Objective To compare the results of the use of irrigation versus no irrigation during burr hole evacuation of chronic subdural hematoma (CSDH). Methodology The study was a retrospective chart review of those patients who underwent burr hole evacuation of CSDH during a period of 5 years. Cases were divided into two groups based on the use of irrigation during surgery. A subdural drain was placed in all patients (i.e., in both the irrigation and no-irrigation groups) and removed 24 to 48 hours postoperatively. Results The total sample size was 56, of which 34 patients were in the irrigation group and 22 in the no-irrigation group. Recurrence rate was 17.6% in the irrigation group and 9.1% in the no-irrigation group (p = 0.46). Systemic complications were predominantly cardiac related in the no-irrigation group compared with respiratory complications in the irrigation group. The irrigation group had a mortality rate of 5.9% compared with 4.5% in the no-irrigation group (p = 0.66). Conclusion No statistically significant difference was found between the two groups in terms of recurrence or mortality.
Nasogastric intubation is a frequent practice in clinical care used for administering enteral feed, gastric decompression, and lavage. The knotting of a nasogastric tube is a rare complication with only a few incidences of narrow bore nasogastric tube knotting and even fewer wide-bore tubes reported [1-4]. Unrecognized knotting of the nasogastric tube with inadvertent removal may cause catastrophic consequences like epistaxis, respiratory distress’ severe laryngeal injury, and tracheoesophageal fistula [5-7]. Tubes have been found to be kinked and less commonly knotted. Cases of knotting have previously been identified during insertion or blockage of the tubes post-insertion. Ours is a case of nasogastric tube knotting identified in a young patient with a working tube that knotted over itself during removal.
Background:High-grade gliomas have high infiltrative potential and spread along white matter and blood vessels. Enhancement of ependymal lining on magnetic resonance imaging (MRI) is considered as a marker of parenchymal spread of disease. In this study, we aimed to assess the sensitivity, specificity, and positive and negative predictive values of ependymal enhancement (EE) for identification of high-grade glial tumors.Methods:We reviewed preoperative MRI scans of 94 consecutive patients surgically treated for space occupying lesions of the brain for EE. Assessment for EE was blind to the final histopathological diagnosis of the patient. An enhancement of more than 2 mm was considered positive. Pathologies of these patients were reviewed and matched to the radiological findings. Percentage and proportion of EE in glial and non-glial pathology groups was then calculated and a sensitivity and specificity analysis was performed.Results:The population included 94 cases (64 males and 30 females) with population mean age 45 ± 15.5 years. Sensitivity of EE in differentiating glioma from total number of cases was 82.61% specificity 35.42% (P value = 0.048). EE had a sensitivity of 67.39% and specificity of 64.58% (P value = 0.002) in identifying high-grade glioma within the glioma group with a positive predictive value of 64.58% (95% CI: 49.46% to 77.83%), negative predictive value of 67.39% (95% CI: 51.98% to 80.46%).Conclusion:EE has moderate sensitivity and specificity for high-grade gliomas. However, larger sample studies are required for further validation of this observations.
Background: Nasopharyngeal angiofibroma is extremely vascular, locally invasive and aggressive tumor. Among all neck and head tumors, NA prevalence is 0.05 percent to 0.5 percent but its most frequent tumor of the nasopharynx and virtually affects the male adolescents only. Nasopharyngeal angiofibroma shows a strong propensity to bleed in the surgical procedure. Currently, preoperative embolization is frequently utilized to reduce such intraoperative blood loss. Objective: The objective of the study was to assess the role of preoperative embolization in surgery for nasopharyngeal angiofibroma among patients. Method: It was cross-sectional descriptive study in which 60 patients with nasopharyngeal angiofibroma admitted in ENT Department of Lahore General Hospital Lahore were included. Data was collected through proforma which was entered into computer software SPSS version 22.0. Results: Among 60 patients, 63.3% were 12-14 years old. All (100.0%) patients had nasal bleeding and nasal obstruction, 10.0% had proptosis and 18.3% patients had broadening of nose. Among patients, 65.0% had 100-200 ml peroperative bleeding and 76.7% had 4-5 days hospital stay. Conclusion: Study concluded that preoperative embolization reduces the peroperative bleeding and hospital stay among patients.
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