Exceptionally rapid recurrence of malignant meningioma: case report

Anaplastic meningioma represents less than 5% of all meningiomas. It is a neoplasm with a poor prognosis due to aggressiveness and a high rate of recurrence. Patients could remain asymptomatic but clinical characteristics of mass effect are the most common presentation. Although diagnosis is made with histological study, this method is difficult to define, with inter-observer variability. When possible, surgical resection is the primary management. We discuss a case of an adult female patient with tonic-clonic seizures and weakness attributed to an anaplastic meningioma in the occipital lobe. The patient was treated with a parietal craniotomy with complete resection. One month later the patient suffered a recurrence of the tumor with the need for further intervention with incomplete resection. Due to extent of the damage the patient deceased two weeks later.

Adjunctive Physiotherapy – A Case Report on the Management and Effective Treatment of Diabetic Neuropathic Foot Ulcer Using Adjunctive Physiotherapy

Physiotherapy must be considered and reprioritized as an adjunctive medical service for long term health and rehabilitation. Comprehensive physiotherapy has the potential to be administered in out-patient rehabilitation facilities, hospitals, and Thermal Health Centers. A review of select adjunctive physiotherapy methods will be presented along with a case report of the successful treatment, with rationally selected physiotherapeutic agents, of a Diabetic Neuropathic Foot Ulcer scheduled for surgical amputation. By highlighting this case, the author is attempting to bring attention to familiar and time-tested therapies that have fallen out of use in a primary intervention context. This case report aims to exemplify that the role for rational physiotherapeutic methods stretches beyond current mainstream applications. Historical Context. Will supply the historical and foundational work in the field of physiotherapy that contextualizes the rational basis for the applications described in the case. Therapies. Lists the physiotherapy methods highlighted in this case, reviews the mechanism of action, discusses the therapeutic application, and provides modern citation for the rationalization of the therapy. Case Report. Reviews a detailed narrative of the case in review. Covers intake, case history, progression of case, as well as clinical applications for physiotherapy as they arise in the course of case management. Conclusion. Reviews the emphasis for reconsidering the role of Physiotherapy in the primary management of acute and chronic illness.

Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital

Background: Cutaneous malignant melanoma (CMM) is a significant cause of skin cancer-related mortality. The time between the diagnostic biopsy and primary surgical excision, the surgical interval (SI), is a modifiable factor that may impact melanoma outcomes. Delays in the SI are attributable to many factors.Aim: To determine the SI in patients with resectable CMM treated at Tygerberg Academic Hospital (TAH).Methods: A retrospective review of patients referred to the TAH multidisciplinary melanoma clinic with histologically confirmed CMM between January 2015 and December 2017 was done. Patients 18 years with resectable melanoma (T1b-T4b N0-3 M0-1a) who received definitive surgery were included.Results: The cohort (n = 40) comprised mostly Caucasians referred from the Cape metropolitan (metro) area, with a median age at diagnosis of 59 years. Thirty-one (77.5%) patients had T3 or T4 lesions on diagnostic biopsy. Twenty patients (50%) underwent a sentinel lymph node biopsy (SLNB) which led to an upstaging in 20% of cases. The median length of the SI was 13.5 weeks. Eighteen patients (45%) underwent primary excision within the recommended 12 weeks from diagnostic biopsy. There was a significant association between the SI and patients living in the Cape metro (p = 0.04) as well as the SI and p Stage (p = 0.01).Conclusion: Surgical interval guidelines for cutaneous melanoma are poorly defined. We used 12 weeks as an extrapolation of international guidelines. Even though this target was not met, the study is proposed to be of value in guiding future protocols and ultimately allowing for improved, timely service to patients.

PENINGKATAN KOMPETENSI PEDAGOGIK GURU MELALUI MANAJEMEN KEPALA SEKOLAH DI SMP NEGERI 1 SUNGAI AMBAWANG

The teacher's pedagogic competence affects the management ability of the principal. Therefore, primary management is an effort based on moving, directing, and maintaining one's ethics so that he is motivated to do something that is planned to achieve the desired goals. In the concept of management related to organizational life, the management ability of the principal plays an important role in moving teachers to be more professional, this is because the principal has a broad influence on the world of education in the school environment. The purpose of this school action research (PTS) is to find out the extent to which principal coaching through principal management can improve teacher pedagogic competence. This School Action Research (PTS) was carried out in 2 cycles, from the results of the actions taken it was proven to be able to improve the pedagogic competence of teachers in learning, from 57.33% in cycle 1 to 78.63% in cycle 2. So the results of the research produced were management principals carried out by researchers as school principals can improve the pedagogic competence of teachers in learning. Keywords: Improve, Principal Management, Teacher Pedagogic Competence

Combined Platelet Rich Plasma and Amniotic membrane in the treatment of Perforated Corneal Ulcers

Purpose To report the outcomes of using synthetic amniotic membrane with platelet rich plasma for the primary management of corneal perforations. Setting Ophthalmology department. Faculty of Medicine, Minia University, Minia, Egypt Methods A case series of 10 patients diagnosed with corneal perforation underwent emergency surgical procedure for repair of the perforation through the implantation of synthetic amniotic membrane with platelet-rich plasma clot under it and the application of platelet-rich plasma eye drops, with a follow up period of up to 4 weeks. Results All cases demonstrated formation of adequate intraocular pressure digitally, within the first 7 days, and all cases showed complete sealing of the corneal perforation within the 4 weeks follow up period, mild symptoms were reported only in the 1st postoperative week like foreign body sensation and lacrimation. 3 of the treated patients underwent penetrating keratoplasty after 6 months with satisfactory visual outcomes. Conclusion The combination of amniotic membrane implant and platelet rich plasma in both the clot and eye drop forms is an effective and easy accessible method for the primary management of corneal perforations

REMOVAL OF RETAINED INTRATHORACIC FOREIGN BODY AFTER PENETRATING CHEST TRAUMA : NEW INSIGHT

Presence of foreign body in thoracic cavity is very uncommon. Most common causes for the presence of such foreign bodies are traumatic, accidental or iatrogenic. The management involves urgent identication and removal of the foreign body. Surgical extraction using thoracotomy or video-assisted thoracoscopic surgery(VATS) remains the primary management strategy. Herein, we report the case of successful removal of retained foreign body from lung after 4 years of penetrating chest trauma by thoracotomy under intraoperative ultrasonographic guidance.

Knowledge of Healthcare Professionals Regarding the Primary Management of Anaphylaxis in Madinah, Saudi Arabia

Aim: To assess the knowledge, attitude and practice of healthcare professionals regarding the anaphylaxis in Medina, Saudi Arabia. Settings and Design: This was a population-based epidemiological study using a survey composed of 20 questions about the causes, symptoms, and treatment of anaphylaxis. Methods: This survey was distributed to healthcare professionals who represented different job categories including consultants, specialists, interns, residents, nurses, and medical students. Statistical Analysis Used: One-way ANOVA is used to compare the knowledge score across different job categories. SPSS V26 software was used for the analysis and a p value of <0.05 was considered significant. Results: The mean of the correct answers for all participants was 60% and no difference in the mean scores was found in all participant from different job categories. The minimum achieved score was 30% and the maximum score was 100%. The score for the correct answers to each question was varied from 21% to 81%. Conclusions: The shortage of knowledge among the healthcare professionals regarding anaphylaxis predicts the occurrence of undesirable outcomes for patients. Educating healthcare professionals regarding the management of anaphylaxis can improve the quality of healthcare services.

Delayed cephalic arch rupture following balloon angioplasty

Background Vascular access care comes with its substantial cost that include but not limited to poor blood flow during dialysis, stenosis throughout the dialysis circuits, aneurysmal dilatation, clots formation and complete thrombosis. Acute cephalic arch rupture is not that uncommon but delayed rupture is rare presentation that was not discussed previously. Case presentation We describe a case of a 70-year-old female with end-stage renal disease (ESRD) undergoing a fistulogram and angioplasty of cephalic arch stenosis that resulted in a small vessel rupture that was successfully treated with prolonged balloon inflation initially. Unfortunately, this was complicated with massive venous rupture after initiating hemodialysis. The diseased segment was successfully treated with covered stent placement. This paper review and discuss cephalic arch stenosis, clinical presentation, and available initial and bailout treatment strategies. Conclusions Primary management of cephalic arch rupture is a prolong-low pressure balloon angioplasty, with covered stent across the site of extravasation if persisted. This case depicted a delayed vascular rupture following hemodialysis in patient with previously controlled extravasation that necessities covered stent placement. No data in the literature suggested the time that is required to avoid dialysis and improve healing.

Primary management of cleft lip and palate

Cleft lip and palate is a condition with the potential to impact the lifetime of a patient, affecting overall health, appearance, communication, facial growth, hearing, eating, dental health, and psychological well-being. To effectively manage these multiple effects, the treatment of cleft lip and/or palate requires involvement of multiple healthcare specialists. This multidisciplinary management is difficult to coordinate so is often delivered by extended multidisciplinary healthcare teams. The early management of a child with a cleft lip and/or palate centres on the well-being of the child. The focus is on feeding, breathing, and managing medical comorbidities. Care can require extensive input from paediatric medical specialists, and needs to occur prior to any surgical management of the cleft lip or palate. This chapter discusses the surgical and perisurgical management of the primary cleft lip and/or palate including manipulation of the cleft lip prior to definitive surgery, primary lip surgery, primary palate surgery, and primary closure of the alveolar cleft with an assumption of medical well-being.