Pleomorphic adenoma is the most common benign salivary gland tumor, predominantly affecting the parotid gland. Despite its benign nature, surgical excision carries significant risks, notably facial nerve injury and postoperative complications such as Frey’s syndrome. This case report discusses the presentation, diagnosis, surgical management, and postoperative challenges of a long-standing parotid tumor in a male patient, emphasizing the delicate balance between complete tumor removal and preservation of facial nerve function. A 58-year-old male, Mr. Toslim Ali, presented with a ten-year history of a slowly enlarging, painless left parotid swelling extending from the preauricular region to the upper neck. Clinical and imaging findings were consistent with a parotid mass. Fine needle aspiration cytology (FNAC) suggested a benign lesion. A superficial parotidectomy was performed under general anesthesia. Intraoperative findings revealed a well-encapsulated mass adherent to the parotid fascia but without evidence of deep lobe invasion. Facial nerve branches were carefully dissected and preserved. Histopathology confirmed pleomorphic adenoma. Postoperatively, the patient recovered without major complications, experiencing only mild transient facial weakness that resolved within four weeks. This case underscores the clinical importance of early surgical intervention in pleomorphic adenoma, meticulous intraoperative dissection for facial nerve preservation, and the need for patient counseling regarding potential complications. The discussion integrates literature on surgical approaches, risk factors, and preventive techniques for parotidectomy-related complications such as facial nerve injury and Frey’s syndrome.

Background: Saddle block anesthesia is widely used for perianal surgeries; however, postoperative analgesia remains limited when local anesthetics are used alone. This study aimed to compare the effects of intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine in saddle block for perianal surgeries Methods: This observational study in the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University Hospital enrolled 64 adults (ASA I–II, 40–60 years) undergoing perianal surgery under saddle block, randomly receiving hyperbaric bupivacaine 7.5 mg with fentanyl 15 μg or dexmedetomidine 5 μg; outcomes included duration of analgesia, pain, sensory and motor block, hemodynamics, patient satisfaction, and adverse events, analyzed using SPSS v23.0. Results: Among 64 patients (mean age 45.3 ± 8.5 years; 48 males, 75%), postoperative VAS scores were lower in the dexmedetomidine group at all time points (peak 4 h: 2.75 vs 3.75). Duration of analgesia was longer with dexmedetomidine (278.5 ± 16.2 min) than fentanyl (198.7 ± 25.2 min, P = 0.0001). Motor and sensory block durations were also prolonged (162.5 vs 126.5 min and 292.1 vs 205.6 min, respectively). Hemodynamics remained stable, and adverse events were minimal (hypotension 2/32 vs 0/32; nausea/vomiting 5/32 vs 8/32; pruritus 4/32 vs 0/32). Conclusion: Dexmedetomidine as an adjuvant to hyperbaric bupivacaine in perianal surgeries under saddle block offers longer analgesia, lower pain scores, and faster sensory block onset than fentanyl.

Background: Pilonidal sinus is a chronic disease of the sacrococcygeal region, commonly seen in young adults, and is characterized by midline pits in the natal cleft associated with hair. This study was conducted to evaluate the outcomes of the Limberg flap procedure in the treatment of primary pilonidal sinus, including postoperative complications, duration of hospital stay, and time to return to work. Methods: This prospective observational study at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh (July 2019–August 2020), included 18 adults with primary pilonidal sinus. Excluding acute abscess and recurrent cases, patients underwent Limberg flap surgery under spinal anesthesia. Demographic, clinical, and outcome data were recorded, with follow-up at 2 weeks, and 1st, 3rd, 6th, and 9th months. Data were analyzed using SPSS® 24. Results: Among 18 patients undergoing Limberg flap repair, mean age was 26.9 ± 5.2 years, 88.9% were male, and most had BMI 18.5–24.9 kg/m². Single external opening was present in 83.3%. Mean operative time was 88.8 ± 12.7 minutes, hospital stay 4.17 ± 0.7 days, drain removal 3.4 ± 0.7 days, suture removal 12.9 ± 1.7 days, and return to work 12.7 ± 1.8 days. Postoperative complications occurred in 5 patients (27.7%), with no recurrences. Four of 5 overweight patients developed complications (r = 0.93, p < 0.001). Conclusion: The Limberg flap is a safe and effective treatment for sacrococcygeal pilonidal sinus, offering low recurrence, minimal complications, and rapid recovery.

This work is about the brain chemicals, and their possible natural catabolic products. Effort has been made to identify if the microwave frequencies of these by products are same as the microwave frequency ranges of sodium and Potassium in ionic solutions present in as well as outside a neurone. It could be a factor responsible for dementia. It is found that excess by products of Tau fragment and Human prion peptide 2 had the same microwave frequency of sodium and Potassium in ionic solutions present in as well as outside a neurone. Therefore, it can affect the neuronal functioning. Efforts have also been made to identify, if any of these Brain chemical bind to each other and block the normal neuronal functioning. In this effort, it is noted that, excess of Human prion peptide 1 can bind to Tau-441 protein. This can affect neuronal function.

Background: Hypertensive crisis is a continuum of elevated blood pressure that may cause acute target-organ damage and represents life-threatening complications if not treated and controlled urgently. Although the emergency department (ED) setting has historically been advocated as the appropriate environment for acute blood pressure control, the importance of enhanced primary care in responding to some high-risk vascular presentations is increasingly emphasized in modern healthcare systems. Comparative “Real-world” data on outcomes in the management of HC by ED and primary care (PC) perspectives regarding treatment of patients presenting with HC in the Middle Eastern health system is scarce. Objective: To compare clinical management, time to blood pressure control, complication rates and outcome of hypertensive crisis between emergency department (ED) and primary care setting in Qatar. Methods: A parallel observational study was done in 75 adult patients diagnosed with hypertensive crisis from January to November 2025. Patients were treated in ED (n = 45) or primary health care (n = 30). Demographics, comorbidities, treatment approaches, time to response and outcomes were described and compared by statistical methods using test of significance (p < 0.05). Results: In ED patients who were managed with IV antihypertensive treatment, blood pressure reduction was significantly faster, intravenous antihypertensive use was significantly greater, and early complication rates were significantly lower. The majority of cases of hypertensive urgency were effectively controlled with oral pharmacracy and outpatient follow-up at primary care centers. Blood pressure was controlled in total in 66.7%, partially in 25.3% and was uncontrolled with continued medication in 8.0%. Conclusion: Emergency departments are essential for hypertensive emergencies, but appropriately resourced primary care facilities can safely and effectively treat hypertensive urgency, preserving healthcare resources and mitigating inappropriate hospital use.

Background: Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide. While Helicobacter pylori is primarily a gastric pathogen, emerging evidence suggests potential extra-gastric manifestations, including possible links to respiratory diseases. However, the association between H. pylori infection and CAP remains poorly characterized. Objective: This systematic review aimed to critically evaluate and synthesize the available evidence regarding the association between Helicobacter pylori infection and community-acquired pneumonia. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science for publications from January 2021 to January 2026. Studies investigating direct or indirect associations between H. pylori infection and CAP were included. Eight studies met eligibility criteria, encompassing diverse designs including cohort, case-control, cross-sectional, and randomized controlled trials. Quality assessment was performed using appropriate tools (Newcastle-Ottawa Scale, JBI Checklist, Cochrane RoB 2). Results: Direct evidence for an H. pylori-CAP association was limited, with only three studies providing direct seroepidemiological or immunological data. These demonstrated that H. pylori infection may modulate systemic inflammatory responses (elevated CXCL10 and IL-10; reduced IL-1β and IL-6) and showed non-significant associations with respiratory pathogen co-exposure. Indirect evidence highlighted that proton pump inhibitor use—commonly prescribed for H. pylori-related conditions—was associated with significantly increased pneumonia risk (adjusted hazard ratio: 1.882 for long-term use). Studies in peptic ulcer patients reported postoperative pneumonia rates of 5–12%. Overall evidence quality was moderate, with significant heterogeneity precluding meta-analysis. Conclusion: Direct evidence linking H. pylori infection to community-acquired pneumonia is remarkably limited and inconclusive. The available data suggest that any association may operate through immunomodulatory mechanisms or indirect pathways, particularly proton pump inhibitor use. Well-designed prospective cohort studies with validated H. pylori diagnostics and adequate confounder adjustment are urgently needed to clarify this relationship.

This study investigates the effects of Cucumis sativus (cucumber) leaf extract on hormonal levels, semen quality, and sperm cell morphology in male Wistar rats. Thirty rats were randomized into three groups: control, 400 mg/kg, and 800 mg/kg extract-treated groups, and administered for 28 days. Hormonal assays revealed significant dose-dependent reductions in follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels in treated groups (p < 0.05). Semen quality analysis showed a significant decline in semen color, consistency, pH, sperm motility, and live proportion, alongside increased abnormal sperm morphology and non-motile spermatozoa, especially in the 800 mg/kg group. Furthermore, differential sperm abnormalities, including head deformities, twisted tails, and bent mid-pieces, were significantly elevated in treated groups, indicating structural and functional damage to sperm cells. The results suggest that Cucumis sativus leaf extract, at higher doses, impairs male reproductive hormones, semen quality, and sperm morphology, potentially due to oxidative stress or phytochemical-induced toxicity. This aligns with prior studies on phytotoxic effects of plant extracts, where flavonoids, alkaloids, and other bioactive compounds were implicated in reproductive toxicity. However, the exact mechanism underlying these effects remains unclear and warrants further exploration. This study provides a foundation for understanding the reproductive toxicity of Cucumis sativus leaf extract, emphasizing the need for cautious use of herbal preparations containing this plant.

Background: Although ESWL is considered safe for upper ureteric stones, the use of JJ stents may influence complication rates and patient morbidity. Objective: To assess the outcome of ESWL for upper ureteric stones with or without Double-J stent. Methods: In this prospective comparative study, 62 patients with upper ureteric stones were randomly allocated into stented (n=31) and non-stented (n=31) groups. Post-procedural complications including ureteric colic, steinstrasse, fever, suprapubic pain, and LUTS were recorded and analyzed. Results: Ureteric colic was significantly lower in the stented group compared to the non-stented group (12.9% vs 35.5%; p<0.05). However, suprapubic pain was significantly higher in the stented group (41.9% vs 16.1%; p<0.05). The incidence of steinstrasse and fever did not differ significantly between groups (p>0.05). Lower urinary tract symptoms were significantly more common in the stented group, including urinary frequency (48.4% vs 9.7%; p<0.01), urgency (54.8% vs 16.1%; p<0.01), and dysuria (61.3% vs 19.4%; p<0.01). Gross haematuria did not differ significantly between groups. Conclusion: Although JJ stenting reduces ureteric colic after ESWL, it is associated with significantly higher lower urinary tract symptoms and patient discomfort. Routine pre-ESWL stenting is therefore not recommended in uncomplicated upper ureteric stones ≤2 cm.