Curēus

Sickle cell disease (SCD) is a chronic and prevalent hemoglobin disorder with various manifestations and complications depending on the organs involved. Red cell transfusion either simple or exchange is crucial due to its prophylactic and therapeutic roles. We present a case showing serologic discrepancy between the red cells phenotype and the developed alloantibodies to emphasize the crucial role of molecular testing in SCD patients requiring chronic blood transfusion.

Dacryocystorhinostomy (DCR) is an effective surgical procedure for addressing lacrimal drainage problems. However, it can be a painful operation that involves incisions both inside and outside the eye, often leading to a high incidence of postoperative nausea and vomiting. Preemptive analgesics can be employed to alleviate this unrelieved pain. Nonetheless, many of the drugs used can induce a wide range of adverse effects. Therefore, the aim of this systematic review and meta-analysis is to assess the current evidence regarding the efficacy of pregabalin in managing postoperative pain following DCR surgery...

Background This study aimed to explore patients' subjective utility for a patient information video (PIV) on cataract surgery and analyse the use of a quick response (QR) code as a mode of delivery of the PIV. Methods A total of 500 patients were included in the study. All patients were given a paper form of the patient information leaflet (PIL) as the standard of care (SoC) in addition to a digital QR code to access a supplementary PIV. The questionnaire explored the patients' understanding of cataracts, the risks and benefits of cataract surgery, and their experience accessing and using the QR code...

The deep Inferior epigastric artery perforator (DIEAP) flap is currently the gold standard for autologous breast reconstruction. This flap is susceptible to venous congestion, which can result in partial or complete flap loss. Apart from external causes, venous congestion may be caused by the flap's vascular architecture, either due to a dominance of the superficial venous system or due to impaired communication between the superficial and deep venous systems. This inefficient vascular architecture can be detected during surgery, and the venous outflow drainage can be improved through several techniques...

INTRODUCTION: Since the outbreak of COVID-19, significant value has been placed on preventative methods for pathogen spread. One such method is the use of telemedicine via telephone clinics (TC). This article is designed to study TC in a District General Hospital in the United Kingdom. AIMS: This clinical audit aims to evaluate the use of a TC in the United Kingdom and assess its effectiveness. It also aims to assess the use of a clinician-led triaging system to select patients who would receive subsequent telephone follow-ups (TFU)...

Background and objective It has been suggested that knee osteoarthritis (KOA) is associated with the development of calcification and an increased risk of cardiovascular (CV) disease, while the contribution of KOA grade is not clearly known enough. This study aimed to investigate the relationship between the grade of KOA, the echocardiographic calcification score (echo-CCS), and CV risk assessment. Methods This cross-sectional study involved 204 patients diagnosed with KOA and classified according to the Kellgren-Lawrence staging criteria...

Background and objective The treatment for symptomatic meniscus-deficient knees with cartilage defects remains challenging on account of insufficient meniscal substitutes. One solution for this might involve combining meniscal allograft transplantation (MAT) and cartilage repair. In this study, we aimed to analyze the effectiveness and safety of MAT concomitant with cartilage repair for symptomatic lateral meniscus-deficient knees in a setting with limited availability of meniscal transplants in Japan. Methods Nine patients who underwent MAT concomitant with osteochondral transplantation (five) and/or autologous chondrocyte implantations (seven) were followed up for at least two years (mean: 51...

Stress fractures are a common and significant source of pain and burden that can require long periods of rest from physical activity to allow adequate healing. Specifically in athletes or those with physically demanding occupations, the prolonged period of rest and the potential for requiring surgical intervention in the case of poor or delayed healing can have devastating impacts on these individuals' careers and socioeconomic well-being. In this population, successful healing, in addition to a quicker healing time and a sooner return to activity, are important outcomes when faced with treating stress fractures...

Spondyloarthritis (SpA) is a multifactorial chronic inflammatory disease affecting the axial skeleton (axSpA) and/or peripheral joints (p-SpA) and entheses. The disease's pathogenesis depends on genetic, immunological, mechanical, and environmental factors. Endoplasmic reticulum aminopeptidase 1 (ERAP1) is a multifunctional enzyme that shapes the peptide repertoire presented by major histocompatibility complex (MHC) class I molecules. Genome-wide association studies (GWAS) have identified different single nucleotide polymorphisms (SNPs) in ERAP1 that are associated with several autoimmune diseases, including axSpA...

Introduction A common complication of first-time or recurrent shoulder dislocations is bone loss at the humeral head and glenoid. Recurrent shoulder instability is often a result of bony defects in the glenoid following shoulder dislocations. In the setting of glenoid bone loss, surgical interventions are generally required to restore stability. The Latarjet procedure is a challenging operation and, due to its complexity, may be associated with operative complications. It can be difficult to explain the procedure to patients in a manner that is easily comprehensible, which may lead to confusion or being overwhelmed with information...

The development of Enhanced Recovery After Surgery (ERAS) has brought about substantial transformations in perioperative care, substituting conventional methods with a patient-centric, evidence-based strategy. ERAS protocol adopts a holistic approach to patient care, which includes all stages preceding, during, and following the operation. These programs prioritize patient-specific therapies that are tailored to their specific requirements. Nutritional assessment and enhancement, patient education, minimally invasive procedures, and multimodal pain management are all fundamental components of ERAS...

Background and aim Gastrointestinal stromal tumors (GISTs) account for a major portion of gastrointestinal mesenchymal tumors. The purpose of the current study is to examine the clinicopathological features, management, and therapeutic outcomes of primary GIST in a tertiary care hospital.  Materials and methods This is a prospective observational analysis. Seventeen patients with GIST have been detected and treated in the Department of Surgery of a tertiary care hospital with an attached medical institution over the last seven years...

Introduction Herpes zoster (HZ) is a viral infection that occurs due to the reactivation of the varicella-zoster virus (VZV). Reactivation of the latent virus causes a painful dermatomal rash that is typical in HZ, which is frequently accompanied by post-herpetic neuralgia (PHN). Although HZ negatively impacts individuals' quality of life, vaccination has been shown to reduce the incidence of HZ and PHN and reduce the severity of the disease in the event of a breakthrough. Nonetheless, several studies have shown a low level of knowledge and poor practices regarding HZ and its vaccine...

Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, occurring through compression of the median nerve as it passes under the transverse carpal ligament. Symptoms include nocturnal pain and paresthesias confined to the thumb, middle, and index fingers. Objective The purpose of this study is to determine the prevalence of CTS symptoms and the associated risk factors in Qassim Province, Kingdom of Saudi Arabia. Materials and methods A total of 314 participants were recruited from Qassim Province using an online survey, which included demographic questions and the Boston Carpal Tunnel Questionnaire (BCTQ)...

Coding inaccuracies in documentation of surgical procedures misrepresent the productivity of departments, with harmful fiscal consequences and detract from effective clinical governance. We aimed to assess the extent of this within our centres.  We retrospectively analysed the operative records of 34 patients from two centres over a period of a month, undergoing varying arthroscopic knee operations. We found that 50% of cases had incorrect coding for procedures performed. On review of the clinical coding, the loss of payment summed up to £29,325...

Fat grafting has been described as a potential treatment for post-mastectomy pain syndrome (PMPS) following oncological breast surgery. The study's aim was to compare and contrast the current literature using a systematic review and meta-analysis to quantify the evidence. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Databases, including MEDLINE, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials (CENTRAL), were searched...

Background Sarcopenia is considered a prognostic factor for advanced chronic liver disease (ACLD) independent of liver function, but the underlying mechanisms are unknown. Here, we investigated whether sarcopenia contributed to hepatic decompensation and worsened prognosis. Methods This was a single-center retrospective study of 708 patients with chronic liver disease who underwent magnetic resonance elastography (MRE). Magnetic resonance imaging (MRI) was used to diagnose sarcopenia and hepatic decompensation (presence of ascites)...

This case report presents the management and diagnosis of an 80-year-old gentleman who presented to the Accident and Emergency Department with refractory hypotension, hypoglycemia, and hyponatremia. Initially diagnosed with sepsis and cellulitis, it was later discovered that the patient was suffering from an Addisonian crisis due to adrenal insufficiency induced by long-term steroid use for rheumatoid arthritis. Prompt administration of intravenous hydrocortisone and fluid resuscitation led to a significant improvement in the patient's condition...

A giant cell tumor of the tendon sheath (GCTTS) presents as a rare neoplasm demanding a heightened index of suspicion for precise diagnostic evaluation, especially when manifesting in the digital phalanges, as it is part of a group of neoplasms known as tenosynovial giant cell tumors (TCGTs). An accurate and timely diagnosis is crucial, as it significantly enhances treatment outcomes for this heterogeneous group of lesions. We describe the case of a male patient who presented with multiple nodules in the fourth finger of his left hand and was ultimately diagnosed with a localized form of a GCTTS, an unusual presentation for localized forms of this entity...

BACKGROUND: Lower extremity amputation (LEA) is a surgical procedure performed to remove either a part or the entire lower limb due to medical conditions such as trauma, infection, peripheral vascular disease, or malignancy. The procedure is becoming increasingly common in Pakistan, with a bulk of patients presenting from rural areas in tertiary care centers. Understanding the indications, levels, and outcomes of LEA is essential for improving patient care and adopting preventive strategies, especially in developing countries...