The objective of this study was to investigate the treatment and prognosis of patients with spinal tuberculosis in Guizhou province. A total of 863 patients with spinal tuberculosis admitted to our hospital from 2006 to 2017 were included in this study. All patients underwent standardized quadruple antituberculosis treatment. Eighty patients were lost to follow-up due to a change of their contact information or noncompliance. A total of 783 patients completed the follow-up. The average follow-up period was 20.33 ± 8.77 months (range: 6 to 38 months). Among these patients, 145 patients underwent conservative treatment, while 638 patients underwent surgical treatment. All patients in the surgery group were treated with lesion removal, bone graft fusion, and internal fixation. Preoperative and postoperative standard quadruple antituberculosis treatment was administered. The clinical efficacy was evaluated according to erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), visual analogue scale (VAS), Cobb angle correction, neurological functional recovery, and interbody fusion with bone graft and tuberculosis outcome. A total of 608 patients achieved clinical cure. The symptoms, physical signs, blood tests and imaging findings were improved in 143 patients. Twenty patients showed refractory clinical symptoms, and 12 patients had local tuberculosis recurrence. Conservative and surgical treatments are the mainstream treatments for spinal tuberculosis. According to the patients' individual conditions, individualized treatments should be used to achieve good efficacy. Standardized antituberculosis treatment should be applied over the course of spinal tuberculosis.
Background. Tuberculosis (TB) is an endemic disease in Guizhou. Spinal TB accounts for approximately 50% cases of skeletal TB. The purpose of this study was to investigate the characteristics and management of patients treated for spinal TB in a certain hospital and to provide guidance for the prevention and treatment of spinal TB. Methods. The clinic records of all patients diagnosed with spinal tuberculosis in a teaching hospital between January 2010 and December 2018 were collected. The epidemiology, clinical characteristics, imaging and laboratory findings, treatment methods, and prognosis were recorded and analyzed. Results. During this nine-year period, 597 patients with spinal TB were identified. There were 313 males and 284 females with an average age of 43 years. The largest number of patients fell in the age group of 21–30 years; mean time from symptom onset to diagnosis in the hospital was 17 months. Back pain was the main clinical manifestation (89.34%). The most common imaging technique was computed tomography (CT, 96.80%), followed by magnetic resonance imaging (MRI, 84.01%). Majority of the lesions involved the lumbar spine (47.30%), followed by the thoracic spine (40.95%). 178 (29.82%) patients in this study had varying degrees of neurological impairment. 22.78% of the patients selected conservative treatment, and surgical treatment was performed in 483 patients (80.90%). Conclusions. The incidence of spinal TB was generally on the rise throughout the study period. After diagnosed with spinal TB, all patients got appropriate treatment and achieved good efficacy, but most of the patients did not pay much attention to the disease and receive timely treatment. Thus, it is essential to strengthen the TB preventive strategies, improve the health awareness of residents and universal resident health examination.
<p class="abstract"><strong>Background:</strong> The aim of the study was to study the etiopathogenesis, age and sex distribution and management, chemical cautery, anterior and posterior nasal packing, nasal septal surgery, blood transfusion and arterial ligation.</p><p class="abstract"><strong>Methods:</strong> It is simple random sampling study undertaken to know the etiopathogenesis and management of epistaxis at government general hospital for 2 years. </p><p class="abstract"><strong>Results:</strong> The incidence of epistaxis was 1.5%. It was more in males with a male to female ratio of 1:9:1. The age incidence was more in the first and second decades and then increased from the fourth onwards with almost 60% cases belonging to this category. The seasonal incidence was more during cold, dry, winter months (70%). The commonest etiological factor was trauma (42%), followed by the hypertension (24%). 72% of patients had anterior nasal bleeding. The treatment options were divided onto non- surgical and surgical modalities. 86% of the patients were managed by conservative measures like medical treatment (42%) cautery (6%), anterior nasal packing (30%) and posterior nasal packing (4%). 14% of the patients required surgical intervention like septoplasty (2%), excision of bleeding nasal polypus (2%), nasal bone fracture reduction (2%), excision of adenoid cystic carcinoma of nose (2%), removal of rhinolith (92%), excision of angiofibroma of nose (4%).</p><p><strong>Conclusions:</strong> Anterior bleeding is more common and trauma is an important etiological factor. Majority cases of epistaxis are managable by conservative measures and only few require surgical intervention. </p>
Rationale: Langerhans cell histiocytosis (LCH) involving adult cervical vertebrae is relatively rare clinically. Patient concerns: An 18-year-old male patient exhibited a 1-month history of neck pain, restricted neck mobility, and numbness and weakness of both upper limbs. The patient reported no pain at other sites, exhibited no fever or night sweats, and was unable to recall any recent injury. Diagnoses: On the basis of the radiological features of the lesion and laboratory tests, there was a high possibility that the patient had a tuberculosis lesion. Postoperative GeneXpert and Mycobacterium tuberculosis (MTB) culture results showed MTB negative. Postoperative pathological results showed: (Cervical 4 vertebrae) LCH. Interventions: Our department did an anterior approach operation. The patient was treated with prednisone combined with vincristine after operation. Outcomes: The patient was discharged from the hospital with complete remission of cervical pain and rapid relief of neurological symptoms. Lessons: Computed tomography-guided biopsy of lesion tissue must be performed when a suspected infection occurs in young patients. If possible, the lesion tissue obtained during the operation should be cultured and pathologically examined for early diagnosis.
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