scholarly journals A case series of adult intussusception diagnosed by ultrasound in South India: an uncommon notion

2020 ◽  
Vol 7 (7) ◽  
pp. 2363
Author(s):  
D. Vinoth ◽  
S. Rajeshkumar ◽  
Sheik Asik Abu Sali
Keyword(s):  
Hospital Admissions ◽  
Tertiary Care ◽  
Case Series ◽  
Clinical Findings ◽  
Adult Intussusception ◽  
Emergency Laparotomy ◽  
Care Hospital ◽  
Initial Screening ◽  
Resection And Anastomosis ◽  
Specific Symptoms

Intussusception is the telescoping of one segment of the gastrointestinal tract into an adjacent one. Adult intussusception is less than 0.1% of all hospital admissions. Non-specific symptoms often delay the diagnosis with most cases diagnosed only after emergency laparotomy, hence the need for imaging as a screening investigation. The gold standard is computed tomography with the limitations of cost, radiation and contrast hazards. Our suggested initial screening tool is ultrasound. the aim of this study was to evaluate the sensitivity of ultrasound in diagnosing this rare entity. Thirteen patients (2013 to 2019) in a single tertiary care hospital diagnosed as “intussusception” were analysed. They were initially diagnosed by ultrasound and confirmed by CT or intra-op as needed. There were no exclusion criteria. The mean age was 50. There were 6 males and 7 females. Ultrasound sensitivity was 72%. Symptoms were variable. 100% had abdominal pain (1 day to 2 years duration). 69% had Intestinal obstruction. The most common type of adult intussusception observed was ileo-ileal (39%). The least common noted was gastro-jejunal (8%). The most common treatment was resection and anastomosis (77%). 3 cases were managed conservatively successfully. The biopsy was mostly benign (54%), 3 were malignant (23%) and 3 were unknown as they were not operated (23%). Our suggested initial screening is ultrasound with a fairly good sensitivity (72%). The upcoming improvement in technology can raise this sensitivity even further. The management protocols, biopsy findings, and clinical findings are however subjected to discretion.

Patient-related factors associated with severe heat-related illnesses in Karachi: A hospital perspective

2020 ◽  
pp. 1-8
Author(s):  
Saima Kanwal ◽  
Sara Sajid ◽  
Noreen Nasir ◽  
Syed Ahsan ◽  
Aysha Almas
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Heat Stroke ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Related Factors ◽  
Hospital Perspective ◽  
The Mean

Abstract In 2015, Karachi saw its first ever epidemic of severe heat-related illnesses that resulted in an extraordinary number of hospital admissions, especially in the intensive care, for fatal heat stroke within-hospital mortality of 3.7%.We conducted this study to elucidate the patient-related factors that lead to an increase in hospital admissions with heat-related illnesses in a tertiary care hospital. It was a descriptive case series conducted in the department of medicine at the Aga Khan University in June 2015. A total of 134 patients were admitted with heat-related illnesses of which 76(56.7%) were males. The mean age of the patients was 66 ±14.5 years. Heatstroke was present in 86 (64.2%) patients, followed by heat exhaustion in 48 (35.8%) and in-hospital mortality from heat-related illnesses was 5(3.7%). Continuous...  

scholarly journals Spectrum of Etiology among Adult Intussusception Patients: Study of 11 Cases at a Tertiary Care Hospital in Bangladesh

2016 ◽  
Vol 14 (1) ◽  
pp. 3-7
Author(s):  
SM Quamrul Akhter ◽  
Md. Mamunur Rahman ◽  
Syed Masud Reza ◽  
Md. Mozammel Hoque ◽  
Syeda Nishat Marium ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Stromal Tumour ◽  
Adult Intussusception ◽  
Resected Specimen ◽  
Care Hospital ◽  
Medical College ◽  
Common Etiology ◽  
Study Population ◽  
One Year

Background: Intussusception in adult patients is occurred in different reasons. Objectives: The purpose of the present study was to see the spectrum of etiology among adult intussusception patients. Methodology: This case series was performed in the Department of Surgery at Shaheed Suhrawardy Medical College, Dhaka from July 2014 to June 2015 for a period of 1(one) year. All the patients presented with intussusceptions were selected as study population. A detailed history was obtained from each patient. Patients with the age of ?18 years, regardless the symptoms like onset, duration, intensity, progression were included for this study. Per-operative diagnosis was further confirmed by histopathology of the resected specimen. Result: A total number of 11 cases were recruited after fulfilling the inclusion and exclusion criteria. Gastro intestinal stromal tumour (GIST) was the most common etiology of intussusceptions which was 5(45.5%) cases followed by adenocarcinoma which was 2(18.2%) cases. Meckel’s diverticulum, Intestinal TB, Lipoma and Leiyomyomatous polyp were also found in 1 case each. Conclusion: Adult intussusception is most commonly occurred due to gastro intestinal stromal tumour followed by adenocarcinoma. Journal of Science Foundation, January 2016;14(1):3-7

scholarly journals Clinical Study of Ectopic Pregnancy in a Tertiary Care Hospital in Nepal

2014 ◽  
Vol 2 (2) ◽  
pp. 37
Author(s):  
Narinder Kaur ◽  
Shreyashi Aryal
Keyword(s):  
Ectopic Pregnancy ◽  
Acute Pain ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Emergency Laparotomy ◽  
Care Hospital ◽  
Pain Abdomen ◽  
Future Fertility ◽  
Surgical History ◽  
Associated Risk Factors

Introduction: Ectopic pregnancy is a cause of pregnancy related mortality and its incidence is on the rise. The aim of modern management of ectopic pregnancy should be to diagnose ectopic pregnancy accurately, so that women can seek prompt diagnosis and treatment and optimize their future fertility. Methods: This prospective study was done for a period of one year in patients suspected clinically to have ectopic pregnancies which were subsequently confirmed by pregnancy test and ultrasonography (n=17). The following parameters: age and parity of the patient, relevant past medical and surgical history, significant clinical findings at presentation, management done and outcome of the management were noted. Results: Most patients 13 (76.47%) were in the age group of 20-25 years and 16 (94.11%) of them presented with acute pain abdomen. In all cases, emergency laparotomy was performed. There were 16 cases of tubal ectopic and one of ovarian pregnancy. Right side was affected in 14 (82.35%) cases including one right sided ovarian ectopic. Tubal rupture was found in 10 (58.82%) patients. The most common 12 (75%) site of tubal pregnancy was ampullary. Salpingectomy was performed in 14 (82.35%) cases. All patients were discharged byseventh postoperative day. Conclusion: Ectopic pregnancy can be suspected clinically by history and associated risk factors. Women presenting with acute pain abdomen with a positive urine β-hCG test should be promptly diagnosed and treated without undue delay to reduce maternal morbidity and mortality.

scholarly journals Case series on congenital malaria from a tertiary care hospital in North Eastern India

2021 ◽  
Vol 12 (9) ◽  
pp. 166-168
Author(s):  
Joydeep Das ◽  
Saugata Choudhury
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Perinatal Period ◽  
Care Hospital ◽  
Igg Antibody ◽  
Atypical Symptoms ◽  
North Eastern ◽  
Atypical Clinical Presentation ◽  
Specific Symptoms ◽  
Congenital Malaria

Malaria in early life is due to transfer of parasitized maternal red blood cell across placenta or direct transfer of parasite from placental syncytotrophoblast. Congenital malaria is defined as malaria acquired from mother in prenatal or perinatal period. Most of the cases in endemic area, passive transfer of high amount of maternal IgG antibody binds to malarial antigen and various components of parasites giving rise to various atypical clinical presentation. This case series will help neonatologist to think malaria in all non-specific symptoms of inconsolable cry, poor feeding, lethargy, even persistence of physiological jaundice. Very few reports of congenital malaria from India is reported in literature. Our series of five cases will address these few atypical symptoms.

scholarly journals Providing safe care for patients in the coronavirus disease 2019 (COVID-19) era: A case series evaluating risk for hospital-associated COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Adult Patients ◽  
Care Hospital ◽  
Strict Adherence ◽  
Large Tertiary Care ◽  
Healthcare Associated ◽  
Serology Testing ◽  
Pcr Test

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan: 2011-2016

2017 ◽  
Vol 157 (4) ◽  
pp. 602-607 ◽  
Author(s):  
Alexander Lanigan ◽  
Brentley Lindsey ◽  
Stephen Maturo ◽  
Joseph Brennan ◽  
Adrienne Laury
Keyword(s):  
Soft Tissue ◽  
Tertiary Care ◽  
Case Series ◽  
Soft Tissue Injuries ◽  
Published Data ◽  
Care Hospital ◽  
Neck Injuries ◽  
Facial Fractures ◽  
Tympanic Membrane Perforations ◽  
Tissue Injuries

Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.

scholarly journals Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Female Gender ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Case Series Study

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.

scholarly journals Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

2021 ◽  
Vol 19 (1) ◽  
pp. 25-29
Author(s):  
Manoj Chaudhary ◽  
Sudha Agrawal
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Case Series ◽  
Sun Exposure ◽  
Care Hospital ◽  
Facial Erythema ◽  
Case Series Study ◽  
The Face ◽  
Triggering Factor ◽  
Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour.   Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face.   Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017.   Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%).   Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

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