As the world continues to study and understand coronavirus disease (COVID-19), existing investigations and tests have been used to try and detect the virus to slow viral transmission and its global spread. A ‘gold-standard’ investigation has not yet been identified for detection and monitoring. Initially, computed tomography (CT) was the mainstay investigation as it shows the disease severity and recovery, and its images change at different stages of the disease. However, CT has been found to have limited sensitivity and negative predictive value in the early stages of the disease, and the value of its use has come under debate due to whether its images change the treatment plan, the risk of radiation, as well as its practicality with infection control. Therefore, there has been a shift to the use of other imaging modalities and tests, such as chest X-rays and ultrasound. Furthermore, the use of nucleic acid-based testing such as reverse-transcriptase polymerase chain reaction (RT-PCR) have proven useful with direct confirmation of COVID-19 infection. In this study, we aim to review and analyse current literature to compare RT-PCR, immunological biomarkers, chest radiographs, ultrasound and chest CT scanning as methods of diagnosing COVID-19.
Despite the breadth of patient safety initiatives, physicians talking about their mistakes to other physicians is a difficult thing to do. This difficulty may be exacerbated by a limited exposure to how to analyze and discuss mistakes and respond in a productive way. At the University of Virginia, we recognized the importance of understanding cognitive biases for residents in both their clinical and personal professional development. We re-designed our resident led morbidity and mortality (M&M) conference using a model that integrates dual-process theory and metacognition to promote informed reflection and analysis of cognitive diagnostic errors. We believe that structuring M&M in this way builds a culture that encourages reflection together to learn our most difficult diagnostic errors and to engage in where our thought processes went wrong. In slowly building this culture, we hope to inoculate residents with the habits of mind that can best protect them from harmful biases in their clinical reasoning while instilling a culture of self-reflection.
Explicit education on diagnostic reasoning is underrepresented relative to the burden of diagnostic errors. Medical educators report curricular time is a major barrier to implementing new curricula. The authors propose using concise student-identified educational opportunities -- differential diagnosis and summary statement writing -- to justify curriculum development in diagnostic reasoning.
Eighteen clerkship and 235 preclinical medical students participated in a 1 h computerized case presentation and facilitated discussion. Students were surveyed on their attitudes toward the case.
All 18 (100% response) clerkship students and 121 of the 235 preclinical students completed the survey. Students felt the module was effective and relevant. They proposed medical schools consider longitudinal computerized case presentations as an educational strategy.
A computerized case presentation is a concise instructional strategy to teach critical points in diagnosis to clerkship and preclinical medical students.
There are more than 24.1 % of the world’s population are Muslim. Considering the religious preference, Drug Control Authority (DCA) requires manufacturers to declare clearly if their products contain materials of animal origin, as well as unsafe drugs. In general, Health supplements, herbal products, and traditional medicine are classified as “food-drug interphase (FDI) products. FDI products are products with a combination of food ingredients and active ingredients for oral consumption. FDI products are widely believed to be able to prevent or even cure many diseases. However, over the past ten years, there are various FDI products in Malaysia contain dangerous drugs. Hence, this study summarizes the harmful effect of listed unsafe drugs possess in the FDI products, the category of the product, and the type of claim. According to the National Pharmaceutical Regulatory Agency (NPRA) recent report, there are 162 FDI products have been mixed up with illegal drugs which majority of them contain Dexamethasone. The most category of products that contain unsafe drugs is among traditional medicine products followed by health supplements, herbal supplement products, and dietary supplements. These products were commonly marketed to strengthen the veins & joint and pain relief, weight loss, sexual enhancement, energy booster, relieve sinus, and gout. Hence, an awareness of adulteration in pharmaceuticals is crucial to ensure the quality, safety, and effectiveness of the products towards human health.
A one-day-old female Holstein calf was presented with subcutaneous masses spread over the whole body. Macroscopically, the masses were firm in touch, greyish-white in colour, 0.5-2 cm in diameter range. Histopathological examination confirmed the cutaneous Kaposiform hemangioendothelioma (KHE). Microscopic examination of the tumor revealed sheets of spindled endothelial cells forming vascular slits. Immunohistochemically, the tumor cells and capillaries gave strongly positive reaction for CD31 while vimentin, alpha smooth muscle actin and cytokeratin AE1/AE3 were negative. In this case, macroscopical, detailed histhopathological and immunohistochemical findings of congenital KHE reported firstly in a newborn calf.
A rare case of uterine leiomyosarcoma associated with chondriod metaplasia, cystic endometrial polyps and uterine horn intussusception in a greater cane rat was macroscopically, histopathologically, immuno-histochemically and ultrastructurally evaluated. The histopathological findings for this tumour were similar to those for leiomyosarcomas described in other species. Immunohistochemical examination demonstrated positive immunoreactivity of neoplastic cells with α-smooth muscle actin, desmin and vimentin. Ultrastructurally, nuclear and cytoplasmic features were consistent with leiomyosarcoma. These results revealed the tumour to be of smooth muscle origin. To our knowledge, this is the first reported case of uterine leiomyosarcoma associated with cystic endometrial polyps, chondriod metaplasia and uterine horn intussusception in a greater cane rat.
This study aimed to disclose the importance of nipple discharge (ND) and the accuracy of its economic and fast cytological interpretation.
All ND cytology cases for Saudi patients done between 2004 and 2013 were retrieved from the Pathology e-system. Only cases that have subsequent tissue diagnoses were included in this study (n = 228). Age and bloody nature of the ND were both tested for association with a higher chance of carcinoma. Diagnostic accuracy of ND cytology was calculated twice, including and excluding the “atypical” cases.
Specificity and positive predictive value were 100% for ND cytology in both cases. Sensitivity (34.6%; 52.9%), negative predictive value (93.15 %; 96.1%), false-negative rate (65.4%; 47.1%), accuracy rate (93.4%; 96.2%), when atypical cases were included and excluded; respectively. Only 10.5% of the patients complaining from nipple discharge had breast cancer. For those who had cancer, nipple discharge cytology was positive and showed the cancer cells in only 37.5%, while the rest were false negative. Bloody ND disclosed a significant association with malignancy (p < 0.001), but the association was statistically not significant for old age (p = 0.062).
The prospect of having breast cancer with the presentation of ND is low, and it can be missed by studying the ND cytology alone in a high proportion of cases. Excluding the atypical category did not make a significant improvement in the test’s accuracy.
Atmospheric plasma jet has different medical applications due to its low temperature at room temperature. In recent years, the effect of nonthermal plasmas on cancer cells has been studied, and it has been shown that this type of plasma has anti-proliferative effects on cancer cells.
To design a plasma jet handpiece, which can be used in cutting operations in less bleeding surgery, eliminating cancer cells without damage to healthy cells and reducing the duration of wound healing.
The plasma handpiece simply consists of a nozzle body and two cathode and anode electrodes and a fully insulated body against heat and high voltage. Argon is introduced into the handpiece, and by plasma treatment, it is used for special purposes. Each piece was made according to its own manufacturing process and by assembling; the final product of the atmospheric plasma jet handpiece was ready for testing. The jet pipeline was then tested, and the effective parameters were examined.
The cold atmospheric plasma jet length depends on factors such as power supply, applied voltage, gas flow rate and the distance between the electrodes. The results showed with increasing velocity, the flame and jet lengths decreased greatly due to high losses of plasma, including ions and electrons. Also with increasing the velocity of argon gas, its concentration decreased.
It is concluded that the performance of the proposed design is successful. The advantages include low-cost manufacturing, highly stable performance, and low erosion and can be considered for future development.