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SU-F-J-126: Influence of Six Dimensional Motions in Frameless Stereotactic Dosimetry Incorporating Rotational Shifts as Equivalent Translational Shifts: A Feasibility Study for Elekta-BrainLAB Stereotactic System. Med Phys 2016. [DOI: 10.1118/1.4956034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Comparison of Obstetric anal sphincter injuries (OASIS) in nulliparous women before and after introduction of the EPISCISSORS-60® at two Hospitals in the United Kingdom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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EP-1685: Influence of flat, flattening filter free beam model and different MLC’s on VMAT based SRS/SRT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32936-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Background: Skin Appendageal tumors are a large and diverse group of tumors that are commonly classified according to their state of appendageal differentiation: follicular, sebaceous, eccrine and apocrine. Objectives of this study were to study the clinic-epidemiological profile of skin appendageal tumors and to correlate the clinico-histopathological diagnosis.Materials and Methods: This was a retrospective and prospective study which included all cases of skin adnexal tumours diagnosed histologically during the period of f
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Do technological advances in linear accelerators improve dosimetric outcomes in stereotaxy? A head-on comparison of seven linear accelerators using volumetric modulated arc therapy-based stereotactic planning. Indian J Cancer 2016; 53:166-73. [DOI: 10.4103/0019-509x.180815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Assessment of short term effects of sildenafil therapy in patients with secondary pulmonary hypertension. Indian Heart J 2015. [DOI: 10.1016/j.ihj.2015.10.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Perspectives on the presentation, treatment, and outcomes of acute coronary syndromes in India: A prospective analysis of registry data from a major center in Uttar Pradesh. Indian Heart J 2015. [DOI: 10.1016/j.ihj.2015.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association? Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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To detect occult coronary artery disease in global severe left ventricular hypokinesia. Indian Heart J 2015. [DOI: 10.1016/j.ihj.2015.10.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Utility of fine needle aspiration cytology in detecting metastatic deposits in an uncommon case of malignant transformation in a giant cell tumour of bone. Cytopathology 2015; 27:505-507. [PMID: 26614564 DOI: 10.1111/cyt.12278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Changing perspective on tissue processing - comparison of microwave histoprocessing method with the conventional method. JOURNAL OF PATHOLOGY OF NEPAL 2015. [DOI: 10.3126/jpn.v5i10.15665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Histopathological examination of tissues requires sliver of formalin fixed tissue that has been chemically processed and then stained with Haematoxylin and Eosin. The time honored conventional method of tissue processing, which requires 12 to 13 hours for completion, is employed at majority of laboratories but is now seeing the
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SU-E-T-583: Operated Left Breast and Chest Wall Radiotherapy: A Dosimetric Comparison Between 3DCRT,IMRT and VMAT. Med Phys 2015. [DOI: 10.1118/1.4924945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Atraumatic restorative technique: case report on dental management of a patient with Moebius syndrome. Aust Dent J 2015; 60:255-9. [PMID: 25989267 DOI: 10.1111/adj.12319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical challenges associated with Moebius syndrome, a rare congenital neuromuscular disorder, include orofacial anomalies like microstomia, limited mouth opening and severe gag reflex. METHODS This case report presents the dental management of an anxious female with Moebius syndrome. For restorations, atraumatic restorative technique (ART), using glass ionomer cement was used with hand instruments. RESULTS All necessary dental treatment was completed in the dental chair, thus avoiding the need for a general anaesthetic, and associated complications with airway management due to orofacial abnormalities. CONCLUSIONS ART is an appropriate technique for people with microstomia and/or limited mouth opening, such as those with Moebius syndrome. The application of ART can be extended to other special needs patients (people with physical and intellectual disabilities, extreme anxiety, needle phobia and the frail elderly in aged care facilities), where access or cooperation is difficult or limited.
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Maternal and Neonatal Health Knowledge, Service Quality and Utilization: Findings from a Community Based Quasi-experimental Trial in Arghakhanchi District of Nepal. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2015; 13:78-83. [PMID: 26411718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND As part of the Partnership for Maternal and Newborn Health Project (PMNH), HealthRight International collaborated with Mother and Infant Research Activities (MIRA) to conduct operations research in Arghakhanchi district of Nepal to explore the intervention impact of strengthening health facility, improving community facility linkages along with Community Based Newborn Care Program (CB-NCP) on Maternal Neonatal Care (MNC) service quality, utilization, knowledge and care seeking behavior. METHODS This was a quasi-experimental study. Siddahara, Pokharathok, Subarnakhal,Narpani Health Posts (HPs) and Thada Primary Health Care Center(PHCC)in Electoral Constituency-2 were selected as intervention sites and Arghatosh, ,Argha, Khana, Hansapur HPs and Balkot PHCC in Electoral Constituency-1 were chosen as controls. The intervention started in February 2011 and was evaluated in August 2013. To compare MNC knowledge and practice in the community, mothers of children aged 0-23 months were selected from the corresponding Village Development Committees(VDCs) by a two stage cluster sampling design during both baseline (July 2010) and endline (August, 2013) assessments. The difference in difference analysis was used to understand the intervention impact. RESULTS Local resource mobilization for MNC, knowledge about MNC and service utilization increased in intervention sites. Though there were improvements, many effects were not significant. CONCLUSIONS Extensive trainings followed by reviews and quality monitoring visits increased the knowledge, improved skills and fostered motivation of health facility workers for better MNC service delivery. MNC indicators showed an upsurge in numbers due to the synergistic effects of many interventions.
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Osteosarcomas in the upper distal extremities: are their oncological outcomes similar to other sites? Eur J Surg Oncol 2014; 41:407-12. [PMID: 25442503 DOI: 10.1016/j.ejso.2014.11.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/02/2014] [Accepted: 11/10/2014] [Indexed: 11/16/2022] Open
Abstract
AIMS To investigate whether the oncological outcomes of patients with osteosarcomas in the upper distal extremity are similar to other sites and assess if limb-salvage surgery is safe in this location. METHODS The centre database was used to identify all patients with osteosarcomas in the lower humerus and distally between 1985 and 2012. Patient, tumor, treatment and outcome data was collected. RESULTS Twenty-six patients were included in this study. There were 9 males and 17 females with a mean age of 33 years (9-90). Seventeen osteosarcomas were located in the forearm bones (65%), six in the distal humerus (23%), and three (12%) in the hand. The three most common sub-diagnoses were parosteal 7/21 (33%), fibroblastic 4/21 (19%) and osteoblastic osteosarcomas 3/21 (14%). 2 patients (8%) had Paget's disease and 19 patients (73%) had high-grade tumors. Local excision was carried out in 12 patients (48%), 4 patients underwent endoprosthetic replacement (16%) and 9 underwent amputation (36%). The overall risk of local recurrence was 4% in our series. The five-year overall survival rate was 67%, with low tumor grade and parosteal type of osteosarcoma being positive predictors of survival. CONCLUSION This series has shown that patients with high-grade osteosarcomas of the upper distal extremities have a higher amputation risk than other limb sites but have favorable outcomes with limb-salvage surgery, comparable to other anatomical sites. Parosteal osteosarcomas in particular have a good prognosis.
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Impact of atropine and aminophylline on atrioventricular block after acute inferior wall myocardial infarction. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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HbA1c level correlation as predictor of coronary artery disease and its severity in patients undergoing coronary angiography. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Aims: To assess the prevalence of teenage pregnancies and to compare the obstetric performance of teenage pregnant woman with that of adult pregnant woman. Methods: A prospective study was conducted in Nepal Medical College Teaching Hospital from August, 2010 to February, 2012 (one and half year duration). All the teenage pregnancies were included and outcomes were compared with adult (20-24 years) pregnancies, selected randomly who had delivered during the same period of time. The patient characteristics (age, gravidity, parity, gestation age) and obstetric outcome (medical and obstetrical complications, mode of delivery, complications during delivery, fetal outcome, birth weight) were compared between the two groups. Statistical analysis was preformed using PHSTATZ and Z test for proportion. Results: There were total 2708 deliveries during the study period, out of which teenage pregnancy was 264 (9.7%). There were 69(26.1%0) teenage mothers of age 16 to 17 years and 195(73.9%) of age group 18 to 19 years. As expected, maximum patients in the test group i.e. teenagers were primigravida as compared to control group. (90.1% vs. 68.5%). As for mode of delivery, normal delivery in test and control was 82.9% vs 81.1% (p=0.56) and rate of cesarean delivery was similar 10.2% and 10.7%, (p=0.84) in both the groups. The incidence of instrumental delivery was more in control group although it was not statistically significant( 0.7% vs 2.2%, p=0.16). Preterm delivery was 3.0% in teenage as compared to control which is 2.2%. The percentage of intrauterine fetal death was 0.7% vs 0% in test and control group (p=0.15). Proportion of low birth weight babies in test and control group was 7.2% vs 5.9% (p=0.55). Similarly pregnancy related complications were also compared in teenage and control groups. It was found that postpartum hemorrhage occurred more in teenage pregnancy 1.8% vs 0.7% (p=0.84) but statistically not significant. Incidence of hypertensive disorders was 6.4% and 5.6% (p=0.66) in test and control group. Proportion of babies with intrauterine growth restriction was 3.0% in test and 1.1% (p=0.009) in control, the only parameter that is statistically significant. Fetal congenital anomaly was 0.7% vs 0.4% (p=0.54) Conclusions: Teenage pregnancy can have an equally good outcome if we give good obstetric care and encourage institutional delivery. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11139 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 29-32
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Crossed Testicular Ectopia. JNMA J Nepal Med Assoc 2014; 52:943-945. [PMID: 26982671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Crossed testicular ectopia also known as transverse testicular ectopia is a rare anomaly of the testis which is ectopically located in contralateral hemiscrotum with absent testis in the ipsilateral hemiscrotum. Most case are incidentally discovered intraopeartively during operation of inguinal hernia and few case reports are available which have reported preoperative diagnosis of crossed testicular ectopia. We report a case of crossed testicular ectopia in 12 year old boy who presented with right undescended testis diagnosed preoperative on Ultrasound and Magnetic Resonance Imaging as crossed testicular ectopia.
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Survey of external cephalic version services in the East of England region: comparison of services in 2007 and 2012. J OBSTET GYNAECOL 2014; 34:659-61. [PMID: 24911163 DOI: 10.3109/01443615.2014.920785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
External cephalic version (ECV) has been recognised by the Royal college of Obstetricians and Gynaecologists (RCOG) as a safe procedure for the conversion of breech presentations to cephalic presentation. The need to reduce the incidence of breech presentations is due to the associated increase in complications for both mother and baby in a breech delivery. The RCOG published the Green-top Guideline No. 20a in December 2006 and revised it in December 2010. In our study, we conducted a survey across all hospitals in the East of England (EoE) region in 2007 and 2012 to assess the ECV service and to determine if this fulfils the RCOG recommendations.
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Abstract
Abdominal cocoon is an uncommon peritoneal condition characterized by partial or complete encasement of small bowel by a thick rind of fibrous tissue and adhesions. Only few cases of this disease have been reported in world literature. The etiology of this condition is unknown, and most often it is found in adolescent girls from tropical or subtropical countries, and usually diagnosed incidentally on exploration. Surgery (membrane dissection and extensive adhesiolysis) is the treatment of choice. Here, we report a case of abdominal cocoon in a 20-year-old male patient, with a brief review of the literature.
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Factors influencing oral health of adults with physical and intellectual disabilities in various living arrangements. Aust Dent J 2014. [DOI: 10.1111/j.1834-7819.2007.tb06138.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Quantitative Mueller matrix fluorescence spectroscopy for precancer detection. OPTICS LETTERS 2014; 39:243-6. [PMID: 24562117 DOI: 10.1364/ol.39.000243] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Quantitative fluorescence spectroscopic Mueller matrix measurements from the connective tissue regions of human cervical tissue reveal intriguing fluorescence diattenuation and polarizance effects. Interestingly, the estimated fluorescence linear diattenuation and polarizance parameters were considerably reduced in the precancerous tissues as compared to the normal ones. These polarimetry effects of the autofluorescence were found to originate from anisotropically organized collagen molecular structures present in the connective tissues. Consequently, the reduction of the magnitude of these polarimetric parameters at higher grades of precancer was attributed to the loss of anisotropic organization of collagen, which was also confirmed by control experiments. These results indicate that fluorescence spectral diattenuation and polarizance parameters may serve as potentially useful diagnostic metrics.
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Surgical repair of the ruptured Achilles tendon: the cost-effectiveness of open versus percutaneous repair. Knee Surg Sports Traumatol Arthrosc 2013; 21:1361-8. [PMID: 23377798 DOI: 10.1007/s00167-013-2423-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 01/21/2013] [Indexed: 12/28/2022]
Abstract
PURPOSE Recent meta-analyses have shown reduced re-rupture rates for the surgical management of Achilles ruptures. However, percutaneous repair has been demonstrated to lead to improved function and patient satisfaction but greater complications than open repair. In the current economic climate, it is reasonable to consider the financial cost of rupture management for both the patient and the provider. The cost-effectiveness of operative treatment of ruptures of the Achilles tendon was determined based upon theatre occupancy, clinic attendance and cast changes, operative complications and functional assessment score. METHODS The cost-effectiveness of the surgical management of Achilles tendon ruptures between 2005 and 2011 in our unit was audited by comparing 49 patients receiving percutaneous repair to 35 patients whom had open repairs. RESULTS There was no significant difference in complications between the two surgical techniques: (Open vs. Percutaneous) overall rates 14.3 versus 10.4 %: infection; 2.7 versus 2.0 %, transient sural nerve damage: 5.6 versus 8.1 %, wound breakdown: 2.8 versus 0.0 %, re-rupture: 2.8 versus 2.0 %. Achilles Total Rupture Scores (ATRS) were comparable [Open 89 (65-100) at 49 months vs. Percutaneous 88.8 (33-100) at 12 months (n.s.)]. Theatre occupancy (P < 0.00) and hospital stay (P < 0.00) were significantly longer with open repair [43 min (26-70) and 2.9 days (0-4)] compared to percutaneous repair [15 min (12-43) and 1.2 days (0-2)]. Excluding the costs of running the operating theatre, we have estimated the costs of surgery for open repair to be £ 935 and percutaneous repair to be £ 574. CONCLUSIONS This study suggests that percutaneous repair of the Achilles tendon resulted in reduced costs and yet had comparable outcome and complications rates to open repair in surgical management of the Achilles tendon. Percutaneous repair should be considered as the primary method of cost-effective surgical management of Achilles tendon rupture.
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Characterization of a novel model for chronic migraine. J Headache Pain 2013. [PMCID: PMC3620384 DOI: 10.1186/1129-2377-14-s1-p81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Characterization of a novel model for chronic migraine. J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Evaluation of urogynaecology care of an elderly population in a specialist urogynaecology centre. J OBSTET GYNAECOL 2012; 33:60-3. [PMID: 23259881 DOI: 10.3109/01443615.2012.721819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The ageing population of the UK means that demand for urogynaecology services is expected to increase substantially, particularly in patients aged over 65 years. To assess service provision and predict future needs, we reviewed the demographic profile and service requirements of elderly patients referred to our urogynaecology service. We performed a retrospective review of case notes of 125 patients over 65 years of age who attended our urogynaecology clinic within a 6 month period, including comorbidity scoring using a validated instrument. A substantial proportion (56%) of patients did not require hospital-based management, and none of the patients had an adult comorbidity evaluation (ACE-27) score >2. Hence, we recommend assessing patients using the ACE-27 score and not on chronological age alone. A restructuring of urogynaecology services towards better access to community-based clinics is required to reflect the treatment needs of the patient population. This would be in line with national continence care guidance.
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Cardiovascular Benefits and Diabetes Risks of Statin Therapy in Primary Prevention: An Analysis From the JUPITER Trial. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2012.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
OBJECTIVE To report the numbers of patients having childbirth after pelvic floor surgery in England. DESIGN Retrospective analysis of Hospital Episode Statistics data. SETTING Hospital Episode Statistics database. POPULATION Women, aged 20-44 years, undergoing childbirth after pelvic floor surgery between the years 2002 and 2008. METHODS Analysis of the Hospital Episode Statistics database using Office of Population, Censuses and Surveys: Classification of Interventions and Procedures, 4th Revision (OPCS-4) code at the four-character level for pelvic floor surgery and delivery, in women aged 20-44 years, between the years 2002 and 2008. MAIN OUTCOME MEASURES Numbers of women having delivery episodes after previous pelvic floor surgery, and numbers having further pelvic floor surgery after delivery. RESULTS Six hundred and three women had a delivery episode after previous pelvic floor surgery in the time period 2002-2008. In this group of 603 women, 42 had a further pelvic floor surgery episode following delivery in the same time period. The incidence of repeat surgery episode following delivery was higher in the group delivered vaginally than in those delivered by caesarean (13.6 versus 4.4%; odds ratio, 3.38; 95% confidence interval, 1.87-6.10). CONCLUSIONS There were 603 women having childbirth after pelvic floor surgery in the time period 2002-2008. The incidence of further pelvic floor surgery after childbirth was lower after caesarean delivery than after vaginal delivery, and this may indicate a protective effect of abdominal delivery.
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Abstract
Introduction: Ovarian tumors account for fifth most common cause of cancer related death in females involving a variety of histological diagnosis. It accounts for 6% of all cancers. Though it is one of the treatable cancers due to its sensitivity to anticancer therapies, it frequently does not result in symptoms until the cancer has spread extensively.Objectives: To study the incidence, histopathological spectrum and clinical correlates of ovarian tumours at B.P. Koirala Institute of Health Sciences (BPKIHS).Methods: A cross-sectional study was undertaken during a period of one year (1st Jan. 31st Dec 2006). The tumors were classified according to WHO classification after thorough examination of H&E slides under light microscope. Data on clinical presentation and physical findings were also recorded in each case.Results: There were a total of 83 cases. Surface epithelial tumors emerged as the commonest variety accounting for 47%, followed by Germ cell tumors (45.8%). Sex . cord stromal tumors and metastatic tumors accounted 3.6% each. The age range was 10 . 86 years. Metastatic tumors involved younger age groups. Abdominal mass was the commonest clinical presentation followed by pain abdomen.Conclusion: At BPKIHS, ovarian tumors were found to occur in wide range of age (10-86years) with abdominal mass and pain abdomen being the commonest mode of clinical presentation .Histology revealed that surface epithelial tumors and germ cell tumors together constitute the large majority of the case (92.8%). An accurate histological diagnosis and staging is therapeutically and prognostically important.DOI: http://dx.doi.org/10.3126/hren.v10i2.6570 Health Renaissance 2012; Vol 10 (No.2); 87-97
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Hanging: nature of ligature material applied and type of hanging according to point of suspension. NEPAL MEDICAL COLLEGE JOURNAL : NMCJ 2012; 14:103-106. [PMID: 23671957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
One of the most common manners of unnatural death that has been rapidly increasing in Nepal is suicide. The choice of method depends on the accessibility and availability of the means. Therefore suicide by hanging with the ligature material ranging from torn clothing, bed sheet to a shoelace is incorporated. Objective of this study is to find the choice of the type of ligature material used by the victims and the type of hanging found in relation to the point of suspension in both genders. This prospective study was conducted in all cases of death due to hanging (44 cases) during the year January 2007to April 2008 coming for post mortem examination at BPKIHS Dharan Nepal. Nearly half of the hanging victims (21 or 47.72%) used rope for hanging and nearly one third victims (14 or 31.81%) used shawl, rest of victims 4 (9.09%) used sari, 2 (4.54%) victims used either bed sheet or woolen muffler in each and belt was used as ligature by one (2.27%) of the victims. It was observed that in more than half of the cases (25 or 56.81%) hanging was partial (i.e. some body parts were touching the ground). Amongst partial hanging cases, female victims (16 or 64%) outnumbered the male victims (9 or 47.37%).While rest 19 (43.18%) cases were complete hanging (i.e. body was not touching the ground).
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SU-E-T-313: Probe-Type Experimental Dosimetry in Terms of Absorbed Dose to Water in Photon-Brachytherapy a Proposal for a Radiation-Quality Index. Med Phys 2012; 39:3775-3776. [PMID: 28517292 DOI: 10.1118/1.4735399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In photon-brachytherapy (BT), all data for clinical dosimetry (e.g., the dose-rate constant) are not measured in water, but calculated, based on MC-simulation. To enable the measurement of absorbed dose to water, DW, in the vicinity of a source, the complex energy-dependence and other influence quantities must be considered. METHODS The detectors response, R=M/D, is understood as product of a detector-material dependent 'absorbed dose response', Ren, and Rin, the 'intrinsic response'. Ren is described by the Burlin-theory and because of dissimilarities between the detector-material and water, will have energy dependent correction factors which convert Ren into the clinically relevant DW,Qo=MQo × ND,W,Qo. To characterize BT- source-types, we propose a new 'radiation-quality index' QBT=Dprim(2cm)/Dprim(1cm), the ratio of the primary-dose to water at r=2cm to that at the reference distance r=1cm, similar to external beam dosimetry. Although QBT cannot be measured directly, it can be derived from primary and scatter separated dose-data, published as consensus data e.g., in the Carlton AAPM-TG-43-database. RESULTS Mean QBT-values are: for nine HDR and four PDR 192Ir-sources: 0.2258±0.5%; one 169Yb- source: 0.2142; and one 125I-source: 0.1544. CONCLUSIONS The main benefit of this new QBT-concept is that a type of BT-dosimetry-detector needs to be calibrated only for one reference radiation-quality, e.g., for Q0=192Ir. To measure the dose for different source-types, DW can be determined using calculated radiation-quality conversion factors kQ,QoBT, to be included in the AAPM-database and to be provided by the manufacturer for each detector-type. Typical BT-dosimetry-detectors are plastic scintillation detectors, radiochromic film, thermoluminescence detectors, optically stimulated detectors, and small volume ionization chambers. Recently, different DW(1cm)-primary standards have been developed in several European NMIs, enabling to calibrate BT-radiation- sources and BT-dosimetry-detectors and allowing to verify MC-calculated dose-rate constant values. The proposed definition of QBT has to be discussed internationally to find broad consensus.
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Intrauterine growth curves for singleton live babies in Paropakar Maternity and Women's Hospital in Nepal. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2012; 10:160-166. [PMID: 23034381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND To construct birth weight, crown heel length and head circumference centile chart referenced to gestational age for Nepalese infants. METHODS The study was conducted over a period of six months. It included consecutive live births from 28 to 42 weeks of gestation. Their birth weight, crown-heel length and head circumference were recorded. Smoothed percentile values along with curves were created using the Lambda Mu Sigma (LMS) method. The curves were compared with one of the Indian study. RESULTS A total of 9710 newborns were measured. The mean birth weight, crown-heel length, head circumference at 40 weeks were 3023g, 49.22cm and 33.61cm respectively. Smoothed percentile values calculated gave the cutoffs for defining small and large gestational age for Nepalese newborns. Comparison with Indian study showed significant difference (p<0.01) in weight. The Indian babies weighed less than Nepalese babies. CONCLUSIONS The referenced growth standards help in clinical assessment, defining and identifying high risk newborns, thus, leading to improved care and management of neonates. It should help public health policy makers to track population difference due to several factors, intervene and find response over time.
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Oncological outcomes of patients with Ewing's sarcoma: is there a difference between skeletal and extra-skeletal Ewing's sarcoma? ACTA ACUST UNITED AC 2011; 93:531-6. [PMID: 21464495 DOI: 10.1302/0301-620x.93b4.25510] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The aim of this study was to identify whether there was any difference in patient, tumour, treatment or outcome characteristics between patients with skeletal or extra-skeletal Ewing's sarcoma. We identified 300 patients with new primary Ewing's sarcoma diagnosed between 1980 and 2005 from the centres' local database. There were 253 (84%) with skeletal and 47 (16%) with extra-skeletal Ewing's sarcomas. Although patients with skeletal Ewing's were younger (mean age 16.8 years) than those with extra-skeletal Ewing's sarcoma (mean age 27.5 years), there was little difference between the groups in terms of tumour stage or treatment. Nearly all the patients were treated with chemotherapy and most had surgery. There was no difference in the overall survival of patients with skeletal (64%) and extra-skeletal Ewing's sarcoma (61%) (p = 0.85), and this was also the case when both groups were split by whether they had metastases or not. This large series has shown that the oncological outcomes of Ewing's sarcoma are related to tumour characteristics and patient age, and not determined by whether they arise in bone or soft tissue.
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Fitting ordinal regression analysis to anthropometric data. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2011; 9:61-66. [PMID: 22929716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND National level surveys on nutritional status since 1975 to 2006 in Nepal do not indicate the satisfying level of nutrition. Nepal demographic and health survey 2006 uncover that the percent prevalence for underweight and wasted children of under five years of age are 39% and 13% and 49 % of the under five children are stunted. Understanding the factors that affect the nutrition of children is essential. Some studies in other countries show wealth index, size at birth and education as significant contributors. This analysis analyze the factors associated with nutritional status among children of under five years of age. METHODS This study was cross sectional which used secondary data of the Demographic and Health Survey, 2006 conducted in Nepal. STATA 9, SPSS 13 and SPSS 17 are used for analysis. In this analysis, the outcome variables namely stunting, underweight and wasting are in ordered form. Hence ordinal regression is considered as suitable method. RESULTS Ordinal regression well suit the data to model nutritional status through different predictors in case of underweight and wasting however stunting model fails to satisfy the assumption behind ordinal regression. Hence for stunting, model with constraints imposed to certain variables is formed. CONCLUSIONS Underweight is seen significantly less in households with high wealth index, among children of big and average size at birth and among educated women. Education, wealth index and size at birth are found important factors affecting wasting among children. Wealth index and education of mothers are significantly affecting for stunting among children.
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Fertility desire of working women in Kathmandu. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2010; 8:95-98. [PMID: 21876571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND This study is done to describe the fertility pattern and factors associated with unmet desire for additional children among women working in formal and informal sector in Kathmandu, Nepal. METHODS This is a cross-sectional study. Married 177 women in reproductive age group, with at least one child are selected using purposive sampling. Housewives without paid job are excluded. Interview using semi structured questionnaire is conducted. RESULTS Around 14 percent of women want additional children, however due to various reasons they do not intend to have another. Women in age group of 25-29 followed by 30-34 years of age have higher desire for more children as compared to women in more than 40 years of age. Women who earn 25000-33000 Rupees per month have significantly more desire for another child. CONCLUSIONS Childcare time and economic conditions play vital role in fertility desire among working women. Family help is available to most of the women to care their children. These women wish more facilities at workplace during child bearing and rearing period.
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SU-GG-T-278: Clinical Dosimetry of Photon Sources Used in Brachytherapy: Need for ISO Standardization, Based on and Extending the AAPM TG-43U1 Formalism by Calibration in Terms of Absorbed Dose to Water. Med Phys 2010. [DOI: 10.1118/1.3468671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Access to dental care among adults with physical and intellectual disabilities: residence factors. Aust Dent J 2009; 54:204-11. [DOI: 10.1111/j.1834-7819.2009.01120.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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661 IMMEDIATE POSTOPERATIVE PAIN RELIEF AFTER KNEE ARTHROSCOPY: INTRAARTICULAR BUPIVACAINE VS BUPIVACAINE AND MORPHINE COMBINATION. A RANDOMISED CONTROLLED STUDY. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Value of routine transvaginal ultrasound scan in women requesting early termination of pregnancy. J OBSTET GYNAECOL 2009; 24:426-8. [PMID: 15203585 DOI: 10.1080/01443610410001685583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This was a retrospective study of 140 women attending a termination clinic from 1 April 2002 to 31 March 2003. All women had a transvaginal ultrasound scan. Of 140 women, 56 women benefited from the scan; 26.7% had non-viable pregnancy, 35.71% did not remember their LMP, 12.5% had discrepancy between the scan and LMP. Incidental findings were noted in 24.6% of which two had a twin gestation, nine had ovarian cysts, one had an ectopic pregnancy, one had a hydatidiform mole, one conceived with an IUCD and one had a bicornuate uterus with pregnancy in one horn. Two of the nine women with ovarian cysts needed a laparotomy. This study concludes that routine transvaginal scan (TVS) scan is an essential investigation for proper assessment of all women requesting termination of pregnancy. TVS is a safe and effective procedure which provides useful information regarding gestational age, viability of pregnancy and uncertain dates. In cases of the ectopic pregnancy and the hydatidiform mole transvaginal ultrasound helped us in appropriate management from the outset and minimised complications.
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Posterior Reversible Encephalopathy Syndrome Posttransplantation: A Case Report of Possible Association With Cerebrospinal Fluid Leak After Epidural Catheterization. Transplant Proc 2009; 41:1957-60. [DOI: 10.1016/j.transproceed.2008.12.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2008] [Revised: 07/27/2008] [Accepted: 12/02/2008] [Indexed: 11/15/2022]
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SU-GG-J-167: Resonant X-Ray Irradiation of High-Z Nanoparticles for Cancer Theranostics. Med Phys 2008. [DOI: 10.1118/1.2961716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
We report a retrospective review of the incidence of venous thromboembolism in 463 consecutive patients who underwent primary total hip arthroplasty (487 procedures). Treatment included both total hip replacement and hip resurfacing, and the patients were managed without anticoagulants. The thromboprophylaxis regimen included an antiplatelet agent, generally aspirin, hypotensive epidural anaesthesia, elastic compression stockings and early mobilisation. In 258 of these procedures (244 patients) performed in 2005 (cohort A) mechanical compression devices were not used, whereas in 229 (219 patients) performed during 2006 (cohort B) bilateral intermittent pneumatic calf compression was used. All operations were performed through a posterior mini-incision approach. Patients who required anticoagulation for pre-existing medical problems and those undergoing revision arthroplasty were excluded. Doppler ultrasonographic screening for deep-vein thrombosis was performed in all patients between the fourth and sixth post-operative days. All patients were reviewed at a follow-up clinic six to ten weeks after the operation. In addition, reponse to a questionnaire was obtained at the end of 12 weeks post-operatively. No symptomatic calf or above-knee deep-vein thrombosis or pulmonary embolism occurred. In 25 patients in cohort A (10.2%) and in ten patients in cohort B (4.6%) asymptomatic calf deep-vein thromboses were detected ultrasonographically. This difference was statistically significant (p = 0.03). The regimen followed by cohort B offers the prospect of a low incidence of venous thromboembolism without subjecting patients to the higher risk of bleeding associated with anticoagulant use.
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Abstract
We have investigated the oncological outcome of 63 patients with soft-tissue sarcomas of the hand managed at three major centres in the United Kingdom. There were 44 males and 19 females with a mean age of 45 years (11 to 92). The three most common diagnoses were synovial sarcoma, clear cell sarcoma and epithelioid sarcoma. Local excision was carried out in 45 patients (71%) and amputation in 18 (29%). All those treated by amputation had a wide margin of excision but this was only achieved in 58% of those treated by local excision. The risk of local recurrence was 6% in those treated by amputation compared with 42% for those who underwent attempted limb salvage. An inadequate margin of excision resulted in a 12 times greater risk of local recurrence when compared with those in whom a wide margin of excision had been achieved. We were unable to demonstrate any role for radiotherapy in decreasing the risk of local recurrence when there was an inadequate margin of excision. Patients with an inadequate margin of excision had a much higher risk of both local recurrence and metastasis than those with wide margins. The overall survival rate at five years was 87% and was related to the grade and size of the tumour and to the surgical margin. We have shown that a clear margin of excision is essential to achieve local control of a soft-tissue sarcoma in the hand and that failure to achieve this results in a high risk of both local recurrence and metastastic disease.
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Acquaintance with the actuality: community diagnosis programme of Kathmandu Medical College at Gundu village, Bhaktapur, Nepal. Kathmandu Univ Med J (KUMJ) 2008; 6:128-134. [PMID: 18604130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION In Nepal, various field programs such as community diagnosis programmes (CDP) have been initiated to make the education of doctors, nurses and dentists more community oriented and relevant and suited to the health care scenario. Community diagnosis refers to the identification and quantification of the health problems in a community and identification of their correlates for the purpose of defining those individuals or groups at risk or those in need of health care. The article presents the main activities of community diagnosis as a core component of community-based education for the medical students at Kathmandu Medical College, Kathmandu, Nepal. METHODOLOGY A 4 weeks' Community Diagnosis Programme was conducted by MBBS II students (9th Batch) of the Kathmandu Medical College under the supervision of the Department of Community Medicine in November 2006 in the rural community of Gundu VDC (village development committee). The tools used included pre-tested questionnaires, weighing machines, measuring tapes, stethoscopes and sphygmomanometers. After the data collection and compilation, the students presented their findings in oral presentations, accompanied by a written report, including essential recommendations for improving the health status of these communities. RESULTS The students benefited from the necessary process of integrating clinical skills and a public health approach, so as to enhance their epidemiological thinking and be of greater use to the communities where they will practice. The community also benefited by achievement of behavioral changes leading to healthier lifestyles and increased awareness of health-related matters and their role in quality of life. CONCLUSIONS CDP is a way to practically demonstrate that the link between a medical college and society is possible. That is, a medical college can serve the community and thus society, with specific activities to improve health and the skills of students who will serve as future health professionals.
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MeV Au irradiation induced nanoparticle formation and recrystallization in a low energy Au implanted Si layer. NANOTECHNOLOGY 2007; 18:495702. [PMID: 20442483 DOI: 10.1088/0957-4484/18/49/495702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Au implantation at 32 keV into Si(100), in a fluence range of 1 x 10(15)-1 x 10(17) cm(-2), has been used to produce a gold-rich damaged Si layer of thickness around 30 nm. Local recrystallization of this layer, induced by 1.5 MeV Au irradiation, to a fluence of 1 x 10(15) cm(-2), has been studied using Raman scattering, photoluminescence (PL) and x-ray photoemission spectroscopy (XPS). For a sample with a low energy Au fluence of 5 x 10(15) cm(-2), the MeV Au irradiation has been found to result in Si nanocrystal (NC) formation. The size of the NCs, as estimated from the PL data, has been found to be about 4 nm, which agrees well with the result of a thermal spike model calculation. Annealing of the sample at 500 degrees C resulted in an enhanced PL signal, without any significant shift in peak position, indicating an increase in the local concentration of the NCs. In the case of samples with an initial Au fluence above 1 x 10(16) cm(-2), the MeV Au irradiation has been found to result in better overall recrystallization of the amorphous layer, with silicide formation as observed by XPS. However, there was no PL signal, indicating the absence of Si NCs in the system. The results suggest that the initial amorphizing Au fluence plays a crucial role in Si NC formation induced by MeV ion irradiation.
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Abstract
Cryptococcosis is caused by cryptococcus neoformans. Immunosuppression is a predisposing factor for the development of cryptococcosis. However, reports exist that cryptococcus neoformans can cause infection in immunocompetent hosts. We report a case of disseminated cryptococcosis in a 7.5-year-old immunocompetent child.
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To Bite the Bullet of Early Graft Nephrectomy: A Case Report. Transplant Proc 2007; 39:1664-5. [PMID: 17580213 DOI: 10.1016/j.transproceed.2007.01.092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2006] [Accepted: 01/29/2007] [Indexed: 11/19/2022]
Abstract
Isolated renal allograft mucormycosis is rare. Only 8 cases have been reported to date, with patient survival in only 3. We recently encountered a case. The presentation was fever and graft dysfunction, which were unresponsive to extended antibiotic treatment and supportive care. It was only after three graft biopsies that mucormycosis was diagnosed and amphotericin B started. Urgent graft nephrectomy was performed, but the patient died of septicemia. In retrospect, we believe that early institution of amphotericin B and graft nephrectomy are needed for patient salvage in this difficult clinical situation.
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