scholarly journals Analysis of intraoperative findings with clinico-pathological features in appendicitis-an observational study

2021 ◽  
Vol 9 (1) ◽  
pp. 96
Author(s):  
Kumar Lakshman ◽  
Shilpashree Channasandra Shekar ◽  
Naveen Narayan ◽  
Suhas NarayanaSwamy Gowda ◽  
Veena Ghanteppagol ◽  
...  
Keyword(s):  
Observational Study ◽  
Categorical Data ◽  
Scoring Systems ◽  
Inflammatory Cells ◽  
Clinical Findings ◽  
Study Data ◽  
Chronic Appendicitis ◽  
Histopathological Findings ◽  
Suspected Appendicitis ◽  
Operative Findings

Background: Appendectomy is the most common abdominal surgery performed today. Appendicitis consists of vast spectrum ranging from acute to chronic to recurrent forms however existence of recurrent and chronic appendicitis is still doubted by many. In spite of various scoring systems and appendectomy being the ultimate treatment, its timing remains still controversial especially in chronic and recurrent variants of appendicitis.Methods: A total of 100 consecutive cases of suspected appendicitis who were admitted investigated and treated at our centre were taken up for this observational study. Data pertaining to clinical, operative and histopathological findings were collected and tabulated. Mean and SD were used for continuous data and for categorical data, frequency and percentages were calculated. A chi-square test was used for categorical data to find statistical significance.Results: Per operatively the appendix appeared non-inflamed in 57% of patients suggestive of chronic (recurrent) form and inflamed in 43% of patients suggestive of an acute form of appendicitis. The histopathological studies revealed chronic inflammatory cells in 63% of the resected specimens, suggestive of chronic appendicitis and acute inflammatory cells in 37% of the specimens, suggestive of acute appendicitis.Conclusions: We conclude that the correlation of clinical findings, operative findings and the histopathological findings correlate with one another (p<0.001). The surgeon’s clinical and operative findings have specificity of around 87.30% and 90.47% respectively. Hence the diagnostic accuracy of the surgeon is directly dependent on the surgeons’ expertise and there is no substitution for an experienced surgeon’s judgement.

scholarly journals High-resolution computed tomography and histopathological findings in hypersensitivity pneumonitis: a pictorial essay

2016 ◽  
Vol 49 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Pedro Paulo Teixeira e Silva Torres ◽  
Marise Amaral Rebouças Moreira ◽  
Daniela Graner Schuwartz Tannus Silva ◽  
Roberta Rodrigues Monteiro da Gama ◽  
Denis Masashi Sugita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Giant Cells ◽  
Clinical Findings ◽  
High Resolution Computed Tomography ◽  
Histopathological Findings ◽  
Pictorial Essay ◽  
Inflammatory Infiltrates

Abstract Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung disease caused by the inhalation of any one of a number of antigens. The objective of this study was to illustrate the spectrum of abnormalities in high-resolution computed tomography and histopathological findings related to hypersensitivity pneumonitis. We retrospectively evaluated patients who had been diagnosed with hypersensitivity pneumonitis (on the basis of clinical-radiological or clinical-radiological-pathological correlations) and had undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided into acute, subacute, and chronic forms; high-resolution computed tomography findings correlate with the time of exposure; and the two occasionally overlap. In the subacute form, centrilobular micronodules, ground-glass opacities, and air trapping are characteristic high-resolution computed tomography findings, whereas histopathology shows lymphocytic inflammatory infiltrates, bronchiolitis, variable degrees of organizing pneumonia, and giant cells. In the chronic form, high-resolution computed tomography shows traction bronchiectasis, honeycombing, and lung fibrosis, the last also being seen in the biopsy sample. A definitive diagnosis of hypersensitivity pneumonitis can be made only through a multidisciplinary approach, by correlating clinical findings, exposure history, high-resolution computed tomography findings, and lung biopsy findings.

scholarly journals Delay in presentation of acute ischemic stroke in Lahore General Hospital, Lahore

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Rafiq A Basharat ◽  
Kamran Rashid Mirza ◽  
Muhammad Yousuf Qamar
Keyword(s):  
Emergency Department ◽  
Ischemic Stroke ◽  
Ct Scan ◽  
Acute Ischemic Stroke ◽  
General Hospital ◽  
Clinical History ◽  
Clinical Findings ◽  
Study Data ◽  
Time Interval ◽  
Time Required

Objectives: To find out the time interval from onset of the symptoms to admission in the hospital of patients suffering from acute ischemic stroke, in order to assess the feasibility of thrombolytic therapy in Lahore General Hospital. Design: Hospital-based, prospective and observational study Setting: Lahore General Hospital Lahore. Duration: Six months from January - June 2004. Patients: Seventy two patients with acute ischemic stroke diagnosed on basis of clinical findings and CT scan. Methods: Patients o f a cute ischemic stroke including cerebral infarct, T IA, venous infarct and lacunar infarct were diagnosed on basis of clinical history, examination and CT scan and enrolled in the study. Data was collected on a Performa. Time taken by patients to reach hospital after onset of symptoms, distance of patients` residences from hospital, education level of patients and time required to do a CT scan after arrival of patient in hospital were studied. Results: 54.2% were male and mean age of patients was 60 years. 58 patients had cerebral infarction, TIA`s and venous infarction were 8 and 6 respectively. Delay in presentation was divided in three groups. Within three hours (hrs) 15 (21%) patients arrived. 54 and 18 patients arrived in 3-- 24 hrs group and >24 firs group. Mean distance was roughly 44 km. Mean distance for 0-3hrs, 3-24hrs and >24hrs group was 14, 35, and 85 Km respectively. Average time required to do CT scan was nine hours after arrival of patient in emergency department. Sixty-five percent of patients coming were illiterate. Conclusion: Majority of the patients with ischemic stroke present late to. emergency department. Many factors including distance from hospital, illiteracy, non-availability of ambulance services responsible for it. Evaluation-of patients and provision of urgent CT scan is required. in hospitals.

scholarly journals Does Serum Bilirubin Add Value in the Diagnosis of Appendicitis? A Multi-Institution Analysis of 2024 Patients

2021 ◽  
Author(s):  
Andrew Phillip Maurice ◽  
Benjamin David Swinson ◽  
Eduardo Miguel Apellaniz ◽  
Sarah Emily King ◽  
Thomas Grant Mackay ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Neutrophil Count ◽  
Serum Bilirubin ◽  
White Cell Count ◽  
Delayed Diagnosis ◽  
Complicated Appendicitis ◽  
Total Serum ◽  
Suspected Appendicitis ◽  
Uncomplicated Appendicitis ◽  
Operative Findings

Abstract BACKGROUNDEven with modern diagnostics, appendicitis can be difficult to diagnose accurately. Negative appendicectomies (NA) and delayed diagnosis of complicated appendicitis (CA, i.e. perforation or abscess) remain common. Serum bilirubin has been proposed as an additional biomarker to assist with the diagnosis of appendicitis. In this large series, we assessed the value of bilirubin in the diagnosis of appendicitis.METHODS A retrospective review of patients with suspected appendicitis at three hospitals over a three year period was performed. All consecutive patients with appendicectomy were included. In addition, a “discharged” sub-group of consecutive patients who were admitted with suspected appendicitis but discharged without an operation was also identified.Demographic data, presence of fever, tachycardia, total white cell count (WCC), neutrophil count, total serum bilirubin, operative findings and final histology were recorded. Multivariate logistic regression was performed to determine independent predictors of appendicitis and CA. Receiver-operator analysis was performed to compare bilirubin to WCC and neutrophil count.RESULTS There were 2024 patients: 1167 had uncomplicated appendicitis, 355 had CA and 303 underwent NA. 200 non-surgical "discharged" patients were included for comparison. Compared to those without appendicitis (NA and discharged groups), increased serum bilirubin was associated with an increased likelihood of appendicitis (OR 1.030 (1.013, 1.048), p<0.0001) and increased likelihood of CA (OR 1.035, 95% CI (1.021, 1.050), p<0.001). These results remained significant when the discharged group, NA group and uncomplicated appendicitis groups were analyzed separately.The sensitivity and specificity of bilirubin was inferior to neutrophil count for the diagnosis of appendicitis (AUC 0.657 versus 0.725, p<0.0001). Bilirubin, WCC and neutrophils each were all relatively insensitive and non-specific over a variety of cut-off values and combinations did not improve their accuracy.CONCLUSION Hyperbilirubinaemia was independently associated with an increased likelihood of both uncomplicated and complicated appendicitis, however had similar sensitivity and specificity when compared to WCC or neutrophils. Bilirubin, neutrophil count and WCC alone are not discriminatory enough to be used in isolation but may be incrementally useful adjuncts in pre-operative assessment of patients with suspected appendicitis.

Prader-Willi Syndrome: Consensus Diagnostic Criteria

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 398-402 ◽  
Author(s):  
Vanja A. Holm ◽  
Suzanne B. Cassidy ◽  
Merlin G. Butler ◽  
Jeanne M. Hanchett ◽  
Louise R. Greenswag ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Biological Marker ◽  
Scoring Systems ◽  
Clinical Findings ◽  
Laboratory Research ◽  
Prader Willi Syndrome ◽  
Research Activity ◽  
Behaviorally Disturbed ◽  
Adolescents And Adults ◽  
And Behavior

The diagnosis of Prader-Willi syndrome (PWS) is based on clinical findings that change with age. Hypotonia is prominent in infancy. Obesity, mild mental retardation or learning disability, and behavior problems, especially in association with food and eating result in a debilitating physical and developmental disability in adolescence and adulthood. No consistent biological marker is yet available for PWS in spite of recent research activity in cytogenetics and molecular genetics. Diagnostic criteria for PWS were developed by consensus of seven clinicians experienced with the syndrome in consultation with national and international experts. Two scoring systems are provided: one for children aged 0 to 36 months and another one for children aged 3 years to adults. These criteria will aid in recognition of the syndrome in hypotonic infants and in obese, mildly retarded, behaviorally disturbed adolescents and adults. They will also ensure uniform diagnosis for future clinical and laboratory research in PWS.

Epidemiological Features of Neonates With COVID-19 Infection in Iran

2021 ◽  
Author(s):  
Parisa Mohagheghi ◽  
Fereshteh Moshfegh ◽  
Nazanin Zafaranloo ◽  
Narjes Khalili ◽  
Mohammad Heidarzadeh ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Distress ◽  
Gestational Age ◽  
National Registry ◽  
Clinical Findings ◽  
Study Data ◽  
Cross Sectional ◽  
Epidemiological Features ◽  
Common Sign ◽  
Pcr Test

Abstract Objective: Although, the COVID-19 Pandemic has drawn the attention of physicians and researchers from all corners of the globe since it has been out broken in different countries, we have also started to invest more about the epidemiological features of neonates that had been affected by COVID-19 in Iran till now.Method: This is a cross-sectional retrospective study including all neonates from a National Registry supported by Iranian Maternal and Neonatal Network (IMaN). Since February 2020 till February 2021, data of neonates under 28 days who were diagnosed with suspected or confirmed COVID-19 has been registered in this network were collected. General data including epidemiological, clinical outcomes and infection-related information were collected. Results: In our retrospective study, data of 4015 neonates admitted to hospital all over the country and reported in IMAN is included. Totally 3725 PCR tests were performed (92.8% of admitted neonates) and from these neonates 825 (20.5%) showed positive PCR test. There were no differences between gender, weight and gestational age in neonates with positive and negative PCR test. Neonatal clinical findings were dependent to the type of admission. Respiratory distress was the most common sign in neonates, who were admitted immediately after birth (63.9%), and who were transferred from another hospital (17%); however in those who were admitted after one to several days after discharge (19.1%), the most common sign were sepsis like syndrome (31.8%) and fever (27.4%). Almost 50% of admitted neonate`s mothers had positive PCR test (25% during pregnancy and 24.3% after delivery). The most important factor of neonatal death was need for respiratory support (aOR=18.17, 95% CI; 9.24– 35.69). Gestational age of <32 weeks (aOR=2.35, 95% CI; 1.35-4.10) and birth weight of <1500 grams (aOR= 3.47, 95% CI; 1.96-6.17) were the other two factors that correlated to death. Conclusion: This is the largest study of neonatal COVID-19 diseases in Iran published to date. The most common signs of COVID-19 diseases found in neonates are respiratory distress and sepsis-like syndrome.

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

2020 ◽  
Author(s):  
Barbara Baranowska ◽  
Anna Kajdy ◽  
Iwona Kiersnowska ◽  
Dorota Sys ◽  
Urszula Tataj-Puzyna ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Quality Of Healthcare ◽  
Study Data ◽  
Labour Induction ◽  
Healthcare Personnel ◽  
National Guidelines

Abstract BackgroundThere is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The aim of the study was to evaluate oxytocin supply practices of oxytocin for labour induction and augmentation in Polish maternity units.MethodsThe article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). Inclusion criteria were women in term pregnancies, undergoing oxytocin induction or augmentation of labour. Exclusion criteria were women who were in preterm labour, aged less than 18 years, and women whose baby was known to have a malformation. ResultsThe average total amount of oxytocin administrated to women before birth was 7,329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93,6% of all observed labours. We found no statistically significant correlation between the amount of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of total oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, induction to stimulation ratio—the only observed difference was the mode of delivery. ConclusionsThere is a need for a thorough analysis to find out the reasons for the observed discrepancies between protocols and practice.

Lens and Anterior Uvea

2022 ◽  
pp. 359-392
Keyword(s):  
Macular Edema ◽  
Anterior Uveitis ◽  
Clinical Signs ◽  
Inflammatory Cells ◽  
Clinical Findings ◽  
Eye Drops ◽  
Systemic Diseases ◽  
Intravitreal Triamcinolone ◽  
Keratic Precipitates ◽  
Intravitreal Triamcinolone Injection

This chapter illustrates photos of clinical signs seen in uveitis and interesting cases of lens pathologies. Anterior uveitis is the inflammation of the iris and the ciliary body. Anterior uveitis can be idiopathic, isolated, or associated with systemic diseases. The clinical findings observed in anterior uveitis include keratic precipitates, inflammatory cells and flare in anterior chamber, hypopyon, rarely hyphema, miosis, iris nodules and atrophy, synechiae, and band keratopathy in chronic cases (shown in corneal degenerations chapter). The inflammation in anterior uveitis is almost always immune. Treatment includes steroid eye drops, cycloplegic drops, sub-Tenon steroid injections when cystoid macular edema is present. Chronic macular edema can be treated with intravitreal Triamcinolone injection and Dexamethasone implants. In cases of refractory anterior uveitis or associated immune systemic diseases, immunomodulatory treatment or biologic agents are prescribed.

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