scholarly journals A study of clinical, bacteriological and radiological profile of severe pneumonia in children

2021 ◽  
Vol 8 (3) ◽  
pp. 29-33
Author(s):  
Uday Kumar Neelagiri

Pneumonia continues to pose a threat to health of children in developed and developing countries despite improvements in socioeconomic status, immunization and early diagnosis and treatment. Universality, vulnerability and frequency of occurrence of ALRTI in children are well recognized all over the world. Methods: This prospective clinical study of severe pneumonia conducted on n=150 children who were admitted to pediatric wards and PICU in PIMS, Nagunoor, Karimnagar. A detailed examination of each child including anthropometry was carried out. During the general physical examination, emphasis was laid on assessing general condition of the child, respiratory rate (counted over 1 minute), presence of fever and other signs such as cyanosis and pallor. Detailed systematic examination of the respiratory, cardiovascular and central nervous system was done. Any associated illness such as septicemia, meningitis and congestive cardiac failure if present was noted. Result: In this prospective study, n=150 cases of severe pneumonia were studied. In the present study, majority of cases (53%) were less than one year of age. majority of the cases were diagnosed as Bronchopneumonia (66.67%), Lobar pneumonia was diagnosed in 18.6% of cases and pneumonia and its complications in 9.3% of cases. In the present study, radiological findings were present in 80.66% of cases Bacterial pneumonia was detected in 62.67%, viral pneumonia in 14%. Culture was positive in only of cases. S. pneumonia was the most common organism isolated (6 cases) followed by S. aureus (n=5 cases) and Klebsiella (n=3 case). n the present study, antibiotics were given in all cases. Conclusion : In this study we found Bronchopneumonia is the predominant form of presentation in infants and preschool children. Among the risk factors studied, previous history of similar illness, inappropriate immunization for age, anemia, PEM grade 3 and 4, were found significant causes for severe pneumonia.

1994 ◽  
Vol 108 (7) ◽  
pp. 607-609 ◽  
Author(s):  
Abduljabbar Alshaikhly ◽  
Abdalla M. Hamid ◽  
Bahram Azadeh

AbstractA 64-year-old Qatari female, with a one-year history of right otorrhoea and deafness, had a reddish-white mass projecting into the right ear canal, through the tympanic membrane, that proved histopathologically to be a paraganglioma. Computerized tomography (CT) of the temporal bones showed extensive destruction of the right mastoid bone, the posterior ear canal wall, and the sinus plate, with total disruption of the ossicles, simulating a malignant tumour, which is unusual for a middle ear paraganglioma.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Ceyda Sarıal ◽  
Abdulhamıt Tayfur ◽  
Beyza Kap ◽  
Dılara Donder ◽  
Ozum Melıs Ertuzun ◽  
...  

Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests. Results: Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p<.05), whereas there were no differences detected for the other directions (p>.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (p<.05). Conclusion: Adolescent volleyball players with history of injury show lower performance on balance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21168-21168 ◽  
Author(s):  
Y. M. Choi ◽  
S. Shord ◽  
S. Cuellar ◽  
J. Villano

21168 Background: Bevacizumab is an increasingly used anti-cancer treatment with common side effects including hypertension (htn) and proteinuria which occur in approximately 10% and 20% of the patients, respectively. Little is known regarding ethnic variations of bevacizumab induced htn and proteinuria, particularly in African-Americans (AA) who have a high prevalence of htn and susceptibility to kidney disease. Methods: We conducted a retrospective chart review of patients who completed bevacizumab alone or as a chemotherapy regimen at the University of Illinois at Chicago for an 18-month study period. We collected blood pressure (BP) measurements and urinanalyses before starting bevacizumab, during bevacizumab and after stopping bevacizumab, in addition to concurrent medications, past medical history and demographics. Htn and proteinuria were graded by CTC v3.0. Patients with less than two successive doses of bevacizumab or unreliable ethnicity were excluded. Results: 27 subjects were eligible. Eighteen AA (67%) and 9 (33%) non-AA were included. Twenty-two (81%) had colorectal cancer. AA received a median of 10 cycles and non-AA received a median of 6 cycles. Six subjects (22%) developed any grade htn toxicity; maximum grade: grade 2=4 (15%), grade 3=2 (7%). Htn toxicity occurred in 28% AA and 11% non-AA (p=NS). Previous history of hypertension was found in 15 subjects (55%): AA=14 vs. non-AA=1 (p=0.002) and was not correlated with hypertensive toxicity. Twelve subjects (44%) developed any grade proteinuria; maximum grade: grade 1=9 (33%), grade 2=3 (11%). Proteinuria toxicity occurred in 50% AA and 33% non-AA (p=NS). Presence of hypertensive toxicity was associated with increased risk of proteinuria. Clinical benefit (PR, SD) was seen in 15 subjects (55%). Rate of clinical benefit was 67% in AA and 33% in non-AA (p=NS). Clinical benefit did not correlate with hypertensive or proteinuria toxicities. Conclusions: AA were more prone than non-AA to bevacizumab induced hypertension and proteinuria toxicity in this retrospective study. Higher clinical benefit was seen in AA. No significant financial relationships to disclose.


2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 288-288
Author(s):  
Einar Freyr Sverrisson ◽  
Timothy Kim ◽  
Patrick Espiritu ◽  
Wade Jeffers Sexton ◽  
Julio Pow-Sang ◽  
...  

288 Background: 15-50% of patients with upper tract urothelial carcinomas (UTUC) will have a bladder recurrence. Abnormal upper tract cytology (UTC) is an indicator of higher grade tumors but has not been associated with bladder recurrence. We were interested in investigating the role of UTC as a predictor of bladder cancer recurrences in patients with no prior history of bladder cancer presenting with UTUC. Methods: Of 67 patients who had an UTC collected prior to their nephroureterectomy (NU) in 2004-2012, we identified 17 patients with a recurrent disease in the bladder who met the criteria of having no previous history of bladder cancer at the time of their NU. UTC and histology were reviewed and analyzed with the bladder pathology data. Positive or suspicious cytology was defined as abnormal and atypical or reactive as benign. Results: 15 (88%) of 17 patients (11 men and 6 women) who met our criteria were diagnosed with bladder cancer within one year after their NU (average 7.5 months (range 2-26)). 10 (59%) of 17 patients had abnormal UTC with a calculated sensitivity and specificity of 59% and 22%, respectively. 7 (70%) of 10 patients with abnormal UTC compared to 5 (71%) of 7 patients with benign cytology had high grade (HG) bladder cancer (p=1.0). Muscle invasive tumors were found in 5 (29%) of 17 patients and 3 (60%) of those had abnormal UTC. All six women had HG bladder cancer compared to 6 of 10 men (p=0.23). HG tumors were slightly more common in the bladder compared to the upper tract (75% vs 65%, p=0.70) and 14 (87.5%) of 16 bladder tumors had the same tumor grade in the upper tract. Conclusions: Abnormal UTC is a poor predictor of bladder recurrence in patients with a history of UTUC. The majority of patients who developed bladder recurrence presented within one year from NU with HG disease which underscores the importance of aggressive surveillance and the consideration of prophylactic intravesical therapy at the time of NU in this patient cohort.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7601-7601 ◽  
Author(s):  
J. D. Patel ◽  
T. A. Hensing ◽  
V. Villafor ◽  
E. Hart ◽  
P. Bonomi

7601 Background: Pemetrexed in combination with carboplatin has been shown to have promising activity and favorable toxicity profile in NSCLC. Bevacizumab has been shown to improve response rates and survival in pts with advanced non-squamous NSCLC when combined with carboplatin and paclitaxel. This study of pemetrexed and carboplatin plus bevacizumab was designed to evaluate the toxicity profile and to estimate the activity of the regimen in this pt population. Methods: Eligibility required that pts were chemotherapy-naive, had stage IIIB (effusion)/IV non-squamous NSCLC, PS 0–1, with no evidence of CNS metastases. Pts received pemetrexed 500 mg/m2 over 10 minutes, carboplatin AUC 6 over 30 minutes, and bevacizumab 15 mg/kg over 30–90 minutes on a 21-day cycle for 6 cycles. Pts with SD or PR received pemetrexed 500 mg/m2 and bevacizumab 15 mg/kg every 21 days until disease progression or toxicity. All pts received folic acid, vitamin B12 and steroid prophylaxis. Results: From 8/05 to 9/06, 39 pts (of planned 50) were enrolled: 20 M/19 F; median age 64 (range 41 - 80). One pt enrolled and subsequently refused treatment. Median number of cycles was 6 (range 1–22), and 25/38 (66%) completed at least 6 cycles of therapy. There was no grade 4 hematological toxicity. Grade 3 hematological toxicities were anemia (5%, N=2) and thrombocytopenia (3%, N=1). The most common grade 3/4 non-hematological toxicities included proteinuria (3%, N=1, gr 3), venous thrombosis (3%, N=1, gr 3), infection (3%, N=1, gr 4), and diverticulitis (11%: 8%, N=3, gr 3/3%, N=1, gr 4). 1 pt with diverticulitis experienced bowel perforation that required surgical intervention. The trial was temporally suspended and the group of pts with diverticulitis was analyzed separately. The only risk factor identified was previous history of diverticulitis. One CR, 20 PRs were observed for an overall response rate of 55% (95%, CI 43–75%). Conclusions: Treatment with pemetrexed and carboplatin plus bevacizumab in pts with advanced non-squamous NSCLC is feasible with an acceptable toxicity profile. The encouraging activity justifies further development of this regimen. However, pts with a prior history of diverticulitis should be excluded until this observation can be investigated further. No significant financial relationships to disclose.


1998 ◽  
Vol 112 (6) ◽  
pp. 588-591 ◽  
Author(s):  
Yusufhan Süoǧlu ◽  
Burak Erdamar ◽  
İsmail Çölhan ◽  
O. Sami Katircioǧlu ◽  
Uǧur Çevikbas

AbstractThe presentation of tuberculosis as an isolated parotid lump is rare. In this paper, six cases with tuberculous parotitis are reported which were evaluated as a benign parotid neoplasm in 216 specimens pre-operatively. All but one of them had no previous history of tuberculosis and all had a parotid lump as a sole symptom for at least one year. The diagnosis of tuberculosis was made, after superficial parotidectomy, by histopathology. Parenchymal involvement and intraparotid lymph node involvement with tuberculosis were seen in five and three patients, respectively. Two of the patients had lymph node involvement outside the parotid area. One of six patients had a coincidental Warthin tumour. A surgical approach is not only therapeutic but also diagnostic when other diagnostic tools fail.


1987 ◽  
Vol 15 (3) ◽  
pp. 199-203 ◽  
Author(s):  
Ole M. Böstman

At the Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, an acute accident unit with more than 3000 trauma admissions per year, a protocol was kept over the years 1982–84 of patients who were treated for injuries sustained from intentional falls from heights. The number of patients included in the series was 73. The mean age of the patients was 29.8 (range 15–65) years. The male:female ratio was 1.5:I. In 15 patients (21%) there was a previous history of recorded psychiatric disorder and in a further 11 patients (15%) chronic alcoholism. The 73 patients had a total of 164 serious individual injuries. Thirteen patients died, all except one within the first 24 hours. The median duration of the hospital stay at university department level was 49 days. In a follow-up survey one year after the fall, 19 (32% of the survivors) had returned to work, 29 (48%) were pensioned and 12 (20%) still needed institutional care. Eight had permanent complete paraplegia. The patients injured in suicidal falls amounted to 0.8% of all trauma admissions during the investigation period and to 3.3% of the nursing days. In the intensive care unit, however, these figures were 9.2% and 14.1% respectively, values high enough to warrant increasing attention to this kind of self-inflicted injuries.


2013 ◽  
Vol 20 (05) ◽  
pp. 765-771
Author(s):  
SAADIA YASIR, ◽  
BUSHRA KANT, ◽  
TAHIRA JABBAR

Study Objective: The objective of this study is to describe the maternal and perinatal outcome of conservative managementin PPROM. Design: Descriptive prospective study. Period: One year from August 2006 to August 2007. Setting: Maternal and child health(MCH) Centre PIMS Islamabad. Material and Methods: 50 patients between 28-36 weeks of gestation presenting with PPROM. Results:The mean age was 27+5.1 years, 14(28%) were having gestational age between 28to 32 weeks and 36 (72%) were between 33 to 36weeks of gestation. 34 (68.0%) of the mothers had no history of abortions while 10 (20.0%) had 1-2 abortions and 6 (12.0%) had 3 ormore abortions. Sixteen (32.0%) women had previous PRROM while 10 (20.0%) had previous history of preterm labor. Inversecorrelation was observed between latency period and gestational age. Among 14(28%) women with gestational ages between 28 to 32weeks 10 delivered within 48 hours and 4 after 48 hours. Among 36(72%) women with gestational ages between 33-36 weeks 31(62%)delivered in less than 48 hours and 5 (10 %) women delivered after 48 hours.14(28%) of the 50 babies were admitted in NICU withsepticemia, 7(14.0%) with RDS, hypoglycemia in 2(4.0%) and necrotizing enterocolitis in 3(6.0%). 3 neonates died from septicemia and2 from RDS. On first follow-up 34.0% mothers had infections and 8.0% had post-partum hemorrhage. Conclusions: Expectantmanagement till 36 weeks is a suitable option as gestational age at delivery and birth weight both affect neonatal survival and offer time toadminister corticosteroids to allow foetal lung maturity. Foetal deaths occurred due to septicaemia and RDS with direction co-relationshipwith low birth weight.


2011 ◽  
Vol 139 (11-12) ◽  
pp. 790-794
Author(s):  
Marko Bumbasirevic ◽  
Aleksandar Lesic ◽  
Ljiljana Denic-Markovic ◽  
Kristina Zivkovic ◽  
Studijska ORPHEUM

Introduction. Osteoporosis is a serious problem, since about 50% of women over the age of 50 suffer at least one osteoporotic fracture. Objective. The aim of this study was to evaluate compliance as well as the efficiency and safety of ibandronate treatment over a 6-month period in reducing the risk of subsequent fracture in women with postmenopausal osteoporosis. Methods. A multicenter, prospective, observational study was conducted during one year in thirteen medical centres in Serbia. In the first part of the study the participants received ibandronate tablets (150 mg) once a month for six months. In the second part, the patients were under clinical follow-up. Results. The mean age of the 184 menopausal women included in the study was 66.2?9.4 years. In 40.2% of the subjects the disease had been clinically manifest during the five preceding years. The mean T-score value at the onset of our investigation was -3.1?0.84 in 160 (87%) patients who were diagnosed osteoporosis. Compression vertebral fractures alone were noted in 24% of the women, spontaneous nonvertebral fractures in 49.4% and both in 4.9%. A history of osteoporotic fractures was much more common in patients with three or four risk factors (p=0.001). Out of 39 adverse events during therapy with once monthly bisphosphonates only 2 (3.3%) were classified as severe. During the treatment, spontaneous fractures occurred in 13 (7.1%) patients. Conclusion. Ibadronate treatment once a month for 6 months was shown to be very safe, tolerated well and without more serious side effects.


2021 ◽  
pp. 1-4
Author(s):  
Liesbeth van Bergen ◽  
Liesbeth van Bergen ◽  
Simon Nicolay ◽  
Martin Ruppert ◽  
Anthony Beunis ◽  
...  

Objectives: To report a case of a stoma reversal in a patient with an acquired, extreme microcolon after a long-standing transversostomy and to give a review of the current literature. Methods: Case report and literature review by performing a PubMed database search, using the keywords Santulli enterostomy, anal atresia, posterior sagittal anorectoplasty and acquired microcolon. Results: An 18-year-old patient with a previous history of anal, rectal and sigmoid atresia, was admitted to our hospital with an acquired microcolon due to a long-standing transversostomy. The patient had a posterior sagittal anorectoplasty at the age of one year, but by reason of an enormous dilatation of the ascending colon and the associated discrepancy of the caliber of the proximal and distal colon, the colostomy was maintained. The patient was lost in follow-up during several years. Now, 16 years later, the patient requested closure of the colostomy. Since barium enemas still showed a dilated colon ascendens and a microcolon descendens, a staged approach was chosen. First, a right hemicolectomy was performed and a Santulli enterostomy was created by constructing an ileocolostomy just proximal of an end ileostomy. Progressively, more transanal bowel movements were seen and barium enemas showed a progressive expansion of the remaining colon and rectum. Test closing of the enterostomy using an inflated bladder catheter did not cause signs of obstruction. During the second stage, 17 months later, at the age of 20 years, the stoma was closed. Now, the patient has two to three solid stools a day, with a complete fecal continence. Discussion: The used technique is well known in pediatric surgery. We successfully implemented it in the treatment of a microcolon in an adult. The advantage is that we can feed the distal colon to achieve expansion, while the enterostomy functions as a venting system, hereby preventing obstructive complaints when the caliber of the colon is still narrow. In conclusion, long-standing colostomas with a concurrent microcolon can be closed but require a step-by-step approach.


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