Galen Medical Journal最新文献

{"title":"Treatment of Angiomyoblastoma in a Young Lady in Saudi Arabia: A Case Report : Angiomyoblastoma in a Young pLady in Saudi Arabia.","authors":"Roua Shoub Gbril Ali, Ghadeer Adel Mosfer Alghamdi, Raad Hadi Madkhali, Abdulaziz Saleh Alobaid, Zarqa Saleem","doi":"10.31661/gmj.v14i.3861","DOIUrl":"10.31661/gmj.v14i.3861","url":null,"abstract":"<p><strong>Background: </strong>Background: Angiomyofibroblastoma (AMFB) is a rare, benign soft tissue tumor that belongs to the mesenchymal tumor category and affects the female genital tract. Aggressive angiomyxoma, a distinct stroma myxoedematous mesenchymal tumor with a significant risk of local recurrences, must be histomorphologically distinguished from AMFB. Radiography and histopathology are used for accurate diagnosis. The treatment depended on the complete surgical excision.</p><p><strong>Case presentation: </strong>Case Presentation: Herein, we presented a case of a 36-year-old female (P3+0) presented with a left vaginal mass noted two years prior. The radiology report suggested angiomyxoma or myxoid liposarcoma as possible differentials. Surgical resection revealed a benign genital stromal tumor, specifically angiomyofibroblastoma (AMFB). After complete surgical excision, the immunohistochemical analysis supported the diagnosis of angiomyofibroblastoma. Two months postoperatively, an MRI Post-resection images show complete resection with no feasible scar, residual tumour, or recurrence.</p><p><strong>Conclusion: </strong>Conclusion: Our case is rare AMFB. AMFB may be missed when diagnosed with other masses, such as angiomyxoma or myxoid liposarcoma, so we need to do the necessary tests to diagnose and differentiate AMFB accurately from other masses. Ultrasound and MRI are initial diagnostic tools, while histopathology ensures the correct diagnosis. Surgical removal with free margins remains the appropriate treatment. Long-term follow-up is essential to monitor for potential recurrence, though AMFB typically carries an excellent prognosis.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3861"},"PeriodicalIF":0.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of IFN-γ and TGF-β in the Pathophysiology of Chronic Sinusitis :.","authors":"Amer Salih Khalaf, Ammar Mohammed Alwan, Amer Saleem Khalaf","doi":"10.31661/gmj.vi.3948","DOIUrl":"10.31661/gmj.vi.3948","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the role of inflammatory cytokines IFN-γ and TGF-β in the pathophysiology of chronic sinusitis among Iraqi patients.</p><p><strong>Materials and methods: </strong>A case-control study was conducted in Salah-Al-Din Governorate from March to July 2024. We enrolled 60 clinically diagnosed chronic sinusitis patients from Tikrit Teaching Hospital and 30 healthy controls. Serum levels of IFN-γ and TGF-β were measured using sandwich ELISA.</p><p><strong>Results: </strong>The patient cohort (55% male) showed highest prevalence in age groups 20 (37%), 21-30 (25%), and 31-40 years (23%). The most frequent symptoms were nasal obstruction (98%), nasal discharge (95%), and reduced smell sensation (90%). IFN-γ and TGF-β levels were significantly elevated in patients (16.45±7.01 pg/mL and 32.27±11.38 ng/mL, respectively) compared to controls (6.95±2.34 pg/mL and 22.18±7.66 ng/mL; P0.05). ROC analysis demonstrated IFN-γ›s stronger association with disease status (AUC 0.83) than TGF-β (AUC 0.68). A weak positive correlation was observed between the cytokines (r=0.277, P0.05).</p><p><strong>Conclusion: </strong>Our findings suggest IFN-γ and TGF-β play significant roles in the inflammatory processes of chronic sinusitis, particularly among younger patients. While both cytokines were elevated in patients, IFN-γ showed greater discriminatory potential. These results contribute to understanding the immunopathological mechanisms underlying chronic sinusitis.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3948"},"PeriodicalIF":0.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Association between Sjögren Syndrome and Thyroid Cancer Risk: A Systematic Review and Meta-analysis : Sjögren Syndrome and Thyroid Cancer Risk.","authors":"Mansour Salesi, Shadi Botshekan","doi":"10.31661/gmj.v14i.3753","DOIUrl":"10.31661/gmj.v14i.3753","url":null,"abstract":"<p><strong>Background: </strong>Sjögren's syndrome affects the skin, joints, lungs, kidneys, liver, and thyroid. This research was aimed to assess the association of Sjögren's syndrome with the thyroid carcinoma risk.</p><p><strong>Materials and methods: </strong>The present study was used a systematic review and meta-analysis method. This study searched the databases ProQuest, PubMed, Web of Science, Cochrane, and the search engine Google Scholar until July 7, 2024. The level of significance was considered as P0.05, and all data analyses were done in STATA 14 software.</p><p><strong>Results: </strong>A review of 11 studies revealed that Sjögren's syndrome increased the thyroid carcinoma risk in all patients (OR: 2.08, (95%CI: 1.47, 2.94)), in patients aged 40 to 49 years (OR: 1.43, (95%CI: 1.23, 1.67)), 50 to 59 years (OR: 4.65, (95%CI: 1.87, 11.58)), 60 to 69 years (OR: 1.34, (95%CI: 1.08, 1.66)) and in women ((OR:1.83, (95%CI: 1.35, 2.48). However, there was no significant association between Sjögren's syndrome and thyroid carcinoma risk in men ((OR: 1.49, (95%CI: 0.95, 2.34). Moreover, patients with Sjögren's syndrome who had a follow-up period of = 5 years ((OR: 1.68, (95%CI: 1.10, 2.54) and patients with a follow-up period of 5 years ((OR: 5.77, (95%CI: 1.97, 16.97) were at risk of thyroid cancer. Moreover, the thyroid carcinoma risk was in Europe ((OR: 3.26, (95%CI: 1.24, 8.56) and in Asia ((OR: 1.87, (95%CI: 1.27, 2.74). Primary Sjögren's syndrome also significantly increased the thyroid carcinoma risk ((OR: 2.37, (95%CI: 1.44, 3.90).</p><p><strong>Conclusion: </strong>Sjögren's syndrome increased the thyroid carcinoma risk, and female gender, fifth decade of life, European race, and involvement duration of more than 5 years were the exacerbating factors.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3753"},"PeriodicalIF":0.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daratumumab Versus Control Treatment: A Systematic Review and Meta-analysis Study of Survival Outcomes Among Multiple Myeloma Patients : Survival Outcomes of Multiple Myeloma Treatment with Daratumumab.","authors":"Pouria Salajegheh, Amirali Salajegheh, Fatemeh Yazdi Yahyaabadi, Farzaneh Yazdi","doi":"10.31661/gmj.v14i.3958","DOIUrl":"10.31661/gmj.v14i.3958","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis aimed to evaluate the efficacy of Daratumumab compared to control treatments in multiple myeloma across subgroups, including relapsed or refractory (RRMM), newly diagnosed transplant-eligible (ND/ESCT), and transplant-ineligible (ND/ISCT) patients.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science. Randomized controlled trials and comparative studies evaluating Daratumumab versus control treatments in multiple myeloma patients were included. A random-effects model was employed to calculate pooled effect estimates of overall response rate (ORR), progression or death (PRD), minimum residual disease (MRD) negativity, and mortality.</p><p><strong>Results: </strong>The analysis included data from 35 studies, 21 studies (n=7,604 patients) in the RRMM subgroup, 12 studies (n=10,216 patients) in the ND/ISCT subgroup, and 6 studies (n=4,619 patients) in the ND/ESCT subgroup, comprising 22,439 patients (including healthy controls). Daratumumab significantly improved ORR (OR: 2.58, 95% CI: 2.26-2.93, P0.01) and MRD negativity rates across all subgroups. PRD risk was lower in the Daratumumab group (RD: -0.14, 95% CI: -0.16 to -0.12), with consistent efficacy across RRMM, ND/ESCT, and ND/ISCT patients.</p><p><strong>Conclusion: </strong>This meta-analysis confirms Daratumumab's significant efficacy across multiple patient subgroups, providing broad clinical benefits in multiple myeloma treatment. While some heterogeneity and potential publication bias were observed, Daratumumab remains a robust therapeutic option for extending progression-free and overall survival.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3958"},"PeriodicalIF":0.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application of Ultrasonography in Risk Assessment of Reflux and Aspiration in Diabetes Patients Undergoing Gastroparesis Surgery : Application of Ultrasonography in Diabetes Patients Undergoing Gastroparesis Surgery.","authors":"Xiuqing Xu, Hong Bi, Jiuming Dai, Pei Gao","doi":"10.31661/gmj.v14i.4001","DOIUrl":"10.31661/gmj.v14i.4001","url":null,"abstract":"<p><strong>Background: </strong>Diabetic gastroparesis increases the risk of reflux and macro-aspiration during surgery. This study evaluated the predictive role of gastric antral ultrasound in identifying these events in diabetic gastroparesis patients undergoing surgical procedures.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted on 60 diabetic gastroparesis patients at Binhai County People's Hospital (June 2023-June 2025). Gastric antral ultrasound was performed using a SonoSite M-Turbo system, measuring cross-sectional area (CSA), gastric volume (GV), and GV-to-weight ratio (GV/W). Reflux was defined as pharyngeal pH 4, and macro-aspiration was confirmed via bronchial assessment. Statistical analysis (SPSS 27.0) included independent t-tests, chi-square tests, and logistic regression.</p><p><strong>Results: </strong>Among 60 patients (34 male, 26 female; mean age 48.19 ± 7.23 years), 9 (15%) experienced reflux (n=6) or macro-aspiration (n=3). Patients with events had significantly higher CSA (3.28 ± 0.35 vs. 3.07 ± 0.29 cm², P=0.038), GV (12.15 ± 3.28 vs. 10.12 ± 2.76 mL, P=0.013), and GV/W (0.17 ± 0.05 vs. 0.15 ± 0.04 mL/kg, P=0.022). Postoperative SpO2 was lower (94.89 ± 2.11% vs. 97.45 ± 1.88%, P0.001), and gastric protease levels were higher (62.78 ± 10.92 vs. 55.88 ± 11.34 ng/mL, P=0.006) in affected patients. Logistic regression confirmed CSA (OR=1.45, 95% CI: 1.02-2.06, P=0.039), GV (OR=1.22, 95% CI: 1.04-1.43, P=0.015), and GV/W (OR=1.38, 95% CI: 1.03-1.85, P=0.031) as significant predictors.</p><p><strong>Conclusion: </strong>Gastric antral ultrasound effectively predicts reflux and macro-aspiration risk in diabetic gastroparesis patients, with elevated CSA, GV, and GV/W serving as key indicators. These findings support preoperative ultrasound screening to mitigate perioperative complications.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e4001"},"PeriodicalIF":0.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Proximity of the Lower Alveolar Canal to the Apex of Premolar and Molar Teeth in the Mandible Using Cone Beam Computed Tomography (CBCT) in Tabriz, Iran :.","authors":"Shahriar Shahi, Shirin Kolahdouz, Sahar Ghanbaran, Mohammad Gerayeli, Emad Movahed, Mohammad Ali Irani, Shaghayegh Ghadimi","doi":"10.31661/gmj.vi.3936","DOIUrl":"10.31661/gmj.vi.3936","url":null,"abstract":"<p><strong>Background: </strong>Knowing the anatomical link between the IAN and surrounding structures is vital before endodontic operations to avoid injuring the IAN. Examining the relationship between the inferior alveolar canal (IAC) and the apices of mandibular premolars and molars using cone beam computed tomography (CBCT) is the primary objective of this work.</p><p><strong>Materials and methods: </strong>Two hundred and twenty patients, ranging in age from sixteen to seventy-seven, who visited the University of Tabriz's Faculty of Dentistry had their CBCT images examined in this retrospective cohort study. Mandibular fractures, pathologies, or bone syndromes were not considered, as were teeth with diseases impacting canal contact. Additionally, poorly defined IAN pictures were not included. The shortest distance between the root apex and the upper border of the interosseous capsule was determined by taking measurements using cross-sections that were 0.3 mm thick.</p><p><strong>Results: </strong>Analysis of 220 CBCT images revealed a gender distribution of 56.8% female and 43.2% male patients, with age groups of 49 years (32.3%). The greatest mean distance between the teeth and the IAC was observed in the first premolar in males (5.7 mm), while the shortest was in the third molar in females (2.91 mm). Distances from mandibular molars and premolars to the IAC showed significant differences: second and first molars had smaller distal than mesial distances (P0.05), and second premolars had greater distances on the right side (P0.001). Males exhibited greater distances than females for molars and premolars (P0.05), but age had no significant impact (P0.05).</p><p><strong>Conclusion: </strong>Mandibular premolars maintain the most significant distance, while the third molar is closest to the IAC. Gender differences are significant, while age does not impact these measurements.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 S Pt 1","pages":"e3936"},"PeriodicalIF":0.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Maxillary Sinus and Buccal Bone Biometrics via Cone Beam Computed Tomography (CBCT) in an Iranian Sample :.","authors":"Shahriar Shahi, Sahar Ghanbaran, Emad Movahed, AmirMohammad Moharrami, Afsaneh Nekouei, Meysam Mohammadikhah, Shaghayegh Ghadimi","doi":"10.31661/gmj.vi.3935","DOIUrl":"10.31661/gmj.vi.3935","url":null,"abstract":"<p><strong>Background: </strong>The maxillary sinus's close anatomical relationship with posterior teeth roots presents significant challenges in dental and surgical procedures, with variations in sinus morphology influencing clinical outcomes. This study aimed to evaluate maxillary sinus biometrics and buccal bone thickness using Cone Beam Computed Tomography (CBCT) in an Iranian population.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 210 CBCT scans was conducted, measuring root apex proximity to the maxillary sinus floor (MSF) and buccal cortical bone thickness.</p><p><strong>Results: </strong>Findings revealed that 53.06% of right third molar roots protruded into the MSF, while only 2% of left first premolars did. The mesiobuccal root of the third molar had the shortest distance to the MSF (-1.38 ± 0.89 mm), whereas the palatal root of the first premolar was farthest (9.81 ± 3.93 mm). Buccal bone thickness was thinnest at the first premolar (1.21 mm) and thickest at the third molar palatal root (13.23 mm), with significant differences observed among molar roots.</p><p><strong>Conclusion: </strong>These findings underscore the importance of CBCT in preoperative planning to minimize complications during apical surgery and implant placement, particularly in cases involving posterior maxillary teeth.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 S Pt 1","pages":"e3935"},"PeriodicalIF":0.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Interstitial Lung Disease in Patients with Primary Sjogren's Syndrome: A Systematic Review and Meta-analysis of Observational Studies : Prevalence of Interstitial Lung Disease in Patients with Primary Sjogren's Syndrome.","authors":"Majid Molahoseini, Mansour Salesi","doi":"10.31661/gmj.v14i.3752","DOIUrl":"10.31661/gmj.v14i.3752","url":null,"abstract":"<p><strong>Background: </strong>Interstitial Lung Disease (ILD) is the most common pulmonary manifestation in patients with primary Sjögren's syndrome. Therefore, this study aimed to investigate the prevalence of ILD in patients with primary Sjögren's syndrome (pSS) using a systematic review and meta-analysis method.</p><p><strong>Materials and methods: </strong>This study searched databases ProQuest, PubMed, Web of Science, Cochrane, Embase, and the search engine Google Scholar until February 8, 2025. Studies were combined using the sample size and variance of each study. The heterogeneity of the studies was examined using the Q Cochrane test and the I2 index. The significance level of the tests was considered P0.05.</p><p><strong>Results: </strong>34 observational studies, with a total of 9535 individuals, showed that the prevalence of ILD in all patients with pSS was 23.5% (95%CI: 18.6%, 28.4%), in women 31.2% (95%CI: 18.4%, 44.1%), and in men 45.5% (95%CI: 23.6%, 67.4%). Moreover, the prevalence of ILD in patients with pSS in the age group of 30 to 39 years was 22.2% (95%CI: 18.9%, 26%), 40 to 49 years 10.8% (95%CI: 8.7%, 12.9%), 50 to 59 years 27.6% (95%CI: 17.9%, 37.4%), and 60 to 69 years 23.3% (95%CI: 17.9%, 28.7%). Also, the prevalence of ILD in patients with pSS in case-control studies was 15.6% (95%CI: 7.1%, 24.1%), in cohort studies 25.7% (95%CI: 19%, 32.4%), and in cross-sectional studies 21.4% (95%CI: 11.9%, 31%). However, the prevalence of non-specific interstitial pneumonia (NSIP) was 48.8% (95%CI: 41.4%, 56.2%), usual interstitial pneumonia (UIP) 15% (95%CI: 10.5%, 19.5%), LIP 10.8% (95%CI: 6.6%, 15%), and organizing pneumonia (OP) 9.4% (95%CI: 5.4%, 13.4%).</p><p><strong>Conclusion: </strong>One out of every four patients with pSS has ILD, and the prevalence of ILD was higher in men than in women. Moreover, the most common type of ILD was NSIP, followed by UIP, OP, and LIP, and the highest prevalence of ILD was in the age group of 50 to 59 years. Evaluating further studies regarding the impact of various factors on ILD can help in better diagnosing it in patients.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3752"},"PeriodicalIF":0.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Protocols for Spinal Injuries in Adult Patients: A Clinical Guideline : Management Recommendations for Patients with Spinal Cord Injuries.","authors":"Esmael Amirazodi, Sharareh Jahangiri, Farshid Seraji, Ali Arianezhad, Zeynab Kord, Behrooz Zarasvand","doi":"10.31661/gmj.v14i.3783","DOIUrl":"10.31661/gmj.v14i.3783","url":null,"abstract":"<p><strong>Background: </strong>This research aimed to elucidate and establish management recommendations for patients with spinal cord injuries, tailored to the characteristics of Iranian society, through an exploratory mixed-methods study.</p><p><strong>Materials and methods: </strong>The present study was executed in three phases. The initial phase was conducted to identify and elucidate the principal recommendations for the management of spinal cord injuries, comprising two sub-phases: a systematic review and a qualitative guided study. In the second stage, management recommendations were developed by integrating the findings from the first stage, and in the third stage, the clinical guide was prioritized and validated through two rounds of the Delphi method.</p><p><strong>Results: </strong>During the initial phase of the study (qualitative-review phase), 781 codes were derived from interviews with specialists in emergency medicine and neurosurgery, which were subsequently consolidated into six categories. During the second phase of the study, which involved the preparation of the primary draft, a review of pertinent texts was conducted, and researchers assessed 23 chosen clinical guidelines. In the third phase of the study (combination), the findings from the preceding two phases were integrated, and the questionnaire developed by 27 relevant experts was evaluated, culminating in the creation of the final clinical guide.</p><p><strong>Conclusion: </strong>This clinical guide, encompassing six categories-Pre-hospital, Immobilization, Diagnostic Imaging, Pain Management, Medication Recommendations, and Surgical Intervention-has been developed and compiled for the utilization of physicians in the emergency departments of hospitals in Iran.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3783"},"PeriodicalIF":0.7,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Right Heart Failure: An Uncommon Presentation : A Case Report of Right Heart Failure.","authors":"Venus Shahabi Rabori, Oliver McConnell, Olivia Powell","doi":"10.31661/gmj.v14i.3921","DOIUrl":"10.31661/gmj.v14i.3921","url":null,"abstract":"<p><strong>Background: </strong>Aortic dissection poses diagnostic challenges due to its varied symptoms. Prompt diagnosis and intervention are essential to reduce mortality and morbidity.</p><p><strong>Case report: </strong>A 53-year-old woman presented with dyspnoea, palpitations, Epigastric and right upper quadrant pain, following recent chest tightness. She initially was diagnosed with a non-ST elevation myocardial infarction (NSTEMI) based on the electrocardiogram (ECG) and cardiac enzymes. The transthoracic echocardiogram (TTE) showed right heart impairment, mild aortic regurgitation, and significant tricuspid regurgitation. A coronary angiogram showed normal left coronary vessels but failed imaging of the right coronary artery which raised suspicion of aortic dissection due to an abnormal aortic root shape and a history of hypertension. Urgent CT aortography (CTA) confirmed acute Stanford type A aortic dissection with false lumen supplying the RCA ostia. Initially, conservative management was chosen due to right ventricular dysfunction. The patient then presenting with recurring symptoms 8 days later, after a multidisciplinary team meeting surgical intervention was decided. Comprising of full aortic root, aortic arch, and aortic valve replacement, plus tricuspid valve repair and annuloplasty. The patient was discharged post successful surgery.</p><p><strong>Conclusion: </strong>This case highlights the challenges of diagnosing and managing acute aortic syndromes, especially with atypical symptoms. Having a low threshold for cross sectional imaging techniques in such cases is likely to prompt accurate diagnosis and treatment in critical cases.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 ","pages":"e3921"},"PeriodicalIF":0.7,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}