scholarly journals Large atypical odontome in the ramus of mandible: A rare case report

2021 ◽  
Vol 9 (2) ◽  
pp. 88-90
Author(s):  
Meenakshi Singhal ◽  
Devi Charan Shetty ◽  
Saurabh Juneja ◽  
Anshi Jain ◽  
Nikita Gulati
Keyword(s):  
Early Diagnosis ◽  
Clinical Decision Making ◽  
Histopathological Examination ◽  
Present Report ◽  
Clinical Decision ◽  
Unknown Etiology ◽  
Dental Tissues ◽  
Rare Case Report ◽  
The Right ◽  
Compound Odontoma

Compound odontoma is considered to be a developmental anomalies of the dental tissues or a hamartomatous lesion rather than a true odontogenic tumour. It has an unknown etiology. Odontomas are further subdivided into compound and complex types depending on the extent of morpho-differentiation or on the resemblance to normal teeth. Since, these lesions are asymptomatic, they are usually detected in routine radiographs only. Early diagnosis, prompt clinical decision making followed by a proper treatment at the right time, results in a favorable prognosis. The present report describes a large atypical radiopaque mass located in the ramus of mandible. After the lesion was surgically removed under local anesthesia, histopathological examination confirmed the diagnosis of compound odontoma. The results achieved indicate that the early diagnosis of odontomas allows the adoption of a less complex and expensive treatment and ensures better prognosis.

scholarly journals Factors Influencing Physicians' Clinical Decision-making at Upazila Health Complexes in Bangladesh

2020 ◽  
Vol 3 (4) ◽  
pp. 125-133
Author(s):  
M. Aminul Islam ◽  
M. Abdul Awal
Keyword(s):  
Decision Making ◽  
Social Networks ◽  
Clinical Decision Making ◽  
Average Length ◽  
Clinical Decision ◽  
Primary Data ◽  
Decision Making Process ◽  
Cross Sectional ◽  
The Right ◽  
Consultation Session

ABSTRACT Introduction Selecting the most appropriate treatment for each patient is the key activity in patient-physician encounters and providing healthcare services. Achieving desirable clinical goals mostly depends on making the right decision at the right time in any healthcare setting. But little is known about physicians' clinical decision-making in the primary care setting in Bangladesh. Therefore, this study explored the factors that influence decisions about prescribing medications, ordering pathologic tests, counseling patients, average length of patient visits in a consultation session, and referral of patients to other physicians or hospitals by physicians at Upazila Health Complexes (UHCs) in the country. It also explored the structure of physicians' social networks and their association with the decision-making process. Methods This was a cross-sectional descriptive study that used primary data collected from 85 physicians. The respondents, who work at UHCs in the Rajshahi Division, were selected purposively. The collected data were analyzed with descriptive statistics including frequency, percentage, one-way analysis of variance, and linear regression to understand relationships among the variables. Results The results of the study reveal that multiple factors influence physicians' decisions about prescribing medications, ordering pathologic tests, length of visits, counseling patients, and referring patients to other physicians or hospitals at the UHCs. Most physicians prescribe drugs to their patients, keeping in mind their purchasing capacity. Risk of violence by patients' relatives and better management are the two key factors that influence physicians' referral decisions. The physicians' professional and personal social networks also play an influential role in the decision-making process. It was found that physicians dedicate on average 16.17 minutes to a patient in a consultation session. The length of visits is influenced by various factors including the distance between the physicians' residence and their workplace, their level of education, and the number of colleagues with whom they have regular contact and from whom they can seek help. Conclusion The results of the study have yielded some novel insights about the complexity of physicians' everyday tasks at the UHCs in Bangladesh. The results would be of interest to public health researchers and policy makers.

scholarly journals Giant Muscle Invasive Dermatofibroma Clinically Mimicking a Malignant Tumor

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Hideyuki Kinoshita ◽  
Takeshi Ishii ◽  
Hiroto Kamoda ◽  
Toshinori Tsukanishi ◽  
Sumihisa Orita ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Present Report ◽  
Wide Resection ◽  
Large Size ◽  
Muscle Invasive ◽  
Muscle Invasion ◽  
The Right ◽  
Slow Growing ◽  
Muscle Invasive Tumor

Dermatofibromas are common benign fibrohistiocytic lesions, usually appearing as slow growing firm dermal nodules with a predilection for the extremities (mostly the lower legs). They are found mostly in middle-aged women and are usually smaller than 2 cm in diameter. Giant dermatofibromas exceeding 5 cm in diameter are rare. In recent years, reports have suggested a relationship between the primary size of dermatofibromas and rates of local recurrence and metastases after surgery. This relationship is however debated. The present report describes the case of a giant muscle invasive tumor in a 51-year-old female patient who presented with a large ulcerated mass in the right upper arm. The tumor appeared clinically malignant, measuring approximately 12 cm × 6 cm in size, with ulceration and invasion of surrounding muscle. Wide resection of the tumor was performed with myocutaneous flap-plasty. Histopathological examination showed evidence of a dermatofibroma. No recurrence, metastases, or other complications were noted at 5 years after surgery. The present case demonstrates that although dermatofibromas are essentially benign, they may present with atypical features including large size, ulceration, and muscle invasion, clinically mimicking malignant tumors.

scholarly journals Complexity of Clinical Decision Making: Consent, Capacity, and Ethics

2019 ◽  
Vol 40 (03) ◽  
pp. 162-169 ◽  
Author(s):  
Annette Askren ◽  
Paula Leslie
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Negative Charge ◽  
Clinical Decision ◽  
Informed Consent Process ◽  
Thickened Liquids ◽  
Medical Decisions ◽  
Social Media Platforms ◽  
The Right ◽  
Right To Refuse

AbstractSpeech–language pathologists (SLPs), and really their patients, are often faced with challenging clinical decisions to be made. Patients may decline interventions recommended by the SLP and are often inappropriately labeled “noncompliant.” The inappropriateness of this label extends beyond the negative charge; the patient's right to refuse is, in fact, protected by law. Anecdotal exchanges, social media platforms, and American Speech-Language-Hearing Association forums have recently revealed that many SLPs are struggling with the patient's right to decline. Many are not comfortable with the informed consent process and what entails patients' capacity to make their own medical decisions. Here, we discuss the basics of clinical decision-making ethics with intent to minimize the clinician's discomfort with the right to refuse those thickened liquids and eliminate the practice of defensive medicine.

scholarly journals Dysplasia epiphysealis hemimelica: A case report

2014 ◽  
Vol 71 (11) ◽  
pp. 1081-1084
Author(s):  
Dalibor Jovanovic ◽  
Milena Ilic ◽  
Milos Milosavljevic ◽  
Zorica Mihajlovic ◽  
Radisa Vojinovic ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Ankle Joint ◽  
Developmental Disorder ◽  
Histopathological Examination ◽  
Sporadic Case ◽  
Unknown Etiology ◽  
Histological Findings ◽  
Tarsal Bone ◽  
Dysplasia Epiphysealis Hemimelica

Introduction. Dysplasia epiphysealis hemimelica, also known as Trevor?s disease, is an extremely rare skeletal developmental disorder of unknown etiology, characterized by an osteocartilaginous outgrowth of one or more epiphyses or of a tarsal bone during childhood. Case report. We presented a sporadic case of dysplasia epiphysealis hemimelica developed in the talus. A 6- year-old boy complained of swelling of his right ankle joint, with painful and reduced movements. Radiographies suggested excessive overgrowth of the dorsomedial aspect of the talus. The tumor was surgically excised and the gross and histological findings were consistent with those of osteochondroma. Conclusion. Dysplasia epiphysealis hemimelica is diagnosed by clinical, radiographic and histopathological examination. Early diagnosis is important for the condition to be treated before the deformity becomes disabling.

scholarly journals Desmoplastic Fibroma and Cemento Ossifying Fibroma of The Anterior Maxilla: A Rare Case Report

2021 ◽  
Vol 24 (1) ◽  
pp. 21-27
Author(s):  
Victor Pakpahan ◽  
Eky Nasuri ◽  
Vera Julia
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Neck Region ◽  
The Body ◽  
Ossifying Fibroma ◽  
Desmoplastic Fibroma ◽  
Anterior Maxilla ◽  
Main Complaint ◽  
Rare Case Report ◽  
The Right

Tumors located in the maxillofacial part of the body were classified by WHO in 2017 and among these are intraosseous form of fibromatosis known as Desmoplastic and Cemento-ossifying fibromas. These tumors usually occur in the head and neck region, especially in the mandible and are relatively rare in the maxilla. Meanwhile, this study aims to discribe a rare case of the cemento ossifying fibroma that had been previously diagnosed as desmoplastic fibroma with a mass tumor in the anterior of the maxilla. A 22 years old female reported to the Cipto Mangkusumo Hospital with the main complaint of a lump in the right side of the upper jaw which appeared 2 years prior to the operation. In April 2017, the patient had a biopsy in Tarakan Hospital and the result was a desmoplastic fibroma. Due to the lump enlargement, the patient was admitted to RSCM in July 2019 and had biopsy incision with a diagnosis of cemento ossifying fibroma which was confirmed by the histopathological examination and histology report. The resection of the right part of maxilla was conducted alongside with reconstruction using the free fibular flap. Moreover, cemento ossifying fibroma and desmoplastic fibroma shared similar features, namely, clinical, histological and radiological features which are important in establishing the diagnosis and treatment of patient. Hence, extensive enucleation or resection is required due to the progressive nature of the tumor to prevent the potential for further recurrences.

scholarly journals Comparison of Cortisol, Androstenedione and Metanephrines to Assess Selectivity and Lateralization of Adrenal Vein Sampling in Primary Aldosteronism

2021 ◽  
Vol 10 (20) ◽  
pp. 4755
Author(s):  
Giulio Ceolotto ◽  
Giorgia Antonelli ◽  
Brasilina Caroccia ◽  
Michele Battistel ◽  
Giulio Barbiero ◽  
...  
Keyword(s):  
Decision Making ◽  
Primary Aldosteronism ◽  
Inferior Vena ◽  
Clinical Decision Making ◽  
Vena Cava ◽  
Clinical Decision ◽  
Selectivity Index ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling ◽  
The Right

Success of adrenal vein sampling (AVS) is verified by the selectivity index (SI), i.e., by a step-up of cortisol levels between the adrenal vein and the infrarenal inferior vena cava samples, beyond a given cut-off. We tested the hypothesis that androstenedione, metanephrine, and normetanephrine, which have higher gradients than cortisol, could increase the rate of AVS studies judged to be bilaterally successful and usable for the clinical decision making. We prospectively compared within-patient, head-to-head, the selectivity index of androstenedione (SIA), metanephrine (SIM), and normetanephrine (SINM), and cortisol (SIC) in consecutive hypertensive patients with primary aldosteronism submitted to AVS. Main outcome measures were rate of bilateral success, SI values, and identification of unilateral PA. We recruited 136 patients (55 + 10 years, 35% women). Compared to the SIC, the SIA values were 3.5-fold higher bilaterally, and the SIM values were 7-fold and 4.4-fold higher on the right and the left side, respectively. With the SIA and the SIM the rate of bilaterally successful AVS increased by 14% and 15%, respectively without impairing the identification of unilateral PA. We concluded that androstenedione and metanephrine outperformed cortisol for ascertaining AVS success, thus increasing the AVS studies useable for the clinical decision making.

scholarly journals Management of Cancer-Associated Thrombosis: An Evolving Area

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2999
Author(s):  
Corinne Frere ◽  
Jean M. Connors ◽  
Dominique Farge
Keyword(s):  
Cancer Patient ◽  
Clinical Decision Making ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Clinical Decision ◽  
Patient Centered ◽  
Patient Values ◽  
The Individual ◽  
The Right ◽  
Cancer Associated Thrombosis

The management of cancer-associated thrombosis (CAT) is an evolving area. With the use of direct oral anticoagulants as a new option in the management of CAT, clinicians now face several choices for the individual cancer patient with venous thromboembolism. A personalized approach, matching the right drug to the right patient, based on drug properties, efficacy and safety, side effect profile of each drug, and patient values and preference, will probably supplant the one size fits all approach of use of only low-molecular-weight heparin in the near future. We herein present eight translational, clinical research, and review articles on recent advances in the management of CAT published in the Special Issue “Treatment for Cancer-Associated Thrombosis” of Cancers. For now, a multidisciplinary patient-centered approach involving a close cooperation between oncologists and other specialists is warranted to guide clinical decision making and optimize the treatment of VTE in cancer patient.

A RARE CASE REPORT OF PRIMARY NEUROENDOCRINE CARCINOMA OF BREAST

2021 ◽  
pp. 15-16
Author(s):  
Rahmath Unissa ◽  
Amreen Unissa ◽  
M. Bhavani
Keyword(s):  
Case Report ◽  
Clinical Examination ◽  
Rare Case ◽  
Histopathological Examination ◽  
Radical Mastectomy ◽  
Lower Quadrant ◽  
Axillary Clearance ◽  
Rare Case Report ◽  
Trucut Biopsy ◽  
The Right

we report a case of 51 year old lady, presented with complaints of hard lump in the right breast.On clinical examination lump of size 4x3cms in outer lower quadrant was noted. Ultrasonographic imaging showed evidence of 3x2cms ill dened hypoechoic lesion with spiculated margins and microcalcications. Trucut biopsy was done and histopathological report was given as Suspicious for malignancy which was followed by modied radical mastectomy with axillary clearance. Histopathological examination and Immunohistochemistry(IHC) was done.

scholarly journals Localized Castleman’s Disease in the Breast in a Young Woman

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rafael Parra-Medina ◽  
José Ismael Guio ◽  
Patricia López-Correa
Keyword(s):  
Lymphoproliferative Disorder ◽  
Histopathological Examination ◽  
Castleman’S Disease ◽  
Unknown Etiology ◽  
Castleman's Disease ◽  
Axillary Lymphadenopathy ◽  
The Right ◽  
Slow Growing ◽  
Hyaline Vascular Variant

Castleman’s disease (CD) is a rare lymphoproliferative disorder of unknown etiology. It typically occurs in adulthood but it may also develop in childhood. Clinically, this disease may be classified as localized (unicentric) or systemic (multicentric). Six cases of breast CD have been described in the literature, and all have been reported in adults. Herein we describe the case of a 15-year-old female who presented with a slow-growing tumor in the right breast. The tumor was excised and histopathological examination demonstrated hyaline vascular variant CD. After two years of follow-up, the patient was asymptomatic without evidence of cervical or axillary lymphadenopathy.

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