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Pan-3C Protease Inhibitor Rupintrivir Holds SARS-CoV-2 Major Protease within a Exclusive Holding Method.
Gastric trichobezoar consist of the accumulation of chewed hair in the stomach and can extend to other structures of the digestive tract. The relevance of this entity is that it affects the process of nutrition and digestion, and depending on the size and distension of the digestive tract structures, it can cause perforation, infections, cholangitis and obstructive jaundice, intussusception and pancreatitis.

We present the case of a 15-year-old female patient came to the emergency department with a clinical picture of 8h of evolution, abundant vomiting and lack of appetite for more than 15days. Physical examination revealed a palpable mass in the epigastrium and left hypochondrium, without pain. Elective laparotomy was performed with findings of a mass of hard consistency and well organized with gastric shape, with hairs intertwined throughout its thickness, weighing 385g.

Currently, there are gaps in the evidence on the best approach to this condition, although both laparoscopic and endoscopic techniques and open surgery have been used, with satisfactory results. However, for the definitive solution of the primary cause, the surgical team must investigate further to avoid recurrence and greater burden of disease in the future.

Gastric trichobezoar may be caused by involuntary nocturnal trichotillomania. Trichobezoar can seriously compromise the nutritional and physical condition of the affected person. The surgical team can inquire about causes of psychological or psychiatric origin, which may explain the development of trichobezoar, giving an answer to the primary cause and avoiding recurrence.
Gastric trichobezoar may be caused by involuntary nocturnal trichotillomania. Trichobezoar can seriously compromise the nutritional and physical condition of the affected person. The surgical team can inquire about causes of psychological or psychiatric origin, which may explain the development of trichobezoar, giving an answer to the primary cause and avoiding recurrence.
We present a case report of excellent oncological outcome after 7-year follow up in a female Indian patient with pT2N3aM0 rare GRCC of the breast following breast conservation surgery and appropriate adjuvant treatment. Glycogen rich cell carcinoma (GRCC) is a rare subtype of primary malignant neoplasm of the breast which is not commonly discussed. Only approximately 288 cases have been reported since its first description globally with reports of varying prognosis. Even less (4 patients), which have been reported from India have described only clinic pathological features. This is first case report of patient from India discussing long term oncological outcome of a patient with rare GRCC (pT2N3aMO) of the breast following breast conservation surgery and appropriate adjuvant treatment. A 41-year-old lady presented to us with history of 2×2cm right breast lump for 2weeks. A BIRAD IV hypo echoic lesion with slightly irregular margins in the upper outer quadrant of the right breast and right axillary lymphadenen good, contrary to recent 2019 SEER data (Zhou Z, Kinslow CJ, Hibshoosh H, et al. Clinical features, survival and prognostic factors of glycogen-rich clear cell carcinoma (GRCC) of the breast in the US population. J Clin Med. 2019; 8 pii E246).
The purpose of reporting this case is to increase the knowledge about this rare subtype of breast cancer which underwent organ preservation. This case report reveals that clinical behavior and oncological outcome of GRCC breast can be unexpected, unusual, varied and even good, contrary to recent 2019 SEER data (Zhou Z, Kinslow CJ, Hibshoosh H, et al. Clinical features, survival and prognostic factors of glycogen-rich clear cell carcinoma (GRCC) of the breast in the US population. J Clin Med. 2019; 8 pii E246).
Cardiac tumors are uncommon with an estimated incidence of 0.002-0.3% in autopsy series. Most cardiac tumors are metastatic in nature. Renal cell carcinoma (RCC) metastatic to the heart without inferior vena cava (IVC) contiguous involvement is extremely rare with about 31 cases reported in the literature and only one case with bilateral atrial metastases.

In this report, the surgical management of metachronous RCC involving the right and left atrium is described in a 41-year-old male patient three years after initial diagnosis who presented with worsening episodes of cough, dyspnea, chest pain and hemoptysis. Transesophageal echocardiogram revealed significant inflow obstruction. The patient underwent bilateral atrial mass excision via median sternotomy. The postoperative period was unremarkable, and the patient was referred to medical oncology to pursue further treatment.

Among the reported cases of cardiac RCC metastases without contiguous IVC involvement, bilateral atrial metastases are exceedingly rare. To our knowledge, this is the first case with bilateral atrial involvement to undergo surgical resection reported in the literature.

Isolated biatrial cardiac metastases from RCC can be successfully resected with good outcomes in selected patients.
Isolated biatrial cardiac metastases from RCC can be successfully resected with good outcomes in selected patients.
Diaphragmatic injuries are a consequence of penetrating or blunt thoracoabdominal trauma. Minor injuries are often masked. However, they are easily picked in the presence of diaphragmatic herniations. Delayed presentation is associated with the influx of visceral contents into the thoracic cavity, which may cause strangulation and obstruction. Viscerothorax is a rare complication of diaphragmatic injuries.

A case report of a 25-year-old male patient with a history of penetrating chest injury. He presented to our setting with a sharp abdominal pain and episodes of vomiting that were later accompanied by chest pains and difficulty breathing. A CT scan revealed the presence of a left hemidiaphragmatic injury with a viscerothorax and mediastinal shift to the right side. Surgery was immediately done and with a good postoperative outcome.

Diaphragmatic injuries are still uncommon and are often overlooked in initial presentations. The presence of herniation through the defect prompts early diagnosis. Delayed pe surgical repair is the most favoured approach.
We assess the potential of exploiting stopwords in biomedical concept names to complete the logical definitions of concepts that are not sufficiently defined.

Concepts containing stopwords are selected from the Disorder hierarchy of Systematized NOmenclature of MEDicine (SNOMED-CT). SNOMED-CT consists of two types of concepts Fully Defined (FD) concepts which are sufficiently defined and Partially Defined (PD) concepts which are not sufficiently defined. In this work, FD concepts containing stopwords are treated as a source of ground truth to complete the definitions of, lexically and semantically similar, PD concepts. FD and PD concepts are lexically and semantically analysed to create sample-sets. Mandatory attribute-relationships are calculated by using an intersection-set logic for each FD sample-set. PD sample-sets are audited against this mandatory attribute-relationship template to identify inconsistencies in modelling styles and potentially missing attribute-relationships.

Lexical and semantic patterns around 11 stopwords were analysed. 26 sample-sets were extracted for the 11 stopwords. Mandatory attribute-relationships were identified for 24 of the 26 sample-sets. The method identified 62.5% - 72.22% of the PD concepts, containing the stopwords in and due to, to be inconsistent in their modelling style and potentially missing at least one attribute-relationship according to the created template.
Lexical and semantic patterns around 11 stopwords were analysed. 26 sample-sets were extracted for the 11 stopwords. Mandatory attribute-relationships were identified for 24 of the 26 sample-sets. The method identified 62.5% - 72.22% of the PD concepts, containing the stopwords in and due to, to be inconsistent in their modelling style and potentially missing at least one attribute-relationship according to the created template.The covalent organic framework (COF) shows great potential for use in gas separation because of its uniform and high-density sub-nanometer sized pores. However, most of the COF pore sizes are large, and there are mismatches with the gas pairs (3-6 Å), and the steric hindrance cannot work in gas selectivity. In this work, one type of COF (NUS-2) supported ionic liquid membrane (COF-SILM) was prepared for use in CO2/N2 separation. The separation performance was investigated using molecular dynamics simulation. There was an ultrahigh CO2 permeability up to 2.317 × 106 GPU, and a better CO2 selectivity was obtained when compared to that of N2. The physical mechanism of ultrahigh permeability and CO2 selectivity are discussed in detail. The ultrathin membrane, high-density pores and high transmembrane driving force are responsible for the ultrahigh permeability of CO2. The different adsorption capabilities of ionic liquid (IL) for CO2 and N2, as well as a gating effect, which allows CO2 passage and inhibits N2 passage, contribute to the better CO2 selectivity over N2. https://www.selleckchem.com/products/tubastatin-a.html Moreover, the effects of the COF layer number and IL thickness on gas separation performance are also discussed. This work provides a molecular level understanding of the gas separation mechanism of COF-SILM, and the simulation results show one potential outstanding CO2 separation membrane for future applications.Defensive medicine; although a recent concept, is slowly beginning to cement its place in the Indian health system. An interaction of multiple factors has paved way for this form of practice. Need for certainty of the diagnosis, lack of hierarchy in medical care, exponential growth of micro/super specializations and private/corporate health institutions, incentive-based practice, increasing incidences of violence against health personnel, rising trend of defamation suites against doctors, bad publicity by media, and interference by elected representatives have jeopardized the situation. This has led to decline in practice of clinical medicine, increased burden of investigations, especially in already compromised public facilities, and high out-of-pocket health expenditure. As much as ethical medical practice, standard patient management protocols, strict protection of interest of medical practitioners by law, responsible role of media and elected representatives are the need of the hour; we need to find ways to accept and incorporate defensive medicine into the modern medicine. Different stakeholders are required to come together and take substantial steps to understand the phenomenon and preserve the art and science of practicing medicine in its true form.Rising antimicrobial resistance (AMR) is causing therapeutic failures with antibiotics. Inappropriate use is a contributing factor. One such antibiotic on the radar is faropenem, a broad spectrum antibiotic approved in 2005 in India. Recently, faropenem sodium suspension was approved for use in children. There is a potential danger of overuse due to the convenience of oral administration. Other carbapenems such as meropenem are used parenterally. Overuse of faropenem may promote cross- resistance with other carbapenems making them ineffective.
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