Giant fibrokeratoma, a rare soft tissue tumor presenting like an accessory digit, a case report and review of literature.

INTRODUCTION: Acquired digital fibrokeratoma is an uncommon, benign fibrous tumour that usually occurs in adults as a solitary lesion with a typical size of less than 1cm. CASE PRESENTATION: A 48-year-old Afro-Caribbean man presented to our foot and ankle clinic with a long-standing growth over the plantar aspect of the distal phalanx of the left great toe. The growth was painful and affected the patient's mobility. It had gradually increased in size over a period of 17 years. The growth was completely excised, and the base was allowed to heal by secondary intention. The skin eventually healed, and the patient had a good outcome. The histological results confirmed that the growth was a digital fibrokeratoma. CONCLUSION: This case is of interest because of the rarity of digital fibrokeratoma and the unique morphological appearance of the tumor in this case. Additionally, we emphasise the importance of ruling out other causes of abnormal growths and considering fibrokeratoma during differential diagnoses

Atypical presentation of sacrococcygeal pilonidal disease: presentation and surgical management.

Sacrococcygeal pilonidal disease presentation varies greatly between being asymptomatic, acute abscess and chronic sinus. Acute abscess constitutes almost half of the initial presentation of such disease. To our best knowledge, acute abscess presentation hasn’t been reported as a result of acute trauma in the literature. In this paper, we report a case of atypical presentation of sacrococcygeal pilonidal disease after a fall on the back a week earlier. Surgical management of the abscess, incidental finding of the pilonidal disease and lessons learned from such case is discussed in detail

نقل الطاقة لاسلكيا باستخدام الرنين المغناطيسي المقارن

Wireless power transfer (WPT) based on magnetic resonance has become a major field of interest for researchers. Transferring power across air gaps has been achieved according to recent researches. Both small electric equipments such as mobile phones and laptops and large electric equipment such as electric vehicles have been proposed. The objective of this thesis is to design magnetic coupled resonators for wireless power transfer at a distance of one meter with maximum efficiency. Also, the usage of two transmitter system to overcome angle limitation and to increase energy efficiency has been studied. In this work, the professional electromagnetic simulation program (EMPRO) was used to design two models of power transfer systems. The first model consists of a single transmitting coil and a single receiving coil and the second model consists of two transmitting coils and one receiving coil to increase the coverage area. An extensive parametric study has been carried out on system parameters to obtain the highest efficiency of power transfer. In addition, The two models have been fabricated and tested for comparison of the acutal practical results with the simulated results obtained using EMPRO

DESIGN OF WIRELESS POWER TRANSFER SYSTEM WITH TRIPLET COIL CONFIGURATION BASED ON MAGNETIC RESONANCE

Wireless power transfer (WPT) system based on magnetic resonance is presented here. The aim is to transfer energy wirelessly from transmitter coil to receiver coil based on magnetic resonance. A novel system with a two-coil transmitter connected to a single power source is proposed here in a triplet configuration with a single receiving coil. The two-coil transmitter is introduced as an extension to the converge area. The equivalent lumped element circuit model is presented and mathematical equations for scattering parameters have been derived. The proposed configuration is simulated using both circuit (ADS) and electromagnetic (EMPRO) simulators. The effect of the coupling between coils is investigated using simulation. The proposed configuration is practically implemented using solenoid coils and tested to verify the simulation results. The effect of receiver displacement on efficiency is also investigated

Giant fibrokeratoma, a rare soft tissue tumor presenting like an accessory digit, a case report and review of literature

AbstractIntroductionAcquired digital fibrokeratoma is an uncommon, benign fibrous tumour that usually occurs in adults as a solitary lesion with a typical size of less than 1cm.Case presentationA 48-year-old Afro-Caribbean man presented to our foot and ankle clinic with a long-standing growth over the plantar aspect of the distal phalanx of the left great toe. The growth was painful and affected the patient’s mobility. It had gradually increased in size over a period of 17 years. The growth was completely excised, and the base was allowed to heal by secondary intention. The skin eventually healed, and the patient had a good outcome. The histological results confirmed that the growth was a digital fibrokeratoma.ConclusionThis case is of interest because of the rarity of digital fibrokeratoma and the unique morphological appearance of the tumor in this case. Additionally, we emphasise the importance of ruling out other causes of abnormal growths and considering fibrokeratoma during differential diagnoses

Over Use of Ionisation Radiation Imaging With Paediatric Head Trauma

Abstract Purpose: Is to determinate the incidence of paediatric head trauma age 0-17 years in our region in central Europe and the number of radiographic images done for paediatric patients to make a data base for further researches, to be effective in investigating, controlling, and preventing head trauma in our population and to study the real need of radiographic images: Methods: This is a retrospective study from the records of children with head trauma seen at the trauma clinics during the year 2018 Results: There were 3261 attendees recorded in paediatric age groups 0-17 years in 2018. 1168 paediatric patients presented with trauma to the head. 831 (36%) with simple injuries of the head, 295 (23.3%) with wounds in head area, 17 (1.5%) children had fractures, 23 (2%) had concussion and 2 (0.2%) patients had intracranial haematoma. 1097 (93.9%) children with head trauma were imaged by X ray (1032 patients) and CT scan (65 patients) in accordance with local guidelines for head trauma management. The percentage of patients in need of radiation is only 3.42%.Conclusion: Most head trauma in children was minor and not associated with brain injury. The radiation is over used in diagnosis of paediatric head trauma</jats:p

Sex-specific differences in infective endocarditis: A systematic review and meta-analysis of clinical profiles and management outcomes

Background: Infective endocarditis (IE) presents significant morbidity and mortality, with potential sex differences in clinical profile and outcomes. This is the first meta-analysis that aims to compare the clinical profile and outcomes of IE between males and females. Methods: We conducted a meta-analysis of nine studies evaluating the clinical profile and outcomes of IE in males versus females extracted from PubMed, EMBASE, SCOPUS, and Cochrane databases up to 1st of Jan 2024. Results: Our meta-analysis revealed notable sex differences in the incidence and complications of IE. Males exhibited a higher incidence of aortic valve IE (RR 1.57, 95 % CI [1.31, 1.88]), surgical indications for IE (RR 1.38, [1.12, 1.70]), Streptococci infection (RR 1.36, [1.04, 1.77]), intracardiac abscess (RR 1.22, [1.05, 1.42]), and Enterococci IE (RR 1.44, [1.28, 1.61]). In contrast, females had a higher incidence of mitral valve IE (RR 0.79, [0.67, 0.94]) and a higher in-hospital mortality rate (RR 0.84, [0.74, 0.96]). No significant sex differences were found in the incidence of valve vegetations, tricuspid valve IE, embolization, and Staphylococcus IE. In-hospital stay was longer in male patients, however, with borderline significance (RR 3.15, [-0.16, 6.45], p = 0.06). In patients who underwent surgery for IE, mortality rates were significantly lower in male patients (RR: 0.67 [0.59, 0.76], p < 0.01). Conclusions: Compared to females, males exhibit higher rates of aortic valve IE, intracardiac abscess, streptococci IE, enterococci IE and IE-related surgery indication. In contrast, females have higher rates of mitral valve IE and in-hospital mortality

Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups

Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups. Trial registration number NCT0432364

Machine learning risk prediction of mortality for patients undergoing surgery with perioperative SARS-CoV-2: the COVIDSurg mortality score

To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.</jats:p