Annals of Medicine and Surgery最新文献

{"title":"Clinical outcomes of chronic subdural hematoma treated with Foley catheter drainage: a retrospective cohort study.","authors":"Muhammad Sohaib Khan, Syed Shayan Shah, Nafees Uddin, Abdur Rahim, Adnan Khan, Ijaz Ul Haque, Bipin Chaurasia","doi":"10.1097/MS9.0000000000003614","DOIUrl":"10.1097/MS9.0000000000003614","url":null,"abstract":"<p><strong>Background: </strong>Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly among the elderly, that often requires surgical drainage. Due to economic and logistical constraints, traditional closed-system drains are often impractical in low- and middle-income countries (LMICs). Foley catheter drainage has also been proposed as a cost-effective alternative, yet few studies have evaluated its safety and efficacy. This study investigates the clinical outcomes of patients with CSDH who underwent Foley catheter drainage, focusing on its effectiveness and safety.</p><p><strong>Materials and methods: </strong>This retrospective analysis examined the case records of 134 patients who underwent burr-hole craniotomy with Foley catheter drainage for chronic subdural hematoma (CSDH) at our hospital from January 2022 to December 2024. Patient demographics, presenting symptoms, postoperative recovery, recurrence rates, and complications were assessed. Statistical analysis, including Chi-square tests and Pearson correlation, was conducted using SPSS 28, with a significance threshold set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>One hundred thirty-four patients were studied, with a mean age of 61.8 years and male predominance (80.6%). The most frequent presenting symptoms were headache (77.6%) and motor deficits (55.97%). Postoperative recovery was satisfactory, with 85% of patients making a complete recovery. The rate of recurrence was 3.7%, and the most common complications were pneumocephalus (7.5%) and infections (5.2%). There was a positive correlation (<i>r</i> = 0.48, <i>P</i> < 0.0001) between preoperative Glasgow Coma Scale (GCS) scores and functional recovery. However, it was not strong enough to serve as a stand-alone predictor, and clinical correlation, which considers other variables, needs to be taken into consideration while interpreting. The mortality rate was 3%.</p><p><strong>Conclusion: </strong>Foley catheter drainage of cerebrospinal fluid (CSF) hygroma (CSDH) can be considered a reliable and safe alternative in low- and middle-income countries (LMICs), with recovery rates of 85% and a low risk of recurrence. However, further prospective studies are required to prove these findings, as this is a single-arm retrospective study. Though complications were tolerable, attention to surgical technique and vigilant postoperative observation continues to be vital. Further studies and refinement of management are warranted to confirm these results.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5435-5441"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991214","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":"Hypertriglyceridemia induced acute pancreatitis in pregnancy: a case report.","authors":"Sagar Mandal, Astha Chhantyal, Manvi Mukherjee, Pooja Paudyal, Suniti Rawal, Nisha Kharel","doi":"10.1097/MS9.0000000000003594","DOIUrl":"10.1097/MS9.0000000000003594","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Various metabolic and physiologic changes that occur during pregnancy can sometimes lead to severe hypertriglyceridemia during pregnancy. The resultant hypertriglyceridemia may lead to acute pancreatitis in pregnancy, which even being rare poses significant health risks to both the child and the mother.</p><p><strong>Presentation of case: </strong>A 26-year-old female, G4P1L1A2 at 36 weeks and 3 days of gestation, presented with an acute onset of abdominal pain in the epigastric region and multiple episodes of vomiting. With a diagnosis of acute pancreatitis, she was admitted to the intensive care unit for the multidisciplinary approach with a plan to reduce the triglyceride (TG) levels rapidly. The woman was finally discharged against medical advice with oral antibiotics.</p><p><strong>Case discussion: </strong>Hypertriglyceridemia-induced acute pancreatitis in a pregnancy is a rare occurrence, usually seen in females with prior hyperlipidemia and with genetic predisposition, which is associated with significant morbidity and mortality. Our patient presented with TG levels above 1500 mg/dL. The favored treatment modality in our case was insulin therapy and omega-3 fatty acids. Baby was delivered through an elective caesarean section.</p><p><strong>Conclusion: </strong>Proper treatment modality according to the TG levels of the patient, along with proper continuous monitoring of both the mother and the baby, is very much essential. Injectable insulin and diet modification are equally important. The mode of delivery is assessed based on various parameters of fetal maturity and maternal risk factors.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6121-6126"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991468","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 mechanism of NK cell expression of RANKL/RANK/OPG pathway in mouse models of femoral head necrosis.","authors":"Junwei Dai, Jun Tao, Shusheng Wei, Baokun Han, Shuai Ma, Chengyu Wu, Long Sun, Xiaodong Ma, Yimeng Chen","doi":"10.1097/MS9.0000000000003615","DOIUrl":"10.1097/MS9.0000000000003615","url":null,"abstract":"<p><p>This study aimed to investigate the role of natural killer (NK) cells in the RANKL/RANK/OPG pathway in osteonecrosis of the femoral head (ONFH). C57 mice were categorized into a control group, an observation group (10 mice each), and an experimental group comprising 4 NK cell knockout mice. A hormone-induced femoral head necrosis model was created by administering lipopolysaccharide combined with methylprednisolone for 8 weeks to the experimental and control groups. The observation group received subcutaneous injections of an equal amount of normal saline. After 8 weeks, peripheral blood was collected from the mice, and bilateral femoral head specimens were obtained post-mortem. Expression levels of NK cells, OPG, RANK, and RANKL in the peripheral blood and joint fluid of ONFH mice were determined using PCR and ELISA techniques, and compared with the control group. The experimental group exhibited an increased number of NK cells in the peripheral blood and joint fluid compared to the control group. OPG expression was downregulated, while RANK and RANKL were significantly upregulated, resulting in a marked increase in the number of mature osteoclasts. In ONFH patients, NK cells were found to upregulate TNF-α and RANKL, downregulate IFN-γ and OPG, promote osteoclast maturation, disrupt bone balance, accelerate femoral head necrosis collapse, and ultimately hasten the progression of femoral head necrosis.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5494-5502"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991138","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":"Unveiling the link between Oropouche virus and Guillain-Barré syndrome: a growing public health concern.","authors":"Aditya Agrawal, Shailesh Kumar Patel, Nikhil K C, Ankush Kiran Niranjan, Ganesh N Aderao, Jigyasa Rana, Talha Bin Emran","doi":"10.1097/MS9.0000000000003547","DOIUrl":"10.1097/MS9.0000000000003547","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"4710-4712"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815662","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":"Causality between telomere length and breast diseases: a two-sample bidirectional Mendelian randomization study.","authors":"Simin Luo, Jie Chai, Yangyang Cai, Linxiaoxiao Ding, Song Tang","doi":"10.1097/MS9.0000000000003601","DOIUrl":"10.1097/MS9.0000000000003601","url":null,"abstract":"<p><strong>Background: </strong>The relationship between telomere length and breast diseases remains unclear, with conflicting evidence for breast cancer. Using an innovative genetic approach, we were the first to comprehensively assess their bidirectional causal relationship.</p><p><strong>Methods: </strong>Telomere length, breast cancer, benign neoplasm of breast, and breast inflammation were extracted from the genome-wide Association study (GWAS) database as the basis for large-scale population studies. The interaction of telomere length and breast diseases as exposure and outcome factors was analyzed by Mendelian randomization (MR).</p><p><strong>Results: </strong>When telomere length was used as an exposure factor and breast diseases as an outcome, the <i>P</i> value of MR was less than 0.05. Breast cancer (odds ratio (OR) = 1.130, 95% confidence interval (CI) = 1.047-1.219, <i>P</i> = 0.0016), benign neoplasm of breast (OR = 1.002, 95%CI = 1.001-1.004, <i>P</i> = 0.0007) and breast inflammation (OR = 1.487, 95%CI = 1.008-2.191, <i>P</i> = 0.0453). When breast diseases were taken as an exposure factor and telomere length was taken as an outcome, the <i>P</i> value of MR between breast cancer, benign neoplasm of breast, and telomere length was greater than 0.05, and breast inflammation could not be calculated by MR.</p><p><strong>Conclusion: </strong>Telomere length is a risk factor for breast diseases, and longer telomeres increase the risk of breast cancer, benign neoplasm of breast, and breast inflammation. However, the reverse study showed no causal association between breast cancer, benign neoplasm of breast and telomere length, and the causal association between breast inflammation and telomere length was not clear. Moreover, further studies are needed to validate our findings in non-European populations.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5551-5556"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991262","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":"Empowering future doctors: smart inhaler training for MBBS students in polluted cities.","authors":"Muhammad Talha, Maliha Khalid, Aminath Waafira","doi":"10.1097/MS9.0000000000003611","DOIUrl":"10.1097/MS9.0000000000003611","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6234-6235"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991299","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":"Metformin effects on respiratory and metabolic outcomes in asthma and metabolic syndrome: a double-blind, randomized, placebo-controlled clinical trial.","authors":"Hossein Mehravaran, Adeleh Bahar, Fatemeh Hajimohammadi, Zahra Kashi, Masoud Aliyali, Fatemeh Varshoei, Reza Alizadeh-Navaei, Jamshid Yazdani Charati, Alireza Kashefizadeh, Mobina Gheibi, Erfan Ghadirzadeh","doi":"10.1097/MS9.0000000000003552","DOIUrl":"10.1097/MS9.0000000000003552","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic syndrome (MetS) could be associated with worsened asthma control and more severe and frequent asthma attacks. Metformin has been suggested as a potential treatment for MetS, which could decrease airway reactivity and lead to improved asthma control and reduced emergency department (ED) visits. However, the existing data have predominantly focused on diabetic patients only. Thus, in the present study, we aimed to investigate the effects of metformin in patients with concurrent asthma and MetS.</p><p><strong>Methods: </strong>This trial was conducted on two groups of patients (55 in each group) with concurrent asthma and MetS, each receiving either metformin hydrochloride or an identical placebo. Patients were followed up after 3 months and assessed regarding clinical outcomes, asthma control tests (ACTs), pulmonary function test parameters, C-reactive protein (CRP) levels, frequency of asthma attacks, ED visits, and hospitalization rate.</p><p><strong>Results: </strong>The metformin group showed statistically significant improvements in indices regarding ACT score, O₂ saturation, anthropometric indices, blood sugar control, CRP, and lipid profile compared to the placebo group (all <i>P</i> < 0.05). Additionally, the metformin group showed significantly higher forced expiratory volume in 1 s (FEV₁) (<i>P</i> = 0.014, and effect size = 5.6%) and forced vital capacity (FVC) (<i>P</i> = 0.001, and effect size = 9.2%) in the multivariate analysis after controlling for the confounding effects of baseline parameters and sex. Although the metformin group demonstrated a trend toward a reduction in severe asthma attacks, ED visits, or hospitalization rates, the effects were not statistically significant (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Our findings demonstrate that metformin administration in patients with concurrent asthma and MetS could lead to substantial enhancements in ACT score, FEV₁, and FVC.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"4861-4869"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815606","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":"Emergency nurses' knowledge, attitude, and self-efficacy in managing patient pain: a cross-sectional study.","authors":"Somayeh Shahvarooghi, Reza Nabi Amjad, Fatemeh Rahimi, Robabeh Haghverdi, Touran Bahrami Babaheidari","doi":"10.1097/MS9.0000000000003541","DOIUrl":"10.1097/MS9.0000000000003541","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate emergency nurses' knowledge, attitude, and self-efficacy in managing patient pain.</p><p><strong>Methods: </strong>This cross-sectional study, conducted in 2022, collected data using four questionnaires: one on demographic characteristics (including age, gender, marital status, education level, shift type, clinical experience, and history of participating in pain management workshops); the Pain Management Practices Assessment Tool for evaluating nurses' knowledge about pain management; the Nurses' Attitude Survey for assessing nurses' attitudes toward pain management; and the Pain Management Self-Efficacy Questionnaire for measuring nurses' self-efficacy in pain management. The data were analyzed using SPSS version 22 software.</p><p><strong>Results: </strong>212 emergency department nurses participated in this study, averaging 30.83 years (SD = 4.99). The mean score for nurses' knowledge about pain management was 83.33 (SD = 7.95). The mean score for nurses' attitudes toward pain management was 55.48 (SD = 7.44). Additionally, the average score for nurses' self-efficacy about pain management was 46.17 (SD = 16.69). There was a positive and significant correlation between knowledge and self-efficacy (<i>r</i> = 0.552, <i>P</i> < 0.001), as well as between attitude and self-efficacy (<i>r</i> = 0.694, <i>P</i> < 0.001) toward pain management among emergency nurses.</p><p><strong>Conclusions: </strong>Future research should focus on longitudinal studies, objective measures, and interdisciplinary approaches to further understand and improve pain management in emergency settings. These insights can inform policy development and the creation of standardized protocols to ensure effective and consistent pain management practices across healthcare environments.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"4911-4917"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815638","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 role of high-fat diets in cancer mortality: is butter to blame?","authors":"Aly Omer Patel, Hafsa Ali, Mohammed Mahmmoud Fadelallah Eljack","doi":"10.1097/MS9.0000000000003544","DOIUrl":"10.1097/MS9.0000000000003544","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"4726-4727"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815658","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":"N1 and N2 neutrophil subtypes in breast cancer: functional implications and clinical perspectives: a narrative review.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003609","DOIUrl":"10.1097/MS9.0000000000003609","url":null,"abstract":"<p><p>Breast cancer (BC) remains a leading cause of cancer-related deaths globally, with the tumor microenvironment (TME) playing a pivotal role in disease progression. Neutrophils, the most abundant white blood cells, have gained attention for their dualistic role in cancer immunity. Two major neutrophil subtypes, N1 and N2, have been identified, each exhibiting distinct functions in the TME. N1 neutrophils are typically associated with anti-tumor immunity, promoting tumor cell clearance through mechanisms such as reactive oxygen species production, cytokine release, and the activation of cytotoxic immune cells. In contrast, N2 neutrophils promote tumor progression, metastasis, and immune suppression by secreting pro-angiogenic factors and recruiting regulatory immune cells like Tregs and myeloid-derived suppressor cells. The polarization of neutrophils into N1 or N2 subtypes is regulated by the dynamic interactions within the TME, including cytokines, hypoxic conditions, and signals from tumor cells. In BC, factors such as IL-8, transforming growth factor-beta, and granulocyte-macrophage colony-stimulating factor drive N2 polarization, contributing to tumor evasion of immune surveillance. Conversely, pro-inflammatory signals can induce N1 polarization, which is often linked to favorable clinical outcomes. However, in aggressive breast cancer subtypes such as triple-negative breast cancer, the TME is more conducive to N2 polarization, resulting in poor prognosis and resistance to treatment.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5762-5769"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991381","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}