scholarly journals Cases of management of paediatric tubo-ovarian torsion

2019 ◽  
Vol 8 (7) ◽  
pp. 2888 ◽  
Author(s):  
Ruchi Bhandari ◽  
Manju Khemani ◽  
Asif Mustafa
Keyword(s):  
Fallopian Tube ◽  
Ovarian Function ◽  
Case Series ◽  
Conservative Surgery ◽  
Paediatric Population ◽  
Ovarian Torsion ◽  
Vascular Compromise ◽  
Laparoscopic Cystectomy ◽  
Paediatric Age ◽  
Loss Of Appetite

Ovarian torsion is the fifth most common cause of gynaecologic surgical emergency. It warrants early diagnosis as timely surgical management will avoid the further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation. This leads to delay in surgical exploration and loss of ovarian function. In these cases, the ovary and often the ipsilateral fallopian tube twist with the vascular pedicle, resulting in vascular compromise. Unrelieved torsion leads to haemorrhagic infarction. We encountered 3 cases of ovarian torsion in paediatric age group during a period of 12 months. All cases presented with acute pain abdomen for 3-7 days period with loss of appetite and unable to pass motion with varied disappearance of pain. On ultrasound all the cases were diagnosed with ovarian cyst with torsion and underwent laparoscopic cystectomy. This case series is written just to show the results of de-torsion and conserving the fallopian tube and ovary after vascular damage. This type of conservative management may give chance to ovary to return to viability. This was seen in all 3 cases dealt by us on repeat scan on follow up. Even on de-torsion if ovary does not regain its colour immediately it should be conserved, and cystectomy should be performed rather than oophorectomy. Conservative surgery, in the form of ovarian de-torsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

scholarly journals Case series of paediatric adnexal torsion: rare yet urgent entity

2016 ◽  
Vol 6 (1) ◽  
pp. 315 ◽  
Author(s):  
Vineet Mishra ◽  
Shaheen Hokabaj ◽  
Priyankur Roy ◽  
Rohina Aggarwal ◽  
Bhumika Vyas ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Conservative Surgery ◽  
Paediatric Population ◽  
Ovarian Torsion ◽  
Care Hospital ◽  
Paediatric Age ◽  
High Degree

Ovarian torsion is a true emergency which warrants early diagnosis and timely surgical management to avoid the catastrophic consequences of further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation of disease. This leads to delay in surgical exploration and loss of ovarian function. We encountered 6 cases of ovarian torsion in paediatric age group during a period of 2 years, at a tertiary care hospital in Ahmedabad. After enquiry of the symptoms and a series of investigations, a provisional diagnosis of torsion ovary was made and they were taken up for surgery. Intra-operatively all the patients were found to have non-salvageable ovary and fallopian tube on the affected side, and subsequently they underwent salpingo-oophorectomy. Diagnosis of ovarian torsion requires clinician awareness and a high degree of suspicion. Conservative surgery, in the form of ovarian detorsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

scholarly journals A Comparative Analysis of Outcomes of Conventional Cold Dissection Versus Laser Tonsillectomy in Pediatric Cases in a Tertiary Care Hospital in Haryana

2021 ◽  
Author(s):  
Amit Kumar ◽  
Surender Kumar ◽  
Anand Krishnan ◽  
Manish Verma ◽  
Uma Garg ◽  
...  
Keyword(s):  
Operative Time ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Paediatric Population ◽  
Care Hospital ◽  
Secondary Complications ◽  
Post Operative Pain ◽  
Secondary Bleeding ◽  
Paediatric Age ◽  
Cold Dissection

AbstractTonsillectomy is one of the commonest ENT procedures done in paediatric population, the technique of which has evolved over years to decrease the morbidity associated with the surgery. This prospective randomized comparative study is done to evaluate the efficacy of two different techniques of this surgery, conventional cold dissection and laser tonsillectomy based on operative time, blood loss, post-operative pain and occurrence of secondary complications. The study was done in 68 patients of paediatric age group, 34 in each group underwent cold dissection and laser tonsillectomy. Operative time and bleeding were significantly low for laser group. Pain score was comparable in early post-operatives days, but was high towards the end of first week. Our study reported only one incidence of complication in the form of a secondary bleeding.

scholarly journals PATH-18. A MULTI-CENTER CASE SERIES OF ADULT K27M MUTATED DIFFUSE MIDLINE GLIOMAS REVEALING A POPULATION UNIQUE FROM PAEDIATRIC CASES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii167-ii168
Author(s):  
Alexander Yuile ◽  
Madhawa De Silva ◽  
Marina Kastelan ◽  
Veronica Cheung ◽  
Joanne Sy ◽  
...  
Keyword(s):  
Older Patients ◽  
Selection Criteria ◽  
Case Series ◽  
Progression Free Survival ◽  
Paediatric Population ◽  
Asia Pacific ◽  
Royal North Shore Hospital ◽  
Free Survival ◽  
Delay In Diagnosis ◽  
Presenting Symptoms

Abstract BACKGROUND Histone mutations in the K27M gene were first described in 2014, and incorporated into the WHO CNS tumour classification system in 2016. They are typically associated with diffuse midline gliomas (DMG). Presenting symptoms vary greatly, with some experiencing significant delay in diagnosis. Median survival is only 9-12 months for these patients. Biopsy samples are small, and in some due to location, not performed. Although data is predominately based on the paediatric population, DMGs are seen in both adolescence and adults. In this multi-site retrospective study, we describe 11 adult patients with K27M DMG gliomas across two tertiary Neuro-Oncology services in Sydney, Australia. To the authors’ knowledge we present the largest known collection of adult K27M cases in the Asia-Pacific region with correlation of treatment, clinicopathologic and radiologic features with outcomes. METHODS The glioma databases of Royal North Shore Hospital (RNSH) and Royal Prince Alfred Hospital (RPAH) between January 2009 and March 2020 were interrogated to identify patients. Selection criteria included patients aged ≥ 18 years who presented with a DMG, had undergone biopsy, and had confirmed K27M via next generation sequencing. Clinicopathologic, radiologic and treatment outcomes were extracted for correlation. RESULTS Eleven patients fitting the selection criteria were identified and reported. The median age at diagnosis was 30 years and 4 were female. Five presented with hydrocephalus, the most common presenting symptoms were headaches and nausea and/or vomiting (n= 4 and n= 2 respectively). The median progression-free survival was 13 months (4-31 months) and the median overall survival was 23 months (4-59 months). CONCLUSION This case series reports the outcomes of older patients with K27M. The clinical course demonstrated suggests a divergence from paediatric biology. Ongoing studies are required to further characterise the histopathological and clinical differences of these tumours in older patients.

scholarly journals Cornual Polyps of the Fallopian Tube Are Associated with Endometriosis and Anovulation

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
S. A. AlAsiri ◽  
M. Ghahremani ◽  
P. F. McComb
Keyword(s):  
Fallopian Tube ◽  
Case Series ◽  
Infertile Women ◽  
The Relationship

Background. The relationship between tubal cornual polyps and endometriosis and ovulatory disorders in infertile women is unclear. Our objective was to determine such an association from our database and review the literature.Methods. Twenty-two infertile women with tubal cornual polyps were assessed for coexistence of oligoovulation/anovulation and endometriosis with stratification for polyp diameter (large: ≥5 mm diameter, small <5 mm diameter).Result(s). Oligoovulation/anovulation was more prevalent in women with large versus small tubal cornual polyps (P=0.0048). Endometriosis was associated with both large and small polyps.Conclusion(s). This case series confirms the association of tubal cornual polyps with oligoovulation/anovulation and endometriosis in infertile women. This case series is limited by a lack of controls.

scholarly journals Pertussis Vaccination Failure in the New Zealand Pediatric Population: Study Protocol

Vaccines ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 65
Author(s):  
Chisholm ◽  
Howe ◽  
Best ◽  
Petousis-Harris
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Pediatric Population ◽  
Case Series ◽  
Risk Groups ◽  
Paediatric Population ◽  
Investigate Risk Factor ◽  
Case Series Study ◽  
Study Results ◽  
Series Study

Pertussis vaccines have been effective at reducing pertussis-associated morbidity and mortality. However, they have a complex array of limitations, particularly associated with the duration of protection against clinical disease and imperfect immunity (carriage and transmission). Little is known about risk factors for pertussis vaccination failure. Understanding pertussis vaccination failure risk is most important in the paediatric population. This study aims to investigate risk factors for pertussis vaccination failure in (1) infants between birth and six weeks of age born to mothers who received pertussis booster vaccinations during pregnancy and (2) infants after the completion of the primary series (approximately five months old) to four years old. This will be achieved in a two-step process for each study group. Pertussis vaccination failure cases will first be described using a case series study design, relevant case characteristics will be sourced from six national administrative datasets. The case series study results will help select candidate risk factors (hypothesis generating step) to be tested in the retrospective cohort study (hypothesis testing step. Pattern analysis will be used to investigate risk factor patterns in the cohort study. The identification of higher risk groups enables targeting strategies, such as additional doses, to better prevent pertussis disease.

scholarly journals Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

2019 ◽  
Vol 112 (3) ◽  
pp. e40
Author(s):  
Rachel S. Mandelbaum ◽  
Meghan B. Smith ◽  
Lynda D. Roman ◽  
Richard J. Paulson ◽  
Koji Matsuo
Keyword(s):  
Young Women ◽  
Perioperative Complications ◽  
Conservative Surgery ◽  
Ovarian Torsion ◽  
National Trends

scholarly journals COVID-19: lessons to date from China

2020 ◽  
Vol 105 (12) ◽  
pp. 1146-1150
Author(s):  
Xiaoxia Lu ◽  
Yuhan Xing ◽  
Gary Wing-Kin Wong
Keyword(s):  
Gastrointestinal Symptoms ◽  
Paediatric Population ◽  
Asymptomatic Infection ◽  
Lessons Learned ◽  
Severe Illness ◽  
Older Children ◽  
Symptomatic Infection ◽  
Paediatric Age ◽  
Community Transmission ◽  
Novel Coronavirus

The pandemic due to a novel coronavirus has been sweeping across different regions of the globe since January 2020. Early reports of this infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) consisted of mostly adult patients. As the outbreak spreads rapidly beyond the epicentre of Wuhan, it becomes clear that infants and children of all ages are susceptible to this infection. In China, there have been more than 1200 paediatric cases. Most paediatric patients acquire the infection through household contact with infected adults. The disease in children is usually self-limiting and most infected children will recover uneventfully within 7–10 days. Other than symptoms of the respiratory tract, many children may present with gastrointestinal symptoms. Older children are more likely to have asymptomatic infection. Although deaths related to SARS-CoV-2 are rarely reported in the paediatric age group, young children and those with underlying medical conditions are more likely to develop severe illness. Only a small fraction of neonates born to infected mother would acquire the virus by vertical transmission. Because a large proportion of children and adolescents may have asymptomatic or mildly symptomatic infection, children are likely to play an important role in community transmission of this infection. Screening of children who have a definitive contact history will facilitate early diagnosis and isolation of all infected children. This review summarises the lessons learned in China with regard to the current understanding of SARS-CoV-2 infection in the paediatric population.

scholarly journals THE PSYCHOLOGICAL IMPACT OF BREAST-CONSERVING SURGERY VERSUS MASTECTOMY IN EGYPTIAN FEMALE PATIENTS

2021 ◽  
Vol 7 (4) ◽  
pp. 124-133
Author(s):  
Ahmed Abdelatif ◽  
Galal Abounaggah ◽  
Mohamed Elmesery ◽  
Mohamed Asal ◽  
Moataz Eweda
Keyword(s):  
Breast Cancer ◽  
Psychological Impact ◽  
Radical Mastectomy ◽  
Conservative Surgery ◽  
Breast Conserving Surgery ◽  
Breast Cancer Surgery ◽  
Sexual Life ◽  
Surgical Decision ◽  
Factors Affecting ◽  
Loss Of Appetite

The previous research on breast cancer's psychological impact was based on its effects on shape, with breast removal, and the subsequent effect on sexual attractiveness. Several changes that affect life behavior after breast cancer surgery including insomnia, difficulty returning to usual activities and work, nightmares and loss of appetite. These manifestations may be due to depression but they are only considered abnormal if they persist after the period of physical recovery from surgery. We conducted a study to assess the effects of the surgical decision and psychological impact of this decision on Egyptian females with breast cancer. Most patients were subjected to a questionnaire including all environmental and clinical factors affecting the surgical decision either mastectomy or breast-conserving surgery. As a conclusion we can say that breast conservative surgery is better accepted psychologically by patients than modified radical mastectomy as it did not affect sexual life, cosmetic appearance, mood, self-satisfaction, and quality of life.

scholarly journals Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

2020 ◽  
Author(s):  
Miriam Dellino ◽  
Erica Silvestris ◽  
Vera Loizzi ◽  
Angelo Paradiso ◽  
Gennaro Cormio
Keyword(s):  
Ovarian Function ◽  
Conservative Surgery ◽  
Reproductive Age ◽  
Reproductive Outcome ◽  
Stage Iiic ◽  
Rare Tumour ◽  
Patient Demographics ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
The University

Abstract Purpose MOGCTs (malignant ovarian germ cell tumours) is a rare tumour, which mainly affects patients in reproductive age. The aim of this study is evaluate the fertility and survival outcomes in young women with MOCGTs treated with fertility-sparing surgery (FFS).Methods From 2000 to 2018 twenty-eight patients with diagnosis of MOGCTs in reproductive age at the University of Bari were collected. Most received FFS and in patients treated conservatively, the reproductive outcome and survival were investigated. Data of patient demographics, clinical presentation, oncology markers dosage, staging, type of surgery histological examination, survival and reproductive outcome were collected from hospital and office charts. All informed consent was obtained from all patientsResults Twenty-eight patients with diagnosis of MOGCTs were collected. The median age was 24 (range: 9-45). The majority of the patients had stage IIIC. Twenty-four woman received fertility-sparing surgery consisting in unilateral ovariectomy and omentectomy whereas only 4 women based on their stage (IIIC) received a radical surgery (hysterectomy with bilateral adnexectomy, lymphadenectomy and omentectomy). Our study shows that FFS in MOGCTs can produce good results both on reproductive outcomes and on survival. Indeed, in our group there was only one case of exitus as result of recurrence. On the other side, patients after FFS maintained normal ovarian function and 5/5 women who have looked for pregnancy, obtained it spontaneously. The median follow-up was 90 moth (range 3-159).Conclusion Conservative surgery for MOGCTs should be considered for women in the reproductive age group who desire preservation of fertility.

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