Giant Malignant Phyllode Tumor: A Case Report

Phyllodes are an uncommon type of fibroepithelial neoplasm of the breast, which account for only 0.3 to 0.5% of all breast neoplasms. Management requires complete surgical excision with negative margins. Giant phyllode tumors portray a surgical challenge because complete surgical excision with negative margins is vital to reduce local recurrence and metastatic spread. Here, we report a case of giant malignant phyllode tumor, approached with wide local excision and negative margins were successfully achieved. The purpose behind this paper is to report the patient’s clinical history, presentation, intra-operative and histopathological findings, accompanied by a literature review to determine the significance of this finding and the approach in management

Role of Assistive Devices on Gait in Patients with Incomplete Spinal Cord Injury: Systematic Review

Background: People with incomplete spinal cord injury disabilities can be able to live a healthy, productive, and dignified life by using Assistive devices as their role in improving gait. Facilitate locomotion rehabilitation. And enable people with incomplete SCI to ambulate in an upright position. Objective: This systematic review aimed to examine the effectiveness of the role of using assistive devices in gait rehabilitation in patients with incomplete SCI. Material and Methods: Studies were identified from 2000 to 2020 by electronic search using PubMed, Cochrane Database of Systematic Reviews, Google Scholar, and Physiotherapy Evidence Database (Pedro). They were reviewed if they were randomized control trials focused on the effectiveness of Assistive Devices on Gait in Patients in age more than 18 years with incomplete Spinal Cord Injury being published in English. Eight studies were selected according to inclusive and exclusive criteria and descriptive analysis was conducted due to heterogeneity. Results: Eight trials were identified with good quality methodology. Descriptive analysis was applied for three studies that supported the use of assistive devices for those patients and meta-analysis was applied for five studies. The mean difference across all the five studies is -0.69 (95% CI -0.93, -0.45). According to AACPDM, there is level II evidence that supports the use of the assistive device as a method to be able to live a healthy, productive, and dignified life. Conclusion: The current level of evidence supports the effectiveness of assistive devices in improving gait in patients with incomplete spinal cord injury

Hippocampal mitochondrial Ca++ in experimentally induced Alzheimer's disease, link to calpains and impact of vitamin D3 supplementation

Objective: Vitamin D impact on hippocampal mitochondrial Ca++ and calpains was not previously investigated in Alzheimer's disease (AD). The current work aimed to assess the alteration in hippocampal mitochondrial Ca++, ATP & ADP and hippocampal calpains' level in (AlCl3)-induced AD model, and the effect of 2 regimens of vitamin D supplementation on these alterations. Methods: Forty male Wistar rats were randomized into 4 groups; control, AD (AlCl3100 mg/kg, p.o. daily for 42 days), AD and vitamin D co-treated group (AlCl3 as in AD group with vitamin D3 400 IU/kg/day, p.o. for 42 days) and AD, followed by vitamin D3 group (AlCl3 was given as in AD group for 42 days, then vitamin D3 for two weeks). AD was assessed by hippocampal levels of Aβ42, p-tau and spatial memory assessment in Morris water maze. Hippocampal mitochondrial Ca++, ATP and ADP levels besides to calpain-1 & 2 and cytochrome C were assessed in addition to CA1 histological examination. Results: AD animals showed impaired mitochondrial function as denoted by high Ca++ and decreased ATP and ADP and elevated calpain-1 & 2 and cytochrome C. Hippocampal CA1 region showed increased degenerated neurons and reduced thickness of its pyramidal layer. Vitamin D administration minimized the hippocampal mitochondrial impairement induced by AD and mitigated histological alterations even when supplemented post AD establishment. Conclusion: Vitamin D administration to AD rats breaks the deleterious loop in the hippocampus that involves increased Ca++, calpain activation, mitochondrial failure, neuronal degeneration and AD disease progression

Endophthalmitis post pars plana vitrectomy surgery: Incidence, organisms' profile, and management outcome in a tertiary eye hospital in Saudi Arabia

PURPOSE: To determine the incidence of endophthalmitis after pars plana vitrectomy (PPV), organisms' profile, and management outcomes at a tertiary eye hospital in a Middle East country. METHODS: In this single-arm cohort study conducted in 2020, medical records of patients who underwent PPV not accompanied by any other intraocular surgery were reviewed; those with a diagnosis of acute endophthalmitis in the immediate postoperative period (within 6 weeks) during the past 6 years were analyzed. RESULTS: A total of 8153 records of PPV surgeries were reviewed. Five cases had endophthalmitis post-PPV with an incidence of 0.061%. Three (0.037%) had positive cultures, all of them for Staphylococcus epidermidis. The interval between PPV and diagnosis of endophthalmitis ranged from 3 to 25 days (mean, 15.8 days). Final vision after treatment ranged from 20/400 to no light perception, and one eye was eviscerated. CONCLUSION: The incidence of endophthalmitis post PPV is low. Despite prompt diagnosis and standard management, visual prognosis seems to be poor. The infective agents for endophthalmitis were commensals from the ocular surface

Prevalence of screen time use and its relationship with obesity, sleep quality, and parental knowledge of related guidelines: A study on children and adolescents attending Primary Healthcare Centers in the Makkah Region

BACKGROUND: Since the use of handheld electronic devises is prevalent among people of all ages, health organizations have specified appropriate screen times for the different age groups. The aim of this study was to investigate the prevalence of screen use and its association with sleep quality and obesity. MATERIALS AND METHODS: This cross-sectional study was conducted on people attending three Primary Healthcare Centers in the Makkah region between January and October 2019. The three-part questionnaire filled by parents collected data on sociodemographics, parental knowledge of guidelines, and asleep quality. Data were analyzed using STATA 14.2. For continuous variables, groups were compared using t-test; Pearson Chi-squared test or Fisher's exact test, as appropriate, was employed for categorical variables. RESULTS: A total of 450 individuals completed the questionnaire. Children 2–12 years old spent more time and used phones, tablets, and television (TV) more frequently, while those younger than 2 or older than 12 used phones and TVs more than other devices. High body mass index was associated with the daily usage of electronic devices. Fewer hours of sleep, longer time to fall sleep, and longer hours in bed were associated with the usage of all electronic devices. Furthermore, a good knowledge of the maximum time allowed for children and teenagers and content scoring system was associated with hours slept per night, and low knowledge was associated with higher frequency of using electronic devices. CONCLUSION: Children spent long periods using electronic devices, and despite knowing the guidelines, parents still allowed their children to exceed the time acceptable for the use of electronic devices, which could lead to future social problems