Etiology and cranial CT scan profile of nontumoral hydrocephalus in a tertiary black African hospital

2011 ◽  
Vol 7 (4) ◽  
pp. 397-400 ◽  
Author(s):  
Olufemi Idowu ◽  
Adebayo Olumide
Keyword(s):  
Pediatric Population ◽  
Third Ventricle ◽  
Aqueductal Stenosis ◽  
Female Ratio ◽  
Black African ◽  
The Mean ◽  
Walker Malformation ◽  
A Prospective Study ◽  
Evans Ratio ◽  
Mantle Thickness

Object Hydrocephalus is a common condition in the pediatric population. The cause of hydrocephalus, Evans ratio, ventricular index, and cerebral mantle thickness are some of the factors associated with poor surgical outcome. This study was conducted to evaluate the profile of these factors in the authors' patient population. Methods The authors conducted a prospective study from the August 1, 2006, to May 30, 2010. The consecutive patients were all 6 years of age or younger. The demographic information, cause of hydrocephalus, and cranial computerized measurements were taken (including widths of the frontal/occipital horns, third ventricle, and cerebral mantle thickness) and entered into the procedural forms. Results One hundred thirty-seven patients presented to the unit over the stipulated period. The male/female ratio was 1.1:1. The median age at presentation was 4 months (mean 7.3 months, range 4 days to 6 years). Myelomeningocele-associated hydrocephalus, aqueductal stenosis, and postmeningitic hydrocephalus accounted for 30.7%, 22.6%, and 17.5%, respectively, of the cases. The mean Evans ratio was 0.56 (range 0.43–0.70), the mean ventricular index was 197.18 (range 135.0–245.3), and the mean cerebral mantle was 10.8 mm (10–14 mm). Conclusions This study shows that the congenital form of hydrocephalus is the predominant variety in the authors' population. Myelomeningocele-associated hydrocephalus, aqueductal stenosis, Dandy-Walker malformation, and postmeningitic hydrocephalus are common causes of hydrocephalus.

scholarly journals Reading performances of low vision children after using low vision aid

2018 ◽  
Vol 146 (9-10) ◽  
pp. 534-537
Author(s):  
Zorica Toncic ◽  
Natasa Jovovic ◽  
Nada Sakotic ◽  
Veselinka Milovic ◽  
Katarina Janicijevic ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Low Vision ◽  
Reading Speed ◽  
Pediatric Population ◽  
Reading Performance ◽  
Optic Nerve Atrophy ◽  
Stargardt Disease ◽  
Before And After ◽  
The Mean ◽  
A Prospective Study

Introduction/Objective. The objectives of the paper are to assess the causes of low vision (LV) in pediatric population in Montenegro and to evaluate the influence of low vision aids (LVA) on reading performance regarding the speed of reading and the understanding of the read text. Methods. A prospective study was conducted on 40 ?treatable? LV children what represent all registered LV children in Montenegro. All participants read the same text before and after using LVA. Reading rate was calculated as the number of words read per minute. Functional speed of reading was calculated as the ratio of the rate of reading and the understanding of the read text multiplied by 100. Results. The study comprised 40 LV children with the mean age of 12.60 ? 4.06 years (20 boys and 20 girls). The most common cause of LV in children were premature retinopathy (10/40 or 25%), retinitis pigmentosa (8/40 or 20%), optic nerve anomaly (5/40 or 13%), degenerative myopia (4/40 or 10%), macular dysgenesis (4/40 or 10%), Stargardt disease (3/40 or 7%), optic nerve atrophy (2/40 or 5%), and albinism (2/40 or 5%). Nystagmus was found in 11 LV children or 28% of the group. LVA were prescribed to all of them. Reading speed before vs. after LVA use was 36.58 ? 35.60 vs. 73.83 ? 27.05 words/minute (p < 0.001), while functional reading was 26.00 ? 30.43 vs. 59.41 ? 29.34 (p < 0.001). Conclusion. LV children demonstrate a significant improvement in reading performance by using LVA.

scholarly journals A Prospective Study to Assess the Effectiveness of Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopy for Proximal Ureteral Calculi Between Sizes 5 to 10 mm

2020 ◽  
Vol 19 (2) ◽  
pp. 65-69
Author(s):  
Bikash Bahadur Rayamajhi ◽  
Anjan Khadka ◽  
Narayan Thapa
Keyword(s):  
Ureteral Calculi ◽  
National Guidelines ◽  
Female Ratio ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Mean Size ◽  
Surgical Options ◽  
The Mean ◽  
Enhanced Computed Tomography ◽  
A Prospective Study

Introduction: There are various international guidelines for the surgical treatment of upper ureteral calculi. For upper ureteral stone of less than 10 mm size, ESWL and URS are regarded as first line treatment. However, there is lack of national guidelines for appropriate surgical options for such stone in our settings. Methods: The study was prospective comparative type involving 100 patients who were divided into ESWL and URS groups comprising 50 patients in each. ESWL and URS were performed after confirmation of stone size with ultrasonography and non-contrast enhanced computed tomography. All patients underwent X-ray KUB at one week and six weeks post procedure for confirmation of stone clearance. Those with residual calculi of size < 5 mm were considered stone free. Statistical analysis was done using Graph pad prism version 6. Results: The mean age of patients in ESWL and URS groups were 41.28 ± 15.3 years and 42.84 ± 16.1 years respectively. The male to female ratio was higher in ESWL group. The mean size of the stone pre ESWL was 8.58 mm and pre URS was 8.44 mm. The percentage of stone clearance at one week and six weeks for ESWL was 56% and 90% respectively whereas for URS, it was more than 90% at both one week and six weeks. The complications were higher with URS (20%) than ESWL (8%). Conclusions: The ESWL and URS are equally effective in stone clearance. The duration is longer with ESWL and the complications were more in URS group.

Osteotomy for Correction of Premature Growth Plate Closure in 24 Dogs

1994 ◽  
Vol 07 (03) ◽  
pp. 129-135 ◽  
Author(s):  
C.W. Miller ◽  
P.W. Morgan
Keyword(s):  
Corrective Osteotomy ◽  
Functional Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Angular Deformity ◽  
Dynamic Correction ◽  
Age At Surgery ◽  
Limb Deformities ◽  
The Mean ◽  
A Prospective Study

SummaryTwenty-four dogs (27 limbs) were evaluated after surgery for correction of forelimb angular limb deformities. Partial ulnar ostectomies or definitive corrective osteotomies were performed depending upon the age of the dog. According to owner assessment nine of fourteen limbs were considered functionally good, or excellent, after partial ulnar ostectomies. Younger dogs appeared to have better functional results after dynamic correction with the mean age at surgery of dogs with good to excellent results being 6.5 months contrasted to the mean age at surgery of dogs with fair to poor results being 9.75 months. Ten of fourteen limbs were considered functionally good or excellent after definitive corrective osteotomy. One dog had definitive osteotomy after partial ulnar ostectomy in order to further correct a residual angular deformity. However, 58% of the limbs with radiographic follow-up had signs of degenerative joint disease (DJD). There were not significant differences between neither degree of angulation remaining after surgery and the functional result nor the degree of angulation remaining after surgery and the development of DJD. A prospective study is warranted to more objectively assess the efficacy of surgical correction of angular limb deformities in dogs.Twenty-four dogs were evaluated after surgery for correction of forelimb angular limb deformities. The results are described.

Sociodemographic, Clinical Profile and Outcome of Tuberculosis in Baramulla District of North Kashmir of India

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 11-16
Author(s):  
Abdul Ahad Wani ◽  
Javeed Iqbal Bhat ◽  
Muzafar Naik ◽  
Nisar Ahmed Dar ◽  
Syed Masood Ahmed
Keyword(s):  
Elementary Education ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Extrapulmonary Tuberculosis ◽  
Steady Increase ◽  
Female Ratio ◽  
Directly Observed Treatment ◽  
Night Sweats ◽  
Immunodeficiency Syndrome ◽  
A Prospective Study

Background: India accounts for one-fourth of the global tuberculosis (TB) burden. Since the countrywide implementation of RNTCP, tuberculosis care has received renewed focus. Directly observed treatment short-term (DOTS) is a cornerstone of RNTCP program. Objective: To evaluate demographic profile, clinical presentation and outcome of TB in district Baramulla of North Kashmir. Methods:  A prospective study over a period of seven years in patients diagnosed with TB in district Baramulla of North Kashmir. Results: This study was conducted prospectively over seven years from March 2011 to February 2017. A total of 802 patients were enrolled in the study. Among them, there were a total of 638 adult patients and 164 paediatric patients with a male: female ratio of 1:0.99. Majority of patients belonged to rural areas of north Kashmir and had received no or elementary education. Pulmonary tuberculosis was diagnosed in 530 (66 %) patients and 272 (34%) patients were diagnosed as extrapulmonary tuberculosis. Sputum for AFB was important mode of diagnosis in our series and was positive in 525 (65%) our patients. Majority of patients presented with fever, weight loss, and night sweats. None of the patients had Acquired Immunodeficiency syndrome (AIDS). There was a consistent improvement in AFB isolation among TB patients over the study period. Majority of our patients were cured completely of disease Conclusion: Sputum positive pulmonary tuberculosis remains the most common presentation of tuberculosis in North Kashmir. There is a steady increase in the proportion of bacteriologically confirmed TB cases over the study period. Furthermore, DOTS treatment is successful in all forms of tuberculosis. JMS 2018;21(1):11-16

scholarly journals AB0478 CORONARY ATHEROSCLEROSIS IN BEHCET’S DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1537.1-1537
Author(s):  
R. Goloeva ◽  
Z. Alekberova
Keyword(s):  
Behçet’S Disease ◽  
Coronary Atherosclerosis ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Subclinical Atherosclerosis ◽  
Disease Onset ◽  
Atherogenic Index ◽  
Female Ratio ◽  
Behcet's Disease ◽  
The Mean

Background:Behcet’s disease (BD) is systemic vasculitis, which affects all types and sizes of vessels. Increased carotid intima-media thickness (IMT) is parameter associated with subclinical atherosclerosis.Objectives:To determine the prevalence of atherosclerosis in pts with BD.Methods:95 BD pts were evaluated and 45 healthy controls matched for age and gender.IMT was assessed by high-resolution B-mode ultrasonography. Serum concentration of high-sensitivity C-reactive protein (hs CRP) was measured by immunonephelometric assay (BN-100 Analyzer; Dade Behring). Lipid profile evaluation included total cholesterol, TGs, HDL, LDL and atherogenic index.Results:The male-to-female ratio was 3,7:1, the mean age of pts was 29.7 (23-35) yrs, the mean age at the disease onset - 19,9 (14-25) yrs, the mean disease duration - 9,6 (4-15) yrs.Conclusion:Coronary atherosclerosis in BD pts was lower than what we expected. The thinning IMT may be one of the risk factors for aneurysm formation in pts with BD.Disclosure of Interests:None declared

scholarly journals AB0287 HEMATOLOGICAL SIDE EFFECTS OF BIOLOGICAL THERAPY IN RHEUMATOLOGY: DATA FROM THE TUNISIAN REGISTER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1442.2-1442
Author(s):  
H. Bettaieb ◽  
S. Boussaid ◽  
S. Jemmali ◽  
S. Rekik ◽  
E. Cheour ◽  
...  
Keyword(s):  
Side Effects ◽  
Biological Treatment ◽  
Blood Count ◽  
Biological Therapy ◽  
National Registry ◽  
Close Monitoring ◽  
Female Ratio ◽  
Therapy Initiation ◽  
Male Female Ratio ◽  
The Mean

Background:During the last decade, the treatment of chronic inflammatory rheumatism (CIR) has been greatly improved with the advent of biotherapy.However, the use of biological treatment can lead to a number of side effects including abnormalities in the blood count.Objectives:The aim of this study was to assess the different hematological side effects of biological treatment in patients with rheumatoid arthritis (RA) and spondyloarthitis (SA).Methods:This study included patients with RA (ACR/EULAR 2010) and SA (ASAS 2009) registred with the Tunisian Biologic National Registry (BINAR).Patients were followed and treated with biologics for 2 years of less. Clinical data relative to biological treatment, including haematological side effects, have been collected.Results:Two hundred and ninety-eight patients (178 women and 111 men) were included in the study.The mean age was 49.2 ± 14.1 years. The male/female ratio was 0.6. The mean diseases durations for RA and SA were respectively 6.7 ± 3.5 years and 6.5 ±3.6 years.Anti-TNFα agents were prescribed in 87.9% of patients (n = 263) with respectively: Infliximab (20.4%) Etanercept (23.1%), Adalimumab (24.6%) and Certolizumab (26.5%).Tocilizumab and Rituximab were prescribed in 10.4% and 5% of the patients, respectively.Blood count abnormalities were noted in 15.4 % of patients (n=46).Neutropenia was the most frequently anomaly met on the hemogram (9.1%) followed by anemia (3.4%) and thrombocytopenia (3%). Pancytopenia was found in 11.4% of patients (n=34).The median time between biological therapy initiation and the onset of hematologic manifestations was 4.8 months [1-12]. Biological treatment was interrupted in two patients.In the other cases, the biological treatment was maintained with close monitoring of blood cell count. No case of death related to these hematological disturbances has been reported.Conclusion:In our registry, hematological side effects of biological treatment were found in 15.4% of cases and were noted with a median delay of 4.8 [1-12] months after the treatment initiation. Further studies are needed to confirm our preliminary results.Disclosure of Interests:None declared

Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center

2021 ◽  
pp. 1-11
Author(s):  
Hamid Reza Niknejad ◽  
Melissa Frederickx ◽  
Emiel Salaets ◽  
Jurgen Lemiere ◽  
Lieven Lagae ◽  
...  
Keyword(s):  
Aqueductal Stenosis ◽  
Maximum Diameter ◽  
Benign Tumors ◽  
Term Outcome ◽  
Adequate Treatment ◽  
Long Term Outcome ◽  
Tectal Plate ◽  
The Mean

<b><i>Introduction:</i></b> Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients. <b><i>Methods:</i></b> We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression. <b><i>Results:</i></b> In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (<i>p</i> = 0.031) and the estimated tumor volume with 35% (<i>p</i> = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, <i>U</i> = 3, <i>p</i> &#x3c; 0.01, <i>z</i> = −2.71), performance (TPG= 100, IAS = 85, <i>U</i> = 7, <i>p</i> = 0.03, <i>z</i> = −2.2), and verbal intelligence (TPG = 122, IAS = 91.5, <i>U</i> = 2, <i>p</i> &#x3c; 0.00, <i>z</i> = −2.87) as well as working memory (TPG = 109.5, IAS = 77, <i>U</i> = 0.5, <i>p</i> = 0.01, <i>z</i> = −2.46). <b><i>Conclusion:</i></b> Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.

Usefulness of point-of-care ultrasound in military medical emergencies performed by young military medicine residents

2019 ◽  
pp. jramc-2018-001132
Author(s):  
Pierre Perrier ◽  
J Leyral ◽  
O Thabouillot ◽  
D Papeix ◽  
G Comat ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Examination ◽  
Point Of Care ◽  
Military Medicine ◽  
Final Diagnosis ◽  
Absolute Difference ◽  
Point Of Care Ultrasound ◽  
Medical Emergencies ◽  
The Mean ◽  
A Prospective Study

IntroductionTo evaluate the usefulness of point-of-care ultrasound (POCUS) performed by young military medicine residents after short training in the diagnosis of medical emergencies.MethodsA prospective study was performed in the emergency department of a French army teaching hospital. Two young military medicine residents received ultrasound training focused on gall bladder, kidneys and lower limb veins. After clinical examination, they assigned a ‘clinicaldiagnostic probability’ (CP) on a visual analogue scale from 0 (definitely not diagnosis) to 10 (definitive diagnosis). The same student performed ultrasound examination and assigned an ‘ultrasounddiagnostic probability’ (UP) in the same way. The absolute difference between CP and UP was calculated. This result corresponded to the Ultrasound Diagnostic Index (UDI), which was positive if UP was closer to the final diagnosis than CP (POCUS improved the diagnostic accuracy), and negative conversely (POCUS decreased the diagnostic accuracy).ResultsForty-eight patients were included and 48 ultrasound examinations were performed. The present pathologies were found in 14 patients (29%). The mean UDI value was +3 (0–5). UDI was positive in 35 exams (73%), zero in 12 exams (25%) and negative in only one exam (2%).ConclusionPOCUS performed after clinical examination increases the diagnostic accuracy of young military medicine residents.

scholarly journals Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease

2016 ◽  
Vol 124 (4) ◽  
pp. 971-976 ◽  
Author(s):  
Kristin Huntoon ◽  
Tianxia Wu ◽  
J. Bradley Elder ◽  
John A. Butman ◽  
Emily Y. Chew ◽  
...  
Keyword(s):  
Clinical Impact ◽  
Anatomical Location ◽  
Von Hippel Lindau ◽  
Study Enrollment ◽  
Common Location ◽  
Younger Age ◽  
The Mean ◽  
A Prospective Study ◽  
Vhl Disease

OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.

Are ultrasonography measurements of optic nerve sheath diameter an alternative to funduscopy in children with syndromic craniosynostosis?

2011 ◽  
Vol 8 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Caroline Driessen ◽  
Natalja Bannink ◽  
Maarten Lequin ◽  
Marie-Lise C. van Veelen ◽  
Nicole C. Naus ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Predictive Values ◽  
Syndromic Craniosynostosis ◽  
Nerve Sheath ◽  
Age Related ◽  
The Mean ◽  
A Prospective Study ◽  
Ct Measurement

Object Children with syndromic or complex craniosynostosis are evaluated for increased intracranial pressure (ICP) using funduscopy to detect papilledema. However, papilledema is a late sign of increased ICP. Because papilledema might be preceded by an increase in optic nerve sheath (ONS) diameter, the authors conducted a prospective study to establish the validity and applicability of measuring the ONS using ultrasonography. Methods From January 2007 to December 2009, 175 bilateral ultrasonography ONS measurements were performed in 128 patients with syndromic or complex craniosynostosis during the daytime. The measurements were correlated with ONS diameter assessed on CT and simultaneous funduscopy, when available. Furthermore, results were compared by using thresholds for ONS diameters on ultrasonography that are available in the literature. Results The mean ONS diameter on ultrasonography was 3.1 ± 0.5 mm. The CT measurement was significantly correlated with the ultrasonography measurement (r = 0.41, p < 0.001). The mean ONS diameter in 38 eyes with papilledema was 3.3 ± 0.5 mm, compared with 3.1 ± 0.5 mm in the eyes of patients without papilledema (p = 0.039). Relative to the age-related thresholds, the ONS diameter was too large in 11 eyes (3%), particularly in patients with Crouzon syndrome. Compared with funduscopy, ultrasonography sensitivity was 11%, specificity was 97%, and positive and negative predictive values were 40% and 86%, respectively. Conclusions Ultrasonography is a valid and easy way of quantifying the ONS. Although the ONS diameter is larger in children with papilledema, it cannot be used as a daytime screening tool instead of funduscopy. The ONS diameter is possibly a more real-time indicator of ICP.

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