scholarly journals Retrospective Analysis of Firecracker Injuries and Review of Literature at a Tertiary Eye Care Hospital in South India

2021 ◽  
Author(s):  
Kirandeep Kaur ◽  
Bharat Gurnani ◽  
Isha Gupta ◽  
Veena Kannusamy ◽  
Shivananda Narayana
Keyword(s):  
Retrospective Analysis ◽  
Care Hospital ◽  
Eye Care ◽  
Female Ratio ◽  
Open Globe ◽  
Eye Involvement ◽  
The Mean ◽  
Total Blindness ◽  
Anatomical Outcomes

Abstract Purpose: To analyze demographics, risk factors, clinical features, functional, anatomical outcomes, and prevalence of blindness in firecracker injury patients presenting to a major tertiary eye care centre.Methodology: A retrospective analysis of firecracker injury patients who presented to our tertiary eye care hospital was performed from April 2018 to March 2019. A total of 114 patients with a minimum follow-up of 3 months were included. The parameters recorded were demographics, mode of injury, type of cracker, baseline best-corrected visual acuity (BCVA) and on last follow up, detailed anterior and posterior segment evaluation, seidel's test, intraocular pressure, gonioscopy, complications, treatment, functional and anatomical outcomes. Investigations in the form of B Scan, X-ray, or CT scan were undertaken whenever indicated. Results: A total of 132 eyes of 114 patients were analysed. The mean (SD) age of patients was 18.96 +/- 15.4 years (range 3-71 years). Seventy-four (64.91%) patients were less than or equal to 18 years of age. The male-to-female ratio was 4:1. The ratio of right: left eye involvement was 1:1. Eighteen patients (15.79%) had bilateral involvement. A total of 125 eyes had closed globe injury, 7 eyes had open globe injury and 17 patients needed hospital admission for management. The mean (SD) baseline BCVA was 0.54(+/- 0.75). The mean (SD) final BCVA improved to 0.23(+/- 0.62) till the last follow-up. The final outcome was good in most patients, except 5 eyes (3.78%) which resulted in near/total blindness. Conclusion: Firecracker injuries are a major cause of irreversible blindness, and these are more common in the younger age group (64.91%). Prompt diagnosis with meticulous management can prevent devastating sequelae.

scholarly journals Clinical profile of retinoblastoma presenting in a tertiary care hospital, eastern Nepal

2017 ◽  
Vol 13 (3) ◽  
pp. 129-136
Author(s):  
Poonam Lavaju ◽  
BP Badhu ◽  
S Shah ◽  
SK Chaudhary ◽  
P Upadhyaya
Keyword(s):  
Optic Nerve ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Mode Of Presentation ◽  
The Mean ◽  
Clinical Records

Background: Retinoblastoma is the commonest primary intraocular malignancy of childhood. Under-standing the different modes of presentation with timely intervention are associated with prognosis.Objective: To determine the clinical profile of retinoblastoma and its association with optic nerve infiltration by tumor.  Methods: A retrospective analysis of the clinical records and histopathological reports of patients admitted with retinoblastoma in a tertiary heath care center, eastern Nepal (June 2009 to July 2012) was carried out.Results: A total of 27 patients (28 eyes) with retinoblastoma were studied. The mean age at presentation was 2.89 ± 0.93 years. The mean duration of symptoms to presentation was 3.35 month, ranged from 7 days to 2 years. Male to female ratio was 3:2. Thirty-three percent patients were Muslims. Twentyseven patients (96.3%) had unilateral eye involvement. The commonest mode of presentation was leukocoria in 23 eyes (85.2%) followed by redness 9 eyes (33.3%), proptosis in 5 eyes (18.5%) and phthisis bulbi in one eye (3.7%). Histopathological reports of 26 eyes confirmed the diagnosis of retinoblastoma. One patient with distant metastases was referred to oncology center. Infiltration of the optic nerve by tumor cells was seen in five eyes (18.5%); of which two cases had proptosis (p-0.166). At two years follow up, recurrence was seen in one patient with proptosis and optic nerve infiltration (p-0.136). Age at presentation was positively associated with recurrence of tumor (p-0.005).Conclusion: Leucokoria was the most common mode of presentation of retinoblastoma. Larger sample size with longer follow up is required to come to a definite association with optic nerve infiltration by tumor. Health Renaissance 2015;13 (3): 129-136

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Gamma Knife surgery for invasive pituitary macroadenoma

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 26-30 ◽  
Author(s):  
Mooseong Kim ◽  
Sunghwa Paeng ◽  
Seyoung Pyo ◽  
Yeonggyun Jeong ◽  
Sunil Lee ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Pituitary Adenomas ◽  
Gamma Knife Surgery ◽  
Tumor Control ◽  
Pituitary Macroadenoma ◽  
Female Ratio ◽  
Fractionated Radiotherapy ◽  
The Mean

ObjectPituitary adenomas have been treated using a variety of modalities including resection, medication, fractionated radiotherapy, and stereotactic radiosurgery. The policy has been that all adenomas should first be treated with resection to reduce the volume of the tumor. The authors' study was conducted to determine the efficacy of using Gamma Knife surgery (GKS) for pituitary adenomas invading the cavernous sinus.MethodsOf 397 patients with pituitary tumors who underwent GKS between October 1994 and October 2005, 68 patients had pituitary macroadenomas invading the cavernous sinus. Sixty-seven cases were available for follow up. The mean age of the patients in these cases was 42.8 years (range 14–73 years). The male/female ratio was 0.8:1. The mean adenoma volume was 9.3 cm3. A total of 24 patients had undergone craniotomies and resection, and 11 patients had undergone transsphenoidal surgery prior to GKS. The mean follow-up period was 32.8 months. Tumor control was defined as a decrease or no change in tumor volume after GKS. Endocrinological improvement was defined as a decline in hormone levels to below 50% of the pre-GKS level.Tumor control was achieved in 95.5% of the cases. Endocrinological improvement was achieved in 68% of 25 patients. One patient suffered hypopituitarism after GKS.Conclusions Gamma Knife surgery is a safe and effective treatment for invasive pituitary macroadenoma with few complications.

scholarly journals Effect of Analgesia on Complication Free Postoperative Outcome among Day-Care ENT Surgeries in a Tertiary Care Hospital

2020 ◽  
Vol 7 (49) ◽  
pp. 2923-2927
Author(s):  
Jayachandran C.G ◽  
Sanjay Sahadevan ◽  
Sandhya M.S
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Postoperative Period ◽  
Day Care ◽  
Pain Intensity Score ◽  
Care Hospital ◽  
Female Ratio ◽  
Associated Symptoms ◽  
The Mean ◽  
Care Surgery

BACKGROUND Day-care procedures have become accepted and popular among the surgeons and anaesthesiologists all over the world in recent times especially for ENT surgeries. The economic and financial implications are making them acceptable among the general population also. Alleviating acute pain during immediate postoperative period plays a crucial role in deciding the fitness for discharge of the patient. We wanted to evaluate the pain intensity and observe the role of analgesia in its alleviation in postoperative period following day-care ENT surgeries. METHODS 96 adult patients undergoing various types of day-care surgeries in the department of ENT were included in this study. The pain scores were measured using Verbal Pain Intensity Score (VPIS) at frequent two hourly intervals. Opioids, and Paracetamol were used as analgesics. Antiemetic Ondansetron was used to combat nausea and vomiting. The effect of analgesics was assessed using mean values and Friedman test for repeated measures. RESULTS Out of 96 patients 55 (57.29 %) were males and 41 (42.70 %) were females with a male to female ratio of 1.4:1. The mean age was 31.50 ± 4.15 years. 32 / 96 (33.33 %) ear surgeries, 26 / 96 (27.08 %) nose surgeries, 22 / 96 (22.91 %) throat surgeries and 16 / 96 (16.66 %) head and neck surgeries were performed. Moderate to extremely intense grade pain was noticed in 75 / 93 (80.64 %) patients. CONCLUSIONS The prevalence of moderate to extremely intense acute postoperative pain in 75 / 93 (80.64 %) patients was high. But the analgesics prescribed were effective to control the pain and the mean pain intensity was less than 2 in 14 hours, hence 85 / 96 (88.54 %) patients could be discharged in time. The associated symptoms were managed with supportive care and required no additional medications and these patients were discharged after overnight stay. KEYWORDS Day-Care Surgery, Analgesia, Opioids, VPIS, Associated Symptoms, Postoperative Pain

scholarly journals Arthroscopic Diagnosis and Treatment of Chronic Hip Pain After Total Hip Arthroplasty and the Role of Anterior Capsule Disruption in Iliopsoas Tendinopathy

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711985436 ◽  
Author(s):  
Mark R. Nazal ◽  
Ali Parsa ◽  
Scott D. Martin
Keyword(s):  
Total Hip Arthroplasty ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Arthroscopic Surgery ◽  
Strength Test ◽  
Hip Pain ◽  
Anterior Capsule ◽  
The Mean

Background: The use of hip arthroscopic surgery in patients suffering from chronic hip pain after total hip arthroplasty (THA) has a limited presence in the literature, with most studies having limited follow-up. Purpose: The first goal of this study was to evaluate hip arthroscopic surgery in the diagnosis and management of patients with chronic hip pain after THA. The second goal was to describe a new cause of iliopsoas tendinopathy (IPT) involving disruption of the anterior capsule. Study Design: Case series; Level of evidence, 4. Methods: We conducted a retrospective analysis with prospectively collected clinical outcomes of patients after THA who underwent hip arthroscopic surgery for chronic hip pain without an identifiable cause. The patients were at least 18 years old and had a minimum follow-up of 24 months. Results: The retrospective analysis found that hip arthroscopic surgery led to new diagnostic information in 8 patients (80%). Of the 10 patients diagnosed with IPT, 4 (40%) lacked an anatomic cause; however, these patients had a history of difficult exposure of the anterior capsule and/or a lack of capsular repair during index THA. The mean modified Harris Hip Score (mHHS) was 71.9 ± 15.6, and the mean 6-month postoperative visual analog scale (VAS) pain score was 0.8 ± 2.2, which was significantly lower than preoperatively ( P = .0055). There was also significantly improved forward flexion range of motion ( P = .0183) and straight leg raise (SLR) strength test results ( P = .0263). Hip arthroscopic surgery resulted in 8 patients (80%) continuing to be pain-free at a mean follow-up of 6.8 ± 1.4 years, while 2 patients (20%) progressed to revision arthroplasty. There were no major or minor complications. Conclusion: Hip arthroscopic surgery was found to have an important role in the diagnostic and therapeutic management of patients with chronic hip pain after THA, with good clinical outcomes at a mean follow-up of 6.8 years and no complications. We believe that disruption of the anterosuperior acetabular capsule, including the reflected head of the rectus femoris, can allow the iliopsoas tendon to move intra-articularly and precipitate IPT. This disruption may be appreciated on the SLR strength test. Although this study presents a small sample size that cannot substantiate a cause-effect relationship, orthopaedic surgeons performing THA should consider minimizing disruption and/or ensuring repair of the anterior capsule to decrease this potential cause of IPT.

scholarly journals Cost effectiveness analysis in the management of stroke in a tertiary care hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 2566
Author(s):  
Gargi Dey ◽  
Jyothi R. ◽  
Girish K.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Socioeconomic Group ◽  
Early Management ◽  
Effectiveness Analysis ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Background: Stroke has a high economic impact on the society especially in a developing country like India. In India health insurance doesn’t cover all people leading to out of pocket expenditure. The objective of the present study was to study the cost of illness and outcome of stroke in a tertiary care hospital.Methods: Direct medical and nonmedical costs were obtained after 28 days of follow-up. The outcome of the stroke was measured by modified Rankin scale (mRS).Results: The mean age of the patients was 65.38±13.98 years. Majority of the patients suffered from ischemic stroke and belonged to lower middle socioeconomic group. The mean cost of stroke was INR 39819. There was improvement in the mRS score after 28 days following treatment of acute stroke.Conclusions:Direct medical costs forms major component of cost of stroke. Early management and hospital discharge can reduce the economic burden of stroke. 

scholarly journals Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single center

2021 ◽  
Author(s):  
Henghai Huang ◽  
Qijian Ding ◽  
XiaoCao Lin ◽  
DeLin Li ◽  
Jingjing Zeng ◽  
...  
Keyword(s):  
Operative Management ◽  
Pathological Examination ◽  
Computed Tomography Imaging ◽  
Tertiary Referral Hospital ◽  
Female Ratio ◽  
Tomography Imaging ◽  
Male Female Ratio ◽  
The Mean ◽  
The Right

Background: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. Methods: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between January 1, 1996, and December 31, 2017. Results: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19–62 years; male: female ratio, 1:1.16), of whom 7 patients had unilateral AS on the right side, and the remaining 6 on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by computed tomography imaging before the operation. Among the patients, 10 were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6–12.6 cm). All patients underwent surgery, with open adrenalectomy in 5 patients and laparoscopy in 8 patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0–11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. Conclusion: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

scholarly journals Clinical Review of Ocular Traumas Resulting in Enucleation or Evisceration in a Tertiary Eye Care Center in Hungary

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Gábor Tóth ◽  
Milán Tamás Pluzsik ◽  
Béla Csákány ◽  
Gábor László Sándor ◽  
Olga Lukáts ◽  
...  
Keyword(s):  
Ocular Trauma ◽  
Care Center ◽  
Clinical Indication ◽  
Time Interval ◽  
Eye Care ◽  
Primary Indication ◽  
Phthisis Bulbi ◽  
Open Globe ◽  
Department Of Ophthalmology ◽  
The Mean

Purpose. To analyse the demographic and clinical characteristics of ocular traumas resulting in enucleation/evisceration in a large tertiary referral center in a developed country (Hungary) over a period of 15 years. Patients and Methods. A retrospective review of enucleated/eviscerated eyes that underwent surgery between 2006 and 2020 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary, due to ocular trauma as the primary indication for enucleation/evisceration. For each subject, clinical history, B-scan ultrasound report, and histopathology results were reviewed. Results. There were 124 enucleated/eviscerated eyes from 124 patients (91 males (73.4%)). The mean age at the time of trauma was 37.3 ± 26.0 years while the mean age at the time of enucleation/evisceration was 46.9 ± 20.3 years. The main clinical diagnoses after ocular trauma were open globe injury (n = 96; 77.4%), ocular burns (n = 6; 4.8%), traumatic optic neuropathy (n = 4; 3.2%), bulbar avulsion (n = 3; 2.4%), traumatic cataract (n = 2; 1.6%), retinal ablation (n = 1; 0.8%), and traumatic carotid-cavernous fistula (n = 1; 0.8%). Among the 124 patients, 98 (79.0%) underwent enucleation and 26 (21.0%) evisceration. Patients who underwent primary enucleation/evisceration (n = 24 19.4%) were significantly older at the time of the injury (57.7 ± 22.7 years) than people who underwent secondary eye removal (32.4 ± 24.4 years) ( p < 0.0001 ). The mean time interval between trauma and enucleation/evisceration was 114.9 ± 163.5 months. The main clinical indications for anophthalmic surgery were atrophia/phthisis bulbi (n = 56, 45.2%), acute trauma (n = 25, 20.2%), painful blind eye due to glaucoma (n = 17, 13.7%), endophthalmitis (n = 10, 8.1%), and cosmetic reasons (n = 7, 5.6%). One patient (0.8%) had sympathetic ophthalmia. Conclusions. Primary enucleation/evisceration was performed in one-fifth of all ocular trauma-related anophthalmic surgeries in our tertiary eye care center with enucleation being the most common procedure. Atrophia/phthisis bulbi was the most frequent immediate clinical indication for enucleation/evisceration.

scholarly journals Clinical Spectrum and Neuroimaging Changes in Neurodegenerative Disorder-Experiences in Tertiary Care Hospital of Bangladesh

2021 ◽  
Vol 2 (6) ◽  
pp. 10-14
Author(s):  
Gopen Kumar Kundu ◽  
Rumana Islam ◽  
Noor E-Sabah ◽  
ABM Mukib
Keyword(s):  
Neurodegenerative Diseases ◽  
Tertiary Care Hospital ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Female Ratio ◽  
History Of ◽  
The Mean ◽  
Male To Female

Neurodegenerative diseases (NDD) are a heterogeneous group of disorders characterized by progressive loss of previously acquired skills that are of varied etiology, clinical manifestations, and natural course. There is a paucity of data on clinical profile of neurodegenerative diseases in our population. We conducted a retrospective study with 68 diagnosed cases of NDD at a tertiary care hospital in Bangladesh. Among them, more than one-third of children were in 1-5 years age group. The mean age was 10.2±3.1 year and male to female ratio was 2:1. Fifty percent of cases had a history of consanguineous parents. Leukodystrophy was most common (30.88%) among NDDs, followed by Wilson disease (26.47), SSPE (22.1%), and Degenerative Ataxia (20.59%). Motor skill regression was the most common presentation (97%), followed by speech regression in 91% and Gait disorder in 83% of children. Seizure was presenting features in 24% of children. Neuroimaging abnormalities were found in 80.88% NDD cases. Among them white matter hyper intensity in 29.41%, cerabeller atrophy in 13.25 %, and cerebral atropy in 11.76% of children. Eye changes were found in about two-thirds (69.12%) of cases of NDD. Among them, optic atrophy was found in 29.41%, and KF rings in 25.00% of cases.

scholarly journals Role of Decompressive Laminectomy without Instrumentation in the Management of Nurick Grade 4 and 5 Cervical Compressive Myelopathy

2019 ◽  
Vol 10 (01) ◽  
pp. 21-27 ◽  
Author(s):  
Sunil Malagi ◽  
Subhas Konar ◽  
Dhaval P. Shukla ◽  
Dhananjaya I. Bhat ◽  
Nishanth Sadashiva ◽  
...  
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Female Ratio ◽  
Decompressive Laminectomy ◽  
Japanese Orthopedic Association ◽  
Poor Grade ◽  
Cervical Compressive Myelopathy ◽  
The Mean ◽  
Ossified Posterior Longitudinal Ligament ◽  
Compressive Myelopathy

ABSTRACT Introduction: Cervical laminectomy is a very well-known posterior decompressive procedure for cervical compressive myelopathy (CCM). Our objective is to evaluate the functional effect of posterior decompressive laminectomy for poor grade CCM. Methods: This study was an observational retrospective study carried out on patients with poor-grade CCM who underwent decompressive laminectomy from January 2010 to December 2015. Patients with Nurick Grades 4 and 5 (walking with support or bedbound) were included in the study. Clinical data and radiological information were collected from medical records, and objective scales were applied to compare the surgical outcome between preoperative score and postoperative score. Results: A total of 69 patients who underwent decompressive laminectomy for poor grade CCM were included. The mean age was 54.9 years, and the male-to-female ratio was 5.3:1. Ossified posterior longitudinal ligament comprised 52.6% cases. The follow-up data of at least 6 months' duration after surgery was available for 57 (82.6%) cases. On comparing with preoperative Nurick grade at follow-up, 40 of the 57 patients (70.2%) were found to have improvement following surgery by at least one grade. The remaining 17 (29.8%) had either remained the same or had deteriorated further. The mean preoperative modified Japanese Orthopedic Association score was 8.4 ± 2.8, and the mean follow-up score was 11.8±0.3 (P = 0.0001). On multivariate analysis, the number of levels of laminectomy, postoperative deterioration, and anesthesia grade were predictors of outcome. Conclusion: Decompressive laminectomy for poor grade myelopathy is effective in improving functional outcome.

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