scholarly journals Clinical Features and Surgical Management of Pituitary Adenoma During Pregnancy: Case Series and Literature Review

2022 ◽  
Author(s):  
Xinyu Jia ◽  
Xiaopeng Guo ◽  
Mingjie Luo ◽  
Yong Yao ◽  
Wei Lian ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Vision Loss ◽  
Surgical Intervention ◽  
Case Series ◽  
Healthcare Management ◽  
Visual Field Defects ◽  
Tumor Diameter ◽  
College Hospital ◽  
Medical College ◽  
Gestation Time

Abstract Purpose Although conservative treatment was recommended for pregnant patients with pituitary adenomas (PAs), surgical treatment is occasionally necessary for those with acute symptoms. However, surgical intervention among these patients is poorly studied. Methods Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 and another 35 pregnant patients profiled in the literature were included. Results All the 41 enrolled patients (mean age 29.8 ± 5.3 years) had acute symptoms including visual field defects, severe headaches, or vision loss requiring emergency pituitary surgeries. Mean tumor diameter was 2.16 ± 0.9 cm, and 92.6% were macroadenomas. PA apoplexies were found in 23 patients. The average gestation time at surgery was 25.1 ± 7.1 weeks; 55.9% of these patients underwent surgery in the second trimester of pregnancy. Multidisciplinary team was involved from before surgery to after delivery. Except one patient underwent an induced abortion, and one fetus died due to a nuchal cord, thirty-nine patients delivered successfully, and 37 of fetuses were healthy till the last follow-up. One fetus died of congenital diaphragmatic hernia, and another had a low Apgar score after a cesarean section but survived. Conclusion PA surgery for pregnant patients with PAs is effective and safe during the second and third trimesters. Pregnant patients requiring emergency PA surgery need multidisciplinary evaluation and healthcare management. Cooperation of neurosurgery, endocrinology, obstetrics, anesthesiology, and neonatology is necessary for a successful surgical intervention for pregnant patients with PAs.

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 

Incidence of Duodenal Ulcer and its Surgical Management in a Teaching Hospital in Bangladesh

1995 ◽  
Vol 25 (2) ◽  
pp. 67-68 ◽  
Author(s):  
Meer Mahbubul Alam
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Teaching Hospital ◽  
Pyloric Stenosis ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
High Incidence

Duodenal ulcer patients with or without complications admitted in the surgical departments of Rajshahi Medical College Hospital (RMCH) during the period of 13 years from 1980–1992 were studied retrospectively. Duodenal ulcer accounted for 10/1000 admission and five operations per week. Of the 1623 patients with uncomplicated ulcer, only 623 needed surgical treatment. However, all of the 1599 who presented with pyloric stenosis, 1047 with peritonitis due to perforation, and 13 with hematemesis were operated upon. This study confirms previously published reports of high incidence of duodenal ulcer admissions in the hospital but shows a diminishing number in the uncomplicated cases requiring surgery.

scholarly journals A Step towards Control of Multidrug Resistant Tuberculosis: Hospital Based Study from Nashik India

2016 ◽  
Vol 12 (2) ◽  
pp. 34-38
Author(s):  
SV Gosavi ◽  
M Patil ◽  
B Almale ◽  
S Dugad
Keyword(s):  
Case Series ◽  
Previous Treatment ◽  
Multidrug Resistant ◽  
Research Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Medical College ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Introduction: The Global TB report (2012), estimates 73,000 MDR TB patients living in India, among them only 1,660 cases were notified and 68.4% cases were put on treatment. Hence, this study was conducted with objective to assess the treatment outcome of multi drug resistant Tuberculosis patients enrolled in DOTS plus (Cat-VI) site.Methodology: It is a retrospective case series of MDR-TB cases conducted at Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik (Maharashtra). Information was collected on age, gender, HIV status, previous treatment of TB, weight of patient, refused to take treatment for Cat IV. Outcome was recorded in terms of cure rate, rate of failure, defaulter, treatment completed, switch to Cat V and death.Results: Among the study subject, majority of study subjects were male (65%) and highest proportion (49%) of MDR-TB was in 25-44 years of age. Out of 353 patient 241 (68.4%) were still on Cat IV in which 35% patient’s on intensive phase and 65% put on continuation phase while 12.8%, 13.5%, 4%, 1.1%, 3.6% & 0.5% patient were found to be defaulted, died, refused to take treatment, treatment completed, transfer out & switch to Cat V, respectively.Conclusion: In the present study, the majority of study subjects (99.4%) were previously treated for TB, we identified number of operational challenges in the treatment of MDR-TB like rate of defaulter, refuse to take treatment & deaths among MDR-TB patient was high. There is need to study correlates of these factors in details also need of operational research to improve MDR-TB treatment in India is considered as priority.SAARC J TUBER LUNG DIS HIV/AIDS, 2015 XII (2), page: 34-38

scholarly journals Oral health of patients suffering from end-stage solid organ insufficiency prior to solid organ re-transplantation: a retrospective case series study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tobias Moest ◽  
Rainer Lutz ◽  
Arne Eric Jahn ◽  
Katharina Heller ◽  
Mario Schiffer ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Case Series ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Retrospective Case ◽  
Treatment Need ◽  
Case Series Study ◽  
Series Study ◽  
Radiological Examinations

Abstract Background The oral health of organ transplanted patients before organ re-transplantation is largely unknown. This retrospective clinical study evaluates the necessity for intraoral surgical intervention and/or conservative treatment in candidates awaiting organ re-transplantation, both for graft failure and for reasons of another upcoming solid organ transplantation (renal or non-renal). Methods From January 2015 to March 2020 n = 19 transplant recipients in evaluation on the waiting list for solid organ re-transplantation could be included in the retrospective case series study. Using clinical and radiological examinations, necessity for oral surgical or conservative dental treatment was evaluated. On the basis of anamnesis data, current kidney function, renal replacement treatment (RRT), and medication, a risk profile for several patient subgroups was created. Results The clinical and radiological examinations showed a conservative and/or surgical treatment need in n = 13 cases (68.42%). In n = 7 cases (36.84%) surgical intervention was recommended due to residual root remnants (n = 5), unclear mucosal changes (n = 1), and periimplantitis (n = 1). In n = 16 recipients (84.2%) RRT (n = 15 hemodialysis; n = 1 peritoneal dialysis) had been performed. N = 14 recipients (73.68%) received immunosuppressants. In n = 1 patient (5.3%) displayed intraoral and n = 4 patients (21.1%) extraoral neoplasms due to drug-induced immunosuppression. Conclusions Solid organ transplant recipients with renal failure present a complex treatment profile due to a double burden of uremia plus immunosuppressants. In cases of surgical treatment need a hospitalized setting is recommended, where potentially necessary follow-up care and close cooperation with disciplines of internal medicine is possible in order to avoid surgical and/or internal complications.

scholarly journals Volar radial wrist–forearm primary and recurrent ganglia of the flexor carpi radialis tendon secondary to pathology isolated to the trapezial fibro-osseous synovial sheath tunnel: A case series report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2097738
Author(s):  
Jerone T Landstrӧm
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Case Series ◽  
Tendon Sheath ◽  
Etiologic Factor ◽  
Recurrence Rates ◽  
Flexor Carpi Radialis ◽  
Surgical Recurrence ◽  
Case Series Report ◽  
Series Report

Surgical treatment of primary and recurrent volar radial wrist–forearm ganglia has yielded higher recurrence rates of ganglia when compared to surgical treatment of dorsal wrist ganglia. The published surgical literature hypothesizes that the variability in etiology of volar radial wrist–forearm ganglia may account for the higher surgical recurrence rates of these ganglia. Currently, the literature states that volar radial wrist–forearm ganglia may be secondary to arthritic intercarpal joints, carpal interosseous ganglia, or by mechanical stress within tendon sheaths, joint capsules, and ligaments. The literature has not reported pathology isolated to the flexor carpi radialis tendon and its tendon sheath at the volar trapezial fibro-osseous synovial sheath tunnel as a cause of volar radial wrist–forearm ganglia. This case series reports findings of pathology isolated to the flexor carpi radialis tendon at the trapezial fibro-osseous synovial sheath tunnel that caused primary and recurrent volar radial wrist–forearm ganglia. The pathology identified in this case series hypothesizes an additional etiologic factor in development of volar radial wrist–forearm ganglia. Surgeon awareness of potential pathology of the flexor carpi radialis tendon at the trapezial fibro-osseous synovial sheath tunnel may reduce recurrence rates of volar radial wrist–forearm ganglia treated by surgical intervention.

A Ten-year Retrospective Study of Tetanus at a Teaching Hospital in Bangladesh

1970 ◽  
Vol 25 (2) ◽  
pp. 62-69 ◽  
Author(s):  
AHM Feroz ◽  
Hafizur Rahman
Keyword(s):  
Incubation Period ◽  
Wound Care ◽  
Case Series ◽  
The Elderly ◽  
Medical College Hospital ◽  
Acute Injury ◽  
Wound Management ◽  
Age Group ◽  
College Hospital ◽  
Medical College

Aims: To study the demographic, clinical features, treatment as well as outcomes of tetanus patients in the Bangladeshi population from 1994 to 2003. Design: A retrospective descriptive study. Setting: A large public Medical college hospital with a regional as well as referral service. Materials and Methods: All cases of tetanus in adult patients from January 1994 to December 2003 were identified from the medical record at the hospital and these were then retrospectively reviewed. Results: A total of 80 cases of tetanus were seen at the Faridpur Medical college hospital in the 10 years period with a mean of 8 cases per year. There were 55 male (68.75%) and 25 female (31.25%) patients. The mean age of the study population was 51.7±10.08 years. Most cases occurred in the age group of 60-69 years. Risk factor analysis revealed identifiable acute injury (puncture, prick/laceration) in 85%, CSOM (2.5%), surgery (2.5%), abortion (2.5%), skin ulcer (1.25%), burn (1.25%), child birth (1.25%), boil (1.25%). Thirty-two (40%) patients had medical wound care before hospital admission but none received tetanus immunoglobulin despite the absence of tetanus immunity. All the patients had the generalized type of disease. Body stiffness, trismus and dysphagia were the three commonest presenting complaints. All the patients with injury and wound (74/80) had their wound debrided. All the tetanus patients (80/80) received intravenous diazepam infusion as part of their management. Seventy two (90%) patients received intravenous crystalline penicillin. Sixty-five (81.25%) patients received intramuscular human antitetanus immunoglobulin and fourteen (17.5%) had tracheostomy performed. Inhospital complications were observed as respiratory (80%), cardiovascular (65%), gastrointestinal (57-5%), renal (33.37%), neurological (17.%) and others (22.5%). There were eighteen deaths in hospital, accounting for overall mortality of 22.5% (18/80). Higher mortality were observed in age group above 50 years than the age group below 50 years (29.16% vs 12.5%, P<0.05), in female than the male (40% vs 14.54%, P<0.05), in farmer than nonfarmer (30.95% vs 13.15%, P<0.05), in patients who had short incubation period than those who had incubation period more than one week (53.33% vs 23.25%, P<0.05). Conclusion: In general, tetanus remains in Bangladesh an important disease with substantial mortality that primarily affects unvaccinated or inadequately vaccinated individuals. Prevention during wound management of tetanus prone wounds was inappropriate in many patients. The elderly population may have the highest risk for tetanus since they may not have had tetanus toxoid immunization or regular booster injections. It is, however, highly preventable through both routine vaccination and appropriate wound management. Our case series show comparable pattern and outcome with other case series in the developing countries reported in the literatures. (J Bangladesh Coll Phys Surg 2007; 25 : 62-69)

Surgical Treatment of Chronic Hand Ischemia: A Systematic Review and Case Series

2019 ◽  
Vol 24 (03) ◽  
pp. 359-370
Author(s):  
David L. Colen ◽  
Oded Ben-Amotz ◽  
Thibaudeau Stephanie ◽  
Arman Serebrakian ◽  
Martin J. Carney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Surgical Intervention ◽  
Case Series ◽  
Ulnar Artery ◽  
Pharmacologic Therapy ◽  
Cold Intolerance ◽  
Algorithmic Approach ◽  
Surgical Interventions ◽  
Hand Ischemia

Background: Chronic hand ischemia refers to progressive, non-acute ischemic symptoms such as cold intolerance, rest pain, ulceration, tissue necrosis, and digit loss and poses a significant challenge in management. Conservative treatment begins with medical optimization and pharmacologic therapy, but when symptoms persist, surgical intervention may be required. Various operations exist to improve circulation including sympathectomy, arterial bypass, or venous arterialization. The purpose of this study is to systematically review published outcomes and present our experience with each surgical technique. Methods: A systematic review of literature regarding surgical treatment of chronic hand ischemia published between 1990 and 2016 was conducted using PRISMA guidelines. A retrospective-review of surgical interventions for chronic hand ischemia from 2010 to 2016 was then conducted. Primary outcomes included improvement in pain, wound-healing, and development of new ulcerations. Results: The review included 38 eight studies, showing all three techniques were effective in treating chronic hand ischemia. Sympathectomy had the lowest rate of new ulcerations (0.8%); bypass had the highest rate of healing existing ulcerations (89%). Arterialization was associated with consistent pain improvement pain (100%) but more complications (30.8%). Our series included 18 patients with 21 affected hands, 18 sympathectomies, 6 ulnar artery bypasses, and 1 arterialization. Most hands had improvement of wounds (89.5%) and pain (78.9%). No patients developed new ulcerations, but one required secondary amputation. Conclusions: When conservative measures fail to improve chronic hand ischemia, surgical intervention is an effective last line treatment. An algorithmic approach can determine the best operation for patients with chronic hand ischemia.

scholarly journals Diaphragmatic Hernia with Atypical Presentation - A Case Series

2014 ◽  
Vol 32 (1) ◽  
pp. 45-50
Author(s):  
SMA Shahid ◽  
MN Ali ◽  
M Ahmed ◽  
SS Islam ◽  
SB Hossain
Keyword(s):  
Diaphragmatic Hernia ◽  
Case Series ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Chest X Ray ◽  
The Mean ◽  
Challenging Situation ◽  
Male To Female ◽  
Diaphragmatic Hernias

Congenital Diaphragmatic Hernia is one of the most challenging diagnosis faced by pediatric surgeons. From the time of its first anatomic description more than 300 years ago, CDH has carried a high mortality rate. We aimed to review patients who presented with hernia of diaphragm during the last six months. In this retrospective study, the medical records of three patients treated for diaphragmatic hernias who were admitted to Rajshahi Medical College Hospital between July 2012 and December 2012 were analyzed. Three patients with age of 45 days to 7 years were included in the study. Male to female ratio was 1:2. All patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic. One patient needed thoracotomy incision. No patient required mesh repair. The mean hospitalization time was 14 days. There was no postoperative death. Diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21050 J Bangladesh Coll Phys Surg 2014; 32: 45-50

scholarly journals Fixation stability after surgical treatment of strabismus and biofeedback fixation training in amblyopic eyes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Otto Alexander Maneschg ◽  
Mirella Telles Salgueiro Barboni ◽  
Zoltán Zsolt Nagy ◽  
János Németh
Keyword(s):  
Surgical Treatment ◽  
Vision Loss ◽  
Surgical Intervention ◽  
Visual Fixation ◽  
Stable Fixation ◽  
Central Vision Loss ◽  
Fixation Stability ◽  
Potential Use ◽  
Fixation Area ◽  
Fellow Eyes

Abstract Background Visual fixation may be affected in amblyopic patients and, moreover, its stability may be associated with the effects of amblyopic treatments on visual performance in patients with strabismus. Therefore, fixation stability is a relevant biomarker that might predict the recurrence of amblyopia after a therapeutic intervention. Microperimetric biofeedback fixation training (BFT) can stabilize visual fixation in adult patients with central vision loss. It was the purpose of the present study to evaluate the effects of BFT on fixation stability in adult amblyopic patients after surgical intervention to treat strabismus. Methods Participants were 12 patients with strabismus (mean age = 29.6 ± 8.5 years; 6 females) and 12 healthy volunteers (mean age = 23.8 ± 1.5 years; 9 females). The protocol included ophthalmological and microperimetric follow-ups to measure fixation stability and macular sensitivity. BFT was applied monocularly to four amblyopic eyes either on the spontaneous preferential retinal locus or to a fixation area closer to the anatomical fovea after surgical treatment of strabismus. Results Baseline measurements showed significantly altered microperimetric average threshold in amblyopic eyes compared to fellow eyes (p = 0.024) and compared to control eyes (p < 0.001). Fixation was unstable in amblyopic eyes compared to control eyes (p < 0.001). Fixation stability did not significantly change after surgical alignment of strabismus (p = 0.805). BFT applied to operated eyes resulted in a more stable fixation with improvements of about 50% after three months of training. Conclusions Fixation stability improvements following BFT highlight its potential use in adult amblyopic eyes after the surgical alignment of the strabismus. Future investigations may also consider applying this method in combination with standard treatments to improve vision in amblyopic patients.

scholarly journals MATERNAL MORTALITY 2007-2008

2010 ◽  
Vol 17 (02) ◽  
pp. 291-294
Author(s):  
AISHA ABDULLAH SHAIKH ◽  
SADIA SABOOHI ◽  
RUBINA A D MEMON
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Case Series ◽  
Medical College Hospital ◽  
Contributing Factors ◽  
College Hospital ◽  
Maternal Deaths ◽  
Medical College ◽  
Case Series Study

Objectives: To analyse the maternal mortality with its causes and possible contributing risk factors at Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Setting: This study was carried out at Gynae / Obs Unit-1 of Ghulam Mohammad Mahar Medical College Hospital, Sukkur from Jan-2007 to Dec-2008. Study Design: Descriptive case series study. Subjects and Methods: This study was conducted by analysing the death records of all maternal deaths who died over a period of two (02) years from Jan 2007 to Dec 2008. Thedemographic record included age, parity, booking status and education. The cause of death and possible contributing factors were evaluated. Results: 48 mothers died during this period making Maternal Mortality Ratio (MMR) of 1578/ 100,000 live births. Direct causes contributed to 79% (38) of maternal deaths while 21% (10) were due to indirect causes. The major causes of deaths were eclampsia 27% (13), haemorrhage33% (11), Sepsis 21% (10), Obstructed labour 8% (4). Among indirect causes, hepatic encethalopathy, anemia and renal failure were observed. Conclusions: Eclampsia, haemorrhage and Sepsis are still the major killers. Factors which need urgent improvement include education, antenatal booking, early diagnosis and referrals to tertiary care centers.

Sign in / Sign up

Export Citation Format

Share Document