Although abdominal tuberculosis (TB) is quite prevalent in endemic regions, involvement of the pancreas is considerably rare. We describe a case of pancreatic TB presenting as a pancreatic mass in a patient with abdominal pain and jaundice. Due to the similar presentation, it can easily be misinterpreted as a pancreatic neoplasm. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) can help confirm the diagnosis in such cases by providing histopathological evidence of Mycobacterium tuberculosis infection. The patient made a remarkable recovery post anti-tuberculous therapy (ATT) initiation. This exceptional response of pancreatic TB to conservative management makes it imperative that the condition be diagnosed promptly to avoid any futile surgical interventions and associated complications. This can only be achieved if clinicians are aware of the diagnostic possibility of pancreatic TB presenting as a mass in the pancreas.
Background: Intravenous thrombolysis for acute ischemic stroke is time-sensitive with a narrow window period for
treatment initiation. The recommended Door-to-needle (DTN) time of <60 minutes is seldom achieved in Indian centers.
In this study, we aimed to evaluate the DTN time at our hospital and identify the factors that limit thrombolysis of acute stroke patients.
Materials and Methods: All patients that presented with signs of stroke from September to December 2019 were studied. Patient's
demographics, details of symptoms, time of symptom onset, and contraindications to thrombolysis were recorded. The Symptom-to-Door, Doorto-Physician, Door-to-Imaging and Door-to-Needle times were calculated from key temporal data. The factors that inuenced the DTN time
were also recorded.
Results: Out of the 241 patients that presented with symptoms of stroke, 43 (17.8%) were within the window period. Nine patients were
thrombolysed and among these, one (11.1%) was started on rt-PA within 1 hour of arrival. The mean DTN time was 112 minutes (median - 102
minutes).
Conclusion: The DTN time in this study was much higher than what is recommended. The major factors that impede thrombolysis are: ignorance
among the public, lack of a proper triage system at various levels, and lack of a dedicated stroke protocol/team.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.