scholarly journals Clinical evaluation of Amrita Ghrita Sneha-Pana followed by Pippalyadi Yoga Virechana in the management of Vicharchika (chronic dermatitis)

2020 ◽  
Vol 5 (06) ◽  
pp. 1-9
Author(s):  
Pritu Tiwari ◽  
Abhishek Bhattacharjee ◽  
Parashara Murali Krishna
Keyword(s):  
Clinical Presentation ◽  
Assessment Tool ◽  
Treatment Modalities ◽  
Drug Induced ◽  
Standard Assessment ◽  
Post Test ◽  
Analyse Data ◽  
Data Result

Background: Vicharchika is a Kapha dominated Tridoshaja Kshudra Kustha (minor skin disease) primarily characterized by eruptions with hyperpigmentation, itching and profuse discharge, but sometimes there may be dryness with itching, marked linings and thickening of the skin. The clinical presentation of Vicharchika is very much similar to that of Chronic Dermatitis or Eczema. The incidence of the disease is high and the relapsing nature of the disease makes it difficult to cure. Though many treatment modalities are there but in many of the cases the outcome is not satisfactory and long-term conventional treatment increases the chance of drug induced complications. So, in search of an effective, safe and affordable treatment modality the present study was carried-out. Objective: To evaluate the effectiveness of Amrita Ghrita Sneha-pana followed by Pippalyadi Yoga Virecana in the management of Vicarcika (chronic dermatitis). Materials and Methods: An open level clinical trial with pre-test and post test design were carried out where 30 patients suffering from Vicharchika were registered and were treated with Amrita Ghrita Sneha-pana followed by Virechana with Pippalyadi Yoga. Follow-up was done for 60 days. Assessment was done on 0-day, 15th day, 30th day and 60th day based on the symptoms and standard assessment tool specially designed for Chronic Dermatitis (Eczema). Appropriate statistical methods were used to analyse data. Result: Statistically significant improvement was observed in the symptoms of the disease. Conclusion: Amrita Ghrita Snehapana followed by Pippalyadi Yoga Virecana is found to be effective in the management of Vicharchika.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

scholarly journals MBCL-14. A STUDY OF LOW-DOSE CRANIOSPINAL RADIATION THERAPY IN PATIENTS WITH NEWLY DIAGNOSED AVERAGE-RISK MEDULLOBLASTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii390-iii391
Author(s):  
Aaron Mochizuki ◽  
Anna Janss ◽  
Sonia Partap ◽  
Paul Fisher ◽  
Yimei Li ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Treatment Modalities ◽  
Average Risk ◽  
Craniospinal Radiation ◽  
Grade 5 ◽  
Therapy Studies ◽  
Do So

Abstract INTRODUCTION Medulloblastoma is one of the most common malignant brain tumors in children. To date, the treatment of average-risk (non-metastatic, completely resected) medulloblastoma includes craniospinal radiation therapy and adjuvant chemotherapy. Modern treatment modalities and now risk stratification of subgroups have extended the survival of these patients, exposing the long-term morbidities associated with radiation therapy. METHODS We performed a single-arm, multi-institution study, seeking to reduce the late effects of treatment in patients with average-risk medulloblastoma prior to advances in molecular subgrouping. To do so, we reduced the dose of craniospinal irradiation by 25% to 18 gray with the goal of maintaining the therapeutic efficacy as described in CCG 9892 with maintenance chemotherapy. RESULTS 28 patients aged 3–30 years were enrolled across three institutions between April 2001 and December 2010. Median age at enrollment was 9 years with a median follow-up time of 11.7 years. The 3-year relapse-free (RFS) and overall survival (OS) were 78.6% (95% CI 58.4% to 89.8%) and 92.9% (95% CI 74.4% to 98.2%), respectively. The 5-year RFS and OS were 71.4% (95% CI 50.1% to 84.6%) and 85.7% (95% CI 66.3% to 94.4%), respectively. Toxicities were similar to those seen in other studies; there were no grade 5 toxicities. CONCLUSIONS Given the known neurocognitive adverse effects associated with cranial radiation therapy, studies to evaluate the feasibility of dose reduction are needed. In this study, we demonstrate that select patients with average-risk medulloblastoma may benefit from reduced craniospinal radiation dose of 18 gray without impacting relapse-free or overall survival.

Chronic Plantar Heel Pain: Treatment with a Short Leg Walking Cast

1996 ◽  
Vol 17 (1) ◽  
pp. 41-42 ◽  
Author(s):  
Christopher L. Tisdel ◽  
Marion C. Harper
Keyword(s):  
Complete Resolution ◽  
Surgical Intervention ◽  
Pain Treatment ◽  
Heel Pain ◽  
Treatment Modalities ◽  
Plantar Heel Pain ◽  
Long Term Follow Up

The efficacy of a short leg walking cast in the treatment of chronic plantar heel pain was assessed for 32 patients with 37 involved extremities treated over a 2-year period. All patients had failed numerous other treatment modalities and had been symptomatic for an average of 1 year. Long-term follow-up for 24 patients with 28 involved extremities revealed complete resolution of pain for 7 extremities (25%), improvement for 17 (61%), and no improvement for 4 (14%). Ten (42%) patients were completely satisfied with cast treatment, 3 (12%) were satisfied with reservations, and 11 (46%) were dissatisfied. Casting appears to be a reasonable option for patients with recalcitrant heel pain and should be offered before surgical intervention.

scholarly journals Meningiomas of pineal region in children

2007 ◽  
Vol 65 (4a) ◽  
pp. 1000-1006 ◽  
Author(s):  
Hamilton Matushita ◽  
Fernando Campos Pinto ◽  
José Píndaro Pereira Plese
Keyword(s):  
Clinical Presentation ◽  
Complete Removal ◽  
Pineal Region ◽  
Total Resection ◽  
Long Term Follow Up ◽  
One Year ◽  
Velum Interpositum ◽  
Transtentorial Approach

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.

Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature

1993 ◽  
Vol 27 (9) ◽  
pp. 1040-1043 ◽  
Author(s):  
Jerry W. Taylor ◽  
Angela J. Bell
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Lithium Carbonate ◽  
Suspected Drug ◽  
Current Management ◽  
Therapy Discontinuation ◽  
Drug Induced ◽  
Parathyroid Dysfunction ◽  
Management Recommendations

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.

scholarly journals The Role of Ultra-widefield Retinal Imaging as a Standard Assessment Tool in the Cataract Practice

2017 ◽  
Vol 10 (01) ◽  
pp. 31
Author(s):  
Kerry K Assil ◽  
V Nicholas Batra ◽  
◽  
Keyword(s):  
Cataract Surgery ◽  
Assessment Tool ◽  
Comprehensive Evaluation ◽  
Retinal Imaging ◽  
High Expectations ◽  
Optimal Outcomes ◽  
Standard Assessment ◽  
Retinal Pathology ◽  
Quality Of Vision

Comprehensive evaluation of retinal health prior to and following cataract surgery is critical to supporting optimal outcomes. In addition to the importance of identifying retinal pathology that may prevent or delay cataract surgery, continuous advances in refractive intraocular lens technology and cataract surgical technique, coupled with increasingly high expectations regarding visual outcomes among younger patients, make the consideration of long-term quality of vision paramount in the cataract assessment. Optos® ultrawidefield retinal imaging supports this clinical objective by providing imaging standardization in a streamlined, patient-friendly exam process, supporting robust documentation that facilitates mapping of disease progression, and offering potential economic advantages in a resourceconstrained environment.

scholarly journals Case Report: Dilemma To Save Or Not To Save A Tooth

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Yee Woo Yap ◽  
Azillah Mohd Ali
Keyword(s):  
Case Report ◽  
Root Formation ◽  
Dentigerous Cyst ◽  
Permanent Teeth ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Odontogenic Cysts ◽  
Standard Assessment ◽  
Good Healing

Introduction: Dentigerous cyst is the most common odontogenic cysts that are associated with the crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization of the cyst. However, currently there are no standard assessment criteria to dictate which kind of treatment for certain cases. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an unerupted right maxillary permanent canine in an 8-year-old boy. The cyst was enucleated partially but leaving the cystic lining surrounding the unerupted canine in order to preserve the tooth. 3-year follow up revealed good healing with significant root formation and tooth eruption.

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