Foreign body aspiration is frequently encountered in children but can also occur in adults, where it often remains undiagnosed for years. Forgotten foreign bodies within the bronchial tree may later manifest with either vague symptoms or life-threatening complications, such as massive hemoptysis. Contrast-enhanced computed tomography of the thorax is the preferred initial diagnostic modality and can suggest the presence of a foreign body. We present a case involving an adult who remained undiagnosed until adulthood, when he was ultimately found to have a foreign body embedded in the lung parenchyma.

Bladder cancer remains a significant health challenge. Early and accurate diagnoses are crucial for effective treatment and improved patient outcomes. In recent years, artificial intelligence (AI) has emerged as a powerful tool in the medical field, showing great promise in advancing the bladder cancer diagnosis. This review explores the current state and potential of AI technologies, including machine learning algorithms, deep learning networks, and computer vision, in enhancing the diagnostic process for bladder cancer. AI systems can analyze vast amounts of data from various sources, such as medical imaging, genomic data, and electronic health records, enabling the identification of subtle patterns and biomarkers that may indicate the presence of bladder cancer. These systems have demonstrated high accuracy in detecting cancerous lesions in imaging modalities such as cystoscopy, ultrasonography, and computed tomography scans, often surpassing human performance. Moreover, AI-driven diagnostic tools can assist in risk stratification, predicting disease progression, and personalizing treatment plans, thereby contributing to more targeted and effective therapies.

Bladder cancer remains a significant health challenge. Early and accurate diagnoses are crucial for effective treatment and improved patient outcomes. In recent years, artificial intelligence (AI) has emerged as a powerful tool in the medical field, showing great promise in advancing the bladder cancer diagnosis. This review explores the current state and potential of AI technologies, including machine learning algorithms, deep learning networks, and computer vision, in enhancing the diagnostic process for bladder cancer. AI systems can analyze vast amounts of data from various sources, such as medical imaging, genomic data, and electronic health records, enabling the identification of subtle patterns and biomarkers that may indicate the presence of bladder cancer. These systems have demonstrated high accuracy in detecting cancerous lesions in imaging modalities such as cystoscopy, ultrasonography, and computed tomography scans, often surpassing human performance. Moreover, AI-driven diagnostic tools can assist in risk stratification, predicting disease progression, and personalizing treatment plans, thereby contributing to more targeted and effective therapies.

Bladder cancer remains a significant health challenge. Early and accurate diagnoses are crucial for effective treatment and improved patient outcomes. In recent years, artificial intelligence (AI) has emerged as a powerful tool in the medical field, showing great promise in advancing the bladder cancer diagnosis. This review explores the current state and potential of AI technologies, including machine learning algorithms, deep learning networks, and computer vision, in enhancing the diagnostic process for bladder cancer. AI systems can analyze vast amounts of data from various sources, such as medical imaging, genomic data, and electronic health records, enabling the identification of subtle patterns and biomarkers that may indicate the presence of bladder cancer. These systems have demonstrated high accuracy in detecting cancerous lesions in imaging modalities such as cystoscopy, ultrasonography, and computed tomography scans, often surpassing human performance. Moreover, AI-driven diagnostic tools can assist in risk stratification, predicting disease progression, and personalizing treatment plans, thereby contributing to more targeted and effective therapies.

Background: and Purpose Pathogenic variants in the myopalladin gene (MYPN) are known to cause mildly progressive nemaline/cap myopathy. Only nine cases have been reported in the English literature. Methods: A detailed evaluation was conducted of the clinical, muscle magnetic resonance imaging (MRI), and genetic findings of two unrelated adults with MYPN-related cap myopathy. Genetic analysis was performed using whole-exome sequencing. MRI was performed on a 1.5-T device in patient 1. Results: Two unrelated adults born to consanguineous parents, a 28-year-old male and a 23-year-old female, were diagnosed with pathogenic variants in MYPN that cause cap myopathy. Both patients presented with early-onset, insidiously progressive, and minimally disabling proximodistal weakness with mild ptosis, facial weakness, and bulbar symptoms. Patient 1 had a prominent foot drop from the onset. Both patients were followed up at age 30 years, at which point serum creatine kinase concentrations were minimally elevated. There were no cardiac symptoms; electrocardiograms and two-dimensional echocardiograms were normal in both patients. Muscle MRI revealed preferential involvement of the glutei, posterior thigh muscles, and anterior leg muscles. Whole-exome sequencing revealed significant homozygous splicesite variants in both of the probands, affecting intron 10 of MYPN: c.1973+1G>C (patient 1) and c.1974-2A>C (patient 2). Conclusions This study elaborates on two patients with homozygous MYPN pathogenic variants, presenting as slowly progressive congenital myopathy. These patients are only the tenth and eleventh cases reported in the English literature, and the first from South Asia. The clinical phenotype reiterates the mild form of nemaline rod/cap myopathy. A comprehensive literature review is presented.

Background: and Purpose Pathogenic variants in the myopalladin gene (MYPN) are known to cause mildly progressive nemaline/cap myopathy. Only nine cases have been reported in the English literature. Methods: A detailed evaluation was conducted of the clinical, muscle magnetic resonance imaging (MRI), and genetic findings of two unrelated adults with MYPN-related cap myopathy. Genetic analysis was performed using whole-exome sequencing. MRI was performed on a 1.5-T device in patient 1. Results: Two unrelated adults born to consanguineous parents, a 28-year-old male and a 23-year-old female, were diagnosed with pathogenic variants in MYPN that cause cap myopathy. Both patients presented with early-onset, insidiously progressive, and minimally disabling proximodistal weakness with mild ptosis, facial weakness, and bulbar symptoms. Patient 1 had a prominent foot drop from the onset. Both patients were followed up at age 30 years, at which point serum creatine kinase concentrations were minimally elevated. There were no cardiac symptoms; electrocardiograms and two-dimensional echocardiograms were normal in both patients. Muscle MRI revealed preferential involvement of the glutei, posterior thigh muscles, and anterior leg muscles. Whole-exome sequencing revealed significant homozygous splicesite variants in both of the probands, affecting intron 10 of MYPN: c.1973+1G>C (patient 1) and c.1974-2A>C (patient 2). Conclusions This study elaborates on two patients with homozygous MYPN pathogenic variants, presenting as slowly progressive congenital myopathy. These patients are only the tenth and eleventh cases reported in the English literature, and the first from South Asia. The clinical phenotype reiterates the mild form of nemaline rod/cap myopathy. A comprehensive literature review is presented.

Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m 2 for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients’ age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

About one-third of patients with transsphenoidal basal encephaloceles have associated congenital anomalies, including cleft palate. Moreover, they are often plagued by symptomatic exacerbations in the form of upper respiratory obstructions, cerebrospinal fluid leaks, meningitis, etc., with few patients being asymptomatic. We herein present a rare asymptomatic case of transsphenoidal basal encephalocele in an 18-month-old child with cleft palate and highlight a modified version of two-flap palatoplasty.
Cerebrospinal Fluid Leak ; Child ; Cleft Palate ; Encephalocele* ; Humans ; Infant ; Meningitis

Aims: Sponges harbour diverse prokaryotic and eukaryotic microbes. However, diversity of sponge-derived Actinomycetes is of high interest because of its bioactive compounds. In the present study, diversity of Streptomycetes associated with marine sponges collected from Pongibalu (south Andaman) was investigated. Methodology and results: Sponges samples were collected by underwater SCUBA diver and Kuster’s agar media was used for isolation of actinobacteria. Colony morphology and 16s rRNA were studied for identification of isolates and phylogenetic tree was constructed using MEGA.6. A total of ten Streptomyces species were identified based on 16S rRNA gene sequencing from three sponge species (Hemiasterella spp. Tentorium spp. and Tethyopsis spp.). The organic extracts of these ten isolates revealed bioactivity against tow Gram positive and eight Gram negative pathogenic bacteria. Conclusion, significance and impact of study: This study suggests prospects and potentials of the diverse population of Streptomyces with bioactivity in marine sponges. It would be a potential source in the pharmaceutical industries. As well as actinobacteria associated with sponge may prevent the sponge from pathogenic bacteria, fungi, virus and other microflora by secretion of secondary metabolites on surface and inside. To understand the sponge and actinobacteria association and its bioactivity, a profound study need to be conducted.

A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.
Abscess ; Adolescent ; Astrocytoma ; Blood Sedimentation ; Blood Volume ; Brain Abscess* ; Brain* ; Choline ; Craniotomy ; Diagnosis, Differential ; Diffusion ; Edema ; Epithelioid Cells ; Female ; Fever ; Frontal Lobe ; Gadolinium ; Giant Cells, Langhans ; Granuloma ; Head ; Headache ; Humans ; Lactic Acid ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Necrosis ; Neoplasm Metastasis ; Neurologic Examination ; Papilledema ; Perfusion ; Perfusion Imaging ; Weight Loss