scholarly journals Breaking the myth: All carcinoma cervix presenting as pyometra will have only palliative treatment

2016 ◽  
Author(s):  
C. Aarthi ◽  
A. C. Senthil Kumar ◽  
P. Sasireka
Keyword(s):  
Case Series ◽  
Cardiac Risk ◽  
Early Carcinoma ◽  
Age Group ◽  
Carcinoma Cervix ◽  
Appropriate Treatment ◽  
End Of Treatment ◽  
Intravenous Antibiotics ◽  
Disease Free

Introduction: Carcinoma cervix is the second most common female carcinoma. Every year in India, 1,22,844 women are diagnosed with carcinoma cervix and of them 67,477 die. Carcinoma cervix rates among women in the age group between 30-64 has decreased by 1.8% per year on average but still date account for 16%. Of these, advanced carcinoma are about 80% and early are only 20%. Case Series: We are reporting 5 consecutive early carcinoma cervix cases who presented with pyometra and got treated at our hospital from April 2015-September 2015. Cases of early carcinoma cervix presented with pyometra were treated by pyometra drainage, intravenous antibiotics and appropriate treatment in the form of surgery (4 cases underwent Wertheim’s hysterectomy and 1 case had radical chemo radiation as she opted for same in view of high cardiac risk for anaesthesia). All 5 of them are disease free at the end of treatment with follow up of minimum 4 months duration (range 4-10). Conclusion: The idea is to emphasize that all carcinoma cervix with pyometra are not necessarily advanced and can still be given radical treatment like surgery or radiotherapy after pyometra drainage.

Three Patients with CPT1A Deficiency: Literature Review and Case Series

2020 ◽  
Author(s):  
Naser Ali Mirhosseini ◽  
Mahdieh Saatchi ◽  
Sana Taghiyar
Keyword(s):  
Genetic Disorder ◽  
Case Series ◽  
Autosomal Recessive Inheritance ◽  
Abnormal Liver Function Test ◽  
Medical Procedures ◽  
Main Method ◽  
Appropriate Treatment ◽  
Liver And Kidney ◽  
Renal Tubular

Background: Carnitine palmitoyltransferase 1A deficiency is a rare genetic disorder with autosomal recessive inheritance pattern of fatty acid metabolism secondary to CPT1A mutation. Several dozen infants and children have been described with a deficiency of the liver and kidney CPT1 isoenzyme (CPT1-A). Clinical manifestation includes fasting-induced hypoketotic hypoglycemia, occasionally with extremely abnormal liver function test (LFT) and rarely with renal tubular acidosis. Acyl carnitine analysis has been the main method for the diagnosis of CPT1A deficiency.  Prompt treatment of hypoglycemia includes intravenous fluid containing 10% dextrose. To prevent hypoglycemia, infants should eat frequently during the day and have cornstarch continuously at night. Fasting should not last more than 12 hours during illness, surgery, or medical procedures. Case Presentation: We reported three patients with CPT1A deficiency presented with hypoglycemia and Reye like syndrome in early childhood that with early diagnosis and treatment they are well in follow-up. Conclusion: Prognosis of this genetic disorder will be good with appropriate treatment.

scholarly journals Virological and Clinical Outcome of DAA Containing Regimens in a Cohort of Patients in Calabria Region (Southern Italy)

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 101
Author(s):  
Vincenzo Scaglione ◽  
Maria Mazzitelli ◽  
Chiara Costa ◽  
Vincenzo Pisani ◽  
Giuseppe Greco ◽  
...  
Keyword(s):  
Southern Italy ◽  
Liver Stiffness ◽  
Age Group ◽  
Intention To Treat ◽  
Liver Decompensation ◽  
End Of Treatment ◽  
History Of ◽  
Lost To Follow Up ◽  
Treat Analysis

Background and objectives: In Italy, Hepatitis C Virus (HCV) infections are most prevalent in people older than 50 years of age, who often experience multi-morbidities, take co-medications, and have a long history of liver disease. These characteristics could potentially affect tolerability of HCV treatments and adherence in this subgroup. After achievement of sustained virological response (SVR), retention into care is very important both to detect the onset of possible complications and prevent further infections. In this study, SVR rates and retention into care of patients treated with directly acting antivirals (DAAs) of a single-center cohort in Southern Italy were evaluated. Materials and Methods: Patients treated with directly acting antivirals from 2014 to 2018 were included. Patients were stratified by age (i.e., <65 vs. ≥65 years) and by cirrhosis presence (i.e., liver stiffness >14.6 KPa or clinical/ultrasound cirrhosis vs. absence of these criteria). Primary outcome was availability of SVR at Weeks 12–24 after the end of treatment. Inter- and intra-group comparisons were performed along the follow-up for significant laboratory parameters. Results: In total, 212 patients were treated; 184 (87%) obtained SVR after the first treatment course and 4 patients after retreatment. Twenty-two (10.4%) patients were lost to follow-up before assessment of SVR, and two patients died before the end of treatment for liver decompensation. Considering only the first treatment episode, per protocol analysis (i.e., excluding patients lost to follow-up) showed the following rates of SVR: 97% (overall), 97% (older age group), 96% (age group <65 years), 94% (cirrhotics), and 100% (non-cirrhotics). By contrast, at the intention to treat analysis (i.e., patients lost were computed as failures), SVR percentages were significantly lower for patients <65 years of age (80%) and for non-cirrhotics (85%). Conclusions: High rates of SVR were obtained. However, younger patients and those without cirrhosis displayed an apparent high risk of being lost to follow-up. This may have important implications: since those who are lost may transmit HCV in case SVR is not achieved, these subpopulations should receive appropriate counselling during treatment.

Neonatal ventriculitis: a case series and review of literature

2020 ◽  
Vol 50 (3) ◽  
pp. 266-270
Author(s):  
Ramitha R Bhat ◽  
Prerna Batra ◽  
Ravi Sachan ◽  
Gurbachan Singh
Keyword(s):  
Intracranial Pressure ◽  
External Ventricular Drain ◽  
Fatal Outcome ◽  
Case Series ◽  
Age Group ◽  
Raised Intracranial Pressure ◽  
Review Of Literature ◽  
Intravenous Antibiotic ◽  
Intravenous Antibiotics

Ventriculitis after meningitis is a serious complication in the neonatal age group. The role of intraventricular antibiotics in treatment is controversial. We present five such cases which were refractory to conventional intravenous antibiotic therapy, had persistent features of ventriculitis and in whom raised intracranial pressure (ICP) necessitated insertion of an external ventricular drain (EVD). Three of the five infants required intraventricular antibiotics but also developed EVD-related complications. Early diagnosis of ventriculitis and treatment is necessary to avoid a fatal outcome. Intravenous antibiotics are the treatment of choice, but intraventricular therapy may be considered in refractory cases. As the incidence of EVD-associated ventriculitis is high, proper care of EVDs and their early removal is mandatory.

Management of uterine malignancy found incidentally after supracervical hysterectomy or uterine morcellation for presumed benign disease

2008 ◽  
Vol 18 (5) ◽  
pp. 1065-1070 ◽  
Author(s):  
M. H. Einstein ◽  
R. R. Barakat ◽  
D. S. Chi ◽  
Y. Sonoda ◽  
K. M. Alektiar ◽  
...  
Keyword(s):  
Case Series ◽  
Good Prognosis ◽  
Uterine Disease ◽  
Retrospective Case ◽  
Secondary Surgery ◽  
Supracervical Hysterectomy ◽  
Initial Surgery ◽  
Completion Surgery ◽  
Disease Free

Patients who have undergone supracervical hysterectomy or uterine morcellation for presumed benign uterine disease and are found to have malignancy on final pathology represent a management dilemma. Our goal was to analyze our experience and make observations regarding staging, treatment, and outcomes. We performed a retrospective case series of patients referred to our institution with uterine malignancy who previously underwent supracervical hysterectomy or uterine morcellation at the time of original surgery for presumed benign uterine disease. Between January 2000 and March 2006, 17 patients with uterine malignancy were identified. Following initial surgery, 15 (88%) patients had presumed stage I disease and 2 (12%) patients had stage III disease. Two (15%) of 13 patients who underwent completion surgery were upstaged; both had leiomyosarcoma (LMS) originally resected with morcellation. Ten of 11 patients whose stage was confirmed with secondary surgery remain disease free. None of the patients who initially underwent supracervical hysterectomy without morcellation were upstaged by secondary surgery. The median follow-up interval was 30 months (range, 2–90 months). Reoperation for completion surgery and staging is important when uterine malignancy is found incidentally after morcellation or supracervical hysterectomy for presumed benign uterine disease. Approximately 15% of patients will be upstaged by reexploration, particularly those with LMS who underwent morcellation. Patients who undergo completion surgery with restaging and are not upstaged appear to have a good prognosis. Surgical staging is valuable for prognosis and may alter postoperative treatments

scholarly journals CML Developing Three Years after Therapy Completion in a Child with Ph(−) Pre-B-ALL

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
S. Hosseini ◽  
G. H. Bahoush ◽  
P. Vousogh ◽  
Sh. Ansari ◽  
Kh. Arjmandi ◽  
...  
Keyword(s):  
Molecular Detection ◽  
Disease Free Survival ◽  
Blood Cell Count ◽  
Case Scenario ◽  
Free Survival ◽  
End Of Treatment ◽  
History Of ◽  
Therapy Completion ◽  
Disease Free

We report a girl with a history of Ph(−) pre-B-ALL and three years of disease-free survival admitting to our hospital for regular end of treatment checkup with an increased white blood cell count which in follow-up studies and molecular detection of BCR-ABL (p210) fusions gene had been diagnosed as a Ph(+) typical CML. The upcoming question in this case scenario is whether developed CML is a secondary leukemia due to previous ALL chemotherapy or just a relapse case of primary leukemia.

scholarly journals Study of abnormal papsmear result in army families

2015 ◽  
Vol 13 (2) ◽  
Author(s):  
Ratna Khatri
Keyword(s):  
Precancerous Lesions ◽  
Treatment Result ◽  
Pap Smears ◽  
Age Group ◽  
Low Resource Settings ◽  
Cervical Cancers ◽  
Low Resource ◽  
Appropriate Treatment ◽  
Cervical Precancerous Lesions

<p>To study the incidence of abnormal&nbsp; papsmear in Shree Birendra Hospital in the year 2068 among army families. Method: Among the army families all sexually exposed ladies up to age group 60 yrs. are subjected to papsmear. The groups who had positive result are subjected for colposcopy and directed biopsies, and those with cervical precancerous lesions or cancer, received appropriate treatment. Result: Among 7000 gynaecological patients examined in the gynaecology outpatient department 1100 pap smears were done. Out of this, total normal smear were 647 rests were abnormal. Conclusion: In low resource settings a single papsmear testing was associated with significant reduction in the numbers of advanced cervical cancers and deaths from cervical cancers. Therefore, in low resource settings where colposcopy, biopsy, or follow-up with pap smears cannot be done effectively, cryotherapy, as part of a single visit approach is &nbsp;still needed.</p>

scholarly journals Laparoscopic Lavage in Complicated Diverticulitis with Colonic Perforation, Always Be Closing?

2021 ◽  
pp. 765-771
Author(s):  
Jasper Sijberden ◽  
Heleen Snijders ◽  
Susanna van Aalten
Keyword(s):  
Acute Diverticulitis ◽  
Case Series ◽  
Lower Abdominal Pain ◽  
Colonic Perforation ◽  
Postoperative Treatment ◽  
Laparoscopic Lavage ◽  
Intravenous Antibiotics ◽  
Purulent Peritonitis ◽  
Good Clinical Condition

Laparoscopic lavage is seen as an acceptable alternative to colonic resection in selected patients with acute diverticulitis with purulent peritonitis. There is no consensus on what surgical technique should be used when performing this procedure. This case series describes the disease course of 3 patients with acute diverticulitis with purulent peritonitis treated with laparoscopic lavage and direct suturing of a colonic perforation. All patients (38- and 71-year-old males and a 44-year-old female) were seen in the emergency department due to acute lower abdominal pain. Clinical examination and laboratory and imaging studies were suggestive of perforated diverticular disease. Laparoscopic lavage with placement of drain(s) and direct suturing of a colonic perforation was performed. Postoperative treatment with intravenous antibiotics was continued for a variable term. Postoperative courses were uneventful. Patients were discharged on postoperative days 5, 5, and 7. At almost 1-year follow-up, all patients are in good clinical condition and have not had a recurrent episode of diverticulitis<i>.</i> Therefore, this case series shows promising results of laparoscopic lavage with direct suturing of colonic perforation in patients with diverticulitis with perforation and purulent peritonitis.

scholarly journals Effect of Acupuncture on Premature Ovarian Failure: A Pilot Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yingru Chen ◽  
Yigong Fang ◽  
Jinsheng Yang ◽  
Fei Wang ◽  
Yingying Wang ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Premature Ovarian Failure ◽  
Mental Stress ◽  
Case Series ◽  
Ovarian Failure ◽  
Serious Adverse Events ◽  
End Of Treatment ◽  
Case Series Study ◽  
Series Study

To investigate the effect of acupuncture on women with premature ovarian failure (POF), prospective consecutive case series study was applied. 31 women with POF were included; all patients were treated with acupuncture once every other day, three times a week for three months. Acupoints, GV 20, GV 24, GB 13, CV 3, CV 4, BL 23, BL 32, ST 25, ST 28, ST 29, ST 36, SP 6, KI 3, and LR 3, were selected. Serums FSH, E2, and LH level, Self-Rating Anxiety Scale (SAS), and Kupperman score were measured at baseline and at the end of treatment; the menstrual cycle was recorded during one-month follow-up. Compared with baseline, patients’ serums FSH and LH were decreased, E2was increased, and SAS score and Kupperman score were decreased. Four patients resumed menstrual cycle after treatment and two resumed during follow-up. No serious adverse events were found in all patients. The results indicate that acupuncture may decrease serums FSH and LH level, raise serum E2level, relieve anxiety, reduce mental stress, and improve the menopausal symptoms.

Results of JESS (Joshi’s External Stabilizing System) in Relapsed, Neglected and Neurogenic Clubfoot in an Age Group of 2-10 Years

2020 ◽  
Vol 22 (2) ◽  
pp. 121-129
Author(s):  
Kawoosa A Altaf ◽  
Syed Baasit Shafi Shah ◽  
Shafeeq Ahmad ◽  
Umar Mumtaz ◽  
Sayar Ahmad Mantoo
Keyword(s):  
Total Duration ◽  
Lateral View ◽  
Age Group ◽  
Metatarsal Angle ◽  
End Of Treatment ◽  
Severe Group ◽  
The Mean ◽  
Pin Tract Infection ◽  
Mean Time

Background. Joshi’s External Stabilization System (JESS) is an external fixator based methodology to correct different deformities of club foot using differential distraction. Material and methods. 31 difficult clubfeet feet in 24 patients who were neglected, neurogenic or relapsed were treated using JESS between July 2013 to June 2015 with an average follow-up of 4. 2 years. There were 16 males and 8 females in an age group of 2–10 years. 30 feet belonged to the severe and most severe group as per the Dimeglio Scoring System. All patients achieved correction of all components of the clubfoot. Results. However, one patient required tibialis anterior transfer for dynamic forefoot adduction at the end of treatment. The mean total duration in JESS fixation was 69.5 days/foot (range 44-123 days) and the mean time to achieve correction within JESS averaged 52 days. The deformities improved from a mean Dimeglio score of 14.06 to 2.93. The objective radiological assessment of the deformities revealed improvements in the talocalcaneal angle on AP view from 16.39° to 34.52° and on lateral view from 15.97° to 33.03°. The Talo-1st metatarsal angle (AP view) improved from 35.29° to 7°. Complications included 11 cases of superficial pin tract infection, two instances of pin loosening and a case of pin cut out. There were three cases of 1st metatarsophalangeal dislocation that were managed by reversing the process of distraction. Conclusion. JESS is an effective method for managing difficult clubfeet.

The spread of drug-resistant tuberculosis in children: an Italian case series

2013 ◽  
Vol 142 (10) ◽  
pp. 2049-2056 ◽  
Author(s):  
F. MIGNONE ◽  
L. R. CODECASA ◽  
C. SCOLFARO ◽  
I. RAFFALDI ◽  
L. LANCELLA ◽  
...  
Keyword(s):  
Case Series ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Foreign Born ◽  
Italian Case ◽  
Resistant Tuberculosis ◽  
End Of Treatment ◽  
Tuberculosis In Children ◽  
Lost To Follow Up

SUMMARYDrug-resistant paediatric tuberculosis (TB) is an overlooked global problem. In Italy, the epidemiology of TB has recently changed and data regarding drug-resistant forms in the paediatric setting is scanty. The aim of this case series was to report the cases of drug-resistant TB, diagnosed between June 2006 and July 2010 in four Italian tertiary centres for paediatric infectious diseases, in children and adolescents living in Italy. Twenty-two children were enrolled, of these 17 were resistant to one or more drugs and five had multidrug-resistant TB. All but one child were either foreign born or had at least one foreign parent. Twenty-one patients completed their treatment without clinical or radiological signs of activity at the end of treatment, and one patient was lost to follow up. The outcomes were good, with few adverse effects using second-line anti-TB drugs. Although this series is limited, it might already reflect the worrisome increase of drug-resistant TB, even in childhood.

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