scholarly journals Stuttering after Intravenous Anesthesia: A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 929-931
Author(s):  
Suraj Lamichhane ◽  
Murari Raj Upreti ◽  
Yogesh Dhakal
Keyword(s):  
Case Report ◽  
Hospital Stay ◽  
Male Patient ◽  
Speech Therapy ◽  
Past History ◽  
Perianal Abscess ◽  
Speech Disorder ◽  
Intravenous Anesthesia ◽  
Incision And Drainage ◽  
Significant Challenge

Stuttering is a form of speech disorder characterized by involuntary prolongation and repetition of sound, words, syllables or phrases as well as involuntary silent pauses or blocks. We report a case of a healthy twenty-six-year-old male patient without significant past history, who underwent short intravenous anesthesia for incision and drainage for perianal abscess. Postoperatively, the patient presented with prominent stuttering after six hours of surgery. To our knowledge, this is the first reported case of stuttering following short intravenous anesthesia without any airway manipulation. He was diagnosed with a functional speech disorder after excluding organic causes. His speech eventually normalized with six weeks of intensive speech therapy. This event posed a significant challenge for the surgical and anesthesia team to find the potential cause, to plan further management, and lead to two days prolongation of hospital stay.

Analysis of treatment methods and outcomes for perianal abscess (PA) and fistula in ano (FIA) in infants

Nowa Medycyna ◽  
2020 ◽  
Vol 27 (2) ◽  
Author(s):  
Michał Puliński ◽  
Natalia Hawryluk ◽  
Wojciech Choiński
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Retrospective Analysis ◽  
Perianal Abscess ◽  
Paediatric Surgery ◽  
Common Condition ◽  
Incision And Drainage ◽  
Treatment Methods ◽  
Fistula In Ano ◽  
Children's Hospital

Introduction. Perianal abscess (PA) is a relatively common condition in children and occurs in 0.5 to 4.3% of the infant population. In the majority of cases, it is associated with fistula in ano (FIA). Surgical treatment of FIA includes fistulectomy, fistulotomy or, rarely, cryptotomy. Aim. The aim of the study is to perform a retrospective analysis of treatment methods and outcomes for PA and FIA in infants at the Department of Paediatric Surgery and Urology of the Regional Specialised Children’s Hospital in Olsztyn, Poland, in 2014-2019. Material and methods. From January 2014 to December 2019, 44 infants with diagnosed PA and FIA were treated. The majority of patients were boys: 41 (93%) and only 3 (7%) were girls. For PA, three different treatment methods were used: incision and drainage, fistulotomy or fistulectomy. Results. Out of 44 treated infants with diagnosed PA and FIA, 29 were treated only by incision and drainage. Among them, 19 were cured. FIA was identified in 9 patients and fistulectomy or fistulotomy was performed. In this group, there was 1 recurrence, which was retreated with fistulectomy and cured. In 6 patients, PA drained spontaneously; in 3 of them there was recurrence and FIA was diagnosed during another hospital stay. There were 7 fistulotomies and 14 fistulectomies performed and their efficacy was 100 vs 93%, respectively. Conclusions. Fistulotomy is the most effective and safest method of FIA treatment in infants. In every case of perianal abscess diagnosis, a fistula in ano should be looked for.

scholarly journals Thinking beyond Tuberculosis: A Case Report

2020 ◽  
pp. 132-138
Author(s):  
Tauheed Ahmed ◽  
Sanjay Khator ◽  
Sangita D Kamath ◽  
Rudra Prasad Samanta
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Male Patient ◽  
Chest Radiograph ◽  
Lung Tissue ◽  
Past History ◽  
High Prevalence ◽  
History Of

Aspergilloma describes the saprophytic colonization of an area of devitalized lung tissue. It usually develops in pre-existing pulmonary cavities caused by tuberculosis, sarcoidosis and other such conditions. It is found in almost 15% to 25% of patients with cavitatory lesions resulting from tuberculosis. In developing countries with high prevalence of tuberculosis, like India, aspergilloma is often misdiagnosed as tuberculosis. Hemoptysis is often equated with TB, and most patients are diagnosed clinically. Here we report one such case of a 56 year old male patient with past history of tuberculosis, who was initially diagnosed and being treated as a relapse of tuberculosis on the basis of hemoptysis and chest radiograph findings, till further detailed investigations revealed an aspergilloma in a post tubercular cavity as the cause of his symptoms.

scholarly journals Incision and drainage of perianal abscess with primary fistulotomy in case of co-existing low variety fistula

2020 ◽  
Vol 28 (1) ◽  
pp. 85-89
Author(s):  
Mohammad Nazmul Hoque Masum ◽  
Asif Yazdani ◽  
Md Shahnawas Biswas ◽  
Mohammad Masum ◽  
Masfique Ahmed Bhuiyan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Digital Rectal Examination ◽  
Perianal Abscess ◽  
Healing Time ◽  
Complete Healing ◽  
Repeat Surgery ◽  
Average Hospital ◽  
Incision And Drainage ◽  
Patient’S Satisfaction

Background: Perianal abscess is a clinical condition frequently encountered by surgeons. Perianal abscess originates from an infection arising in the cryptoglandular epithelium lining the anal canal. Occasionally; bacteria, fecal material or foreign matter can clog an anal gland and tunnel into the tissue around the anus or rectum, where it may then collect in a cavity called an abscess. About half of perianal abscess may manifest as fistula-in-ano which increases the risk of abscess recurrence requiring repeated drainage. Treating the fistula at the same time of incision and drainage of abscess reduce chances of recurrent abscess development and therefore likelihood of repeat surgery. Primary fistulotomy in case of low variety fistula may be advantageous for perianal abscess because fistulas are more commonly traceable and can be laid open with full preservation of external anal sphincters. Methods: 216 consecutive patients (91.6% males, 8.33% females); mean age, 39 (range 18-70 years) from July, 2015 to January, 2019 with perianal abscesses were treated by incision and drainage and primary fistulotomy. 38 patients had comorbidities as diabetes mellitus, obesity (BMI>26), tuberculosis. Patients were followed up clinically for 2 months. Digital rectal examination performed to assess anal tone before, one week and one month after surgery. Results: Operative time was on average 17 minutes (15-20 minutes). Average hospital stay was 1 day and complete healing time ranged from 30-60 days. Persistent fistulas developed in four patients after surgery (1.85%). Bleeding occurred in 2 patients (1%). Many patients had transient minor incontinence in the form of flatus and loose stool incontinence but eventually resolved after two weeks. No major incontinence was found. Patient’s satisfaction of the treatment maneuver in relation to abscess recurrence and fistula occurrence was 95%. All patients remained fully continent. Operative time, hospital stay, and time for complete wound healing were the same in both groups. Conclusion: Primary fistulotomy for co-existing low variety fistula at the time of drainage of perianal abscess results in very few persistent fistulas and no added risk of fecal incontinence. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 85-89

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

The Effectiveness of Behaviour Therapy in Writer’s Cramp: A Case Report

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Mahesh M M ◽  
Dr. Johnson Alex
Keyword(s):  
Mental Illness ◽  
Case Report ◽  
Family History ◽  
Male Patient ◽  
Motor Nerve ◽  
Conclusive Evidence ◽  
Behaviour Therapy ◽  
Present Treatment ◽  
Writer’S Cramp ◽  
Writer's Cramp

42 years old male patient referred from neurology department, working as a teacher, educated up to MSc, premorbidly anxious personality, family history mental illness (first degree relatives), comes from MSES with presenting complaints of difficulty in writing or copying since seven years. Disability progressed and he was unable to write even a few words legibly and could not hold object which leads to anxiety and dependency. When the patient was examined at Neurology OPD, find out that he has normal sensory and motor nerve functions. The present treatment involved the use of Bahaviour therapy. The findings in this case is very encouraging and studies with large sample sizes can be considered for further conclusive evidence on the treatment of writer’s cramp.

Ayurvedic Management of Sthaulya (Obesity): A Case Report

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Nirmal P. Alodaria ◽  
S. N. Gupta ◽  
Dhaval Dholakiya ◽  
Kaushik B. Vyas
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Life Style ◽  
Health Issue ◽  
Exertional Dyspnoea ◽  
Alternative Approach ◽  
Ayurvedic Treatment ◽  
Excessive Perspiration

Obesity is burning health issue for society nowadays. In Sutrasthana of Charaka Samhita, in different Adhyaya (eg. Astauninditiya, Langhanabrumhaniya, Santarpaniya) causes, symptoms and treatment of Sthaulya are described. As an alternative approach, Ayurvedic treatment may serve as promising modality. A 17 years old male patient came in P.D. Patel Ayurveda Hospital on 22th May 2017. Patients weight was 114.8 kg and BMI was 37.51 which fairly included in obesity category according to NHI guidelines. He also had some associated complaints like exertional dyspnoea, increased appetite, excessive perspiration. He was treated with Snehana (Aabhyantara and Bahya), Swedana, Vamana, Virechana, Niruha Basti, Udvartana along with oral medicines like Varunaadi Kwatha, Arogyavardhini Vati, Triphala Guggulu, and Navayasa Lauha along with prescribed dietary regimes and life style modification. He lost about 9.7 kg of weight, which was 105.1 kgs and BMI was 34.34 only in 26 days without any complications.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

scholarly journals Nasopharyngeal hirudiniasis: a hidden culprit—a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Shreya Agarwal ◽  
Nimish Gupta
Keyword(s):  
Drinking Water ◽  
Case Report ◽  
Foreign Body ◽  
Male Patient ◽  
Natural Water ◽  
Water Sources ◽  
Endoscopic Examination ◽  
Rare Occurrence ◽  
Safety Measures ◽  
Case Presentation

Abstract Background Leech infestation in the nose or nasopharyngeal region is a rare occurrence. The most common known cause is drinking water from natural water sources like ponds and rivers. Its hidden location of attachment in the nasopharynx and its uncommon occurrence make it easy to miss during diagnosis. Case presentation We present a case of a 61-year-old male patient with recurrent unilateral epistaxis without any apparent cause. He was diagnosed with leech infestation in the nasopharynx on endoscopic examination. This article reports the management of nasopharyngeal leech infestation and safety measures for this animate foreign body retrieval. Conclusion A vigilant approach, thorough history, and examination are a must. Though leeches are simple to remove most of the time, certain necessary precaution should be kept in mind for better management and prevention of further complications.

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