INTRODUCTIONBuschke–Löwenstein tumour, also known as Giant condyloma acuminatum, is a rare, sexually transmitted disease that affects ano-genital region. BLT is a slow growing cauliflower-like tumour, locally aggressive and destructive. Human papillomavirus has been identified as an important contributory factor in the development of tumour.PRESENTATION OF CASEA 45 year uncircumcised male presented with complaints of cauliflower like growth on glans penis. Growth started as a small papule on the corona sulcus at 12 O’clock position 6 months back. Patient developed pain and dysuria due to compression of urethral meatus. Patient has history of multiple sexual partners.DISCUSSIONBLT, first described by Buschke and Lowenstein in 1925. They observed a penile lesion that clinically resembled both common condyloma acuminata and squamous cell carcinoma, but differing from both of them regarding the biological behaviour and the histopathological appearance. GCA can be differentiated from ordinary condylomas by the characteristic “pushing” rather than “infiltrating” effect that tends to compress and displace the underlying tissue.CONCLUSIONWe have successfully treated a penile BLT with surgical excision and no relapse up to 6 months. Surgical excision could be considered an effective therapy in the treatment.
not differ significantly between those patients who had taken nonsteroidal anti-inflammatory drugs (20 out of 22; 91 %) and those who had not (33 out of 48; 69%). The relative frequency of consumption of individual non-steroidal anti-inflammatory drugs did not differ between the patients with stricture and the controls (table), and ibuprofen, indomethacin, and aspirin were the drugs most often used by both groups. DiscussionWe found an association between prior consumption of non-steroidal anti-inflammatory drugs and the development of benign oesophageal stricture. Before dysphagia occurred most of our patients had had symptoms of gastro-oesophageal reflux, and almost all had evidence of reflux at the time the stricture was diagnosed. This suggests that such drugs may aggravate reflux oesophagitis and so increase the risk of formation of stricture.Swallowed tablets may remain in the oesophagus for considerable periods; Evans Prostaglandins are believed to have a cytoprotective action on the gastric mucosa,6 and non-steroidal anti-inflammatory drugs may exert their ulcerogenic effect by reducing generation of mucosal prostaglandins. A similar action in the oesophagus might contribute to mucosal damage and aggravate reflux oesophagitis. The proportion of patients suffering from rheumatoid disease did not differ significantly between the patients with peptic stricture and the controls, which suggests that rheumatoid disease in itself does not predispose to the formation of stricture.These findings indicate that non-steroidal anti-inflammatory drugs should be prescribed with caution in the presence of symptomatic gastro-oesophageal reflux; if they are used endoscopic monitoring for oesophageal damage would seem advisable. Introduction "Total" or radical surgical correction of tetralogy of Fallot has become standard practice, and of those patients surviving radical surgery about 95% are alive five to 10 years later.'-3 About half the deaths occurring after the perioperative period are in the first postoperative year and are caused by heart failure resulting from residual abnormalities. These include ventricular septal defects, pulmonary hypertension, and abnormalities of conduction or rhythm. Survivors of surgery show an improvement in effort tolerance and loss of cyanosis.2 4 Uncorrected cyanotic heart disease carries a high risk in pregnancy for both mother and fetus: a review of 57 pregnancies in women with uncorrected tetralogy of Fallot showed a fetal mortality of 22% and a maternal mortality of 7%.5 The high fetal mortality was caused by poor fetal growth, leading to a high incidence of abortion, prematurity, and small-for-dates babies. Pregnancy in patients with surgically corrected tetralogy of Fallot is increasing, but no large, detailed series of such pregnancies has been reported. References
Aims Open fractures of the tibia are a heterogeneous group of injuries that can present a number of challenges to the treating surgeon. Consequently, few surgeons can reliably advise patients and relatives about the expected outcomes. The aim of this study was to determine whether these outcomes are predictable by using the Ganga Hospital Score (GHS). This has been shown to be a useful method of scoring open injuries to inform wound management and decide between limb salvage and amputation. Methods We collected data on 182 consecutive patients with a type II, IIIA, or IIIB open fracture of the tibia who presented to our hospital between July and December 2016. For the purposes of the study, the patients were jointly treated by experienced consultant orthopaedic and plastic surgeons who determined the type of treatment. Separately, the study team (SP, HS, AD, JD) independently calculated the GHS and prospectively collected data on six outcomes for each patient. These included time to bony union, number of admissions, length of hospital stay, total length of treatment, final functional score, and number of operations. Spearman’s correlation was used to compare GHS with each outcome. Forward stepwise linear regression was used to generate predictive models based on components of the GHS. Five-fold cross-validation was used to prevent models from over-fitting. Results The mean follow-up was 11.4 months (3 to 31). The mean time to union was 9.7 months (3 to 21), the mean number of operations was 2.8 (1 to 11), the mean time in hospital was 17.7 days (5 to 84), the mean length of treatment was 92.7 days (5 to 730), the mean number of admissions was 1.7 (1 to 6), and the mean functional score (Lower Extremity Functional Score (LEFS)) was 60.13 (33 to 80). There was a significant correlation between the GHS and each of the outcome measures. A predictive model was generated from which the GHS could be used to predict the various outcome measures. Conclusion The GHS can be used to predict the outcome of patients who present with an open fracture of the tibia. Our model generates a numerical value for each outcome measure that can be used in clinical practice to inform the treating team and to advise patients. Cite this article: Bone Joint J 2020;102-B(1):26–32
Background. Oral health is dependent on the knowledge and awareness of the individuals. Teachers as individuals influence the children in every aspect including oral health maintenance. The objective of this study was to assess the oral health knowledge, attitude, practices, and oral health status among school teachers in Chitwan District, Nepal. Materials and Methods. A cross-sectional study was conducted on 550 school teachers of private and government schools in Chitwan District, to assess the knowledge, attitude, practices, and oral health status. Descriptive analysis was done and data were analyzed using chi-square. A five-point Likert Scale was applied to compute knowledge, attitude, and practices of the school teachers. Results. Most of the school teachers had good knowledge about periodontal diseases in comparison to dental caries. Private school (20.7% : 57) teachers had higher good oral health knowledge as compared to government school teachers (9.8% : 27). An almost equal percentage of private and government teachers (73.5% : 202 and 74.2% : 204, respectively) were found with fair knowledge about oral health. Males had a higher percentage for good oral health knowledge as compared to females. Conclusion. There is an incredible need to improve oral health knowledge and attitude among school teachers concerning different problems of the oral cavity and the avoidance of dental diseases. These enhancements can be applied through regular training of teachers by oral health seminars, materials, and other such types of methods.
Background. Time elapsed between trauma and treatment greatly influences the prognosis of traumatic dental injuries (TDIs). The aim of this study was to analyze clinical and radiographic findings related to complications of TDIs among patients seeking delayed treatment of such injuries. Materials and Methods. 123 permanent teeth with a history of previous TDIs were included in the study. Clinical findings analyzed were the type of fracture, type and number of injured teeth, crown discoloration, and pulpal status of the injured tooth (pulpal diagnosis). The radiographic findings analyzed included pulp canal obliteration (PCO), root resorption (RR), and periapical radiolucency (PR). Statistical analysis included descriptive analysis. Results. Tooth discoloration was the most common presenting complaint (53.65%), while fall (48.78%) was the most frequent cause of trauma. The range of time duration between trauma and presentation for treatment was 5 months to 30 years (average time 12.82 years). Pulp necrosis (PN) was the most common complication (90.24%). Almost half of the teeth with PN had fracture injury and discoloration along with a high frequency of PR (78.37%). Even teeth with a normal appearance were found to have a high incidence of PN (76.92%) and PR (53.84%). The crown discoloration was the second most frequent finding (48.78%). Many teeth (41.66%) with vital pulp were also discolored. Most of the teeth (79.31%) with yellowish discoloration and all teeth with brownish discoloration were nonvital. A high frequency of PN (90%) and PR (78.33%) was found in teeth with discoloration. PR was the most common radiographic finding (69.10%), while PCO and RR were observed in 17.88% and 21.13% of teeth, respectively. Conclusion. The findings of this study support the fact that delayed treatment of TDIs leads to increased complications. PN was the most common complication followed by tooth discoloration, RR, and PCO among patients seeking delayed treatment after TDIs.
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