scholarly journals H type tracheo-oesophageal fistula: 2 cases with review of literature

2021 ◽  
Vol 8 (4) ◽  
pp. 1350
Author(s):  
Apoorva Makan ◽  
Syamantak Basu ◽  
Pankaj Dwivedi ◽  
Akriti Tulsian ◽  
Vini Joseph ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Oesophageal Atresia ◽  
Review Of Literature ◽  
Common Life ◽  
Life Threatening ◽  
Classical Triad ◽  
High Degree ◽  
History Presentation ◽  
Pulmonary Status

Tracheo-oesophageal fistula (TEF) with oesophageal atresia is a common life threatening congenital malformation. H type TEF is a rare subtype (1.8 to 4.2% of all TEF) with the least association with congenital anomalies. We report two cases of H type TEF, first patient was a 2 month old girl who presented with the classical triad of symptoms, and the second patient was a 2 year old girl who presented with recurrent attacks of pneumonia, choking on feeding and noisy breathing. After radiological confirmation, optimization of pulmonary status and nutritional improvement, both underwent right cervicotomy with disconnection of the H fistula. Both patients are doing well on regular follow up. Detection of H fistula is difficult as compared to TEF since the clinical symptoms are variable, radiological detection difficult and diagnosis is based on a high degree of clinical suspicion. We present these two cases to document the history, presentation, clinical management and surgical procedure done in these patients.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Bordetella parapertussis Infection in Children: Epidemiology, Clinical Symptoms, and Molecular Characteristics of Isolates

1998 ◽  
Vol 36 (4) ◽  
pp. 999-1002 ◽  
Author(s):  
Paola Mastrantonio ◽  
P. Stefanelli ◽  
M. Giuliano ◽  
Y. Herrera Rojas ◽  
M. Ciofi degli Atti ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Pulsed Field Gel Electrophoresis ◽  
Molecular Characteristics ◽  
Duration Of Symptoms ◽  
Bordetella Parapertussis ◽  
Severe Clinical Picture ◽  
Genomic Dnas ◽  
High Degree

The clinical trial conducted in Italy to evaluate the efficacy of acellular pertussis vaccines provided an opportunity to estimate the frequency of clinical infections with Bordetella parapertussis and to compare the clinical characteristics of children suffering from Bordetella pertussis illness with those of children with B. parapertussis illness. This study dealt with 76 B. parapertussis infections diagnosed from a population of 15,601 children participating in the follow-up of suspected cases of pertussis. An overall incidence of 2.1 cases of laboratory-confirmed parapertussis per 1,000 person-years was observed. Children affected by B. parapertussisinfections showed a less severe clinical picture both in the duration of symptoms and in the percentage of patients affected, even when compared with vaccinated children with pertussis. To characterize the isolated strains, we performed assays for susceptibility to erythromycin and sulfamethoxazole-trimethoprim, and we examined the genomic DNAs by pulsed-field gel electrophoresis. The results showed a high degree of genetic stability among B. parapertussis strains regardless of time of collection and geographical distribution.

scholarly journals Emphysematous pyelonephritis: is conservative management effective? Our experience and review of literature

2020 ◽  
Vol 7 (3) ◽  
pp. 849
Author(s):  
Atul Kumar Khandelwal
Keyword(s):  
Percutaneous Drainage ◽  
Early Stage ◽  
Abdominal Mass ◽  
Review Of Literature ◽  
Emphysematous Pyelonephritis ◽  
Life Threatening ◽  
Laboratory Investigations ◽  
Time Of Presentation ◽  
Time Of Admission

Background: Emphysematous pyelonephritis (EPN) is a urologic emergency caused by a life-threatening necrotizing infection of the kidney leading to an accumulation of gas in the renal parenchyma and perirenal tissue. we present the clinical details and outcome of twelve patients of managed at our institute and discuss their management and outcomes.Methods: Twelve consecutive patients with EPN were managed in our institute from July 2014 to July 2018. Data on demographic profile, clinical features, laboratory investigations, imaging studies, outcome of patients and follow up details were recorded.Results: Out of 12 patients with EPN, nine were female and three were male. Ten patients were diabetic (83%). All the diabetic patient had raised blood sugar at the time of admission ureteric stone was present in two nondiabetic patients. All the patients had fever at the time of presentation while localized flank pain was present in 6 (50%) patients. On examination, renal angle tenderness was present in ten patients while abdominal mass found in three patients. Pyuria was found in all patients while leukocytosis found in 10 patients. Two patients had thrombocytopenia while 4 had deranged renal parameters at the time of admission. Urine culture showed Escherichia coli in 8 patients and Klebsiella in two patients. Four patients required percutaneous drainage. Interval nephrectomy was done in one patient due to non-functioning kidney.Conclusions: Majority of patients diagnosed as emphysematous pyelonephritis were managed conservatively due to diagnosed at an early stage. Percutaneous drainage is successfully utilized in patients with more advanced disease.

Unusual Cerebral Involvement of Rheumatoid Arthritis Mimicking a Tumor

2020 ◽  
Vol 16 (2) ◽  
pp. 145-148
Author(s):  
Sevil Tokdemir ◽  
Huseyin Toprak ◽  
Alpay Alkan
Keyword(s):  
Rheumatoid Arthritis ◽  
Unusual Case ◽  
Clinical Symptoms ◽  
Cns Involvement ◽  
Contrast Administration ◽  
Life Threatening ◽  
History Of ◽  
Brain Involvement ◽  
Minimal Contrast

Background: The central nervous system’s involvement in Rheumatoid Arthritis (RA) is infrequent and can be life-threatening. Mass-like CNS involvement is an unusual presentation. A 45 year old man had suffered seropositive rheumatoid arthritis for five years referred to our hospital with one-week history of right-sided facial paralysis, left hemiparesis and headache. Discussion: MRI demonstrated hyperintense mass-like lesion extended from mesencephalon to right hippocampus and basal ganglia on T2 and FLAIR images. On DWI, restricted diffusion was not present. After contrast administration, minimal contrast enhancement was noted. After methotrexate and steroid treatment, the size had been markedly shrunken on the follow-up images. The clinical symptoms were also improved. Conclusion: To our knowledge, the mass-like presentation was not reported in the literature. We report an unusual case of brain involvement of rheumatoid arthritis mimicked tumor

scholarly journals DICER1 Syndrome and Cancer Predisposition: From a Rare Pediatric Tumor to Lifetime Risk

2021 ◽  
Vol 10 ◽  
Author(s):  
Anna Maria Caroleo ◽  
Maria Antonietta De Ioris ◽  
Luigi Boccuto ◽  
Iside Alessi ◽  
Giada Del Baldo ◽  
...  
Keyword(s):  
Thyroid Neoplasms ◽  
Pleuropulmonary Blastoma ◽  
Type I ◽  
Cystic Nephroma ◽  
Genetic Condition ◽  
Pediatric Tumor ◽  
Common Life ◽  
Life Threatening ◽  
Dicer1 Syndrome

DICER1 syndrome is a rare genetic condition predisposing to hereditary cancer and caused by variants in the DICER1 gene. The risk to present a neoplasm before the age of 10 years is 5.3 and 31.5% before the age of 60. DICER1 variants have been associated with a syndrome involving familial pleuropulmonary blastoma (PPB), a rare malignant tumor of the lung, which occurs primarily in children under the age of 6 years and represents the most common life-threatening manifestation of DICER1 syndrome. Type I, II, III, and Ir (type I regressed) PPB are reported with a 5-year overall survival ranging from 53 to 100% (for type Ir). DICER1 gene should be screened in all patients with PPB and considered in other tumors mainly in thyroid neoplasms (multinodular goiter, thyroid cancer, adenomas), ovarian tumors (Sertoli-Leydig cell tumor, sarcoma, and gynandroblastoma), and cystic nephroma. A prompt identification of this syndrome is necessary to plan a correct follow-up and screening during lifetime.

scholarly journals Managing Life-Threatening Malignant Superior Mediastinal Syndrome in Pregnancy: When Benefits of Radiation and Chemotherapy Outweigh the Risks—A Case Report and Review of Literature

2021 ◽  
Vol 42 (02) ◽  
pp. 208-212
Author(s):  
Aashima Arora ◽  
Gaurav Prakash ◽  
Rashmi Bagga ◽  
Radhika Srinivasan ◽  
Arihant Jain
Keyword(s):  
Mediastinal Mass ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Grade ◽  
Multidisciplinary Management ◽  
Review Of Literature ◽  
Life Threatening ◽  
Ionizing Radiation Exposure ◽  
Superior Mediastinal Syndrome

AbstractThere is scarce literature on managing superior mediastinal syndrome during pregnancy. We report a case of 26-year-old primigravida who presented with life-threatening superior mediastinal syndrome at 32 weeks of gestation. The diagnosis was significantly delayed and, as a result, she reached the emergency with stridor and impending respiratory failure. She was diagnosed with primary mediastinal B cell lymphoma Lugano Stage II with a bulky mediastinal mass. She was treated with chemoimmunotherapy and underwent a preterm vaginal delivery after a week. She delivered a 1.6 kg healthy child with no malformations. Later, she completed three cycles of rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone and five cycles of dose-adjusted etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin, rituximab, followed by radiotherapy. She continues to be in remission at 18 months of follow-up. Delaying diagnostic imaging that involves ionizing radiation exposure and chemotherapy to avoid teratogenic and obstetric complications during pregnancy can adversely affect the prognosis in certain patients with high-grade malignancies. On the contrary, prompt multidisciplinary management can lead to a gratifying outcome.

scholarly journals Fatal outcome in acute fatty liver of pregnancy and review of literature

2019 ◽  
Vol 8 (3) ◽  
pp. 1197
Author(s):  
Reena Rani ◽  
Asmita M. Rathore ◽  
Sangeeta Bhasin
Keyword(s):  
Fatty Liver ◽  
Clinical Symptoms ◽  
Fatal Outcome ◽  
Fetal Mortality ◽  
Review Of Literature ◽  
Third Trimester ◽  
Acute Setting ◽  
Clinical Criteria ◽  
Life Threatening ◽  
Acute Fatty Liver

Acute fatty liver of pregnancy (AFLP) is an uncommon life-threatening disorder of pregnancy seen commonly in third trimester. When not diagnosed at right time it can lead to hepatic failure, encephalopathy, coagulopathy, maternal and fetal mortality. The clinical symptoms and signs are nonspecific, and it needs to be identified early in order to prevent poor outcome. The gold standard for diagnosis of AFLP is liver biopsy, which is difficult in an acute setting and in abnormal coagulation profile hence the diagnosis is usually based on clinical criteria   Early termination of pregnancy and good intensive care support are the mainstay of management. The authors here presented a case report where even early delivery and good critical care failed to prevent maternal mortality. Review of literature regarding etiopathogenesis, management and recurrences of AFLP are also discussed.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

Cerebellotrigeminal Dermal Dysplasia (Gómez-López-Hernández Syndrome)

2018 ◽  
Vol 16 (05) ◽  
pp. 362-368 ◽  
Author(s):  
Federica Sullo ◽  
Agata Polizzi ◽  
Stefano Catanzaro ◽  
Selene Mantegna ◽  
Francesco Lacarrubba ◽  
...  
Keyword(s):  
De Novo ◽  
Chromosomal Rearrangements ◽  
Number Of Patients ◽  
Wide Range ◽  
Visual Problems ◽  
Neurodevelopmental Abnormalities ◽  
Clinical Triad ◽  
High Degree ◽  
Motor Handicap

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

scholarly journals Chinese Herbal Medicine Dingji Fumai Decoction for Ventricular Premature Contraction: A Real-World Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bo Liang ◽  
Fei-Hu Zou ◽  
Ling Fu ◽  
Hui-Ling Liao
Keyword(s):  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Clinical Symptoms ◽  
Medication Compliance ◽  
Controlled Trial ◽  
Ventricular Premature Contraction ◽  
Traditional Chinese Medicine Syndrome ◽  
Chinese Herbal ◽  
Double Blinded

Background. Chinese herbal medicine Dingji Fumai Decoction (DFD) is widely clinically used for ventricular premature contraction (VPC). This real-word trial was designed to assess the safety and effectiveness of DFD for VPC. Methods. This was a double-blinded, randomized placebo-controlled trial. Patients with VPC were randomized (1 : 1) to treatment with DFD combined with metoprolol (DFD arm) or metoprolol combined with placebo (MET arm). A primary end point was a composite of clinical symptoms and signs determined by the traditionalChinese medicine syndrome score and the number of VPC determined by the Holter examination. Second outcomes were adverse events, medication compliance, and laboratory examination. Results. 144 patients were randomized to DFD arm (76 patients) or MET arm (68 patients), and 136 cases (71 in DFD arm and 65 in MET arm) finally completed this trial. After a 12-week follow-up, DFD arm significantly decreased traditional Chinese medicine syndrome score and the number of VPC compared with MET arm (P=0.003 and 0.034, respectively). There was no adverse drug effect and patient medication compliance was good. Conclusions. Superiority with DFD arm for VPC was demonstrated over MET arm for both the safety and effectiveness end points.

Sign in / Sign up

Export Citation Format

Share Document