Traumatic isolated intracerebellar haematoma without any supratentorial lesion

Purpose. Pure isolated cerebellar haematoma of traumatic aetiology, without associated posterior fossa sub- or epidural haematomas and without supratentorial bleed is a rare entity. We conducted this retrospective study to analyze the management strategy of isolated traumatic intracerebellar haematoma without supratentorial lesion in our institute. Methods. We retrospectively reviewed records of more than 15000 head injury patients in our department of neurosurgery between January 2014 and November 2019. In this isolated intracerebellar hematoma patients are 60. Patients were divided into two groups assessed by the GCS score at the time of presentation – Group A (GCS>13) Group B (GCS lesser than or equal to 13). Group A treated conservatively and B surgically. Group A subdivided according to the size of hematoma into1st (>3cm ) and 2nd (<3 cm ). Group B subdivided according to GCS into 1st ( <8 ) and 2nd ( 8-13). Results. Most Group B, subgroup 1st ( GCS<8) patients found to be associated with poorer outcome ( 60 %) and subgroup 2nd ( GCS 8-13) had only 10 %. Group A subgroup 1st ( > 3 cm hematoma) has associated with poor outcome ( 28.57%) and Subgroup 2nd ( < 3 cm ) has 4.34% . GCS score at the time of admission, hematoma size, hematoma location, the timing of surgery were important factors for outcome. Conclusion. We concluded that hematoma size is > 3 cm and GCS > 8 patient should operate within 12 hr. Patient of GCS < 8 results of surgery are poor( 60%.) .If the size of hematoma < 3 cm, lateral hematoma and GCS >13 should be treated conservatively. The factors which may be associated with the poor outcome are Low GCS score at the time of admission(<8), the large size of hematoma (>3cm), median location and delay time of surgery(>12hr).

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Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204179 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1804

Author(s):

Priyanka Aggarwal ◽

Barjinder Singh Sohal ◽

J. P. Goyal

Keyword(s):

Success Rate ◽

Cost Effective ◽

Patient Comfort ◽

Hearing Improvement ◽

Post Operation ◽

Group A ◽

Group B ◽

The Cost ◽

Results Of Surgery ◽

Endoscopic Tympanoplasty

Background: To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.Methods: Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.Results: The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.Conclusions: Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.

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Comparative Study of Surgical Treatment of Chalazion

Faridpur Medical College Journal ◽

10.3329/fmcj.v9i2.25676 ◽

2015 ◽

Vol 9 (2) ◽

pp. 68-69

Author(s):

Khandaker Anowar Hossain ◽

Md Abdur Rashid ◽

AKM Rafiqul Islam

Keyword(s):

Inflammatory Lesion ◽

Skin Surface ◽

Meibomian Gland ◽

Medical College ◽

Large Size ◽

Intralesional Steroid ◽

Intralesional Steroid Injection ◽

Group A ◽

Group B

A chalazion is chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices & stagnation of sebaceous secretion. Common practices in treatment of chalazion are intralesional steroid injection, incision & curettage and excision of chalazion. Recurrence rate is high for incision & curettage in case of large chalazion. The aim of the study is to established that excision large chalazion give better result than incision & curettage. The study was carried out at Diabetic Association Medical College & Hospital, Faridpur and General Hospital, Fadidpur. A total 100 cases were selected for study. Technique of operation were incision & curettage through conjunctival surface and excision of chalazion through skin surface. In 50 % cases we performed incision & curettage both in small (size <5mm) and large (size >5mm) chalazion. In 50 % cases of large chalazion we performed excision of chalazion. The follow up period was 3 months to 6 months. In group -A with incision & curettage through conjunctival surface, in case of small chalazion 27 out of 30 patients were cured (90%). In case of large chalazion 14 out of 20 patients were cured (70%). In group B with excision of chalazion through skin surface, in case of large chalazion 49 out of 50 patients were cured (98%). So higher success rate after excision of large chalazion through skin surface.Faridpur Med. Coll. J. 2014;9(2): 68-69

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Comparison of within 7 Day All-Cause Mortality among HDU Patients with Modified Early Warning Score of ≥5 with those with Score of <5

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.2.2832 ◽

2021 ◽

Vol 37 (2) ◽

Author(s):

Majid Ahmed Sahikh ◽

Avinash Punshi ◽

Mohan Lal Talreja ◽

Tazeen Rasheed ◽

Nimrah Bader ◽

...

Keyword(s):

Early Warning ◽

Early Warning Score ◽

Positive Trend ◽

Creative Commons ◽

All Cause Mortality ◽

Significant Area ◽

Group A ◽

Group B ◽

Time Of Admission ◽

Open Access Article

Objective: To compare 7-Day All-Cause Mortality among HDU Patients with Modified Early Warning Score of ≥5 with Those with Score of <5. Methods: All patients of age more than 18 years, of either gender admitted in HDU of Medical Unit-II, CHK between September 2019 to February 2020 were included. MEWS was calculated for each patient at time of admission. Patients with MEWS score of ≥5 were allocated to Group-A and those with score of <5 were allocated to Group-B. Patients were followed for seven days and outcome status of alive, expired or discharged was noted. Results: Total of 336 patients were selected out of which 168 patients was inducted in Group-A and 168 patients in Group-B. MEWS Score in patients who expired was significantly higher (Mdn=11) than in those who survived (Mdn=4), p <.001. 7-day mortality in Group-A was 62 (39.9%) while in Group-B was 40 (23.8%). ROC was plotted of MEWS Score for mortality, it showed significant area under curve of 68.4% (p <0.001, 95% CI = 0.62 to 0.75). MEWS Score of 3.5 showed sensitivity of 89.2% and specificity of 65%. Conclusion: Our results show that MEWS has a positive trend to predict mortality. MEWS score of 3.5 is suggested cut off based on ROC in our study. doi: https://doi.org/10.12669/pjms.37.2.2832 How to cite this:Shaikh MA, Punshi A, Talreja ML, Rasheed T, Bader N, Zuberi BF. Comparison of within 7 Day All-Cause Mortality among HDU Patients with Modified Early Warning Score of ≥5 with those with Score of <5. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2832 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Hypertriglyceridemia: An indicator of poor prognosis in acute pancreatitis – A hospital based study

Asian Journal of Medical Sciences ◽

10.3126/ajms.v5i4.9971 ◽

2014 ◽

Vol 5 (4) ◽

pp. 21-24

Author(s):

Mosin Mushtaq ◽

Abid H Wani ◽

Faud Sadiq ◽

Mudasir Mushtaq ◽

Sameena Tabassum ◽

...

Keyword(s):

Acute Pancreatitis ◽

Serum Triglyceride ◽

Final Conclusion ◽

Medical Sciences ◽

Gall Stones ◽

Group A ◽

Study Population ◽

The Mean ◽

Group B ◽

Time Of Admission

Background and study aims: Hypertriglyceridemia can be a primary cause for acute pancreatitis or secondary to other factors prior to the increase of lipid levels, or both. The aim of our study was to assess the severity of acute pancreatitis with elevation in serum triglyceride levels and report the outcomes of our series. Patients and methods: One hundred twenty?six patients of acute pancreatitis were admitted within 72 hours of onset of symptoms, out of whom 26 patients were excluded during the course of study due to preexisting comorbidities. 100 patients in the study population were divided into group A having serum triglyceride levels ≥500 mg/dl (n = 30) and group B having <500 mg/dl (n = 70) at the time of admission. Results: The mean age of group A was similar to group B (50.2 ± 17.1 vs 49.26 ± 17.2 years; p = 0.860). Most common etiological factor of acute pancreatitis was found to be gall stones (56%) in both groups. Ranson's score at admission in group A was 2.93 ± 0.22 and in group B it was 1.34 ± 0.99. Mortality below two weeks was noted in (12/30, 40%) of group A and (6/70, 8%) of group B patients, which was statistically significant, (p = 0.015). Conclusions: The final conclusion of this study was that patients of acute pancreatitis with elevated triglyceride levels form a morbid group and these should be monitored aggressively for the development of any complications. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9971 Asian Journal of Medical Sciences 2014 Vol.5(4); 21-24

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Influences of Intravenous Thrombolysis with Recombinant Tissue-type Plasminogen Activator on the Outcome of Atrial Fibrillation Patients with Acute Ischemic Stroke: A Case a Case-control Study of 227 Patients

10.21203/rs.3.rs-618564/v1 ◽

2021 ◽

Author(s):

Hai-xia Wang ◽

Nan Zhang ◽

Guo-Qiang Wang ◽

Yong-hua Huang

Keyword(s):

Atrial Fibrillation ◽

Tissue Type ◽

Short Term ◽

Nihss Score ◽

Tissue Type Plasminogen Activator ◽

Poor Outcome ◽

Type Plasminogen Activator ◽

Group A ◽

The Difference ◽

Group B

Abstract Background: It is a debatable topic about the benefit of intravenous (IV) thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) for atrial fibrillation (AF) patients with acute ischemic stroke (AIS). This study aimed to identify whether IV rt-PA could improve the short-term outcome of patients with AF-AIS.Methods: Medical data of patients with AIS onset within 72hs admitted in the department of neurologic of our hospital between January 1st, 2015 and December 31, 2020 were extracted. The AF-AIS patients were selected and divided into IV rt-PA group (group A) and non-rt-PA group (group B). The baseline characteristics, imaging changes and modified Rankin Scale (mRS) score (≤ 2 as good prognosis, > 2 as poor, = 6 as death) at discharge were obtained to compare the differences between the two groups. Logistic regression was used to analyze the factors influencing on the outcome. Results: Among a total of 1663 AIS patients, there were 280 had AF, of them 227 AF-AIS cases were conformed to the inclusion criteria, including 45 in group A and 182 in group B. All of AF-AIS patients, 48.0% had larger size of infarction and 62.1% had National Institute of Health stroke scale (NIHSS)score more than 10, the differences in the size and NIHSS between the two groups were not significant. A total of 51 cases (22.5%) died during hospitalization, the difference between group A and group B was not obvious (20.0% vs. 23.1%, P=0.658). The cumulative poor outcome (including deaths) at discharge was 75.3%, the difference between the two groups was also not significant (77.8% vs. 74.7%, P=0.671). The incidence of hemorrhagic transformation (HT) in group A was higher than that of in group B (40.0% vs. 21.4, P=0.010), the same was true for parenchymal hematoma (PH) in group A than group B (22.2% vs. 5.5%, P = 0.001). On univariate analysis, poor outcome was significantly associated with infarct size, NIHSS and PH, but not thrombolysis. The proportion of PH in patients with poor outcome between the two groups was also not remarkable. On adjusted multiple logistic regression analysis, both baseline infarction size [(P=0.013, odds ratio (OR) =4.558, 95% 95% confidence interval (CI): 1.373- 15.133] and NIHSS (P<0.001, OR=1.348, 95% CI=1.219-1.491) but not thrombolysis or PH entered into the final model as significant independent risk factors of poor outcome. Conclusion: Patients with AF-AIS had larger infarction size, higher NIHSS score, higher rate of mortality and worse outcome, for them, the IV rt-PA increased the incidence of PH except significantly improved their short-term prognosis.

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MESH VERSUS SIMPLE ANATOMICAL REPAIR OF EPIGASTRIC AND PARAUMBILICAL HERNIAS

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2016.6.1.708-713 ◽

1969 ◽

Vol 6 (1) ◽

pp. 708-713

Author(s):

AJMAL KHAN ◽

AMIULLAH ◽

MANZOOR ALI ◽

SAIFUREHMAN ◽

ANWAR SYED

Keyword(s):

Hospital Stay ◽

Mesh Repair ◽

Umbilical Hernia ◽

Rectus Sheath ◽

Epigastric Hernia ◽

Large Size ◽

Group A ◽

The Mean ◽

Group B ◽

Simple Repair

BACKGROUND: The standard method of repair of Para-umbilical hernia (PUH) and Epigastric herniais by the Mayo technique, using a double-breasted flap of the rectus sheath. The result of this techniquein the hands of others is highly variable. The present study describes and evaluates the comparison of aProlene mesh versus simple anatomical repair of (PUH) and Epigastric hernias. The use of a Prolenemesh in hernia repair is not a new concept with previous investigators yielding consistently excellentresults in the repair of Para-umbilical and Epigastric Hernias.OBJECTIVE: To compare the outcomes of the two modalities of surgical procedures (mesh versussimple anatomical repair) in terms of post-operative complications, hospital stay and rate of recurrencein two groups of Para-umbilical and epigastric hernia patients.MATERIAL AND METHODS: This comparative prospective study was conducted in the Departmentof Surgery Saidu group of teaching Hospital Saidu Sharif Swat KPK. One Hundred and Thirty twoconsecutive patients having large size, Para umbilical and epigastric hernia were included for the study,from Feb 2010 to Feb 2014 in two groups, 72 (group A) for mesh repair and 60 (group B) for simpleanatomical repair. All patients of these type hernias were admitted throughout patient department(OPD). Less than 4cm size hernia, Pregnant ladies, patients having strangulated hernia presented asemergency and patient unfit for general anesthesia were excluded from study.RESULTS: Majority of patients 63% belong to age of 35 to 60 years and 87 % were females. Supraumbilical swelling was the commonest presentation 80%.Cough impulse and reducibility was positive in90% of cases (some Epigastric hernias were irreducible). Contents of sac were omentum in 74% to 83%and small intestine 17% to 26%. Operative time was longer in group A (mesh repair) ranged from 60 to90 minutes while that was 50 to 70 minutes in group B (simple anatomical repair). Post-operativeevaluation took place after 2weeks then, 1, 2, 3months then 6monthly for 30 months (average 18months). The number of complications requiring treatment was the primary aim. There were threerecurrences observed in group A (4.16%) but six cases of group B (10%) presented with recurrence inwhich simple anatomical repaired was performed. The mean hospital stay for group A was 3.7 days andfor group B, 4.6 days.CONCLUSION: Mesh repair compare to simple anatomical repair, is with less hospital stay and lessrecurrence for Para umbilical and epigastric hernia having a defect of more than4 cm in leneaAlba.KEYWORDS: Para-umbilical hernia, simple repair, meshplasty, complications, recuurence.

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Comparison of the Characteristics of Asymptomatic and Presymptomatic Patients with Coronavirus Disease 2019 in the Republic of Korea

Journal of Epidemiology and Global Health ◽

10.1007/s44197-021-00011-7 ◽

2021 ◽

Vol 11 (4) ◽

pp. 354-363

Author(s):

Miri Hyun ◽

Ji Yeon Lee ◽

Jae Seok Park ◽

Jin Young Kim ◽

Hyun Ah Kim

Keyword(s):

Clinical Manifestations ◽

Tertiary Hospital ◽

Chest Radiographs ◽

Reactive Protein ◽

Asymptomatic Patients ◽

Group A ◽

The Republic ◽

Group B ◽

Time Of Admission

Abstract Purpose This retrospective study aimed to evaluate the baseline characteristics of asymptomatic patients with coronavirus disease 2019 at admission and to follow-up their clinical manifestations and radiological findings during hospitalization. Methods Patients with coronavirus disease 2019 who were asymptomatic at admission were divided into two groups—those with no symptoms until discharge (group A) and those who developed symptoms after admission (group B). Patients who could not express their own symptoms were excluded. Results Overall, 127 patients were enrolled in the study, of whom 19 and 108 were assigned to groups A and B, respectively. The mean age and median C-reactive protein level were higher in group B than in group A. All patients in group A and one-third of patients in group B had normal initial chest radiographs; 15.8% and 48.1% of patients in groups A and B, respectively, had pneumonia during hospitalization. One patient in group B, whose condition was not severe at the time of admission, deteriorated due to aggravated pneumonia and was transferred to a tertiary hospital. Conclusion We summarize the clinical characteristics during hospitalization of patients with coronavirus disease 2019 who were purely asymptomatic at the time of admission. The majority of asymptomatic patients with coronavirus disease 2019 were discharged without significant events during hospitalization. However, it may be difficult to predict subsequent events from initial chest radiographs or oxygen saturation at admission.

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Patterns of lactate dehydrogenase isoenzymes in serum of patients with acute pulmonary edema.

Clinical Chemistry ◽

10.1093/clinchem/34.9.1880 ◽

1988 ◽

Vol 34 (9) ◽

pp. 1882-1884 ◽

Cited By ~ 3

Author(s):

Z Rotenberg ◽

I Weinberger ◽

E Davidson ◽

J Fuchs ◽

O Sperling ◽

...

Keyword(s):

Lactate Dehydrogenase ◽

Pulmonary Edema ◽

Acute Pulmonary Edema ◽

Typical Pattern ◽

Group A ◽

Group B ◽

Time Of Admission ◽

Group D ◽

Isoenzyme Patterns ◽

Lactate Dehydrogenase Isoenzymes

Abstract Total lactate dehydrogenase (LD; EC 1.1.1.27) activity in serum and proportions of LD isoenzymes were quantified on admission and discharge in 170 selected (from 240) patients with acute pulmonary edema (APE). The patients were divided into group A, 75 patients with normal LD values (less than 225 U/L); and groups B-E, with increased LD activity in serum: group B, 40 patients with increase in the proportion of LD-3 (greater than 38%); group C, 12 patients with increased LD-5; group D, 36 patients with an isomorphic pattern of LD isoenzymes; and group E, seven patients with LD-1/LD-2 greater than 0.75. Nine patients in group C (75%) had also signs of right-sided congestive heart failure, 30 in group D (83%) had hypotension on admission, and six in group E (86%) had signs of recent myocardial infarction. Evidently, half of patients with APE may show increased total LD activity in serum at the time of admission. LD isoenzyme proportions should be determined in such patients, because there is no one typical pattern of LD isoenzymes and some LD isoenzyme patterns may be associated with specific clinical situations.

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Effects of Surgery on the 30-Day Survival Rate in Spontaneous Supratentorial Intracerebral Hemorrhage

Brain Sciences ◽

10.3390/brainsci11010005 ◽

2020 ◽

Vol 11 (1) ◽

pp. 5

Author(s):

Adrian Balasa ◽

Dana Ghiga ◽

Razvan-Sebastian Andone ◽

Ancuta Elena Zahan ◽

Ioan Alexandru Florian ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Medical Treatment ◽

Postoperative Mortality ◽

Severe Form ◽

Surgical Indications ◽

Group A ◽

Group B ◽

Gcs Score ◽

Postsurgical Outcomes ◽

The Relationship

Background: Spontaneous intracerebral hemorrhage (ICH) is a severe form of stroke. The efficacy of surgery as ICH treatment is controversial. We sought to compare the 30-day postoperative mortality rate between patients with surgically and medically treated ICH; Methods: This prospective study enrolled patients consecutively diagnosed with ICH and treated between 2017 and 2019. Patients meeting the study surgical indications were assigned to either surgical or medical treatment. The relationship between Glasgow Coma Scale (GCS) score, age, ICH location, ICH volume, and 30-day mortality was analyzed. Results: A total of 174 ICH patients were enrolled in this study. Of these, 136 met the surgery criteria; 65 of these underwent surgery (Group A), and 71 received medical treatment (Group B). Age and ICH location did not modify mortality. Although surgery did not overall improve mortality some better postsurgical outcomes were observed among patients surgically treated with GCS scores of at least 10 points and ICH volumes between 30 to 50 mL; Conclusions: Despite achieving an immediate reduction in intracranial pressure, surgery seems to be advantageous only for patients with ICH volumes between 30 to 50 mL and GCS scores of 10 points or higher;

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Mycobacterial Cervical Adenitis in Children: Medical and Surgical Management

Ear Nose & Throat Journal ◽

10.1177/014556139307201111 ◽

1993 ◽

Vol 72 (11) ◽

pp. 733-742 ◽

Cited By ~ 12

Author(s):

Donald B. Hawkins ◽

Maisie L. Shindo ◽

Emily J. Kahlstrom ◽

Eithne F. MacLaughlin

Keyword(s):

Cure Rate ◽

Disease Treatment ◽

Treatment Groups ◽

Cervical Adenitis ◽

Diagnostic Biopsy ◽

Group A ◽

Group B ◽

Second Procedure ◽

Time Of Presentation ◽

Group D

This is a review of the treatment results of cervicofacial mycobacterial adenitis in 85 children and adolescents. Twenty-three patients were treated with only anti-tuberculous medications (Group A). Thirteen underwent surgical procedures at the time of presentation for drainage of abscess or diagnostic biopsy, followed by treatment with anti-tuberculous medications (Group B). Forty-nine were initially treated with anti-tuberculous medications, with or without needle aspirations, and subsequently required surgery for one of the following reasons: 1) drainage and/or excision of abscess (Group C); 2) diagnostic biopsy (Group D); and 3) excision of persistent, enlarging, or recurrent nodes, or of draining fistulas (Group E). Four patients who were initially treated with surgery required a second procedure for persistent or recurrent disease. The cure rate for patients treated only with medications (Group A) was 95%. The cure rate for patients in the surgical groups after the initial procedures were 50% for Group B, and 100% for Groups C, D, and E. The overall cure rate was 92% for surgical treatment groups B-E and 93% for all 5 treatment groups. The clinical features of the disease, treatment outcome, and guidelines for management are discussed.

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