Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1668004351
Shobhana Singh, R. Fuke, Kirti Rachwani
Introduction: Pancytopenia is defined as decrease in all three cellular elements of peripheral blood leading to anemia, leucopenia and thrombocytopenia1.Pancytopenia usually presents with symptoms of bone marrow failure such as pallor, dyspnea, and bleeding, bruising and increased tendency to infections2. The most common causes leading to pancytopenia on bone marrow examination are hypoplastic/aplastic bone marrow (29.05%), megaloblastic anemia (23.64%), hematological malignancies i.e. acute myeloid leukemia (21.62%), and erythroid hyperplasia (19.6%).3 The commonest clinical manifestations of pancytopenia are usually fever (86.7%), fatigue (76%), dizziness (64%), weight loss (45.3%), anorexia (37.3%), night sweats (28%), pallor (100%), bleeding (38.7%), and spleenomegaly (48%). A pregnancy complicated by severe AA is a great challenge for obstetricians.4,5 Objective: To assess the clinico-hematological parameters and & fetal outcomes among pregnant mothers with pancytopenia. Methods: Pregnant mothers with pancytopenia visiting ANC OPD or admitted patients were enrolled into the study with sample size of 96. Written informed consent was taken and study design explained to them, and the investigations were done and data was collected. Results and discussion: subjects presented with symptoms of pancytopenia like pallor, bleeding diathesis, fatigue and fever, glossitis cheilosis. Platelet count of 30 % of subjects were in the range of 71000 to 90000. 32.3 % mothers had megaloblastic anaemia, Aplastic anaemia was present in 18.7 % and pregnancy induced hypertension in 14.7 % subjects, and eclampsia in 5.2 % subjects. Conclusion: Association of pancytopenia with pregnancy is a rare entity yet it has increased risk of adverse maternal and foetal outcome. Early diagnosis and intervention bring favourable maternal and foetal outcome. This study identified the risk factors of mortality and morbidity in pregnant women with severe aplastic anaemia as well as the obstetrical complications associated with neonatal outcome. Key words: AA-Aplastic anaemia
{"title":"The Clinico-Hematological assessment and feto-maternal outcome of pancytopenia during pregnancy","authors":"Shobhana Singh, R. Fuke, Kirti Rachwani","doi":"10.5455/ijmrcr.172-1668004351","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1668004351","url":null,"abstract":"Introduction: Pancytopenia is defined as decrease in all three cellular elements of peripheral blood leading to anemia, leucopenia and thrombocytopenia1.Pancytopenia usually presents with symptoms of bone marrow failure such as pallor, dyspnea, and bleeding, bruising and increased tendency to infections2. The most common causes leading to pancytopenia on bone marrow examination are hypoplastic/aplastic bone marrow (29.05%), megaloblastic anemia (23.64%), hematological malignancies i.e. acute myeloid leukemia (21.62%), and erythroid hyperplasia (19.6%).3 The commonest clinical manifestations of pancytopenia are usually fever (86.7%), fatigue (76%), dizziness (64%), weight loss (45.3%), anorexia (37.3%), night sweats (28%), pallor (100%), bleeding (38.7%), and spleenomegaly (48%). A pregnancy complicated by severe AA is a great challenge for obstetricians.4,5 Objective: To assess the clinico-hematological parameters and & fetal outcomes among pregnant mothers with pancytopenia. Methods: Pregnant mothers with pancytopenia visiting ANC OPD or admitted patients were enrolled into the study with sample size of 96. Written informed consent was taken and study design explained to them, and the investigations were done and data was collected. Results and discussion: subjects presented with symptoms of pancytopenia like pallor, bleeding diathesis, fatigue and fever, glossitis cheilosis. Platelet count of 30 % of subjects were in the range of 71000 to 90000. 32.3 % mothers had megaloblastic anaemia, Aplastic anaemia was present in 18.7 % and pregnancy induced hypertension in 14.7 % subjects, and eclampsia in 5.2 % subjects. Conclusion: Association of pancytopenia with pregnancy is a rare entity yet it has increased risk of adverse maternal and foetal outcome. Early diagnosis and intervention bring favourable maternal and foetal outcome. This study identified the risk factors of mortality and morbidity in pregnant women with severe aplastic anaemia as well as the obstetrical complications associated with neonatal outcome. Key words: AA-Aplastic anaemia","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86646212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1669800300
A. Curval, Ana Igreja, V. Viana, M. Guardiano
Introduction Social support, especially as provided by close family and friends, has been consistently identified as one of the most powerful predictors of psychological adjustment among parents raising children with ASD. Material and methods A cross-sectional study including 51 parents of children with ASD was carried out in our pediatric development department. The objective of the study was to verify the degree of satisfaction of the participants regarding their family, friends, intimacy, and social activities. Results There was a negative correlation between the children’s age and the degree of parental satisfaction. There was a statistically significant association between the parents' educational level and the degree of satisfaction reported by them in all domains, except for the family domain. Conclusion Based on study findings regarding the importance of help from parents’ informal social network, special attention in this regard should be focused on developing services that assist parents in making more effective use of existing sources of support from family members, friends, and other parents of children with ASD.
{"title":"Perceptive social support among parents of children with autism spectrum disorder","authors":"A. Curval, Ana Igreja, V. Viana, M. Guardiano","doi":"10.5455/ijmrcr.172-1669800300","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1669800300","url":null,"abstract":"Introduction Social support, especially as provided by close family and friends, has been consistently identified as one of the most powerful predictors of psychological adjustment among parents raising children with ASD. Material and methods A cross-sectional study including 51 parents of children with ASD was carried out in our pediatric development department. The objective of the study was to verify the degree of satisfaction of the participants regarding their family, friends, intimacy, and social activities. Results There was a negative correlation between the children’s age and the degree of parental satisfaction. There was a statistically significant association between the parents' educational level and the degree of satisfaction reported by them in all domains, except for the family domain. Conclusion Based on study findings regarding the importance of help from parents’ informal social network, special attention in this regard should be focused on developing services that assist parents in making more effective use of existing sources of support from family members, friends, and other parents of children with ASD.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77247587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1672101017
J. es, M. Coelho, A. Nunes, Inês Antunes, A. Costa
Introduction: Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder characterized by isolated low platelet counts, that occurs because of increased platelet destruction by the production of autoantibodies against platelet antigens. ITP secondary to solid neoplasia is rare. The treatment consists of pharmacological treatment to improve thrombocytopenia and the treatment of the underlying malignancy. Case Report: A 72-year-old woman was admitted in the emergency department with petechial lesions and spontaneous ecchymosis with about three weeks of evolution. Analytically confirmed severe thrombocytopenia, without anemia and normal leukogram, and positive direct antigliadin test, admitting thrombocytopenic purpura. In the subsequent etiological study, a nodular formation was identified in the right para renal area, later biopsied confirming the diagnosis of dedifferentiated retroperitoneal liposarcoma. Despite an initial favorable response to corticosteroid therapy, there was persistence of low platelet count despite first-line therapy (corticosteroids and immunoglobulin), with the need to associate second-line drugs (rituximab and Eltrombopag). There was remission of ITP after complete tumor excision. Conclusion: The association of immune thrombocytopenia with dedifferentiated liposarcoma is very rare, with only one previous case described in the medical literature. The treatment of an underlying malignancy may lead to resolution of thrombocytopenia, which is why, although the association of ITP with solid tumors is very uncommon, it is important to screen for solid tumor in the etiological study of ITP. KEYWORDS Immune thrombocytopenia, dedifferentiated retroperitoneal liposarcoma, paraneoplastic syndrome.
{"title":"Immune Thrombocytopenic Purpura presenting as paraneoplastic syndrome in a Dedifferentiated Liposarcoma: A case report","authors":"J. es, M. Coelho, A. Nunes, Inês Antunes, A. Costa","doi":"10.5455/ijmrcr.172-1672101017","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1672101017","url":null,"abstract":"Introduction: Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder characterized by isolated low platelet counts, that occurs because of increased platelet destruction by the production of autoantibodies against platelet antigens. ITP secondary to solid neoplasia is rare. The treatment consists of pharmacological treatment to improve thrombocytopenia and the treatment of the underlying malignancy. Case Report: A 72-year-old woman was admitted in the emergency department with petechial lesions and spontaneous ecchymosis with about three weeks of evolution. Analytically confirmed severe thrombocytopenia, without anemia and normal leukogram, and positive direct antigliadin test, admitting thrombocytopenic purpura. In the subsequent etiological study, a nodular formation was identified in the right para renal area, later biopsied confirming the diagnosis of dedifferentiated retroperitoneal liposarcoma. Despite an initial favorable response to corticosteroid therapy, there was persistence of low platelet count despite first-line therapy (corticosteroids and immunoglobulin), with the need to associate second-line drugs (rituximab and Eltrombopag). There was remission of ITP after complete tumor excision. Conclusion: The association of immune thrombocytopenia with dedifferentiated liposarcoma is very rare, with only one previous case described in the medical literature. The treatment of an underlying malignancy may lead to resolution of thrombocytopenia, which is why, although the association of ITP with solid tumors is very uncommon, it is important to screen for solid tumor in the etiological study of ITP. KEYWORDS Immune thrombocytopenia, dedifferentiated retroperitoneal liposarcoma, paraneoplastic syndrome.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86383193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1654142315
A. Bhat, T. Motten, Faisal N. Mir, N. Ali, Aabid M. Rather, Mohamad Gilani
{"title":"Clinico-radiological results of osteosynthesis of unstable fractures of tubular bones of hand using mini fragment plate and screw system.","authors":"A. Bhat, T. Motten, Faisal N. Mir, N. Ali, Aabid M. Rather, Mohamad Gilani","doi":"10.5455/ijmrcr.172-1654142315","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1654142315","url":null,"abstract":"<jats:p />","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81269829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1678819573
Dr Majella, Dr Adaikkalam
BACKGROUND- Computed tomography (CT) of the chest is an efficient tool to assess COVID-19 pneumonia. Nevertheless, imaging characteristics that overlap with cardiogenic pulmonary edema are not infrequent. CT chest characteristics pose challenges for which additional transthoracic echocardiography is an additional invaluable simple tool to aid in the diagnosis. In this article, we present the CT chest findings of patients with only covid-19 pneumonia, isolated heart failure, and combined covid-19 pneumonia and heart failure. Methods- This study included 120 patients in a tertiary care hospital in South India with dyspnoea and SP02 ≤ 95% between April 2021 to March 2022 who were subjected to chest CT imaging and transthoracic echocardiography and the results were analyzed. Isolated COVID-19 (n=60), isolated heart failure (n=39), and combined covid-19 pneumonia and heart failure (n-21) were identified depending on the CT chest imaging features. Results- There was no statistical difference in the imaging findings like ground glass opacities, crazy pavementpatternswithCOVID-19pneumonia, HF, and also in combined (covid 19 + cardiac failure )groups. However, in HF patients, diffuse patterns were more common than in COVID-19 pneumonia, which was statistically significant (p=0.001). Notably, CT images in HF patients were more likely to have interlobular septal thickening (ILST)(p=0.001) cardiomegaly (p=0.001), increased artery-to-bronchus ratio (p=0.0001), and bilateral pleural effusion (p=0.0001 ), and pericardial effusion (p=0.0001 ) Conclusion- Chest CT is an indispensable tool in the early diagnosis of COVID-19 pneumonia.CT chest features overlap, and separating COVID-19 pneumonia from heart failure is not always easy. Yet, certain specific CT features may suggest heart failure over covid -19 pneumonia. In HF patients, thickening of the interlobular septa, increased artery-to-bronchus ratio, cardiomegaly, and bilateral pleural effusion, pericardial effusion are more common. Additional transthoracic echo showing dilated left ventricle with reduced ejection fraction is an additional key to aid diagnosis.
{"title":"Computed Tomography-Chest in COVID-19 Pneumonia and cardiac failure: An Imaging Enigma","authors":"Dr Majella, Dr Adaikkalam","doi":"10.5455/ijmrcr.172-1678819573","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1678819573","url":null,"abstract":"BACKGROUND- Computed tomography (CT) of the chest is an efficient tool to assess COVID-19 pneumonia. Nevertheless, imaging characteristics that overlap with cardiogenic pulmonary edema are not infrequent. CT chest characteristics pose challenges for which additional transthoracic echocardiography is an additional invaluable simple tool to aid in the diagnosis. In this article, we present the CT chest findings of patients with only covid-19 pneumonia, isolated heart failure, and combined covid-19 pneumonia and heart failure. Methods- This study included 120 patients in a tertiary care hospital in South India with dyspnoea and SP02 ≤ 95% between April 2021 to March 2022 who were subjected to chest CT imaging and transthoracic echocardiography and the results were analyzed. Isolated COVID-19 (n=60), isolated heart failure (n=39), and combined covid-19 pneumonia and heart failure (n-21) were identified depending on the CT chest imaging features. Results- There was no statistical difference in the imaging findings like ground glass opacities, crazy pavementpatternswithCOVID-19pneumonia, HF, and also in combined (covid 19 + cardiac failure )groups. However, in HF patients, diffuse patterns were more common than in COVID-19 pneumonia, which was statistically significant (p=0.001). Notably, CT images in HF patients were more likely to have interlobular septal thickening (ILST)(p=0.001) cardiomegaly (p=0.001), increased artery-to-bronchus ratio (p=0.0001), and bilateral pleural effusion (p=0.0001 ), and pericardial effusion (p=0.0001 ) Conclusion- Chest CT is an indispensable tool in the early diagnosis of COVID-19 pneumonia.CT chest features overlap, and separating COVID-19 pneumonia from heart failure is not always easy. Yet, certain specific CT features may suggest heart failure over covid -19 pneumonia. In HF patients, thickening of the interlobular septa, increased artery-to-bronchus ratio, cardiomegaly, and bilateral pleural effusion, pericardial effusion are more common. Additional transthoracic echo showing dilated left ventricle with reduced ejection fraction is an additional key to aid diagnosis.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86468212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1684511320
Zhan Ya
Hepatocellular carcinoma (HCC) is celerity increasing throughout the world with a high mortality rate. The progression of HCC in patients is induced mainly by cirrhosis and hepatitis. Surgical treatment has played a crucial role for HCC therapy, especially at the very early/early HCC stage. It is widespread for patients to experience a postoperative complication after surgery, including Hepatic encephalopathy/myelopathy. This case report disclosed in details a patient diagnosed and treated in our hospital suffered from recurrent hepatic encephalopathy along with hepatic myelopathy due to the secondary surgical resection of HCC.
{"title":"Recurrent Hepatic Encephalopathy Complicated with Hepatic Myelopathy after Secondary Resection with Hepatocellular Carcinoma: A Case Report","authors":"Zhan Ya","doi":"10.5455/ijmrcr.172-1684511320","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1684511320","url":null,"abstract":"Hepatocellular carcinoma (HCC) is celerity increasing throughout the world with a high mortality rate. The progression of HCC in patients is induced mainly by cirrhosis and hepatitis. Surgical treatment has played a crucial role for HCC therapy, especially at the very early/early HCC stage. It is widespread for patients to experience a postoperative complication after surgery, including Hepatic encephalopathy/myelopathy. This case report disclosed in details a patient diagnosed and treated in our hospital suffered from recurrent hepatic encephalopathy along with hepatic myelopathy due to the secondary surgical resection of HCC.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79324643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1682483223
P. Rastogi, V. Niranjan, R. Mathur, Prashant Maravi, Vijay Raghuwanshi
{"title":"Assessment of expressed emotions in caregiver of dementia patients: Its sociodemographic and clinical correlates","authors":"P. Rastogi, V. Niranjan, R. Mathur, Prashant Maravi, Vijay Raghuwanshi","doi":"10.5455/ijmrcr.172-1682483223","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1682483223","url":null,"abstract":"<jats:p />","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74761330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1672425445
Alexandra J. Ferreira, P. Ferreira, Rodrigo Rosenfeld, Arymar Junior, L. Branco, M. Rigueira, L. Cortez
Reduction mammoplasty is one of the most common plastic surgeries performed around the world. Incidental breast cancer found in the reduction specimen is rare and its management is challenging. Preoperative assessment is crucial in identifying risk factors that increase the likelihood of breast cancer and that require further investigation. Mammography remains the most practical and cost-effective method for preoperative breast cancer screening but some tumors are occult. Marking the orientation of the reduction mammoplasty specimen is extremely important to allow the evaluation and guarantee adequate margins. Sentinel node biopsy is possible after reduction mammoplasty. This case report is about a 49-year-old woman with no risk factors for breast cancer who underwent bilateral reduction mammoplasty for macromastia which revealed an incidental breast tumor. The patient had preoperative mammography and breast ultrasound which did not show any suspicious lesions. She was referred to our Hospital for further evaluation by a multidisciplinary team. After breast MRI without alterations and a negative right axillary sentinel node biopsy, hormone therapy and radiotherapy were started. Incidental breast cancer found in the reduction specimen is rare but its management is challenging therefore surgeons should be aware to this issue. This clinical report intends to alert to this diagnosis and review the literature on this topic.
{"title":"Incidental Breast Cancer after Reduction Mammoplasty, a Case Report.","authors":"Alexandra J. Ferreira, P. Ferreira, Rodrigo Rosenfeld, Arymar Junior, L. Branco, M. Rigueira, L. Cortez","doi":"10.5455/ijmrcr.172-1672425445","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1672425445","url":null,"abstract":"Reduction mammoplasty is one of the most common plastic surgeries performed around the world. Incidental breast cancer found in the reduction specimen is rare and its management is challenging. Preoperative assessment is crucial in identifying risk factors that increase the likelihood of breast cancer and that require further investigation. Mammography remains the most practical and cost-effective method for preoperative breast cancer screening but some tumors are occult. Marking the orientation of the reduction mammoplasty specimen is extremely important to allow the evaluation and guarantee adequate margins. Sentinel node biopsy is possible after reduction mammoplasty. This case report is about a 49-year-old woman with no risk factors for breast cancer who underwent bilateral reduction mammoplasty for macromastia which revealed an incidental breast tumor. The patient had preoperative mammography and breast ultrasound which did not show any suspicious lesions. She was referred to our Hospital for further evaluation by a multidisciplinary team. After breast MRI without alterations and a negative right axillary sentinel node biopsy, hormone therapy and radiotherapy were started. Incidental breast cancer found in the reduction specimen is rare but its management is challenging therefore surgeons should be aware to this issue. This clinical report intends to alert to this diagnosis and review the literature on this topic.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87563162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1669044162
S. Maddala, A. Gupta, Ira M
INTRODUCTION: Preoperative assessment of various anatomic and clinical features helps in identifying potentially difficult laryngoscopy and intubation in advance allowing the anesthetist to be prepared for such a scenario. Though “ Short Neck” is a commonly used term in airway assessment indicating the possibility of a difficult airway. there is a lack of clarity regrading the cut off value and the association of different neck lengths (Anterior, Posterior and Lateral) to the laryngoscopic view. AIM : Evaluation of anterior, posterior and lateral neck length in neutral and extended positions and correlate each measurement with prediction of difficult laryngoscopic view. MATERIALS AND METHODS : This prospective observational study was conducted on 150 patients belonging to American Society of Anesthesiologists (ASA) grade 1/11 , aged 18-65 years with body mass index (BMI) 18 to 35 kg/m2,scheduled to undergo elective surgeries under general anaesthesia with endotracheal intubation. Each subject’s anterior,lateral and posterior neck lengths (ANL,LNL,PNL) were measured pre operatively. Direct laryngoscopy was done to achieve the best Cormack Lehane(CL) grade using manoeuvres (Backward upward rightward manoeuvre(BURP)/OELM/Change of Blade/Change of pillow height/RAMP positioning) when indicated and the same compared to the measured neck lengths. RESULT : The incidence of difficult laryngoscopy was found to be 18 per cent in our study population. Anterior neck length in neutral position was found to be the best predictor of difficult laryngoscopy, with a threshold of less than or equal to 9 cms. No particular neck length correlated with BMI and age. All the neck lengths showed positive correlation with the height of the subject CONCLUSION : ANL with a cut off criterion of less than or equal to 9 cm in neutral position can used objectively when measuring neck length. All neck lengths showed significant change with neck mobility. Rate of change of both PNL and LNL with head extension position showed significant change in difficult laryngoscopy subjects.
{"title":"Evaluation of neck measurements and their correlation with prediction of difficult laryngoscopic view","authors":"S. Maddala, A. Gupta, Ira M","doi":"10.5455/ijmrcr.172-1669044162","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1669044162","url":null,"abstract":"INTRODUCTION: Preoperative assessment of various anatomic and clinical features helps in identifying potentially difficult laryngoscopy and intubation in advance allowing the anesthetist to be prepared for such a scenario. Though “ Short Neck” is a commonly used term in airway assessment indicating the possibility of a difficult airway. there is a lack of clarity regrading the cut off value and the association of different neck lengths (Anterior, Posterior and Lateral) to the laryngoscopic view. AIM : Evaluation of anterior, posterior and lateral neck length in neutral and extended positions and correlate each measurement with prediction of difficult laryngoscopic view. MATERIALS AND METHODS : This prospective observational study was conducted on 150 patients belonging to American Society of Anesthesiologists (ASA) grade 1/11 , aged 18-65 years with body mass index (BMI) 18 to 35 kg/m2,scheduled to undergo elective surgeries under general anaesthesia with endotracheal intubation. Each subject’s anterior,lateral and posterior neck lengths (ANL,LNL,PNL) were measured pre operatively. Direct laryngoscopy was done to achieve the best Cormack Lehane(CL) grade using manoeuvres (Backward upward rightward manoeuvre(BURP)/OELM/Change of Blade/Change of pillow height/RAMP positioning) when indicated and the same compared to the measured neck lengths. RESULT : The incidence of difficult laryngoscopy was found to be 18 per cent in our study population. Anterior neck length in neutral position was found to be the best predictor of difficult laryngoscopy, with a threshold of less than or equal to 9 cms. No particular neck length correlated with BMI and age. All the neck lengths showed positive correlation with the height of the subject CONCLUSION : ANL with a cut off criterion of less than or equal to 9 cm in neutral position can used objectively when measuring neck length. All neck lengths showed significant change with neck mobility. Rate of change of both PNL and LNL with head extension position showed significant change in difficult laryngoscopy subjects.","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82912416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5455/ijmrcr.172-1673369494
Jayeeta Bhadra, S. Ansari, Meena Singh
{"title":"Serum Free Light Chain ratio: Utility as marker of residual disease in monoclonal gammopathies","authors":"Jayeeta Bhadra, S. Ansari, Meena Singh","doi":"10.5455/ijmrcr.172-1673369494","DOIUrl":"https://doi.org/10.5455/ijmrcr.172-1673369494","url":null,"abstract":"<jats:p />","PeriodicalId":13694,"journal":{"name":"International Journal of Medical Reviews and Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84182899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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