scholarly journals Clinical and ultrasound characteristics of virilizing ovarian tumors in pre- and postmenopausal patients: a single tertiary center experience

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mi Zou ◽  
Rong Chen ◽  
Yahong Wang ◽  
Yonglan He ◽  
Ying Wang ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Serum Testosterone ◽  
Ovarian Tumors ◽  
Imaging Method ◽  
First Line ◽  
College Hospital ◽  
Medical College ◽  
Tertiary Center ◽  
Line Imaging ◽  
Endocrine Symptoms

Abstract Background A virilizing ovarian tumor (VOT) is a rare cause of hyperandrogenism in pre- and postmenopausal women. Although transvaginal ultrasound is considered as the first-line imaging method for ovarian tumors, it is examiner-dependent. We aimed to summarize the clinical and ultrasound manifestations of VOTs to help establish the diagnosis with emphasis on those causing diagnostic difficulty. Method We retrospectively identified 31 patients with VOTs who underwent surgery at Peking Union Medical College Hospital. Results Patients with VOTs were predominantly premenopausal. All patients showed androgenic manifestations with serum testosterone levels elevated to varying degrees. The tumor size of VOTs was significantly correlated with age (P < 0.001). The VOTs in the postmenopausal group were significantly smaller than those in the premenopausal group (median 1.8 cm [range, 1.3–4.8 cm] vs 4.5 cm [range, 0.7–11.9 cm]; P = 0.018). Twenty-seven out of 31 VOTs were successfully identified by ultrasound. On ultrasound, VOTs are mostly solid and hypoechoic masses with enhanced vascularity. Four VOTs (0.7–1.5 cm) were radiologically negative, and they were the smallest among all patients. Conclusion Patients with VOTs showed androgenic manifestations with varying degrees of hyperandrogenemia. Older patients tend to have smaller VOTs. Ultrasound is an effective method for the detection of VOTs. Some VOTs can be very small and difficult to visualize radiologically, especially in postmenopausal patients. Examiners must remain vigilant about very small VOTs on the basis of endocrine symptoms.

scholarly journals Re-Emargence of Susceptibility to Conventional First Line Drugs in Salmonella Typhi and Paratyphi a Isolated from Enteric Fever Patients in a Tertiary Care Hospital of Northern Bangladesh.

2017 ◽  
Vol 11 (1) ◽  
pp. 3-5
Author(s):  
Maiz Ul Ahad Suman ◽  
Md Abdullah Siddique ◽  
SM Shamsuzzaman ◽  
Abu Rayhan Khandakar
Keyword(s):  
Enteric Fever ◽  
Health Care Cost ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
First Line ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Enteric fever is endemic in Bangladesh and involves significant health care cost. The first-line drugs chloramphenicol and co-trimoxazole have not been the part of empirical therapy for decades due to development of multidrug resistant Salmonella strains. The objective of this study was to determine the antibiogram pattern of Salmonella strains isolated from the blood of clinically suspected enteric fever patients. A cross sectional study was conducted in Rajshahi Medical College Hospital & Dhaka Medical College from August 2014 to July 2015. Total 323 blood samples were collected from suspected enteric fever patients and isolation rate of Salmonella was 9.29% [S.typhi (3.41%), and S.paratyphi A (5.88%)]. Among isolated S.typhi, 9.09% were resistant to chloramphenicol, cotrimoxazole and cefixime and there were no S.typhi resistant to azithromycin and cefotaxime. Among the isolated S.paratyphi A, 5.26% were resistant to chloramphenicol, co-trimoxazole, azithromycin, cefotaxime, and cefixime. There were no ceftriaxone resistant Salmonella. Low proportion of resistance to first line antibiotics (chloramphenicol, co-trimoxazole) suggests that these drugs can be used once again. Bangladesh J Med Microbiol 2017; 11 (1): 3-5

scholarly journals Hepatic Lobectomy-Case Report of Two Patients, Performed at Chittagong Medical College Hospital

1970 ◽  
Vol 26 (3) ◽  
pp. 153-157
Author(s):  
SM Ashraf Ali ◽  
Md Margub Hussain
Keyword(s):  
Case Report ◽  
Life Experience ◽  
Left Lobe ◽  
Medical College Hospital ◽  
General Surgeon ◽  
College Hospital ◽  
Socioeconomic Condition ◽  
Low Socioeconomic ◽  
Medical College ◽  
Tertiary Center

Lobectomy of liver is indicated for different conditions; mainly malignancy and trauma. Though it is highly specialized operation and preferably be performed in specialized tertiary center, sometime a general surgeon may not be in a position to avoid the surgery due to very low socioeconomic condition or to tackle emergency traumatic condition. Two case report of Lobectomy of liver; right lobectomy for hepatocellular carcinoma, and left lobectomy for left lobe big cyst and multiple stones in it were performed at Chittagong Medical College Hospital utilizing the existing facilities. Both patients recovered uneventfully. Case I expired after two month and fourteen day, Case II leading a pain free cheerful normal life. Experience of management of these two cases of resection of liver is recorded at Chittagong Medical College Hospital. DOI: 10.3329/jbcps.v26i3.4201 J Bangladesh Coll Phys Surg 2008; 26: 153-157

scholarly journals Characterization of Focal Liver Lesions using Contrast Enhanced Ultrasound as a First Line Method: a Large Monocentric Experience

2014 ◽  
Vol 23 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Ioan Sporea ◽  
Alina Martie ◽  
Simona Bota ◽  
Roxana Sirli ◽  
Alina Popescu ◽  
...  
Keyword(s):  
Focal Liver Lesions ◽  
Imaging Method ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
First Line ◽  
Clear Cut ◽  
Contrast Enhanced ◽  
Line Imaging ◽  
Conclusive Diagnosis

Aim: To present a large monocentric experience in the characterization of focal liver lesions (FLLs) using Contrast Enhanced Ultrasound (CEUS).Method: A retrospective study was performed in the Gastroenterology and Hepatology Department, Timisoara, including 1100 patients with 1329 FLLs evaluated between September 2009 and January 2013. A CEUS examination was considered conclusive if the FLL respected the typical enhancement pattern as described in the EFSUMB Guidelines.Results: From the 1329 FLLs, CEUS was conclusive for a specific pathology in 1102 cases (82.9%). For the differentiation of benign/malignant lesions, CEUS reached a conclusive diagnosis in 1196 (90%) cases. The percentage of conclusive CEUS examinations was significantly higher in patients without chronic liver disease as compared with those with chronic hepatopathies: 87.3% vs. 74.4% (p<0.0001).Conclusion: CEUS patterns of enhancement fell into clear cut specific diagnostic patterns in 83% of the FLLs discovered by US, and into clear cut benign versus malignant patterns in 90% of the cases. For this reason, we can strongly recommend CEUS as a first line imaging method to characterize FLLs found at US, at least in centers with a good experience in CEUS.

Antibiotic Response to Pediatric Scrub Typhus in South India: Is Clinical Failure to Azithromycin to be Worried?

2021 ◽  
Vol 67 (1) ◽  
Author(s):  
Ilamaran Veerappan ◽  
Rathisharmila Ramar ◽  
Soundararajan Palanisamy
Keyword(s):  
Clinical Response ◽  
Failure Rate ◽  
Scrub Typhus ◽  
Clinical Failure ◽  
First Line ◽  
College Hospital ◽  
Medical College ◽  
Control Time ◽  
Antibiotic Response ◽  
Symptoms And Signs

ABSTRACT Background Scrub typhus is typically associated with a rapid defervescence and clinical improvement within 48 h of initiation of appropriate antibiotics. But increasing reports of resistance to anti-rickettsial medications in scrub typhus are being reported in the literature. Methods This is a retrospective observational study of children up to the age of 14 years admitted between July 2017 and March 2020, to a private medical college hospital in southern part of India. The aim of this study was to compare the clinical response to antibiotic therapy with doxycycline and azithromycin in pediatric scrub typhus infection. Results One hundred thirty-eight children with scrub typhus infection were included for analysis. The median fever control time (h) was 12 (IQR = 6–29) and 24 (IQR = 10–52) with doxycycline and azithromycin respectively (p &lt; 0.001*). Rapid fever control within 48 h was observed in 92% with doxycycline and in 74% with azithromycin (p &lt; 0.001*). The clinical failure rate (defined by the necessity to change the antibiotics due to: (i) worsening of symptoms and signs of scrub typhus despite 48 h of antibiotics or (ii) persistence of fever and other symptoms of scrub typhus beyond 72 h), was significantly less with doxycycline (1%) compared with azithromycin (9.6%). Conclusion There has been a significant delayed clinical response to azithromycin in the treatment of scrub typhus in India, when compared to doxycycline. Hence it is preferable to use doxycycline as the first line of antibiotic for undifferentiated fever in scrub typhus endemic areas. Lay summary This retrospective study aims to compare the clinical response to doxycycline or azithromycin in the treatment of scrub typhus infection in children. The median fever control time, clinical failure rate and the proportion of children with rapid defervescence of fever within 48 h were significantly superior with doxycycline as compared to azithromycin. The findings of this study and those of similar studies in India represent a spectrum of delayed clinical response of Orientia tsutsugamushi to azithromycin as compared to doxycycline in this region.

scholarly journals A Retrospective Clinicopathological Study of Malignant Ovarian Tumors: A 3 Year Experience in a Tertiary Health Care Center of Dhaka, Bangladesh

2021 ◽  
Vol 29 (2) ◽  
pp. 100-105
Author(s):  
Joysree Saha ◽  
Sohana Siddique ◽  
Sumaya Akter ◽  
Md Abdul Quader ◽  
Indrajit Prasad ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Abdominal Distension ◽  
Ovarian Tumors ◽  
Common Finding ◽  
College Hospital ◽  
Duration Of Symptoms ◽  
Health Care Center ◽  
Medical College ◽  
Serous Cyst

Background: Ovarian tumors are a heterogeneous group of neoplasm that have become increasingly important now-a-days because of their large variety of neoplastic entities and gradually increased rate of mortality due to female genital cancers. Objectives: The aim of this study was to analyze the histopathological pattern and clinical presentation of malignant ovarian tumors according to the WHO classification of ovarian tumors [2003] in a tertiary care center of Dhaka, Bangladesh. Materials and Methods: This retrospective study included and studied a total of 54 cases of malignant ovarian tumors at the Department of Obstetrics and Gynecology, Popular Medical College Hospital, Dhaka, Bangladesh over a period of 3 years from Jan 2015 to Dec 2017. Results: The mean age was 47.44±14.24 years old (age ranged from 20-70 years). Of the 54 malignant ovarian tumors studied, the commonest histological pattern observed in the study was serous cyst adenocarcinoma constituting 26 cases (48.15%) followed by adenocarcinoma of ovary (25.9%), mucinous cyst adenocarcinoma (14.8%), endometriod adenocarcinoma (3.7%), dysgerminoma (3.7%) and ovarian choriocarcinoma (3.7%). High level of serum CA125 was found in most of the cases (n=48; 88.89%). The chief complaints were abdominal pain (n=38; 70.37%) and abdominal distension (n=29; 53.70%). Majority were admitted with less than one month duration of symptoms. The size of the tumor varied from 2.2 to 20 cm. All the patients were admitted in III and IV stage. Conclusions: Serous cyst adenocarcinoma was the common finding of this study. The prognosis and varying therapeutic strategies of malignant ovarian tumors necessitate an accurate histopathological evaluation. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 100-105

scholarly journals A Rare Case of Adrenal Pheochromocytoma With Unusual Clinical and Biochemical Presentation: A Case Report and Literature Review

2020 ◽  
Vol 21 (2) ◽  
pp. 168-171
Author(s):  
Munshi Akid Mostofa ◽  
AKM Shahadat Hossain ◽  
Hafiz Al Asad ◽  
Md Mahfuzur Rahman Chowdhury ◽  
Lutful Hasan
Keyword(s):  
Plasma Catecholamines ◽  
Serum Testosterone ◽  
Urinary Free Cortisol ◽  
College Hospital ◽  
Medical College ◽  
Basal Cortisol ◽  
Free Cortisol ◽  
Adrenal Pheochromocytoma ◽  
Suprarenal Mass ◽  
History Of

A 45 years old male, nondiabetic, hypertensive, nonasthmatic, nonsmoker, farmer from Pabna presented with the complaints of pain over right hypochondrium for 4 months andalso gave history of significant weight loss of about 15 kg in the last 6 months. He also developed bilateral gynecomastia for 2 years.On examination, Blood pressure was 200/100 mm of Hg and bilateral gynecomastia were present.Both testes were mildly atrophied.Systemicexamination revealed mild tenderness in right hypochondrium on deep palpation of abdomen.USG of W/A revealed A heterogenous mixed echogenic mass (9.9*8.9) was seen in upper polar region of right kidney. Suggestive of Right suprarenal mass. CT scan W/A with contrast showed heterogenous contrast enhancing well defined rounded soft tissue density lesion measuring about 90*86 mm was noted in right adrenal region which revealed a right adrenal mass consistent with adrenal pheochromocytoma. However,clinical biochemistry tests revealed normal levels of plasma catecholamines (dopamine,norepinephrine, and epinephrine) and metanephrine, which are unusual findings in adrenal pheochromocytoma.Serum Aldosterone,Basal cortisol, Renin in plasma, ACTH and 24 hours Urinary Free cortisol were normal.Meanwhile, The patient had persistent hypokalemia and serum Testosterone, LH and FSH were below normal level. Open right adrenalectomy was done. Histopathology and immunohistochemistryconfirmed the diagnosis of adrenal pheochromocytoma. Following surgery, the patient did well and showed full recovery at follow-up after one month. To our knowledge, this is the first report in Dhaka Medical college hospital of the extremely rare entity of pheochromocytoma with an unusual clinical and biochemical scenario. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.168-171

Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review

2020 ◽  
Vol 38 (02/03) ◽  
pp. 216-226
Author(s):  
Mee Kristine Aas-Eng ◽  
Eliana Montanari ◽  
Marit Lieng ◽  
Joerg Keckstein ◽  
Gernot Hudelist
Keyword(s):  
Tertiary Care ◽  
Transvaginal Sonography ◽  
Imaging Method ◽  
First Line ◽  
Deep Endometriosis ◽  
Delay In Diagnosis ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Ovarian Endometriomas ◽  
Sonographic Imaging

AbstractImaging of endometriosis and in particular deep endometriosis (DE) is crucial in the clinical management of women facing this debilitating condition. Transvaginal sonography (TVS) is the first-line imaging method and magnetic resonance imaging (MRI) may provide supplemental information. However, the delay in diagnosis of up to 10 years and more is of concern. This problem might be overcome by simple steps using imaging with emphasis on TVS and referral to tertiary care. Finally, TVS is crucial in mapping extent and location of disease in planning surgical therapy and counseling women regarding various therapeutic options. This review presents the available data on imaging of endometriosis with a focus on TVS and MRI for DE, adenomyosis, and ovarian endometriomas including endometriomas in pregnancy as well as the use of “soft markers.” The review presents an approach that is in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement.

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