Successful revascularization of inferior ST-segment elevation myocardial infarction with positive "Dead Man Sign": A case report.

This case report outlines the management of a 43-year-old male with no past medical history presenting with inferior ST-segment elevation myocardial infarction and a positive "Dead Man Sign." Prompt administration of antiplatelet therapy and emergent percutaneous coronary intervention led to successful revascularization of the occluded right coronary artery and left anterior descending artery. The patient remained asymptomatic throughout hospitalization and was discharged home with instructions for monthly follow-up for 1 year. Subsequent assessments demonstrated normal echocardiography and Electrocardiography (ECG) findings, indicating favorable cardiac recovery. This case emphasizes the critical importance of rapid recognition and intervention in ST-segment elevation myocardial infarction cases, as well as the significance of the Dead Man Sign as a predictor of the occluded culprit coronary vessels, demonstrating favorable outcomes achievable with timely revascularization strategies.

Excision of Solitary Non-syndromic Oral Plexiform Neurofibroma Utilizing a Diode Laser: A Case Report.

Plexiform neurofibroma is a benign peripheral nerve sheath tumor known to be pathognomonic for neurofibromatosis type 1. However, solitary plexiform neurofibroma in the oral cavity is extremely rare. Herein, we presented a 73-year-old Saudi male with solitary plexiform neurofibroma located on the maxillary alveolar ridge, which was excised successfully using a 940 nm diode laser. Microscopic examination revealed a multinodular arrangement of benign spindle cells in a haphazard pattern. Immunohistochemical analysis showed positive staining for S100 and CD34 in the tumor cells.

Dental bitewing radiographs segmentation using deep learning-based convolutional neural network algorithms.

OBJECTIVES: Dental radiographs, particularly bitewing radiographs, are widely used in dental diagnosis and treatment Dental image segmentation is difficult for various reasons, such as intricate structures, low contrast, noise, roughness, and unclear borders, resulting in poor image quality. Recent developments in deep learning models have improved performance in analyzing dental images. In this research, our primary objective is to determine the most effective segmentation technique for bitewing radiographs based on different metrics: accuracy, training time, and the number of training parameters as a reflection of architectural cost. METHODS: In this research, we employ several deep learning models, namely Resnet-18, Resnet-50, Xception, Inception Resnet v2, and Mobilenetv2, to segment bitewing radiographs. The process begins by importing the radiographs into MATLAB®(MathWorks Inc), where the images are first improved, then segmented using the graph cut method based on regions to produce a binary mask that distinguishes the background from the original X-ray. RESULTS: The deep learning models were trained on 298 and 99 radiograph training and validation sets and were evaluated using 99 images from the testing set. We also compare the segmentation model using several criteria, including accuracy, speed, and size, to determine which network is superior. Furthermore, we compare our findings with prior research to provide a comprehensive understanding of the advancements made in dental image segmentation. The accurate segmentation achieved was 93.67% and 94.42% by the Resnet-18 and Resnet-50 models, respectively. CONCLUSION: This research advances dental image analysis and facilitates more accurate diagnoses and treatment planning by determining the best segmentation technique. The outcomes of this study can guide researchers and practitioners in selecting appropriate segmentation methods for practical dental image analysis.

The Use of Diode Laser for the Surgical Removal of Pyogenic Granuloma of the Dorsum of the Tongue: A Case Report.

Pyogenic granuloma (PG) is a common reactive oral lesion predominantly involving the gingiva and rarely occurring on the dorsum of the tongue. It can develop at any age but more commonly in the second decade with a female predilection. Numerous factors are associated with its development, and surgical removal is the standard treatment. Various surgical modalities have been used to excise it. Herein, we report a case of a female patient in her late 60s who presented with an exophytic lesion involving the dorsum of the tongue, which was excised using a 940 nm diode laser. In addition, it discusses the advantages of diode laser as a surgical modality and describes this lesion's clinical features and pathogenesis.

Comparison between a fitness tracker (EquimetreTM) and standard base-apex electrocardiography in dromedary camels.

Background: Personalized healthcare technology has grown explosively through the use of portable and smart monitoring devices for diagnosis. The objective of this study was to determine the practicality and usability of the EquimetreTM fitness tracker on camels in comparison to the standard base-apex system in normal and clinical cases. Methods: Five apparently healthy adult camels, five clinical adult cases and two clinical calves were enrolled in this study. The camels were equipped with two monitoring systems: EquimetreTM and a standard base-apex electrocardiogarphy. Each tracing was evaluated for the normal ECG variable's measure, including heart rate beats per min, P-R, QRS, R-R, Q-T, S-T intervals, and P-R and S-T segments in seconds. The amplitudes for P, Q, R, S, and T-peaks were evaluated in millivolts. Results: EquimetreTM showed stability on ECG tracing with less movement artifacts compared with the standard base-apex system. Different polarities were observed for the P-waves and T-waves between the standard base-apex system and EquimetreTM. Both devices showed perfect agreement for heart rate (ICC = 1.00, P ≥ 0.0001, 95% = 1.00-1.00) in healthy and clinical adults. A good correlation was observed for the R-R interval between the devices in healthy and clinical adults. A moderate correlation was observed between the devices for Q-peak in clinical adults, with no correlation in clinical calves. Conclusions: This study demonstrated acceptable ECG measurements between the standard base-apex and EquimetreTM device. This suggests that EquimetreTM could be a useful device in camels for initial electrocardiographic examinations in remote areas such as deserts.

Efficacy and Safety Outcomes of Short Duration Antiplatelet Therapy with Early Cessation of Aspirin Post Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.

BACKGROUND: The optimal duration of dual antiplatelet therapy is a matter of ongoing research. Clinical studies are assessing the optimal duration with the most favourable risk to benefit ratio. The efficacy of P2Y12 receptor inhibitors comparable to aspirin in preventing recurrent ischaemic events in patients with coronary artery diseases. OBJECTIVES: To investigate the outcomes of short-duration dual antiplatelet therapy after PCI with early discontinuation of aspirin while maintaining patients on P2Y12 inhibitor through systematic review and meta-analysis of available literature. METHODS: We systematically searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov. We included randomized controlled studies that measured clinical outcomes of efficacy (mortality and ischaemic events) and safety (bleeding) of short and standard-duration dual antiplatelet therapy. The protocol of this study was registered in the international prospective register of systematic reviews PROSPERO registry (CRD42020171468). RESULTS: Four randomized controlled trials were included; GLOBAL LEADERS, SMARTCHOICE, STOPDAPT-2, and TWILIGHT. The total number of patients was 29,089. The safety outcomes showed a significant reduction in major bleeding events with short-duration dual antiplatelet therapy; the risk ratio was 0.61 (95% CI 0.38-0.99; z=2,00, p=0.05). There was no difference between short and standard-duration dual antiplatelet therapy regarding efficacy outcomes (all- cause death, major adverse cardiovascular events, myocardial infarction, stroke, and stent thrombosis). CONCLUSION: Short-duration dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy after PCI is a feasible option and can be adopted, especially in patients with a high risk of bleeding.

Blue Light Laser Results in Less Vocal Fold Scarring Compared to KTP Laser in Normal Rat Vocal Folds.

OBJECTIVES: Preliminary investigations suggest that a novel blue light (BL) laser with a wavelength of 445 nm is comparable to the commonly utilized potassium titanyl phosphate (KTP) laser (532 nm) for treatment of various laryngeal pathologies. The objective of the current study is to make a direct histological comparison of the degree of vocal fold scarring after either BL or KTP laser treatment in an animal model. STUDY DESIGN: This was a randomized controlled study using rats. METHODS: Twenty-four Sprague-Dawley rats were randomized to BL or KTP laser treatment. Laser was delivered in non-overlapping pulses to normal rat vocal folds. Larynges in each group were harvested at three time points: post-operative day 1, 30, and 90. Three animals served as negative controls. The excised whole larynges were sectioned transversely and stained with hematoxylin/eosin and trichrome. Presence of subepithelial inflammation and protein deposition/fibrosis indicative of scarring were scored semi-quantitatively (from grade 1-3) by two pathologists blinded to treatment groups. RESULTS: Between-group comparison showed that both laser treatments resulted in significantly elevated subepithelial protein deposition/fibrosis 90 days after treatment compared to negative controls (BL: 2 ± 0; KTP: 2.67 ± 0.29; control: 1.17 ± 0.29; P < .05). However, the degree of protein deposition/fibrosis was significantly higher in the KTP group compared to the BL group (P = .016). Within-group comparison showed that the KTP group showed evidence of fibrosis as early as 30 days after treatment, which was not observed in the BL group. CONCLUSIONS: The current study suggests that the degree of scarring is significantly less after BL laser treatment compared to KTP in normal rat vocal fold tissue. LEVEL OF EVIDENCE: NA Laryngoscope, 131:853-858, 2021.

Hyperhomocysteinia is a risk factor for retinal venous occlusion: a case control study.

BACKGROUND: We evaluated the role of hyperhomocysteinemia as a risk factor for retinal vein occlusion (RVO) in Indian patients. TYPE OF STUDY: Matched case control type of longitudinal study was conducted in 2006-2007. MATERIALS AND METHODS: Two medical retina specialists examined the eyes having an event of RVO in the last 15 days. A similar number of eyes without RVO were also examined. The serum and urine homocysteine levels of these persons were tested. Matched pair analysis was carried out to determine the risk of RVO among those with hyperhomocysteinemia. RESULTS: We included 20 cases of RVO and 20 age- and sex-matched persons without RVO. The risk of RVO was significantly higher in persons with hyperhomocysteinemia [difference of mean 31.62 µmol/L (95% Confidence Interval 16.60-47 . 86), P = 2.1 × 10-13 ]. The mean urine homocysteine level among cases and controls was not statistically significant. There were 12 persons with hypertension in both cases and control groups. CONCLUSION: Hyperhomocysteinemia is a risk factor for RVO. Any list of investigations for a case of RVO should include total plasma homocysteine (tHcy) levels.