-
Mymensingh Medical Journal : MMJ Jul 2024An anal fissure is a small cut or tears in the skin or mucosal lining of anal passage or at the opening of anus. It affects the quality of life due to severe pain and...
An anal fissure is a small cut or tears in the skin or mucosal lining of anal passage or at the opening of anus. It affects the quality of life due to severe pain and sometimes causes bleeding also while passing the stool. It can affect people of any age. In recent time, laser treatment creates a new era for management of anal fissure. It is easier, safer, faster for the treatment of chronic anal fissure. The aim of the study was to evaluate short term and long term clinical and surgical outcome of laser treatment. In this prospective study total 82 patients with chronic anal fissure underwent laser treatment from July 2019 to June 2020 at Anower Khan Modern Medical College Hospital and Care Medical College Hospital, Bangladesh. All the patients who completed their 1.5 months and 6 months follow up were included for the study and their data was analyzed. Out of 82 patients, 71 were females and 11 were male. The mean age 40.31±9.23, mean operative time was 15.0±10.0 minutes. Mean hospital stay 24.35±1.23 hours (1 day). Mean healing time was 14.03±12.04 days. All patients were followed upto at outpatient clinic 1.5 and 6.0 months postoperatively. This study shows that laser treatment is a simple, safe, and effective procedure to treat the anal fissure with a low rate of complications. It can be treated as an effective treatment for patients with chronic anal fissure. However, this procedure has some limitations.
Topics: Humans; Fissure in Ano; Female; Male; Adult; Chronic Disease; Prospective Studies; Laser Therapy; Middle Aged; Treatment Outcome
PubMed: 38944714
DOI: No ID Found -
BMC Infectious Diseases Jun 2024Since May 2022, Mpox has spread extensively outside of Africa, posing a serious threat to the health of people globally, and particularly to the men who have sex with...
PURPOSE
Since May 2022, Mpox has spread extensively outside of Africa, posing a serious threat to the health of people globally, and particularly to the men who have sex with men (MSM) population. Chongqing, a province in Southwest China, has relatively large MSM and people living with HIV (PLWH) populations, presenting conditions conducive to the wide dissemination of Mpox. In this study, we investigated the clinical characteristics of Mpox patients among MSM and PLWH in Chongqing, aiming to inform the development of targeted prevention, control, and treatment strategies for Mpox.
METHOD
We evaluated the clinical characteristics, travel history, time of onset, distribution and number of skin lesions of Mpox patients admitted to the Chongqing Public Health Medical Center between September 2022 and October 2023. Meanwhile, a series of clinical samples were collected and the pathogen of interest was identified as Mpox virus using quantitative polymerase chain reaction (qPCR). The results were presented in the form of cycle thresholds (Ct), which help to approximate the quantification of viral load.
RESULTS
As of October 11, 2023, the Chongqing Public Health Medical Center reported a total of nine Mpox virus infections. All the patients identified were male and belonged to the MSM population, among whom seven (77.8%) were living with HIV, and maintained a preserved immune system while achieving viral suppression via effective ART. We observed no discernible clinical differences between MSM with Mpox with or without HIV, and no fatalities were recorded. Viral loads were observed to be higher in samples taken from the skin than those from the throat, nasopharynx, blood, or semen.
CONCLUSION
In this retrospective study, the clinical manifestations of MPXV infection appeared consistent among MSM patients, regardless of HIV status. Elevated MPXV viral loads in the skin and mucosal tissues, particularly at genital and anal sites, indicate that transmission is more likely to occur via direct physical contact as opposed to respiratory pathways or through exposure to bodily fluids.
Topics: Humans; Male; China; Retrospective Studies; Viral Load; Adult; Homosexuality, Male; HIV Infections; Middle Aged; Young Adult; Female
PubMed: 38926635
DOI: 10.1186/s12879-024-09537-0 -
Zhonghua Wei Chang Wai Ke Za Zhi =... Jun 2024This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early...
This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early rectal cancer, focusing on the postoperative status of the vertical margins. On January 26, 2024, a patient with early rectal cancer (cT1-2N0M0) underwent Endoscopic Intermuscular Dissection. The EID procedure consists of six steps: (1) mucosal incision; (2) submucosal dissection; (3) superficial muscular layer incision; (4) intermuscular dissection; (5) complete tumor removal; (6) wound management. The patient was a 70-year-old male with rectal cancer (cT1-2N0M0). The tumor was located on the left anterior wall of the rectum, approximately 9 cm from the anal margin, and measured 20mm in size. The dissection rate was 2.68 mm²/minute, and the total duration of the surgery was 109 minutes. The patient was successfully discharged on the fifth day after surgery. Pathological examination of the post-endoscopic surgery specimen revealed pT1b, with negative vertical margins. Follow-up after more than one month showed good recovery with no complications such as bleeding, perforation, infection, or stricture occurring. Colonoscopy indicated the presence of a granulation tissue suggestive of inflammation. Endoscopic Intermuscular Dissection for the diagnostic resection of early rectal cancer is potentially safe and may achieve negative vertical margins.
Topics: Humans; Rectal Neoplasms; Aged; Male; Endoscopic Mucosal Resection; Dissection; Rectum
PubMed: 38901999
DOI: 10.3760/cma.j.cn441530-20240314-00098 -
World Journal of Clinical Cases Jun 2024Rectal mucosal melanoma is a rare and highly aggressive disease. Common symptoms include anal pain, an anal mass, or bleeding. As such, the disease is usually detected...
BACKGROUND
Rectal mucosal melanoma is a rare and highly aggressive disease. Common symptoms include anal pain, an anal mass, or bleeding. As such, the disease is usually detected on rectal examination of patients with other suspected anorectal diseases. However, due to its rarity and nonspecific symptoms, melanoma of the rectal mucosa is easily misdiagnosed.
CASE SUMMARY
This report describes the case of a 58-year-old female patient who presented with a history of blood in her stool for the prior one or two months, without any identifiable cause. During colonoscopy, a bulge of approximately 2.2 cm × 2.0 cm was identified. Subsequently, the patient underwent endoscopic ultrasound (EUS) to characterize the depth of invasion of the lesions. EUS suggested a hypoechoic mucosal mass with involvement of the submucosal layer and heterogeneity of the internal echoes. Following surgical intervention, the excised tissue samples were examined and confirmed to be rectal malignant melanoma. The patient recovered well with no evidence of recurrence during follow-up.
CONCLUSION
This case shows that colonoscopy with EUS and pathological examination can accurately diagnose rare cases of rectal mucosal melanoma.
PubMed: 38899292
DOI: 10.12998/wjcc.v12.i16.2862 -
Minerva Dental and Oral Science Jun 2024This review provides practical recommendations for dental practitioners in dealing with oral lesions associated with sexually transmitted diseases (STDs), offering...
This review provides practical recommendations for dental practitioners in dealing with oral lesions associated with sexually transmitted diseases (STDs), offering clinically relevant insights to increase the awareness of these diseases in the mainstream of everyday practice. STDs are acquired through unprotected vaginal, anal or oral sex and are caused by more than 30 different types of bacteria, viruses and protozoa. Saliva, precum, semen, vaginal secretions and menstrual blood could be likely vehicles of infections and defensive barriers to infection by pathogenic microbes could be represented via intact mucosal membrane, the diluent function of saliva, and the antimicrobial action of salivary enzymes that collectively contribute to oral health and protection. STD, can directly and indirectly affect mucous membranes, manifesting with characteristic diagnostic signs and lesions. Given their potential oral manifestations, dental professionals need a comprehensive understanding of STD. The findings of this review lay a foundation for comprehending several STDs, emphasizing the importance of physicians as well dental practitioners being open to discussing sexuality issues with patients and providing appropriate therapeutic interventions.
PubMed: 38869836
DOI: 10.23736/S2724-6329.24.04996-9 -
Revista Do Instituto de Medicina... 2024Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine...
Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine clinical assessments, serological screening, and HPV data for planning prevention policies. This study aimed to identify HPV and its specific types in the cervical, anal, and oral mucosa of HIV-seropositive women, associating it with viral load and lymphocyte count. Sociodemographic characteristics, health data (CD4+ and CD8+ T cell counts and viral load), and biological samples (cervical, anal, and oral) were collected from 86 HIV-positive women undergoing antiretroviral therapy. Data were classified according to the presence or absence of HPV-DNA, HPV-DNA presence at one or more anatomic sites, and level of oncogenic risk, considering low- and high-risk oncogenic HPV-DNA groups. The presence of HPV in the cervicovaginal site was 65.9%, 63.8% in anal canal, and 4.2% in oral mucosa. A viral load ≥75 HIV copies/mL was associated with the presence of HPV-DNA. There was an association between viral load and the low-risk HPV or high-risk HPV groups. We found a high prevalence of HPV infection in HIV-seropositive women, particularly in the cervical and anal mucosa, with viral load ≥75 HIV copies/mL being associated with HPV-DNA presence.
Topics: Humans; Female; Viral Load; Papillomavirus Infections; Adult; HIV Infections; DNA, Viral; Cervix Uteri; Papillomaviridae; Middle Aged; Lymphocyte Count; Mouth Mucosa; Anal Canal; Prevalence; Cross-Sectional Studies; Socioeconomic Factors; CD4 Lymphocyte Count; Risk Factors; Human Papillomavirus Viruses
PubMed: 38865574
DOI: 10.1590/S1678-9946202466036 -
Translational Animal Science 2024The objective of this study was to determine the efficacy of the direct-fed microbial 10-G upon cattle growth performance, liver and lung health, carcass quality, and...
The objective of this study was to determine the efficacy of the direct-fed microbial 10-G upon cattle growth performance, liver and lung health, carcass quality, and yield outcomes, as well as prevalence and enumeration of in feces and lymph nodes. Fed beef heifers ( = 1,400; initial shrunk body weight [] 343.3 ± 36.2 kg) were blocked by the day of arrival and randomly allocated to one of two treatments (0 [negative control, CON] or 2 g of a direct-fed microbial [10-G] that provided 1 billion CFUs per animal per day of , , , , and ) with 10 pens per treatment. Recto-anal mucosal fecal samples (; = 477) and subiliac lymph nodes (; = 479) were collected longitudinally at harvest from 23 to 25 heifers per pen. Data were analyzed using mixed models; pen served as the experimental unit; block and harvest date were random effects. No differences were detected in dry matter intake ( = 0.78), final BW ( = 0.64), average daily gain ( = 0.51), gain to feed ( = 0.71), hot carcass weight ( = 0.54), dressed carcass yield ( = 0.52), 12th rib fat depth ( = 0.13), longissimus muscle area ( = 0.62), calculated empty body fat ( = 0.26), or marbling score ( = 0.82). Distributions of liver scores ( ≥ 0.34), quality grades ( ≥ 0.23), and yield grades ( ≥ 0.11) were also not different between treatments. A tendency was detected for more normal lungs ( = 0.08; 10-G = 65.96%, CON = 61.12%) and fewer inflated lungs at harvest for cattle fed 10-G ( = 0.10; 10-G = 0.29%, CON = 1.16%); other lung outcomes did not differ ( ≥ 0.54). prevalence did not differ for RAM samples ( = 0.41; 10-G = 97.74%, CON = 96.82%) or SLN ( = 0.22; 10-G = 17.92%, CON = 13.66%). concentration of RAM samples ( = 0.25; 10-G = 3.87 log CFU/g, CON = 3.32 log CFU/g) or SLN ( = 0.37; 10-G = 1.46 log CFU/g, CON = 1.14 log CFU/g) also did not differ between treatments at harvest. These results do not demonstrate any difference in live animal performance, carcass characteristics, or carriage for heifers fed 10-G.
PubMed: 38863595
DOI: 10.1093/tas/txae086 -
Minerva Surgery Jun 2024Hemorrhoids are a common problem associated with symptoms, like swelling, local thrombosis and generally with a decreased quality of life, often in otherwise healthy...
BACKGROUND
Hemorrhoids are a common problem associated with symptoms, like swelling, local thrombosis and generally with a decreased quality of life, often in otherwise healthy subjects. Hemorrhoids can be classified by grades (I to IV) according to their severity. In this registry study subjects treated with excisional hemorrhoidectomy (EH) for the first time, were included. After surgery, edema tends to complicate surgical areas causing relevant symptoms. Most hemorrhoids symptoms are related to alterations in bowel habits. Increase in diet fibers to avoid constipation, exercise, and limiting straining reduce recurrence after surgery.
METHODS
The aim of the registry study was to evaluate the effects of Pycnogenol (Horphag Research, Geneva, Switzerland) on relieving postoperative symptoms following hemorrhoidectomy. Pycnogenol 150 mg/day was used between one month before surgery up to one month after surgery. The main postoperative symptoms were scored.
RESULTS
Thirty-eight subjects completed the 60-day supplement registry study. Eighteen subjects were supplemented with Pycnogenol in addition to the standard management (SM) and 20 subjects only received SM and were considered as controls. The two groups were comparable for age, sex and main symptoms distribution and for their clinical characteristics at inclusion. No other disease was present. The scores for pain, discomfort, and constipation were significantly lower with the supplement compared to controls (P<0.05) 10 and 30 days after surgery. In addition, the quality-of-life score was higher with Pycnogenol (P<0.05) while bleeding (minimal, not clinically evaluable) and a possible residual anal stenosis (requiring a longer period of observation) were barely observed. A satisfactory return to activity was observed 30 days after surgery in the 18 subjects using Pycnogenol, and in only 15 out of 20 patients (75%) in the control group (P<0.05). All Pycnogenol subjects were able to drive and perform daily tasks in comparison with 14 out of 20 subjects in the control group. The proportion of patients that took pain medication from day 10 to 30 post-surgery was significantly lower in the Pycnogenol group than in controls (P<0.05).
CONCLUSIONS
In this post-surgical pilot, registry study, Pycnogenol was effective in preventing and controlling postoperative symptoms after hemorrhoidectomy. To confirm the results, more cases are needed, including different surgical methods and clinical conditions. Mucosal and cutaneous edema and perianal swelling - generally seen after surgery - seem to be clearly reduced with Pycnogenol and the supplement intake was associated with a more regular and pain-controlled convalescence and healing.
Topics: Humans; Plant Extracts; Flavonoids; Male; Female; Hemorrhoids; Hemorrhoidectomy; Middle Aged; Registries; Adult; Dietary Supplements; Quality of Life; Aged; Pain, Postoperative; Postoperative Complications; Treatment Outcome
PubMed: 38847768
DOI: 10.23736/S2724-5691.23.10241-3 -
Endoscopy Dec 2024
Topics: Humans; Anus Neoplasms; Male; Endoscopic Mucosal Resection; Carcinoma, Squamous Cell
PubMed: 38838728
DOI: 10.1055/a-2321-9527 -
Medical Image Analysis Jul 2024Segmentation of bladder tumors from medical radiographic images is of great significance for early detection, diagnosis and prognosis evaluation of bladder cancer. Deep...
Segmentation of bladder tumors from medical radiographic images is of great significance for early detection, diagnosis and prognosis evaluation of bladder cancer. Deep Convolution Neural Networks (DCNNs) have been successfully used for bladder tumor segmentation, but the segmentation based on DCNN is data-hungry for model training and ignores clinical knowledge. From the clinical view, bladder tumors originate from the mucosal surface of bladder and must rely on the bladder wall to survive and grow. This clinical knowledge of tumor location is helpful to improve the bladder tumor segmentation. To achieve this, we propose a novel bladder tumor segmentation method, which incorporates the clinical logic rules of bladder tumor and bladder wall into DCNNs to harness the tumor segmentation. Clinical logical rules provide a semantic and human-readable knowledge representation and are easy for knowledge acquisition from clinicians. In addition, incorporating logical rules of clinical knowledge helps to reduce the data dependency of the segmentation network, and enables precise segmentation results even with limited number of annotated images. Experiments on bladder MR images collected from the collaborating hospital validate the effectiveness of the proposed bladder tumor segmentation method.
Topics: Urinary Bladder Neoplasms; Humans; Neural Networks, Computer; Magnetic Resonance Imaging; Image Interpretation, Computer-Assisted; Deep Learning
PubMed: 38776840
DOI: 10.1016/j.media.2024.103189