scholarly journals PRIMARY OSTEOSARCOMA DISTAL FEMUR;

2013 ◽  
Vol 20 (02) ◽  
pp. 256-260
Author(s):  
FAAIZ ALI SHAH ◽  
ABDUL AZIZ ZIA ◽  
ZAHIR KHAN ◽  
Kifayatullah -
Keyword(s):  
Pulmonary Metastasis ◽  
Distal Femur ◽  
Tertiary Care ◽  
Case Series ◽  
Pulmonary Involvement ◽  
Initial Presentation ◽  
Initial Assessment ◽  
Careful Examination ◽  
Care Hospital ◽  
Primary Osteosarcoma

Objectives: This study was designed to estimate the incidence rate of pulmonary metastasis at the time of diagnosis ofprimary osteosarcoma distal femur in a tertiary care hospital. Study Design: Descriptive case series. Setting and Duration: OrthopaedicSurgery Unit, Mardan Medical Complex Teaching hospital, Bacha Khan Medical College, Mardan, KPK, Pakistan from March 2011 toSeptember 2012. Methodology: Nine patients of primary osteosarcoma distal femur were assessed with CT chest for pulmonarymetastasis. The frequency and patterns of pulmonary metastasis on CT chest were documented. After the biopsy reports all patientswere referred for neo adjuvant chemotherapy before any definite surgical procedure. The histological types of osteosarcoma were noted.RESULTS: Nine patients including 7 male (77.7%) and 2 females (22.2%) with mean age 12.4 years were included in our study. 66.6 %(n=6, 5 males, 1 female) had pulmonary metastasis on CT chest at initial presentation while 33 %( n=3,2 males,1 female) had nopulmonary metastases on CT chest. Three (50%) patients had pulmonary metastasis in the right lung, 1(16.6%) had on left side while2(33.3%) had bilateral pulmonary involvement. Of the cases with metastases at diagnosis, 55.5% had osteoblastic histology ofosteosarcoma compared with 33.3% of those with non metastatic disease. Conclusions: Majority of osteosarcoma distal femurpresented with pulmonary metastasis at initial presentation. A high index of suspicion accompanied by careful examination of the limband appropriate radiographs at initial assessment may reduce the incidence of such delays in diagnosis and the associated risks.

scholarly journals Providing safe care for patients in the coronavirus disease 2019 (COVID-19) era: A case series evaluating risk for hospital-associated COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Adult Patients ◽  
Care Hospital ◽  
Strict Adherence ◽  
Large Tertiary Care ◽  
Healthcare Associated ◽  
Serology Testing ◽  
Pcr Test

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.

A STUDY OF THE MORPHOLOGY OF PLACENTA IN TERTIARY CARE HOSPITAL OF CENTRAL KARNATAKA, INDIA

2021 ◽  
pp. 51-53
Author(s):  
Saryu Sain ◽  
Tupakula Sharmila ◽  
Uttam Kumar ◽  
Anita Anita
Keyword(s):  
Tap Water ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Careful Examination ◽  
Minimum Length ◽  
Care Hospital ◽  
Dispersal Pattern ◽  
Medical College ◽  
Foetal Membranes ◽  
Morphology And Morphometry

Introduction: Placenta is a temporary structure, developed during Pregnancy and discarded at Parturition. Human Placenta is of Discoid and Haemo-Chorial type. It connects the foetus with the mother's womb. It is formed by the contribution of two Individuals - both Mother and Baby. At 1 term four- fth of Placenta is of foetal origin and one- fth is of maternal. Along with Amnion, Chorion, Allantois and Yolk sac, Placenta can also be considered as one of the foetal membranes, which acts as Nutritive and Protective to the developing Embryo. Method: - The present study was done on morphology and morphometry of 150 placentae carried at the Department of Anatomy, Basaveshwara Medical College & Hospital (BMCH), Chitradurga. The placentae were collected with prior ethical clearance and proper consent. Soon after the delivery the placental surface was washed thoroughly under running tap water which were then weighed, tagged and brought to the department of Anatomy, BMCH. The parameters like size, shape and attachment of umbilical cord were noted down. Gross examination was carried out according to the proforma. Result: - The maximum number of placentae belong to the range of 501-600 gms (38.7%). Least placental weight is recorded as 205 gms, showing dispersal pattern. The maximum recorded weight is 835 gms and the average being 491.4 gms. The majority of the placentae are discoid (63.3%). The minimum length recorded is 8.9 cms, maximum as 23.80 cms and the average being 18.3 cms. Conclusion: - Careful examination of Placenta can help in explaining adverse outcomes, their management in subsequent pregnancies and assessment of new born risk.

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

scholarly journals Pulmonary Manifestations in Paediatric Rheumatic Diseases (PRDs): Experience in Tertiary Care Hospital

2018 ◽  
Vol 41 (2) ◽  
pp. 96-100
Author(s):  
Mohammad Imnul Islam ◽  
Kalayan Benjamin Gomes ◽  
Mujammel Haque ◽  
Mohammed Mahbubul Islam ◽  
Manik Kumar Talukder ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Pulmonary Function Tests ◽  
Tertiary Care ◽  
Pulmonary Involvement ◽  
Care Hospital ◽  
Cross Sectional ◽  
Pulmonary Manifestations ◽  
Paediatric Rheumatic Diseases

Background: There are several forms of pulmonary manifestations in Paediatric Rheumatic Diseases (PRDs), not only by the disease itself, but also by infections and toxicity of medications used for treatment.Objectives: To evaluate the pulmonary manifestations and to identify their pattern in PRDs including Systemic Lupus Erythematosus (SLE), Juvenile Idiopathic Arthritis (JIA), Systemic Sclerosis (SSc), Juvenile Dermatomyositis (JDM) and Polyarteritis Nodosa (PAN) patients.Methods: It was a cross-sectional analytical study. PRDs with pulmonary problems who attended the Paediatric Rheumatololgy follow up clinic of BSMMU from January 2010 to December 2014 were enrolled in this study. All patients having PRDS with pulmonary symptoms were investigated by chest x-ray. High regulation CT scan of Chest (HRCT) and pulmonary function tests (PFTs) were done in some of the feasible cases.Results: Total 20 cases were identified as paediatric rheumatic diseases with pulmonary manifestations. Out of them 8 patients were diagnosed as SLE, 6 patients as SSc, 4 patients as JIA, and 2 patients as JDM and PAN respectively. Mean age of the patients were 8.5 years. Fever (86.8%), prolonged cough (65%), dyspnoea (29%) and chest pain (3%) were the common pulmonary features. Pneumonitis (35%), pleural effusion (29.3%), consolidation (23.5%) were important radiological findings. Chest CT were done in 5 patients and features of brochiectasis (75%), thickening (25%), pleural effusion (50%) and pneumonitis (50%) were found. The higher rate of pulmonary involvement was found in Ssc (100%). Spirometric analysis were done in only 7 patients and found restrictive pattern of defect and most of them were SSc.Conclusion: Pulmonary manifestations in PRDs were not uncommon. SLE, JIA and SSc were the predominant PRDs who had pulmonary manifestations obsevered in this study. So timely intervention of this issue could minimize morbidity and mortality of these diseases in the long run.Bangladesh J Child Health 2017; VOL 41 (2) :96-100

The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan: 2011-2016

2017 ◽  
Vol 157 (4) ◽  
pp. 602-607 ◽  
Author(s):  
Alexander Lanigan ◽  
Brentley Lindsey ◽  
Stephen Maturo ◽  
Joseph Brennan ◽  
Adrienne Laury
Keyword(s):  
Soft Tissue ◽  
Tertiary Care ◽  
Case Series ◽  
Soft Tissue Injuries ◽  
Published Data ◽  
Care Hospital ◽  
Neck Injuries ◽  
Facial Fractures ◽  
Tympanic Membrane Perforations ◽  
Tissue Injuries

Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.

scholarly journals Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Female Gender ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Case Series Study

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.

scholarly journals Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

2021 ◽  
Vol 19 (1) ◽  
pp. 25-29
Author(s):  
Manoj Chaudhary ◽  
Sudha Agrawal
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Case Series ◽  
Sun Exposure ◽  
Care Hospital ◽  
Facial Erythema ◽  
Case Series Study ◽  
The Face ◽  
Triggering Factor ◽  
Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour.   Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face.   Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017.   Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%).   Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

scholarly journals Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center

2021 ◽  
Author(s):  
Tilak TVSVGK ◽  
Ajay Handa ◽  
Kishore Kumar ◽  
Deepti Mutreja ◽  
Shankar Subramanian
Keyword(s):  
Observational Study ◽  
Pulmonary Toxicity ◽  
Imaging Finding ◽  
Tertiary Care ◽  
Case Series ◽  
Fiberoptic Bronchoscopy ◽  
Chemotherapeutic Agents ◽  
New Drugs ◽  
Care Hospital ◽  
Persistent Symptoms

Abstract Background Pulmonary toxicity due to chemotherapeutic agents can occur with many established and new drugs. Strong clinical suspicion is important as the clinical presentation is usually with nonspecific symptoms like cough, dyspnea, fever, and pulmonary infiltrates. Timely discontinuation of the offending agent alone can improve the condition. Methods A prospective observational study on patients receiving chemotherapy at an 800-bedded tertiary care hospital was performed from 2014 to 2016. Consecutive patients on chemotherapy, presenting with nonresolving respiratory symptoms were evaluated with contrast-enhanced computerized tomography of chest, diffusion lung capacity for carbon monoxide (DLCO), fiberoptic bronchoscopy with lavage, and biopsy, after excluding all causes for pulmonary infections. Descriptive data has been depicted. Results A total of 18 patients were evaluated for persistent symptoms of dry cough, dyspnea, and fever among 624 who received chemotherapy during the study period. Ground-glass opacities on high-resolution CT was the most common imaging finding, others being patchy subpleural consolidation and pleural effusion. Lymphocyte-predominant bronchoalveolar lavage was detected in nine. Eight of the 15 patients who underwent DLCO, had abnormal results. Seven had significant histopathological findings on bronchoscopic lung biopsy, which revealed organizing pneumonia as the most common pattern. Paclitaxel, fluorouracil, gemcitabine, and tyrosine kinase inhibitors were the common culprit drugs. Discontinuation alone of the culprit drug was effective in 15 and 3 needed oral corticosteroids for relief of symptoms. None of the patients died due to the toxicity. Conclusion An incidence of 2.8% for chemotherapy-induced lung injury was seen in our observational study of 3 years, with parenchymal, interstitial, and pleural involvement due to various chemotherapeutic agents. Oral steroids maybe required in a subset of patients not responding to discontinuation of the culprit agent.

scholarly journals Immediate Outcomes of Traumatic Brain Injury at a Tertiary Care Hospital Of Pakistan- A Retrospective Study

2020 ◽  
Author(s):  
Maria Khan ◽  
Uzair Yaqoob ◽  
Zair Hassan ◽  
Muhammad Muizz Uddin
Keyword(s):  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Initial Assessment ◽  
Care Hospital ◽  
Hospital Data ◽  
Epidemiological Characteristics ◽  
The Impact

Abstract Background: Traumatic Brain Injury (TBI) which is the leading cause of morbidity and mortality all over the world and the impact is much worse in Pakistan. The objective of the study is to describe the epidemiological characteristics of patients with TBI in our country and to determine the immediate outcomes of patients with TBI after the presentation.Method: This retrospective study was conducted at the Lady Reading Hospital. Data were extracted from the medical record room from January 1st to December 31st, 2019. The severity of TBI was based on Glasgow Coma Scale (GCS) and was divided into mild (GCS 13-15), moderate (GCS 9-12), and severe TBI (GCS <8) based on the GCS. SPSS v.23 was used for data analysis. Results: Out of 5047 patients, 3689 (73.1%) males and 1358 (26.9%) females. The most commonly affected age group was 0-10 years (25.6%) and 21-30 years (20.1%). was the predominant cause of injury (38.8%, n=1960) followed by fall (32.7%, n=1649). Most (93.6%, n=4710) of the TBIs were mild. After the full initial assessment and workup, and completing all first-aid management, the immediate outcome was divided into four, most frequent (67.2%, n=3393) of which was “disposed (discharged)”, and 9.3% (n=470) were admitted for further management.Conclusion: Our study represents a relatively conclusive picture of epidemiological data on the burden of TBI in Pakistan. Although a large proportion of patients had a mild TBI, they may likely be under-diagnosed. This warrants for further investigation of MTBI in population-based studies across the globe.

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