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Currently, guidelines recommend the uptake of high-dose statins before and after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. However, the association of high-dose statins with the incidence of the no-reflow phenomenon remains unclear. This study aimed to review the evidence of preprocedural high-dose statin therapy to reduce no-reflow incidence after PCI. PubMed, Embase, and Google Scholar were searched from inception until May 2022 for studies comparing high-dose statins with low-dose or no statin therapy before PCI. Studies reporting the no-reflow phenomenon were shortlisted. The National Institutes of Health tool for randomized and cohort studies was used to assess the quality of included studies. A random-effects model was used to derive odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). A total of 11 studies were included, with a population of 4,294 patients. The use of high-dose statins before PCI significantly reduced postprocedural no-reflow (OR 0.51, 95% CI 0.35 to 0.74, p = 0.0005, I2 = 32%). A total of 7 studies included patients who underwent PCI without previous use of statins. A significant decrease in overall no-reflow events was observed with high-intensity statin treatment versus low-intensity statin/placebo (OR 0.55, 95% CI 0.34 to 0.88, p = 0.01, I2 = 25%) among patients who were statin naive. Acute high-dose statin therapy before PCI significantly reduces the hazard of post-PCI no-reflow events in patients with acute coronary syndrome. Our results encourage the routine use of statins before PCI.

Hemophagocytic lymphohistiocytosis (HLH) is a complex disease disorder that involves dysregulated activation of the immune system resulting in cytokine storm which can lead to widespread tissue injury. HLH is associated with a mortality rate of 41%. The diagnosis of HLH requires a median of 14 days to reach likely due to a varied range of symptoms and signs the disease can present with. Liver disease and HLH can have a significant overlap. Liver injury itself is frequently noticed in patients with HLH, with more than 50% of patients having elevated aspartate transaminase, alanine transaminase, and bilirubin levels. This case report describes a young individual who had developed intermittent fever, vomiting, fatigue, and weight loss with labs remarkable for elevated transaminases and bilirubin. His initial workup revealed an acute Epstein-Barr virus infection. The patient later presented again with similar signs and symptoms. He underwent a liver biopsy with histopathological features initially concerning for autoimmune hepatitis. However, by engaging a multidisciplinary team, a correct diagnosis was achieved. This case report serves to highlight the increased level of suspicion required to correctly diagnose HLH, especially in the presence of clinical features concerning for autoimmune hepatitis.

It has been well documented that social media use among adolescents is rising. However, most research has focused on social media use among typically developing adolescents and less on its use among adolescents with autism spectrum disorder (ASD). The goal of this study was to compare the time spent as well as to identify the purpose of social media use in adolescents with ASD compared to non-ASD adolescents. This was a cross-sectional study of adolescents between ages 13-18 who were attending a hospital-based child and adolescents psychiatry clinic. Participants completed a self-report 18-item questionnaire to assess the pattern and reasons for using social media sites. The sample size was 26 for ASD and 24 for the non-ASD group. We found that the time spent on social media among adolescents with ASD was comparable to those without ASD diagnosis. However, participants with ASD differed from their non-ASD counterparts in both preferred social media sites as well as reasons for use. The most favourable social media site for ASD adolescents was YouTube. In contrast, the preferred social media site among adolescents without ASD was Snapchat. About 92.3% of participants without ASD reported using social media sites for primarily social interactions. In contrast, 59.1% of participants with ASD reported entertainment purposes as their primary reason for choosing a social media site. Although the current study is based on a small sample of participants, the findings suggest that the pattern of usage and reasons for using social media differ significantly between the two groups. There is, therefore, a definite need for further research with a larger sample size to examine the implications of these differences and to determine how social media could be used as a tool for learning social skills and its efficacy and safety in the ASD population.

Background Post-secondary students frequently experience high rates of mental health challenges. However, they present meagre rates of treatment-seeking behaviours. This elevated prevalence of mental health problems, particularly after the COVID-19 pandemic, can lead to distress, poor academic performance, and lower job prospects following the completion of education. To address the needs of this population, it is important to understand students' perceptions of mental health and the barriers preventing or limiting their access to care. Methods A broad-scoping online survey was publicly distributed to post-secondary students, collecting demographic, sociocultural, economic, and educational information while assessing various components of mental health. Results In total, 448 students across post-secondary institutions in Ontario, Canada, responded to the survey. Over a third ( n  = 170; 38.6%) of respondents reported a formal mental health diagnosis. Depression and generalized anxiety disorder were the most commonly reported diagnoses. Most respondents felt that post-secondary students did not have good mental health ( n  = 253; 60.5%) and had inadequate coping strategies ( n  = 261; 62.4%). The most frequently reported barriers to care were financial ( n  = 214; 50.5%), long wait times ( n  = 202; 47.6%), insufficient resources ( n  = 165; 38.9%), time constraints ( n  = 148; 34.9%), stigma ( n  = 133; 31.4%), cultural barriers ( n  = 108; 25.5%), and past negative experiences with mental health care ( n  = 86; 20.3%). The majority of students felt their post-secondary institution needed to increase awareness ( n  = 231; 56.5%) and mental health resources ( n  = 306; 73.2%). Most viewed in-person therapy and online care with a therapist as more helpful than self-guided online care. However, there was uncertainty about the helpfulness and accessibility of different forms of treatment, including online interventions. The qualitative findings highlighted the need for personal strategies, mental health education and awareness, and institutional support and services. Conclusions Various barriers to care, perceived lack of resources, and low knowledge of available interventions may contribute to compromised mental health in post-secondary students. The survey findings indicate that upstream approaches such as integrating mental health education for students may address the varying needs of this critical population. Therapist-involved online mental health interventions may be a promising solution to address accessibility issues.

This study aimed to observe the impact of laser-assisted hair removal (LAHR) on the quality of life in women with polycystic ovary syndrome (PCOS)-associated hirsutism. An observational study was conducted on 172 women living with PCOS at a specialized clinic. The Dermatology Life Quality Index (DLQI) and Ferriman-Gallwey (FG) score were employed to assess the quality of life and severity of hirsutism, respectively. Laser therapy was administered using ruby diode or alexandrite lasers. Follow-up on the DLQI and FG score assessment was done at 12-, 18-, and 24-week post-treatment. The number of cases that reported stress, anxiety, and depression reduced over time. However, there was no correlation between the patient-reported decrease and DLQI scores. The FG score was significantly related to mental health. The severity of the hirsutism impacted mental health. The regrowth of hair at six months indicated limited long-term efficacy LAHR.  LAHR significantly improves the quality of life in the short term for women living with PCOS. However, the short-term benefit of the therapy indicates a need for research to find new treatment strategies.

Colorectal cancer (CRC) ranks as the second leading cause of cancer-related mortality among women and the third leading cause of cancer-associated mortality among men. Treatment of colon cancer is very crucial for a patient's survival. In this study, we assessed the reliability, efficacy, and safety of raltitrexed in intraoperative intraperitoneal chemotherapy for colon cancer. A total of 57 patients with clinical stages II and III of colon cancer were included in the study. R0 resection surgery + hyperthermic intraperitoneal chemotherapy (HIPEC) procedure was done with raltitrexed. It was given in a dose of 3 mg/m in a 0.9% NS injection in a volume of 500 milliliters. Postoperative complications were observed. The most common postoperative complication was nausea/vomiting, which was seen in 21 out of 57 patients (37%). The second most common complication was fever (18/57). None of the patients died or developed renal toxicity, hepatic toxicity, and intestinal obstruction. Raltitrexed is a reliable, efficient, and safe drug and can be used in intraoperative intraperitoneal chemotherapy of colon cancer.

Hyperhomocysteinemia is an independent risk factor for acute myocardial infarction (MI). This case report describes a 19-year-old male with a marfanoid phenotype and no conventional risk factors presenting with acute MI. It highlights the significance of acknowledging hyperhomocysteinemia as a potential risk factor for MI, especially in young patients.

IntroductionIn recent years, eye-tracking has been proposed as a promising tool to identify potential biomarkers for mental disorders, including major depression. We will conduct an updated systematic review and meta-analysis on eye-tracking research in adults with major depressive disorder or other clinically diagnosed depressive disorders.Methods and analysisThis protocol follows all reporting items in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol extension. We will conduct a systematic search of PubMed, PsycINFO, Google Scholar and EMBASE for sources published up until March 2023. Abstract and full-text review will be completed independently by two reviewers. Non-randomised studies using eye movement tasks in individuals with a depressive disorder versus controls will be included. Eye movement tasks of interest include, but are not limited to, saccade, smooth pursuit, fixation, free-viewing, attentional disengagement, visual search and attentional blink tasks. Results will be categorised by eye movement task. Risk of bias will be assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and confidence in cumulative evidence will be assessed using Grading of Recommendations, Assessment, Development and Evaluation criteria.Ethics and disseminationEthics approval is not required due to the nature of the proposed analysis. Results will be disseminated through a journal article, conference presentations and/or dissertations.