scholarly journals Intraspinal Space-Occupying Lesions in Children: Clinical Features, Neuroimaging and Surgical Outcomes of 27 Cases

Author(s):  
Haigang Chang ◽  
Jingkuo Yan ◽  
Yaxiao Wang ◽  
Lei Hui ◽  
Yan Li ◽  
...  

Abstract Background: Pediatric intraspinal space-occupying lesions are relatively uncommon. However, these lesions can result in neurological disabilities due to misdiagnosis and delayed treatment. The main goal of the present study is to evaluate the clinical and radiological features and treatment options of pediatric intraspinal space-occupying lesions in order to improve the clinical recognition and management. Methods: Clinical data of 27 children with intraspinal space-occupying lesions who underwent surgery treatment in a tertiary-care hospital between 2010 and 2018 were retrospectively reviewed and analyzed. Results: Of these 27 patients, 14 (51.85%) were girls and 13 (48.15%) were boys. The most common age group affected was 10~14 years (62.96%, 9 girls and 8 boys in this age group). The mean age was 10.11 years old. Pain and weakness were the most common clinical symptoms. Preoperative magnetic resonance imaging (MRI) identified intramedullary (10 cases, 37.04%), intradural extramedullary (10 cases, 37.04%) and extradural (7 cases, 25.92%) lesions, respectively. The majority of the lesions were intraspinal tumors (23 cases, 85.19%). The histological diagnosis of tumors included embryonic residual tumors (6 cases, 22.22%), ependymoma (5 cases, 18.52%), primitive neuroectodermal tumors (PNET) (3 cases, 11.11%), schwannomas (2 cases, 7.4%), ganglioneuroma (1 case, 3.7%), Ewing’s sarc (1 case, 3.7%), B-cell non Hodgkin lymphoma (1 case, 3.7%), Hodgkin lymphoma (1 case, 3.7%), chondrosarcoma (1 case, 3.7%), ganglioglioma (1 case, 3.7%), and glioma (1 case, 3.7%). Conclusions: The incidence of pediatric intraspinal space-occupying lesions is low, and the clinical manifestation is lack of specificity. The prognosis for children with malignant tumors is poor and surgical resection is still the primary treatment option.

2021 ◽  
Vol 15 (11) ◽  
pp. 2853-2855
Author(s):  
Rabia Amin Butt ◽  
Zonaira Rathore ◽  
Afia Sarwar ◽  
Faiza Azam ◽  
Faria Waqar Khan ◽  
...  

Aim: To determine the frequency of different diseases resulting in cervical lymphadenopathy in specimens of patients presenting in tertiary care hospital. Methodology: It was a cross sectional study conducted at the histopathology section of the pathology department of Services Institute of Medical Sciences/Services Hospital Lahore. The study was approved by the ethical committee of the institution. The study was completed in six months.100 cases fulfilling the inclusion criteria were registered. Inclusion criteria included patients above 16 years of age, patients from both sexes, unilateral or bilateral irrespective of duration. Lymph nodes less than 1cm were not included in the study. Informed consent was taken. Both FNAC and Biopsy were used as diagnostic tools. All the data was analysed with SPSS version 11. Results: During a period of six months, a total of 100 cases of cervical lymphadenopathy were studied. These included 75 benign and 25 malignant cases. Out of benign cases 53% were diagnosed as tuberculous lymphadenitis. About 81.3% were in the age range of 16-25 years and 18.7% were in the age range of 26-35 years. 22% cases were diagnosed as reactive lymphadenitis. About 54.54% of these patients were in the age range of 16-25 years and 45.46% were in the age range of 26-35 years. The highest frequency among malignant lesions consisted of Non-Hodgkin lymphoma 16% followed by Hodgkin lymphoma 5% and metastatic disease 4%.The age range of malignant lesions was in the range of 36-78 years. Conclusion: Our study concludes that cervical lymphadenopathy is the common clinical presentation in our setup and tuberculosis is the commonest cause. Keywords: Hodgkin lymphoma, Non-Hodgkin lymphoma, Fine needle aspiration cytology


2020 ◽  
Vol 28 (1) ◽  
pp. 30-36
Author(s):  
Chiranjib Das ◽  
Pritam Chatterjee

Introduction Majority of lymphomas involving the head and neck are Non-Hodgkin lymphoma (NHL). Most of them present as cervical lymphadenopathy. The objectives of this study are to present the problems encountered in the diagnosis of extra-nodal NHL in head and neck region and show the importance of thorough clinical examination and proper investigation. Materials and Methods A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from July 2015 to June 2018. Patients diagnosed as NHL on the basis of histopathology and immunohistochemistry were included in this study. Patients who were lost in follow up were excluded from the study. Patients were treated with chemotherapy and radiotherapy by Oncologist. All patients were followed up routinely both by Otorhinolaryngologist and Oncologist.     Results There were 26 male and 11 female patients in this study. Patients were between 22 years to 76 years of age with highest incidence in 6th decade of life. Patients presented with only cervical lymphadenopathy; asymmetrical tonsillar enlargement with cervical lymphadenopathy; unilateral tonsillar enlargement only; huge inta-oral mass with stridor; parotid gland swelling; thyroid swelling with multiple cervical lymphadenopathy; epistaxis, palatal ulcer and cheek swelling; severe trismus with inconspicuous retro-mandibular mass. Majority of patients did well with chemoradiotherapy. Two patients succumbed to death, one with huge intra-oral NHL and another with nasal T/NK-cell lymphoma.  Conclusion Good knowledge of the clinical characteristics of extra-nodal NHL and the methods to establish the diagnosis are essential for a correct and timely therapy of the disease.


Author(s):  
Jayalaxmi Mahur ◽  
Aisha Humera

Background: Vulvovaginitis is a common unavoidable health problem encountered in a woman’s life. Because of its recurrent and persistent symptoms, it leaves a negative impact on the quality of woman’s life and its management poses a challenge. This study is aimed to analyse the clinical profile, clinical symptoms - presentations and various etiological agents in vulvovaginitis.Methods: A study of 125 cases of vulvovaginitis in the age group of 18-50 years was done. This study was based on the data collected like - age, parity, symptoms, clinical presentations and cytological findings. Speculum examination was done with the given consent and high vaginal swabs were taken for cytological study. Based on Amsel’s criteria bacterial vaginosis was confirmed, trichomoniasis by wet mount examination and candidiasis by culture study were confirmed.Results: The present study showed maximum incidence of vaginitis 63.2% among 21-30 years age group, more common in multiparous women 44.8% and vaginal discharge was the commonest symptom 88%. Cytological study showed 53.6% bacterial vaginosis {BV), 27.2% vulvovaginal candidiasis (VVC), 2.4% trichomoniasis and remaining 17% mixed infections like BV + VVC 15.2% and 1.6% BV + VVC + Trichomoniasis.Conclusions: All women of reproductive age should have mandatory regular evaluation for early detection and proper management of vulvovaginitis. Creating awareness among women improves their quality of life.


Author(s):  
Dr. Satya Narayan Bijarnia ◽  
Dr. Deveshwar Dev ◽  
Dr. R K Gupta

Background: Celiac disease is reported to be the most common genetic and food related intolerance, globally. Celiac disease is an autoimmune disease that reported among genetically susceptible individuals. The autoimmune process is reported to be triggered by a well-identified associated environmental factor known as gluten and its related prolamins which are present in wheat, barley and rye. Material & Methods: The present prospective study was conducted at department of pediatrics of our tertiary care hospital. The study was an observational study on 30 self-reported patients during a period of one year from January 2017 to December 2017. Patients without any exclusion criteria of sex, religion and socioeconomic status were enrolled by simple random sampling. Results: In the present study, on the basis of clinical symptoms we found that in the age group of less than 5 years 75% had diarrhea, 87.5% had abdominal distension, 87.5% had abdominal pain, 75% had anorexia. In the age group of 5-10 years 50% had diarrhea, 66.6% had abdominal distension, 58.3% had abdominal pain, 66.6% had anorexia and 16.6% had constipation. In the age group of more than 10 years 70% had diarrhea, 60% had abdominal distension, 50% had abdominal pain, 40% had anorexia and 20% had constipation. Conclusion: We concluded from the present study that most common clinical symptom among children was diarrhea followed by abdominal distention, pain in abdomen, anorexia, constipation, pallor,edema, vitamin deficiencies and mouth ulcers. Keywords: Celiac disease, IgA-anti tissue transglutaminase antibodies, Screening.


2012 ◽  
Vol 29 (2) ◽  
pp. 109-118 ◽  
Author(s):  
Lidija Dokmanovic ◽  
Nada Krstovski ◽  
Dragan Vukanic ◽  
Dimitrije Brasanac ◽  
Predrag Rodic ◽  
...  

Author(s):  
Rasheed Fatima ◽  
Sandhya M. ◽  
Sowmya T. S.

Background: The ovary is a striking exception to the Virchow’s dictum that organs that are frequently the site of primary cancer are rarely involved in secondary malignancy, and vice versa. Both primary and secondary carcinomas of the ovary are relatively frequent and show an astounding variety of pathologic patterns. The objectives were to study the histomorphological diversity of various neoplasms and non neoplastic lesions of ovary. To provide a specific diagnosis based upon the histomorphological study which is of paramount clinical significance in further management of the patient.Methods: The present study is based on histomorphological evaluation of 100 cases of ovarian neoplastic and non neoplastic lesions received at the department of Pathology, tertiary care hospital from June 2008 to Aug 2010.Results: A wide variation of age was noted. Among neoplastic lesions, majority of the cases were seen in age group of 20-39 years i.e., 50.6%. Non neoplastic lesion occurred in all age group, but majority of the incidences were seen in the age group of 20 to 40 years of age, accounting for 60% of total occurrence. the commonest ovarian tumor was serous cyst adenoma constituting 54.1% (46 cases) of all ovarian neoplasm. Mucinous cyst adenoma was the second most common tumor. There were 72 cases (85%) of benign, 2 cases (2%) of borderline and 11 cases (13%) of malignant tumors in the present study.Conclusions: The diversity of neoplasms makes it mandatory to classify the tumors accurately by histopathological features following universally accepted classification.


2020 ◽  
Vol 27 (07) ◽  
pp. 1401-1407
Author(s):  
Abdul Rabb Bhutto ◽  
Amanullah Abbasi ◽  
Sultan Ahmed Chandio ◽  
Aftab Ahmed Lolai ◽  
Muhammad Arsalan

Objectives: To observe the effects of different combinations of medicines in GERD patients by using FSSG score. Study Design: Observational Study. Setting: Al-Tibri Medical College Hospital, Isra University Karachi Campus Karachi. Period: June 2017 to December 2017. Material & Methods: The study was conducted on GERD patients at Tertiary Care Hospital of Karachi. Adult patients from male and female gender with clinical symptoms suggestive of GERD were included. During clinical history taking patients were interviewed to respond symptoms frequency of FSSG questionnaire score from 0 to 4 on each question. All 154 eligible patients enrolled in the study and divided into three groups Group I (PPI alone), Group II (PPI with prokinetic) and Group III (PPI, prokinetic and SSRI). After 2 weeks of treatment, FSSG score of every participant was calculated. Results: Results of 134 patients 72 (53.3%) males and 63 (46.7%) females were analyzed. The cumulative mean age was 37.12±8.221 (range 16 – 60) years. The patients were grouped by single blind randomization method, each group I and group II consisted of 45 subjects and 44 patients were enrolled in group III. The mean FSSG score prior to treatment and after treatment was 21.194±4.786 and 14.962±3.696 respectively, hence, the gradient of pre-treatment and post-treatment was 6.231±4.601. The three groups shown significant improvement in FSSG score after treatment but the group III had shown highest improvement in mean FSSG score of 7.522±3.592, followed by group II with 7.2889±3.805and group I had shown the lowest improvement of 3.911±5.346 but statistical analysis revealed these improvements within each group as insignificant while turned to be significant when groups were analyzed with each other. (p 0.003). Conclusion: The results of this study suggests that PPIs alone have good therapeutic role but as dysmotility aspect of GERD and psychological comorbidity is very common in those patients and is likely to play an important role in response, or failure of response, to proton pump inhibitor treatment. Hence, addition of prokinetic and anxiolytics can augment the response rate.


2017 ◽  
Vol 3 (3) ◽  
pp. 338-343
Author(s):  
Mohammad Didar Khan ◽  
Md. Ibrahim ◽  
Md. Mizanur Rahman Moghal ◽  
Dipti debnath ◽  
Asma Kabir ◽  
...  

Objective: The present epidemiological study was conducted with the objectives of providing an insight into the current use of antidiabetic medications to diabetics and hypertensive diabetics in urban areas and determining how the patient factors influence the prescribing of antidiabetic medications. Methodology: Data of patients of past two years were collected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. The details were entered in the structured patient profile form. Data were statistically analyzed using the Microsoft Excel 2007 software. Result: A total of 958 patient’s data were collected and analyzed of which 632 (65.97 %) were males and 326 (34.03 %) were females. These patients were further categorized based on their age. 330 patients (34.45 %) belonged to the age group 20 – 44 years, 504 (52.61 %) to the age group 45 – 65 years and 124 (12.94 %) to the age group 65 – 80 years. 684 (71.4%) patients out of the 958 patients studied were suffering from coexisting hypertension. Co-existing hypertension was found to be more prevalent in the age group 45 – 65 years (67.69%) and was found more in females (84.04%). Conclusion: Metformin was the oral hypoglycemic which was the highest prescribed. In hypertensive diabetics Metformin and Pioglitazone were most frequently prescribed drugs. Biguanides and Insulin were the most commonly prescribed antidiabetics. A combination of two or more drugs of different classes was prescribed to hypertensive diabetics. It is necessary to have an improved understanding of the etiology and pathophysiology of diabetes to focus on research efforts appropriately.


Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.


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