Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye. MRI (magnetic resonance imaging) of the brain showed left temporal extra-axial cystic lesion of 5.40 × 4.10 cm in size, representing arachnoid cyst, with bilateral frontoparietal subdural hygromas. Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes. Postoperatively the child recovered uneventfully and was discharged on the seventh postoperative day. Histopathology proves it to be arachnoid cyst of the brain with subdural CSF (cerebrospinal fluid) collection or hygroma.
Primary peritonitis is a rare phenomenon in modern antibiotic era. A case of pediatric primary peritonitis is presented here, in which a child presented with complaints of abdominal pain, vomiting for one day. Abdominal examination showed marked tenderness and guarding, diagnosis of appendicitis was made and laparoscopic appendectomy done. Later, ascitic fluid analysis and appendix histopathology proved it to be a case of primary peritonitis.
A young child presented to the emergency department of a tertiary care hospital with on and off headache, focal seizures involving the left side of the body, weakness of left upper and lower limbs and vomiting for 2 weeks. Examination showed an alert child with grade 4/5 powers in left upper and lower limbs. Blood investigations were normal. An urgent CT of the brain showed intra-axial mass in the right frontal cerebral cortex, superolateral to the right lateral ventricle. MRI of the brain showed supratentorial extraventricular mass of 5.20 × 3.70 × 3.80 cm, in the right frontal cortex, emitting heterogeneous signals on T1, T2 and fluid-attenuated inversion recovery sequences and impression of astrocytoma, ependymoma or choroid plexus papilloma was made. Complete surgical resection of mass was performed. Histopathology of the mass proved it as WHO grade III anaplastic ependymoma. The child made an uneventful postoperative recovery and radiotherapy was followed.
Objective: The main objective was to study different clinical presentations and outcomes of patients after acute industrial chlorine gas exposure in Oman with evaluation of overall incident management to help develop a chemical exposure incident protocol. Methods: This was a retrospective observational study of 15 patients exposed to chlorine gas after an accidental chlorine gas leak in a metal melting factory in Oman. Results: Six (40%) patients were admitted and nine (60%) patients were discharged from the emergency department (ED) after initial management. The important post-chlorine gas exposure clinical symptoms were eye irritation (66.6%), cough (73.3%), shortness of breath (40.0%), chest discomfort (66.6%), rhinorrhea (66.6%), dizziness (40.0%), vomiting (46.6%), sore throat (13.3%), and stridor (53.3%). Important signs included tachycardia (40.0%), tachypnea (40.0%), wheeze (20.0%), and use of accessory muscles for breathing (20.0%). Signs and symptoms of eye irritation, rhinorrhea, tachycardia, tachypnea, wheeze, and use of accessory muscles for breathing have shown significant correlation with outcome (admission) having P value of <.05. Conclusion: In the presented acute chlorine gas exposure incidence, 15 exposed persons were brought to the ED, out of which six were admitted and nine were discharged after symptomatic treatment. Signs and symptoms of eye irritation, rhinorrhea, tachycardia, tachypnea, wheeze, and use of accessory muscles of breathing show significant relation with the outcome of admission.
Objectives: To study the epidemiology of drowning among children cases reported at Sultan Qaboos University Hospital in Oman. Methods: We conducted a retrospective study of the patients who were presented at emergency department with the history of drowning over a period of 10 years from January 2008 to December 2017. Patients with age 1 to 18 years were included in the study. The data including demographics, timing and location of drowning, season, adult supervision, swimming ability, medical risk factors, duration of submersion, on spot resuscitation, emergency medicine department assessment, hospital management and outcome were collected from electronic hospital information system using a preformed proforma. Outcome was categorized into either full recovery, severe neurological injury or brain death based on the pediatric cerebral performance category (PCPC). A good outcome represents to a score of 1-3 points and PCPC 2 of 4-6 points corresponds to poor outcome. We calculated correlation for all variables with the outcome by using chi square and fisher exact tests. P value of <0.05 is taken as significant value. Results: A total of 74 patients were included in the study. Of them, 54 (73%) were male, children of less than six years of age were 47 (63.5%). More than 50% of drownings happened in outside swimming pool, 21 (28.4%) of patients were unsupervised during incident and 39 (52.7%) required cardiopulmonary resuscitation. Out of all studied subjects, 3 (4%) were brain dead and 2 (2.7%) developed severe neurological injury. On univariate analysis, the following variables were statistically significant (p<0.05) predicting the poor outcome like lack of adult supervision, duration of submersion >10 minutes, asystole, Glasgow Coma Scale <8, temperature <35c, PH <7, anion gap >20, blood glucose >10 mmol/L, abnormal chest x-ary findings, rewarming, cardiopulmonary resuscitation, intubation, inotrope support and pediatric intensive care unit admission. Conclusion: This study suggests that children especially male below 6 years of age without swimming ability need strict supervision next to body of water. Furthermore; preventive measures might include raising community awareness about the risk factors of drowning, commencing public CPR lessons and strict pool safety regulation by related authorities.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.