scholarly journals Postoperative outcome in thoracolumbar spinal tuberculosis: a retrospective study

2020 ◽  
Vol 8 (9) ◽  
pp. 3208
Author(s):  
Shaji U. Abu ◽  
Lijo J. Kollannur ◽  
Sreenath K.
Keyword(s):  
Clinical Symptoms ◽  
Symptom Relief ◽  
Spinal Tuberculosis ◽  
Postoperative Outcome ◽  
Motor Symptoms ◽  
Medical College ◽  
Common Location ◽  
Bowel Involvement ◽  
Spine Tuberculosis ◽  
Bladder Symptoms

Background: Spinal tuberculosis is the most common location of extra pulmonary tuberculosis. ATT alone may not be suitable in all situations, especially when treating patients with risk of instability, progression of neurologic deficit, and failure of medical treatment. Surgical intervention is a major treatment modality for symptom relief in spinal tuberculosis.Methods: The aim of this study was to assess the immediate post-operative outcome in surgically treated patients with dorsolumbar spine tuberculosis at Department of Neurosurgery Government Medical College, Thrissur. All operated patients of dorsolumbar spinal tuberculosis during 2014 September to 2019 august were included under study.Results: A total of 57 patients were included in the study. The mean age of the patient was 42.77 years. There were 40 males (70.2%) and 17 females (29.8%). 55 (96.5%) out of 57 patients were having sensory symptoms. 41 (71.9%) out of 57 patients were having motor symptoms. Bladder involvement 23 (40.4%) and bowel involvement 15 (26.3%) were also noted in the study. Sensory symptoms improvement in post-operative period was noted in 46 (80.7%). Motor symptoms improvement was observed in 23 (56.1%) out of 41. Bladder symptoms improved in 6 (26.1%) out of 23. There is improvement in clinical symptoms, neurological function immediately after surgery. Surgical patients have faster improvement and can be mobilized earlier. Improvement in sensory symptoms (96.5%), motor symptoms (56.1%) and bladder symptoms (26.1%) were noted in our study in the immediate post-operative period.Conclusions: There was significant immediate relief in symptoms and morbidity of patients undergoing surgical treatment for dorsolumbar spine tuberculosis.

scholarly journals Analysis of clinical profile of women presenting with pyrexia in pregnancy

2018 ◽  
Vol 7 (4) ◽  
pp. 1406
Author(s):  
Surabhi Porwal ◽  
Amita Sharma
Keyword(s):  
Clinical Symptoms ◽  
Public Health Problem ◽  
Clinical Profile ◽  
Major Public Health Problem ◽  
Abdominal Wall Defects ◽  
Chi Square ◽  
Medical College ◽  
Central Nervous System Defects ◽  
High Risk Situation ◽  
In Pregnancy

Background: Pyrexia in pregnancy is major public health problem in India. Pyrexia in pregnancy is associated with resorption of the embryo, foetal deaths and potentially lethal malformations such as central nervous system defects, abdominal-wall defects, and cardiovascular malformations. This study was carried out to analyse clinical profile of women presenting with pyrexia during pregnancy.Methods: After approval by institutional ethical committee the prospective case control study was conducted in the department of obstetrics and gynecology, NSCB Medical College, Jabalpur (M.P.) from 1st June 2012 to 31st October 2013. Total 100 antenatal women with pyrexia taken as cases and 50 antenatal women without pyrexia taken as control were included and analyzed in this study. In women fulfilling inclusion criteria detailed history was taken and documented in proforma. Required investigations were sent to the department of pathology and virology laboratory of Indian Council of Medical Research, Jabalpur. Results were analyzed statistically by using t test and chi square test.Results: On analysis of clinical symptoms pyrexia, cough, malaise, rash, headache, nausea and vomiting, joint pain, anorexia, breathlessness and burning and frequency of micturition were significantly higher in cases as compare to control. Viral pathogens were responsible for most of the cases of pyrexia in pregnancy.Conclusions: Pyrexia in pregnancy is a high-risk situation, early identification and prompt treatment will reduce maternal and perinatal morbidity and mortality associated with pyrexia in pregnancy.

scholarly journals Spinal tuberculosis in western mexico, 2008-2013

2014 ◽  
Vol 13 (4) ◽  
pp. 298-301 ◽  
Author(s):  
Rafael Bustos Mora ◽  
José María Jiménez Ávila ◽  
Ana Corona Nakamura
Keyword(s):  
Medical Records ◽  
Anterior Approach ◽  
Spinal Tuberculosis ◽  
Postoperative Outcome ◽  
Daily Activities ◽  
Tuberculous Spondylitis ◽  
Western Mexico ◽  
Infectious Spondylodiscitis ◽  
Mixed Approach ◽  
Infectious Spondylitis

Objective: To identify the prevalence, clinical features and postoperative outcome of patients with spinal tuberculosis at the Instituto Mexicano del Seguro Social, in Jalisco, Mexico from 2008 to 2013. Methods: Prevalence study of patients undergoing spine surgery due to tuberculosis. Clinical, surgical pre- and postoperative parameters were evaluated by analysis of 41 medical records. Results: Seventeen (41.4%) were women and 24 (58.6%) were men with a mean age of 47.7 years. The main diagnoses were tuberculous spondylitis in 14 (34.1%) patients; discitis in 13 (31.7%); infectious spondylitis in 9 (21.9%); chronic spondylitis in four (9.7%); abscess in one patient (2.4%). Only 22% of patients were positive for epidemiological study of tuberculosis contacts. The most affected region was the lumbar spine followed by the thoracic spine and the most affected vertebrae were L3-L4. The most used surgical instrumentation was by posterior approach with drainage on 29 occasions, anterior approach with drainage in nine, and the mixed approach in three. Twenty-nine patients were independent to perform daily activities after discharge. Conclusion: The discitis or infectious spondylodiscitis should be considered in any patient with localized pain at any level of the spine. Once solved the problem of infection and stability, patients respond favorably to the surgical procedure.

scholarly journals Salivary gland tumours - a three years experience at King Edward Medical College, Lahore

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Asmaa Qureshi ◽  
Khalilur Rehman ◽  
Sohail Husain ◽  
Nasirul Hasan Khawaja ◽  
Ghulam Rasood Qureshi ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Salivary Glands ◽  
Pleomorphic Adenoma ◽  
Single Case ◽  
Malignant Neoplasms ◽  
Salivary Gland Tumours ◽  
Medical College ◽  
Common Location ◽  
Female Predominance

Salivary gland tumours make an important part of oral & maxillofacial pathology. Only few studies have been done in Pakistani population. The aim of this study was to describe morphological types of salivary gland tumours diagnosed at King Edward Medical College/ Mayo Hospital, Lahore during the years 1999-2001 and to compare their demographic data with those previously published. Material & Methods: This descriptive cross-sectional study was carried out at King Edward Medical College/ Mayo Hospital, Lahore. It reports 117 cases of salivary gland tumours diagnosed at Pathology Department during 1999-2001. Results: Of the 128 specimens of salivary glands, 117(91.4%) were confirmed as salivary neoplasms. Out of them, 62.7% were benign and 37.6% malignant and a slight female predominance (58.1%) was found. The most common location was the parotid gland (65.8%) followed by minor salivary glands (19.6%). Majority oft he t tumours was diagnosed during 3rd to 5 decades of life. Median age for benign tumours was 33 years (range 1-78) and a female predominance (58.9%) was seen again. Median age for malignant neoplasms was 45 years (range 9-70) with a female predilection ( 56.8%). However, 4 out o f 5 patients with Warthin`s tumour were men. Pleomorphic adenoma was the most frequent tumour (51.3%), followed by mucoepidermoid carcinoma (25.6%), adenoid cystic carcinoma (7.7)), Warthin`s tumour (4.3%) and monomorphic adenoma (2.6%). Two cases each of oncytoma & adenocarcinoma were recorded. Rare categories (single case each) of salivary tumours included lipoma, acinic cell carcinoma, basal cell adenoma, capillary haemangioma, metastatic carcinoma and non Hodgkin`s lymphoma. Conclusion: The principal site of salivary tumours was the parotid gland and females were most affected. Pleomorphic adenoma was the most frequent finding. The results of this study are comparable with other studies.

scholarly journals Predicting neurological deficit in patients with spinal tuberculosis – A single-center retrospective case-control study

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 7
Author(s):  
Samarth Mittal ◽  
Gagandeep Yadav ◽  
Kaustubh Ahuja ◽  
Syed Ifthekar ◽  
Bhaskar Sarkar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neurological Deficit ◽  
Spinal Tuberculosis ◽  
Multivariate Logistic Regression Analysis ◽  
Cord Compression ◽  
Early Surgery ◽  
Retrospective Case ◽  
Common Location ◽  
Significant Difference ◽  
Canal Encroachment

Background: Identifying the risk factors for the neurological deficit in spine tuberculosis would help surgeons in deciding on early surgery, thus reducing the morbidity related to neurological deficit. The main objective of our study was to predict the risk of neurological deficit in patients with spinal tuberculosis (TB). Methods: The demographic, clinical, radiological (X-ray and MRI) data of 105 patients with active spine TB were retrospectively analyzed. Patients were divided into two groups – with a neurological deficit (n = 52) as Group A and those without deficit (n = 53) as Group B. Univariate and multivariate logistic regression analysis was used to predict the risk factors for the neurological deficit. Results: The mean age of the patients was 38.1 years. The most common location of disease was dorsal region (35.2%). Paradiscal (77%) was the most common type of involvement. A statistically significant difference (p < 0.05) was noted in the location of disease, presence of cord compression, kyphosis, cord oedema, loss of CSF anterior to the cord, and degree of canal compromise or canal encroachment between two groups. Multivariate analysis revealed kyphosis > 30° (OR – 3.92, CI – 1.21–12.7, p – 0.023), canal encroachment > 50% (OR – 7.34, CI – 2.32–23.17, p – 0.001), and cord oedema (OR – 11.93, CI – 1.24–114.05, p – 0.03) as independent risk factors for predicting the risk of neurological deficit. Conclusion: Kyphosis > 30°, cord oedema, and canal encroachment (>50%) significantly predicted neurological deficit in patients with spine TB. Early surgery should be considered with all these risk factors to prevent a neurological deficit.

Abstract W P172: Prevalence of Positive Dwi Findings in Relation to Tia Etiology

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yasufumi Gon ◽  
Manabu Sakaguchi ◽  
Syuhei Okazaki ◽  
Hideki Mochizuki ◽  
Kazuo Kitagawa
Keyword(s):  
Symptom Onset ◽  
Clinical Symptoms ◽  
Motor Symptom ◽  
Unknown Etiology ◽  
Symptom Duration ◽  
Motor Symptoms ◽  
Duration Of Symptoms ◽  
Prolonged Duration ◽  
History Of ◽  
Toast Classification

Objective: Previous studies have shown that the prolonged duration of TIA symptoms or ABCD2 score are associated with DWI abnormality, and the presence of DWI abnormality is associated with an increased early risk of stroke. However, there are few reports that show the relation between TIA clinical etiology and DWI abnormality. Our aim of this study is to clarify the prevalence of positive DWI in relation to characteristics of patients and TIA. Methods: The subjects were enrolled from patients who were admitted to our stroke unit within 7 days after symptom onset from January 2006 to July 2013. The diagnosis of TIA was done by NINDS criteria, and we classified TIA etiology by TOAST classification based on clinical symptoms, ECG monitoring, carotid ultrasound, MR angiography and transesophageal echocardiography. All patients underwent DWI-MRI within 7 days after symptom onset. We examined an association between TIA etiology, symptom, duration of symptoms and DWI abnormality. Results: A total of 141 patients (mean 64 years; 63% men) were admitted with TIA during this period. Those included lacuna TIA (n=17, 12.1%), atherothrombotic TIA (n=32, 22.7%), cardioembolic TIA (n=23, 16.3%), TIA due to other causes (n=35, 24.8%), and TIA with unknown etiology (n=34, 24.1%). Prevalence of positive DWI findings were 47.1% in lacunar TIA, 43.7% in atherothrombotic TIA, 52.1% in cardioembloic TIA, 42.8% in TIA due to other causes, and 23.5% in TIA with unknown etiology. DWI abnormality was the most frequent in cardiogenic TIA. In relation to symptom duration, the prevalence of DWI positive findings were 45.2% in less than 1 hour (N=53), 36.6% in 1-3 hour (N=41), 25.0% in 3-6 hour (N=12) and 42.9% in 6-24 hours (N=35). In relation to motor symptoms, there was no difference in prevalence of DWI abnormality between patient with motor symptoms (39.8%, N=113) and without (42.8%, N=28). There was no relation between DWI abnormalities and age, a history of stroke/TIA episode or vascular risk factors. Conclusion: Prevalence of DWI positive findings was high in cardiogenic TIA, and low in TIA with unclassified etiology. There were no relation between DWI abnormality, duration of symptom, and motor symptom.

Structural Manubrium Autograft in Cervical Fusion for Patients With Cervical Tuberculosis: A Preliminary Study

2020 ◽  
Author(s):  
Shuang Xu ◽  
QING WANG ◽  
YI LING XIONG ◽  
GAOJU WANG ◽  
JIN YANG ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Posterior Instrumentation ◽  
Donor Site ◽  
Spinal Tuberculosis ◽  
Visual Analog Scale Score ◽  
Cervical Fusion ◽  
Radiographic Findings ◽  
Neurological Outcomes ◽  
Spine Tuberculosis

Abstract Background The purpose of this study was to evaluate the efficacy and safety of structural manubrium autografts in the surgical treatment of cervical spinal tuberculosis.Methods From January 2015 and December 2018, 10 patients with lower cervical spine tuberculosis (C4-C7) underwent anterior debridement, interbody fusion with structural manubrium autograft, and anterior or posterior instrumentation. The medical records and radiographic findings of the patients were reviewed.Results The surgery duration was 198.5 min and blood loss was 355.0 mL. The average preoperative kyphosis angle was 16.3 ± 8.2° and returned to -2.1 ± 2.8° two weeks postoperatively (P < 0.05 ), reaching -1.4 ± 2.5° at final follow-up (P < 0.05 vs. preoperative). The average preoperative visual analog scale score of neck pain was 4.1 ± 1.1, which decreased to 1.5 ± 0.8 one week after the surgery (P < 0.05 ) and to 0.7 ± 0.5 at final follow-up. The ESR and CRP gradually decreased postoperatively, becoming normal at final follow-up. Bony fusion was achieved in all patients by 6 months after surgery. Neurological outcomes were improved by 1–2 grades in most patients. There were no postoperative complications associated with the donor site, and there was no recurrence of tuberculosis in any patient.Conclusion Structural bone obtained from the manubrium is safe, providing a viable alternative to cervical fusion for patients with cervical spine tuberculosis. It confers the advantages of autograft fusion without the complications associated with donor site morbidities.

scholarly journals Correlation between Clinical Symptoms of Various Colorectal Diseases and Colonoscopic Findings

2019 ◽  
Vol 17 (1) ◽  
pp. 16-19
Author(s):  
Roman Kidwai ◽  
Anup Sharma
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Symptoms ◽  
Colorectal Polyps ◽  
Bowel Habit ◽  
Female Ratio ◽  
Medical College ◽  
Inflammatory Conditions ◽  
The Mean ◽  
Colorectal Diseases ◽  
Male To Female

Background: About 30% of patients presenting to surgical outpatient department has lower gastrointestinal (LGI) symptoms. Colonoscopy is a low risk and at the same time investigation of choice in these patients which allows visualization of the entire colon and the terminal portion of ileum. This study was done to find out the diagnostic accuracy of colonoscopy in relation to the clinical symptoms of the disease.  Methods: This was a prospective, hospital based study from February 2014 to March 2019 carried out at Nepalgunj Medical College and Teaching Hospital. The colonoscopy diagnosis was compared with the clinical symptoms and further confirmed with histological examination.  Results: 341 patients underwent colonoscopy. There were 234 (68.62%) males and 107 (31.37%) females with the male to female ratio of 2.18: 1. The age ranged from 16 to 81 with the mean age of 59.63±10.37. The most common presenting symptom was per rectal bleeding (40.34%) the after were alteration in bowel habit (17.30%), constipation (12.90%), hematochezia (11.43%). The least common indication for colonoscopy was unexplained anemia. Haemorrhoids were the most common findings consisting 32.55%. In 19.94% it was normal. Majority had various inflammatory conditions, among them 10.85% had proctocolitis, 2.34% were suspected to have ulcerative colitis. There were 17(4.98%) patients with colonic and 13(3.18%)with rectal carcinoma. 10.55% had colorectal polyps. Out of 111 patients suspected to have hemorrhoids clinically 102 had same findings on colonoscopy. Similarly 34 patients presenting with chronic diarrhea with bleeding and 59 with alteration in bowel habit where inflammatory conditions were suspected had similar findings on colonoscopy in 29 and 34 patients respectively. Similarly the suspicion of malignancy on clinical basis was also correlated on colonoscopy. The inflammatory conditions diagnosed on colonoscopy were confirmed in 85.04 % by histology. Similarly malignancy and the presence of polyps diagnosed on colonoscopy were confirmed by histology in 97.05% and in 97.22% cases respectively. Conclusion: Colonoscopy is a safe and effective investigation to diagnose various colorectal conditions. There was a correlation between the clinical symptoms and the colonoscopicdiagnosis especially in conditions like inflammatory and neoplastic colorectal diseases. When combined with histology the diagnostic accuracy can be near 100% in conditions like inflammatory and benign or malignant diseases.

Using Traditional Chinese Medicine to Relieve Asthma Symptoms: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 47 (08) ◽  
pp. 1659-1674 ◽  
Author(s):  
Mei-Hua Wang ◽  
Chiehfeng Chen ◽  
Mei-Ling Yeh ◽  
Jaung-Geng Lin
Keyword(s):  
Systematic Review ◽  
Asthma Symptom ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Symptom Relief ◽  
Governor Vessel ◽  
Asthma Symptoms ◽  
Bladder Meridian ◽  
Conception Vessel ◽  
Meta Analyses

Studies have demonstrated the effect of acupoint-based interventions in relieving the clinical symptoms of asthma. However, the effect of meridian-based interventions in asthma symptom relief is unknown. This systematic review and meta-analysis determined the effect of multiplex meridian interventions in asthma symptom relief. Eight electronic databases were searched for relevant randomized controlled trials (RCTs) that involved patients with asthma, were published before March 2018, used acupoint stimulation interventions targeting acupoints that correspond to meridians, and considered asthma symptom relief as an outcome. In 204 RCTs that were identified and used in a meta-synthesis, meridians were used 521 times, with the bladder meridian being the most frequently used. Furthermore, 23 RCTs were included in the meta-analysis. Egger’s and inconsistency tests revealed no significant differences among the studies ([Formula: see text]). However, the interventions differed significantly in terms of asthma symptom relief effect, as demonstrated by pairwise (odds ratio [Formula: see text], 95% confidence [Formula: see text]–0.37) and network ([Formula: see text], 95% credibility [Formula: see text]–0.41) meta-analyses. Surface under the cumulative ranking (SUCRA) revealed that the bladder–conception vessel–governor vessel–stomach multiplex meridian intervention was more effective than non-meridian interventions in relieving asthma symptoms. Additionally, either bladder–conception vessel–stomach or bladder–conception vessel–governor vessel–kidney multiplex meridians may be selected in interventions. This study suggests that practitioners target multiplex meridians, especially the meridians of the bladder and conception vessel, to effectively relieve asthma symptoms.

scholarly journals Can elevated concentrations of ALT and AST predict the risk of ‘recurrence’ of COVID-19?

2020 ◽  
Vol 148 ◽  
Author(s):  
L. Z. Chen ◽  
Z. H. Lin ◽  
J. Chen ◽  
S. S. Liu ◽  
T. Shi ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Prevention And Control ◽  
Clinical Symptoms ◽  
Concomitant Disease ◽  
Risk Of Recurrence ◽  
Tongji Medical College ◽  
Medical College ◽  
And Control

Abstract ‘Recurrence’ of coronavirus disease 2019 (COVID-19) has triggered numerous discussions of scholars at home and abroad. A total of 44 recurrent cases of COVID-19 and 32 control cases admitted from 11 February to 29 March 2020 to Guanggu Campus of Tongji Hospital affiliated to Tongji Medical College Huazhong University of Science and Technology were enrolled in this study. All the 44 recurrent cases were classified as mild to moderate when the patients were admitted for the second time. The gender and mean age in both cases (recurrent and control) were similar. At least one concomitant disease was observed in 52.27% recurrent cases and 34.38% control cases. The most prevalent comorbidity among them was hypertension. Fever and cough being the most prevalent clinical symptoms in both cases. On comparing both the cases, recurrent cases had markedly elevated concentrations of alanine aminotransferase (ALT) (P = 0.020) and aspartate aminotransferase (AST) (P = 0.007). Moreover, subgroup analysis showed mild to moderate abnormal concentrations of ALT and AST in recurrent cases. The elevated concentrations of ALT and AST may be recognised as predictive markers for the risk of ‘recurrence’ of COVID-19, which may provide insights into the prevention and control of COVID-19 in the future.

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