scholarly journals PREVELANCE OF HORIZONTAL STRABISMUS FOUND IN PEDIATRIC POPULATION IN A TERTIARY CARE EYE HOSPITAL IN EASTERN NEPAL

2021 ◽  
pp. 122-123
Author(s):  
Bhadra Priya ◽  
Sanjay Kumar Singh ◽  
Tirtha Kumar Singh ◽  
Sharad Hemant
Keyword(s):  
Visual Acuity ◽  
Retrospective Analysis ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Posterior Segment ◽  
Proper Training ◽  
Excellent Care ◽  
Information History ◽  
Cover Test

PURPOSE:To determine the prevalence of horizontal strabismus in patients less than 15 years of age. METHODS:A retrospective analysis of data of children attending pediatric OPD from January 2016 to December 2020 was done. A proforma was made and following information was entered information : history, clinical presentation, ocular examination including visual acuity, anterior and posterior segment evaluation,extraocular motility, cover tests, Prism bar cover test,worth four dot test,Bagolini's striated glasses test,Lang test,cycloplegic refraction. RESULTS: A total of 1,17,700 attended the pediatric OPD in 5 year period, prevalence of horizontal strabismus was 1.43%. Exotropia was more common than esotropia. Concomitant deviation was more common than incomitant deviation. CONCLUSION: strabismus is frequently encountered in pediatric clinics now. Proper training of pediatric ophthalmologists is required to give excellent care to these children.

scholarly journals Validation of the Maxillary Sinus Roof as a Landmark for Navigating the Pediatric Skull Base

2019 ◽  
Vol 129 (1) ◽  
pp. 12-17
Author(s):  
Sean S. Evans ◽  
Catherine Banks ◽  
Joshua Richman ◽  
Audie Woolley ◽  
Do Yeon Cho ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Skull Base ◽  
Retrospective Analysis ◽  
Pediatric Population ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Growth Patterns ◽  
Sinus Surgery ◽  
Nasal Floor ◽  
Anatomic Relationship

Objective: To define a new anatomic relationship in pediatric sinus surgery, assessing the maxillary roof as a constant safe landmark to avoid skull base injury in the pediatric population. Study Design: Retrospective analysis. Setting: Tertiary care children hospital. Subjects and Methods: A retrospective analysis was performed of all computed tomography scans of the sinuses and facial bones at the emergency department of a tertiary children’s hospital over the course of a year. Radiographic measurements included the lowest cribriform plate and planum sphenoidale (PS) heights, or posterior skull base when not yet pneumatized, as well as the highest maxillary roof height. The nasal floor was used for reference. Statistics were performed via Shapiro-Wilks test with a P-value of .05 indicating statistical significance. Results: Three hundred and seven unique scans were reviewed (38.9% female; n = 122; P = .58). Age stratification was based on previously described sinus growth patterns. In all patients, the maximum maxillary height was inferior to the lowest measured cribriform lamella and PS ( P < .001; CI, 98.5%-99%). Inter- and intrarater reliability and accuracy were verified through blinded review and re-review (ρ = .99 and .98 respectively, P ≤ .001). The validity of sole coronal measurements due to incomplete sagittal reformatting was also confirmed (ρ = 1.00, P ≤ .001). Conclusion: Despite variation in sinus growth and development in children, the current study demonstrated the validity of the maxillary sinus roof as a constant safe landmark in the pediatric population, offering a novel anatomic relationship for teaching safety in performing pediatric sinus surgery. Level of Evidence: 4

scholarly journals An analysis of clinical presentation and laboratory profile of scrub typhus among pediatric population in a semi urban centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1160
Author(s):  
Sathyamoorthy M. ◽  
Subash S. ◽  
Karthikeyan P. ◽  
Prasanna Raju
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Presentation ◽  
Scrub Typhus ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Specific Treatment ◽  
Study Group ◽  
Urban Centre ◽  
College Hospital ◽  
Laboratory Profile

Background: Scrub typhus is a re-emerging acute infectious disease caused by Orientia (Rickettsia) tsutsugamushi, in India and globally. Scrub typhus goes undiagnosed at early stages of the illness because many factors like of low index of suspicion, nonspecific signs and symptoms. This study was done to analyse the various clinical demographic factors and their significance in making the clinical diagnosis of scrub typhus and also the analysis of other non-specific laboratory parameters present in the serologically confirmed cases of scrub typhus. The objective of this study was to study the clinical presentation and laboratory profile of scrub typhus in pediatric patients admitted in a tertiary care hospital.Methods: It was prospective and descriptive study conducted in the pediatric ward of a Medical College Hospital. The study population consisted of 50 children aged 5-15 years having fever of more than 5 days duration. Children with persistent fever with known focus and etiology were excluded from the study.Results: Among the study group of 50 children, majority were between 5 and 15 years age group. Male children constituted 66% (33 out of 50). Out of 50 children, 94% (47 children) had Eschar.  82% of children did not have any history of tick exposure. Less than 25% of children had Vomiting similar to conjunctival congestion. 94% children had lymphadenopathy and 98% children had mild anemia. 54% children had maculopapular rash and 20% had jaundice. 62% children had hepatomegaly and 96% had splenomegaly. Pedal edema was seen in 22% of cases and anasarca in 2% of cases 76% of children had normal WBC counts, 24% had leucocytosis. Platelet counts of 38,000 to 2,87,000 was noted in the study group and 26% of patients had thrombocytopenia. 98% children had hemoglobin less than 10 gms%. C reactive protein was positive in 96% of cases. Hypoalbuminemia was noted in 48% of children. 60% children were positive for urine albumin. Conclusions: Scrub typhus should be considered in early part of the illness and patient has to be examined for the presence of Eschar. A clinical diagnosis can be made based on the associated rash, splenomegaly, lymphadenopathy etc. and specific treatment with antimicrobials can be initiated for scrub typhus. 

scholarly journals Open Globe Injury in a Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 62-65
Author(s):  
Bikram Bahadur Thapa ◽  
Dabal Bahadur Thapa ◽  
Har Karan Nath
Keyword(s):  
Visual Acuity ◽  
Primary Repair ◽  
Tertiary Care ◽  
College Teaching ◽  
Posterior Segment ◽  
Care Hospital ◽  
Open Globe Injury ◽  
Young Males ◽  
Medical College ◽  
Open Globe

Introduction: Open Globe Injury (OGI) is a type of mechanical eye injury in which there is a full thickness defect of the outer fibrous coat of eye ball. The Prognosis in the eyes with OGI has improved in these days. 2.4% of blindness in Nepal was due to ocular trauma in 1981. The aim of this study was to describe epidemiological profile, clinical profile and treatment outcome in eyes with open globe injury. Methodology: It is the prospective interventional non randomized hospital based study on the patients of open globe injury presented to the Nepalgunj Medical College, Nepalgunj from April 2017 to May 2018. Visual acuity, anterior and posterior segment evaluation, site and size of wound were recorded. All the eyes were underwent primary repair surgery. Postoperative visual acuity, anterior and posterior segment evaluation was carried out on all follow up. Second surgery was done if required. Results: 0.4% of ophthalmic and 0.016% of all hospital patients had open globe injury. Most of the victims were young males. The mean age of study population was 10.98±17.1 year. Playing (62.5%) was the most common time of injury and wooden stick (50%) was most common agent of injury. Zone I involvement (87.5%) and penetrating type (91.7%) was found in most of cases. 87.5% of eyes were blind, 4.2%were visually impaired and 8.3% had normal vision at the time of presentation. 79.2 % of eye were improved after treatment on visual function, 12.5% remained unchanged while 8.3% deteriorates and leads to pthysis bulbi. Conclusion: The incidence of open globe injury was 0.4% among ophthalmic patients and 0.016% among all patients of Nepalgunj Medical College Teaching Hospital, Nepalgunj. Early Primary repair, use of systemic antibiotics and postoperative care provides encouraging anatomical and functional outcome in these eyes with OGI.

scholarly journals Clinico-Radiological Profile of Abdominal Pain in Children Admitted in a Tertiary Care Centre-A Retrospective Cohort Study

2021 ◽  
pp. 133-138
Author(s):  
Jai Durairaj Paramasivam ◽  
Thangella Manasa ◽  
Melpakkam Venkatesan Srinath ◽  
Hari Prasaadh
Keyword(s):  
Abdominal Pain ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Paediatric Surgery ◽  
Tertiary Care Centre ◽  
Diagnostic Modality ◽  
Lower Quadrant ◽  
Mesenteric Lymphadenitis ◽  
Laboratory Parameters

Background and Aim: Mesenteric lymphadenitis in pediatric population usually presents with abdominal pain mimicking appendicitis mounting a challenging task for physicians to diagnose. It is a self-limiting inflammatory process and resolves spontaneously. In addition to clinical features, ultrasonography is the primary diagnostic modality. We aimed to evaluate the clinico-radiological characteristics of mesenteric adenitis in patients presenting with abdominal pain. Materials and Methods: A total of 108 patients attending paediatric out-patient and paediatric surgery clinic in Saveetha Medical College and Hospital, Chennai, between January 2018 and December 2020 with abdominal pain for several aetiologies were included in this study. The clinical presentation, laboratory parameters and the ultrasonographic findings were noted. Data summarized as numbers, percentages and Mean ± Standard Deviation (SD). Results: Peak prevalence was found to be at around 8 [range 6-10] years. Clinically, 58.3% had fever, 40.7% had dysuria and 36.1% had diarrhoea. Laboratory parameters were non-specific for this condition. Majority of the enlarged lymph nodes were found in the right lower quadrant (81.5%) followed by (10.2%) in the para-umbilical region and (8.3%) in left lower quadrant. Conclusions: Mesenteric lymphadenitis as an individual clinical entity is a very challenging task for the paediatricians to evaluate and diagnose due to several possible variations in the clinical presentation. Although mesenteric lymphadenitis is usually a self limiting entity, a cohort of children warrant medical interventions.

scholarly journals Profile and outcome of pediatric intussusception: a 5-year experience in a tertiary care center

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Aqeela J. Madan ◽  
Fayza Haider ◽  
Saeed Alhindi
Keyword(s):  
Seasonal Variation ◽  
Success Rate ◽  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Operative Intervention ◽  
Secondary Outcome ◽  
Lead Point ◽  
Pneumatic Reduction ◽  
Tertiary Center

Abstract Background Intussusception is the most frequent cause of bowel obstruction in infants and toddlers; idiopathic intussusception occurs predominantly under the age of 3 and is rare after the age of 6 years; the highest incidence occurs in infants between 4 and 9 months; the gold standard for treatment of intussusception is non-operative reduction. This research will tackle the problem of pediatric intussusception in our center which is the largest tertiary center in our region. The primary outcome is to study the profile of intussusception; the secondary outcome is to assess the success rate of pneumatic reduction in the center’s pediatric population as well as to study the seasonal variation if present. Results During the study period, eighty-six (N=86) cases were identified, from which 10 cases were recurrent intussusception. Seventy-six (N=76) cases were included from the study period. N=68 (89%) were less than 3 years of age, and only N=2 (3%) were above 6 years. Seasonal variation was not significant; N=69 (91%) patients had successful pneumatic reduction under fluoroscopy while thirteen patients N=13 (17%) needed operative intervention. Conclusion Ileocolic intussusception is one of the most common pediatric surgical emergencies that can be successfully managed non-operatively in our institute; 89% of the cases were below 3 years of age, and no seasonal variation was demonstrated. Operative intervention was required in 13 cases with the main reason being lead point. The fact that the pediatric surgeon performs the reduction might have contributed to a high success rate reaching 91% in our center. This study provides a valuable opportunity for future regional data comparisons and pooled data analyses.

scholarly journals Diagnosis and treatment delay of head and neck cancers during COVID-19 era in a tertiary care academic hospital: what should we expect?

2021 ◽  
Author(s):  
Pietro De Luca ◽  
Antonella Bisogno ◽  
Vito Colacurcio ◽  
Pasquale Marra ◽  
Claudia Cassandro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Head And Neck ◽  
Retrospective Analysis ◽  
Tertiary Care ◽  
Diagnostic Delay ◽  
Treatment Delay ◽  
Head And Neck Cancers ◽  
Control Measures ◽  
Academic Hospital ◽  
The Impact

Abstract Background Since the spreading of SARS-CoV-2 from China, all deferrable medical activities have been suspended, to redirect resources for the management of COVID patients. The goal of this retrospective study was to investigate the impact of COVID-19 on head and neck cancers’ diagnosis in our Academic Hospital. Methods A retrospective analysis of patients treated for head and neck cancers between March 12 and November 1, 2020 was carried out, and we compared these data with the diagnoses of the same periods of the 5 previous years. Results 47 patients were included in this study. We observed a significative reduction in comparison with the same period of the previous 5 years. Conclusions Our findings suggest that the COVID-19 pandemic is associated with a decrease in the number of new H&N cancers diagnoses, and a substantial diagnostic delay can be attributable to COVID-19 control measures.

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