scholarly journals Tuberculosis in the pituitary fossa: a common pathology in an uncommon site

2014 ◽  
Vol 2014 ◽  
Author(s):  
K Majumdar ◽  
M Barnard ◽  
S Ramachandra ◽  
M Berovic ◽  
M Powell
Keyword(s):  
Previous History ◽  
Young Female ◽  
Interesting Case ◽  
List Type ◽  
Rare Presentation ◽  
Pituitary Fossa ◽  
Mortality And Morbidity ◽  
Histological Features ◽  
Secondary Hypothyroidism ◽  
The World

Summary Tuberculosis (TB) is an important cause of mortality and morbidity across the world. In 2–5% of all cases of systemic TB, the C is affected, with lesions reported in the meninges, cortex and ventricles. Intrasellar tuberculomas, however, are extremely rare. We report the interesting case of a young female patient who presented with secondary hypothyroidism and hyperprolactinaemia. She was treated successfully for pituitary TB. We also highlight and discuss some interesting (and hitherto unreported) endocrine issues. Radiological and histological features and treatment of pituitary TB are discussed using this case as an example. Learning points Intrasellar TB continues to be a rare presentation, but incidence and prevalence are expected to grow with increasing numbers of multidrug-resistant TB and shrinking geographical boundaries across the world. Pituitary TB can present with features of a typical adenoma, but has certain radiological and histological features that help to differentiate from an adenoma. Patients can present with a variety of endocrine abnormalities at different times. The presence of an intrasellar mass in individuals at a high risk of developing TB, or with a previous history of systemic TB, should prompt the diagnosis of pituitary TB. In such individuals, it may be worth considering a trial of anti-tuberculous therapy, before considering surgery.

Study of Carbon Monoxide Intoxication in Fire Victimis

2018 ◽  
Vol 68 (12) ◽  
pp. 2932-2935
Author(s):  
Sofia David ◽  
Anton Knieling ◽  
Calin Scripcaru ◽  
Madalina Diac ◽  
Ion Sandu ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Inverse Correlation ◽  
Blood Samples ◽  
Mortality And Morbidity ◽  
Carbon Monoxide Intoxication ◽  
Gas Poisoning ◽  
The World ◽  
Fire Victims ◽  
In Fire

Carbon monoxide poisoning is the leading cause of mortality and morbidity of toxic origin in the world. Its insidious and polymorphic symptomatology makes it difficult to diagnose. It occurs accidentally, because of non-supervised domestic fires, or in fire victims. In fire victims, in particular, the differential diagnosis between carbon monoxide gas poisoning, inhalation of other toxic products of combustion like cyanide, oxygen deprivation, thermal burns and shock due to burns as a cause of death is not an easy task. The authors examined 107 fire victims that were autopsied at the Forensic Medicine from Iasi, Romania, in the last 10 years (2007-2016). Most cases were males (69.16%), young (0-9 years) or older than 60 with a burned surface of 91-100% in 68.22% of cases. Blood samples from the cadavers were collected in all cases in order to analyse carboxyhaemoglobin concentration and haemolysis. Toxicological analysis revealed a carboxyhaemoglobin level of maximum 95% but the majority of cases (70.72%) had a concentration inferior to 50%. An inverse correlation was identified between carboxyhaemoglobin concentration and haemolysis, an indicator of heat dissociation. Our study proves that many fire victims may die because of carbon monoxide intoxication prior to the extent of burns at a lethal potential.

Fighting Childhood Pneumonia in Uganda

2017 ◽  
pp. 1-17
Author(s):  
Tim Calkins ◽  
Kara Palamountain ◽  
Aniruddha Chatterjee ◽  
Robert Frantz ◽  
Elizabeth Hart ◽  
...  
Keyword(s):  
Stakeholder Analysis ◽  
List Type ◽  
Patient Journey ◽  
Childhood Pneumonia ◽  
Pharmaceutical Manufacturers ◽  
The World ◽  
Women And Children ◽  
Potential Impact ◽  
Global Stakeholders ◽  
The U.S

It is January 2014, and the case protagonist, David Milestone (senior advisor at the Center for Accelerating Innovation and Impact at the U.S. Agency for International Development's Global Health Bureau), is preparing for a meeting of global stakeholders and pharmaceutical manufacturers who are interested in reducing mortality caused by childhood pneumonia and are prepared to donate $10 million to support this effort.Milestone's goal is to propose a strategy to address childhood pneumonia in Uganda, toward which the $10 million donation would go. In addition to effectively and sustainably reducing childhood pneumonia deaths, the plan must align the interests of various stakeholders behind the problem. A successful strategy in Uganda could be a model for interventions elsewhere. The United Nations Commission on Lifesaving Commodities for Women and Children recently identified Uganda as a “pathfinder” country, meaning it could serve as the example for other countries wrestling with the same issues. This is a remarkable opportunity to change the lives of children in Uganda—and all around the world.After reading and analyzing the case, students will be able to: Perform a stakeholder analysis Appreciate the challenges involved in improving public health, especially in developing countries Create a patient journey and use it to identify potential impact points

scholarly journals Sickle Cell Anemia Presenting with Vaso-Occlusive Pain: Should We Screen for COVID-19?

2021 ◽  
pp. 1-4
Author(s):  
Mohammad Ali ◽  
Lina Okar ◽  
Nabil E. Omar ◽  
Jabeed Parengal ◽  
Ashraf Soliman ◽  
...  
Keyword(s):  
High Risk ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Signs And Symptoms ◽  
Risk Groups ◽  
Position Statement ◽  
Interesting Case ◽  
International Federation ◽  
Cell Disease ◽  
The World

Despite the widespread of coronavirus disease-19 (CO­VID-19) infection around the world, there are very scarce reported literature about the care of patients with a known diagnosis of hemoglobin disorders such as sickle cell disease (SCD) or thalassemia and confirmed COVID-19 infection. Thalassemia International Federation issued a position statement to include patients with thalassemia and SCD among the high-risk groups of patients. Here, we present an interesting case of a 42-year-old patient know to have SCD presenting with Vaso-occlusive (VOC) pain episode in the absence of COVID-19 signs and symptoms, who tested positive for COVID-19 infection and had a smooth recovery. This case highlights the importance of screening SCD patients presenting with VOC-related events even in the absence of COVID-19 signs and symptoms.

Isolated multidrug-resistant tubercular tenosynovitis of the flexor tendon of the little finger

2021 ◽  
Vol 14 (2) ◽  
pp. e238339
Author(s):  
Sunny Chaudhary ◽  
Subhajit Maji ◽  
Varun Garg ◽  
Vivek Singh
Keyword(s):  
Flexor Tendon ◽  
Extrapulmonary Tuberculosis ◽  
Functional Limitation ◽  
Clinical Signs ◽  
Multidrug Resistant ◽  
Interesting Case ◽  
Antitubercular Therapy ◽  
Histopathological Diagnosis ◽  
Rare Presentation ◽  
Little Finger

Isolated multidrug-resistant (MDR) tubercular tenosynovitis of the flexor tendons of finger without involvement of wrist is a rare presentation. Tenosynovitis of hand is an uncommon manifestation of extrapulmonary tuberculosis. Pyogenic flexor tenosynovitis of hand is frequently seen and is the closest differential. Non-specific clinical signs may lead to delay in diagnosis, which is often made after biopsy. Management includes surgical excision of necrotic tissue and infected synovium along with antitubercular therapy after histopathological diagnosis. MDR tuberculosis of hand is extremely rare and, to the best of our knowledge, has not been reported in the literature so far. We report an interesting case of MDR tubercular flexor tendon tenosynovitis of the little finger without any pulmonary involvement in an immunocompetent patient. The case was managed by complete synovectomy and second-line antitubercular therapy with complete resolution of disease and had no functional limitation.

A Report on COVID-19 Variants, COVID-19 Vaccines and the Impact of the Variants on the Efficacy of the Vaccines

2021 ◽  
Author(s):  
Michael Halim
Keyword(s):  
South Africa ◽  
Immune Response ◽  
Clinical Characteristics ◽  
Systemic Review ◽  
Review Of Literature ◽  
Negative Effects ◽  
Mortality And Morbidity ◽  
The World ◽  
Different Strains ◽  
The Impact

The Coronavirus pandemic has caused negative effects across the globe; mortality and morbidity being the main impact. After WHO, termed the disease a pandemic in March 2020, they gave in health guidelines to follow to control the spread of the disease. The health industry, academia, and different governments are united to develop and test various vaccines at an unprecedented speed to combat the pandemic fully and bring the world back to its feet. Some of the vaccines developed include Pfizer, Moderna, and AstraZeneca. However, just like other viruses, the SAR-CoV-2 virus keeps changing through mutation, as various variants, different from the first one are emerging. Evidence shows that the three new variants; UK, Brazil, and South Africa are more severe in terms of transmissibility, disease severity, evading of the immune response, and reducing the ability to neutralized antibodies, compared to the original coronavirus. With such knowledge of the existence of different strains, the arises concerns on whether the already available vaccines are effective enough in preventing the new COVID-19 strains. Studies are still underdeveloped to learn more on the virologic, epidemiologic, and clinical characteristics of the ever-emerging variants. This research, through a systemic review of literature, seeks to find out whether the variants of SAR-CoV-2 have an impact on the efficacy of various vaccines developed in fighting the disease and the entire body’s immune response.

Study of factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation

2021 ◽  
Vol 19 (2) ◽  
pp. 35-39
Author(s):  
Pradeep Chandra Sharma ◽  
Keyword(s):  
Duodenal Ulcer ◽  
Previous History ◽  
Common Factors ◽  
Duodenal Perforation ◽  
High Morbidity ◽  
Delayed Presentation ◽  
Mortality And Morbidity ◽  
Factors Affecting ◽  
Ulcer Perforation ◽  
Duodenal Ulcer Perforation

Background: Peptic ulcer disease in the general population had lifetime prevalence of 5-10% with incidence of 0.1–0.3% per year. Despite the tremendous improvement in preventive therapies, the rate of complication of this disease is still high and is burdened by high morbidity and mortality. In present study, we aimed to study factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation at our tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study conducted in patients admitted, diagnosed with duodenal ulcer perforation and surgically treated at our hospital. Results: In present study period total 56 patients were studied. All were male, most common age group was 51-60 years (37.5%) followed by 41-50 years (23.21%). Duration from onset of symptoms to admission was >24 hours (30.36%) in most of patients followed by 12-24 hours (28.57%). Most commons symptoms were pain in abdomen (100%), vomiting (100%). Anaemia (37.5%), LRTI and Pulmonary complications (19.64%), Diabetes mellitus (12.5%) and Hypertension (10.71%) were common comorbidities noted. Associated risk factors were previous history of PUD (41.07%), Alcohol use (64.29%), Cigarette smoking (51.79%) and Use of NSAIDs (12.5%). Presence of free gas under diaphragm was noted in 83.93% patients. Intraoperatively duodenal perforation diameter was 1–5 mm (60.71%) in most of patients followed by 6–10 mm (23.21%). Only 1 patient had duodenal perforation diameter was > 20mm. Common postoperative complications were wound infection (37.5%) and pulmonary infection (21.43%). In present study mortality within 1 month was noted in 13 patients (23.21%). Most common factors related to mortality were delayed presentation > 24 hours (61.54%), age > 60 years (46.15%), diabetes mellites (38.46%), Size of perforation > 1 cm (38.46%) and septicaemic shock (23.08%). Conclusion: Delayed presentation > 24 hours, age > 60 years size of perforation > 1 cm were common factors related to mortality in duodenal ulcer perforation patients.

scholarly journals Terrorism, Trust and Tourism

2017 ◽  
Vol 5 (2) ◽  
pp. 25
Author(s):  
Susanne Jensen ◽  
Gert Tinggaard Svendsen
Keyword(s):  
Competitive Advantage ◽  
Comparative Studies ◽  
Western Europe ◽  
Social Trust ◽  
Interesting Case ◽  
Terrorist Attacks ◽  
Future Research ◽  
The World ◽  
Quantitative And Qualitative Methods ◽  
Country People

How does terrorism affect social trust and tourism? The rising number of terrorist attacks in Western Europe has caused safety problems not only for local citizens but also for tourists. In fact, terrorists challenge the formal violence monopoly of the state thus creating a sense of anarchy and distrust. Social trust is about trusting strangers, so when less predictable behaviour occurs in, a given country, people become more careful as they tend to trust most other people less. An interesting case for future research is Scandinavia as the level of terrorism is still low and, at the same time, Scandinavia can record most social trust in the world meaning a competitive advantage when attracting tourists. Arguably, a double dividend is created from fighting terrorism, namely more social trust accumulated and more tourists attracted. Future research should therefore try to further test our model by both quantitative and qualitative methods, for example by undertaking extensive comparative studies between Scandinavia and other countries with more terrorism and less trust.

scholarly journals Measuring the health of populations: explaining composite indicators

2012 ◽  
Vol 1 (3) ◽  
pp. 35 ◽  
Author(s):  
Adnan A. Hyder ◽  
Prasanthi Puvanachandra ◽  
Richard H. Morrow
Keyword(s):  
Disease Burden ◽  
Policy Decision ◽  
Main Approach ◽  
Mortality And Morbidity ◽  
Alternative Interventions ◽  
Composite Measures ◽  
Value Choices ◽  
The World ◽  
Health Policy Decision ◽  
Policy Decision Making

Indicators that summarise the health status of a population and that provide comparable measures of a population disease burden are increasingly vital tools for health policy decision making. Decisions concerning health systems across the world are greatly affected by changes in disease profiles and population dynamics, and must develop the capacity to respond to such changes effectively within the resources of each nation. Decisions must be based on evidence of the patterns of diseases, their risk factors and the effectiveness of alternative interventions. This paper focuses on the main approaches used for developing summary measures that include mortality and morbidity occurring in a population. It discusses the rationale for composite measures and reviews the origins of each main approach. The paper also examines methodological differences among these approaches making explicit the value choices that each entails, outlines the advantages and limitations of each measure, and shows how they relate to one another.

scholarly journals A novel CASR variant in a family with familial hypocalciuric hypercalcaemia and primary hyperparathyroidism

2020 ◽  
Vol 2020 ◽  
Author(s):  
Satyanarayana V Sagi ◽  
Hareesh Joshi ◽  
Jamie Trotman ◽  
Terence Elsey ◽  
Ashwini Swamy ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Organ Damage ◽  
Urinary Calcium ◽  
Interesting Case ◽  
List Type ◽  
Loss Of Function ◽  
Clearance Ratio ◽  
Hormone Levels ◽  
Severe Hypercalcaemia

Summary Familial hypocalciuric hypercalcaemia (FHH) is a dominantly inherited, lifelong benign disorder characterised by asymptomatic hypercalcaemia, relative hypocalciuria and variable parathyroid hormone levels. It is caused by loss-of-function pathogenic variants in the calcium-sensing receptor (CASR) gene. Primary hyperparathyroidism (PHPT) is characterised by variable hypercalcaemia in the context of non-suppressed parathyroid hormone levels. Unlike patients with FHH, patients with severe hypercalcaemia due to PHPT are usually symptomatic and are at risk of end-organ damage affecting the kidneys, bone, heart, gastrointestinal system and CNS. Surgical resection of the offending parathyroid gland(s) is the treatment of choice for PHPT, while dietary adjustment and reassurance is the mainstay of management for patients with FHH. The occurrence of both FHH and primary hyperparathyroidism (PHPT) in the same patient has been described. We report an interesting case of FHH due to a novel CASR variant confirmed in a mother and her two daughters and the possible coexistence of FHH and PHPT in the mother, highlighting the challenges involved in diagnosis and management. Learning points: Familial hypocalciuric hypercalcaemia (FHH) and primary hyperparathyroidism (PHPT) can coexist in the same patient. Urinary calcium creatinine clearance ratio can play a role in distinguishing between PHPT and FHH. Genetic testing should be considered in managing patients with PHPT and FHH where the benefit may extend to the wider family. Family segregation studies can play an important role in the reclassification of variants of uncertain significance. Parathyroidectomy has no benefit in patients with FHH and therefore, it is important to exclude FHH prior to considering surgery. For patients with coexisting FHH and PHPT, parathyroidectomy will reduce the risk of complications from the severe hypercalcaemia associated with PHPT.

scholarly journals The long-term effects of modifiable and unmodifiable risk factors of stroke

2020 ◽  
Vol 7 (11) ◽  
pp. 4626
Author(s):  
Khaled M. Hassan ◽  
Asala M. Wafa ◽  
Manea S. Alosaimi ◽  
Kawthar A. Bokari ◽  
Mosab A. Alsobhi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Arabian Peninsula ◽  
Modifiable Risk Factors ◽  
Long Term Effects ◽  
Kingdom Of Saudi Arabia ◽  
Mortality And Morbidity ◽  
The Third ◽  
The World

Stroke is a major cerebrovascular disease causes high mortality and morbidity in people around the world. Stroke is the third leading cause of death and the leading cause of adult disability. The largest country in the middle East, the Kingdom of Saudi Arabia (KSA), has been occupying approximately four-fifths of the Arabian Peninsula supporting a population of more than 28 million. Stroke is getting to be a quickly expanding issue and is the leading cause of illness and deaths in Saudi Arabia. It is clear that researches and studies regarding the incidence, prevalence and their sociodemographic properties of stroke is still incomplete due to lack of present studies being conducted in these specified areas. This article aims to discuss the aspect of stroke in Saudi Arabia beside the effects of modifiable and the non-modifiable risk factors from the literature published. 

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