scholarly journals Complications of Neck Dissection in Thyroid Malignancy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Alaaeldin ◽  
M S Farahat ◽  
A N K Elhoofy ◽  
A M M Yonis
Keyword(s):  
Neck Dissection ◽  
Indirect Laryngoscopy ◽  
Thyroid Malignancy ◽  
Thyroid Lesion ◽  
Normal Thyroid ◽  
X Ray ◽  
Chest X Ray ◽  
Laboratory Investigations ◽  
Work Up ◽  
Normal Adults

Abstract Background The normal thyroid gland is caudal to the larynx and encircles the anterolateral portion of the trachea. It is about 10 to 20 grams in weight in normal adults. Aim of the Work The aim of this study is to characterize the morbidity and complications of neck dissection in thyroid malignancy. Patients and Methods The present study will include 20 patients with thyroid cancer. All patients will undergo total thyroidectomy plus neck dissection. Neck dissection procedure was performed unilaterally in 16 patients (80%), and bilaterally in 4 (20%), making a total of 24 ND procedures. Results There were fifteen females (75%) and five males (52%), their age ranged between 26 and 70 years with a mean of 50 years. All patients were subjected to thorough history taking, complete clinical examination and vocal cord assessment by indirect laryngoscopy. Laboratory investigations (T3, T4, TSH, serum Ca, and routine laboratory work up), followed by neck ultrasonography (US), and computed tomography (CT) were performed for all patients, as well as chest X-ray, and CT chest when needed. Biopsy from suspicious thyroid lesion and suspicious cervical LNs (whether blind or US guided) was performed. Conclusion Morbidity and complications of neck dissection are numerous and variable so meticulous dissection is needed.

A Comparison in Work-Up Between the First and Second Covid 19 Infection in the Same Patients in the ED Tawam Hospital, UAE

2021 ◽  
Author(s):  
Hussein Kzar Basi Al-Shamri
Keyword(s):  
Laboratory Tests ◽  
The Other ◽  
Routine Laboratory ◽  
Infection Group ◽  
X Ray ◽  
Severity Of Disease ◽  
Chest X Ray ◽  
Laboratory Investigations ◽  
Work Up ◽  
First Time

Aim of study: To identify the significance of routine laboratory investigations conducted in patients infected with COVID-19 for the second time as compared to being infected with COVID-19 for the first time in the UAE. Methods: 345 patients between the ages of 16 and 65 years who were infected with COVID-19 were included in the study. Patient’s charts were reviewed and all laboratory tests and imaging conducted were reviewed. Furthermore, patients were divided into two groups: one as a first time COVID-19 infection group and the other as a second time COVID-19 infection group. Results: Fifteen laboratory tests have been conducted. Of these tests, 44.4% (4 tests) (procalcitonin, phosphate, magnesium, amylase, and lipase) that were abnormally elevated in patients in the first infection group were found to be significantly reduced in patients with a second COVID-19 infection. Also, two imaging modalities done which included Chest–X ray and CT thorax without contrast were abnormal in all the patients in the second infection group. Conclusion and recommendations: We recommend not using the following labs in patients with COVID-19 infection for the second time: procalcitonin, magnesium, lipase, amylase, phosphate. However, we do recommend performing Chest X-ray and CT thorax without contrast in assessing severity of disease in patients with COVID-19 infection for the second time.

scholarly journals Simple, fast and affordable triaging pathway for COVID-19

2020 ◽  
pp. postgradmedj-2020-138029
Author(s):  
Elizabeth Jane Eggleton
Keyword(s):  
Health Services ◽  
Viral Infection ◽  
Clinical Assessment ◽  
Blood Analysis ◽  
X Ray ◽  
Mild Disease ◽  
Global Pandemic ◽  
Chest X Ray ◽  
Severe Respiratory Infection ◽  
Laboratory Investigations

Coronavirus disease 2019 has caused a global pandemic. The majority of patients will experience mild disease, but others will develop a severe respiratory infection that requires hospitalisation. This is causing a significant strain on health services. Patients are presenting at emergency departments with symptoms of dyspnoea, dry cough and fever with varying severity. The appropriate triaging of patients will assist in preventing health services becoming overwhelmed during the pandemic. This is assisted through clinical assessment and various imaging and laboratory investigations, including chest X-ray, blood analysis and identification of viral infection with SARS-CoV-2. Here, a succinct triaging pathway that aims to be fast, reliable and affordable is presented. The hope is that such a pathway will assist health services in appropriately combating the pandemic.

scholarly journals Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Luigi Cattarossi ◽  
Roberto Copetti ◽  
Giacomo Brusa ◽  
Stefano Pintaldi
Keyword(s):  
Birth Weight ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Lung Ultrasound ◽  
Chest Drainage ◽  
X Ray ◽  
Lower Accuracy ◽  
Chest X Ray ◽  
Diagnostic Work ◽  
Work Up

Background. Pneumothorax (PTX) still remains a common cause of morbidity in critically ill and ventilated neonates. At the present time, lung ultrasound (LUS) is not included in the diagnostic work-up of PTX in newborns despite of excellent evidence of reliability in adults. The aim of this study was to compare LUS, chest X-ray (CXR), and chest transillumination (CTR) for PTX diagnosis in a group of neonates in which the presence of air in the pleural space was confirmed.Methods. In a 36-month period, 49 neonates with respiratory distress were enrolled in the study. Twenty-three had PTX requiring aspiration or chest drainage (birth weight 2120 ± 1640 grams; gestational age = 36 ± 5 weeks), and 26 were suffering from respiratory distress without PTX (birth weight 2120 ± 1640 grams; gestational age = 34 ± 5 weeks). Both groups had done LUS, CTR, and CXR.Results. LUS was consistent with PTX in all 23 patients requiring chest aspiration. In this group, CXR did not detect PTX in one patient while CTR did not detect it in 3 patients. Sensitivity and specificity in diagnosing PTX were therefore 1 for LUS, 0.96 and 1 for CXR, and 0.87 and 0.96 for CTR.Conclusions. Our results confirm that also in newborns LUS is at least as accurate as CXR in the diagnosis of PTX while CTR has a lower accuracy.

scholarly journals Dengue and scrub typhus co-infection causing septic shock

2021 ◽  
Vol 2021 (11) ◽  
Author(s):  
Prakriti Subedi ◽  
Manoj Ghimire ◽  
Karun Shrestha ◽  
Kalpana Ghimire ◽  
Sudeep Adhikari ◽  
...  
Keyword(s):  
Septic Shock ◽  
Clinical Improvement ◽  
Scrub Typhus ◽  
Intravenous Fluids ◽  
High Grade Fever ◽  
X Ray ◽  
Chest Auscultation ◽  
History Of ◽  
Chest X Ray ◽  
Laboratory Investigations

ABSTRACT A 33-year-old female presented with a history of high-grade fever, cough, dyspnea, joint pain and myalgia. On examination, the patient was febrile with tachycardia, hypotension and decreased oxygen saturation. Chest auscultation revealed bilateral decreased air entry with crepitation supported by bilateral pulmonary infiltrates on chest X-ray. The laboratory investigations showed leukocytosis, thrombocytopenia, transaminitis and renal impairment. The patient was treated with intravenous fluids, ceftriaxone and levofloxacin; however, there was no clinical improvement till 48 h. She was then diagnosed with scrub typhus and dengue co-infection via serologies. Doxycycline was started following which the patient improved in 24 h. Scrub typhus can present with septic shock but does not respond to the usual antibiotics and the addition of doxycycline will result in rapid clinical improvement. Co-infection with other tropical diseases such as dengue is also common, hence it is important to test based on local endemicity.

scholarly journals Internal medicine residents’ evaluation of fevers overnight

Diagnosis ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Jessica Howard-Anderson ◽  
Kristin E. Schwab ◽  
Sandy Chang ◽  
Holly Wilhalme ◽  
Christopher J. Graber ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Complete Blood Count ◽  
Resident Training ◽  
Blood Cultures ◽  
X Ray ◽  
Internal Medicine Residents ◽  
Chest X Ray ◽  
Multivariable Regression ◽  
Febrile Episodes ◽  
Work Up

Abstract Background Scant data exists to guide the work-up for fever in hospitalized patients, and little is known about what diagnostic tests medicine residents order for such patients. We sought to analyze how cross-covering medicine residents address fever and how sign-out systems affect their response. Methods We conducted a prospective cohort study to evaluate febrile episodes that residents responded to overnight. Primary outcomes included diagnostic tests ordered, if an in-person evaluation occurred, and the effect of sign-out instructions that advised a “full fever work-up” (FFWU). Results Investigators reviewed 253 fevers in 155 patients; sign-out instructions were available for 204 fevers. Residents evaluated the patient in person in 29 (11%) episodes. The most common tests ordered were: blood cultures (48%), urinalysis (UA) with reflex culture (34%), and chest X-ray (30%). If the sign-out advised an FFWU, residents were more likely to order blood cultures [odds ratio (OR) 14.75, 95% confidence interval (CI) 7.52–28.90], UA with reflex culture (OR 12.07, 95% CI 5.56–23.23), chest X-ray (OR 16.55, 95% CI 7.03–39.94), lactate (OR 3.33, 95% CI 1.47–7.55), and complete blood count (CBC) (OR 3.16, 95% CI 1.17–8.51). In a multivariable regression, predictors of the number of tests ordered included hospital location, resident training level, timing of previous blood culture, in-person evaluation, escalation to a higher level of care, and sign-out instructions. Conclusions Sign-out instructions and a few patient factors significantly impacted cross-cover resident diagnostic test ordering for overnight fevers. This practice can be targeted in resident education to improve diagnostic reasoning and stewardship.

Tuberculosis: Diagnostic Challenges in Rural Africa

Praxis ◽  
2019 ◽  
Vol 108 (15) ◽  
pp. 991-996
Author(s):  
Ngisi Masawa ◽  
Farida Bani ◽  
Robert Ndege
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
X Ray ◽  
Molecular Tests ◽  
Rural Settings ◽  
Chest X Ray ◽  
Screening Questions ◽  
Rural Africa ◽  
Tb Diagnostics ◽  
Strip Test ◽  
Urine Strip

Abstract. Tuberculosis (TB) remains among the top 10 infectious diseases with highest mortality globally since the 1990s despite effective chemotherapy. Among 10 million patients that fell ill with tuberculosis in the year 2017, 36 % were undiagnosed or detected and not reported; the number goes as high as 55 % in Tanzania, showing that the diagnosis of TB is a big challenge in the developing countries. There have been great advancements in TB diagnostics with introduction of the molecular tests such as Xpert MTB/RIF, loop-mediated isothermal amplification, lipoarabinomannan urine strip test, and molecular line-probe assays. However, most of the hospitals in Tanzania still rely on the TB score chart in children, the WHO screening questions in adults, acid-fast bacilli and chest x-ray for the diagnosis of TB. Xpert MTB/RIF has been rolled-out but remains a challenge in settings where the samples for testing must be transported over many kilometers. Imaging by sonography – nowadays widely available even in rural settings of Tanzania – has been shown to be a useful tool in the diagnosis of extrapulmonary tuberculosis. Despite all the efforts and new diagnostics, 30–50 % of patients in high-burden TB countries are still empirically treated for tuberculosis. More efforts need to be placed if we are to reduce the death toll by 90 % until 2030.

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

Hubungan antara Luas Lesi pada Foto Toraks Penderita TB Paru Dewasa yang Memiliki Riwayat Diabetes Melitus dengan Indeks Massa Tubuh di Rumah Sakit Hasan Sadikin Bandung

2016 ◽  
Vol 1 (3) ◽  
pp. 138-144
Author(s):  
Ina Edwina ◽  
Rista D Soetikno ◽  
Irma H Hikmat
Keyword(s):  
Chest Radiograph ◽  
Chi Square ◽  
Pulmonary Tb ◽  
X Ray ◽  
Consecutive Sampling ◽  
Close Relationship ◽  
Chi Square Test ◽  
Chest X Ray ◽  
The Relationship ◽  
Diabetes Melitus

Background: Tuberculosis (TB) and diabetes mellitus (DM) prevalence rates are increasing rapidly, especially in developing countries like Indonesia. There is a relationship between TB and DM that are very prominent, which is the prevalence of pulmonary TB with DM increased by 20 times compared with pulmonary TB without diabetes. Chest X-ray picture of TB patients with DM is atypical lesion. However, there are contradictories of pulmonary TB lesion on chest radiograph of DM patients. Nutritional status has a close relationship with the morbidity of DM, as well as TB.Objectives: The purpose of this study was to determine the relationship between the lesions of TB on the chest radiograph of patients who su?er from DM with their Body Mass Index (BMI) in Hasan Sadikin Hospital Bandung.Material and Methods: The study was conducted in Department of Radiology RSHS Bandung between October 2014 - February 2015. We did a consecutive sampling of chest radiograph and IMT of DM patients with clinical diagnosis of TB, then the data was analysed by Chi Square test to determine the relationship between degree of lesions on chest radiograph of pulmonary TB on patients who have DM with their BMI.Results: The results showed that adult patients with active pulmonary TB with DM mostly in the range of age 51-70 years old, equal to 62.22%, with the highest gender in men, equal to 60%. Chest radiograph of TB in patients with DM are mostly seen in people who are obese, which is 40% and the vast majority of lesions are minimal lesions that is equal to 40%.Conclusions: There is a signifcant association between pulmonary TB lesion degree with BMI, with p = 0.03

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