Background: Anesthetic technique plays a critical role in determining postoperative recovery and complications. General anesthesia (GA) is widely used, but regional anesthesia (RA) has been suggested to offer several perioperative benefits. Objective: To compare the effects of general versus regional anesthesia on postoperative outcomes, including pain scores, complication rates, and hospital stay duration in elective abdominal surgeries. Methods: A total of 246 adult patients undergoing elective abdominal surgeries were enrolled using non-probability consecutive sampling. Patients were divided into two groups based on the anesthetic technique administered: Group A (n = 132) received general anesthesia, while Group B (n = 114) underwent surgery under regional anesthesia.  Results: Patients in the regional anesthesia group reported significantly lower postoperative pain scores (mean VAS: 3.2 ± 1.1 vs. 5.6 ± 1.3; p < 0.001), a reduced incidence of PONV (15.8% vs. 34.1%; p = 0.002), and a shorter mean hospital stay (3.4 ± 1.2 vs. 4.7 ± 1.5 days; p < 0.001) compared to the general anesthesia group. Moreover, early ambulation was more commonly achieved within 24 hours in the RA group (74.6% vs. 49.2%; p < 0.001). Postoperative complications were also fewer in the RA group. Conclusion: Regional anesthesia is associated with superior postoperative outcomes in elective abdominal surgeries, including better pain control, lower complication rates, and faster recovery. RA should be considered a favorable alternative to GA in appropriate surgical candidates to enhance postoperative care and efficiency.

Background: Ovarian and endometrial cancers are among the most prevalent gynaecological malignancies, with significant morbidity and mortality. Recent advancements in molecular biology have emphasized the role of genetic mutations in tumorigenesis and disease progression. Objective: To investigate the contribution of key genetic mutations, including BRCA1/2, PTEN, TP53, and mismatch repair (MMR) genes, in the development and progression of ovarian and endometrial cancers. Methods: A retrospective molecular profiling study was conducted on 220 biopsy-confirmed cases of ovarian and endometrial cancers. Next-generation sequencing (NGS) was used to identify germline and somatic mutations. Statistical correlations were drawn between mutation profiles, clinical staging, and patient outcomes. Results: BRCA1/2 mutations were present in 38% of high-grade serous ovarian cancers. PTEN loss and mutations in PI3K/AKT/mTOR pathway genes were detected in 46% of endometrial carcinomas. TP53 mutations were associated with poor prognosis in both cancer types. Defective MMR genes were present in 21% of endometrial cancers, linked with microsatellite instability (MSI) and early onset.

Conclusion: Genetic mutations significantly influence the development and clinical course of ovarian and endometrial cancers. Genetic profiling should be integrated into standard care for early diagnosis, risk assessment, and personalized treatment strategies.

Background: Cataract surgery is a widely performed procedure globally, and the choice of anesthesia general anesthesia (GA) or regional anesthesia (RA) significantly impacts postoperative outcomes, recovery, and patient satisfaction. Objective: To evaluate the comparative efficacy of GA and RA in cataract surgeries, focusing on postoperative visual acuity, recovery times, patient satisfaction, and cost-effectiveness. Methods: A total of 155 patients undergoing cataract surgery were randomly assigned to GA (n=78) or RA (n=77). Primary outcomes included postoperative visual acuity and recovery times, while secondary outcomes were patient satisfaction, incidence of complications, and cost analysis. Data were analyzed using parametric and non-parametric statistical tests. Results: At 24 hours, RA achieved better visual acuity (62% achieving 6/9 or better) compared to GA (48%, p=0.04). By 1 week and 1-month, visual outcomes were comparable. RA demonstrated shorter recovery times, with a mean hospital stay of 8 ± 3 hours versus 12 ± 4 hours for GA (p<0.01), and 92% of RA patients ambulating within 4 hours compared to 74% for GA (p<0.01). RA patients reported higher satisfaction (89% rated excellent/very good vs. 76% in GA, p=0.02). Minor complications were slightly higher in the RA group (6% vs. 3%, p=0.17), but not statistically significant. Conclusions: It is concluded that RA provides significant advantages over GA in cataract surgeries, including faster recovery, higher satisfaction, and cost-effectiveness, while achieving comparable visual outcomes. Anesthesia choice should be personalised to patient-specific factors and clinical contexts for optimal results.

Background Chronic suppurative otitis media (CSOM) is a prevalent middle ear infection characterized by persistent purulent discharge, leading to significant hearing loss. It is commonly seen in children, particularly from low socioeconomic backgrounds, and is associated with a variety of microbial pathogens. This study aims to identify the bacterial pathogens responsible for CSOM in a tertiary care hospital setting.  Methods: A prospective study was conducted over one year, involving 61 clinically diagnosed CSOM patients. Ear discharge samples were collected under aseptic conditions, cultured, and subjected to Gram staining and biochemical identification to determine the bacterial pathogens. Results: Of the 61 samples, 60 (98.36%) showed significant bacterial growth. The majority of isolates were Gram-negative bacteria (78.69%), with Klebsiella pneumoniae (24.59%) being the most common pathogen, followed by Pseudomonas aeruginosa and Proteus mirabilis (18.03% each). Monomicrobial growth was observed in 93.44% of cases, while polymicrobial infections were found in 4.92%. Seasonal variations in bacterial prevalence were noted, with Pseudomonas aeruginosa peaking in March and Klebsiella pneumoniae in August. Conclusion Gram-negative bacteria, especially Klebsiella pneumoniae and Pseudomonas aeruginosa, are the predominant pathogens in CSOM. Early microbiological diagnosis and targeted treatment are crucial in managing CSOM to prevent hearing loss and other complications.

Introduction In recent years, the surgical treatment of benign prostatic hyperplasia has focused on minimally-invasive endoscopic procedures, promising the same functional outcomes but lower perioperative complications compared to traditional techniques such as open prostatectomy and transurethral resection of the prostate (TURP). Case report We present the case of a 65-year old man who presented to our department describing urinary incontinence episodes after he had undergone a greenlight laser (KTP) photoselective vaporization of the prostate. Seven months after the laser vaporization the patient underwent a TURP. After this procedure the symptoms did not subside, so after an urodynamic evaluation, he was prescribed antimuscarinics, which had no effect. The patient started treatment with solifenacin succinate 10 mg OD for 6 months and after that the urodynamic tests were repeated and the results were in normal parameters with the exception of a higher level of bladder pressure during the filling phase, about 10 cm H2O. We considered that decreasing this pressure might prevent the urinary leakage, so we decided to perform a set of 30 intradetrusorian injections with botulinum toxin 500 Speywood units. After this treatment the symptoms subsided and after 2 months an urodynamic investigation revealed a storage pressure of 3-4 cm H2O, with no leakage or detrusor instability. Two years after this treatment the patient has no urinary incontinence and no current need for further treatment. Conclusion An incomplete preoperative evaluation in addition to the use of a surgical technique that has not established itself over time had led to the development of a bothersome symptomatology, lasting about 2 years and having a severe emotional impact on the patient.

Introduction In Romania, extrapulmonary tuberculosis occurred in 8% of all new cases in 2014. It is known that immunocompromised hosts are more susceptible to disease, but the latest studies have also reported tuberculosis in immunocompetent patients. Case report Our case describes a fifteen year old female who presented prolonged high fever, ascites and increased CA-125 serum level. Biochemical analysis of ascites fluid revealed a high value for adenosine deaminase, negative smear for Gram and Ziehl-Neelsen stain and undetectable Mycobacterium tuberculosis at PCR assay. Epiploic fringes identified in magnetic resonance imaging of the pelvis led to indicate exploratory laparoscopy and peritoneal biopsy. Conclusion After we reviewed the medical literature, we consider that adenosine deaminase might be useful in the early diagnosis of extrapulmonary tuberculosis.

Introduction Percutaneous NephroLithotomy (PCNL) is one modern alternative in renal stone management, a technique widely used in most urological centers. Despite its advantages on stone removal, such as being fast and minimally invasive, this technique also associates a lot of intraoperative and postoperative complications, bleeding being one of the most serious. Case report A 51-year old woman presented for recurrent pain in the left lumbar area that had started about 2 months before. After the clinical exam an ultrasound and intravenous urography exploration revealed a 17 mm stone in the left renal pelvis. We discussed the treatment alternatives with the patient and offered PCNL or 2 to 3 sessions of Extracorporeal Shock Wave Lithotripsy (ESWL). The patient chose to undergo PCNL because this was the fastest way for treating the stone, with better success rates than ESWL. A left PCNL was performed and after the intervention, a stone-free status was obtained and the patient was discharged in the 4th day following the intervention. In the 11th day after PCNL, the patient was hospitalized with gross hematuria which stopped 2 hours later, but restarted after 3 more days while the patient was still hospitalized. This time the bleeding was more severe and after 30 minutes, the patient’s systolic blood pressure had dropped to 75 mmHg and blood tests revealed a hemoglobin level of 7 g/dL. The patient was transferred to the Interventional Radiology Department and a selective angiographic embolization was performed stopping the bleeding. Conclusion PCNL remains the gold standard for the treatment of kidney stones which are not suitable for ESWL, but this minimally invasive procedure may also associate significant complications.

Introduction Pertussis is a contagious, acute respiratory illness caused by Bordetella pertussis. Symptoms and signs in adolescents and adults are nonspecific and the diagnosis may not even be considered in the differentials usually. Case report Herein we present the case of a middle aged nonsmoking South Indian man with history of paroxysmal cough associated with air hunger and post-tussive vomiting. On evaluation he was confirmed to have criteria for a clinical diagnosis of pertussis. This was corroborated by demonstration of the presence of high titer of pertussis antibodies. Conclusion Adult pertussis is not uncommon. A high index of suspicion is essential to make one think of pertussis as a probable etiology in patients presenting with acute and sub-acute cough.

Influenza infection alters the pulmonary homeostasis and the local immune responses, rendering the host more vulnerable to pneumococcal invasion. We performed a literature review using the search terms "Streptococcus pneumoniae” or "S. pneumoniae” or "pneumococcal” and "influenza” on PubMed, to identify fundamental studies published between January 2016 and January 2017 that describe the pathogenesis of influenza virus and S. pneumoniaeinfection. This review focuses mainly on the following three mechanisms that drive the co-pathogenicity between these two microbial agents: deficit of mucociliary clearance, dysfunction of immune cells and abnormal secretion of inflammatory mediators.

It is a well-known fact that before a new drug becomes available on the market, it goes through years of clinical trials, performed in multiple centers, on different populations, in order to describe to the highest level of detail not only the beneficial effects, but also every single side effect or complications that may arise from its use. This extremely complex mechanism is rigorously controlled by different governmental agencies, like the FDA in the USA and EMEA in the EU. However, when it comes to treatment techniques that do not involve the use of new chemical substances, these are not as strictly regulated. This responsibility falls on the shoulders of scientific journals, which publish the results from different clinicians. If we were to refer specifically to the field of dentistry, and to be more precise to dental implants, there are virtually no regulations to enforce one technique over the other, even though they may be in perfect opposition to one another.