scholarly journals AMEBIC LIVER ABSCESS

2010 ◽  
Vol 17 (04) ◽  
pp. 527-531
Author(s):  
RANA ASRAR AHMAD KHAN ◽  
FAKHAR Hameed ◽  
M. BADAR BASHIR ◽  
Mohamad Mohsin Rana ◽  
Hamed Raza Mazhar
Keyword(s):  
Liver Abscess ◽  
Case Series ◽  
Left Lobe ◽  
Amoebic Liver Abscess ◽  
High Grade Fever ◽  
Case Series Study ◽  
Common Diagnosis ◽  
Clinical Background ◽  
The Right

Amoebic liver abscess is a common infection in third world countries like ours due to poor sanitary arrangements. It presents with severe pain and high grade fever and if not diagnosed and treated promptly, may lead to complications and mortality. Objectives: To estimate the incidence, need for aspiration and treatment outcome. Design: Case series study. Setting: At respective consultations centers inFaisalabad. Period: From 1st, January, 2007 to 31st December 2008. Patients and Methods: All patients suspected of the diagnosis of liver abscess whether presenting to physicians or surgeon were referred for ultrasonography for the confirmation of the diagnosis. Basic biodata, coexisting medical or surgical diseases and relevant investigation were recorded, and patient was assessed for the need to aspirate the abscess. After initial treatment patients were reassessed for the need to aspirate the abscess on third, tenth and twentieth day both clinically and ultrasonically. Results: We had 188 cases in the study. There were 128(68 %) males and 60 (32%) females. Majority, 156 (76.6%), of the abscesses were single, 40(21%) had double and 4 (2%) had three abscesses.166 (83%) were situated in the right lobe, 28(15%) in the left lobe and 4 (2%) had abscess in both lobes. 16 (9%) were aspirated at presentation due to their size or position. Only 4 (2%) were aspirated at first follow-up on third day due to non resolution of pain or fever or increase in size. All the patients who were not lost from follow up responded to standard treatment of metronidazole. Discussion: Amoebic liver abscess is a common diagnosis in our setup. Patients presents with right upper quadrant pain and fever. Clinical background and ultrasonogram give a reasonable suggestion about amoebic etiology. If initial aspiration is not indicated due to size larger than 5cm. or proximity to surface or nonresolution of symptoms or lesion in left lobe, conservative treatment with oral or intravenous metronidazole is successful.

scholarly journals AMEBIC LIVER ABSCESS

2010 ◽  
Vol 17 (03) ◽  
pp. 527-531
Author(s):  
RANA ASRAR AHMAD KHAN ◽  
FAKHAR HAMEED ◽  
M. BADAR BASHIR ◽  
Mohamad Mohsin Rana ◽  
Hamed Raza Mazhar
Keyword(s):  
Liver Abscess ◽  
Case Series ◽  
Left Lobe ◽  
Amoebic Liver Abscess ◽  
High Grade Fever ◽  
Case Series Study ◽  
Common Diagnosis ◽  
Clinical Background ◽  
Right Lobe ◽  
The Right

Amoebic liver abscess is a common infection in third world countries like ours due to poor sanitary arrangements. It presents with severe pain and high grade fever and if not diagnosed and treated promptly, may lead to complications and mortality. Objectives: To estimate the incidence, need for aspiration and treatment outcome. Design: Case series study. Setting: At respective consultations centers in Faisalabad. Period: From 1st, January, 2007 to 31st December 2008. Patients and Methods: All patients suspected of the diagnosis of liver abscess whether presenting to physicians or surgeon were referred for ultrasonography for the confirmation of the diagnosis. Basic biodata, coexisting medical or surgical diseases and relevant investigation were recorded, and patient was assessed for the need to aspirate the abscess. After initial treatment patients were reassessed for the need to aspirate the abscess on third, tenth and twentieth day both clinically and ultrasonically. Results: We had 188 cases in the study. There were 128(68 %) males and 60 (32%) females. Majority, 156 (76.6%), of the abscesses were single, 40(21%) had double and 4 (2%) had three abscesses.166 (83%) were situated in the right lobe, 28(15%) in the left lobe and 4 (2%) had abscess in both lobes. 16 (9%) were aspirated at presentation due to their size or position. Only 4 (2%) were aspirated at firstfollow-up on third day due to non resolution of pain or fever or increase in size. All the patients who were not lost from follow up responded to standard treatment of metronidazole. Discussion: Amoebic liver abscess is a common diagnosis in our setup. Patients presents with right upper quadrant pain and fever. Clinical background and ultrasonogram give a reasonable suggestion about amoebic etiology. If initial aspirationis not indicated due to size larger than 5cm. or proximity to surface or nonresolution of symptoms or lesion in left lobe, conservative treatment with oral or intravenous metronidazole is successful.

scholarly journals A clinical study on amoebic liver abscess

2014 ◽  
Vol 14 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Aswini Kumar Sahoo ◽  
Sudhasmita Rauta
Keyword(s):  
Liver Abscess ◽  
Medical Science ◽  
Liver Lesion ◽  
Elisa Test ◽  
Left Lobe ◽  
Amoebic Liver Abscess ◽  
High Grade Fever ◽  
Common Diagnosis ◽  
Clinical Background ◽  
Right Lobe

Background: Amoebic liver abscess presents with severe pain and high grade fever and if not diagnosed and treated promptly, may lead to complications and mortality. Aim and objectives: The objective of the present study was to estimate the incidence, need for aspiration and prognosis. The diagnosis was based on clinical features, positive Elisa test, ultrasonography, aspiration of anchovy sauce from the liver lesion, isolation of E. Histolytica (cyst/trophozoite) from the stool of the patient. Result: We had 65 cases in the study. There were 52 males & 13 females with a ratio of 4:1. Solitary abscess was found in 48 (73.8%) patients which are located as follows; right lobe(43), left lobe(2) and in both lobe(3). 9% were aspirated at presentation due to their size or position. Only 4 (2%) were aspirated at first follow-up on third day due to non resolution of pain or fever or increase in size. All the patients are responded to standard treatment of metronidazole. Amoebic liver abscess is a common diagnosis in our setup. Conclusion: Clinical background and sonogram give a reasonable suggestion about amoebic etiology. If initial aspiration is not indicated due to size larger than 10 cm or proximity to surface, conservative treatment with oral or intravenous metronidazole is successful. DOI: http://dx.doi.org/10.3329/bjms.v14i1.15525 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.49-52

scholarly journals A COMPARATIVE STUDY OF CONSERVATIVE MANAGEMENT VERSUS ULTRASOUND GUIDED ASPIRATION OF SMALL AMOEBIC LIVER ABSCESS

2020 ◽  
Vol 7 (2) ◽  
pp. 165-171
Author(s):  
Osman Musa ◽  
Mohd Faizan Khan ◽  
Bichitra Nath Shukla ◽  
Nisar Ahmed Ansari ◽  
Brijesh Rathore
Keyword(s):  
Liver Abscess ◽  
Conservative Management ◽  
Medical Management ◽  
Surgical Intervention ◽  
Amoebic Liver Abscess ◽  
Ultrasound Guided ◽  
Chief Complaints ◽  
Right Lobe ◽  
The Right

To compare the outcome of patients undergoing conservative management versus ultrasound guided aspiration of small amoebic liver abscess (=<200ml). This observational prospective study was conducted on 60 patients, aged between 18 to 80 years,After confirming the diagnosis, patients were exposed to medical management or USG guided Aspiration. Patients coming for regular follow-up after completing treatment were included in the study. It was found that the majority of the patients were male (86.7%) and with mean age of the studied patients was 37.10±12.66 years. Chief complaints were pain (100%) followed by fever (85.0%) and Nausea/Vomiting (48.3%) pallor (33.3%), icterus (25.0%) and Tenderness (16.7%). Majority of patients had the right lobe of the liver affected (93.4 %) with Single abscess (94.0%). Duration of Hospital stay and time of half reduction in size was significantly higher in conservative management than the USG guided Aspiration. Reoccurrence of abscess in conservative management was in 6 (20.0%) and need of Surgical intervention was in 4 (13.3%) patients while in USG guided Aspiration group only 1 (3.3%) patient shows Reoccurrence. No mortality was observed in our study. In the present study abscess containing volume of pus (<200 cc) was treated with either conservative treatment or USG guidedAspiration. Our data suggested that the USG guided Aspiration and conservative medical management in treatment ofAmoebic liver abscess are almost equal.

Effect of Isolated Medial Patellofemoral Ligament Reconstruction in Patellofemoral Instability Regardless of Predisposing Factors

2020 ◽  
Author(s):  
Jae Ik Lee ◽  
Mohd Shahrul Azuan Jaffar ◽  
Han Gyeol Choi ◽  
Tae Woo Kim ◽  
Yong Seuk Lee
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Trochlear Dysplasia ◽  
Case Series ◽  
Patellofemoral Instability ◽  
International Knee Documentation Committee ◽  
Predisposing Factors ◽  
Mpfl Reconstruction ◽  
Patellar Tilt ◽  
Case Series Study

AbstractThe purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to −0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18–74) preoperatively to 94.71 (range: 86–100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10–81) preoperatively to 94.14 (range: 86–100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT–TG distance, or valgus alignment. This is a Level 4, case series study.

The case for skin camouflage in the management of upper limb scarring – A case series

Hand Therapy ◽  
2021 ◽  
pp. 175899832110078
Author(s):  
Laura Adamson ◽  
Anna Selby
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Primary Objective ◽  
Self Confidence ◽  
Published Evidence ◽  
Case Series Study ◽  
Visual Impact ◽  
Series Study ◽  
Increasing Function

Introduction For some people the appearance of their hands is as important as function. Upper limb scarring can cause some patients distress. Skin camouflage is an intervention that can be used to reduce the visual impact of a scar but there is limited published evidence for its use for hand scarring. Methods This is a case series study with a primary objective to determine whether skin camouflage reduces distress in patients with an upper limb scar and to evaluate this new service. Patients experiencing distress from an upper limb scar were recruited from a hand therapy outpatient clinic. The intervention delivered was a one hour skin camouflage session. Photographs of the upper limb pre and post skin camouflage intervention were taken. The patient-rated Michigan Hand Questionnaire (MHQ) and Derriford Appearance Scale (DAS24) were completed before treatment, at 1 week and 1 month after treatment. Results Six participants reporting distress from an upper limb scar received skin camouflage intervention. Only three out of six participants completed all follow-up. All three showed improvement in at least two domains of the MHQ (function and aesthetics) at one month post treatment. Increased confidence during functional and work-based activities was also reported on the DAS24. Participants reported increased engagement in daily activities as a result of being able to camouflage their scars. Conclusions This small case series shows that skin camouflage intervention may be beneficial for some patients who are experiencing distress related to an upper limb scar by increasing function and self-confidence.

scholarly journals The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

2020 ◽  
pp. 219256822098044
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Hitoshi Shitara ◽  
Tokue Mieda ◽  
Eiji Takasawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biceps Brachii ◽  
Case Series ◽  
Manual Muscle Test ◽  
Cuff Tear ◽  
Cervical Spondylotic Amyotrophy ◽  
Case Series Study ◽  
Shoulder Abductor ◽  
Series Study

Study Design: Case series study. Objective: We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). Methods: We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. Results: Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. Conclusion: RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.

Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

2021 ◽  
pp. 107110072199542
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph O’Neil ◽  
Steven Raikin
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Return To Sport ◽  
Osteochondral Lesions ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Additional Surgery ◽  
Case Series Study

Background: Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair. With orthobiologics being proposed to augment repair, there exists a clear gap in the study of long-term clinical outcomes of microfracture to determine if this added expense is necessary. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopedic surgeon from 2007 to 2009 was performed. Patients meeting the inclusion criteria were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales and visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure and their likelihood to recommend the procedure to a friend with the same problem using 5-point Likert scales. Patient demographics were reviewed and included for statistical analysis. Results: Of 45 respondents, 3 patients required additional surgery on their ankle for the osteochondral defect, yielding a 10-year survival rate of 93.3%. Of surviving cases, 90.4% (38/42) reported being “extremely satisfied” or “satisfied” with the outcome of the procedure. The VAS score at follow-up averaged 14 out of 100 (range, 0-75), while the FAAM-ADL and FAAM-Sports scores averaged 90.29 out of 100 and 82 out of 100, respectively. Thirty-six patients (85.7%) stated that their ankle did not prevent them from participating in the sports of their choice. Conclusion: The current study represents a minimum 10-year follow-up of patients undergoing isolated arthroscopic microfracture for talar osteochondral defects, with a 93.3% survival rate and 85.7% return to sport. While biological adjuvants may play a role in improving the long-term outcomes of microfracture procedures, larger and longer-term follow-up studies are required for procedures using orthobiologics before their cost can be justified for routine use. Level of Evidence: Level IV, retrospective cohort case series study.

scholarly journals Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

2021 ◽  
Author(s):  
Ilkka Rauma ◽  
Tiina Mustonen ◽  
Juha Matti Seppä ◽  
Maritta Ukkonen ◽  
Marianne Männikkö ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Events ◽  
Case Series ◽  
Retrospective Case ◽  
Serious Adverse Events ◽  
Highly Active ◽  
Disease Modifying Therapy ◽  
Case Series Study ◽  
Multiple Sclerosis Patients

Abstract Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.

scholarly journals Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

2014 ◽  
Vol 86 (1) ◽  
pp. 15 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Hassan El-Tatawy ◽  
Ahmed Eissa ◽  
Abdel Hamid Elbahnasy ◽  
Mohamed Elbendary
Keyword(s):  
Case Series ◽  
Surgical Reconstruction ◽  
Urethral Injury ◽  
Penile Curvature ◽  
Retrospective Case ◽  
Penile Fracture ◽  
Case Series Study ◽  
Long Term Follow Up

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

scholarly journals Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Teaching Hospital ◽  
Case Series ◽  
University Teaching ◽  
Case Series Study ◽  
The Mean ◽  
The University

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

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