CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

2014 ◽  
pp. 51-56
Author(s):  
Minh Loi Hoang ◽  
Thi Thu Hien Dang

Objectives: This study describes the characteristics of hepatic steatosis on ultrasound imaging by grading of Hagen - Assert. Determining the factors related with fatty liver. Methodology: Cross-sectional study. Results: By studying 448 patients went to general examination at Hue University Hospital from 1/5/2013 to 1/9/2013, we have some of comments: 76.1% of patients has hepatic steatosis on ultrasound imaging in the aged of 30-60 years, common in men than women,with male – female ratio:1.23. The majority (96%) hepatic steatosis was complete all lobes, and the remaining 4% patient was focal fatty liver. Grading hepatic steatosis by Hagen-Ansert classification (1995): there were 66.5% grade 1, 30.5% grade 2, and grade 3 of 3.0%. 26 - 32% patients’ hepatic steatosis on ultrasound combinated with increasing of Lipidemia (Cholesterol, Triglycerid and LDL Cholesterol). Conclusion: There were 66.5% patients grading level 1 by Hagen-Ansert classification for hepatic steatosis. Increasing of Lipidemia index represented only 26 – 32% of patients. Our study did not found significant compatible change between the hepatic steatosis on ultrasound imaging and Triglycerid blood concentrations (p > 0.05). Keywords: Image, ultrasound, hepatic steatosis, fatty liver


2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Alpha Boubacar Bah ◽  
Seylan Diawara ◽  
Ibrahima Sory Souare ◽  
Abdoulaye Barry ◽  
Ansoumane Donzo ◽  
...  

Bedside percutaneous twist drill aspiration (TDA) is described as a surgical method of management of Chronic subdural hematoma (CSDH) and appear to be a reasonable approach in low medical resources environment. We report the results of TDA of CSDH in a single tertiary centre in Conakry Republic of Guinea in West Africa, for the period March 2015 to October 2017. The charts and medical record of 38 cases of CSDH treated with TDA were collected retrospectively, with a mean follow-up of 84.2 days. The outcome data assessed were neurologic status evaluated by the follow-up Markwalder grading scale (MGS: 0=normal to 4=coma), recurrence, infection and mortality. The Male-Female ratio was 1.3:1. Mean age at diagnosis was 78.2+/-12 years. Traumatic brain injury (TBI) was identified as causal in 28.2% of cases studied. All patients were operated on under local anesthesia and had a postoperative drain left in place for 3 days. The mean postoperative MGS was 1.06, up from a mean preoperative MGS of 3.7. Two cases of recurrence occurred subsequent to TDA causing death and three other patients died from unknown causes during the follow-up period. No cases of post-operative infection were diagnosed during the follow-up. Our study shows that Bedside TDA appears to be a suitable alternative to burr hole craniotomies in urgent cases of CSDH in the low socio-economic setting, where a surgical theatre is not always available.


2021 ◽  
Vol 18 (2) ◽  
pp. 79-84
Author(s):  
Olusola Ayodele Sogebi ◽  
Emmanuel Abayomi Oyewole

Background: Nasal septum collections (hematoma and abscess) can lead to structural and functional abnormalities. Our objective was to assess the clinical characteristics, management and complications of nasal septal collections, and document factors associated withtheir complications. Methods: This was a retrospective study of patients managed for nasal septal collections. Socio-demographic and clinical information was recorded, and the main investigations and results noted. Follow-up and complications of septal collections were documented and the clinical factors associated with the complications explored. Results: Twenty-four patients records were studied: male: female ratio=2:1, mean age 40.1±13.1years,62.5% presented with complaints of nasal obstruction, 66.7% had antecedent nasal trauma, presentation was from 2 to 13 days,25%had co-morbid disease(s). All patients had incision and drainage of the septal collection within 1–7 h; 41.2% of the aspirated collections cultured microorganisms, 20.8% developed complications. Increased age above 45 years, co-morbidity, delayed presentation, culture-positive aspirate was all significantly associated with development of complications. Conclusion: Nasal septal collections were more common in adult males with antecedent nasal trauma; 20% developedcomplications associated with the presence of culturepositive abscesses, increased age, and duration of septal collection. Keywords: Nasal trauma, Septal hematoma, Septal abscess, Complications


2021 ◽  
Vol 21 (1) ◽  
pp. 159-65
Author(s):  
Anju Khairwa

Background: IgA nephropathy (IgAN) is most common primary glomerulopathy. There are variations in prevalence of IgAN and its clinical features in different studies from India. Aim: To summarize overall scenario of IgAN in India. Methods: In this systematic review, studies related to IgAN and related renal disease were included. Data searched were PubMed, EMBASE, Google scholar, and Cochrane Database from inception to 31st January 2019. Results: Total 49 studies (N=2480) were included: 21studies (N=2309) of primary IgAN; 19 studies (N=21) of Secondary IgAN; four studies (N=133) of IgA vasculitis nephropathy (IgAVN); and five studies (N=17) of IgA dominant nephropathy (IgADN). Prevalence of IgAN was 16.5% in India. Age of affected persons was ranging from 27.2±16.7 to 48.6±21.3 years . Male female ratio was 1.8:1. Clinical features of Primary IgAN, IgAVN, IgADN & Secondary IgAN were microscopic hematuria (49.6%, 44.4%, 15.6% & 59.5%), macroscopic hematuria (5.1%, 0.4%,40.9%,& 35.7%), Subnephrotic proteinuria (42.1%, 29.4%, 23.2%, & 52.3%), nephrotic proteinuria (16.0%, 4.4%, 76.8%,& 47.6%), and hypertension (25.8%,18.3%, 35.5%,& 47.6%).. The 24 hours proteinuria was ranging from 2.6±1.5 to 4.7±2.3 gm/day and serum creatinine (mg/dl) was ranging from 0.9±0 to 3.5±3.9 mg/dl. Histolomorphologically, all type of IgAN showed mesangial hypercellularity and Immunofluorescence revealed IgA deposition. Conclusion: The overall prevalence of primary IgAN in India was 16.5%. The subnephrotic proteinuria and microscopic hematuria were common clinical features. Keywords: IgA Nephropathy; histomorphology; prevalence; India.


2019 ◽  
Vol 1 (1) ◽  
pp. 5-9
Author(s):  
Binita Bhattarai ◽  
Koshal Shrestha ◽  
Sushila Patel ◽  
Laxmi Devi Manandhar ◽  
Rosy Karki ◽  
...  

Background: Chalazion is a common eyelid disease caused by plugged meibomian glands and chronic lipogranulomatous inflammation. It can affect individuals of all ages and may cause local eye symptoms such as irritation and inflammation and cosmetic disfigurement. There are mainly three methods of treating chalazion: Intralesional Triamcinolone Acetonide (0.1-0.3 ml of 40mg/ml), Incision and Curettage and Conservative Treatment (hot compression +lid hygiene + antibiotic ointment) to the affected eyelid. To comparing which method is the best this study has been carried out Methodology: Patients with chalazion presenting to OPD from 15 March to 15 July 2017 were included in the study. They underwent any of the three procedures according to their choice. Follow up visit was done at two weeks to determine effectiveness in terms of reduction of size or complete resolution of the chalazion. Results: Out of 112 patients enrolled in study 65(58%) were females and 47(42%) were male with a male: female ratio of (0.7:1). The mean age of involvement was 25.7years (SD 10.3). At 2 weeks follow up there was complete resolution in incision and curettage (I and C) group 77 %( 41/53) and in Triamcinolone Acetonide (TA) injection group 63 %( 20/32). Pearsons correlations showed that I and C were superior to any other forms of intervention for any size of chalazion followed by intralesional injection of TA. Conclusion: Among the three methods, Incision and Curettage remained the best choice for treatment of chalazion followed by triamcinolone acetonide injection but may need multiple injections. Keywords: Chalazion, Intralesional Triamcinolone, Incision and Curettage, Meibomian Gland


2015 ◽  
Vol 14 (1) ◽  
pp. 36-37
Author(s):  
Mozammel Hoq Sharife ◽  
M Jalal Uddin ◽  
Mostak Ahmed

Objective: The study was conducted to evaluate outcome of probing for congenital nasolacrimal duct obstruction. It was an interventional study at a tertiary level hospital of Chittagong. Methods: The study was conducted during April 2009 to March 2013 (04 years). Total 120 eyes of 102 children of 1-3 years age group were probed. Minimum follow up time was 01 year. Results: 110 eyes fully cured, 05 eyes needed re-probing, 03 eyes needed Dacrocystorhinostomy operation (DCR) and 02 cases were dropped out. Male female ratio was 72 (60%) and 48 (40%). Conclusion: Outcome of probing is better among 1-2 years age group than that of 2- 3 years age group. A discussion is made with updated literature review. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22879 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 36-37


Author(s):  
Silvia Ferrari ◽  
Giorgio Mattei ◽  
Mattia Marchi ◽  
Gian Maria Galeazzi ◽  
Luca Pingani

There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.


1998 ◽  
Vol 16 (1) ◽  
pp. 70-77 ◽  
Author(s):  
M M Cheung ◽  
J K Chan ◽  
W H Lau ◽  
W Foo ◽  
P T Chan ◽  
...  

PURPOSE To study the clinical features and outcome for primary non-Hodgkin's lymphomas of the nose/nasopharynx (NNP-NHLs) according to immunophenotype. PATIENTS AND METHODS One hundred thirteen Chinese patients with primary NNP-NHLs that belonged to the categories E, F, G, or H according to the Working Formulation (WF), with full immunophenotypic data and complete clinical follow-up data, were analyzed in this retrospective study. RESULTS Ninety (79.6%) patients had localized (stage I or II) disease, while 23 (20.4%) had stage III or IV disease. The lymphomas in 51 (45.1%), 24 (21.3%), and 38 (33.6%) patients showed natural killer (NK)/T- (CD56-positive), T-cell, and B-cell immunophenotype, respectively. Seventy-three patients (65.8%) achieved a complete remission, of whom 34 (46.6%) subsequently relapsed. The median follow-up time for those alive was 88 months. The 5-year actuarial disease-free and overall survival rates were 34.4% and 37.9%, respectively. Multivariate analysis showed that only stage and immunophenotype were significant for survival. NK/T lymphomas were distinctive among the three immunophenotypes in the following aspects: the highest male-to-female ratio, more frequent involvement of the nasal cavity alone, higher risk of dissemination to the skin, more frequent development of hemophagocytic syndrome, and the worst prognosis (overall median survival, 12.5 months). CONCLUSION The three immunophenotypes studied are shown to exhibit different clinical patterns. Since the NK/T phenotype carries the worst prognosis, patients who present with NNP-NHL should have their tumors analyzed for CD56 expression.


Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 297
Author(s):  
Dovilė Jančauskaitė ◽  
Virginija Rudienė ◽  
Gabrielius Jakutis ◽  
Laurie W Geenen ◽  
Jolien W Roos-Hesselink ◽  
...  

Background and Objectives: After successful surgical repair of a congenital shunt lesion, pulmonary hypertension (PH) often disappears. However, PH can persist long-term after the closure. This study aimed to assess the prevalence of PH long-term after surgical repair of congenital heart disease (CHD), and to evaluate the outcomes and preoperative factors related to residual PH. Materials and Methods: In this retrospective cohort study, we reviewed patients who underwent right heart catheterisation in Vilnius University Hospital Santaros Klinikos during the period of 1985–2007. Among 4118 right heart catheterisations performed, 160 patients underwent congenital systemic-to-pulmonary shunt repair at a young age (<18 years) and had pre-operative PH. Half of the patients were foreigners whose follow-up data were unavailable. Eventually, 88 patients with available follow-up data were included in this study. Results: The median age at diagnosis of CHD with PH was 0.8 (0.6–3.0) and 1.1 (0.6–3.9) years at surgery (50% females). Residual PH was assessed 9.5 years after surgery and observed in 30.7% (n = 27) of the patients. It was associated with having more than one shunt (44.4% (n = 12), p = 0.016) and higher median pulmonary vascular resistance (3.4 (2.5–6.5) vs. 2.2 (1.0–3.7), p = 0.035) at baseline. After a median follow-up of 21 (15–24) years, 9.1% of the patients were deceased. Kaplan–Meier survival analysis revealed significantly higher mortality in the residual PH group (p = 0.035). Conclusions: Residual PH affects a significant proportion of patients after surgical repair of a shunt lesion and is associated with worse long-term outcome.


Author(s):  
Giovanni Cammaroto ◽  
Luigi Marco Stringa ◽  
Luca Cerritelli ◽  
Giulia Bianchi ◽  
Giuseppe Meccariello ◽  
...  

Background: Acquired nasopharyngeal stenosis is a rare and heterogeneous pathological condition that has different causes, generally resulting as a complication of a pharyngeal surgery, especially in patients affected by obstructive sleep apnea (OSA). Different approaches have been proposed for the treatment of nasopharyngeal stenosis but a unique and standardized management has not yet been presented. The aim of our paper is to evaluate the efficacy of our surgical technique, describing its steps and results with the aim to consider it as a possible solution for the treatment of this condition. Methods: This is a retrospective cohort study. Eight patients (mean age 27.25 years old (yo), range 8–67 yo; Male/Female ratio 4/4; mean body mass index (BMI) 26.1) affected by OSA (mean apnea hypopnea index (AHI) before OSA surgery was 22.1) and acquired nasopharyngeal stenosis as a consequence of different pharyngeal surgeries were treated with our modified approach in the Department of Otolaryngology, Morgagni Pierantoni Hospital, Forlì, Italy. Resolution of stenosis and complication rate were the main outcome measures. Results: Complete resolution of the stenosis was achieved in all cases and no complications were recorded at three weeks, six months, and 2 years follow-up. Conclusions: Our technique appears to be a promising method for the management of nasopharyngeal stenosis in OSA patients. However, further studies comparing different techniques and reporting on larger series and longer follow up time are needed to prove the efficacy of the proposed technique.


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