Oncocytic Carcinoma with Liver Metastasis: Unusual Treatment Strategies and Clinical Insights-A Case Report and Review of the Literature.

We report a distinctive case of malignant oncocytic carcinoma originating in the pancreas, an organ rarely associated with such tumours. We discuss the diagnostic journey, highlighting the tumour's resemblance to renal cell carcinoma but without renal involvement. A significant aspect of this case is the successful and sustained response to combined immunotherapy and tyrosine kinase inhibitors, demonstrating a potential therapeutic pathway for similar rare cases. This study contributes to a deeper understanding of pancreatic oncocytic tumours and their management.

Unilateral Axillary Lymphadenopathy in Cancer Patients Post-COVID-19 Vaccination: Review and Case Series.

Novel coronavirus-19 (COVID-19) variants continue to spread worldwide with the development of highly transmissible strains. Several guidelines addressing management of cancer patients during the COVID-19 pandemic have been published, primarily based upon expert opinion. The COVID-19 pandemic has affected all aspects of breast cancer care including screening, diagnosis, treatment, and long-term follow-up. Recent reports indicate that mRNA COVID-19 vaccines can provoke lymphadenopathy in both cancer patients and healthy individuals. Unilateral axillary lymphadenopathy (UAL) post-COVID-19 vaccination is a challenging presentation for cancer patients because of the potential for misinterpretation as malignancy. The World Health Organization's target to vaccinate 70% of the world's population by mid-2023 is likely to increase the incidence of post-COVID-19 vaccination UAL. In this article, we review the published evidence regarding UAL post-COVID-19 vaccination and present diverse cases of breast cancer patients where false-positive UAL post-COVID-19 vaccination proved to be a therapeutic challenge. The United Arab Emirates (UAE) vaccination program is well ahead of other countries in the world, having accomplished the target of 100% vaccination of the population with at least one dose. Therefore, an increasing number of recently vaccinated patients are likely to present with UAL, detected by surveillance imaging, post-vaccination. We have therefore made recommendations regarding the management of cancer patients with UAL post-COVID-19 vaccination in order to avoid misdiagnosis and unnecessary imaging or invasive biopsy procedures.

Norepinephrine May Exacerbate Septic Acute Kidney Injury: A Narrative Review.

Sepsis, the most serious complication of infection, occurs when a cascade of potentially life-threatening inflammatory responses is triggered. Potentially life-threatening septic shock is a complication of sepsis that occurs when hemodynamic instability occurs. Septic shock may cause organ failure, most commonly involving the kidneys. The pathophysiology and hemodynamic mechanisms of acute kidney injury in the case of sepsis or septic shock remain to be elucidated, but previous studies have suggested multiple possible mechanisms or the interplay of multiple mechanisms. Norepinephrine is used as the first-line vasopressor in the management of septic shock. Studies have reported different hemodynamic effects of norepinephrine on renal circulation, with some suggesting that it could possibly exacerbate acute kidney injury caused by septic shock. This narrative review briefly covers the updates on sepsis and septic shock regarding definitions, statistics, diagnosis, and management, with an explanation of the putative pathophysiological mechanisms and hemodynamic changes, as well as updated evidence. Sepsis-associated acute kidney injury remains a major burden on the healthcare system. This review aims to improve the real-world clinical understanding of the possible adverse outcomes of norepinephrine use in sepsis-associated acute kidney injury.

Voltammetric Determination of Ascorbic Acid in Pharmaceutical Formulations Using Modified Iodine-Coated Platinum Electrode / Determinación voltamétrica del ácido ascórbico en formulaciones farmacéuticas utilizando un electrodo de platino modificado recubierto de yodo

Background: Despite the high reactivity of the platinum electrode, the iodine-coated platinum electrode shows obvious inertness toward adsorption and surface processes. For that, iodine-coated platinum electrodes accommodate themselves to interesting voltammetric applications. Objectives: This study reports using the modified iodine-coated polycrystalline platinum electrode as a voltammetric sensor for ascorbic acid determination in pharmaceutical formulations. Methods: The developed voltammetric method based on recording cyclic voltammograms of ascorbic acid at iodine-coated electrode The optimized experimental parameters for the determination of ascorbic acid were using 0.1 M KCl as a supporting electrolyte with a scan rate of 50mV/s. Results: The anodic peak related to ascorbic acid oxidation was centered at nearly 0.28V. An excellent and extended linear dependence of the oxidative peak current on the concentration of ascorbic acid was observed in the range 2.84x10-3 - 5.68 mM. The limit of detection (LOD) and limit of quantitation (LOQ) were 1.0 µM and 3.01 µM, respectively, attesting to the method's sensitivity. The investigation for the effect of potential interference from multivitamin tablet ingredients (vitamins B1, B6, B12, folic acid, citric acid, sucrose, glucose, and zinc) indicated specific selectivity toward ascorbic acid and the absence of any electrochemical response toward these components. Recovery results in the range 98.93±2.78 - 99.98±5.20 for spiked standard ascorbic acid in pharmaceutical formulations further confirmed the potential applicability of the developed method for the determination of ascorbic acid in real samples. Conclusions: The developed method was successfully applied to the analysis of ascorbic acid (vitamin C), and the obtained results were in good agreement with the labeled values; besides, the statistical tests indicated no significant difference at p=0.05 with a 95% confidence level

Antecedentes: A pesar de su alta reactividad, el electrodo de platino recubierto de yodo muestra una inercia evidente hacia la adsorción y los procesos superficiales. Por ello, los electrodos de platino recubiertos de yodo se adaptan a interesantes aplicaciones voltamétricas. Objetivos: Este estudio informa sobre el uso del electrodo de platino policristalino recubierto de yodo modificado como sensor voltamétrico para la determinación del ácido ascórbico en formulaciones farmacéuticas. Métodos: El método voltamétrico desarrollado se basa en el registro de voltamperogramas cíclicos del ácido ascórbico en el electrodo recubierto de yodo Los parámetros experimentales optimizados para la determinación del ácido ascórbico fueron utilizando KCl 0,1 M como electrolito de soporte con una velocidad de barrido de 50mV/s. Resultados: El pico anódico relacionado con la oxidación del ácido ascórbico se centró en casi 0,28V. Se observó una excelente y extendida dependencia lineal de la corriente del pico oxidativo con respecto a la concentración de ácido ascórbico en el rango 2,84x10-3 - 5,68 mM. El límite de detección (LOD) y el límite de cuantificación (LOQ) fueron 1,0 µM y 3,01 µM, respectivamente, lo que demuestra la sensibilidad del método. La investigación del efecto de la interferencia potencial de los ingredientes de las tabletas multivitamínicas (vitaminas B1, B6, B12, ácido fólico, ácido cítrico, sacarosa, glucosa y zinc) indicó una selectividad específica hacia el ácido ascórbico y la ausencia de cualquier respuesta electroquímica hacia estos componentes. Los resultados de recuperación en el rango de 98,93±2,78 - 99,98±5,20 para el ácido ascórbico estándar adicionado en formulaciones farmacéuticas confirmaron además la potencial aplicabilidad del método desarrollado para la determinación del ácido ascórbico en muestras reales. Conclusiones: El método desarrollado se aplicó con éxito al análisis de ácido ascórbico (vitamina C), y los resultados obtenidos coincidieron con los valores etiquetados; además, las pruebas estadísticas no indicaron diferencias significativas a p=0,05 con un nivel de confianza del 95%

Method development, validation and bioequivalence of varenicline in human plasma by liquid chromatography tandem mass spectrometry.

A method based on liquid chromatography coupled to tandem mass spectrometry was developed for quantitative determination of varenicline in human plasma. Varenicline and the internal standard (25.0ng/mL of Clarithromycin) were extracted from human plasma by liquid-liquid extraction, using methyl tertiary butyl ether as the organic solvent. The chromatographic separation was achieved using C8 column with isocratic elution using a mixture of acetonitrile:0.001M ammonium acetate (adjusted to pH 4.0) (70:30%, v/v). The method was validated over the concentration range of 0.1-10.0ng/mL by investigating specificity, sensitivity, linearity, precision, accuracy, recovery, matrix effect and stability according to United State Food and Drug Administration guideline. The validated bioanalytical method was successfully applied to evaluate bioequivalence of two commercial products of 1mg varenicline single dose.

Foregut duplication cyst: an unusual presentation during childhood.

Congenital duplications can occur anywhere in the GIT, one third of all duplications are foregut duplications (esophagus, stomach, first and second part of duodenum). Respiratory symptoms are the most common symptoms in foregut duplications, most cases present with respiratory distress which may be present from birth, or symptoms may be insidious with cough, wheeze, or recurrent respiratory infections. We are presenting a 2-year-old boy presenting with cough and fever. Radiological investigation showed left mediastinal mass that was removed by excisional biopsy and revealed an esophageal cyst. Cough with or without fever could be rare presentations for esophageal cyst.

Timing of planned caesarean section and the morbidities of the newborn.

BACKGROUND: Elective caesarean section rates have risen over the last decade worldwide. The increase in this rate is not associated with clear benefit for the baby or mother but proportionally associated with increased morbidity for both. Neonatal adverse outcomes in infants born before 39 weeks of gestation are increased and increase progressively as gestational age at birth declines AIM: To compare neonatal outcomes of elective caesarean section performed at or beyond completed 37 weeks of gestation with ≥ 38 weeks of gestation. MATERIAL AND METHOD: This is a prospective observational study. During the period from July 2010 through April 2011 a total 134 neonates delivered by elective Cesareans at term and were divided into two groups, those who were born (early term) before 38 weeks of gestation (37+0 - 37+6) and those who were born (late term) at or greater than 38 weeks of gestation. We analyzed the following variables sex, number of maternal parities, mode of anesthesia, Apgar score at first and fifth minute, respiratory complications, hypothermia, hypoglycemia, feeding difficulties and admission to neonatal intensive care unit. RESULTS: During the period of the study 890 live births whether delivered by Cesarean section or normal vaginal delivery. Of these only 134 neonates fulfilling the inclusion criteria were included. About 50% of them were delivered before 38 weeks of gestation. We performed our analysis on those 134 neonates and we found a significant risk in the early Cesareans group in comparison to later group for development of respiratory complications (P=0.0001), hypothermia (P=0.0001) and feeding difficulty (P=0.0001). CONCLUSION: Significant reduction in the neonatal morbidities if the time of elective Cesareans is at completed 38 weeks or beyond 38 weeks of gestation. Further larger studies are needed to analyze the factors responsible for our new date regarding the hypothermia and feeding difficulty in neonates born electively by Cesareans before 38 completed weeks of gestation.