Appendicitis after Appendectomy: A Rare Presentation of Acute Appendicitis as Stump Appendicitis

Appendicitis is one of the frequent complaints for which patients visit the Emergency Department. Appendectomy is one of the most commonly performed procedures. Stump appendicitis is a rare but severe complication of appendectomy due to the inflammation of the remaining part of the appendix. Because it is rare and partly due to physicians’ lack of understanding of this entity, the diagnosis is highly delayed, leading to severe complications including perforation or peritonitis. This article aims to raise the importance and awareness and shed light on how possibly it could be avoided

Survival of oral tongue cancer in low middle-income country: a cohort study

Abstract Introduction The incidence of oral tongue squamous cell carcinoma (OTSCC) is increasing. OTSCC is comparatively higher in our region owing to the consumption of tobacco, beetle nut, alcohol, and poor oral hygiene. There is paucity of survival data for OTSCC from our high-burden region. Background There is paucity of survival data for OTSCC from our high-burden region, we aimed to determine 5-year overall and disease-free survival of patients with OTSCC. Methods A retrospective chart review was conducted for all the patients treated for oral tongue squamous cell carcinoma from January 2000 and December 2013. The data on overall survival and disease-free survival was collected via telephonic interviews up till 2018. Kaplan Meier curves were plotted to graphically represent survival. Results A total of 131 patients were included. The mean age of the patients was 49.4 ± 12.98 years, with most patients being male (65.9%). The most common tumor stage was T2 (55.1%) and the most common nodal stage was N0 (57.7%). Five-year disease-free survival was 59.2%, and overall survival was 60.7%. Overall survival dropped steeply from 84.4 to 7.5% in patients who developed recurrence in our cohort. Conclusion The most significant factor influencing the survival of patients with OTSCC is tumor recurrence. 5-year recurrence-free survival was 84.4% which is greater than reported in literature. This could be due to the low incidence of perineural and perivascular invasion in our population. Further research on factors leading to recurrence should be done

Single versus second observer vs artificial intelligence to increase the ADENOMA detection rate of colonoscopy-A network analysis

Background and aims: Screening colonoscopy has significantly contributed to the reduction of the incidence of colorectal cancer (CRC) and its associated mortality, with adenoma detection rate (ADR) as the quality marker. To increase the ADR, various solutions have been proposed including the utilization of Artificial Intelligence (AI) and employing second observers during colonoscopies. In the interest of AI improving ADR independently, without a second observer, and the operational similarity between AI and second observer, this network meta-analysis aims at evaluating the effectiveness of AI, second observer, and a single observer in improving ADR.Methods: We searched the Medline, Embase, Cochrane, Web of Science Core Collection, Korean Citation Index, SciELO, Global Index Medicus, and Cochrane. A direct head-to-head comparator analysis and network meta-analysis were performed using the random-effects model. The odds ratio (OR) was calculated with a 95% confidence interval (CI) and p-value \u3c 0.05 was considered statistically significant.Results: We analyzed 26 studies, involving 22,560 subjects. In the direct comparative analysis, AI demonstrated higher ADR (OR: 0.668, 95% CI 0.595-0.749, p \u3c 0.001) than single observer. Dual observer demonstrated a higher ADR (OR: 0.771, 95% CI 0.688-0.865, p \u3c 0.001) than single operator. In network meta-analysis, results were consistent on the network meta-analysis, maintaining consistency. No statistical difference was noted when comparing AI to second observer. (RR 1.1 (0.9-1.2, p = 0.3). Results were consistent when evaluating only RCTs. Net ranking provided higher score to AI followed by second observer followed by single observer.Conclusion: Artificial Intelligence and second-observer colonoscopy showed superior success in Adenoma Detection Rate when compared to single-observer colonoscopy. Although not statistically significant, net ranking model favors the superiority of AI to the second observer

The effectiveness of a worksite lifestyle intervention program on high-risk individuals as potential candidates for bariatric surgery: My unlimited potential (MyUP)

This is a single-arm, pre and post effectiveness study that evaluated the impact of a comprehensive workplace lifestyle program on severe obesity among high cardiovascular disease risk individuals in a large, diverse employee population. Employees of Baptist Health South Florida were considered eligible to participate if they had 2 or more of the following cardiometabolic risk factors: total cholesterol ≥200 mg/dL, systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, hemoglobin A1c ≥6.5%, body mass index ≥30kg/m(2). Participants received a personalized diet plan and physical activity intervention, and were followed for 1 year. Data on anthropometric measurements, blood pressure, blood glucose, and other biochemical measures were collected. Participants\u27 body mass index was calculated and their eligibility for bariatric surgery (BS) also assessed. A total of 297 persons participated in the program; 160 participants completed all procedures through 12 months of follow-up. At baseline, 34% (n = 100) of all participants were eligible for BS. In an intention-to-treat analysis, 27% (n = 27) of BS eligible participants at baseline became ineligible after 12 months. Considering program completers only, 46% of BS eligible participants at baseline became ineligible. Irrespective of BS eligibility at 12 months, mean values of cardiometabolic risk factors among program completers improved after the follow-up period. Workplace wellness programs provide an important option for weight loss that can obviate the need for BS, reduce cardiovascular disease risk, and potentially reduce costs. However, in designing future worksite lifestyle interventions, measures should be taken to improve participation and retention rates in such programs