Stroke is a leading cause of disability and death. The condition requires prompt diagnosis and treatment. The quality of care provided to patients with stroke can vary depending on the availability of medical resources, which in turn, can affect prognosis. Recently, there has been growing interest in using machine learning (ML) to support stroke diagnosis and treatment decisions based on large medical data sets. Current ML applications in stroke care can be divided into two categories: analysis of neuroimaging data and clinical information-based predictive models. Using ML to analyze neuroimaging data can increase the efficiency and accuracy of diagnoses. Commercial software that uses ML algorithms is already being used in the medical field. Additionally, the accuracy of predictive ML models is improving with the integration of radiomics and clinical data. is expected to be important for improving the quality of care for patients with stroke.

This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

Mixed urinary incontinence (UI) is common in women. This study aimed to assess the efficacy of anti-incontinence surgery in female patients with equally severe stress UI (SUI) and urge UI (UUI). All patients had equal severity of SUI and UUI. The postoperative cure rate was categorized into the cure group (CG) and failure group (FG). Postoperative satisfaction was categorized into the satisfaction group (SG) and the dissatisfaction group (DG). Statistical significance was set at P<0.05. Ninety patients (SG, 73.3%; DG, 26.7%; CG, 93.3%; FG, 6.7%) were included in the study. In the univariate analysis, body mass index (BMI), total bladder capacity, and overactive bladder symptom score (OABSS) were significantly different between the SG and DG groups. Peak urinary flow, Valsalva leak point pressure (VLPP), and OABSS were significantly different between the CG and FG groups. In the multivariate analysis, OABSS (P=0.001) and BMI (P=0.032) were independent predictors of postoperative satisfaction. VLPP (P=0.023) was the only independent factor associated with the postoperative cure rate. In equal severity of SUI and UUI, VLPP was found to be the only independent factor associated with postoperative cure rates. Higher VLPP values were associated with higher cure rates. BMI and OABSS were identified as independent predictors of postoperative satisfaction, with lower BMI and OABSS associated with higher postoperative satisfaction.

This study assessed risk factors for blood transfusion after Cesarean section in patients with partial placenta previa. We retrospectively reviewed the medical records of 149 patients who underwent Cesarean sections for partial placenta previa between January 2010 and October 2021. Clinical characteristics were compared between the two groups: the blood transfusion group (n=22), defined as patients who received a blood transfusion during surgery or within 24 hours after surgery, and the non-blood transfusion group (n=127), which included other patients. Multivariable logistic regression analysis identified two risk factors independently associated with blood transfusion: antenatal hemorrhage (adjusted odds ratio [aOR], 16.283; 95% confidence interval [CI], 4.405-60.190; P<0.001) and preoperative hemoglobin (g/dL) (aOR, 0.427; 95% CI, 0.246-0.739; P=0.002). Thus, patients who are at risk for these two factors should be carefully managed with sufficient preparation for blood transfusion and anesthetic management.

Aneurysmal venous dilatation is a frequent complication of arterio venous fistulas (AVFs) created for hemodialysis. Venous aneurysm rupture can lead to lethal hemorrhage. A 49-year-old male patient presented with a giant aneurysmal dilatation of his AVF 10 years after its creation. The patient had complaints of pulsating pain and discomfort due to swelling of the left forearm. We performed an aneurysm resection and revised the overlying dermal lesion through a brachial plexus block. Here, we describe the pathological features of the arterialized venous aneurysm compared to simple venous aneurysms.

Empty nose syndrome is an uncommon complication of turbinoplasty and other nasal operations. It presents with various manifestations, with the most common symptom being paradoxical nasal obstruction. Here, we report the case of a 67-year-old male patient diagnosed with empty nose syndrome 20 years after turbinoplasty. Autologous auricular conchal cartilage was harvested and implanted into the lateral wall of the inferior turbinate to reduce nasal volume. The patient experienced significant relief from subjective nasal obstruction symptoms immediately after surgery. Over a 23-month follow-up period, no side effects or symptom recurrence was reported.