Medicine
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Both sleep-related disorders (SRD) and hypertension (HTN) are closely related to the occurrence of cardiovascular disease (CVD); however, few studies have explored their combined effect. Based on the National Health and Nutrition Examination Survey (NHANES) database, we comprehensively analyzed the combined effect of SRD and HTN on the occurrence of CVD. The weighted multivariate logistic regression analysis was adopted to explore how SRD and HTN can affect the occurrence of CVD. ⋯ The results indicated that SRD (Model 3: OR = 1.90, 95% CI: 1.60-2.25) and HTN (Model 3: OR = 2.28, 95% CI: 1.87-2.79) were both significantly associated with an increased risk of CVD. Additionally, we observed a significant additive interaction (RERI = 0.88, 95% CI: 0.03-0.65; AP = 0.22, 95% CI: 0.01-0.21; SI = 1.15, 95% CI: 1.07-1.33) and a significant multiplicative interaction (OR = 1.07, 95% CI: 1.03-1.10) between SRD and HTN on the occurrence of CVD. While both SRD and HTN are associated with CVD occurrence, their interaction can also contribute to the development of CVD.
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Owing to the abundant collateral blood supply to the duodenum, the development of a hepatoduodenal fistula after transarterial chemoembolization (TACE) is an extremely rare complication that usually requires hospitalization and intensive medical intervention. Here, we report a case of a silent hepatoduodenal fistula following TACE. ⋯ Hepatic fistulas may arise following TACE for HCCs near the gastrointestinal tract and may be present with nonspecific symptoms. This case suggests that increased efforts should be directed toward achieving selective embolization when treating HCC adjacent to the gastrointestinal tract, with close monitoring required after treatment.
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Case Reports
Uncommon yet critical: Pulmonary embolism in a 14-year-old Nigerian child: A case report.
Pulmonary embolism is a rare life-threatening condition in pediatric populations. Diagnosis is often challenging in resource-constrained settings suffering chronic shortages of specialist and diagnostic services. We report the prompt recognition and challenging management of pulmonary embolism in an adolescent presenting to a private specialist hospital in a resource-constrained country. Although, majority of the Nigerian population utilize private healthcare, most centers are not equipped with sophisticated radiological and advanced laboratory services. These services were outsourced to a recently equipped state-owned tertiary hospital. ⋯ The case highlights the need for low-resource settings to address diagnostic limitations and emphasizes the importance of a multidisciplinary approach to managing pulmonary embolism cases. It also adds to the growing evidence of the effective role of pharmacological therapy in the management of pulmonary embolism.
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Case Reports
Diagnosis of a large cystic teratoma of accessory ovary complicated with torsion by ultrasound: A case report.
An accessory ovary complicated by cystic teratoma and torsion is extremely rare and requires prompt diagnosis and surgical treatment. However, evidence for effective preoperative imaging diagnosis has barely been reported. Our study presented a case in which preoperative ultrasound reasonably suspected ovarian tumor torsion and an accessory ovary, and laparoscopic surgery was strategically performed. ⋯ Clinical manifestations of accessory ovarian tumors combined with torsion are similar to those of eutopic ovarian torsion, and timely surgery is required.
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Observational Study
Risk factors and severity of melasma in patients attending dermatology outpatient department of a tertiary care hospital: A cross-sectional study.
Melasma is a chronic acquired dysfunction of melanogenesis characterized by dark brown irregular macules on skin. Genetic predisposition, pregnancy, sun exposure, and hormonal therapy are common risk factors. Prevalence of melasma is variable, ranging from 5% to 46%. ⋯ Moreover, the use of digital screens was not associated with an increase in melasma severity. Most of the cases had mild melasma. Severity was significantly associated with age, parity, pattern, practice of cosmetic use, and presence of dermatological comorbidities.