Male To Female Ratio Research Articles

The histological grading of fibrosis in Budd-Chiari syndrome: A chronic liver disease, different from others.

Budd-Chiari syndrome (BCS) is an uncommon disease caused by hepatic venous outflow obstruction. They can result in centrilobular fibrosis, nodular regenerative hyperplasia and cirrhosis. Assessing liver fibrosis is crucial for determining the stage of BCS, predicting disease progression and guiding treatment decisions. Although this pathology has been known for decades, no useful grading system was assigned. This study aims to introduce a histologic fibrosis grading system for BCS patients. All patients from 2017 to 2022 (Sanjay Gandhi Postgraduate Institute of Medical Sciences [SGPGIMS]), Lucknow diagnosed with BCS for whom liver biopsy was performed were included in the study. The Budd-Chiari syndrome-Hepatic Fibrosis system (BCS-HFS) was implemented to grade fibrosis. The fibrosis grade was compared with the fibrosis percentage area and a correlation was found with the hemodynamic variables (hepatic venous pressure gradient[HVPG])and the prognostic scores. There were 56 patients with BCS. The median age was 27years, with a male-female ratio of 1.8:1. There was a significant difference in the fibrosis percentage, hemorrhage percentage and model for end-stage liver disease (MELD) score among the BCS-HFS grades (p < 0.05). There was a significant correlation between BCS-HFS and HVPG (ρ = 0.699, p < 0.001) and the MELD prognostic score (ρ = 0.474, p < 0.001). BCS-HFS is applicable for grading fibrosis in BCS. It can help in uniform histopathology reporting and for further prospective and comparative studies.

Management of Burn Wound in Diabetic Old Patient with Panchagavya Formulations – A Case Report

ABSTRACT Burn injuries are often prevalent and among the most catastrophic injuries encountered in casualty or surgery departments, involving skin and other tissues. These injuries typically result from heat sources such as solids, liquids, or fire, while scalds arise from hot liquids, electricity, chemicals, cold, friction, or radiation. Despite varying causes, the male-female ratio of burn cases remains consistent. In India, the annual incidence of burns is estimated at six to seven million. Topical antimicrobial agents are crucial for treatment. This case study focuses on an 83-year-old woman with acute burn wounds on her right leg and abdomen, accompanied by pain, discharge, foul odor, edema, and skin discoloration. Treatment involved Panchagavya Chikitsa, utilizing local applications of Gomutra twice daily for wound cleaning and Jatyadi Ghrita twice daily for wound healing over 60 days. Additionally, 15 ml of Gomutra Arka was administered internally twice daily for 15 days. Significant improvements were observed, including complete wound healing and associated symptom resolution. The positive outcomes may be attributed to the local and systemic effects of Gomutra, Jatyadi Ghrita, and Gomutra Arka, which possess antimicrobial, antiseptic, scrapping, and wound-healing properties. The findings suggest that Panchagavya formulations effectively and safely manage burn wounds, even in geriatric patients. Jatyadi Ghrita and Gomutra demonstrated promising results without causing adverse effects in this case.

EPID-36. CLINICAL FEATURES OF 614 PRIMARY INTRACRANIAL GERM CELL TUMORS: AN 15-YEAR EXPERIENCE OF A SINGLE CENTER IN CHINA

Abstract Incidence of primary intracranial germ cell tumors (ICGCT) in Asian countries is higher than Western countries. This study aims to describe the characteristics of ICGCT patients in China. Data on all patients with ICGCT who were seen at the Department of Neuro-oncology, Sanbo Brain Hospital, Capital Medical University from 2007 to 2022 were collected retrospectively. Patient demographics, disease characteristics and treatment outcomes were analyzed. A total of 614 patients were identified, with 309 germinomas and 305 non-germinomatous germ cell tumors (NGGCT). The median age at diagnosis was 12.8 years. The male-female ratio is 2.4 to 1. The primary disease sites were mainly pineal gland and suprasellar region. Adults (age≥23) were more likely to develop germinomas (65.3%). 78% patients received radiotherapy after initial diagnosis. In M0 patients, whole brain radiotherapy was the most common approach, while in M+ was craniospinal radiotherapy. Whole ventricle radiotherapy was uncommon (4%). The most common chemotherapy regimen for germinoma was a combination of bleomycin, cisplatin and etoposide/tenipside; while for the NGGCT was ifosfamide combined with carboplatin/cisplatin and etoposide. For germinoma, the median recurrence-free survival (RFS) and overall survival (OS) were 150.3 months and 222 months; the 10 year RFS and OS were 58.2% and 85.1%, respectively. For NGGCT, the median RFS and OS were 80.4 months and 166.7 months; the 10 year RFS and OS were 46.9% and 60.5%. At relapse, four (0.65%) developed secondary malignancies. Seven (1.14%) developed extracranial dissemination. Chemotherapy and radiotherapy could improve the RFS and OS. Higher radiation dose was associated with better prognosis. The prognosis of focal radiotherapy alone was poor. M0 germinoma treated with focal radiotherapy alone were more likely relapse. This study suggested that treatment outcomes of our ICGCT patients are comparable with those in Western centers. Adjuvant chemotherapy and whole brain/craniospinal radiotherapy are pivotal treatment.

Evaluation of Split Hand Syndrome in Early Diagnosis of Amyotrophic Lateral Sclerosis by Nerve Conduction Study as a Diagnostic Tool

Background: Amyotrophic lateral sclerosis (ALS), a degenerative disease of the motor neurons that can present diversly. Needle electromyography (EMG) is the gold standard investigation for the diagnosis of ALS. Split hand syndrome (SHS) demonstrated by nerve conduction study (NCS); a noninvasive tool could be useful in diagnosing ALS. This study aimed to assess SHS by NCS in ALS. Methods: This diagnostic accuracy case-control study included 37 cases of ALS and 37 age and gender-matched controls. Compound muscle action potential (CMAP) and distal motor latency (DML) of median and ulnar nerves and the ratio of median and ulnar CMAP and DML were compared between study groups. The diagnostic validity testing of electrophysiological SHS was also done. Results: The mean age of the ALS and control groups were similar, 39.8±2.7 and 39.3±2.6 years, respectively. Sixteen (43.2%) ALS patients were in 30-59 years age group. Male-female ratio was 5.2. In the ALS group, median-ulnar CMAP ratio was lower and median-ulnar DML ratio was prolonged than the control. The diagnostic efficacy of median-ulnar CMAP ratio and DML ratio were calculated. A median-ulnar CMAP ratio cut-off value ≤1 showed 70% sensitivity, 97% specificity, 96% positive predictive value and 77% negative predictive value. A median-ulnar DML ratio cut-off value ≥1.5 showed 48% sensitivity, 89% specificity, 82% positive predictive value and 65% negative predictive value. Conclusion: NCS demonstrating SHS can be an important tool in the early diagnosis of ALS. J Bangladesh Coll Phys Surg 2024; 42: 350-354

Critical values for carbon monoxide in cases admitted to the emergency department in a local hospital

Abstract Carbon monoxide (CO) poisoning has been an important concern in winter particularly due to malfunctioning coal stoves, in many developing countries, including Turkey. Winter months, especially February, were the most dangerous periods for CO exposure. Carbon monoxide has no color or smell so has known as the silent killer. Brain, heart, and other organs are under risk in CO poisoning. Because patients usually present with non-specific symptoms, CO poisoning should be considered in the differential diagnosis of unexplained nausea and vomiting, neurological or cardiac signs and symptoms. Carboxyhemoglobin (COHb) is a reliable marker to monitor the patient. Lactate is also important as a measure of impaired systemic oxygen delivery. Fifteen patients with a diagnosis of CO poisoning were included in the study. This is the number of all cases admitted to the emergency in the last one and a half months in our local hospital located in a town with almost 48.918 residents. Blood gas analysis was performed by ABL90 FLEX, Radiometer. Reference for COHb was 0.6-1.5 % and for lactate was 0.5-1.6 mmol/L. Troponin I levels were also analyzed in some patients to assess possible myocardial ischemia. Troponin levels were analyzed by ARCHITECT i2000, Abbott and reference range was &amp;lt;16 ng/mL in woman, &amp;lt;34 ng/mL in men. Graph Pad Prism program was used for statistical analysis of the data. We had 15 cases aged between 4-56 years with COHb values with panic values (&amp;gt; 20%) except two of the cases with values 16.5% and 19%. The female-male ratio was 6/9. On admission to the Emergency Department, 46.6% of patients (n=7) had headache and vomiting, 40% of patients (n=6) had headache, 6.6% (n=1) fatigue and 6.6% of patients (n=1) had syncope. Median value of COHb % was 23.7(16.5-40.8), lactate was 1.9 (0.8-4.8), pH was 7.39 (7.30-7.47). Excluding three patients as outliers, lactate levels had a good correlation with carboxyhemoglobin values (R2=0.9413). It was notable that 1 patient had a higher-than-normal Troponin I level (24.9 ng/mL) who has highest lactate level (4.8 mmol/L). Four of the patients, from the same family was admitted for suspected food poisoning for the symptoms of nausea, vomiting, diarrhea. A diagnosis of CO poisoning was made after a COHb value between 16.5-25.7% for these patients. This was very critical for the accurate treatment given to those patients being hyperbaric oxygen treatment in CO poisoning cases. CO poisoning should be considered in patients admitting to the emergency department with complaints of headache, dizziness, weakness, nausea, and vomiting. Reporting panic values is a means of alerting the clinician for the right diagnosis.

The challenging reality of the clinical learning environment at Damascus University Faculty of Dental Medicine in Syria: A qualitative study

Introduction In Syria, specialist dentists undergo five years of undergraduate education and four years of postgraduate education. In the latter, students engage in treating complex cases as part of their professional training. This study aimed to obtain in-depth qualitative understanding of the clinical learning environment at Damascus University Faculty of Dental Medicine, Syria. Methods Semi-structured interviews were held with eight postgraduate dental students at Damascus University Faculty of Dental Medicine. The faculty has eight clinical departments; therefore, a single participant was purposively sampled from each department. The male-female ratio of the eight interviewed participants was 1:1. All interviews were conducted between 26th April 2020 and 8th January 2021. Data were analyzed inductively using reflective thematic analysis. Pragmatic saturation was discussed during the analysis and the authors made an interpretative judgement to stop data collection at the eighth interview. Results Major themes which emerged covered different aspects of the clinical learning environment such as clinical training, social interaction and assessment procedures. Faculty’s negligence of their teaching duties was one of the most recurrent themes. In clinical training and due to faculty inaccessibility, students had to rely on themselves or their senior peers in training. The social climate was perceived negatively and assessment was described as unfair and biased. Discussion The findings of this study were framed within Gruppen et al. (2019) theory of the learning environment wherein four dimensions emerge: the personal, the social, the organizational and the material. The findings of this study showcased the continuing deterioration of the clinical learning environment at Damascus University. It is hoped that these findings will encourage decision makers to introduce a comprehensive reform that addresses the curriculum, teaching practices and assessment procedures in clinical professional training.

Diagnostic Performance of Computed Tomography in Laryngeal Carcinoma and its Extension

Background: Laryngeal carcinoma is a common malignant neoplasm of the head and neck with high incidence of new malignancies worldwide every year. Several imaging techniques including magnetic resonance imaging (MRI) and computed tomography (CT) scans are widely used to detect laryngeal carcinoma. Of them, CT scan is relatively cheaper, easily available and sensitive in the evaluation of laryngeal carcinoma. Objective: To find out the diagnostic performance of CT scan in laryngeal carcinoma and its extensions. Methodology: This cross-sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical CollegeHospital, Dhaka, during the period of July, 2016 to June, 2018 for a period of 2(two) years. A total of 50 samples were included purposively. The enrolled patients were attending outpatient department (OPD) or admitted in indoor and referred to the Radiology and Imaging department for CT scan. All the enrolled cases had laryngectomy and resected tissues were sent for histopathological examination. Data collection was done by the principal investigator and a preformed questionnaire was used during data collection. Following completion of data collection, it was analyzed by SPSS 20.0. Results: Age range of the patients was from 18 to 84 years, with the mean age of 61.2 years + 13.4 years standard deviation and a male-female ratio of about 7.3:1. By multidetector CT scan, majority (32, 64.00%) of the tumours were found confined in a specific area with no extension, followed by 12 (24.00%) involving both supraglottic and glottic region. On the other hand, by histopathology, almost all (47, 94.00%) of the cases were found malignant and majority of the malignant cases (31, 65.96%) were found without nodal metastasis. Validity tests of CT in the diagnosis of laryngeal carcinoma revealed sensitivity, specificity, accuracy and positive predictive values of 97.9%, 66.7%, 96% and 97.9% respectively. In case of nodal metastases, the sensitivity, specificity, accuracy and positive predictive value were 93.8%, 97%, 96% and 93.8% respectively. Conclusion: Contrast enhanced CT scan has good role in detecting nodal metastases, but had complementary role in detecting laryngeal carcinoma. Journal of Monno Medical College December, 2023; 9 (2): 63-67

Effectiveness of Soleus Muscle Flap for The Coverage of Wound in Open Tibia Fracture in The Mid Shaft

Introduction: An open fracture of the tibia has been one of the most common long bone injuries. Soleus muscle flap supply can be a remedy for this kind of soft tissue difficulties. The soleus muscle flap’s blood supply may help in the construction of a longer, safer, and more functional flap. When the incision is clinically fit for covering, the flaps from the same leg are elevated between 0 and 14 days following the damage. In the majority of these cases, the flaps are covered with a split-thickness skin graft taken from the anterior aspect of the thigh in the same sitting. This can be a great solution. Aim of the study: The study aimed to assess the effectiveness of soleus muscle flap for the coverage of wound in open tibia fracture in the mid shaft. Methods: This prospective interventional study aimed to evaluate the outcomes of early coverage using the soleus muscle flap in the management of Gustilo type-IIIB fractures of the mid-shaft tibia. The study followed a quasi-experimental design and was conducted over an 18-month period from January 1, 2010, to June 30, 2011. The research took place in the Department of Orthopaedics and Traumatology at Dhaka Medical College Hospital (DMCH) and the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) in Dhaka. The study population included all 15 patients admitted to the hospitals with clinical and radiological evidence of open Gustilo type-IIIB fractures of the mid-shaft tibia followed by the inclusion and exclusion criteria. Informed written consent was taken before data collection and confidentiality was maintained. The analysis was done by SPSS version 15. Result: Among 15 patients most (12) were male, 3 were female. Mean age was 38 ± 12 years. Majority were in 31-45 years. Male female ratio was 4:1. The selected study subjects were predominantly motor driver (26.66%), followed by day labor, housewife, service holder, farmer, and businessman (each was-13.33%), and student was 6.66%. ...

Sensitization and allergy to pineapple and coconut juice in patients followed up for allergic diseases in Parakou, Benin

Objectives: Little is known about adverse food reactions. The aim of this study was to investigate the sensitization and allergy to two tropical fruits, pineapple (Ananas comosus) and coconut (Cocos nucifera), among patients followed up for allergic disease in Borgou Teaching Hospital in Parakou, Benin. Materials and Methods: A prospective cross-sectional study was conducted in 2021. Adult patients (≥18 years) who were followed up for allergic asthma, rhinitis, or conjunctivitis were included in the study. Information on clinical manifestations following pineapple juice or coconut water drinking was collected, and skin prick testing was carried out. Results: Overall, 101 patients were enrolled, male-female ratio of 0.4:1 and mean age of 33.4 (±14.4) years. Clinical manifestations were triggered by pineapple in 53.5%, mainly mouth and lip pruritus (38.6%). The prevalence of sensitization was 36.6%. Allergy was diagnosed in 24.8% (or 46.3% of those who complained) and was associated with mouth and lip pruritus (odds ratio [OR] = 4.1; 95% confidence interval [CI] = 1.6–10.6; P = 0.003), bronchospasm (OR = 3.7;95%CI = 1.1–12.7; P = 0.031), allergic rhinitis (OR = 3.5; 95%CI = 1.2–10.4; P = 0.020), and conjunctivitis (OR = 4.4; 95%CI = 1.6–12.5; P = 0.007). Clinical manifestations after ingestion of coconut water reportedly occurred in 18.8% and were mostly bronchospasm (8.9%). The prevalence of sensitization was 20.8%. Allergies were diagnosed in 6.9% (or 33.3% of those who complained), with no association found with demographic or clinical characteristics. Conclusion: Pineapple is a common cause of food allergy among patients who are followed up in Borgou Teaching Hospital, while coconut is less responsible for this disorder. More studies are required to improve knowledge of allergic diseases in Sub-Saharan Africa, which is facing an epidemiological transition.

Result of consistent use of hearing aid in speech and language development.

Objective: To determine the benefits of proper guidance and proper use of hearing aid in language development age. Study Design: Descriptive Cross-sectional study. Setting: Department of ENT, Abbasi Shaheed Hospital and Karachi Medical and Dental College. Period: January 2022 to December 2023. Methods: In this study those cases were included which came with hearing loss. Both sexes were included in this study. After informed consent complete history and examination was done. Also relevant investigations were performed where required. Results: In this study, male were 72 (60%), male female ratio was 1.5:1. Highest number of patients were between the age of 6-8 years 60 (50%). Between 1.5 to 3 years, 51 children were properly guided and followed the proper instruction of use of hearing aid while 9 children were not properly guided and not properly used of hearing aid. 92 patients (76.6%) used hearing aid consistent with proper guidance, in which 79 (85.8%) children developed good speech and language. while 13 (14.1%) children were found poor in speech and language development while 28 (23.33%) children did not use hearing aid properly and all found poor in speech and language. Conclusion: Proper use of hearing aid which may be beneficial in improvement of word recognition and speech development in hearing impaired child under proper guidance and training from otologist and audiologist.

The Prevalence Pediatric Patients Attending in A Tertiary care Hospital in Dhaka, Bangladesh

Introduction The incidence of skin conditions in young people typically varies between nations and within a single nation’s regions based on social, economic, racial, and environmental factors. A significant public health issue is the morbidity that skin diseases cause in children. There is a dearth of research on this pediatric issue in our nation, which is either centered on a condition, a community, or a particular population group. Objective To evaluate the dermatological complaints of the pediatric patients attending a dermatology outpatient department in a tertiary care hospital. Materials And Methods We retrospectively analyzed a total of 2472 pediatric patients who were in age range 0-18 years and came to the OPD of dermatology &amp; venereology department of Ibn Sina Medical College Hospital, Dhaka, Bangladesh, over a period of 1½ year from January, 2020 to June, 2021. Data were collected on special proforma and analyzed with appropriate method. Results Among 2472 patients 1157 (46.8%) were male and 1315 (53.2%) were female and most of the patients belonged to the age group 12-18 year (52.6%). Male female ratio was 0.88:1. All diseases were broadly classified into noninfectious (71.2%) and infectious dermatoses (28.8%). Dermatitis (38.9%), infections (28.8%) and acne (14.44%) came out to be the top most common cause for OPD attendances. For the specific skin diseases, 20.1% were atopic dermatitis, 14.44% were acne, and 11.8 % were fungal infections. Atopic dermatitis was the most common condition below 12 years of age. In 12-18 years of age group, the most common condition was acne; females were more affected than males. Among the viral infections, wart was the most common (22.1%). Conclusion Atopic dermatitis was found to be the most common noninfectious disease and fungal infection was the most common infectious disease in all age groups and genders. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1054-1059

Diagnostic Utility of Squash Smear Cytology in Chordoma: A Tertiary Care Center Experience

Abstract Background and Aims: Chordomas are rare notochordal tumors. They are suitable candidates for squash smear cytology (SSC) owing to their gelatinous consistency and destructive nature. SSC is an important tool for making a quick intra-operative preliminary diagnosis and taking real-time surgical and further management decisions. This study aimed to evaluate the diagnostic accuracy of SSC for chordoma cases. Materials and Methods: This retrospective study conducted in a North Indian tertiary care center enrolled chordoma cases histopathologically diagnosed between 01.01.2013 and 31.07.2023, for which SSC was also performed. SSC smears and their corresponding histopathology slides (±immunohistochemistry [IHC] slides) were retrieved. Histo-cytological correlation was performed. Results: In total, 13 such cases were retrieved. The mean age was 34.4 + 5.6 years. The male–female ratio was 1:1.6. The most common location was the spheno-occipital region (10 cases), followed by sacro-coccygeal (two cases) and vertebral regions (1 case). The SSC was positive for chordoma in 10/13 cases. Thus, the calculated accuracy of SSC in chordoma diagnosis was 76.9%. A total of 3/13 (23.1%) cases where SSC was inconclusive for chordoma were difficult to diagnose cases, requiring IHC for ultimate diagnosis. Cytological features such as abundant myxoid matrix and physaliphorous cells help in correct diagnosis of chordoma on SSC. Conclusions: We found the diagnostic accuracy of SSC in chordoma diagnosis to be 76.9%. Features such as abundant myxoid matrix and physaliphorous cells are helpful in correct diagnosis on SSC. Thus, even though chordomas are rare, one should consider them among the differential diagnoses in cases presenting with appropriate clinico-radiological features and characteristic cytological findings.

A study of inflammatory diseases of external ear

Background: Inflammatory disease of external ear is one of the most common entities in otorhinolaryngological practice and is also frequently encountered in primary care. Due to the characteristic of its anatomical location, the external ear is exposed and easily damaged due to trauma, weathering, inflammation and environment. Objective: Objective is to study different etiological factors, clinical features, to evaluate treatment modalities, results and complications. Material and methods: A prospective observational study was conducted on 400 patients with inflammatory disease of external ear who will be undergoing ENT examination, diagnosis and treatment at Tertiary Care Center from the year 2020 to 2023. Results: Out of 400 patients, the male-female ratio is 1.2:1, the most common aetiology is bacterial but most common condition is otomycosis. Earache is the most common symptoms among the patients and 74% of the patients recovered with medical management only and complication rate was 10% only. Discussion: Commonest aetiology is otomycosis owing to hot and humid environment. Most common affected age group is younger may be because of environmental exposure. In most of the cases diagnosis was made to their clinical presentation and improved with conservative treatment so investigations were not required.

Factors affecting the level of parental knowledge about their children's congenital heart diseases and their care.

To assess parental knowledge about their children's congenital heart disease using a newly-designed scale. The cross-sectional study was conducted from June 2020 to May 2021, at Alkhansaa maternity and child hospital, Mosul Iraq; after approval from the ethics review committee of Ninevah Medical College, Ninevah University, Iraq, and comprised parents with children having congenital heart disease. Data, including age, gender, type of congenital heart disease as well as parents' educational and socioeconomic levels, residence, internet use and knowledge of the disease with respect to type, burden, bacterial endocarditis, outcome, etc. was noted. Parental knowledge levels were measured using a self-designed scoring scale, having a total score of 18 and 4 categories; <6 = some knowledge, 7-12 = good knowledge, 13-17 = very good knowledge, and 18 = full knowledge. Data was analysed using SPSS 26. There were 364 children with mean age 83.72±47.4 months and a male-female ratio of 0.98. The mean age at diagnosis was 12.1±8.32 months. The overall mean parental knowledge level was 8.41± 3.88, with 126(34.6%) parents having some knowledge, 178(48.9%) having good, 58(16%) having very good, and 2(0.5%) having full knowledge about their children's health condition (p<0.001) There was a significant association of parental knowledge with educational level, socioeconomic status and the type of doctor caring for the child (p<0.05). The duration of the illness showed a significant correlation with knowledge level (p=0.021). Heart Defects, Congenital, Endocarditis, Bacterial, Social Class.

The Functional Outcome of Boswarth Technique in terms of Ability to Stand on Tip Toes of Affected Side and Power of Planter Flexion

Background: Bosworth healed an Achilles tendon rupture by wrapping a wide strip of the proximal aponeuros is around the proximal and distal tendon stumps. Objective: To find out the functional outcome of Boswarth Technique in terms of ability to stand on tip toes of affected side and power of planter flexion. Methodology: DMCH conducted this prospective research from July 2006 to December 2007. Non-randomized purposive sampling chose 20 DMCHF outpatients.18 patients were first studied. Data was hand-edited. After that, SPSS data was entered. Results: The youngest patient was 17 years old and the oldest 47 years old.5:1 male-female ratio. Nearly 40% of patients were injured by an overhanging toilet pan, 27.8% by traumatic rupture, and 11.1% by a sharp weapon. The median injury level was 3.5 cm above the tendoachilles insertion, whereas the lowest and highest were 2.5 and 6 cm. Objective examination shows 45% of patients had excellent functional outcomes, 38.9% good, 11.1% fair, and 5.6% poor. This study's results were good in 83.3% and unsatisfactory in 16.7%. Conclusion: The Bosworth approach was simple to learn, making it potentially appropriate for foot and ankle surgeons with less training.

Epistaxis and Clinic Blood Pressure Values: Is There a Relationship?

Epistaxis is the most common otorhinolaryngological emergency and historically there have been an important debate whether there is a cause-effect relationship with high blood pressure. This retrospective study explored whether hypertension is a significant risk factor for epistaxis in Emergency Department (ED) patients and examined associations between blood pressure levels and epistaxis episodes. Two groups were studied: Group A (patients with epistaxis) and Group B (control). Patient characteristics, comorbidities, and medication use were recorded. Blood pressure measurements were taken upon ED arrival and after specialist evaluation. Statistical analyses included descriptive statistics, T-test, χ2 test, and logistic regression. Group A, enrolled from April 2014 to February 2015, included 102 patients, mean age 67, male-female ratio 2:1. Blood pressure on arrival was over 140/90 mmHg in 73%, decreasing to 26% after 30 minutes. Group B, enrolled from May 2023 to August 2023, included 126 patients, mean age 59, male-female ratio 2:1. Blood pressure on arrival was over 140/90 mmHg in 60%, decreasing to 23% after 30 minutes. Both groups showed reduced blood pressure post-evaluation. Logistic regression identified anticoagulant and/or antiplatelet therapy as the main independent risk factor for epistaxis. Age, sex, blood pressure levels, and hypertension did not significantly influence epistaxis occurrence. No significant correlation between hypertension and epistaxis was found. Anticoagulant and/or antiplatelet therapy was the primary independent risk factor, highlighting the importance of considering medication history in evaluating epistaxis.

Clinical profiles of older adults in French Caribbean nursing homes: a descriptive cross-sectional study.

Nursing homes in the Caribbean are scarce and the characteristics of their residents have not been previously documented. This study aimed to describe the clinical profiles of residents living in nursing homes in Guadeloupe and Martinique (French West Indies). This is a cross-sectional study of the baseline screening data from the KASEHPAD (Karukera Study of Ageing in nursing homes) study. Clinical characteristics and geriatric scale scores, including the Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment Short-Form (MNA-SF) and Short Physical Performance Battery (SPPB) were collected and analysed. A total of 332 older adults were recruited between September 2020 and November 2022. The mean age of the residents was 81.3 ± 10.1, with a male-female ratio of 1:1. Diabetes was reported in 28.3% of the residents, hypertension in 66.6% and heart disease in 18.4%. Dementia was diagnosed in 52.3% of the residents and 74.9% had a MMSE score ≤18. The prevalence of Parkinson's disease was 9.0%. Additionally, 18.4% were unable to perform any basic activities of daily living (ADL score of 0). The prevalence of physical impairment (SPPB < 8) was 90.0%. One-quarter of the residents were classified as undernourished (MNA-SF score ≤ 7). Residents in Caribbean nursing homes are younger than in metropolitan France, whereas they present quite similar clinical profiles. Notably, a high prevalence of diabetes, cardiovascular diseases and neurodegenerative diseases was observed. This study represents a preliminary effort to address the knowledge gap regarding the aging trajectories of older adults in the Caribbean and could guide the development of future nursing homes in these countries.

Inflammatory fibroid polyp of the esophagus: a systematic review.

Esophageal inflammatory fibroid polyp (IFP) is a rare benign tumor of the gastrointestinal tract with limited available data on clinicopathologic features and treatment strategies. A systematic review of the literature in PubMed/Medline and Scopus databases was performed for articles concerning esophageal IFP in adult population. A total of 16 studies were identified, involving 16 patients with a Male-Female Ratio of 3:1 and mean age of 50.38 years. Clinical presentation of esophageal IFP included progressive dysphagia in 56.3% of cases, with additional symptoms such as epigastric and retrosternal pain, weight loss, vomiting, and melena. Diagnostic modalities involved endoscopy in all cases, with endoscopic ultrasound (EUS) employed in 50% of cases and tissue biopsy performed during endoscopy in 87.5% of the patients. Therapeutic approach of esophageal IFP consisted of surgical resection in 75% of the patients and endoscopic resection in the remaining 25%, with various surgical procedures employed based on tumor location. Follow-up data, available for 11 patients over a median duration of 15.5 months, indicated two instances of recurrence following endoscopic resection, while the other nine patients remained asymptomatic with no evidence of recurrence. Esophageal IFP is a rare benign tumor of the gastrointestinal tract presenting with dysphagia, regurgitation, and heartburn. Resection, either endoscopic or surgical, is the primary treatment approach. Prognosis for esophageal IFP is favorable, with low recurrence rates. Further research is required to investigate potential risk factors and etiology for this lesion, and to explore novel therapeutic approaches that may improve patient outcomes.

ThP3.9 - Direct to PET-CT in oesophagogastric cancers: A pilot project at a tertiary upper gastrointestinal surgical referral centre

Abstract Background Oesophageal cancer contributes to 18% of cancer mortalities worldwide. The aim of this pilot project was to offer direct positron emission tomography- computed tomography (PET-CT) imaging and observe any differences in time to investigation and treatment in the cohorts. Methods Patients referred with a diagnosis of oesophageal cancer between 1st January 2022 to 31st December 2022 were included. Data was collected from the electronic patient record and retrospective analysis was performed using Microsoft Excel. Results A total of 189 patients with OG cancer were included. There were 89 local and 100 network patients. Median age was 71[range 37 – 93]. Locally male female ratio was 52:37 and in the network 73:27 [“p” 0.03]. Of 35 patients who had direct PET-CT (A) 31(88%) were local and 4(12%) from the network. Among 115 patients who had a CT followed by PET scan (B) 29(25%) were local and 86 (75%) from the network [ “p” 0.00001]. Waiting times were 27 days for a PET-CT as compared to 32 days for PET after CT scan [ “p” 0.09]. Reports were available in a median 4 days in group A compared to 3.5 days in group B [ “p” 0.66]. In group A 12 (35%) had metastases with nodal metastases in 9(75%) and distant metastases in 3(25%). Conclusion Whilst direct to PET-CT improved patient experience there were no statistically significant differences in the time to investigations and treatment. Three patients with distant metastases offered direct PET-CT could have been diagnosed by CT.

Clinical analysis of 21 cases of children with ectopic bronchogenic cyst

Objective: To analyze the clinical characteristics, treatment, and prognosis of ectopic bronchogenic cysts in children. Methods: A retrospective analysis was conducted on the data including the clinical characteristics, auxiliary examination and treatment of 21 children with ectopic bronchogenic cysts diagnosed pathologically at Children's Hospital Affiliated to Zhengzhou University from July 2015 to December 2023. There were 16 males and 5 females, with a male-female ratio of 3.2∶1, and the age ranged from 4 days to 8 years old (median age 2 years and 8 months). Results: Among the 21 cases of ectopic bronchogenic cysts, 11 cases were found in the pharynx, with symptoms including dyspnea (4 cases), snoring during sleep (3 cases), and choking on milk(4 cases).Ten cases were found in the head, neck or anterior chest, 5 of these cases had infection history, and 5 showed progressive mass growth.Imaging and endoscopy showed 9 patients underwent preoperative color ultrasonography revealed cystic masses with well-defined boundaries. CT examination was performed on 13 patients, which showed round or nearly round masses with homogeneous density, smooth margins, and regular cyst walls. CT attenuation values ranged from 2 to 52 Hounsfield Units (HU). Four cystic lesions were assessed via MRI, 3 cases demonstrated long T1 and long T2 signals, while 1 case had a slight short T1 and long T2 signal, with high signal intensity on fat-suppressed images. Eleven cases of pharyngopharyngeal cysts were examined by electronic nasopharyngoscopy. The cysts appeared as spherical or ovoid masses with smooth surfaces, close to or slightly light in color with the surrounding tissue, with one cyst presenting with a bluish blue in the oropharynx. All 11 pharyngeal cysts were excised using low-temperature plasma under general anesthesia and intubation assisted by a nasal endoscope. The cysts were pulled and excised as completely as possible.Ten cases of neck and anterior chest cysts were completely excised. Postoperative histopathology confirmed bronchogenic cyst. Twenty-one children were followed up postoperatively for 4 months to 7 years without recurrence, except for 1 patient who was lost to follow-up. Conclusions: Ectopic bronchogenic cysts are uncommon and lack of typical imaging and clinical features.Combination of ultrasonography, CT and MRI is recommended for cases occuered in neck and anterior chest, while electronic nasopharyngoscopy complements pharyngeal evaluations. Surgical intervention is the preferred treatment choice for this disease.