scholarly journals Clinical Experience with Frame Based Stereotactic Biopsy for Intracranial Space Occupying Lesion

2018 ◽  
Vol 56 (212) ◽  
pp. 749-753
Author(s):  
Suresh Bishokarma ◽  
Shikher Shrestha ◽  
Munu Napit ◽  
Dinesh Nath Gongal
Keyword(s):  
Stereotactic Biopsy ◽  
Diagnostic Yield ◽  
Treatment Plan ◽  
Cross Sectional Study ◽  
Glial Tumor ◽  
Cross Sectional ◽  
Female Ratio ◽  
Common Location ◽  
Mean Size ◽  
Space Occupying Lesion

Introduction: Preoperative diagnosis of intracranial space occupying lesion based solely on clinical and neuroimaging evaluation may not be sufficient to institute treatment plan without histopathological certainty. Frame based stereotactic biopsy is a technique of retrieving biopsy specimen to determine the histopathology. The aim of this study is to assess the efficacy and accuracy of frame based technique. Methods: This is a cross-sectional study conducted among 80 patients who underwent computed tomography guided frame based stereotactic biopsy during a period of 6 years. All operations were performed under local anesthesia. Histopathology reports were retrieved and accuracy of biopsy technique analyzed. Results: Out of 80 patients, 58 were male with male to female ratio of 2.6:1. Median age of patients were 50 years with range from 16 to 75 years. Most lesions were in deeper location lesions that was 49 (61.3%). Most common location was Parietal, 15 (18.8%) followed by Thalamic, 12 (15%). Mean size of lesion was 2.88±0.71cms ranged from 2 to 5cms. Biopsy was accurate to retrieve target in 74 (92.5%) patients. Histopathology revealed glial tumor in 41 (51.2% ) of cases. Overall morbidity was observed in 3 (5.5%) patients. There is no procedure related mortality in this study during study period. Conclusions: Frame based biopsy of intracranial space occupying lesion is safe and efficacious procedure with high diagnostic yield.

scholarly journals Common Site of Urinary Calculi in Kidney, Ureter and Urinary Bladder Region: Jos Experience

2019 ◽  
Vol 7 (10) ◽  
Author(s):  
Samuel Moses Danjem ◽  
Salaam AJ ◽  
Kolade- Yunusa HO ◽  
Shuaibu SI
Keyword(s):  
Urinary Bladder ◽  
Urinary Calculi ◽  
Renal Stones ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Common Location ◽  
The Common ◽  
Male To Female

Objective: To determine the common location of calculus along the urinary tract using CT scan.  Methods: This cross sectional study was conducted using CT from November 2016 to September 2018, in a tertiary hospital in Jos, Nigeria. The CT images acquired from this period were evaluated and 50 patients were positive for urolithiasis. The data was subjected to statistical analysis based on age, gender and calculus location. Results: Out of the 50 patients with calculi, 34 were males and 16 were females with a male to female ratio of 2.13:1. 137 urinary calculi were documented in which 90 were in males and 47 in the female patients. Highest occurrence of calculi was seen in age group 31-40 years (34.0%). 112(82%) were renal stones, 12(9%) were ureteric stones, 8(6%) were found in pelvi-ureteric junction (PUJ), 3(2%) were in the vesico-ureteric junction (VUJ), 2(1%) were in the urinary bladder and none in the urethra. Conclusion: Kidney stones are the most common followed by the ureter, the pelvi-ureteric junction, the vesico-ureteric junction and the bladder.  

scholarly journals Clinical Experience of Fluroscopy Guided Percutaneous Transpedicular Biopsy of Spinal Lesion

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Suman Rijal ◽  
Pankaj Raj Nepal ◽  
Manita Raut ◽  
Dinesh Nath Gongal
Keyword(s):  
Diagnostic Yield ◽  
Treatment Plan ◽  
Osteoporotic Fractures ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Spinal Lesions ◽  
Spinal Lesion ◽  
Life Threatening ◽  
Wrong Diagnosis ◽  
Proper Diagnosis

Introduction: The diagnosis of the spinal lesions often puts the clinician in dilemma. The definite diagnosis is obviously needed for the proper management of the disease. The wrong diagnosis not only imposes the adverse effects, but sometimes may lead to the disabling conditions and even prove to be life threatening. This study is aimed at evaluating the need of fluoroscopy guided percutaneous transpedicular biopsy for establishing the proper diagnosis and find the diagnostic yield.Methods: This is the descriptive cross-sectional study conducted over the period of 10 years in the Upendra Devkota Memorial National Institute of Neurological and Allied Sciences among the patients who underwent transpedicular biopsy for various spinal lesions.Results: Among the 77 cases, 38 (49%) of the lesions on MRI were single level whereas 39 (51%) of the lesions were multiple. Most of the lesions were diagnosed as the non-tubercular infection 30 (42%), followed by the osteoporotic fractures and malignancy in 18 (25%) and 15 (21%) respectively. The sensitivity and specificity of the radiology with the background of clinical scenario was 79.5% and 90.9% respectively. The diagnostic yield of the biopsy was 93.5%.Conclusions: The transpedicular biopsy of the spinal lesion is the must for the proper diagnosis and treatment plan of such cases. The change in the diagnosis after biopsy is often possible which will drastically alter the treatment plan. Keywords: fluoroscopy guided; metastasis; spinal lesions; transpedicular biopsy; tuberculosis.

scholarly journals Triple-phase multidetector computed tomography:an evaluation of hepatic space occupying lesion in cirrhotic patients

2018 ◽  
Vol 44 (1) ◽  
pp. 23-29
Author(s):  
Reza Taufiq Muhammad Hasinuzzaman ◽  
Shyamal Kumar Roy ◽  
Md Sazzad Hossain ◽  
Fonindra Nath Paul ◽  
Monira Akther ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Cross Sectional Study ◽  
High Serum ◽  
Dysplastic Nodule ◽  
Cross Sectional ◽  
Predictive Values ◽  
Female Ratio ◽  
Imaging Department ◽  
Cirrhotic Patients ◽  
Space Occupying Lesion

Hepatocellular carcinoma (HCC) is a common tumor with an incidence of 1 - 6 % among cirrhotic patients. Dysplastic nodule often occurs within regenerative cirrhotic nodules. They can show low or high grade dysplasia. MRI best differentiates this iso-or hypo intense lesion from hyper intense HCC. The current study was designed to assess the usefulness of Triple-phase multiphasic multidetector computed tomography (MDCT) in evaluation of hepatic space occupying lesion in cirrhotic patients.This cross sectional study was carried out in Radiology and Imaging department in collaboration with Hepatology and Hepatobiliary surgery department, of Bangabandhu Sheikh Mujib Medical University, Dhaka during July 2014 to June 2016. A total of 62 cirrhotic patients with hepatic space occupying lesion were included in this study. MDCT was done in all these patients and they were followed-up from the admission up to post operative tissue diagnosis of hepatic space occupying lesion in respective pathology departments to assess the histopathological correlation. Patients with suspected hepatic space occupying lesion diagnosed by clinical andultrasonography and having high serum α-fetoprotein level were enrolled. The mean age was 50.0±13.6 years with ranged from 25 to 79 years. Male female ratio was 2.3:1.In MDCT, a total of 54 malignant cases were found, out of which 49(79.0%) patients had HCC, 4(6.5%) had metastases and 1(1.6%) had dysplastic nodule. In benign tumor group, 6(9.7%) patients had cirrrhotic nodule, 1(1.6%) had hepatic adenoma and 1(1.6%) had haemangioma. In histopahology, a total 53 malignant cases were found, out of them 48(77.5%) patients had HCC, 3(4.8%) had metastases and 2(3.2%) had dysplastic nodule. Triphasic MDCT in diagnosis of hepatic space occupying lesion in cirrhotic patients revealed a sensitivity of 98.1%, specificity of 77.8%, accuracy 95.2%, positive predictive values 96.3% and negative predictive values 87.5%. While the same diagnostic tool showed a sensitivity95.8%, specificity 78.6%, accuracy 91.9%, positive predictive values 93.9% and negative predictive values 84.6% in identification of HCC. In evaluation of metastasis MDCT had a sensitivity of 100.0%, specificity 98.3%, accuracy 98.4%, positive predictive values 75.0% and negative predictive values 100.0%. In evaluation of dysplastic nodule MDCT had sensitivity 50.0%, specificity 100.0%, accuracy 98.4%, positive predictive values 100.0% and negative predictive values 98.4%.So, MDCT can be an ideal diagnostic tool for detecting as well as characterizing the hepaticspace occupying lesion (SOLs) in cirrhotic patients.Bangladesh Med Res Counc Bull 2018; 44(1):23-29

scholarly journals Anatomical location of undescended testes and comparison between their size at different anatomical locations: A cross sectional study

2021 ◽  
pp. 16-26
Author(s):  
Aliya Ishaq ◽  
Mariya Ishaq ◽  
Muhammad Shadab Khan ◽  
Abida Parveen ◽  
Muhammad Jamshaid Hussain Khan ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Undescended Testis ◽  
Cross Sectional Study ◽  
Testicular Descent ◽  
Anatomical Location ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Location ◽  
Significant Difference ◽  
Mean Size

Introduction: Undescended testis (UDT) or cryptorchidism is a common childhood condition in which a boy is born without having one or both testes in their scrotum. It is a very frequent clinical finding in boys, with a prevalence of about 2-4%. The inguinoscrotal phase of testicular descent normally takes place in the last trimester of pregnancy. The regulation of prenatal testicular descent in humans is not fully understood, but numerous genetic and endocrinal factors are thought to have been involved. Preterm boys have been described to have a higher rate of UDT. The classification of UDT is performed according to palpable or nonpalpable testis. If the testis is located inside the normal path of descent, the testis is called ’intra-abdominal’, for those located in the abdomen is called ’intracanalicular’, for those located between the internal and external rings or ’suprascrotal’, for those located between the entrance of the scrotum and the external ring. This study was conducted to determine the frequency of anatomical location of undescended testis in pediatric patients undergoing orchidopexy as well as to compare the mean size of undescended testis at different anatomical location in pediatric patients undergoing orchidopexy as a secondary objective. Methods: It’s a cross sectional study of 94 patients with total 110 testes as per inclusion criteria. Study was performed at pediatric surgery department of Liaquat National university hospital Karachi, Pakistan for a duration of eight months. Orchidopexy was performed under general anesthesia as a surgical day care procedure. At orchiopexy, the outcome variables i.e. location and size of the testis was noted. The size of the testis was measured in anteroposterior and mediolateral dimensions vernier caliper, graduated in mm. The size of testis was calculated by modified Lambert’s formula (0.71xlengthxwidth2). All the collected data were entered into the proforma attached at the end. Results: Mean±SD of age was 4.29±2.19 with C.I (3.38…….4.74) years. Mean±SD of size of testis was 425.68±244.43 with C.I. (375.89……..475.47) mm. In location of testis 4 (4.2%) was located at intra-abdominal, 15 (16%) at intracanalicular and 75 (79.8%) was located at distal to superficial ring. Mean size of testis in intra-abdominal location was 276.29±145.47, intra-canalicular 367.89±196.15, distal to superficial ring was 442.27±54.08 and non-significant P-value was found i.e. (p=0.264). Conclusion: No significant difference was found between mean size of testis and location of undescended testis. The most common location was distal to superficial ring. Keyword: Testes; Undescended; Anatomical Location; Orchidopexy; Anatomical Location

scholarly journals To Determine the Frequency of Dural Tear in Patients Presenting with Depressed Skull Fracture

2017 ◽  
Vol 4 (1) ◽  
pp. 18-22
Author(s):  
Sohail Amir ◽  
Syed Amir Shah ◽  
Khaleeq -Ur- Zaman
Keyword(s):  
Skull Fracture ◽  
Cross Sectional Study ◽  
Temporal Region ◽  
Dural Tear ◽  
Cross Sectional ◽  
Female Ratio ◽  
Depressed Skull Fracture ◽  
Common Location ◽  
Ct Brain ◽  
One Year

OBJECTIVEThe objective of this study was to determine the frequency of dural tear in patients with depressed skull fractures.MATERIAL and MethodThis cross-sectional study was conducted in department of Neurosurgery Pakistan institute of Medical Sciences Islamabad from January 2010 to December 2011. All patients of either gender with depressed skull fracture above one year of age were included in the study. CT brain with bone window done in all patients. Per-operative dura in the region of depressed skull fracture was closely observed for any dural tear. The data collected on pre designed proforma. and analyzed using SPSS version 20.0RESULTSA total of 96 patients were recruited in the study out of which 58(60.4%) were male and 38(39.5%) were female. Male to female ratio was 1.5:1. And mean age was 19.23 + 2.54 years. The most common location of depressed skull fracture was parietal 37(38.5%), followed by frontal in 27(28.1%), 15(15.6%)in temporal region,13(13.5%) in occipital region and only 4(4.1%) located in posterior fossa. Dural tear was present in 33(34.3%) while in 63(65.6%) it was absent. Other finding associated with depressed skull fracture per operatively were extradural hematoma in 16(16%), subdural hematoma in 11(11.4%), contusion in 16(16.6%) and pneumoencephalus was observed in 20(20.8%) cases.CONCLUSIONThe frequency of dural tear in DFS is quite high, so one should be vigilant to identify the defect and repair it properly to minimize post operative complications.

scholarly journals EXUDATIVE PLEURAL EFFUSION

2016 ◽  
Vol 23 (08) ◽  
pp. 970-974
Author(s):  
Nosheen Saifullah ◽  
Saifullah Baig ◽  
Niaz Hussain Soomro ◽  
Nadeem Rizvi
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Inclusion Criteria ◽  
Pleural Biopsy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Specific Diagnosis ◽  
Male To Female

Objectives: To compare the pleuroscopic and closed pleural biopsy by Abramsneedle in terms of diagnostic yield and obtaining specific diagnosis in cases of exudative pleuraleffusion. Study Design: Cross sectional study. Period: August 2014 to February 2015. Setting:Department of Thoracic Medicine Jinnah Post Graduate Medical Center Karachi. Methodology:All patients with pleural effusion who were admitted and fulfilling the inclusion criteria wereincluded in the study .Closed pleural biopsy using Abrams needle followed by pleuroscopy witha flexible pleuroscope was performed from the same incision, in the same sitting. The sampleswere sent for histopathology. To control bias samples were coded as A and B and the codewas not known to the histopathologist. Results: Among 60 patients, Mean age was 42.85 yearswith ±18.2 standard deviation and male to female ratio was 1.6 :1. Specific diagnosis throughpleuroscopic biopsy had shown 27 (45%) cases of tuberculosis, 25 (41.7%) of adenocarcinoma,5 (8.3%) of chronic non specific inflammation, one (1.7%) case of lymphoma and 2 (3.3%)cases could not be reached for any diagnosis. Conclusion: Pleuroscopy has better yield thanthe Abrams needle biopsy in terms of both diagnostic yield and specific diagnosis

scholarly journals Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

2021 ◽  
Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa
Keyword(s):  
Developing Countries ◽  
Head Injury ◽  
Road Traffic ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Incidence And Mortality ◽  
Male Female Ratio ◽  
Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

2021 ◽  
Vol 15 (9) ◽  
pp. 2841-2843
Author(s):  
Muhammad Omer Farooq ◽  
Niaz Ahmed ◽  
Hassan Nadeem ◽  
Kashif Rafi ◽  
Sadia Jabbar ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Cross Sectional Study ◽  
Meld Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Score Study ◽  
Insignificant Difference ◽  
Cirrhotic Patients ◽  
Male To Female

Objective: To determine the frequency of high MELD score in cirrhotic patients undergoing liver resection due to hepatocellular carcinoma also compare the frequency of mortality in patients with high or low MELD score. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. Duration: 6months i.e. 23 12-2017 to 22-06-2018. Methodology: 75 patients were enrolled. Then blood sample was obtained. Reports assessed and MELD score calculated. Scores were labeled as high or low. Patients underwent liver resection according to BCLC. The mortality was noted. All the collected data was entered and analyzed on SPSS version 22. Results: In this study out of total 75 cases 60 were males and 15 females. The mean age of patients was 39.44±9.76 years, male to female ratio was 4:1. Low MELD class was noted in 45 (60%) cases and high MELD class noted in 30(40%) cases. Mortality occurred in 27(36%) cases. Insignificant difference found between the MELD class with mortality. Conclusion: High MELD score was seen in 40% cirrhotic patients undergoing liver resection due to HCC. Post HCC resection, mortality occurred in 36% patients within three months of surgery. No significant association was found between the mortality and MELD score. Keywords: MELD, Hepatocellular Carcinoma, Mortality, Cirrhosis

HIV Prevalence and Frequency of Risk Behavior in Injecting Drug Users Entering Treatment and Out of Treatment: A Cross-Sectional Study in Five Italian Cities

1994 ◽  
Vol 24 (3) ◽  
pp. 527-535 ◽  
Author(s):  
Giovanni Rezza ◽  
Stefania Salmaso ◽  
Damiano Abeni ◽  
Giovanna Brancato ◽  
Alessandra Anemona ◽  
...  
Keyword(s):  
Risk Behavior ◽  
Drug Users ◽  
Injecting Drug Users ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Outreach Programs ◽  
Male To Female

We conducted a study to describe current patterns of drug-related behaviors, and to identify characteristics that may distinguish injecting drug users entering treatment from those out of treatment, in five Italian cities. Overall, 1,180 subjects were recruited — 568 entering treatment and 612 out of treatment. Male to female ratio was 6.6:1. The median age was similar in the two groups. A high proportion of injecting drug users recruited out of treatment had been in treatment at least once. HIV prevalence among injecting drug users entering treatment was not higher than that of those who were out of treatment. Furthermore, a large proportion of injecting drug users who still were out of treatment reported having adopted safe behaviors. The results of the study emphasize the need to implement outreach programs aimed at harm reduction.

scholarly journals To what extent are GCS and AVPU equivalent to each other when assessing the level of consciousness of children with head injury? A cross-sectional study of UK hospital admissions.

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023216 ◽  
Author(s):  
Amy GL Nuttall ◽  
Katie M Paton ◽  
Alison M Kemp
Keyword(s):  
Head Injury ◽  
Hospital Admissions ◽  
Diagnostic Yield ◽  
Cross Sectional Study ◽  
Initial Assessment ◽  
Clear Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Level Of Consciousness

ObjectiveTo evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury.DesignCross sectional study.SettingUK hospital admissions: September 2009–February 2010.Patients<15 years with head injury.InterventionsGCS and/or AVPU at injury scene and in emergency departments (ED).Main outcomeMeasures used, the equivalence of AVPU to GCS, GCS at the scene predicting GCS in ED, CT results by age, hospital type.ResultsLevel of consciousness was recorded in 91% (5168/5700) in ED (43%: GCS/30.5%: GCS+AVPU/17.3%: AVPU) and 66.1% (1190/1801) prehospital (33%: GCS/26%GCS+AVPU/7%: AVPU). Failure to record level of consciousness and the use of AVPU were greatest for infants. Correlation between AVPU and median GCS in 1147 children <5 years: A=15, V=14, P=8, U=3, for 1163 children ≥5 years: A=15, V=13, P=11, U=3. There was no significant difference in the proportion of infants who had a CT whether AVPU=V/P/U or GCS<15. However diagnostic yield of intracranial injury or depressed fracture was significantly greater for V/P/U than GCS<15 :7/7: 100% (95% CI 64.6% to 100%) versus 5/17: 29.4% (95% CI 13.3% to 53.1%). For children >1 year significantly more had a CT scan when GCS<14 was recorded than ‘V/P/U only’ and the diagnostic yield was greater. Prehospital GCS and GCS in the ED were the same for 77.4% (705/911).ConclusionThere was a clear correlation between Alert and GCS=15 and between Unresponsive and GCS=3 but a wider range of GCS scores for responsive to Pain or Voice that varied with age. AVPU was valuable at initial assessment of infants and did not adversely affect the proportion of infants who had head CT or the diagnostic yield.

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