scholarly journals Spectrum of Clinical Presentation and Surgical Outcome in Patients with Chronic Subdural Haemorrhage: A Retrospective Study

2021 ◽  
Author(s):  
Malaya Patel ◽  
Acharya Suryakant Pattajoshi ◽  
Harish Chandra Dhamudia ◽  
A Unnikrishnan ◽  
J Paul ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Outcome ◽  
Subdural Haematoma ◽  
Clinical Presentation ◽  
Young Subject ◽  
Medical Science ◽  
Treatment Modalities ◽  
Subdural Haemorrhage ◽  
Elderly Male ◽  
Early Recovery

Introduction: Chronic subdural haematomas are one among common neurosurgical emergencies especially affecting elderly male. Usually, presents with subacute Cerebro Vascular Accident (CVA), impaired higher mental function and sometimes with reversible dementia. Rarely, it presents with end stage herniation. Burr Hole Drainage (BHD) is the most popular and worldwide procedure of choice and it successfully address the problem in majority of cases. However, in a small group of patients it needs a wider craniotomy to deal with the subdural membrane which is mainly associated with recurrence of the entity. Aim: To evaluate the comparative incidence of various clinical presentation and analysing the outcome of different treatment modalities in different subgroups of patients with chronic subdural haemorrhage with respect to complication and survivality. Materials and Methods: This retrospective study enrolled data of 100 consecutive patients of subacute (n=30) and chronic subdural haematoma (n=70) who were admitted and undergone neurosurgical management of Veer Surendra Sai Institute of Medical Science and Research (VIMSAR), Burla, Odisha between September 2018 to September 2020. Variables were collected from patient’s records at discharge and analysed with respect to spectrum of clinical presentation and surgical outcome of different treatment modalities and problems associated with it. Results: The mean age group was 57.39 years and headache was the most common clinical presentation in the present study (86%) followed by hemiparasis (74%). BHD was carried out in 94 patients (94%). Primary craniotomy and membrane excision was carried out in 5 patients. Secondary craniotomy was performed in 1 patient after early re-accumulation and clinical deterioration. The outcome was assessed utilising Glasgow outcome scale with total five deaths in the series. Conclusion: Chronic Subdural Haemorrhage (CSDH) a problem of late adulthood (5th to 6th decade) which mostly follows two to three weeks after trauma. It needs proper preoperative assessment and requires timely intervention with skilled nursing care for early recovery. Post-traumatic subacute subdural haematoma in young subject and alcoholics needs special attention during course of their treatment. Bilateral puppilary failure, low Glasgow Coma Scale (GCS) and seizure association are risk factors for poor outcome.

scholarly journals Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

2021 ◽  
Author(s):  
Rahul Singh ◽  
Ravi Shankar Prasad ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
Nityanand Pandey
Keyword(s):  
Retrospective Study ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Motor Response ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Age Group ◽  
Female Ratio ◽  
Severity Of Injury

Abstract Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clinical presentation was altered sensorium (98.25%). The most common comorbidity was hypertension (n = 32, 28.07%). GCS at admission, severity of injury, pupillary changes, and best motor response (p < 0.0001) were significantly associated with surgical outcome. Conclusion GCS at admission, severity of injury, pupillary changes, and best motor response were significantly (p < 0.05) associated with surgical outcome. Age and gender of patients were not found to be significantly associated.

scholarly journals Review of Treatment of Reflex Sympathetic Dystrophy

2012 ◽  
Vol 11 (3) ◽  
pp. 160-164
Author(s):  
JC Ghosh ◽  
SC Hazra ◽  
ME Haque ◽  
PS Ghamsari ◽  
SK Singha
Keyword(s):  
Reflex Sympathetic Dystrophy ◽  
Clinical Presentation ◽  
Medical Science ◽  
Preventive Measure ◽  
Treatment Modalities ◽  
Standardized Protocol ◽  
Management Protocol ◽  
Review Study ◽  
Pharmacological Method ◽  
Selection Of

A review study was done by searching literature through PubMed. Reflex sympathetic dystrophy is a life altering disease pathogenesis of which are not yet clearly known likewise its management protocol has not been established. Treatment of longstanding Reflex sympathetic dystrophy is empirical and of limited efficacy. This disease may lead to dreadful squeal which may need amputation for their management and few of these patients may even develop suicidal tendency. Patient with Reflex sympathetic dystrophy usually present late. It was found that the clinical presentation of RSD are too much variable, although different modalities of treatment are used either alone or in combination, the outcomes are often unpredictable and of variable efficacy. Understanding of the treatment modalities and proper selection of treatment option are essential for best outcome. Preventive measure does play a role in management of these patients. Option of treatment includes pharmacological method, sympathetic nervous system interruption, use of calcitonin and bisphosphonate. More study is required to find out the mechanism that triggers the pain and other clinical manifestation so that a standardized protocol for its management can be developed DOI: http://dx.doi.org/10.3329/bjms.v11i3.11714 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12

Resveratrol as an Adjuvant for Normal Tissues Protection and Tumor Sensitization

2020 ◽  
Vol 20 (2) ◽  
pp. 130-145 ◽  
Author(s):  
Keywan Mortezaee ◽  
Masoud Najafi ◽  
Bagher Farhood ◽  
Amirhossein Ahmadi ◽  
Dheyauldeen Shabeeb ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Cancer Treatment ◽  
Cancer Cells ◽  
Clinical Studies ◽  
Normal Tissue ◽  
Medical Science ◽  
Treatment Modalities ◽  
Radiation Toxicity ◽  
Normal Tissues ◽  
Normal Tissue Toxicity

Cancer is one of the most complicated diseases in present-day medical science. Yearly, several studies suggest various strategies for preventing carcinogenesis. Furthermore, experiments for the treatment of cancer with low side effects are ongoing. Chemotherapy, targeted therapy, radiotherapy and immunotherapy are the most common non-invasive strategies for cancer treatment. One of the most challenging issues encountered with these modalities is low effectiveness, as well as normal tissue toxicity for chemo-radiation therapy. The use of some agents as adjuvants has been suggested to improve tumor responses and also alleviate normal tissue toxicity. Resveratrol, a natural flavonoid, has attracted a lot of attention for the management of both tumor and normal tissue responses to various modalities of cancer therapy. As an antioxidant and anti-inflammatory agent, in vitro and in vivo studies show that it is able to mitigate chemo-radiation toxicity in normal tissues. However, clinical studies to confirm the usage of resveratrol as a chemo-radioprotector are lacking. In addition, it can sensitize various types of cancer cells to both chemotherapy drugs and radiation. In recent years, some clinical studies suggested that resveratrol may have an effect on inducing cancer cell killing. Yet, clinical translation of resveratrol has not yielded desirable results for the combination of resveratrol with radiotherapy, targeted therapy or immunotherapy. In this paper, we review the potential role of resveratrol for preserving normal tissues and sensitization of cancer cells in combination with different cancer treatment modalities.

A Holistic Approach to Phimosis in Children

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Rajendra Paliwal ◽  
Rashmi Pareek
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Medical Science ◽  
Holistic Approach ◽  
Review Article ◽  
Local Application ◽  
Treatment Modalities ◽  
Recurrent Attack ◽  
New Born ◽  
Tract Infections

Phimosis is described as condition in which prepuce or foreskin of glans penis is not retracted backwards resulting in poor narrowed stream of urine during micturition causing ballooning of prepuce along with recurrent attacks of balanoposthitis and Urinary Tract Infections (UTIs). Majority of new born boys do have non-retractile foreskin called as Physiological Phimosis. In Ayurveda phimosis is described as Nirudhaprakasha. Physiological phimosis usually does not require any kind of treatment as it resolve spontaneously within first couple of years mostly taking 3 to 6 years after which measures are considered to correct it surgically. Pathological phimosis is condition in which prepuce get adhered to glans secondary to adhesions or scarring made because of infection, inflammation or trauma. Pathological phimosis and physiological phimosis with recurrent attack of balanoposthitis and UTIs do require treatment. There are several treatment modalities are available according to severity of adhesions such as local application of steroid cream or oil, manual retraction, dilatation and Circumcision. In this review article we assess the various treatment modalities available in Ayurveda and contemporary medical science for better management of Phimosis.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

scholarly journals Neurilemmomas of the Hand—A Review of the Clinical Presentation, Surgical Outcome, and Potential Risk Factors

2017 ◽  
Vol 22 ◽  
pp. 48-51
Author(s):  
Ka-Chun Jonathan Chan ◽  
Fu-Keung Ip ◽  
Tak-Chuen Wong ◽  
Oi-Yee Prisilla Leung ◽  
Sze-Yan Chan
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Surgical Outcome ◽  
Clinical Presentation ◽  
Potential Risk Factors

scholarly journals Surgical Outcome of Chronic Subdural Haematoma: An Analysis of 300 Cases

2016 ◽  
Vol 24 (2) ◽  
pp. 126-131
Author(s):  
Sukriti Das ◽  
Asit Chandra Sarkar ◽  
Md Rafiqul Islam ◽  
Md Manirul Islam
Keyword(s):  
Normal Saline ◽  
Surgical Outcome ◽  
Subdural Haematoma ◽  
Subdural Space ◽  
Acute Subdural Haematoma ◽  
Related Factors ◽  
College Hospital ◽  
Complete Replacement ◽  
Poor General Health ◽  
Medical College

Chronic Subdural Heamatoma (CSDH) is defined as collection of blood in the brain’s surface, subdural space between dura and arachnoid. It is one of the most common clinical entities in daily neurosurgical practice among the elders, several weeks after the head injury. CSDH doesn’t always produce symptoms but when it does, it generally requires surgical treatment. The diagnosis and treatment are well established, but the cause of recurrence, complications and related factors are not completely understood. This study evaluated the clinical features, radiological findings and surgical results in a large series of patients treated at the Neurosurgery department of Dhaka Medical College Hospital. 300 consecutive patients (250 men and 50 women) age ranging from 30-85 years, GCS 5-15, volume of blood >25cc, symptomatic with CSDH were treated by one or two burr hole craniostomies. Haematoma cavity was irrigated with normal saline and closed system subdural drainage was continued for 1-2 days from January 2012 to December 2015. The clinical outcome was measure on 1st, 3rd, 5th and 7th POD using GCS scoring and GOS after 4 and 8 weeks of operations. Most patients 94%(282) had good recovery (GOS 5,4,3), 4%(12) showed no changes (GOS 2) and 2%(6) worsened (GOS 1). Recurrence of haematoma was recognized in 5%(15) patients 1-8 weeks after the first operation. 4%(12) patients suffered post operative complications of which 1.33%(4)patients were acute subdural haematoma caused by incomplete haemostasis of the scalp wound, 1.33%(4)patients were tension pneumocephalus and remaining due to hypertension, use of anticoagulants, poor general health and medical problems. Careful haemostasis and complete replacement of subdural haematoma with normal saline to prevent influx of air into the subdural space will further improve the surgical outcome for patients with CSDH.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 126-131

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