Outcome of Surgical Management of Sacrococcygeal Pilonidal Sinus Disease with Rotation Flap in 52 Patients—A Retrospective Study

Background  Surgical treatment of sacrococcygeal pilonidal sinus disease (SPSD) consists of radical excision of the entire tract and treatment of the resultant raw area. Here, the authors have reviewed the results of the rotation flap for closure of the SPSD. Aim  This study aims to evaluate the outcomes following SPSD excision and rotation flap closure. Materials and Methods  All patients were treated for SPSD with excision and closure using a rotation flap from January 2010 to September 2018. Cases having a follow-up of at least 6 months post surgery were evaluated. Result  A total of 52 patients were included in the study; 42 cases were of primary disease while 10 were of recurrent disease. The patients’ follow-up records on the 3rd day, 10th day, 1 month, and 6 months were evaluated. None of the patients showed any signs of recurrence on follow-ups. One patient developed a hematoma on the third day post surgery which was treated conservatively. One patient developed a seroma in the perianal region on the fifth postoperative day which required aspiration. Both these patients healed well subsequently. Conclusion  Rotation flap is a (simple and reliable) treatment option for closure of postexcision SPSD defect. It not only takes the tension away from suture line, but also pushes the gluteal fat from the sides into the midline, obliterating the deep crevice of the natal cleft which is believed to be one of the important factors in the causation of SPSD, thus minimizing recurrence.     

GDF15 promotes prostate cancer bone metastasis and colonization through osteoblastic CCL2 and RANKL activation

Bone metastases occur in patients with advanced-stage prostate cancer(PCa). The cell-cell interaction between PCa and the bone microenvironment forms a vicious cycle that modulates the bone microenvironment, increases bone deformities, and drives tumor growth in the bone. However, the molecular mechanisms of PCa-mediated modulation of the bone microenvironment are complex and remain poorly defined. Here, we evaluated growth differentiation factor-15(GDF15) function using in vivo preclinical PCa-...     

Prevalence and impact of diabetes and cardiovascular disease on clinical outcome among patients with COVID-19 in Bangladesh

BackgroundPatients with coronavirus disease-2019 (COVID-19) with preexisting diabetes and cardiovascular metabolic diseases have higher fatality rate. The circulation of new variants with emerging clinical characteristics requires more studies focusing the impact of preexisting health conditions on outcome of COVID-19 accurately.AimsMain aim of this study was to investigate the impact of diabetes and cardiovascular disease (CVD) on disease prognosis and severe health outcomes among patients with COVID-19.MethodsA retrospective study was performed on 799 patients with COVID-19 during December 10, 2020, to February 10, 2020 in Bangladesh. Logistic regression analysis was performed for age, sex, diabetes, CVD and symptoms on fatality. Kaplan-Meier survival analysis was conducted to predict the survival rate.ResultsFatality was detected in 40% (318 of 799) patients with COVID-19. Among 318 fatalities, 90.6% were detected in patients with CVD and 74.5% in patients with diabetes. Case fatality rate was highest in patients with COVID-19, CVD and diabetes (94, 184 of 195). Fever (91%) and dry cough (71%) were the most frequent symptoms. CVD (42.2%), diabetes (32.7%) and obesity (18%) were prevalent. The highest odds of risk was detected in patients with COVID-19, CVD and diabetes (OR: 6.98, 95% CI, 4.21 to 7.34). Female patients had the highest survival rate.ConclusionsIn this study, 318 fatality was seen in 799 patients with COVID-19. The highest odds of fatality risk was detected in patients with COVID-19, CVD and diabetes. The risk increased many folds when CVD and diabetes coexisted in patients.