Vagal paraganglioma is a rare finding that develops from paraganglionic tissue found around the vagus nerve; it has a prevalence of 0.012% of all tumors. It is the third most common paraganglioma of the head and neck but still accounts for less than 5% of these tumors, and it has a well-established female prevalence. It is a difficult tumor to identify early based on its symptoms alone and only a thorough investigation can help solidify its diagnosis. In this report, we discuss a presentation of this phenomenon that is not only unique in its manifestation but also a very difficult diagnosis due to its deceptive presentation and multiple extensions. These masses need a good surgical regime to be removed properly and postoperative complications are very frequent in most of these cases.
COVID-19, which is caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), is known to cause a myriad of complications along with the typical lower respiratory tract involvement. One of the emerging complications is a hypercoagulable state leading to venous or arterial thromboembolism. These complications are more common in those presenting with a severe disease with significantly elevated inflammatory markers. Although co-morbid illnesses play a role in worsening such complications, yet they are not the main determinants as these complications also occur in those without any co-morbid illness.Here, we report a case of a 64-year-old male with severe COVID-19 pneumonia presenting with acute limb ischemia with a non-salvageable limb who required subsequent amputation of the affected limb.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is best known for causing febrile pneumonia with lung parenchymal involvement. However, that is often not the only disease presentation, as many studies have shown that coronavirus disease 2019 (COVID-19) can present with other complications involving the cardiovascular and neurologic systems. Here, we report a case of COVID-19 pneumonia presenting with a peculiar finding of unilateral diaphragmatic paralysis. The patient presented with dyspnea requiring oxygen support via a nasal cannula. He was managed with the hospital's COVID-19 treatment protocols and clinically improved within 14 days of admission. This case helps shine some light on the neuroinvasive potential of SARS-CoV-2.
Background: Professional behavior or professionalism refers to the traits that a skilled person must possess in order to be maximally effective. When it comes to a medical professional, professionalism refers to the values and behaviors that connect a health professional to society. Professionalism has always been a part of curriculum, but students are hardly involved in development of professional curriculum including its outcomes. This study was designed to formulate an undergraduate model of competencies expected in a medical professional, based on perceptions of medical students. Methods: A focus group discussion of purposive sample of 17 final year medical students in 2 groups was conducted under supervision of an experienced moderator. The study comprised of 3 rounds of discussion, each lasting for 90 minutes. Consensus was extracted by content analysis and numerical analysis.Results: Out of 28 competencies extracted initially, eight professional competencies were shortlisted by manual thematic analysis, which included learning skills, behavioral skills, procedural skills, self-regulation skills, organizational skills, research skills, teaching skills, and emotional skills. This resulted in generation of 8-limbed Octopus skills model of a medical professional, which would help the students in better compliance of medical professionalism. Conclusion: Being generated by medical students, the ‘Octopus’ Model of Skills is expected to give ownership of these eight competencies to be acquired during formative years by all future doctors and may serve as students’ perspective in curriculum and professional development.
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