing lesions, suggesting an abscess formation. Bronchial washings and BAL samples confirmed a lower respiratory tract infection. Cultures from the bronchial washings grew Klebsiella pneumoniae.ConclusionsMetastatic brain abscesses caused by Klebsiella pneumoniae are exceedingly rare but life-threatening conditions. Timely diagnosis and effective antimicrobial treatment are critical for patient outcomes. This case underscores the significance of recognizing atypical presentations of bacterial infections, as early detection and appropriate management can significantly impact patient outcomes.

A dimensional analysis of experienced intensive care unit nurses' clinical decision-making for bleeding after cardiac surgery.

Bleeding following cardiac surgery is common and serious, yet a gap persists in understanding how experienced intensive care nurses identify and respond to such complications. To describe the clinical decision-making of experienced intensive care unit nurses in addressing bleeding after cardiac surgery. This qualitative study adopted the Recognition-Primed Decision Model as its theoretical framework. Thirty-nine experienced nurses from four adult intensive care units participated in semi-structured interviews based on the critical decision method. The interviews explored their clinical judgements and decisions in bleeding situations, and data were analysed through dimensional analysis, an alternative to grounded theory. Participants maintained consistent vigilance towards post-cardiac surgery bleeding, recognizing it through a haemorrhagic dimension associated with blood loss and chest drainage and a hypovolemic dimension focusing on the repercussions of reduced blood volume. These dimensions organized their understanding of bleeding types (i.e., normal, medical, surgical, tamponade) and necessary actions. Their decision-making encompassed monitoring bleeding, identifying the cause, stopping the bleeding, stabilizing haemodynamic and supporting the patient and family. Participants also adapted their actions to specific circumstances, including local practices, professional autonomy, interprofessional dynamics and resource availability. Nurses' decision-making was shaped by their personal attributes, the patient's condition and contextual circumstances, underscoring their expertise and pivotal role in anticipating actions and adapting to diverse conditions. The concept of actionability emerged as the central dimension explaining their decision-making, defined as the capability to implement actions towards specific goals within the possibilities and constraints of a situation. This study underscores the need for continual updates to care protocols to align with current evidence and for quality improvement initiatives to close existing practice gaps. Exploring the concept of actionability further, developing adaptability-focused educational programmes, and understanding decision-making intricacies are crucial for informing nursing education and decision-support systems.

Issues in the diagnosis and evaluation of pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Patients with chronic obstructive pulmonary disease (COPD) may present with various forms of pulmonary aspergillosis, including invasive pulmonary aspergillosis (IPA), chronic cavitary pulmonary aspergillosis, and allergic bronchopulmonary aspergillosis. Accurate diagnosis and disease evaluation are essential for tailoring individualized treatment strategies. Key aspects include: (1) Comprehensive assessment of IPA risk factors, with enhanced monitoring for critically ill patients; (2) Understanding the clinical manifestations and radiological features of different forms of pulmonary aspergillosis and emphasizing the importance of bronchoscopic examination; (3) Obtaining microbiological evidence whenever possible; (4) Differentiating colonization from infection to avoid overdiagnosis; (5) Vigilance for co-existing sensitization to Aspergillus. During treatment and long-term disease management, the use of inhaled or systemic corticosteroids and antifungal agents should be dynamically adjusted according to the patient's condition.

Updates on Treatment Modalities for Primary Rhegmatogenous Retinal Detachment Repair.

Rhegmatogenous retinal detachment, a severe eye condition, presents anatomic separation of the neurosensory retina from its outermost layer-the retinal pigment epithelium. Early recognition of this relatively common finding and proper referral of patients to the retinal surgery department is essential in order to minimize its consequent possible severe reduction in vision. Several major surgical methods for the repair of primary rhegmatogenous retinal detachment have been in use over the last several decades, and they all aim to find and close the break in the retina that has caused the detachment. Surgery can be performed as pneumatic retinopexy, pars plana vitrectomy, and/or episcleral surgery (buckling). General surgical trends for reattaching the retina include moving from extraocular to intraocular surgery and from bigger gauge to smaller gauge via minimal invasive vitrectomy surgery (MIVS), with implementing shorter-lasting intraocular tamponades. Surgical options for rhegmatogenous retinal detachment treatment nowadays emphasize gaining retinal reattachment, preferably with one surgery and with minimum damage to the eye. The procedure should not bring secondary eye conditions and complications with severe impairment of visual acuity, and it should be performed on as much as a smaller budget, with possibly peribulbar anesthesia, enabling the patient the quickest possible recovery. It should be adjusted to the patient's condition, not to the surgeon's skills or preferences.

Prevalence and determinants of post-stroke psychosis in Aswan: a prospective study

BackgroundPost-stroke psychosis (PSP) is a rare but serious neuropsychiatric condition characterized by delusions and/or hallucinations following a stroke. Despite its impact on prognosis and quality of life, PSP remains underdiagnosed and undertreated, with limited data on its prevalence and risk factors. The purpose of this study is to assess the prevalence and determinants of post-stroke psychosis (PSP), as well as to compare PSP and non-PSP patients in terms of improvement and daily living outcomes. This nested case–control study included 2,624 acute stroke patients from a university hospital between May 2017 and April 2022. Patients who developed PSP within 6 months post-stroke were identified as cases (n = 108), and 119 patients without PSP were randomly selected as controls. Comprehensive assessments included clinical, laboratory, and imaging evaluations at baseline. After 6 months, follow-up evaluations were conducted, including neurological examinations, psychiatric assessments, and stroke severity assessments using the Barthel index (BI). The psychiatric assessments included the Hamilton Depression Rating Scale for depression and the Mini-Mental State Examination for cognitive status.ResultsThe prevalence of PSP was 5.4%. risk factors significantly associated with PSP included older age, male patients, lower education level (≤ 5 years), hemiplegia, sphincter affection, cortical lesion, brain atrophy, small vessel disease, ischemic stroke, post-stroke dementia, and seizures. Non-specified psychosis and delusional disorder were the most common psychosis subtypes. There was a significantly higher percentage of excellent patients in the non-PSP group compared to those who had PSP regarding the observed improvement in the patient's condition. Also, there is a higher percentage of deteriorated patients in the PSP group (46.6%) compared to another group (18.9%) regarding BI.ConclusionPSP is a prevalent post-stroke complication associated with distinct risk factors and poor functional outcomes. Early screening and identification of high-risk patients, along with multidisciplinary management strategies, are crucial for optimizing recovery and quality of life in stroke survivors.

Postoperative hemorrhages in vestibular schwannoma surgery pontine hemorrhage. Clinical case report

Vestibular schwannoma (acoustic neuroma) is a benign tumor that develops from Schwann cells and can be life-threatening. Nowadays, surgical treatment is the method of choice in the management of patients with this type of tumor. We present a clinical case report of 71 y.o. patient with vestibular schwannoma (Koos grade IV, Samii grade 4B) with severe compression of the pons and the left cerebellar hemisphere. Microsurgical removal of the tumor was performed via the retrosigmoid approach. Starting from postoperative day 1, signs of respiratory distress developed. Control multislice spiral computed tomography (MSCT) of the brain revealed the area of hemorrhage in the left regions of the pons. On postoperative day 24 the patient's condition rapidly worsened progressing to coma with pronounced arterial hypotonia and cardiac arrest. Hemorrhage in the brain stem structures is a rare and life-threatening postoperative complication in vestibular schwannoma surgery. The incidence of postoperative hemorrhage is 2–11% of cases. Vascular complications are the leading cause of mortality. The key predisposing factors are older age, large and giant size of the tumor, tumor invasion into the pia mater of the brainstem, and vascularization of the tumor stroma. Comprehensive assessment of the tumor blood supply status, the state of the brainstem, intra- and postoperative clinical and neurophysiological monitoring, careful and thorough dissection of the tumor capsule and strict control of blood pressure in the postoperative period are the basis for the prevention of these complications.

Vitamin D Insufficiency and Deficiency in Chronic Kidney Disease Patients on Hemodialysis

About one billion people in the world suffer from vitamin D deficiency or insufficiency. Moreover, many data points indicate that vitamin D insufficiency and deficiency are highly prevalent among patients with chronic kidney disease (CKD) or undergoing dialysis. This study aimed to evaluate the level of vitamin D for dialysis patients at the Tripoli dialysis and treatment center. In this single center observational study, hospitalized dialysis patients who were diagnosed of Stage 5 CKD and healthy (control) groups had taken measurement of serum 25(OH)D in the Tripoli dialysis and treatment center. In this regard, One hundred and four patients were included in this study, of which (37%) were in Vitamin D insufficiency state while (30%) were in Vitamin D deficiency state. For the comparison between vitamin D levels among dialysis patients and control group which revealed that there were no significant differences between them with a p-value of 0.094. Furthermore, the correlation between serum 25 (OH) vitamin D, creatinine, PTH, and urea showed that there was a weak negative correlation between serum vitamin D and creatinine (r = -0.364, p = 0.255), between vitamin D and PTH (r = -0.378, p = 0.226), and between vitamin D and urea (r = -0.347, p = 0.269). Obviously, although vitamin D deficiency is strongly linked to kidney failure, the tests that work for this disease are limited, so introducing vitamin D for dialysis patients with CKD helps in understanding the patient's condition and helps in disease management.

Clinical features and treatment of acute motor axonal neuropathy

This paper aims to investigate the clinical features and treatment of patients with acute motor axonal neuropathy (AMAN). The clinical data of 9 patients with AMAN treated in our hospital were retrospectively analyzed from prodromal infections, clinical features, neuroelectrophysiological examination, treatment and the scores of Hughes functional grading scale. Diarrhea was the most common prodromal infection, and weakness of four limbs and muscles atrophy acutely emerged. The patient's condition progressed rapidly. In these cases, therapy of immunoglobulin combined with methylprednisolone was effective. Therefore, early diagnosis and timely treating with immunoglobulin therapy are most important methods to improve the prognosis.

FEATURES OF PHYSICAL THERAPY FOR SCOLIOSIS

Introduction. The article analyzes contemporary domestic and foreign publications regarding the effectiveness of physical therapy (PT) in scoliosis treatment. Physical therapy is one of the key methods in treating scoliosis, a condition characterized by abnormal curvature of the spine. Scoliosis is a common problem that can occur at any age, but it is more frequently detected in children and adolescents. However, despite its prevalence, many people have a limited understanding of the effectiveness and importance of PT in treating this condition. Therefore, highlighting the importance of PT in scoliosis treatment, including its role in improving the patient's condition, preventing the progression of spinal curvature, and enhancing the quality of life of patients, is relevant. The aim of the study. The aim of the study is to investigate the effectiveness of physical therapy in scoliosis to determine optimal approaches to treating this condition and improving the quality of life of patients. Conclusions: Scoliosis is a common problem, especially among children and adolescents, and its treatment is an important medical issue. Since scoliosis can lead to serious health consequences, including pain, spinal deformity, and functional limitations, the search for effective treatment methods is crucial to ensure optimal outcomes for patients. Physical therapy is one of the potentially effective methods for treating scoliosis, as it aims to strengthen the back muscles, improve flexibility, and maintain proper spinal alignment. However, despite several studies confirming the effectiveness of PT, further scientific research is needed to establish its optimal parameters, such as types of exercises, duration, and intensity of training loads, as well as the impact of PT on different categories of patients with various degrees and forms of scoliosis.

Factors Associated with Patient Triage Accuracy in the Emergency Department

Triage in the Emergency Department (ED) aims to provide timely emergency interventions in accordance with the urgency of the patient's condition. Triage decisions may be related to both nursing and patient factors. This study aimed to identify factors associated with the accuracy of patient triage in the ED of Arifin Achmad Regional General Hospital in Riau Province, Indonesia. The study utilized a quantitative approach with a descriptive analytic design using a cross-sectional approach. The study population were adult patients aged 18 years and above who came to the ED, with a sample size of 80 patients selected through consecutive sampling. Triage data were collected using an observation sheet, and triage accuracy was assessed by comparing nursing triage decisions with those of the attending ED physician, considered as the gold standard. Data analysis included univariate and bivariate analyses using Fisher's exact test, as well as multivariate analysis with logistic regression. The majority of respondents were adults aged 18-59 years (n=56, 70.0%), male (n=55, 68.8%), non-trauma emergency status (n=65, 81.2%), self-transported (n=66, 82.5%), and 68 respondents (85%) had accurate triage results. Fisher's exact test showed significant associations between age, gender, mode of transportation, type of emergency, and triage accuracy, with all p-values <0.005. The most significant factors associated with triage accuracy were male gender (OR 8.237, 95% CI= 1.875-36.199, p-value 0.005) and adult age (OR 5.270, 95% CI= 1.267-21.927, p-value 0.022). In conclusion, there were significant associations between age, gender, mode of transportation, type of emergency, and triage accuracy, with male gender and adult age being the most significant factors. Regular monitoring and evaluation of triage implementation are necessary to improve triage accuracy and patient outcomes in the ED.

Spring coil displacement after interventional embolization of severe pelvic fracture: a case report.

Haemorrhagic shock, which arises as a complication of pelvic fracture subsequent to severe trauma, represents a perilous state. The utilization of interventional endovascular haemostasis assumes a pivotal role in the management of patients with vascular injury following pelvic fracture. This article reports the treatment of a patient with pelvic fracture caused by a serious work-related vehicle accident. Despite the implementation of timely blood and fluid transfusion to combat shock, the application of aortic balloon obstruction, and interventional iliac artery embolization for haemostasis, the patient's condition failed to display any discernible improvement. Repeat angiography further revealed a displacement of the interventional embolization material, and the patient subsequently died of multiple organ failure. The occurrence of spring coil displacement is infrequent, but the consequences thereof are considered grave, necessitating meticulous discernment in the selection of haemostatic materials for this type of patient. The diagnostic and therapeutic processes encompassing the particular case described here were analysed and are discussed with the objective of augmenting the efficacy and success rate of treatment modalities for patients in similar circumstances.

Nursing Students' Experiences of Empathy in a Virtual Reality Simulation Game: A Descriptive Qualitative Study.

Empathy is significant in nursing, and showing empathy toward a patient positively impacts a patient's health. Learning empathy through immersive simulations is effective. Immersion is an essential factor in virtual reality. This study aimed to describe nursing students' experiences of empathy in a virtual reality simulation game. Data were collected from nursing students (n = 20) from May 2021 to January 2022. Data collection included individual semistructured interviews; before the interviews, the virtual reality gaming procedure was conducted. Inductive content analysis was used. Nursing students experienced compassion and a feeling of concern in the virtual reality simulation game. Students were willing to help the virtual patient, and they recognized the virtual patient's emotions using methods such as listening and imagining. Students felt the need to improve the patient's condition, and they responded to the virtual patient's emotions with the help of nonverbal and verbal communication and helping methods. Empathy is possible to experience by playing virtual reality simulation games, but it demands technique practicing before entering the virtual reality simulation game.

A fatal case of diphtheria endocarditis complicated with microangiopathic haemolytic anaemia and multiple septic emboli causing brain infarctions in a patient with smear-positive pulmonary tuberculosis

ndocarditis due to non-toxigenic Corynebacterium diphtheriae is emerging as a rare subtype of endocarditis, with limited case reports available. It has been related to the presence of prosthetic valves, underlying cardiac disease, or the use of injectable drugs. We present a fatal case of endocarditis due to non-toxigenic Corynebacterium diphtheriae in a native aortic valve complicated with microangiopathic haemolytic anaemia and multiple septic emboli in the brain causing infarctions in a patient with smear-positive pulmonary tuberculosis who was on anti-tuberculosis therapy (ATT). Following blood culture positivity and suggestive evidence from the echocardiogram, the patient was initially treated with intravenous ceftriaxone and vancomycin along with ATT. Evolution was assessed by sterile blood cultures post therapy and follow-up transthoracic echocardiograms (TTE) and transesophageal echocardiograms (TOE). Even though the patient's condition improved with intravenous antibiotic therapy, it later deteriorated with disseminated intravascular coagulation and liver injury followed by prerenal acute kidney injury and multiple septic emboli causing the patient’s demise, which may have necessitated surgical interventions.

A Rare Case Report: Bilateral Spontaneous Twin Tubal Ectopic Pregnancy from Iran

Introduction/Background: One of the main problems of women of reproductive age is ectopic pregnancy. Lack of early diagnosis and treatment can lead to internal bleeding and death of the patient. Approximately 1.2 to 1.4% of the reported pregnancies is ectopic pregnancy and one of the rarest types of ectopic pregnancy is bilateral ectopic pregnancy, which is reported in only 0.0005% of pregnant women. Case Presentation: A 35-year-old woman with polycystic ovary syndrome, weight 65 kg and height 153 cm, referred for pregnancy. Using examination and history taking, ultrasound and β-hCG titer measurement, one of the masses at 5 to 6 weeks and in the area of the isthmus of the right tube and the other mass two weeks later at 7 to 8 weeks, in the area Infundibulum of the left tube was diagnosed. The most common complication that the patient complained about was abdominal pain and frequent bleeding. Both times, the patient underwent laparoscopy and because of the patient's condition, salpingectomy was performed on both left and right tubes of the patient. Conclusion: Due to the rarity of bilateral twin ectopic pregnancy, early diagnosis with the help of history taking and clinical examination, measurement of β-hCG titer and ultrasound is necessary. Early diagnosis can lead to the reduction of women's mortality.

Segmentation model of soft tissue sarcoma based on self-supervised learning.

Soft tissue sarcomas, similar in incidence to cervical and esophageal cancers, arise from various soft tissues like smooth muscle, fat, and fibrous tissue. Effective segmentation of sarcomas in imaging is crucial for accurate diagnosis. This study collected multi-modal MRI images from 45 patients with thigh soft tissue sarcoma, totaling 8,640 images. These images were annotated by clinicians to delineate the sarcoma regions, creating a comprehensive dataset. We developed a novel segmentation model based on the UNet framework, enhanced with residual networks and attention mechanisms for improved modality-specific information extraction. Additionally, self-supervised learning strategies were employed to optimize feature extraction capabilities of the encoders. The new model demonstrated superior segmentation performance when using multi-modal MRI images compared to single-modal inputs. The effectiveness of the model in utilizing the created dataset was validated through various experimental setups, confirming the enhanced ability to characterize tumor regions across different modalities. The integration of multi-modal MRI images and advanced machine learning techniques in our model significantly improves the segmentation of soft tissue sarcomas in thigh imaging. This advancement aids clinicians in better diagnosing and understanding the patient's condition, leveraging the strengths of different imaging modalities. Further studies could explore the application of these techniques to other types of soft tissue sarcomas and additional anatomical sites.

Nutrition Care Process on Obesity Patient with Acute Decompensated Heart Failure (ADHF) Wet and Warm, Atrial Fibrillation Moderate Ventricular Response, and Acute Kidney Injury: A Case Report

Background: Obesity is caused by an imbalance between excessive energy intake and insufficient physical activity over a prolonged period. Obesity can increase the risk of metabolic syndrome, including heart failure. Severe heart failure can further elevate the risk of complications such as atrial fibrillation and acute kidney injury. In order to mitigate the exacerbation of heart failure severity in obese patients, it is imperative to institute a cardiovascular diet therapy employing the principles of adequate energy provision, low-fat content, and restricted protein intake within the framework of a Nutrition Care Process (NCP). Objective: To investigate the management of standard nutritional care in obese patients with acute decompensated heart failure, atrial fibrillation, and acute kidney injury through the administration of a cardiovascular diet. Methods: A case study was conducted in February 2023 on a patient at the University of Airlangga Infectious Disease Hospital, Surabaya. Results: The results of the clinical evaluation demonstrated an improvement in the patient's physical condition, as evidenced by the absence of dyspnea and stable vital signs within the normal range at the end of the intervention. The patient's food intake increased progressively, although some macronutrient targets were not fully met (<75%). Conclusion: The patient's condition showed significant improvement, as indicated by positive changes in physical/clinical monitoring. Additionally, there was an increase in food intake, although the target macronutrient intake was not fully achieved.

FEATURES OF ANESTHESIA IN PATIENTS WITH SPECIAL NEEDS. PART 1

The non-medical use of cannabis can negatively impact the morpho-functional state of almost all organs and systems of the human body. During acute intoxication and established drug dependence, it can unevenly distort the effects of drugs for local and general anesthesia, leading to life-threatening complications. Part 1 of this review presents the results of acute and chronic cannabis use on homeostasis. Cerebral vasospasm and atherosclerosis are identified as major etiological factors for cannabis-related cerebrovascular diseases. Young to middle-aged individuals (30–50 years), male gender (male-to-female ratio 3.7:1), and chronic use (86%) are significant independent predictors of neurovascular toxicity, cerebral hypoperfusion, and stroke. Cannabis smoking causes damage to the respiratory mucosa similar to tobacco. Regular cannabis smokers can expect irritation of the upper respiratory tract, swelling, obstruction, chronic cough, bronchitis, lung emphysema, and bronchospasm. Some reports advocate the use of dexamethasone during surgery to alleviate these symptoms. The detrimental effects of chronic cannabis use on liver and kidney functions are somewhat overstated. Disturbances in immune system, thermoregulation, blood clotting, and carbohydrate metabolism in the absence of anesthetic precautions can significantly complicate the patient's condition in the perioperative period. Cannabinoids can interact with drugs from various groups. Awareness of the pathophysiological and biochemical consequences of cannabis use allows anesthesiologists to anticipate and effectively manage perioperative complications in this patient category

Terapi Non Farmakologi dalam Pengendalian Tekanan Darah pada Pasien Hipertensi

Changes in the pattern of communicable diseases to non-communicable diseases are classified as non-communicable diseases that do not cause scanning effects on other people and are a major factor in disorders of the blood vessels and chronic kidney disease, namely hypertension. Consumption of antihypertensive drugs continuously for a long time is not controlled and can increase the occurrence of Drug Related Problems (DRP). DRP is an effect experienced by the patient due to the involvement of the choice of treatment therapy used by the patient and is actually able to have an impact on the patient's condition such as non-adherence to drug consumption, drug side effects, or allergies that arise due to the drug consumed. This is proof that other alternative therapies are needed that are able to reduce the risk of dependence on drugs in maintaining the quality of life of people with hypertension, so the authors made a Literature Review on "Non-Pharmacological Therapy in Controlling Blood Pressure in Hypertensive Patients". To find out non-pharmacological therapy in controlling blood pressure in hypertensive patients. This type of research uses Literature Review with a Narrative Review approach. Where the database used is Clinical Key, Google Scholar, NCBI, textbook, MedScape, WHO, and data from the Indonesian Ministry of Health. Based on a Literature Review of the 12 articles analyzed in the study, it was stated that non- pharmacological therapy for hypertension is proven to be an alternative to lowering blood pressure through various means such as lifestyle interventions, biofeedback techniques, foot reflexology, slow deep breathing exercises, consumption various herbal plants to reduce the side effects of consuming synthetic drugs. Non-pharmacological therapy for hypertensive patients can reduce blood pressure with various methods.

Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report

BACKGROUND Langerhans cell histiocytosis (LCH) is characterized by diabetes insipidus and is an uncommon occurrence. Pathological biopsies still have a certain degree of diagnostic probability. We present a case in which LCH initially affected the pituitary gland. This resulted in a misdiagnosis of chronic inflammation upon pathological examination. CASE SUMMARY A 25-year-old female exhibited symptoms of diabetes insipidus. Magnetic resonance imaging revealed an enhanced foci in the pituitary gland. After surgical resection of the pituitary lesion, the pathological diagnosis was chronic inflammation. However, the patient later experienced bone destruction in the skull and lower limb bones. After the lower limb bone lesion was compared with the initial pituitary lesion, the final diagnosis was modified to LCH. The patient was treated with multiple chemotherapy courses. However, the patient’s condition gradually worsened, and she eventually passed away at home. CONCLUSION LCH should be considered when patients exhibit diabetes insipidus and absence of high signal intensity in the pituitary gland on sagittal T1-weighted image and abnormal enhancement in the pituitary region.