INNV-43. MORE THAN WHAT MEETS THE EYE: ETMR AN UNDER RECOGNISED ATYPICAL BRAINSTEM PRIMARY. A RARE BRAIN TUMOR CONSORTIUM (RBTC) STUDY

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi114-vi115
Author(s):  
Sara Khan ◽  
Palma Solano-Paez ◽  
Jordan R Hansford ◽  
Mei Lu ◽  
Salma Al-karmi ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Signs And Symptoms ◽  
Pediatric Brain Tumors ◽  
Female Ratio ◽  
Dismal Prognosis ◽  
History Of ◽  
Cranial Neuropathies ◽  
Intensified Chemotherapy ◽  
Male To Female

Abstract 10% of all pediatric brain tumors arise in the brainstem. Amongst these gliomas are the most common while other entities are rare and infrequently described in the literature. In this study we investigated the prevalence of non-gliomatous tumors in the brainstem. Amongst the 1323 embryonal tumours received at the RBTC, we identified 17 cases of ETMRs (17/165) that presented as brainstem primaries. Previously grouped within CNS-PNETs, ETMR, is a new WHO diagnostic entity, characterized by C19MC alterations. ETMR is a disease of infancy, the clinical spectrum of which is poorly understood. ETMRs arise at multiple CNS locations including cerebrum being most common (60%,) followed by cerebellum (18%) and midline structures (6%); notably 10% were brainstem primaries, mimicking DIPG radiologically. All patients presented with a short history of progressive neurological symptoms, with most common signs and symptoms of cranial neuropathies, long tract signs and gait disturbance. Median age at diagnosis was 27 months (range 16-75months) with a male to female ratio of 0.9:1. Predominantly localized (M0-94%, M2-3 -6%) majority of patients underwent upfront biopsy or partial resection (15/17:88%), while complete tumor resection was achieved in 2 cases. All patients received heterogenous combination of chemotherapy with and without radiotherapy. Majority of patients progressed rapidly with median time to progression of 4 months and overall survival of < 13 months. The only long-term surviving patient had complete resection dose intensified chemotherapy and radiation (OS 202months). Primary ETMRs in the brainstem are under recognised entities and carry a dismal prognosis. Although rapidly progressive, prompt recognition, maximal resection and management with multimodal adjuvant therapy should be considered in cases with brainstem disease.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

DEMOGRAPHIC PROFILE OF ACUTE FEBRILE ENCEPHALOPATHY CASES IN PEDIATRIC AGE GROUP PATIENTS: A STUDY FROM WESTERN RAJASTHAN

2021 ◽  
pp. 72-73
Author(s):  
Laxmi Rathore ◽  
P. K. Khatri ◽  
Saroj K. Meena ◽  
Archana Bora ◽  
Suneel Bhooshan
Keyword(s):  
Lower Class ◽  
Mental States ◽  
Clinical Feature ◽  
Female Ratio ◽  
Pediatric Age Group ◽  
History Of ◽  
Laboratory Investigations ◽  
Demographic Distribution ◽  
Viral Etiologies ◽  
Male To Female

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.

COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

2021 ◽  
pp. 70-72
Author(s):  
Gaurav Santosh Nemade ◽  
Sumit Nitin Dhus ◽  
Arushi Ramesh Shetty ◽  
Neha Dhananjay Firake
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary Tuberculosis ◽  
Younger Age ◽  
Tobacco Addiction ◽  
History Of ◽  
Early Case ◽  
Male To Female ◽  
Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

scholarly journals Hospital based study of demography and clinical picture of vernal keratoconjunctivitis

2017 ◽  
Vol 6 (1) ◽  
pp. 65 ◽  
Author(s):  
Maneesha Sethi ◽  
Ridham Nanda ◽  
Amarjeet Singh Bali ◽  
P. Sadhotra
Keyword(s):  
Mixed Type ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Vernal Keratoconjunctivitis ◽  
Female Ratio ◽  
Northern India ◽  
Department Of Ophthalmology ◽  
Male Female Ratio ◽  
History Of ◽  
Ocular Morbidity

Background: Vernal Keratoconjunctivitis (VKC) is common cause of ocular morbidity in children living in tropical countries. Its diagnosis is based on signs and symptoms of the disease. The study was undertaken to stress upon the demography and clinical presentation of VKC.Methods: Retrospective pre-formed proforma of 155 patients of VKC, who were detected at random in the out - patient department of ophthalmology, ASCOMS, Jammu from May 2016 to April 2017, were analyzed.Results: Mean age at presentation was 10.31 years +4.05. The Male: Female ratio was 4.96:1. Majority of patients reported in the month of May. Mixed type of VKC was predominant. Personal or family history of allergy was seen in 5.8% of patients. Itching (100%) was commonest symptom and palpaberal papillae were commonest sign seen in 78.70% of patients.Conclusions: Clinical pattern of VKC seen in hot and dry climate of Northern India is like that seen in other parts of country.

scholarly journals Typhoid ileal perforation in Shisong, Northwestern Cameroon

2019 ◽  
pp. 08-24
Author(s):  
Bamidele Johnson Alegbeleye
Keyword(s):  
Computer Software ◽  
Operation Time ◽  
Time Interval ◽  
Female Ratio ◽  
Ileal Perforation ◽  
X Ray ◽  
Dismal Prognosis ◽  
Northwestern Region ◽  
Male To Female ◽  
Prompt Diagnosis

Background: The study aims to provide an overview of the spectrum of perforated typhoid fever cases and their outcome that were managed in resource constrained rural mission hospital, Northwestern of Cameroon. Methods: This was a retrospective observational study which was conducted in St Elizabeth Catholic General Hospital, Shisong, Northwestern region of Cameroon over a two year period covering January 2016 and December 2018. The patients included were those admitted and diagnosed of typhoid ileal perforation. Data collected were analyzed using SPSS computer software version 22. Results: During the study period, thirty-eight patients underwent surgery for typhoid ileal perforation. They included 26 (68.43%) males and 12 (31.57%) females with Male to Female ratio of 2.2: 1. Sixty -five percent of cases occurred between the months of July and September. The most common presentations were with abdominal pains (92.11%), and abdominal distention (92.11%). X-ray abdomen revealed pneumo -peritoneum in 26 (68.4%) cases, while ultrasound detected free peritoneal collection in 34 (90%) cases. Perforations were surgically treated depending upon the number of perforations, general health status of patient and degree of fecal contamination. Perforated typhoid still carries dismal prognosis. The mortality was associated with duration of delay in obtaining blood pre - operatively for patients requiring transfusion (p=0.018) and duration of presentation to operation time interval (p=0.026). Conclusion: Typhoid intestinal perforation is still endemic in our setting with dismal prognosis. Urgent public health concerted effort is required with emphasis on preventive measures such as safe drinking water, appropriate sewage disposal, and typhoid vaccination. Educating the populace on early and prompt diagnosis, adequate resuscitation as well as early surgery in patients with typhoid ileal perforation to keep the mortality low.

scholarly journals Aetiological factors of hoarseness in patients attending at Kathmandu University Hospital

2013 ◽  
Vol 19 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Bikash Lal Shrestha ◽  
Ram Chaya Man Amatya ◽  
Sekhar KC ◽  
Inku Shrestha ◽  
Monika Pokharel
Keyword(s):  
Longitudinal Study ◽  
Age Groups ◽  
University Hospital ◽  
Microsoft Excel ◽  
Special Investigation ◽  
Female Ratio ◽  
Common Cause ◽  
Manual Analysis ◽  
History Of ◽  
Male To Female

Objective: To evaluate the aetiological factors of hoarseness. Methods: This is a prospective, non- randomized and longitudinal study conducted from 1st august 2011 to 1st august 2012 in department of otorhinolaryngology of Kathmandu university Hospital, Dhulikhel, Nepal. All the patients with history of hoarseness underwent clinical examination, routine as well as special investigation to find the diagnosis. The final results were analyzed by simple manual analysis with frequency and percentage using Microsoft Excel software 2007. Results: There were total 280 patients included in the study. Among them the age groups of 21 – 30 years and 31 – 40 years were mainly suffer from hoarseness. Similarly, among 280 patients 200 (71.45%) were males whereas 80 (28.6%) were females with male to female ratio of 2.5:1.. The most common cause as per the distribution was acid peptic laryngitis with frequency of 37.8% whereas tuberculosis of larynx, papillary carcinoma of thyroid and papilloma of vocal cord accounts for only 0.4% each. Conclusion: There was etiological variation in hoarseness ranging from simple laryngitis to malignancies. So it is important not to ignore the hoarseness and precise history, examination and investigations should be done. DOI: http://dx.doi.org/10.3329/bjo.v19i1.11877 Bangladesh J Otorhinolaryngol 2013; 19(1): 14-17

Stroke in a Subsaharan Nigerian Hospital—A Retrospective Study

1989 ◽  
Vol 19 (1) ◽  
pp. 11-14 ◽  
Author(s):  
S A Bwala
Keyword(s):  
Duration Of Symptoms ◽  
Female Ratio ◽  
Transient Ischaemic Attacks ◽  
History Of ◽  
Hospital Deaths ◽  
Insulin Dependent ◽  
The Mean ◽  
The University ◽  
First Time ◽  
Male To Female

The case records of 53 consecutive Nigerian inpatients with stroke in the University of Maiduguri Teaching Hospital, Maiduguri were retrospectively reviewed. The mean age at presentation was 55 years and the male to female ratio was 2.5: 1. The mean duration of symptoms before presentation was 11.1 weeks and the average duration of stay in hospital was 3 weeks. Thirty-three (63%) of the lesions were infarctive and 19 (37%) were haemorrhagic. Only 3 (6%) patients gave a history of prior transient ischaemic attacks (TIAs). Forty-two (79%) patients were hypertensive at presentation out of which 27 (64%) had the hypertension diagnosed for the first time. Four (8%) patients were non-insulin dependent diabetics. There were 11 hospital deaths (21%). Thus hypertension, more than half undiagnosed at admission, was the most common risk factor for stroke in the hospital population studied.

Is pharyngeal pouch stapling superior to open pharyngeal pouch repair? An analysis of a single institution's series

2016 ◽  
Vol 130 (9) ◽  
pp. 873-877 ◽  
Author(s):  
E Agalato ◽  
J Jose ◽  
R J England
Keyword(s):  
Surgical Procedures ◽  
Symptom Control ◽  
Open Approach ◽  
Pharyngeal Pouch ◽  
Female Ratio ◽  
Open Procedure ◽  
Long Term Follow Up ◽  
Male To Female

AbstractBackground:Endoscopic stapling has become the primary procedure for pharyngeal pouch surgery because it is quick, less invasive and safe, but less is known about long-term outcomes.Method:Medical records were reviewed to compare rates of morbidity, operative failure, symptom control and revision surgery between open and closed procedures.Results:A total of 120 pharyngeal pouch procedures, carried out on 97 patients from 2000 to 2014, were studied. These included 80 endoscopic stapling and 40 open procedures. Twelve patients had complications (15 per cent) and there was one mortality (1.2 per cent) in the endoscopic stapling group. Ten patients (25 per cent) developed complications in the open procedure group, with no mortalities. Symptom recurrence was significantly greater in the endoscopic stapling group (26 per cent) than in the open procedure group (7.5 per cent). Multiple surgical procedures were required for 22 endoscopically stapled patients (32 per cent); none were required in the open procedure group. Although the male-to-female ratio for pharyngeal pouch incidence was 2:1, the ratio for multiple surgical procedures was 10:1.Conclusion:Endoscopic stapling outcomes are not as good as those following an open approach on long-term follow up, and the early advantages are eliminated if pouch excision is avoided.

scholarly journals Aural foreign bodies and their management: our experience

2020 ◽  
Vol 6 (4) ◽  
pp. 646
Author(s):  
Padma Harini ◽  
Suneel Kudamala
Keyword(s):  
Foreign Bodies ◽  
Incidental Finding ◽  
Tertiary Care ◽  
Age Groups ◽  
Paediatric Population ◽  
Outpatient Department ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
History Of ◽  
Male To Female

<p class="abstract"><strong>Background:</strong> Aural foreign bodies (FB) are a common presentation at ENT outpatient department mostly seen in paediatric population. Some are easily managed while others should be dealt with caution and extreme care. The objectives of the study were to analyze the types of aural FB, their incidence in different age groups and evaluate management methods.</p><p class="abstract"><strong>Methods:</strong> This is a prospective descriptive study on patients of all age groups with aural FB presenting to the ENT Outpatient Department in a tertiary care centre for a period of 1 year. The clinical presentation, type of FB, incidence in different age groups and management methods were analyzed.  </p><p class="abstract"><strong>Results:</strong> 200 patients aged 2-78 years were evaluated. Age group of under 15 years was most affected (70%). Male to female ratio was 1:1.326. Majority (104 out of 200) presented with a history of FB insertion in the ear while others presented with aural pain and discharge. In 10 cases, ear foreign body was an incidental finding. Most common FB was seeds in children and cotton buds, bird feathers in adults. Most of the cases were managed without anaesthesia with use of headlight. Ear probes were used in 45% cases followed by forceps, suction and syringing in remainder.</p><p class="abstract"><strong>Conclusions:</strong> Most of the aural foreign bodies can be managed in the outpatient department itself without any anaesthesia under direct vision of headlight with the help of simple instruments without any complications.</p><p class="abstract"> </p>

scholarly journals NORMAL PLANTAR FASCIA THICKNESS IN ADULT

2022 ◽  
Vol 8 (1) ◽  
pp. 16-20
Author(s):  
Yusak Mangara Tua Siahaan ◽  
Pricilla Yani Gunawan ◽  
Jeffry Foraldy Haryanto ◽  
Veli Sungono
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Heel Pain ◽  
Sectional Study ◽  
Normal Range ◽  
Cross Sectional ◽  
Female Ratio ◽  
History Of ◽  
Male To Female

Background: Plantar fasciitis is a common problem caused by thickening of the plantar fascia. The normal plantar fascia thickness ranged between 2-3 mm and it was generally accepted that value more than 4mm was considered pathologic. Objective: to identify normal plantar fascia thickness in adults using ultrasonography. Methods: This is a cross sectional study measuring the thickness of plantar fascia in 145 subjects with no history of heel pain. Plantar fascia thickness was measured in both feet using an ultrasound. Age, height and weight were recorded and analysed. Results: As much as 145 subjects were included in this study. Male to female ratio was 0.7. Mean age was 44 and body mass index (BMI) was mostly within normal range. Plantar fascia thickness in male was 2.71 ± 0.48 mm in right foot, and 2.74 ± 0.47 mm in left foot. Fascia thickness in female was 2.55 ± 0.50 mm in right foot, and 2.57 ± 0.45 mm in left foot. There was a significant plantar fascia thickness difference between male and female (p = 0.035 in right foot, and p=0.04 in left foot). Age, weight and BMI had a significant correlation towards plantar fascia thickness. In multivariate analysis, age and BMI revealed to have a linear correlation to plantar fascia thickness Conclusion: Age and BMI were found to be the best predictive factor of plantar fascia thickness.

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