North Memorial Medical Center

Tubercular cholecystitis is an extremely rare form of abdominal tuberculosis. It is a rare entity that often masquerading as chronic cholecystitis. We report a case of a 40-year-old male hospitalized with chronic upper abdominal pain, fever, and cough and subsequently diagnosed as a case of chronic cholecystitis through routine investigations and imaging procedures in a private medical college hospital in Bangladesh. Histopathological examination after cholecystectomy revealed classical features of tuberculosis including granulomas with caseous necrosis and Langhans giant cells. The patient was initiated on anti-tubercular therapy postoperatively and showed excellent recovery. To our knowledge, there are very few reported cases of gallbladder tuberculosis from Bangladesh, particularly from private medical hospital settings. This case underscores the importance of considering tuberculosis in gallbladder pathology in endemic areas. Early recognition and initiation of antitubercular therapy lead to an excellent patient outcomes. Mugda Med Coll J. 2025; 8(1): 69-71

: Cancer is one of the primary concerns of mortality throughout the world in the present day. Among different types of cancers, lung cancer (LC) is predominant (21.77% of overall cancer caused death). It is classified into two major categories: oat cell or small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). The mortality due to NSCLC (~85%) is almost six times higher than the SCLC (15%). The identification of risk factors can reduce cancer burden and human fatality; however, this cannot prevent the severity of LC. In this case, the early diagnosis of LC can be an effective pathway in providing better treatment to the patients, which eventually may result in less fatality. This article offers an overview of several existing screening methods for the early diagnosis of LC. Nevertheless, these methodologies have limitations of reliability towards the diagnosis of cancer malignancy. Therefore, the prospects of different alternative approaches and their challenges to overcome this barrier for the early diagnosis of malignant tumor cells have been articulated in this article.

Aberrant sialylation is accepted as a carcinogenic biomarker. In previous work, fluorescently labeled wheat germ agglutinin (WGA) distinguished between cancerous and normal oral biopsies. The purpose of this study was to investigate WGA-fluorescein isothiocyanate (FITC) as a point-of-care tool for detecting oral malignant and dysplastic lesions in vivo. Subject recruitment was divided into two groups: (1) the clinically normal oral mucosa group; or (2) the presence of clinically suspicious oral lesion(s) group. A WGA-FITC solution was topically applied to observable lesions or to half the subject's mouth (sagittal plane) if lesions were absent. Fluorescent molecular imaging was used to evaluate WGA-FITC localization. Fluorescent imaging in 55 subjects demonstrated that WGA-FITC could detect histopathologically-confirmed cancerous and dysplastic lesions with high sensitivity (100% and 81%, respectively) and specificity (82%). This study supports in vivo fluorescent molecular imaging of WGA-FITC to visualize aberrant sialic acid expression associated with carcinogenesis. This technique resulted in the immediate chairside detection of oral cancerous and dysplastic lesions.

BACKGROUND: In order to increase trauma-related research and elevate trauma on the national research agenda, the National Trauma Institute (NTI) issued calls for proposals, selected funding recipients and coordinated sixteen federally funded (Department of Defense [DoD]) trauma research awards over a four-year period. We sought to collect and describe the lessons learned from this activity in order to inform future researchers of barriers and facilitators.METHODS: Fifteen principal investigators participated in semi-structured interviews focused on study management issues such as securing institutional approvals, screening and enrollment, multi-site trials management, project funding, staffing and institutional support. NTI Science Committee meeting minutes and study management data were included in the analysis. Simple descriptive statistics were generated and textual data were analyzed for common themes. RESULTS: PIs reported challenges in obtaining institutional approvals, delays in study initiation, screening and enrollment, multi-site management and study funding. Most were able to successfully resolve challenges and have been productive in terms of scholarly publications, securing additional research funding and training future trauma investigators. CONCLUSIONS: Lessons learned in the conduct of the first two funding rounds managed by NTI are instructive in four key areas: regulatory processes, multi-site coordination, adequate funding and the importance of an established research infrastructure to ensure study success. Recommendations for addressing institution-related and investigator-related challenges are discussed along with ongoing advocacy efforts to secure sustained federal funding of a national trauma research program commensurate with the burden of injury.

PURPOSE: Part of the limited success of community-based walking programs for people with peripheral artery disease (PAD) and intermittent claudication (IC) in the calf is a lack of strategies to manage pain during exercise. Carbon fiber ankle foot orthoses (AFO) could delay the onset of IC as they store elastic energy during stance that assists the calf muscles during gait propulsion. Clinical dogma may limit AFO implementation as many practitioners believe that AFO will reduce muscle recruitment during gait with a decline in function over time. Our purpose was to determine the gait adaptions in ankle mechanics, walking speed, and calf muscle recruitment when using AFOs to supplement a community walking program. METHODS: Fifteen patients with PAD (Age=67±12 yrs) were fitted with bilateral AFO. An initial 3D gait analysis with plantar flexor electromyography data was completed 1 week after fitting. We used a within-session comparison of walking with/without the AFO. Patients were then given standard advise to walk at home using the devices ad libitum for 12 weeks. Twelve patients completed follow up testing after 12 weeks. Differences between conditions and test times were analyzed using paired t-tests. RESULTS: The AFO reduced peak ankle plantar flexion power during the propulsion phase of walking at initial testing (mean±SE with AFO=1.5 ± 0.2 W · kg-1, without AFO=2.6 ± 0.3, p < 0.001). Reduced propulsion power was coupled with 4.5° less dorsiflexion during the terminal phase of stance (with AFO=8.6 ± 0.7°, without AFO=13.6 ± 0.9°, p < 0.001). Peak ankle plantar flexion moment and calf muscle recruitment did not change between conditions (p>0.05). The same pattern of results occurred at 12 weeks with no change in the variables over time (p>0.05). Gait speed was constant between conditions and over time (p>0.05; pooled initial=1.09 m · sec-1, pooled 12 weeks=1.06 m · sec-1). CONCLUSIONS: Maintenance of calf muscle recruitment when using the AFO was an unexpected, but favorable finding that contradicts conventional wisdom. Patients maintained normal values of ankle motion using AFO and sustained their gait velocity over time. The AFO reduces power demands on the calf muscle which has potential to reduce IC while still maintaining muscle integrity and walking function. Funding: Pilot and Mini-grants from NIH NIGMS 5U54GM104944.