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Testing the effects of physique detail about fish maneuverability by way of robophysical designs.
Clinicopathologic features of EPC were compared with IDC. Results The mean age of the EPC patients was 51.81±13.94 years, with a mean tumor size of 2.97±2.46 cm. The majority of cases were grade II, and axillary metastasis was present in 18.8% of cases. About 56.3% of cases were in situ, and 43.8% showed foci of invasion in the form of IDC. Recurrence was noted in 12.5% of cases with a survival rate of 93.8%. ER, PR, and HER2/neu positivity was noted in 81.3%, 75%, and 12.5% cases, respectively. EPC was significantly noted to have lower tumor grade and pathological T-stage than IDC. Similarly, a lower frequency of axillary metastasis was noted in EPC than IDC. Conclusion EPC is a rare distinct subtype of papillary breast tumors with overall good survival and low recurrence rate. Compared to IDC, we found EPC to be associated with better prognostic parameters such as lower tumor grade and T-stage and lower frequency of axillary metastasis.Thiamine (vitamin B1) deficiency is uncommon in developed countries and is most commonly seen in patients with poor dietary intake, malabsorption syndromes, and alcoholism. With the increasing rates of alcohol use, thiamine deficiency is likely an under-recognized and potentially reversible cause of sensorimotor dysfunction called dry beriberi. We present a case of profound lower extremity weakness in a 28-year-old female from Nepal with decompensated alcohol-induced cirrhosis. Based on laboratory testing, it was determined that the cause of her neuropathy was dry beriberi. She was subsequently started on thiamine replacement therapy with slow improvement over the next six months.Introduction Saudi Arabia has a high prevalence of sickle cell disease (SCD). Leg ulceration is one of the complications associated with SCD. There is a gap in the literature in regard to the prevalence of leg ulcers among SCD patients in Saudi Arabia. Objectives The primary objective of this study was to evaluate the lifetime prevalence of leg ulcers in SCD patients in our population and to study the predictive factors of leg ulcers by using sociodemographic factors, clinical manifestations of SCD, and other relevant factors like hydroxyurea. Methods A cross-sectional study design was utilized. Data collection was done using an electronic survey to collect self-reported information for the prevalence of leg ulcers and possible associated factors. The survey was distributed using social media platforms. Chi-square test was used to test for the presence of an association between having leg ulcers and sociodemographic variables as well as SCD related history. Furthermore, binary logistic regression was utilizedcomplications of sickle cell disease or hydroxyurea.Tumor lysis syndrome (TLS) is the phenomenon of metabolic derangements that typically follows the initiation of cytotoxic chemotherapy. Metabolic disturbances include hyperphosphatemia, hyperkalemia, hyperuricemia and hypocalcemia. Hematological malignancies are associated with spontaneous TLS (STLS), which is cell lysis in the absence of chemotherapy. STLS is extremely rare in chronic lymphocytic leukemia (CLL). Clozapine N-oxide This has been documented only once in the medical literature, making this an extraordinarily uncommon case. We present here a 68-year-old male with a history of benign prostatic hyperplasia (BPH) who is admitted for a two-week history of abdominal pain and three days of anuria, despite adequate fluid intake. Laboratory values yielded a greatly elevated leukocyte count with a lymphocytic predominance and smudge cells. Potassium, phosphorus, and uric acid were also significantly increased. EKG revealed peaked T-waves. Flow cytometry confirmed the presence of an abnormal B-cell population consistent with B-cell chronic lymphocytic leukemia, with the following markers CD19+, CD20+, CD23+, CD5+, CD10-. He was diagnosed with CLL and treated with aggressive fluid resuscitation, allopurinol and rasburicase. The patient had another similar episode within one month. His CLL fluorescence in-situ hybridization (FISH) showed complex cytogenetics with unmutated IgVH and he was subsequently started on ibrutinib.
Glycated haemoglobin (HbA1c) is amarker that reflects thecontrol of diabetes mellitus (DM) over a three-month period. We sought to compare cardiovascular outcomes of diabetic patients with and without controlled levels of HbA1c post percutaneous coronary intervention (PCI) presenting to King Faisal Cardiac Center. Methods A retrospective single-center study of all patients with type two DM who were treated with PCI during the period between January 2015 and January 2018. All data were obtained from health informatics system. Demographics, clinical data, and major adverse cardiovascular and cerebrovascular events (MACCE) were collected to compare outcomes among diabetic patients with and without controlled HbA1c.

The study included 177 patients with type two DM who underwent PCI. The mean age was 63.3 (SD±12).Males represented 73.4% and 26.6% were females. The mean HbA1c on admission was 8.7%. At presentation 31% of the patients had relatively controlled blood sugar (HbA1c mean 7.5%, SD±0.5) and 69% preseontrol reflected by glycated haemoglobin is associated with improved survival and lower incidence of composite MACCE.
Tibia plateau fractures are most commonly managed with open reduction and internal fixation (ORIF) technique, external fixation via minimally invasive technique are an excellent alternative. The aim of this study was to assess the results of tibia plateau fractures by using the Ilizarov external fixator. The analysis was done both clinically and radiologically.

Some 72 patients with isolated tibia plateau fractures were brought to ED and clinics and assessed. The fractures were classified according to Schatzker Tibia Plateau Fracture classification, only Schatzker type III to VI were included using conventional X-rays. All patients for their tibia plateau fractures underwent surgical correction using Ilizarov technique with full weight bearing and knee range of motion allowed the next day. Patient follow-up up to one year was done. KOOS and self-appraisal were used to evaluate the knee pain and function.

All the fractures healed with 67 patients achieving a range of motion better than 0-100º. KOOS score shows that patients who had worse fracture patterns (Schatzker-V and VI) have worse global scores (p=0.
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