scholarly journals Management of labial adhesion in a developing country—an observational study

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Saurabh Srivastava ◽  
Anand Pandey ◽  
Piyush Kumar ◽  
Survesh K. Gupta ◽  
Sudhir Singh ◽  
...  
Keyword(s):  
Observational Study ◽  
Vaginal Opening ◽  
Labia Minora ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
Mupirocin Ointment ◽  
Labial Adhesion ◽  
Local Examination ◽  
Antibiotic Ointment

Abstract Background Labial adhesion is the fusion of the labia minora or majora. The literature reports conservative management. However, the situation may be different in our setup, where management differs due to prevailing circumstances. The present study was conducted to evaluate labial adhesion presentation, management, and outcome in our center. Methods It was a retrospective observational study from January 2015 to January 2020. The patients were evaluated for age at presentation, presenting symptoms, type of adhesions, treatment, recurrence, and follow-up. The treatment included the manual release of labial adhesion and Mupirocin ointment application for 15 days. They were advised to attend the outpatient department after 1 month for evaluation and later on in case of any problem. Results The total number of patients was 150, of which 104 (69.33%) were from rural backgrounds. The complaint was of the absent vaginal opening in all patients. Seventeen (11.33%) were advised ultrasonography of the abdomen elsewhere to look for the presence of internal genital organs. The local examination revealed poor hygiene in 65 (43.33%) patients. The patient with thick adhesions has minor erythema after the release of adhesions. Ten (6.66%) patients had a recurrence managed by repeat release with no recurrence. Conclusion Despite being a benign entity, labial adhesion may be a cause of severe concern. Manual separation and antibiotic ointment may be a viable first option in its management with minimal recurrence. Maintenance of local hygiene may be needed to prevent a recurrence. The overall outcome is excellent.

scholarly journals HEROIC: a 5-year observational cohort study aimed at identifying novel factors that drive diabetic kidney disease: rationale and study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e033923
Author(s):  
Kieran Mccafferty ◽  
Ben Caplin ◽  
Sinead Knight ◽  
Paul Hockings ◽  
David Wheeler ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Observational Study ◽  
Diabetic Kidney Disease ◽  
Laboratory Data ◽  
Premature Mortality ◽  
Primary Objective ◽  
Imaging Data ◽  
Diabetic Kidney ◽  
Number Of Patients

IntroductionDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide and a major cause of premature mortality in diabetes mellitus (DM). While improvements in care have reduced the incidence of kidney disease among those with DM, the increasing prevalence of DM means that the number of patients worldwide with DKD is increasing. Improved understanding of the biology of DKD and identification of novel therapeutic targets may lead to new treatments. A major challenge to progress has been the heterogeneity of the DKD phenotype and renal progression. To investigate the heterogeneity of DKD we have set up The East and North London Diabetes Cohort (HEROIC) Study, a secondary care-based, multiethnic observational study of patients with biopsy-proven DKD. Our primary objective is to identify histological features of DKD associated with kidney endpoints in a cohort of patients diagnosed with type 1 and type 2 DM, proteinuria and kidney impairment.Methods and analysisHEROIC is a longitudinal observational study that aims to recruit 500 patients with DKD at high-risk of renal and cardiovascular events. Demographic, clinical and laboratory data will be collected and assessed annually for 5 years. Renal biopsy tissue will be collected and archived at recruitment. Blood and urine samples will be collected at baseline and during annual follow-up visits. Measured glomerular filtration rate (GFR), echocardiography, retinal optical coherence tomography angiography and kidney and cardiac MRI will be performed at baseline and twice more during follow-up. The study is 90% powered to detect an association between key histological and imaging parameters and a composite of death, renal replacement therapy or a 30% decline in estimated GFR.Ethics and disseminationEthical approval has been obtained from the Bloomsbury Research Ethics Committee (REC 18-LO-1921). Any patient identifiable data will be stored on a password-protected National Health Services N3 network with full audit trail. Anonymised imaging data will be stored in a ISO27001-certificated data warehouse.Results will be reported through peer-reviewed manuscripts and conferences and disseminated to participants, patients and the public using web-based and social media engagement tools as well as through public events.

Prevalence and natural history of arachnoid cysts in adults

2013 ◽  
Vol 118 (2) ◽  
pp. 222-231 ◽  
Author(s):  
Wajd N. Al-Holou ◽  
Samuel Terman ◽  
Craig Kilburg ◽  
Hugh J. L. Garton ◽  
Karin M. Muraszko ◽  
...  
Keyword(s):  
Natural History ◽  
Brain Mri ◽  
Arachnoid Cysts ◽  
Consecutive Series ◽  
Middle Fossa ◽  
Presenting Symptoms ◽  
History Analysis ◽  
Number Of Patients ◽  
History Of

Object Arachnoid cysts are a frequent finding on intracranial imaging. The prevalence and natural history of these cysts in adults are not well defined. Methods We retrospectively reviewed the electronic medical records of a consecutive series of adults who underwent brain MRI over a 12-year interval to identify those with arachnoid cysts. The MRI studies were reviewed to confirm the diagnosis. For those patients with arachnoid cysts, we evaluated presenting symptoms, cyst size, and cyst location. Patients with more than 6 months' clinical and imaging follow-up were included in a natural history analysis. Results A total of 48,417 patients underwent brain MRI over the study period. Arachnoid cysts were identified in 661 patients (1.4%). Men had a higher prevalence than women (p < 0.0001). Multiple arachnoid cysts occurred in 30 patients. The most common locations were middle fossa (34%), retrocerebellar (33%), and convexity (14%). Middle fossa cysts were predominantly left-sided (70%, p < 0.001). Thirty-five patients were considered symptomatic and 24 underwent surgical treatment. Sellar and suprasellar cysts were more likely to be considered symptomatic (p < 0.0001). Middle fossa cysts were less likely to be considered symptomatic (p = 0.01. The criteria for natural history analysis were met in 203 patients with a total of 213 cysts. After a mean follow-up of 3.8 ± 2.8 years (for this subgroup), 5 cysts (2.3%) increased in size and 2 cysts decreased in size (0.9%). Only 2 patients developed new or worsening symptoms over the follow-up period. Conclusions Arachnoid cysts are a common incidental finding on intracranial imaging in all age groups. Although arachnoid cysts are symptomatic in a small number of patients, they are associated with a benign natural history for those presenting without symptoms.

Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery

2011 ◽  
Vol 7 (4) ◽  
pp. 375-379 ◽  
Author(s):  
David Benglis ◽  
Derek Covington ◽  
Ritwik Bhatia ◽  
Sanjiv Bhatia ◽  
Mohamed Samy Elhammady ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Pediatric Patients ◽  
Neurological Deficits ◽  
Type I ◽  
Imaging Studies ◽  
Chiari Malformation Type I ◽  
Presenting Symptoms ◽  
Asymptomatic Patients ◽  
Number Of Patients

Object The natural history of untreated Chiari malformation Type I (CM-I) is poorly defined. The object of this study was to investigate outcomes in pediatric patients with CM-I who were followed up without surgical intervention. Methods The authors retrospectively reviewed 124 cases involving patients with CM-I who presented between July 1999 and July 2008 and were followed up without surgery. The patients ranged in age from 0.9 to 19.8 years (mean 7 years). The duration of follow-up ranged from 1.0 to 8.6 years (mean 2.83 years). Imaging findings, symptoms, and findings on neurological examinations were noted at presentation and for the duration of follow-up. Results The mean extent of tonsillar herniation at presentation was 8.35 mm (range 5–22 mm). Seven patients had a syrinx at presentation. The syrinx size did not change in these patients on follow-up imaging studies. No new syrinxes developed in the remaining patients who underwent subsequent imaging. The total number of patients with presenting symptoms was 81. Of those 81 patients, 67 demonstrated symptoms that were not typical of CM-I. Of the 14 patients with symptoms attributed to CM-I, 9 had symptoms that were not severe or frequent enough to warrant surgery, and surgery was recommended in the remaining 5 patients. Chiari malformation Type I was also diagnosed in 43 asymptomatic patients who had imaging studies performed for various reasons. No new neurological deficits were noted in any patient for the duration of follow-up. Conclusions The majority of patients with CM-I who are followed up without surgery do not progress clinically or radiologically. Longer follow-up of this cohort will be required to determine if symptoms or new neurological findings develop over the course of many years.

scholarly journals Assault-related severe ocular chemical injury at a London ophthalmic referral hospital: a 3-year retrospective observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038109
Author(s):  
Jeremy John Hoffman ◽  
Edward Joshua Casswell ◽  
Alex John Shortt
Keyword(s):  
Observational Study ◽  
Outcome Measures ◽  
Surgical Intervention ◽  
Retrospective Observational Study ◽  
Secondary Outcome ◽  
Tertiary Referral ◽  
Work Related ◽  
Number Of Patients ◽  
Grade 3

ObjectivesTo understand the incidence, causes, management and outcomes of intentional (assault) and unintentional severe ocular chemical injuries (SOCI) at an urban tertiary referral centre in the UK.DesignRetrospective observational study.SettingA London tertiary referral ophthalmic centre, Moorfields Eye Hospital.ParticipantsAll cases of SOCI presenting between 1 September 2011 and 31 August 2014 were identified. The definition of SOCI was grade 3 or 4 on the Hughes-Roper-Hall classification system. We identified 25 cases (6 in 2011–2012, 8 in 2012–2013, 11 in 2013–2014). Median age was 31.1 years. 23 cases (92%) were male.Primary and secondary outcome measuresThe primary outcome was the proportion of cases of SOCI caused by assault, per year. Secondary outcome measures included the number of cases of SOCI, injury characteristics and mechanism, initial and long-term management, visual outcome and the need for surgical intervention.ResultsBetween 2011 and 2012, 3/6 cases were due to assault (50%); between 2012 and 2013, 7/8 were due to assault (87.5%); and between 2013 and 2014, 6/11 were due to assault (54.4%). Assault was responsible for 16/25 (64%) cases overall, while 8/25 (32%) cases were work related. The causative agent was known to be alkali in 16/25 (64%), while 10/25 (40%) did not complete the follow-up. The mean number of clock hours of limbal ischaemia was 5.24 (SD 2.97). 17/25 (68%) were Hughes-Roper-Hall grade 3. Surgical intervention occurred in 1/25. The final best-corrected visual acuity was 6/12 or worse in 11/25 (44%) and was counting fingers or worse in 4/25 (16%).ConclusionsPrevious studies found that SOCI had a low incidence and that work-related injuries were the most common cause. Our study demonstrates an increasing incidence of SOCI, which may be accounted for by a rise in assault using corrosive substances. A high number of patients did not attend regularly for follow-up and visual outcomes from these injuries are poor.

scholarly journals An observational study to evaluate psychological experience and social stigmas in COVID-19 patients: a prospective study on home isolated patients

2021 ◽  
Vol 8 (9) ◽  
pp. 4518
Author(s):  
Ankit R. Mistry ◽  
Parth Gupta ◽  
Sagar R. Bhimani ◽  
Kamlesh P. Patel ◽  
Supriya D. Malhotra ◽  
...  
Keyword(s):  
Observational Study ◽  
Social Stigma ◽  
Care Service ◽  
Public Mental Health ◽  
Physical Symptoms ◽  
Asymptomatic Patients ◽  
Number Of Patients ◽  
A Prospective Study ◽  
First Time

Background: Coronavirus disease 2019 (COVID-19) has caused significant distress. Apart from evident physical symptoms in infected cases, it has caused serious damage to public mental health. The present study was carried out to assess disease burden, fear and stigma associated in home isolated patients.Methods: A Prospective, observational study of 8 weeks began after IEC approval in diagnosed COVID 19 patients who were home isolated and visited by the researcher as part of Sanjeevni home care service launched by the municipal corporation. Number of patients turning symptomatic from asymptomatic was recorded. Frequency for transmission was also noted. Fear and social stigma by Fear of COVID 19 scale (FCV-19S) and Stigma scale was measured respectively.Results: A total of 746 patients were included in the study (mean age: 40.2±16.2 years). About 105 patients (14.07%) suffered from co-morbidities like Hypertension, Diabetes, Obesity. About 38.47% were asymptomatic while 61.53% were symptomatic during their home isolation period. Among asymptomatic patients, 48.78% became symptomatic during their period of home isolation and follow up. A family member being found positive was 35.19% from asymptomatic patients while 34.85% from symptomatic patients. The mean score of the patients for fear and stigma in our study was 14.74±5.13 and 35.13±8.48 respectively.Conclusions: Both symptomatic as well as asymptomatic patients can transmit the disease with equal frequency. Asymptomatic at diagnosis also converts to symptomatic in almost half of the population. This further highlights the importance of home isolation. This was the first time we have used a Stigma and Fear scale in patients affected by COVID 19 who were home isolated. Higher score of Fear scale was seen in >50 years of age.  

scholarly journals A prospective multicentric observational study to evolve the usefulness of 13 predefined homoeopathic medicines in the management of acute rhinitis in children.

2021 ◽  
Vol 9 (30) ◽  
pp. 30-42
Author(s):  
Chaturbhuja Nayak ◽  
Vikram Singh ◽  
Krishna Singh ◽  
Hari Singh ◽  
Praveen Oberai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Observational Study ◽  
Symptom Score ◽  
Presenting Symptoms ◽  
Rhinitis Symptom ◽  
Central Council ◽  
Significant Change ◽  
Acute Rhinitis

Aims: The study aimed to evaluate the effect of a group of homeopathic medicines in children with acute rhinitis. Materials and methods: In this multi-centric open clinical trial, a total of 784 children (408 males; 384 females) aged 6 months to 15 years, presenting symptoms of acute rhinitis were enrolled from 7 Institutes/ Units under the Central Council for Research in Homeopathy (India). Symptoms were assessed using an acute rhinitis symptom score (ARSS). A total of 13 homeopathic medicines were shortlisted after repertorizing the nosological symptoms of acute rhinitis in children and the results were analyzed. The medicines were prescribed in dilution 6c (10-12) and doses were repeated from few minutes to few hours as per the need of the case. Appearance of any change (improvement or worsening) was followed by placebo / change in dilution or change in medicine according to the response of the patient. The follow up period was up to the 7th day of illness. Results: Out of 784 children enrolled, 638 children were followed up and analyzed. A significant change in the score from the baseline (p

IS STEP RATE ASSOCIATED WITH RUNNING INJURY INCIDENCE? AN OBSERVATIONAL STUDY WITH 9- MONTH FOLLOW UP

2020 ◽  
Vol 15 (2) ◽  
pp. 221-228
Author(s):  
Eliza B. Szymanek ◽  
Erin M. Miller ◽  
Amy N. Weart ◽  
Jamie B. Morris ◽  
Donald L. Goss
Keyword(s):  
Observational Study ◽  
Injury Incidence ◽  
Step Rate ◽  
Running Injury

STRUCTURAL AND DYNAMIC FEATURES OF EAR-LY DISABILITY DUE TO MENTAL DISEASES

2020 ◽  
pp. 62-67
Author(s):  
Shmakova O.P.
Keyword(s):  
People With Disabilities ◽  
Child And Adolescent Psychiatry ◽  
Child Psychiatrist ◽  
Childhood And Adolescence ◽  
Disabled Children ◽  
Dynamic Features ◽  
Factors Affecting ◽  
Number Of Children ◽  
Number Of Patients

Prevention of disability is one of the most significant tasks of child and adolescent psychiatry. Obtaining data on the dynamics of the number of people with disabilities and the factors affecting this indicator seems to be one of the relevant aspects. Aim: to trace the dynamics of the number of children with disabili-ties and to assess the change in the structure of early disability over the past decades. Materials and Meth-ods. A comparative analysis of two cohorts of patients was carried out: 1st - patients born in 1990-1992. (1203 patients (men - 914, 76%; women - 289, 24%)) who applied to the district neuropsychiatric dispensa-ry for outpatient care in childhood and adolescence; II - children and adolescents born in 2005 - 2018 (602 patients (male - 410, 68%; female - 192, 32%), ob-served at the time of the study by a child psychiatrist in the neuropsychiatric dispensary. Research methods: clinical and psychopathological; follow-up; statisti-cal. Results. Comparison of the number and nosologi-cal distribution of disabled children in two cohorts showed that over the 15th year there has been a shift towards an increase in the proportion of disabled children among patients observed by child and ado-lescent psychiatrists. The increase in the number of children with disabilities was due to those suffering from childhood autism and other disorders of general development. There were no statistically significant differences in the number of people with disabilities who received benefits before the age of 7, as well as differences in gender ratios among disabled people in the two cohorts. Conclusion. Early disability is a mul-tifactorial phenomenon, prevalence, dynamics, the structure of which depends not only on clinical, but also on socio-administrative realities. Children with autism require increased attention, since there has been a multiple increase in the number of patients with this diagnosis.

Cerebellotrigeminal Dermal Dysplasia (Gómez-López-Hernández Syndrome)

2018 ◽  
Vol 16 (05) ◽  
pp. 362-368 ◽  
Author(s):  
Federica Sullo ◽  
Agata Polizzi ◽  
Stefano Catanzaro ◽  
Selene Mantegna ◽  
Francesco Lacarrubba ◽  
...  
Keyword(s):  
De Novo ◽  
Chromosomal Rearrangements ◽  
Number Of Patients ◽  
Wide Range ◽  
Visual Problems ◽  
Neurodevelopmental Abnormalities ◽  
Clinical Triad ◽  
High Degree ◽  
Motor Handicap

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

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