MASH Journal Volume 7 Issue I

March 2022
Dermatofibrosarcoma Protuberans With Fibrosarcomatous Transformation: A Case Report & An Overview
Eyrique G, Riham H and Arrazeen H

Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma of the skin characterized by plaque like tumor derived from mesenchymal cell. Fibrosarcomatous transformation of DFSP (FS-DFSP) is an even rarer variant of which it is clinically indistinguishable from other DFSP variant - diagnosed by histopathological characteristics. As it is known to be more aggressive with higher risk of distant metastases, treatment should be carefully planned followed by strict post-op follow ups.


This is a case of a 57 years old man with a slow growing large tumor on his forearm following a minor trauma 10 years ago, presented to our institution for further management due sudden rapid enlargement and discomfort. The result of the lesion sent for histopathological examination is diagnosed as FS-DFSP without distant metastases (from a full body CT scan). On 3rd month of follow up, neither recurrence nor symptoms of distant metastases has been observed.


In conclusion DFSP needs a histopathological examination to distinguish its variant. This is important as FS-DFSP has higher risk of recurrence and metastasis. There are options of technique to ensure complete surgical resection of tumor. In cases of metastases and unresectable tumor, radiotherapy and pharmacological treatment is to be considered.  In our case, there is no signs of recurrent or distant metastases. However, long -term follow up is strictly recommended.

A 6 Step Approach In Initiating Essential Emergency Critical Care Services In A Resource Limited Emergency Department Setting.
Gurjeet Singh a/l Harvendhar Singh

The emergency departments of today no longer only cater for treatment of life threatening conditions as it also involves monitoring and lodging of critically ill patients pending admission to the wards in view of overcrowding and longer boarding times in the emergency. Application of critical care services will ensure that the patients who are critically ill and boarding in the emergency departments especially the red zones receive proper monitoring and ICU like care services. However, advanced emergency and critical care services require many resources which may not be possible in many resource limited facilities. This calls for the introduction of essential emergency critical care, a concept that provides the essentials of critical care in the emergency setting to ensure good monitoring and continuous critical care for lodging patients. In this article we introduce a 6 step method employed in a resource limited setting to implement essential emergency critical care services in the red zones of the emergency department.

A Brief on Exercises in Gym with Some Misconceptions
Ashraful Kabir


Ancient gymnasiums were the places for social interaction, recreation and leisure, but they were first and foremost educational institutions where the intellectual and athletic training of a military character was supposed to be accomplished. The Greek gymnasium was a popular recreational space for the members of the aristocratic class as it provided those with an opportunity to perform and enhance their outstanding persona and family [1]. Gyms are one of the most pursued leisure places in western societies and can be said to have established themselves as part of a white middle-class culture [2, 3, 4, 5, 6-8, 9]. Almost 13% of the UK population is registered as members of a private health and fitness gym or publicly-owned fitness facility, with London having the most registered users [10]. Depending on the size and target group, multi-purpose amenities encourage pre- or post-training activities, for example at their spas and beauty centers or they organize social activities at the weekend [11]. Indeed, gym membership usually starts with the diagnostic procedure of a health check where weight, height, body fat, blood pressure, body mass index, etc., are measured and compared to what has been established as a scientific norm so that goals for further training can be identified and changes noticed. Bodies can be sculpted and corrected by the right diet, exercise and cosmetic products. Advertisements suggest that individuals are personally responsible for monitoring and controlling their attractiveness and ambition [12]. Gym participants over 65 years old tend to come to the gym not only for physical training but also to form social bonds [13]. The medical condition might experience to come in a gym as a compulsory homework [14].