Rejected

Pheochromocytomas are rare tumours originating in chromaffin cells which predominantly are located in adrenal glands They are a representation of 0.1%-1% of all cases of secondary hypertension. Pheochromocytoma is the most typical cause of hypertension by promoting hypertension remission in the majority of patients after surgical procedure. Sustained or paroxysmal hypertension is the most frequent sign of pheochromocytoma, possibly associated with the classic triad: episodic headaches, sudoresis and tachycardia. We present a case of giant right adrenal pheochromocytoma.

() is an important opportunistic pathogen, frequently associated with pyoderma and otitis in dogs. The emergence and rapid expansion of methicillin-resistant (MR) is problematic due to multidrug resistance and reduced treatment options. The aim of this study was to determine i) the prevalence of MR in dogs with pyoderma or otitis externa, ii) the antimicrobial resistance patterns of MR from South African isolates, and iii) the risk factors for MR-associated pyoderma or otitis externa in dogs in South Africa (RSA). Sixty-eight presumptive clinical isolates (collected from 65 dogs) from five geographically dispersed laboratories in RSA were collected over 2 years. Possible MR isolates were flagged when resistance to oxacillin was observed. Thereafter, all isolates were confirmed as by polymerase chain reaction (PCR) and further genotyped for the A gene. Fifty-seven of 68 isolates were confirmed to be (83.8%), while 49/57 (85.9%) carried A. Our findings showed that preliminary phenotypic methods supplemented by genotypic methods increased the accuracy of correctly identifying . All isolates were resistant to at least one antimicrobial drug. There was a high incidence of amoxicillin (70.1%) and enrofloxacin (65%) resistance. Important risk factors for A positive carriage were previous hospital admission, pruritus, and previous antibacterial failure. This study demonstrates a high prevalence of A positive carriage (85.9% of samples) in MR pyoderma and otitis in dogs in RSA. There is an urgent need for better laboratory diagnosis of MR and surveillance of dogs presenting with pyoderma and otitis in South Africa.

The deficiency of the triceps tendon has been considered a relative contraindication to performing a total elbow arthroplasty. One of the conditions that may compromise triceps integrity is the presence of an olecranon non-union (ON). In this scenario, the placement of a total elbow arthroplasty in a patient with end-stage elbow arthritis is a complex problem to be solved. The aim of this study is to describe the surgical technique for the placement of a TEA in the context of a previous ON and to report the results of three cases. Surgical technique: the focus of the nonunion is identified, and the olecranon fragment is proximally reflected with the triceps tendon to allow accurate exposure of the medullary canal of the ulna and easy access to the joint. With the elbow in a fully flexed position, the previously assembled test prosthesis is placed and the proximal ulna fragment should then be reduced to match the distal ulna. Osteosynthesis with a tension band technique was performed at 45° of elbow extension. A non-absorbable Krackow suture (Ti-Cron 2-0) from the triceps's tendon to the hole of the wire in the distal ulna is applied to decrease the triceps tension traction. Bone grafting is performed when a persistent gap is present at the fracture site following reduction. This technique enables us to achieve a stable elbow with little pain and maintains the extensor apparatus's continuity.

 The aim of this study was to compare the effects of epidural analgesia on relief of labor pain, progress, and outcome of labor in primigravid parturients to those who did not receive any analgesia.

Colorectal cancer in young adults is on the rise. This rise combined with delayed childbearing increases the likelihood of colorectal cancer diagnosed during pregnancy or in the postpartum period.

Myocarditis is an inflammatory condition that impacts cardiac myocytes and is caused mostly by viruses. It can manifest as chest pain, dyspnea, palpitations, fatigue, syncope, shortness of breath, and in severe cases frank cardiogenic shock. It accounts for around 10 percent of all sudden cardiac deaths in young adults, who are described as being in their early thirties. Inflammatory cardiomyopathy resulting from acute myocarditis may also appear as new-onset heart failure (HF), delaying the diagnosis and treatment of these patients. It is crucial to recognize the sensitivity of symptom onset, especially in young individuals; mildly elevated troponin levels that are inconsistent with the severity of left ventricular ejection fraction (LVEF) impairment and associated left ventricular dilatation strongly suggest inflammatory cardiomyopathy rather than acute myocarditis. The current treatment for myocarditis is primarily supportive, with an emphasis on the management of heart failure and arrhythmias in accordance with clinical practice guidelines. In this case report, we describe a male in his early forties who presented with abrupt onset exertional shortness of breath and chest discomfort. His cardiac catheterization did not show evidence of coronary artery disease; however, an echocardiogram revealed new-onset heart failure with reduced ejection fraction, the diagnosis of coxsackievirus myocarditis was made based on his clinical presentation, and a positive coxsackievirus immunoassay.

Meningitis is an infection of the membranes (meninges) surrounding the brain and spinal cord. It is a dangerous condition with potentially serious consequences if misdiagnosed or left untreated. Our study aimed to summarise the clinical and laboratory predictors in patients with acute meningitis at one hospital in the Gaza Strip.

Coronavirus disease-2019 (COVID-19) presents with a variety of symptoms, but rhabdomyolysis has rarely been reported in children.

To evaluate retinal nerve fiber layer (RNFL) thickness in children with migraine, with and without aura, compared to healthy controls using optical coherence tomography (OCT).

Fibromyalgia syndrome (FM) is a complex disease that is mainly characterised by chronic pain, fatigue, and sleep disturbances and may be precipitated or worsened by many stressors. The aim of this study was to examine the effects of respiratory muscle training (RMT) on respiratory efficiency and health-related quality of life (HRQoL) in women with FM.