scholarly journals UPPER GI HEMORRHAGE;

2017 ◽  
Vol 24 (09) ◽  
pp. 1295-1301
Author(s):  
Sanam Panhwar ◽  
Muhammad Aslam Rind ◽  
Maria Nazir Khyber
Keyword(s):  
Gastrointestinal Hemorrhage ◽  
Demographic Data ◽  
Case Series ◽  
Relevant Information ◽  
Gastric Varices ◽  
Operational Definition ◽  
Medical Unit ◽  
Ulcer Disease ◽  
Case Series Study ◽  
Study Results

Objectives: To predict the frequency of rebleeding by pre-endoscopic clinicalRockall scoring system in patients presenting with upper gastrointestinal hemorrhage. StudyDesign: Descriptive Case series study. Period: six months. Settings: Departments of Medicine,Liaquat University of Medical and Health sciences Jamshoro/Hyderabad. Material & Methods:The source of data was 187 patients who reported with the presenting complaint of hematemesisin ER and were then transferred to Medical Unit for further management. At the time of inclusionthe concerned Physician collected the demographic data, vital and relevant information for thepresence of co morbidities. After admission patients were shifted to endoscopy suite (situatedin Medical Unit) for the endoscopic diagnosis of the underlying condition. Any new episode ofhematemesis was considered as a re-bleed (within 120 hours of time zero). Rockall scoringwas calculated as per operational definition in the specifically designed proforma for the study.Mortality was noticed in the time the patient stayed in the hospital. Rebleeding was the endpoint of this study. Results: A total of 187 patients were selected for this study. Out of these 119were males (63.64%) and 68 (36.36%) were females. The mean age of patients was 59.25 years± 10.3 SD. Mean systolic BP was 107.08 ± 13.3, heart rate was 90.3 ± 11.9 and clinical Rockallscore of 3.5 ± 0.8 SD. A total of 111 (59.4%) patients presented with bleeding esophagealvarices, 36 (19.3%) presented with bleeding gastric varices, together chronic liver diseasewas responsible for 78.4% (147) of patients. Gastric erosions were seen to be the cause ofupper gastrointestinal hemorrhage in 18 (9.6%) of patients, whereas peptic ulcer disease wasthe cause responsible in 20 (10.7%). Lastly gastric carcinoma was seen in only 2 (1.1%) ofpatients. A total of 35 (18.7%) of patients experienced rebleeding episodes during the hospitalstay. Mortality was seen in 31 patients (16.6%). Conclusion: Clinical Rockall score is a goodpredictor of rebleeding and mortality. However, application of this score for the purpose oftriage of patients reporting with bleeding esophageal varices is problematic because this grouphas the presentation of liver failure along with hematemesis so getting low Rockall scores (andpredicting survival without endoscopic intervention) is not possible in this group of patients.

Treatment strategies for inverted papillomas with intracranial or intraorbital involvement

2021 ◽  
pp. 1-7
Author(s):  
D Spinos ◽  
T Kalamatianos ◽  
D Terzakis ◽  
M Piagkou ◽  
C Georgalas
Keyword(s):  
Demographic Data ◽  
Treatment Strategies ◽  
Case Series ◽  
Recurrence Rates ◽  
Case Series Study ◽  
Patient Demographic Data ◽  
Complete Tumour ◽  
Prospective Case Series ◽  
Benign Tumours ◽  
Inverted Papillomas

Abstract Objective Sinonasal inverted papillomas are challenging benign tumours of the nasal cavity because of their high recurrence rates and the lifetime malignant transformation risk of 10 per cent as well as their locally aggressive behaviour. This study aimed to describe treatment strategies for inverted papillomas with intracranial or intraorbital involvement. Method This was a prospective case series study of 18 patients with inverted papilloma with intracranial or intraorbital involvement. Patient demographic data, imaging, pathology, surgical technique and recurrences were recorded prospectively over a period of seven years. Results A total of 83 per cent of the patients in this study had been previously operated on, consisting of 8 cases with intracranial involvement, 1 case with intraorbital involvement and 9 with both. During follow up with a medium of 37 months (range, 13–115 months) there were two recurrences. Conclusion It was postulated that intracranial or intraorbital involvement observed in this series was the result of multiple revisions. However, using accurate imaging protocols and the pedicle-oriented approach for tumour excision, complete tumour removal was achieved in most cases with minimal post-operative complications.

scholarly journals Pertussis Vaccination Failure in the New Zealand Pediatric Population: Study Protocol

Vaccines ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 65
Author(s):  
Chisholm ◽  
Howe ◽  
Best ◽  
Petousis-Harris
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Pediatric Population ◽  
Case Series ◽  
Risk Groups ◽  
Paediatric Population ◽  
Investigate Risk Factor ◽  
Case Series Study ◽  
Study Results ◽  
Series Study

Pertussis vaccines have been effective at reducing pertussis-associated morbidity and mortality. However, they have a complex array of limitations, particularly associated with the duration of protection against clinical disease and imperfect immunity (carriage and transmission). Little is known about risk factors for pertussis vaccination failure. Understanding pertussis vaccination failure risk is most important in the paediatric population. This study aims to investigate risk factors for pertussis vaccination failure in (1) infants between birth and six weeks of age born to mothers who received pertussis booster vaccinations during pregnancy and (2) infants after the completion of the primary series (approximately five months old) to four years old. This will be achieved in a two-step process for each study group. Pertussis vaccination failure cases will first be described using a case series study design, relevant case characteristics will be sourced from six national administrative datasets. The case series study results will help select candidate risk factors (hypothesis generating step) to be tested in the retrospective cohort study (hypothesis testing step. Pattern analysis will be used to investigate risk factor patterns in the cohort study. The identification of higher risk groups enables targeting strategies, such as additional doses, to better prevent pertussis disease.

scholarly journals Clinical profile and visual outcome following pars plana vitrectomy in acute post-operative endophthalmitis

1970 ◽  
Vol 3 (2) ◽  
pp. 102-108 ◽  
Author(s):  
R Thapa ◽  
G Paudyal
Keyword(s):  
Cataract Surgery ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Visual Outcome ◽  
Clinical Profile ◽  
Case Series Study ◽  
Study Results ◽  
Pars Plana ◽  
The Mean ◽  
Good Vision

Introduction: Endophthalmitis following cataract surgery is a rare but devastating ocular complication where delay in treatment not only results in vision loss but also in difficulty to save the eye ball. Objective: To explore the clinical profile and visual outcome following pars plana vitrectomy (PPV) in acute endophthalmitis after cataract surgery. Materials and methods: This is a retrospective interventional case series study conducted at Tilganga Institute of Ophthalmology (TIO), Nepal. All consecutive cases of acute endophthalmitis following cataract surgery treated with PPV from January 2005 to August 2010 were included in the study. Results: There were a total of 34 cases (34 eyes) treated with PPV. The age range was 8 - 93 years with mean age of 56.9 ± 19.5 years. The mean duration of presentation and duration following cataract surgery was 7.7 ± 8.1days and 13 ± 11.6 days respectively. Small incision cataract surgery was done in 75 % of cases followed by phacoemulsification (15.6 %). The mean duration of the last follow -up was 4.3 months. Vision was improved in two-thirds of cases (67.67 %) with a good vision of 6/18 or better in 17.6 %. Among the available vitreous samples of 22 cases, 36.36 % had an abnormality in Gram and Giemsa stains and culture was positive in 13.6 % of cases. Conclusion: Despite the late presentation, the majority of eyes were salvaged with improvement of vision in 67.67 %, with a good vision of 6/18 or better in 17.6 4 % of cases following PPV in acute post operative endophthalmitis. Key words: Endophthalmitis, vitrectomy, cataract surgery, visual outcome DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5260 Nepal J Ophthalmol 2011; 3(2): 102-108

scholarly journals Thromboembolic Events Secondary to Endoscopic Cyanoacrylate Injection: Can We Foresee Any Red Flags?

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yujen Tseng ◽  
Lili Ma ◽  
Tiancheng Luo ◽  
Xiaoqing Zeng ◽  
Yichao Wei ◽  
...  
Keyword(s):  
Literature Review ◽  
Adverse Events ◽  
Treatment Protocol ◽  
Case Series ◽  
Gastric Varices ◽  
Patient Treatment ◽  
High Morbidity ◽  
Retrospective Case ◽  
Case Series Study ◽  
Severe Adverse Events

Background. Gastric varices (GV) are associated with high morbidity and mortality in patients with portal hypertension. Endoscopic cyanoacrylate injection is the first-line recommended therapy for GV obliteration. This study aims to explore the reason behind related adverse events and better prevent its occurrence. Methods. A retrospective case series study was conducted from January 1, 2013, to December 31, 2016, to identify patients who experienced severe adverse events secondary to endoscopic cyanoacrylate injection. A literature review of similar cases was performed on two medical databases, Medline and Embase. Results. A total of 652 patients underwent cyanoacrylate injection at our center within the study duration. Five cases of severe adverse events related to the use of tissue adhesives were identified. Detailed clinical presentation, patient treatment, and outcomes were reviewed and analyzed. Twenty-seven similar cases were identified based on the literature review providing further insight into the study. Conclusion. Although rare in incidence, systemic embolism associated with cyanoacrylate injection is often fatal or debilitating. This report may raise awareness in treatment protocol, including the necessity of preoperative angiographic studies, to avoid similar adverse events in clinical practice.

scholarly journals HEPATITIS–B VIRUS INFECTION;

2018 ◽  
Vol 21 (05) ◽  
pp. 950-955
Author(s):  
Arif Zulqarnain ◽  
Imran Iqbal ◽  
Naveed Anjum
Keyword(s):  
Hepatic Encephalopathy ◽  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Demographic Data ◽  
Case Series ◽  
Female Ratio ◽  
Clinical Presentations ◽  
Study Results ◽  
B Virus

Objective: To describe the clinical presentations of hepatitis B virus infectionin children. Methodology: Children presenting with symptoms of liver diseases and otherdiseases who were found to be HBsAg positive by screening or ELISA method were enrolled.Children suffering from thalassemia, hemophilia and hemolytic anemia, which need multipletransfusions, were excluded. On the basis of history, examination and investigations the clinicalpresentation of the patient was categorized. Basic demographic data, relevant clinical history,physical examination, lab investigations and clinical presentations category were entered in thepredesigned proforma. As this is the descriptive study, no hypothesis were required. Design:Descriptive case series. Setting: Paediatric unit-2 NishtarHospital Multan. Period: 16th May2012 to 15th November 2012. Results: Study results consist of relative frequencies of differentclinical presentations of HBsAg positive patients. Fifty children who were HBsAg positive wereenrolled in a six month period. Out of 50 patients, 21 (42%) were of hepatic encephalopathy,14 (28%) were with acute hepatitis, 12 (24%) were cirrhosis, 2 (4%) were asymptomatic carrierand 1 (2%) was presented with chronic hepatitis B. There were 40 (80%) males and 10 (20%)females. The overall male to female ratio was 4:1. Conclusions: Most common presentationwas hepatic encephalopathy which has a very bad prognosis, next comes the acute hepatitisand then cirrhosis. There is another inference that males are more and severely affected byhepatitis-B virus infection.

scholarly journals Actions speak louder: Young female patients with acute ischemic stroke in the emergency department

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Mor Saban ◽  
Tal Shachar ◽  
Heli Patito ◽  
Lev Zaretsky
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Demographic Data ◽  
Case Series ◽  
Young Female ◽  
Initial Examination ◽  
Young Females ◽  
Case Series Study

The aim was to explore the diagnostic cascade of young females with acute ischemic stroke (AIS) in the emergency department (ED) setting. A retrospective case series study was conducted between the years 2016-2018 in the ED of a tertiary hospital (N=10). We collected socio-demographic data, clinical risk factors and co-morbidities, ED characteristics and medical examination related data. Ten females presenting with AIS were identified. Results show that each case had a variety of characteristics, there are no similar medical background or clear-cut risk factors, and each case has been presented clinically different. All these factors, with the possible added effect of age and sex bias serve as possible hindrance for correct and efficient diagnosis of stroke in young females. In conclusion, clinical presentation of young female with AIS is misleading. Initial examination in the ED setting may appear to be the determining point of impact on the outcome severity in young females.

scholarly journals Versatility of Reverse Sural Artery Flap for Coverage of Heel and Proximal Foot Defects in Children

2021 ◽  
Vol 15 (7) ◽  
pp. 1755-1759
Author(s):  
Muhammad Anwar ◽  
Faisal Waheed ◽  
Khadija Hussain
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Case Series ◽  
Soft Tissue Defects ◽  
Degloving Injury ◽  
Case Series Study ◽  
Study Results ◽  
Sural Artery ◽  
Tissue Defects ◽  
Ankle And Foot

Objective: The objective of the study was to determine the versatility of reverse sural artery flap in terms of its reliability and efficacy for reconstruction of soft-tissue defects of heel and proximal foot in children. Material and Methods: A total of 30 patients aged 5-13 years with ankle and foot defects admitted to the Plastic Surgery and Burn department at the Sheikh Zayed Hospital, Rahim Yar Khan from January 2018 to July 2020 were studied by designing a retrospective cross-sectional case series study. Results: Out of 30 flaps, 26 (86.7%) healed fully, whereas 4 (13.3%) complicated by partial necrosis requiring a secondary procedure. Nineteen (63.3%) patients had wheel spoke injuries, eight (26.6%) sustained degloving injury after a road traffic accident, and three (0.1%) patients were having a history of electric burn. In 22 patients an interpolated flap was used and in 8 cases an islanded flap. Donor sites were skin grafted in all patients. Two patients developed hypertrophic scarring at donor area. All patients showed good functional results, however flap remained insensate throughout the follow-up period that was minimum for 6 months. Conclusion: The reverse sural artery flap is versatile, reliable and a method of choice in reconstructing soft-tissue defects of the hind foot in children. This flap is easy to dissect, has robust blood supply and does not sacrifice any major blood vessel of the leg. Key Words: Reverse Sural Artery Flap, children, Ankle and Foot, Soft-tissue Defects, Wheel Spook Injury

scholarly journals OUTCOME OF EARLY CLOSURE OF TEMPORARY STOMA

2016 ◽  
Vol 21 (4) ◽  
pp. 214
Author(s):  
Muhammad Shahid Alam ◽  
Khalid Masood Gondal ◽  
Humayun Siddique ◽  
Yar Muhammad
Keyword(s):  
Anastomotic Leakage ◽  
Surgical Procedure ◽  
Case Series ◽  
Wound Complication ◽  
Wound Complications ◽  
P Value ◽  
Temporary Stoma ◽  
Case Series Study ◽  
Study Results ◽  
Early Closure

AbstractIntroduction:A stoma is a surgical procedure in which a part of gut is taken out and connected on the anterior abdominal wall. An anastomosis is the joining together of the two intestinal ends that remain after a diseased section has been removed. The closure of the stoma though thought to be minor surgical procedure, yet it may be associated with appreciable morbidity. When the reversal of stoma is done in less than 8 weeks following primary surgery then it is considered to be early closure. Early closure of the temporary stoma might reduce both stoma related complications and patient ailment. Wound complications are common but there are many associated morbidities due to delay in closure. So the aim of this study is to find the complications associated with early closure of temporary stomaObjective:To evaluate the outcome of early closure of temporary stoma.Material and Methods:This descriptive case series study of 350 patients of both gender aged between13 70 years was conducted in surgical ward of mayo hospital, Lahore in one year duration from 01-01-2014 to 31-12-2014. The non-probability purposive sampling technique was used in this study. Written consent was obtained from the patients. Only the most senior consultants with 5 years experience after post-graduation were the part of the team. Following admission they were advised distal loopogram to rule out any distal obstruction, leakage or any other pathology. Closure was performed and the evaluation of the patient and relevant investigations pertaining to diagnose complications like anastomotic leakage and wound complications was done. This was recorded daily for 5 days post-operatively in ward and then a follow up weekly for 1 month was performed. Analysis of data was done statistically using version 13.0. Mean SD were calculated for age. Frequency and percentages were calculated for gender, anastomotic leakage and wound complications. Post-stratification chi-square test was applied keeping a P-value ? 0.05 as significant.Results:In our study mean age of the patients was 42.73 13.68 years, 60% patients were males whereas 40% patients were females. The study results showed that anastomotic leakage was found in 29 (8.3%) patients and wound complication was found in 20.57% patients. Statistically insignificant difference was found between the wound complication and gender of the patients i.e. p-value = 0.82.Conclusion:According to our study results the outcome of early closure of temporary stoma is a feasible and effective procedure with fewer complications.Keywords:Early Closure, Temporary Stoma, Wound Complication, Anastomotic Leakage.

Observational Case Series Evaluation of the Granisetron Transdermal Patch System (Sancuso) for the Management of Nausea/Vomiting of Pregnancy

2017 ◽  
Vol 34 (09) ◽  
pp. 851-855
Author(s):  
Tran Le ◽  
Michael Adler ◽  
Holly Ouillette ◽  
Pamela Berens ◽  
Judith Smith
Keyword(s):  
Clinical Observation ◽  
Case Series ◽  
First Trimester ◽  
Transdermal Patch ◽  
Case Series Study ◽  
Study Results ◽  
Series Evaluation ◽  
Potential Benefits ◽  
Series Study ◽  
Oral Ondansetron

Objective The objective of this study was to observe the efficacy of antiemetic therapy (no emesis/retching episodes and no rescue medication use) when granisetron is administered via a transdermal patch system (TDS) in women who are 6 to 14 weeks pregnant when compared with oral ondansetron by evaluating the frequency of the use of rescue medications for control of nausea/vomiting of pregnancy (NVP). Methods This was an observational case series study to observe the potential benefits of granisetron TDS compared with oral ondansetron for management of NVP in pregnant patients during the first trimester. Dates of data collection were September 1, 2014, through December 31, 2015. There was no direct contact with patient. The oral ondansetron and granisetron TDS patients were matched by age, 4:1. The proportion of patients who received rescue antiemetics was calculated from those patients who continued to experience NVP. Risk factors for NVP were identified and compared between groups. Descriptive statistics were used to describe study results. Results Patients were prescribed rescue antiemetics in 0/3 patients in the granisetron TDS group compared with 2/12 patients in the oral ondansetron group. Conclusion Prospective efficacy studies on the use of granisetron TDS for management of NVP are needed to confirm this clinical observation.

scholarly journals Chondrosarcoma pelvis, beyond the boundaries.

2020 ◽  
Vol 27 (09) ◽  
pp. 2014-2022
Author(s):  
Badaruddin Sahito ◽  
Maratib Ali ◽  
Dileep Kumar ◽  
Nauman Hussain ◽  
Noman Parekh ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Total Duration ◽  
Case Series ◽  
Pubic Bone ◽  
Internal Hemipelvectomy ◽  
Nerve Root Injury ◽  
Case Series Study ◽  
Study Results ◽  
Duration Of Surgery ◽  
Level I

Objectives: The objective of our study to find the outcome of extensive chondrosarcoma pelvis after surgery. Study Design: Case Series study. Setting: Department of Orthopaedic Surgery Dow University of Health Sciences / Civil Hospital Karachi. Period: From April 2014 to December 2018. Material & Methods: Seven patients with Chondrosarcoma pelvis included in this study. Results: All Seven patients were male. 2 patient age was in 20’s, three in 40’s and two in 60’s with median age of 44. Clinically presentation of patients was variable. One patient present with groin lump, one with pain and swelling lower abdomen, three with hip pain, one patient with severe gluteal pain and lump, one with massive lump extending from the mid abdomen to groin and urine retention and constipation. Five patients have left pelvis involved and two have right side. Two patients have pubic bone and ischium (Level III) involved, two have ilium (Level I) and three have ilium, acetabulum and pubis (Level I, II, III). Two patients with have preoperatively sciatic nerve palsy. Two patients have medical comorbid. One was asthmatic and one had psychiatric illness. No patient had metastasis at presentation. Pubis and ischium with tumor resected in two cases, partial ilium resection in one case, one complete P1 resection with sciatic nerve, one patient have internal hemipelvectomy and one patient had internal hemipelvectomy that bone recycled in liquid nitrogen and pelvis re-implanted and fixed with recon plates and hip joint reconstructed with total hip replacement. One patient had external hemipelvectomy due to pus at tumor site. Total duration of surgery in patient having thirteen hours, and remaining have 3 to 5 hours. Blood loss during these surgeries was in between 1000 to 1200 ml. Three patients have wound infection, one patient had L5 nerve root injury. Patient with external hemipelvectomy develop wound dehiscence and uro-cutaneous fistula. Two patients died, one with recycled bone after 15 months due cardiac problem and 2nd due to disease related complications within 3 months of surgery. Conclusion: Pelvic chondrosarcoma must be operated by the team of surgeons including orthopaedic surgeon, urologist and general surgeon because of the tumor presents with massive lumps due to unrestricted compartment and can involve the important pelvic organ. With team any complication can be prevented and treated immediately.

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