The classical pattern in HRCT of COVID-19 infected individuals is GGO that progressed into a consolidation with increasing severity of infection.• The most common distribution pattern of COVID-19 is bilateral involvement of lungs with multiple lesions in peripheral areas of both lungs.• Typical but less common findings are pleural effusion, reversed halo sign and lymph adenopathy.
Introduction: Preterm birth is a common cause of neonatal mortality with an additional burden of adverse neurodevelopmental outcomes. It is caused by different factors that can be either perinatal, natal or postnatal leading to white matter injury/intracranial hemorrhages. These lesions can be readily assessed by cranial ultrasound which provides cost-effective, radiation-free, bedside imaging. Conclusion: Cranial ultrasound is an innovative method to assess brain injury in preterm infants. Ultrasonographic evaluation of preterm brain is recommended as early as possible after birth with interval follow up. Three distinct patterns of brain injury can be seen in preterm infants: Periventricular leukomalacia (PVL), Germinal Matrix-Intraventricular hemorrhage (GMH-IVH) and cerebellar hemorrhages. Germinal matrix hemorrhage is found to be most common pattern with cystic PVL being next among three patterns of brain injury. Ultrasound is an operator-dependent technique with poor visualization of few abnormalities on two-dimensional images. The limitation of conventional ultrasonography opens up new aspects of 3 D scanning with better imaging outcomes
Objective: To demonstrate challenges in treating infratentorial Brain tumors in pediatrics at The Children’s Hospital and Institute of Child Health, Lahore Methodology: This Descriptive observational study was done at the Department of Pediatric Hematology & Oncology at CH&UCH Lahore from August 2021 to February 2022. Sixty-four newly diagnosed patients of infra-tentorial tumors were enrolled by using non-probability, consecutive sampling technique. Main variables of study were age, parents education, socioeconomic status, traveling distance, TLS, stagging workup, Histopathology, Treatment, and Outcome . SPSS version 23.1 was used for data analysis. Test of significance was applied taking p value ≤0.05 as significant value. Results: In this study, the mean age of children was 7.14 ± 3.76 years. Out of 64 children, 35 (54.7%) were males and 29 (45.3%) females Forty three (67%) patients belong to rural area and 21 (32%) from urban area. In our study population, Father of 24 (37.5%) patients and mother of 38 (59.37%) patients never attended school. Fifty six (87.5%) patients belong to low income socioeconomic status while 8(12.5%) patients from middle income status. Thirty four (53.12%) patients had a travelled for more than 200KM. Lag time 1 (patient interval) was <2 weeks in 43 (67.2%) cases, and 2-4 weeks in 20 (31.3%) cases. Lag time 2 (referred interval) was noted as <1 Month in 19 (29.7%) cases, and <2 Months in 26 (40.6%) cases. Lag time 3 (treatment interval) was noted in <1 Month in 2 (3.1%) cases, and <2 Months in 6 (9.4%) cases, but in 48 (75.0%) cases lag time 3 was not applicable. Out of 64 cases, cure with Gross Total Resection was noted in 5 (7.8%) cases, residual tumor in 21 (32.8%) and palliation in 37 (57.8%) cases. Practical implication: The aim was to demonstrate all the challenges in treating Infratentorial tumors and start awareness in the doctor community specially GPs for proper and timely reffral,aware families about the danger signs and symptoms that could be brain tumor. Conclusion: Advanced disease presentation is common, infra tentorial brain tumors are always challenging and has the least favorable outcomes amongst all pediatric tumors. Delayed diagnosis due to cultural and financial barriers and lack of care at primary health care level and poor referral to oncology units owing to deficient health care system are the major contributory challenges for management and poor outcomes. Keywords: lag time, infra-tentorial tumors, challenges, Pediatrics
Objective: To assess the rationale for bone marrow biopsy/aspiration as a part of a routine systemic workup in advanced intraocular retinoblastoma (RB) in relation to high-risk histopathological post-enucleation features.
Background: The most common and frequent tumors in the children’s are central nervous system tumors (CNS). Objective: For evaluation of the lag time and clinical spectrum of pediatric supratentorial brain tumors from the time of appearance of symptoms in a patient to the time the patient presents to the hospital. Study design: It is an observational and cohort study conducted in the radiology and oncology department of our institute teaching hospital. Material and Methods: This prospective research was conducted at the oncology department of the children hospital ICH Lahore for one year. The study was approved by the IRB. The duration of the study was from March 2021 to March 2022. The sample size was calculated. The patients of age range between 0 months to 17 years were included in the study. SPSS version 24.0 was used for statistical analysis. Data will be stratified to see the effect modulators. Results: This study included 60 patients 30 girls and 30 boys. The average age of the patients at the time they were diagnosed with pediatric supratentorial brain tumor was 7 years. The majority of the patients reported to have type I neurofibromatosis. Some of the most common symptoms that the patients reported were vomiting, oculo-visual issues, motor problems, headache and endocrine dysfunction. Conclusion: The lag time and clinical spectrum of pediatric supratentorial brain tumors from the time of appearance of symptoms in a patient to the time the patient presents to the hospital was reported to be 2-6 months in majority almost 61% of the children. The 71% children visited the two regional area doctors before visiting the tertiary care hospital. The complex interplay of underdiagnoses, unavailability of the neuro-oncology treatments facilities and higher rates of abandonment in the LIMC are the basic reason behind survival gaps of the delayed presented patients. Keywords: Pediatric supratentorial brain tumors, lag time, low/middle income countries (LMIC), Central nervous system (CNS) tumors and intraxial tumors.
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