Endoscopic Transorbital Superior Eyelid Approach for the Management of Selected Spheno-orbital Meningiomas: Preliminary Experience

2017 ◽  
Vol 14 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Iacopo Dallan ◽  
Stefano Sellari-Franceschini ◽  
Mario Turri-Zanoni ◽  
Matteo de Notaris ◽  
Giacomo Fiacchini ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Tumor Volume ◽  
Endoscopic Management ◽  
Symptom Improvement ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
Endoscopic Transorbital ◽  
Superior Eyelid Approach ◽  
Orbital Meningioma ◽  
Male To Female

Abstract BACKGROUND Feasibility and safety of spheno-orbital meningioma resection by means of endoscopic-assisted transorbital route. OBJECTIVE To evaluate the feasibility and outcomes of the transorbital endoscopic management of selected spheno-orbital meningiomas. As secondary aims, symptom improvement and tumor volume removed were evaluated. METHODS Retrospective chart evaluation of patients with spheno-orbital meningiomas treated by means of endoscopic transorbital superior eyelid approach in 3 referral centers over the last 4 yr. RESULTS Fourteen cases were included in this study. In 4 patients, the transorbital endoscopic approach was combined with an endonasal route. Mean age was 51 and male-to-female ratio was 1:6. In 8 patients (57.1%), an intraorbital involvement was observed, 3 of them (21.4%) showed significant intraconal disease. No patient presented significant cavernous sinus infiltration. Main presenting symptoms were proptosis, diplopia, and visual impairment in 14, 6, and 6 patients, respectively. Mean proptosis improvement was 2 mm (standard deviation 2.3). We observed no major postoperative complications. CONCLUSION Our preliminary clinical experience seems to demonstrate that selected spheno-orbital meningiomas can be safely managed by means of an endoscopic transorbital route through a superior eyelid approach. Patients with orbital or cavernous sinus infiltration are at highest risk of persistence.

scholarly journals Accidental Poisoning in Children with Special Reference to Kerosene Poisoning

2017 ◽  
Vol 18 (1-2) ◽  
pp. 45
Author(s):  
Dachrul Aldy ◽  
Rusdidjas Rusdidjas ◽  
Helena Siregar
Keyword(s):  
Retrospective Study ◽  
Broad Spectrum ◽  
Accidental Poisoning ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
Oxygen Administration ◽  
Lower Socioeconomic ◽  
Increasing Trend ◽  
Poisoning In Children ◽  
Male To Female

A 6-year (1970- 1975) retrospective study of kerosene poisoning in children admitted to the General Hospital, Medan, is presented. The total number of admission was 10.643, 124 of which were kerosene poisoning. Tho mortality was 4.8%. In North Sumatera the incidence of kerosene poisoning along with the consumption of kerosene showed an increasing trend. The male to female ratio was 75 by 49 (3:2). The majority of cases were brought to the hospital within one hour after ingestion of kerosene. The presenting symptoms in the majority of cases were coughing (78.8%), vomiting (48.9%), dyspnoe 29%, fever 20.9%, brochopneumonia 12.9%, cyanosis 4.0%, and shock 1.6%. Treatment consisted of broad spectrum antibiotics, intravenous fluid, and oxygen administration. Kerosene in the household of the patients was used as fuel, either for cooking, or light source. More than 75% of the cases belonged to the lower socioeconomic class.

scholarly journals Surgery of Eventration of the Diaphragm

2021 ◽  
Vol 63 (2) ◽  
pp. 57-59
Author(s):  
Waleed M. Hussen ◽  
Ahmed M. Mohammed ◽  
Akeel S. Yuser
Keyword(s):  
Phrenic Nerve ◽  
Surgical Repair ◽  
Female Ratio ◽  
X Ray ◽  
Presenting Symptoms ◽  
Left Hemidiaphragm ◽  
Eventration Of Diaphragm ◽  
Chest X Ray ◽  
Male To Female ◽  
Eventration Diaphragm

Abstract Background: Eventration of diaphragm is an abnormal elevation of the diaphragm. Publishing on eventration of diaphragm in Iraq is scarce. Objective: This study was carried out to report on the Iraqi experience on eventration of diaphragm. Methods: A total of 18 patients with eventration diaphragm were included in this study. A review of case records of patients with eventration diaphragm treated in Ibn Al-Nafees Teaching Hospital was done. Review of records took place for the period of March 2012 to Dec. 2017. Results: The age of patients was ranged 5 months to 70 years, giving male to female ratio of 2:1. Dyspnea was dominating presenting symptoms followed by cough. The left hemidiaphragm was the most affected site (83.3%). The cause of eventration of diaphragm was idiopathic in 72.2% of patients. Chest X ray showed the elevation of the affected hemidiaphragm. CT scan demonstrated the thinned-out raised hemidiaphragm. The most common complications were atelectasis, and recurrent chest infection. Hospital stay was ranging 4-14 days. Conclusion: Eventration of diaphragm is not uncommon in Iraq. Presentation, management, and complication are similar to that reported in global centers.   Key words:  Diaphragm. Eventration.  Plication. Surgical repair. Phrenic nerve injury  

scholarly journals A clinical study of gastric outlet obstruction

2018 ◽  
Vol 5 (12) ◽  
pp. 3913 ◽  
Author(s):  
Ashwin K. ◽  
R. Lakshmi Visruja
Keyword(s):  
Gastric Outlet Obstruction ◽  
Early Stage ◽  
Operative Procedure ◽  
Barium Meal ◽  
Outlet Obstruction ◽  
Female Ratio ◽  
Medical College ◽  
Presenting Symptoms ◽  
Male To Female ◽  
Meal Study

Background: Gastric outlet obstruction (GOO) is a diagnostic and therapeutic challenge in developing countries to a Surgeon. Gastric outlet obstruction, a clinical condition impeding emptying of stomach mechanically, can be due to varied etiology. This study was taken up to know the etiological factors and management.Methods: This was a descriptive prospective study done at Madurai Medical College for a period of 2 years from September 2009 to August 2011. A set of inclusion and exclusion criteria were defined and followed. Upper gastro-intestinal endoscopy (OGD) was done in all cases while Barium meal study was done in few cases to make the diagnosis. Relevant operative procedure was done, and patients were managed post operatively.Results: Cicatrised Duodenal ulcer (DU) was the commonest cause followed by Carcinoma Pyloric antrum (Ca PA). Majority of the patients were males (67.5%) with male to female ratio of 2.07:1. Vomiting was one of the major presenting symptoms in all the patients.Conclusions: Cicatrised DU was the commonest cause for GOO in present study. Present study highlights the increasing incidence of Ca PA. This could be due to better management of DU at an early stage.

scholarly journals Patterns and clinical presentation of Foreign Bodies in ENT among Sudanese Children in Khartoum state hospitals.

2017 ◽  
Vol 12 (3) ◽  
pp. 151
Author(s):  
Rana Ahmed Abdelrahman Nasir ◽  
Sharfi Abdelgadir Omer Ahmed ◽  
Ibrahim Gaffar Ibrahim
Keyword(s):  
Foreign Bodies ◽  
Clinical Presentation ◽  
Public Health Education ◽  
Optimum Conditions ◽  
Female Ratio ◽  
State Hospitals ◽  
Presenting Symptoms ◽  
Close Supervision ◽  
Life Threatening ◽  
Male To Female

Abstract: -Background: Foreign bodies (FBs) in ENT are a common problem in Sudanese children and are associated with life threatening complications.Objectives: To study the patterns and presenting symptoms of children who are presented with foreign bodies Inhalation, Ingestion and insertion in the Nose and Ears.Methodology: This is a prospective hospital based descriptive study, conducted at Khartoum ENT Hospitals  from March 2013 to January 2015.Result: 150 patients with foreign bodies were studied in Khartoum ENT Hospitals. The commonest age group between 3–6 years in 64% of patients. Male to Female ratio is1.3:1.F.Bs  nose constituted higher percentage in (28%) of cases, F.Bs  inhalations were presented in(24.7%), F.Bs  ear were presented in (24.7%) and F.Bs  ingestion were presented in (22.7%).Regarding the type of inhalations, peanut was presented in (56.8%) of cases and the commonest presenting symptoms was cough in (94%) of patients.                                                                                                                                                                   Conclusion: Certain food items especially peanuts if given to children below the age of 2 years have to be given with caution and under close supervision. Bronchoscopy should always be considered in optimum conditions. Public health education is essential in order to prevent these avoidable problems.Key words:    F.Bs , ENT ,Khartoum.   

scholarly journals LINC-28. EPIDEMIOLOGICAL CHARACTERISTICS AND SURVIVAL OUTCOMES OF CHILDREN WITH MEDULLOBLASTOMA TREATED AT THE NATIONAL CANCER INSTITUTE (INCA) IN RIO DE JANEIRO, BRAZIL

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii383-iii384
Author(s):  
Gabriela Oigman ◽  
Diana Osorio ◽  
Joseph Stanek ◽  
Jonathan Finlay ◽  
Denizar Vianna ◽  
...  
Keyword(s):  
High Risk ◽  
Maternal Education ◽  
Survival Outcomes ◽  
Middle Income ◽  
Female Ratio ◽  
High Risk Patients ◽  
Presenting Symptoms ◽  
Risk Patients ◽  
Epidemiological Characteristics ◽  
Standard Risk

Abstract BACKGROUND Medulloblastoma (MB), the most malignant brain tumor of childhood has survival outcomes exceeding 80% for standard risk and 60% for high risk patients in high-income countries (HIC). These results have not been replicated in low-to-middle income countries (LMIC), where 80% of children with cancer live. Brazil is an upper-middle income country according to World Bank, with features of LMIC and HIC. METHODS We conducted a retrospective review of 126 children (0–18 years) diagnosed with MB from 1997 to 2016 at INCA. Data on patients, disease characteristics and treatment information were retrieved from the charts and summarized descriptively; overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier Method. RESULTS The male/female ratio was 1.42 and the median age at diagnosis was 7.9 years. Headache (79%) and nausea/vomiting (75%) were the most common presenting symptoms. The median time from onset of symptoms to surgery was 50 days. The OS for standard-risk patients was 69% and 53% for high-risk patients. Patients initiating radiation therapy within 42 days after surgery (70.6% versus 59.6% p=0.016) experienced better OS. Forty-five patients (35%) had metastatic disease at admission. Lower maternal education correlated with lower OS (71.3% versus 49% p=0.025). Patients who lived >40km from INCA fared better (OS= 68.2% versus 51.1% p=0.032). Almost 20% of families lived below the Brazilian minimum wage. CONCLUSIONS These findings suggest that socioeconomic factors, education, early diagnosis and continuous data collection, besides oncological treatment must be adressed to improve the survival of children with MB.

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.

Astrocytomas of the spinal cord in children and adolescents

1985 ◽  
Vol 63 (5) ◽  
pp. 669-675 ◽  
Author(s):  
Ronald Reimer ◽  
Burton M. Onofrio
Keyword(s):  
Spinal Cord ◽  
Histological Grade ◽  
Extended Period ◽  
Spinal Deformities ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Content Type ◽  
Orthopedic Procedure ◽  
Male To Female ◽  
Fine Print

✓ The authors review 32 cases of spinal cord astrocytoma in patients under 20 years of age who were treated at the Mayo Clinic between 1955 and 1980. There was a 1.3:1 male to female ratio. Twenty patients were between 6 and 15 years of age at the time of diagnosis. The duration of symptoms prior to definitive diagnosis varied from 5 days to 9 years, with an average of 24 months. The most common symptoms were pain (62.5%), gait disturbance (43.7%), numbness (18.8%), and sphincteric dysfunction (18.8%). The most common neurological findings were a Babinski response (50.0%), posterior column sensory dysfunction (40.6%), and paraparesis (37.5%). A median follow-up period of 8.6 years (range 0.8 to 25.5 years) revealed that the survival time diminished with increased histological grade of the astrocytoma (p < 0.001). The development of postlaminectomy spinal deformities represented a serious postoperative complication. This occurred in 13 patients and was first recognized between 8 and 90 months postoperatively. Six deformities occurred following cervical laminectomy, and eight patients required at least one orthopedic procedure. It is crucial to follow these patients for an extended period of time to watch for postoperative spinal deformities.

scholarly journals Clinicohematological Study of Thrombocytosis in Children

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Nathiya Subramaniam ◽  
Suneel Mundkur ◽  
Pushpa Kini ◽  
Nalini Bhaskaranand ◽  
Shrikiran Aroor
Keyword(s):  
Platelet Count ◽  
Myeloid Leukemia ◽  
Prospective Observational Study ◽  
Myelogenous Leukemia ◽  
Distribution Width ◽  
Female Ratio ◽  
Reactive Thrombocytosis ◽  
Acute Myelogenous ◽  
Male To Female ◽  
Primary Thrombocytosis

Introduction. Primary thrombocytosis is very rare in children; reactive thrombocytosis is frequently observed in children with infections, anemia, and many other causes. Aims and Objectives. To identify the etiology of thrombocytosis in children and to analyze platelet indices (MPV, PDW, and PCT) in children with thrombocytosis. Study Design. A prospective observational study. Material and Methods. A total of 1000 patients with thrombocytosis (platelet > 400×109/L) were studied over a period of 2 years. Platelet distribution width (PDW), mean platelet volume (MPV), and plateletcrit (PCT) were noted. Results. Of 1000 patients, 99.8% had secondary thrombocytosis and only two children had primary thrombocytosis (chronic myeloid leukemia and acute myelogenous leukemia, M7). The majority of the children belonged to the age group of 1month to 2 years (39.7%) and male to female ratio was 1.6 : 1. Infection with anemia (48.3%) was the most common cause of secondary thrombocytosis followed by iron deficiency alone (17.2%) and infection alone (16.2%). Respiratory infection (28.3%) was the predominant infectious cause observed. Thrombocytosis was commonly associated with IDA among all causes of anemia and severity of thrombocytosis increased with severity of anemia (P=0.021). With increasing platelet count, there was a decrease in MPV (<0.001). Platelet count and mean PDW among children with infection and anemia were significantly higher than those among children with infection alone and anemia alone. None were observed to have thromboembolic manifestations. Conclusions. Primary thrombocytosis is extremely rare in children than secondary thrombocytosis. Infections in association with anemia are most commonly associated with reactive thrombocytosis and severity of thrombocytosis increases with severity of anemia.

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