Clinical and radiological characteristics of brain abscess caused by Streptococcus species: a cross-sectional study

Abstract Background: Streptococcus species are mostly reported the predominant organisms causing brain abscess (BA), however, there is no article focusing on the characteristics of patients with BA caused by Streptococcus species to date. This study aimed to describe the clinical and radiological features of patients with BA caused by Streptococcus species. Methods: All patients who were hospitalized due to BA with intracranial pus culture result of Streptococcus species alone after neurosurgical intervention from May 2015 to August 2018 in Huashan Hospital in Shanghai were included in this study. The data of patient demographics, clinical and radiological presenting features, microbiological results, surgical and antimicrobial treatment, and outcomes were collected. Results: Thirteen patients (10 male, 3 female) of primary brain abscesses were involved. The most frequent clinical presentations included headache (76.9%), fever (38.5%) and limb weakness (38.5%).The radiological features of abscesses in these patients included singularity, big size, thick wall and obvious oedema. The average abscess diameter before surgery was 51.62±11.00mm. The mean thickness of abscesses wall was 5.23±1.78mm. The mean range of oedema and distance between abscess margin were 93.62±16.31mm, 26.38±8.03mm, respectively. The strains isolated in this study all belonged to the viridans group and showed high susceptibility to cefotaxime and levofloxacin. All patients had good outcomes at discharge. Conclusion: Patients with BAs caused by Streptococcus species had unspecific clinical signs, but specific radiological features, which might be helpful for early diagnosis.

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P017 Complications of Juvenile Idiopathic Arthritis

Rheumatology ◽

10.1093/rheumatology/keab722.009 ◽

2021 ◽

Vol 60 (Supplement_5) ◽

Author(s):

S Miladi ◽

S Bouzid ◽

A Fazaa ◽

L Souabni ◽

M Sellami ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Adverse Effects ◽

Disease Onset ◽

Clinical Signs ◽

Membranous Glomerulonephritis ◽

Cross Sectional Study ◽

Chronic Inflammatory Disease ◽

Cross Sectional ◽

Renal Manifestation ◽

The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease characterized by onset before the age of 16. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and prognosis. The study aimed to determine JIA complications in 51 patients. Methods A cross-sectional study including patients diagnosed with JIA according to ILAR criteria was conducted for 26 years [1995– 2021]. Epidemiological, clinical, therapeutic, and evolutive aspects were noted. Results Twenty-nine males and 22 females were included. The mean age of the disease onset was 7.6 years [1,5–16]. The mean age of patients at the time of the study was 23.29 years [9–45]. Polyarticular and seronegative form was the most frequent (34.5%). Other subtypes diagnosed were systemic (25%), enthesitis-related arthritis (21.2%), oligoarticular (12.5%), and seropositive polyarticular (5.8%). Standard X-Ray imaging showed articular damage in 50% of the cases. Hip arthritis was observed in 32% and surgery was needed in 16.9%. One patient presented with atlantoaxial subluxation. Growth retardation was noted in 28.6%. Cardiac manifestations were seen in 3 patients (pericarditis = 2, myocarditis = 1), uveitis in 3 cases, renal manifestation (extra membranous glomerulonephritis) in one patient with polyarticular form. One patient was diagnosed with multiple sclerosis. Small doses of corticosteroids were prescribed in 71.7%. Methotrexate was prescribed in 70.5% (interrupted for adverse effects in 3 patients), sulfasalazine in 30.6%, hydroxychloroquine in 5.7%, leflunomide in 15.4%. bDMARDs were needed in 16 patients: 14 patients received TNF alpha inhibitors, rituximab was prescribed for one patient with a polyarticular form, and tocilizumab in a patient with a systemic form. A switch of bDMARDs was conducted in 10 patients: for inefficiency in 4 cases and adverse effects in other 4 cases. Three patients developed uveitis under Etanercept, septicemia under Adalimumab, an allergic reaction, and depression under Infliximab. One patient died from a convulsive seizure at the age of 9. Conclusion The presence of complications is an additional burden to JIA patients. A multidisciplinary approach is required for the management of these complications.

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Correlation between interleukin-6 and septic shock in children

Paediatrica Indonesiana ◽

10.14238/pi52.6.2012.352-5 ◽

2012 ◽

Vol 52 (6) ◽

pp. 352

Author(s):

Stephanie Yulianto ◽

Ari Runtunuwu ◽

Vivekenanda Pateda ◽

Jose Mandei ◽

Julius Lolombulan

Keyword(s):

Septic Shock ◽

Interleukin 6 ◽

Clinical Signs ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Threatening Condition ◽

Life Threatening ◽

The Mean ◽

Pediatric Sepsis

Background Sepsis is a life􀁆threatening condition and the mostcommon cause of death in intensive care units in developingcountries, such as Indonesia. The first clinical signs of sepsis areusually non􀁆spedfic. More specific signs and laboratory parametersoften occur late and are associated 'With organ dysfunction andhigh mortality rates. Interleukin􀁆6 (IL--6) is a biomarker reported tobe superior to clinical signs and conventional tests for sepsis. IL--6levels may indicate microorganism invasion, as well as progressionof infection into sepsis, severe sepsis, and septic shock.Objective To evaluate a correlation between interleukin (IL)􀁆6and septic shock in childrenMethods This cross􀁆sectional study was conducted in the pediatricintensive care unit of Prof. Dr. R.D. Kandou Hospital, Manado,between June to September 2011. Subjects were children withsepsis or septic shock aged 1 month to 13 years, v.ith diagnosesbased on the International Pediatric Sepsis Consensus ConferenceCriteria 2005. A one􀁆time measurement of IL--6 plasma levelswas done at the time of diagnosis. Data was analyzed by logisticregression test using SPSS version 17 software. A P value of <0.05indicated statistical significance.Results The mean IL--6 plasma level in the septic group was 1.68(95%CI 1.45 to 1.91) pg/mL and that of the septic shock groupwas 2.33 (95%CI 1.79 to 2.86) pg/mL. Our results showed astrong positive correlation between IL􀁆6 plasma levels v.ith theprobability of septic shock in children v.ith sepsis (regressioncoefficient􀁇1.3lO, P􀁇O.024).Conclusion Higher plasma IL--6 levels were associated v.ith ahigher risk of septic shock in children with sepsis. [Paediatrrndones.2012;52:352-5].

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The prevalence of keratoconus in children with allergic eye disease in an Egyptian population

European Journal of Ophthalmology ◽

10.1177/1120672120942691 ◽

2020 ◽

pp. 112067212094269

Author(s):

Alyaa Saeed Ahmed ◽

Mohamed-Sameh H El-Agha ◽

Mahmoud Osama Khaled ◽

Shireen Mostafa Shousha

Keyword(s):

Allergic Conjunctivitis ◽

Clinical Signs ◽

Cross Sectional Study ◽

Vernal Keratoconjunctivitis ◽

Ophthalmological Examination ◽

Ocular Allergy ◽

Cross Sectional ◽

Duration Of Symptoms ◽

The Mean ◽

Study Participants

Purpose: To determine the prevalence of keratoconus (KC) among children with ocular allergy. Methods: A cross-sectional study was conducted on all children presenting with ocular allergic disease from September 2017 to September 2018. All study participants were subjected to history taking (a specially designed questionnaire), routine ophthalmological examination, and corneal tomography. Results: A total of 79% of the study patients had vernal keratoconjunctivitis (VKC) while the remaining had perennial allergic conjunctivitis (10%), seasonal allergic conjunctivitis (9%) and atopic keratoconjunctivitis (2%). Manifest KC was seen in 7% of cases, suspect KC was found in 27% of cases, and 66% had no evidence of KC. For the manifest KC, 56% had clinical signs, while 44% were diagnosed by tomography. For the purpose of statistical analysis, the cohort was divided into group KC (manifest or suspicious KC) and group non-KC (no KC). The mean age was 11.2 years in group KC, and 9 years in group non-KC ( p < 0.001). The mean duration of allergic symptoms was 3.75 years in group KC, and 2.5 years in group non-KC ( p = 0.001). The mean duration of eye rubbing was 2.5 years in group KC, and 0.83 years in group non-KC ( p = 0.02). Systemic atopy was present in 35.3% of group KC, and in 12.5% in group non-KC ( p = 0.005). Conclusion: The overall prevalence of KC was 34%. Risk factors for the development of KC in patients with ocular allergy were age, duration of symptoms specially eye rubbing, systemic atopy and VKC. Tomographic diagnosis of KC can be present in absence of clinical signs.

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Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50744 ◽

2020 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Mohammad Enayet Hussain ◽

Bithi Debnath ◽

AFM Al Masum Khan ◽

Md Ferdous Mian ◽

Md Nahidul Islam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Clinical Diagnosis ◽

Optic Neuropathy ◽

Cross Sectional Study ◽

P Value ◽

Pattern Reversal ◽

Cross Sectional ◽

The Mean ◽

Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

10.33798/ajmas2019/00265. ◽

2019 ◽

Vol 2 (1) ◽

pp. 1-18

Author(s):

Chijioke Okeudo ◽

B.U. Ezem

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Cross Sectional Study ◽

Fluid Volume ◽

Singleton Pregnancy ◽

Cross Sectional ◽

South Eastern ◽

Amniotic Fluid Volume ◽

The Mean ◽

Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

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Advantages and limitations of the endoscopic tympanoscopy a prospective study

10.30574/ijsra.2020.1.1.0016 ◽

2020 ◽

Vol 1 (1) ◽

pp. 012-017

Author(s):

Najib Zouhair ◽

Anass Chaouki ◽

Amine M’khatri ◽

Youssef Oukessou ◽

Sami Rouadi ◽

...

Keyword(s):

Middle Ear ◽

Operating Time ◽

Cross Sectional Study ◽

Cross Sectional ◽

Invasive Approach ◽

Intraoperative Bleeding ◽

Advantages And Disadvantages ◽

Early Return ◽

The Mean ◽

Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

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Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32638 ◽

2020 ◽

Vol 22 (3) ◽

pp. 141-145

Author(s):

Krishna Chandra Devkota ◽

S Hamal ◽

PP Panta

Keyword(s):

Pleural Effusion ◽

Cross Sectional Study ◽

Pleural Space ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical College ◽

The Common ◽

The Mean ◽

Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

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High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries

Nutrients ◽

10.3390/nu13030995 ◽

2021 ◽

Vol 13 (3) ◽

pp. 995

Author(s):

Israa M. Shatwan ◽

Eiman A. Alhinai ◽

Balqees Alawadhi ◽

Shelini Surendran ◽

Najlaa M. Aljefree ◽

...

Keyword(s):

Mediterranean Diet ◽

Total Sample ◽

Cross Sectional Study ◽

Inverse Association ◽

Protective Effects ◽

Hip Circumference ◽

Cross Sectional ◽

Gulf Countries ◽

The Mean ◽

The Mediterranean

The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20–55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.

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Altered retinal oxygen metabolism in patients with combined ocular and central nervous system sarcoidosis

Rheumatology ◽

10.1093/rheumatology/keaa781 ◽

2020 ◽

Author(s):

Astrid Kindt ◽

Keld-Erik Byg ◽

Jimmi Wied ◽

Torkell Ellingsen ◽

Jesper Rømhild Davidsen ◽

...

Keyword(s):

Oxygen Metabolism ◽

Cross Sectional Study ◽

Screening Methods ◽

Cross Sectional ◽

Corrected Visual Acuity ◽

Multi Linear Regression ◽

The Mean ◽

Arteriovenous Difference ◽

Retinal Arteriolar ◽

Retinal Oximetry

Abstract Objective To evaluate retinal oxygen metabolism by retinal oximetry for ocular and CNS diseases in a cross-sectional study of sarcoidosis. Methods Overall 201 eyes from 103 biopsy-verified sarcoidosis patients were included and divided into four groups depending on the organ affection: (i) sarcoidosis without ocular or CNS affection, (ii) ocular sarcoidosis, (iii) CNS sarcoidosis, and (iv) combined ocular and CNS sarcoidosis. Retinal oximetry was obtained and analysed, with the mean retinal arteriolar and venular saturation as well as arteriovenous difference as principal outcomes. Comparison between groups was done in a multi linear regression model adjusted for age, sex, duration of sarcoidosis, best corrected visual acuity and retinal oximetry quality. Results Mean (s.d.) age was 50.5 (13.4) (95% CI: 47.9, 53.1) years and 52.2% were males. Eyes of the combined Ocular/CNS group had a higher retinal arteriovenous difference than eyes of the Non-ocular/no-CNS group (42.1% vs 37.7%, P = 0.012) but did not differ between other groups. Eyes in the four groups (Non-ocular/no-CNS, Ocular, CNS and Ocular/CNS) did not differ according to retinal arterial (94.5%, 93.5%, 93.5% and 94.5%, respectively) or venular (57.5%, 56.4%, 55.0% and 52.5%, respectively) oxygen saturation. Conclusions The results of this study suggest that eyes of sarcoidosis patients with combined ocular and CNS affection have an altered oxygen metabolism indicating a subclinical eye affection that is not recognized by conventional screening methods.

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Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

The American Journal of Sports Medicine ◽

10.1177/0363546520987819 ◽

2021 ◽

pp. 036354652098781

Author(s):

Mathias Paiva ◽

Lars Blønd ◽

Per Hölmich ◽

Kristoffer Weisskirchner Barfod

Keyword(s):

Trochlear Dysplasia ◽

Cross Sectional Study ◽

Magnetic Resonance Images ◽

Tibial Tubercle ◽

Control Group ◽

Trochlear Groove ◽

Sectional Study ◽

Cross Sectional ◽

Mean Values ◽

The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

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