Penn Highlands Healthcare

Clinical History and Diagnosis: A 14-year male presented with history of frequency of urination for last 5 months. Ultrasound abdomen pelvis showed 1.7 × 1.5 cm papillary lesion in urinary bladder near left ureteric orifice and it was confirmed in a contrast enhanced CT abdomen pelvis. Urine cytology was negative, and we planned for Cystoscopy and Holmium laser en bloc transurethral resection of bladder tumor under general anesthesia. Intervention: We used a 17 Fr Cystoscope and a 550 micron Holmium laser fiber stabilized over a 5 Fr open-ended ureteral catheter with the setting of 1.5 J and 30 Hz. Lumenis 100 w Holmium laser machine with long pulse width was used for better hemostasis. The initial incision was made 5 mm away from the tumor stalk at 6 o'clock position till the detrusor muscle was reached, and then we progressed toward the 12 o'clock potion using the beak of the cystoscope to lift the tumor and progress with the retrograde resection. The tumor was retrieved using an Alligator grasping forceps. Results: A 14 Fr 2 way Foley catheter was placed. Total operative time was 7 mins. The Frozen section confirmed the tumor as carcinoma and the patient received Intravesical Mitomycin 40 mg in 20 mL of sterile water. He was discharged the same day, and the Foley catheter was removed the next day. The Final pathology showed Urothelial carcinoma urinary bladder cTa low grade <3 cm, low risk. Follow-up: The surveillance flexible cystoscopy at 3 and 12 months did not show any recurrence. The patient is on yearly Ultrasound follow up without any recurrence in 3 years. The source of work or study: Apollo Multispecialty Hospitals, Kolkata, India. Author Disclosure Statement: The authors declare that they have have no conflicts of interest during the last 3 years related to this study. No funding, grants, or other financial support was received for this work. The authors affirm that they have no financial relationships, affiliations, or personal interests that could influence the research or its outcomes. The authors have received and archived patient consent for video recording/publication in advance of video recording of procedure. The authors declare that there are no conflicts of interest related to the place of work or affiliation. The study was conducted independently, and no institutional or organizational influences have impacted the research design, data analysis, or interpretation of results. Runtime time of video: 4 mins 58 secs.

Chandipura virus (CHPV) is currently implicated in outbreaks of viral encephalitis in rural India. The current outbreak in India has grown to 59 cases, 51 of which have been reported from Gujarat and the remaining from Rajasthan. It is of the utmost importance that all relevant health authorities carefully monitor the ongoing situation to bolster and protect international health security and ensure it is not compromised. Chandipura virus causes febrile disease. After the febrile phase, patients begin to present with neurological symptoms, as the virus is neurotropic in nature and results in encephalitis. No specific treatment for CHPV is available, and the management of cases is chiefly by symptomatic treatment. The Chandipura virus may have global implications. It is of global importance that the relevant authorities handle Chandipura and prevent further transmission.

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Diagnosis and management of liver abscesses in low- and middle-income countries (LMICs) is difficult due to limited diagnostic imaging availability. Limited data is available describing the use of point-of-care ultrasound (POCUS) in the diagnosis and percutaneous aspiration of liver abscesses in resource-limited countries. We describe a 21-year-old female who was diagnosed with a liver abscess. The diagnosis of liver abscess was made via POCUS, and the patient was successfully managed with empiric antimicrobials and repeated POCUS-assisted percutaneous needle aspiration. In resource-limited settings, adequate training of personnel and availability of POCUS may help in early diagnosis and treatment of liver abscess - thus helping to reduce its related morbidity and mortality - while also aiding in resource conservation.

Microplastics and Nano-particles ( MNP’s) surround the world around us, and are now not only found within the natural external environment but are also found within our very own internal environment (our tissues). As the world has entered the 21st century and as technology has advanced, the use of plastics predominantly single-use plastics (which are polymeric materials) has rapidly increased to match the global demand and the lifestyle habits as well as creature comforts which are demanded by the modern human being. As time has passed and technology has progressed our understanding of these polymeric compounds and how they interact with our environment and the manner in which they affect our health has improved. It is however noted that our knowledge with regards to these MNP’s still has major gaps and further research is necessitated to understand their full effect on our bodies and natural environment. Micro-plastics and nanoparticles are also known as MNP’s, for a piece of plastic to be considered a “microplastic” it must be less than 5mm in length and a nanoparticle is deemed one if it ranges between 1 to 1000 nanometers in size. The ubiquitous nature of these MNP’s within our environment poses a threat both directly and indirectly to the human race. The majority of these plastic polymeric compounds are produced from petro-chemicals and have innate substances and toxins which contaminate organic living matter. It is clearly evident that MNP’s have a detrimental effect on cardiovascular health, the extent to which is unclear. Further larger scale studies are required and are imperative to providing an improved insight for legislation and governing action.