Unilateral Congenital Choanal Atresia in a 48-Year-Old Patient

2017 ◽  
Vol 9 (1) ◽  
pp. 28-31
Author(s):  
Lília Ferraria ◽  
Sílvia Alves ◽  
Helena Rosa ◽  
Mário Santos ◽  
Luis Antunes
Keyword(s):  
Surgical Repair ◽  
Choanal Atresia ◽  
Diagnostic Procedures ◽  
Clinical History ◽  
Accurate Diagnosis ◽  
Live Births ◽  
Major Symptom ◽  
Detailed Clinical History ◽  
Congenital Condition ◽  
History Of

ABSTRACT Aim To report a case of unilateral choanal atresia diagnosed in a 48-year-old, presenting with fatigue as the major symptom. To highlight the importance of a detailed clinical history and physical examination for an accurate diagnosis. Background Choanal atresia is an uncommon and often poorly recognized cause of unilateral or bilateral nasal obstruction. It is a congenital condition that occurs in approximately 1 in 5,000 to 8,000 live births. Case report This study reports a case of unilateral choanal atresia diagnosed in a 48-year-old presenting with fatigue as the major symptom. The patient presented with a lifelong history of tiredness investigated in cardiology. She was treated by a combined transseptal and transnasal endoscopic surgical technique. Topic use of mitomycin was performed with no use of stents, with clinical regression of the symptoms. Conclusion Unilateral choanal atresia usually presents in younger patients but can be undiagnosed until adulthood due to the nonspecific nature of the symptoms. This diagnosis should be, therefore, considered in all ages and bedside diagnostic procedures should, then, be done. Nasal endoscopy and computed tomography (CT) scan are the gold standard for the diagnosis. The use of stents and mitomycin C topically as an adjunct to the surgical repair of choanal atresia is a controversial subject. How to cite this article Ferraria L, Alves S, Rosa H, Santos M, Antunes L. Unilateral Congenital Choanal Atresia in a 48-Year-Old Patient. Int J Otorhinolaryngol Clin 2017;9(1):28-31.

scholarly journals Workplace eye safety: a neglected essential

2020 ◽  
Vol 7 (11) ◽  
pp. 4518
Author(s):  
Aastha N. Patel ◽  
Shankar S. Ganvit
Keyword(s):  
Significant Proportion ◽  
Working Hours ◽  
Clinical History ◽  
Significant Loss ◽  
Working Environment ◽  
Age Group ◽  
Female Ratio ◽  
Chemical Hazards ◽  
Detailed Clinical History ◽  
History Of

 Background: An occupational hazard is a hazard experienced in the workplace. This includes many types of hazards like chemical hazards, biological hazards, psychosocial hazards and physical hazards. Occupational ocular trauma holds significant proportion of visual morbidity worldwide. This can be prevented with the use of proper protective eyewear and strict compliance. This survey was conducted to study occupational related ocular hazard in our tertiary health care system hospital having patients involved in various occupations.Methods: A total of 90 occupational ocular injuries were recorded during study period. The age group of the patients to be studied was between 20 to 60 years. Brief history of present complaints, detailed clinical history and occupation history as like type of work, working environment, place, working hours was recorded. Required ophthalmological check-up was done. All valid responses were tabulated and analysed. Appropriate treatment was given.Results: Our study showed that majority (85.6%) of patients were not wearing protective eye equipment. Male to female ratio was approximately 3:1. Major age group affected was between 31-40 years (41.1%). Welders (40%) were more prone to injury occupation wise.Conclusions: Occupational eye injury is often severe and it contributes to significant loss. Incompliance of appropriate protective eye wear can lead to potential eye damage and permanent blindness.

scholarly journals Evaluation of elderly patients with hearing impairment.

2020 ◽  
Vol 27 (10) ◽  
pp. 2154-2158
Author(s):  
Syed Ali Naqi ◽  
Syed Maisam Ali ◽  
Arslan Akhtar ◽  
Tabassum Aziz ◽  
Tahira Sajid ◽  
...  
Keyword(s):  
Hearing Impairment ◽  
Past History ◽  
Clinical History ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Variable Degree ◽  
Cross Sectional ◽  
Detailed Clinical History ◽  
History Of ◽  
Study Setting

Hearing is decreased in later age is due to aging and is normally seen in most of the elderly people all over the world. Objectives: To ascertain the degree of hearing in elders in relation to age, pattern and extent of hearing weakness in old age so that interventional strategies can be planned to improve their wellbeing. Study Design: Cross Sectional Study. Setting: ENT Outdoor Clinic of Akbar Niazi Teaching Hospital of Islamabad Medical and Dental College, Bhara Kahu, Islamabad. Period: December 2017 to October 2018. Material & Methods: 200 patients were part of the study with age > 50 years and no past history of drug therapy. Data was gathered by detailed clinical history, clinical examination and audiometric findings. Result: 57% patients were found with normal hearing and 43% had variable degree of hearing deterioration. Highest number of hearing weakness was found in 9th decade. Most of hearing deterioration was found in both the ears and that of sensorineural in type. Conclusion: Sensorineural type of hearing impairment is very frequently occurring problem seen in the latter part of life in our community. The frequency and severity of decreased hearing is directly proportional to age.

scholarly journals (Doctor…My child keeps falling over) unexpected MRI findings in children with history of frequent falls and dizziness: a case series

2019 ◽  
Vol 12 (7) ◽  
pp. e229849 ◽  
Author(s):  
Ashraf Nabeel Mahmood ◽  
Osama Abulaban ◽  
Arshad Janjua
Keyword(s):  
Physical Examination ◽  
Case Series ◽  
Clinical History ◽  
Brain Stem Glioma ◽  
Mri Findings ◽  
Group Management ◽  
Wide Range ◽  
Detailed Clinical History ◽  
History Of ◽  
Low Threshold

Frequent falls and dizziness are common complaints in children. These symptoms can be caused by wide range of underlying pathologies including peripheral vestibular deficits, cardiac disease, central lesions, motor skills delay and psychogenic disorders. We report three paediatric cases who presented with complaints of repeated falls and imbalance. MRI scan revealed underlying brain lesions (frontal lobe arteriovenous malformation, exophytic brain stem glioma and cerebellomedullary angle arachnoid cyst with cerebellar tonsillar ectopia). By reporting these cases, we would like to emphasise the importance of a thorough assessment of children with similar symptoms by detailed clinical history, physical examination and maintaining low threshold for investigations, including radiological imaging. Taking in consideration, the wide range of differential diagnosis, the challenge of obtaining detailed history and difficulty of performing reliable physical examination in this age group. Management of underlying disorders can be medical, surgical or just observational.

scholarly journals Cutaneous Adverse Drug reactions: A Four-Year Study from Western Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 21-26 ◽  
Author(s):  
S Neupane ◽  
B Basnet
Keyword(s):  
Adverse Drug Reactions ◽  
College Teaching ◽  
Clinical History ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Medical College ◽  
Johnson Syndrome ◽  
Detailed Clinical History ◽  
Life Threatening ◽  
History Of

Background: Cutaneous adverse drug reactions (CADRs) range from minor reactions to several life threatening complications. Objectives: To study the clinical spectrum of cutaneous adverse drug reactions, determine the causative drugs responsible for the reactions and to assess the preventability.Methods: The study was carried out in the Department of Dermatology of Gandaki Medical College Teaching Hospital from June 2011 to June 2015. All the patients attending the Dermatology Outpatient Department and the patients admitted in the wards with suspected cutaneous adverse drug reactions to systemic drugs were included in the study. A detailed clinical history, including the history of drug intake was noted. Each case was assessed for its causality by using the WHO definitions. Data analysis was done using SPSS software.Results: There were 102 patients in total. The mean age of the patient was 32 ±15.7 years. Maximum patients belonged to the 21 to 30 years age group. There were 59 female patients and 43 male patients. Severe type of cutaneous adverse drug reactions was noted in 7.8% of patients. Antibiotics were responsible for most of the cutaneous adverse drug reactions. Cefixime was the most commonly incriminated drug. Exanthematous drug reaction was the most common type seen in 45%. Stevens-Johnson syndrome was the commonest type noted among the serious adverse drug reactions. Drug preventability was noted in 6% of patients.Conclusions: The commonest type of CADR noted was exanthematous type. Antibiotics were the commonest drug group involved in CADR. Six percent of CADR were preventable. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 21-26

scholarly journals A STUDY ON RIGHT ILIAC FOSSA MASS

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Pradeep Kumar Verma ◽  
Dr. Sanvar Mal Kantva
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Pathological Process ◽  
Accurate Diagnosis ◽  
X Ray ◽  
Detailed Clinical History ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist. Thus, thorough understandings of the anatomy and pathological process that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected o various investigations like x ray erect abdomen, chest x-ray, contrast x-ray. Results: In this study of 100 cases 86 % of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 3 cases of ileocaecal tuberculosis. Conclusion: This study showed that appendicular mass is the commonest pathology in right iliac foss. Keywords: Appendicular mass, ileocaecal tuberculosis, carcinoma caecum, right iliac fossa mass

scholarly journals Macular cherry red spot is an important diagnostic marker in children with myoclonic epilepsies

2016 ◽  
Vol 03 (02) ◽  
pp. 095-097
Author(s):  
Minal Kekatpure ◽  
K. Vinayan ◽  
Sheela Nampoothiri ◽  
Gopal Pillai ◽  
Anand Kumar
Keyword(s):  
Case Series ◽  
Clinical History ◽  
Accurate Diagnosis ◽  
Rare Disorders ◽  
Developmental Regression ◽  
Progressive Myoclonus Epilepsy ◽  
Myoclonus Epilepsy ◽  
Cherry Red Spot ◽  
History Of ◽  
Eye Examination

AbstractSymptomatic myoclonus is the major presenting feature of a small but very important and genetically diverse group of rare disorders included under the umbrella of progressive myoclonus epilepsy (PME) and progressive myoclonus ataxia (PMA) syndromes. These disorders often require extensive investigations to arrive at an accurate diagnosis. We present a case series highlighting the importance of a detailed fundoscopic eye examination; particularly when occurring in conjunction with a clinical history of myoclonus, developmental regression and other systemic features in clinching an etiologic diagnosis of storage disorder, specifically, gangliosidosis and sialidosis in children with suspected progressive myoclonus epilepsies. The causes of macular cherry red spot (CRS) on fundoscopic examination are limited and in a given child may provide an important clue for narrowing the differential diagnoses and finally making an accurate diagnosis. Current literature on symptomatic myoclonus, cherry red spot and their occurrence in PME/PMA syndromes is also reviewed.

scholarly journals Study of Clinico-Radiological Profile in Childhood Tuberculosis

2020 ◽  
Vol 8 (1) ◽  
pp. 09-14
Author(s):  
Triya Malde ◽  
Gaurang Pabani ◽  
O.P. Shukla
Keyword(s):  
Clinical History ◽  
Childhood Tuberculosis ◽  
Clinical Profile ◽  
Age Group ◽  
Female Ratio ◽  
Childhood Tb ◽  
Detailed Clinical History ◽  
History Of ◽  
Epidemiological Profile ◽  
Systemic Examination

Background: Tuberculosis still is one of the deadliest diseases in the world killing nearly 2 million people every year. In India, two deaths occur every three minutes from tuberculosis. The actual global disease burden of childhood tuberculosis is not known, as childhood Tuberculosis is notoriously difficult to diagnose because of the absence of a ‘gold standard’ as bacteriologic confirmation is rarely achieved. The present study was designed to study clinical profile of various forms of childhood TB. Objective of this study was to study clinic-epidemiological profile of various forms of childhood TB.Subject and Method:Retrospective analysis of clinical profile of 100 patients of childhood TB in the age group of 6 months to 12 years. A detailed clinical history, family history of contact with Koch’s disease, history of BCG vaccination of each child was recorded. A complete examination was carried out and findings regarding the general and systemic examination were recorded. Result:Age distribution in our study showed that 51% cases in the age of 5-12 years, 47% cases in the age group 1-5 years and  2 % cases falling in the age group 0-1 years, with male to female ratio of a 1.27:1. 95% of the patients belonged to the lower socio-economic class. The distribution of TB was- pulmonary tuberculosis(42%),TBME(30%),pleural effusion(12%),abdominal TB (12%), TB lymphadenitis(4%), Osteotuberculosis(2%), miliary TB(2%). 12% of the patients had mild to moderate malnutrition (PEM Grade I, II)and 57 % were severely malnourished. 72% of the patients were BCG vaccinated and history of Koch’s contact were present in 21% of all cases. The most frequently seen symptoms were fever (88%), cough (65%), weight loss in 50%, anorexia in 35% of cases and in physical examination cachexia was the most common (50%) followed by hepatomegaly (40%),lymphadenopathy(16%) and Splenomegaly (8%) of  cases. Conclusion:childhood TB is commonly seen in children more than 1 year, lower socioeconomic class and in severely malnourished children.

Osteoid Osteoma

2007 ◽  
Vol 97 (5) ◽  
pp. 405-409 ◽  
Author(s):  
Scot Freschi ◽  
Nicholas B. Dodson
Keyword(s):  
Osteoid Osteoma ◽  
Clinical Presentation ◽  
Clinical History ◽  
Magnetic Resonance Images ◽  
Benign Bone Tumor ◽  
Induced Stress ◽  
Second Metatarsal ◽  
Detailed Clinical History ◽  
History Of ◽  
Surgically Induced

An osteoid osteoma located in the forefoot can be difficult to diagnose, and the diagnosis is frequently delayed. We present a clinical case of a patient with pain, erythema, and swelling of the left forefoot with no history of trauma. Although rarely seen in the metatarsal, osteoid osteoma should be included in the differential diagnosis of foot pain. Findings from radiographs, magnetic resonance images, and a detailed clinical history led to the diagnosis of osteoid osteoma of the left second metatarsal. The lesion was surgically excised using curettage. This process significantly weakened the lateral cortex of the metatarsal shaft. To correct this surgically induced stress riser, an external fixator was applied to provide stability, allow for callus distraction, and allow the patient to walk as early as possible. We review osteoid osteoma, including the classic clinical presentation and treatment associated with this benign bone tumor. (J Am Podiatr Med Assoc 97(5): 405–409, 2007)

Component resolved diagnostics in peanut sensitized children with and without a history of clinical reaction

2020 ◽  
Vol 41 (5) ◽  
pp. 336-340
Author(s):  
Yasmin Hamzavi Abedi ◽  
Cristina P. Sison ◽  
Punita Ponda
Keyword(s):  
Retrospective Chart Review ◽  
Clinical History ◽  
Specific Ige ◽  
Exact Test ◽  
Ara H 1 ◽  
Sige Level ◽  
History Of ◽  
Laboratory Procedures ◽  
Ige Mediated ◽  
The Relationship

Background: Serum Peanut-specific-IgE (PN-sIgE) and peanut-component-resolved-diagnostics (CRD) are often ordered simultaneously in the evaluation for peanut allergy. Results often guide the plans for peanut oral challenge. However, the clinical utility of CRD at different total PN-sIgE levels is unclear. A commonly used predefined CRD Ara h2 cutoff value in the literature predicting probability of peanut challenge outcomes is 0.35kUA/L. Objective: To examine the utility of CRD in patients with and without a history of clinical reactivity to peanut (PN). Methods: This was a retrospective chart review of 196 children with PN-sIgE and CRD testing, of which, 98 patients had a clinical history of an IgE-mediated reaction when exposed to PN and 98 did not. The Fisher's exact test was used to assess the relationship between CRD and PN-sIgE at different cutoff levels, McNemar test and Gwet’s approach (AC1 statistic) were used to examine agreement between CRD and PN-sIgE, and logistic regression was used to assess differences in the findings between patients with and without reaction history. Results: Ara h 1, 2, 3, or 9 (ARAH) levels ≤0.35 kUA/L were significantly associated with PN-sIgE levels <2 kUA/L rather than ≥2 kUA/L (p < 0.0001). When the ARAH threshold was increased to 1 kUA/L and 2 kUA/L, these thresholds were still significantly associated with PN-sIgE levels of <2, <5, and <14 kUA/L. These findings were not significantly different in patients with and without a history of clinical reactivity. Conclusion: ARAH values correlated with PN-sIgE. Regardless of clinical history, ARAH levels are unlikely to be below 0.35, 1, or 2 kUA/L if the PN-sIgE level is >2 kUA/L. Thus, if possible, practitioners should consider PN-sIgE rather than automatically ordering CRD with PN-sIgE every time. Laboratory procedures that allow automatically and reflexively adding CRD when the PN-sIgE level is ≤5 kUA/L can be helpful. However, further studies are needed in subjects with challenge-proven PN allergy.

Stepping up detection, response, preparedness and readiness measures for “COVID-19”- A Pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1042-1047
Author(s):  
Khushbu Balsara ◽  
Deepankar Shukla
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Clinical History ◽  
Frontline Workers ◽  
Diagnostic Assays ◽  
Care Workers ◽  
Short Period ◽  
History Of ◽  
Detection Response ◽  
Care Worker

In a very short period of time, “COVID-19” has seized the consciousness globally by making remarkable changes in our day to day living and has superintended as a public health emergency globally. It has high radar of transmission, affecting an individual at work to frontline workers. The measures and planning for a response plays a key role from drawing up an emergency committee and this follows an equation which broadly deals with epidemiological to clinical history of the patient, management steps from isolation, screening, diagnostic assays for identification and treatment. The application of an organized plan with secure structure aids in better performance, increases efficacy of management and saves time. Also saves time for a health care worker to g through routine levels of channels of administration if already a familiar way of operation is known for such situations. Thus, planning and developing a ‘blueprint of approach’ towards management of patient while facing such situation is a must. This review provides an insight to the measures for detection, response and preparedness of the hospital and health care workers should largely be inclusive of; also highlights the measures to be taken at every step after coming in contact with a positive case of “COVID-19”.

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