scholarly journals Approach to management of penile fracture- Our Three-year experience at a Teaching Hospital

2021 ◽  
Vol 24 (1) ◽  
pp. 10-13
Author(s):  
Sunil Basukala ◽  
Narayan Thapa ◽  
Bikash Bahadur Rayamajhi ◽  
Bikram Basukala ◽  
Saurav Karki
Keyword(s):  
Teaching Hospital ◽  
Clinical Presentation ◽  
Tunica Albuginea ◽  
Tertiary Care ◽  
Time Interval ◽  
Penile Fracture ◽  
Presenting Symptoms ◽  
Presentation Time ◽  
Manual Manipulation ◽  
Penile Hematoma

Introduction: Penile fracture is a rare surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of the two corpora cavernosa; a rupture of both masses is an uncommon finding. We conducted this study to determine the etiology, clinical presentation and to review the causes and management of penile fracture. Methods: The retrospective study was carried out on 17 patients, admitted in the department of Urosurgery from January 2017 to December 2020 with penile fracture in a tertiary care teaching hospital in Kathmandu. Patient demographic profile, etiology, clinical presentation, time interval from injury to presentation, investigation done, treatment given and intraoperative findings were analyzed. Results: The main cause of penile fractures was sexual intercourse (82.35%) followed by manual manipulation (17.65%). Crackling sound (100%) followed by penile hematoma and pain were the most common presenting symptoms among the patients.  Surgical exploration and repair of injury was done in all patients. Conclusion: Most of the time diagnosis of penile fracture can be made reliably by history and physical examination. Early surgical intervention is associated with a good outcome, regardless of the timing of presentation.

scholarly journals Penile fracture; three years’ experience from a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 553
Author(s):  
Hanief Mohamed Dar ◽  
Tariq Ahmed Mala ◽  
Yaqoob Hassan ◽  
Shahid Amin Malla ◽  
Mir Mujtaba Ahmad ◽  
...  
Keyword(s):  
Sexual Intercourse ◽  
General Surgery ◽  
Tunica Albuginea ◽  
Tertiary Care ◽  
Urethral Injury ◽  
Time Interval ◽  
Tertiary Care Centre ◽  
Penile Fracture ◽  
Early Management ◽  
Surgery Department

Background: To study cause, presentation, diagnosis and early management of penile fracture and to prevent the complications.Methods: In this study 48 patients of penile fracture were included in the study who were admitted in general surgery department at Government Medical College Srinagar from May 2007 to May 2010. All patients were evaluated with detailed history, clinical examination and baseline investigations followed by immediate surgical repair.Results: Age range of patients was 21-75 years. Youngest being 21 years and eldest being 75 years (median-30 years). 38(79.1%) patients were married while as 10(20.9%) patients were unmarried. Sexual intercourse was main cause, seen in 41(85.4%) of patients, aggressive masturbation in 5(10.4%) patients and rolling over in bed during erection was seen in 3(6.2%) patients. All patients presented in general surgery department with complaints of pain and swelling in penile region. Time interval between injury and presentation to the department ranged from 4-24 hours (mean 11 hours). Isolated cavernosa injury was seen in 43 (89.6%) patients, while as 5 (10.4%) patients were having associated urethral injury (3 were having partial injury and 2 complete urethral disruption). There was a ventral rent in 31(64.6%) patients and lateral rent in17 (35.4%). Size of tear in tunica albuginea was less than 1cms in 19(39.6%) patients, 1-2cm in 17(35.4) patients and more than 2cms in 12 (25%) patients. Patients were discharged on 2-5 days (mean 3.1 days). There were no immediate postoperative complications. 2 (4.1%) patients had pricking sensation at repair site, 1(2.05%) patient had pain during erection and 2 (4.01%) patients had mild deviation during erection on follow up.Conclusions: Penile fracture is a relatively rare urological emergency which mostly occurs during sexual intercourse or aggressive masturbation and is usually a clinical diagnosis. Early surgical repair avoids complications and preserves both sexual and voiding functions.

scholarly journals A national study of choanal atresia in tertiary care centers in Canada – part I: clinical presentation

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Josee Paradis ◽  
Agnieszka Dzioba ◽  
Hamdy El-Hakim ◽  
Paul Hong ◽  
Frederick K. Kozak ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Choanal Atresia ◽  
Case Series ◽  
Retrospective Chart Review ◽  
National Study ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Tertiary Care Centers

Abstract Background To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center. Results The health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome. Conclusions The present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of co-morbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted. Graphical abstract

scholarly journals A prospective observational study to analyse clinical profile of varicose vein cases treated in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 769
Author(s):  
Maragadha Mani ◽  
Anand A.
Keyword(s):  
Observational Study ◽  
Clinical Presentation ◽  
Vascular System ◽  
Varicose Veins ◽  
Demographic Data ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Leg Pain ◽  
Care Hospital ◽  
Presenting Symptoms

Background: Varicose veins are common vascular disorder. The study was conducted to analyse the clinical presentation, treatment options and complications of varicose veins.Methods: This observational study was conducted in Thanjavur Medical College Hospital. Adults with clinically diagnosed unilateral or bilateral varicose veins of lower limbs were studied in surgical wards between August 2013 to July 2014. The demographic data and presenting symptoms, signs and previous treatment were collected using a structured proforma. Thorough clinical examination, duplex scan and abdominal and pelvic examination were done in all cases to find out the secondary causes. Peripheral vascular system was examined. All the patients were followed regularly for the period of one month to one year after treatment.Results: A total of 60 cases were included. Most participants belonged to 2nd and 3rd decade of life. 55 (91%) participants were male and5 (9%) participants were females. 45 (75%) participants were agriculturists. 10 (17%) participants had bilateral involvement. Most participants 30 (50%) participants had 1 to 5 years duration of disease, most common clinical presentation of the study participants was varicosity with 70.0%, followed by lipodermo sclerosis, leg pain, hyperpigmentation, pruritus as 63.0%, 56.0%, 15% and 11.6% respectively. 17 (28.33%) patients were present with a venous ulcer. 32 (53%) participants were managed surgically, and 28 (47%) participants were managed conservatively. Most participants were treated with multiple ligation 21.8% followed by trendelenburg operation+ stripping18.75%.Conclusions: Regarding the treatment, surgery is the treatment of choice for primary varicose veins and conservative treatment for secondary varicose veins.

scholarly journals Spectrum of ectopic pregnancy in tertiary care centre

2018 ◽  
Vol 7 (4) ◽  
pp. 1435
Author(s):  
Ishrat Zuber ◽  
Vaishali Chaurasia
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Previous History ◽  
Stable State ◽  
Clinical Findings ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Presenting Symptoms

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergency in day-to-day practice. Objectives of present study were to know the incidence of Ectopic pregnancy at Tertiary care centre, the age group, parity and risk factor of ectopic pregnancy, the clinical presentation of ectopic pregnancy and the outcome and management of ectopic pregnancy.Methods: It was a retrospective study conducted at Chirayu Medical College and Hospital, Bhopal from 1st June 2009 to 31st May 2014. A total of 42 patients with ectopic pregnancy were analyzed on clinical presentation, clinical findings, investigations, operative findings and outcome.Results: A majority of women (64.29%) were in the age group of 21-30 years and 78.57% were multigravida. Commonest risk factors were previous history of abortion (23.80%) and pelvic inflammatory disease (14.28%) Amenorrhea (92.85%) and pain abdomen (89.22%) were the most common presenting symptoms. Ampulla of fallopian tube was the commonest site (45.23%). Unilateral salpingectomy was performed in 40.47% patients. There were no maternal deaths and majority (80.96%) were discharged within seven days.Conclusions: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.

scholarly journals Clinical Presentation and Treatment Outcomes of Children and Adolescents With Pheochromocytoma and Paraganglioma in a Single Center in Korea

2021 ◽  
Vol 11 ◽  
Author(s):  
Hyojung Park ◽  
Min-Sun Kim ◽  
Jiwon Lee ◽  
Jung-Han Kim ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Treatment Outcomes ◽  
Genetic Screening ◽  
Clinical Presentation ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Screening Tests ◽  
Laboratory Findings ◽  
Presenting Symptoms

PurposePheochromocytoma (PCC) and paraganglioma (PGL) (PPGL) are rare neuroendocrine tumors, and data on managing these conditions in children and adolescents are lacking. The objective of this study was to demonstrate the clinical presentation and treatment outcomes in children and adolescents with PPGL in a single tertiary care center in Korea.MethodsThis retrospective study included 23 patients diagnosed with PCC (n = 14) and PGL (n = 9) before the age of 21 at Samsung Medical Center (from June 1994 to June 2019). We describe age, gender, family history, clinical characteristics, laboratory findings, pathologic findings, therapeutic approaches, and treatment outcomes.ResultsOf the 23 patients, 14 had PCC and nine had PGL. The median age at diagnosis was 16.8 years (range, 6.8–20.8 years). The common presenting symptoms were hypertension (n = 10), headache (n = 9), palpitation (n = 4), and sweating (n = 4). The plasma or 24-hour urine catecholamine and/or metabolite concentrations were markedly elevated in 22 patients with PPGL, but were normal in one patient with carotid body PGL. All tumors were visualized on computed tomography. Genetic tests were performed in 15 patients, and seven patients showed mutations in RET (n = 3), SDHB (n = 3), and VHL (n = 1). All patients underwent surgery, and complete excision was performed successfully. Three patients with metastasis underwent postoperative adjuvant therapy.ConclusionThis study suggests that pediatric PPGL tends to be extra-adrenal and bilateral and shows a higher potential for genetic mutations. Considering the hereditary predisposition of pediatric PPGL, genetic screening tests are strongly recommended, and lifelong follow-up is needed to detect recurrence and metastasis. Further research with a larger sample size and routine genetic screening is needed to better understand the genetic conditions and long-term prognosis of PPGL.

scholarly journals Clinical profile of patients with hypertensive crisis in a tertiary care hospital in Haryana, India – A retrospective cross-sectional study

2022 ◽  
Vol 13 (1) ◽  
pp. 66-72
Author(s):  
Navtej Singh ◽  
Tarun ◽  
Ravinder Pal ◽  
Ankit Chamoli
Keyword(s):  
Clinical Presentation ◽  
Target Organ Damage ◽  
Tertiary Care ◽  
Hypertensive Crisis ◽  
Organ Damage ◽  
Hypertensive Emergency ◽  
Time Interval ◽  
Care Hospital ◽  
Hypertensive Urgency ◽  
Cross Sectional

Background: A hypertensive crisis may manifest as hypertensive emergency or urgency. Hypertensive emergency is characterized by target organ damage and poses immediate threat to life, a situation not seen in urgency. Aims and Objectives: The aims of the study were as follows: (1) To determine the prevalence of hypertensive crisis classified as emergency, urgency, and pseudocrisis. (2) To assess the various systems (neurological, cardiovascular, and renal) affected in relation to a particular type of hypertensive crisis. Materials and Methods: The retrospective study comprised analysis of medical records of 100 patients of hypertensive crisis admitted to emergency unit of BPS Government Medical College and Hospital for Women, Sonepat, Haryana, India, in the 2 years period from January 2018 to December 2019 and study their prevalence among hospital emergencies and clinical presentation. Results: Total number of clinical emergencies analyzed during this time interval was 6666. The prevalence of hypertensive crisis accounted to 1.5% of all the clinical emergencies received. About 66% presented as hypertensive emergencies, 32% as hypertensive urgency, and 2% presented as hypertensive pseudocrisis. Males of the fifth decade of life while females of the sixth decade of life were most affected by hypertensive crisis. Headache (58%) followed by giddiness (44%) was the most common clinical presentation in the emergency. About 34% of patients had associated neurological deficit. Only 16% of patients had cardiovascular system involvement. Conclusion: Symptoms provided by patients in the emergency department are of paramount importance for the outcome of hypertensive crisis. Severe complication of hypertensive crisis can be prevented if hypertension is timely diagnosed and appropriately managed.

scholarly journals Penile Fracture : Experience from a Tertiary Care Hospital

2019 ◽  
Vol 6 ◽  
Author(s):  
Malik Suhail Ahmad ◽  
Irfan Nazir Mir ◽  
Malik Faizan Abbass
Keyword(s):  
Tunica Albuginea ◽  
Tertiary Care ◽  
Corpus Cavernosum ◽  
Care Hospital ◽  
Postoperative Complication Rate ◽  
Penile Fracture ◽  
Jammu And Kashmir ◽  
History Of ◽  
The Mean ◽  
Erect Penis

Introduction: Penile fracture is a misnomer,penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination.standard mode of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital srinagar ,(Jammu and Kashmir), extending over a period of about three and a half years from june 2013 to January 2017 . All patients with diagnosed penile fracture were included in this study. All except one patient were operated one the same day of admission.Results: out of a total of 50 patients studied ,the mean age of presentation was 26.7 years.Majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as cause of trauma,followed by vaginal intercourse in38% and rolling on erect penis in 20%.About 80% patients gave history of audible click/crackling sound.All patients had swelling and discolouration on examination,90% patients had penile deformity,only 36 % had palpable defect.Dopler USG was correct in 93% patients.Majority (44%) patients had defect less than 1cm.defect was mostly seen on right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of penile fracture.

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