Atypical perforated appendicitis secondary to schistosomiasis: a rare case report.

Introduction: Schistosomiasis is the second most common parasite disease after malaria and a rare cause of appendicitis. It has been well-documented in the literature that schistosomiasis infection can have several multisystem effects. The unusual condition known as schistosomal appendicitis was initially described by Turner. Case presentation: We present a 48-year-old man with perforated appendicitis and schistosomiasis-like radiological findings. An appendectomy was performed, and schistosomiasis was confirmed by a histological study of the excised appendix. Praziquantel was administered in a single dosage. Conclusion: Although schistosomiasis is a rare cause of appendicitis and is very prevalent in developing nations, it should be considered when managing the condition. Anti-shistosoma drugs, which are not frequently used in post-appendectomy cases, should also be considered in the management.

COVID-19 telehealth expansion can help solve the health care underutilization challenge.

The telehealth policy changes enacted for short-term control of the coronavirus disease 2019 (COVID-19) pandemic present an opportunity to address the fundamental gap in health care underutilization.

Microsurgical versus endovascular interventions for blood-blister aneurysms of the internal carotid artery: systematic review of literature and meta-analysis on safety and efficacy.

OBJECTIVE Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) have a poor natural history associated with high morbidity and mortality. Currently, both surgical and endovascular techniques are employed to treat BBAs; thus, the authors sought to perform a meta-analysis to compare the efficacy and safety of these approaches. METHODS A literature search of PubMed, MEDLINE, and Google Scholar online databases was performed to include pertinent English-language studies from 2005 to 2015 that discussed the efficacy and safety of either surgical or endovascular therapies to treat BBAs. RESULTS Thirty-six papers describing 256 patients with BBAs treated endovascularly (122 procedures) or surgically (139 procedures) were examined for data related to therapeutic efficacy and safety. Pooled analysis of 9 papers demonstrated immediate and late (mean 20.9 months) aneurysm occlusion rates of 88.9% (95% CI 77.6%-94.8%) and 88.4% (95% CI 76.7%-94.6%), respectively, in surgically treated patients. Pooled analysis of 12 papers revealed immediate and late aneurysm obliteration rates of 63.9% (95% CI 52.3%-74.1%) and 75.9% (95% CI 65.9%-83.7%), respectively, in endovascularly treated aneurysms. Procedure-related complications and overall poor neurological outcomes were slightly greater in the surgically treated cases than in the endovascularly treated cases (27.8% [95% CI 19.6%-37.8%] vs 26.2% [95% CI 18.4%-35.8%]), indicating that endovascular therapy may provide better outcomes. CONCLUSIONS Blood-blister aneurysms are rare, challenging lesions with a poor prognosis. Although surgical management potentially offers superior aneurysm obliteration rates immediately after treatment and at the long-term follow-up, endovascular therapy may have a better safety profile and provide better functional outcomes than surgery. A registry of patients treated for BBAs may be warranted to better document the natural course of the disease as well as treatment outcomes.