scholarly journals Histopathological and Histochemical Study of Human Cholecystitis

2021 ◽  
pp. 768-772
Author(s):  
V. Dhamodharan
Keyword(s):  
Signs And Symptoms ◽  
Total Acid ◽  
Female Ratio ◽  
Acid Mucin ◽  
Neutral Mucin ◽  
Grade 3 ◽  
Upper Abdominal ◽  
Calculous Cholecystitis ◽  
Male To Female ◽  
Severe Grade

In our study the following inferences were made. Chronic calculous cholecystitis was seen in the age group of 41 to 50 years. A female preponderance was noted with male to female ratio of 2:3. The most common signs and symptoms were upper abdominal tenderness and right hypochondria pain. The mucosa showed ulceration in 63%, hyperplastic mucosa in 34% and metaplasia in 5%. 22% of cases showed mild (Grade-I) inflammation while 41 % of cases and 27% of cases showed moderate(Grade-2) and severe (Grade-3) inflammation respectively. 44 % of cases showed mild (Grade-I) fibrosis while 22% of cases and 15% of cases showed moderate (Grade-2) and severe (Grade-3) fibrosis. With increase 1n severity of inflammation and fibrosis, the total acid mucin content decreased while the neutral mucin content increased. Similar changes were observed in cases of metaplasia too.

INNV-43. MORE THAN WHAT MEETS THE EYE: ETMR AN UNDER RECOGNISED ATYPICAL BRAINSTEM PRIMARY. A RARE BRAIN TUMOR CONSORTIUM (RBTC) STUDY

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi114-vi115
Author(s):  
Sara Khan ◽  
Palma Solano-Paez ◽  
Jordan R Hansford ◽  
Mei Lu ◽  
Salma Al-karmi ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Signs And Symptoms ◽  
Pediatric Brain Tumors ◽  
Female Ratio ◽  
Dismal Prognosis ◽  
History Of ◽  
Cranial Neuropathies ◽  
Intensified Chemotherapy ◽  
Male To Female

Abstract 10% of all pediatric brain tumors arise in the brainstem. Amongst these gliomas are the most common while other entities are rare and infrequently described in the literature. In this study we investigated the prevalence of non-gliomatous tumors in the brainstem. Amongst the 1323 embryonal tumours received at the RBTC, we identified 17 cases of ETMRs (17/165) that presented as brainstem primaries. Previously grouped within CNS-PNETs, ETMR, is a new WHO diagnostic entity, characterized by C19MC alterations. ETMR is a disease of infancy, the clinical spectrum of which is poorly understood. ETMRs arise at multiple CNS locations including cerebrum being most common (60%,) followed by cerebellum (18%) and midline structures (6%); notably 10% were brainstem primaries, mimicking DIPG radiologically. All patients presented with a short history of progressive neurological symptoms, with most common signs and symptoms of cranial neuropathies, long tract signs and gait disturbance. Median age at diagnosis was 27 months (range 16-75months) with a male to female ratio of 0.9:1. Predominantly localized (M0-94%, M2-3 -6%) majority of patients underwent upfront biopsy or partial resection (15/17:88%), while complete tumor resection was achieved in 2 cases. All patients received heterogenous combination of chemotherapy with and without radiotherapy. Majority of patients progressed rapidly with median time to progression of 4 months and overall survival of < 13 months. The only long-term surviving patient had complete resection dose intensified chemotherapy and radiation (OS 202months). Primary ETMRs in the brainstem are under recognised entities and carry a dismal prognosis. Although rapidly progressive, prompt recognition, maximal resection and management with multimodal adjuvant therapy should be considered in cases with brainstem disease.

scholarly journals Clinical Characteristics of Inpatients with Anaphylaxis in China

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Rui Tang ◽  
Han-Yi Xu ◽  
Ju Cao ◽  
Shi Chen ◽  
Jin-Lu Sun ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Multiple Organ ◽  
Female Ratio ◽  
Multisystem Involvement ◽  
Organ Systems ◽  
Number Of Patients ◽  
Male Patients ◽  
Male To Female

Objective.To analyze the clinical characteristics of inpatients with anaphylaxis and the factors that influenced those characteristics.Methods.Using the patient records from 1990 to 2013 from three highly ranked Chinese hospitals, we retrospectively analyzed the characteristics of 108 inpatients with anaphylaxis (not anaphylaxis admitted).Results.The mean patient age was42±20years old and male-to-female ratio was 1 : 1.3. The number of patients with anaphylaxis increased gradually, and cases diagnosed after 2005 accounted for 68.5% of the 108 total cases. The most common trigger was medications. The most common clinical manifestations included cutaneous, nervous, respiratory, circulatory, and digestive signs and symptoms. Male patients were more likely to experience loss of consciousness. Multisystem involvement was more likely to develop in patients with low BP, whereas it was uncommon in those with anaphylaxis induced by antibiotics or anesthetics. Epinephrine was used as the first-line treatment for 56 cases.Conclusions.Inpatient with anaphylaxis was more common in female patients and the number increased gradually during the study period. The most common trigger was medications. Patients with low BP were prone to having multisystem involvement, whereas the cases of anaphylaxis induced by antibiotics and anesthetics were less likely to involve multiple organ systems.

scholarly journals GALLBLADDER STONES SPECTRUM IN SAUDI POPULATION BY USING ULTRASONOGRAPHY

2021 ◽  
Vol 9 (02) ◽  
pp. 97-103
Author(s):  
Abdullah Hamdan ◽  
◽  
NasraldeenAlnaeem M. Alkhidir ◽  
Abdelmoneim Saeed ◽  
◽  
...  
Keyword(s):  
Spinal Cord ◽  
Microsoft Excel ◽  
Female Ratio ◽  
Gallbladder Stones ◽  
The Social ◽  
Common Causes ◽  
Upper Abdominal ◽  
Age Range ◽  
Male To Female ◽  
Spinal Cord Injured

Objective:This study was designed with an aim to determine the incidence of gallbladder stonesandto evaluate the accuracy of ultrasonography in the diagnosis of calculus, occur in Saudi patients whom presents at the Radiology and Ultrasound Department. Materials and method: Retrospective study in the period 22 August 2020 to 22 December 2020, a total of 108 patientsunderwentultrasound. When the gallbladder is investigated using ultrasound imaging (US) modality. Ultrasound instrument used was spatial digital U22 Philips Convex probe 3.5 Data analysis performed using the tables and computerized systems,ultrasound using different types of ultrasound units with 3.5 MHz and 5 MHz curve linear probes.Statistical analysis was performed using Microsoft Excel Software and the Standard Statistical Package for the Social Sciences version 15 for windows. Result: Out of 108 examined samples [mean age of 29 years male to female ratio of .9:1].Gallstones in this study were more common in the age range from 2 to 39, (58.3%).The most common causes of gallbladder stones are, 0ral contraceptives44(40.7%),Cholesterol28 (25.9%),Biliary dyskinesia 17 (15.7%),Diabetes 12 (11.1%),and Spinal cord injury7 (6.5%)one of the commonest complaints is upper abdominal pain,52(48.1%) and in majority of the cases the etiology is treatable,Nausea30 (27.8%) andVomiting 26(24.1%).Confirmation is done by CT scan 20 (18.5%) for the cases of small gall stones (<2mm) and impacted stones in cystic duct and operations, Cholecystectomy 14(13%) were done for stones large than (>2 cm), who have a nonfunctional or calcified (porcelain) gallbladder and patients for spinal cord injured. Conclusion: Ultrasound (US) is the preferred method for evaluating gallstones with 96% accuracy. The number, size and calcification can be evaluated by virtue of US inversion and attenuation. If there are more than five stones, the accuracy decreases.

scholarly journals Serum adenosine deaminase levels and other laboratory parameters in the diagnosis of extrapulmonary tuberculosis: a clinicopathological study

2017 ◽  
Vol 5 (7) ◽  
pp. 3140
Author(s):  
Prabhavati Mugulkod ◽  
Sateesh Chavan S.
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Female Ratio ◽  
Extra Pulmonary Tuberculosis ◽  
Laboratory Parameters ◽  
Acid Fast Bacilli ◽  
Caseating Granuloma ◽  
Appropriate Therapy ◽  
Male To Female

Background: Diagnosis of extra pulmonary tuberculosis (EPTB) is difficult due to its nonspecific signs and symptoms and paucibacillary nature. Early diagnosis and institution of appropriate therapy is essential to reduce the morbidity. The aim of the study was to study correlation between clinical findings, cytological/histological findings of EPTB with other laboratory parameters such as erythrocyte sedimentation rate (ESR), acid fast bacilli (AFB) status on Ziehl Neelson (ZN) stained sections /smears and serum adenosine de aminase (ADA) levels.Methods: All histologically and cytologically diagnosed cases of EPTB were included in the study and were examined for AFB on ZN stained smears and correlated with clinical findings and laboratory parameters such as ESR and serum ADA levels.Results: A total number of 230 cases of extrapulmonary tuberculosis were studied. Most common site of EPTB was lymph nodes. The most common age group affected was 3rd and 4th decade. Over half of the patients were females with male to female ratio 1:1.03. Majority had elevated ESR and caseating granuloma and only minority showed AFB positivity. Serum adenosine de aminase levels were raised in 83.3% (45 out of 54 cases). Majority of cases of EPTB with raised serum ADA levels had elevated ESR but negative for acid fast bacilli.Conclusions: Both histopathology (including cytology smears) as well as Ziehl Neelsen smears for acid fast bacilli are an “independent” diagnostic parameter and still be considered as “gold standard” while serum ADA levels are most valuable surrogate parameter.

scholarly journals Advance Laparoscopy in Minimal Resource Settings: Experience from a Public Sector Hospital in a Lower Middle Income Country.

2021 ◽  
Author(s):  
Muhammad Kaiser ◽  
Awais Amjad Malik ◽  
Danish Ali ◽  
Muhammad Qasim Farooq ◽  
Anwar Zeb Khan ◽  
...  
Keyword(s):  
Public Sector ◽  
Middle Income ◽  
Female Ratio ◽  
Laparoscopic Procedures ◽  
Grade 5 ◽  
Public Sector Hospital ◽  
Technical Issues ◽  
Grade 3 ◽  
Surgical Teams ◽  
Male To Female

Abstract Background: To share our experience of performing advanced laparoscopic procedures with minimal resources in a public sector hospital.Methods: A retrospective study of laparoscopic cases performed from December 1st 2016 till Dec 31st 2020 was done. All the cases were done by single surgical unit but with different surgical teams both as elective as well as emergency procedure. Type of procedure, conversion to open, and immediate post operative complications and outcomes were recorded. Complications were recorded on the basis of the Clavian Dindo Classification. Results: In 49 months a total of 1550 procedures were performed. 1133 basic and 417 advanced laparoscopic procedures were performed. Only advanced laparoscopic procedures are discussed further. Median patient aged was 33 years (Range 10 to 70 years). Male to female ratio was 1:1.2 (191:226). There was a conversion rate of 8.6% with 36 operations converted to open due to either technical issues or any complication. Median hospital stay was 2 to 12 days. Median operative time was 90minutes. Complications were seen in 48 patients. Grade 1/2 complications in 38 patients. Grade 3 complications were seen in 9 patients. Grade 4 in 1 patient. No Grade 5 (Mortality) complications were seen. Conclusions: Advanced laparoscopic surgery can be safely undertaken in public sector hospitals in low resource countries with limited resources.

scholarly journals A rare case of right-sided varicocele in right renal tumor in the absence of venous thrombosis and IVC compression

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Priyabrata Adhikari ◽  
Siddalingeshwar I. Neeli ◽  
Shyam Mohan
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Renal Vein ◽  
Renal Tumor ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Spermatic Vein ◽  
Careful Study ◽  
Rare Presentation ◽  
Grade 3

Abstract Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal disease such as renal cell neoplasm. Such tumors are usually associated with a thrombus in renal vein or spermatic vein. We report a rare presentation of right-sided renal tumor causing right-sided varicocele in the absence of thrombus in renal vein and spermatic vein but due to an anomalous vein draining from the tumor into the spermatic vein as demonstrated by computed tomography angiogram. Case presentation A 54-yr-old hypertensive male presented with unilateral grade 3 right-sided varicocele and no other signs and symptoms. Ultrasound examination of his abdomen showed the presence of a mass lesion in the lower pole of right kidney. Computed tomography confirmed the presence of right renal mass, absence of thrombus in right renal vein or inferior vena cava. The angiographic phase of CT scan showed an anomalous vein from the tumor draining into the pampiniform plexus causing varicocele. Conclusion The presence of right-sided varicocele should raise a suspicion hidden serious pathological retroperitoneal condition, renal malignancy in particular, and should prompt the treating physician to carry out imaging studies of the retroperitoneum and careful study of the angiographic phase of the CT scan can ascertain the pathogenesis of the varicocele.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

scholarly journals Disparities between IgG4-related kidney disease and extrarenal IgG4-related disease in a case–control study based on 450 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qiaozhu Zeng ◽  
Jingyuan Gao ◽  
Xinyu Zhang ◽  
Aichun Liu ◽  
Zhenfan Wang ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Clinical Laboratory ◽  
Imaging Finding ◽  
Age At Onset ◽  
Female Ratio ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Peking University ◽  
Chinese Cohort ◽  
Male To Female

AbstractWe aimed to compare the demographic, clinical and laboratory characteristics between IgG4-related kidney disease (IgG4-RKD+) and extrarenal IgG4-related disease (IgG4-RKD−) in a large Chinese cohort, as well as describing the radiological and pathological features of IgG4-RKD+. We retrospectively analyzed the medical records of 470 IgG4-related disease (IgG4-RD) patients at Peking University People’s Hospital from January 2004 to January 2020. The demographic, clinical, laboratory, radiological and pathological characteristics between IgG4-RKD+ and IgG4-RKD− were compared. Twenty IgG4-RD patients who had definite etiology of renal impairment including diabetes, hypertension and etc. were excluded. Among the remained 450 IgG4-RD patients, 53 were diagnosed with IgG4-RKD+ . IgG4-RKD+ patients had older age at onset and at diagnosis. Male to female ratio of IgG4-RKD+ patients is significantly higher. In the IgG4-RKD+ group, the most commonly involved organs were salivary gland, lymph nodes and pancreas. It was found that renal function was impaired in approximately 40% of IgG4-RKD+ patients. The most common imaging finding is multiple, often bilateral, hypodense lesions. Male sex, more than three organs involved, and low serum C3 level were risk factors for IgG4-RKD+ in IgG4-RD patients. These findings indicate potential differences in pathogenesis of these two phenotypes.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

scholarly journals High rates of gastroesophageal cancers in patients with dyspepsia undergoing upper gastrointestinal endoscopy in Uganda

2021 ◽  
Vol 09 (07) ◽  
pp. E997-E1000
Author(s):  
Ronald Mbiine ◽  
Cephas Nakanwagi ◽  
Olivia Kituuka
Keyword(s):  
Positive Association ◽  
Referral Hospital ◽  
Outcome Variable ◽  
Mulago Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Female Ratio ◽  
Mulago National Referral Hospital ◽  
Male To Female ◽  
Upper Gastrointestinal ◽  
National Referral Hospital

Abstract Background and study aims Dyspepsia is the most common presenting symptom in the gastrointestinal clinic of Mulago National Referral hospital. The etiology is essentially not fully described in our patient population. This study was therefore conducted to establish the causes of dyspepsia based on endoscopic diagnosis among patients with dyspepsia seeking care at the National Referral hospital of Uganda. Patients and methods This retrospective study conducted in the endoscopy unit of Mulago hospital reviewed 356 patient endoscopy reports spanning January 2018 to July 2020 with a focus on those with a referral indication of dyspepsia. Age and sex were the independent variables of interest while the endoscopy findings as reported by the endoscopist were the outcome variable of interest. Results Of the 356 endoscopy reports reviewed, 159 met the inclusion criterion of dyspepsia as the indication. Participant mean age was 47.7 years (± 16.53) with the majority (25.79 %) in the fifth decade while the male to female ratio was 1. The majority of patients had organic dyspepsia (90.57 %) while the commonest finding was gastritis 69 (43.4 %). Gastroesophageal cancers represented (18) 11.32 % of all findings. There was a positive association between age > 50 years with gastroesophageal cancers (7.639) as well as age < 50 years and functional dyspepsia (2.794); however, all these were not statistically significant (P = 0.006 and (P = 0.095, respectively). Conclusions Organic/structural dyspepsia comprises over 90 % of investigated dyspepsia with 11 % comprising cancer among patients seeking endoscopy at the National Referral Hospital of Uganda.

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