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Right Sided Ureterocele Presented with Multiple Calculi: A Rare Case Report
No full textAn ureterocele is a congenital abnormality found in the ureter where the distal ureter balloons at its opening into the bladder, forming a sac-like pouch. It is most often associated with a duplicated collecting system, where two ureters drain their respective kidney instead of one. Ureterocele occur in approximately 1 out of every 4,000 babies and are 10 times more common in girls than in boys with a left sided preponderance because a duplex collecting system (two ureters for one kidney) is more common in girls. This case report is about a 34 years old male patient complaining of lower abdominal pain, burning pain during micturation (dysuria), flank pain occasionally on right side and frequent urination. On USG and IVP x-ray, diagnosis was made as right renal hydronephrosis with right hydroureter due to right side intravesical ureterocele with right vesicoureteric calculi (multiple about 265 stones). Ureterocoele was incised endoscopically and total 265 small calculi was removed
Unusually Large Sialolith of Wharton’s Duct: A Case Report with Review of Literature
No full textSialolithiasis is a common disease of the salivary glands and a major cause of salivary gland dysfunction. The dominance of submandibular sialoliths is widely investigated. Giant stones (>15 mm) are rare, approximately every tenth or twelfth of the stones belong to this category. Large sialoliths have been reported in the body of salivary glands; however, they have rarely been described in the salivary ducts. We report a case of a 23 year old female with a giant sialolith occurring solely in the submandibular duct, which was removed via a transoral approach under local anesthesia. On gross examination, the sialolith measured 25 mm. The patient’s gland was managed conservatively with sialagogues and analgesics. The gland recovered normal function quickly, and follow-up showed an asymptomatic and normally functioning gland. Thus, a conservative approach to the gland will spare the patient the morbidity associated with gland removal
Role of Facial N Decompression in Unresolved Bells Palsy: Surgical Outcome
No full textIntroduction: Incomplete return of facial motor function and synkinesis continue to be long-term sequelae in some patients with Bell’s palsy. No definitive management option is quoted in literature. Objective: The aim of this research is to describe a prospective study in which a well-defined surgical decompression of the facial nerve was performed in a population of patients with Bell’s palsy who exhibit grade V and VI (House-Brackmann) after 3 weeks of conservative treatment. Study Design and Methods: A prospective clinical study. Results: Out of 24 patients 25 (96%) patients improved after facial nerve decompression performed in patients who didn’t recovered after conservative treatment of 3 weeks. Conclusion: Surgical decompression distal to the geniculate ganglion significantly improves the chances of normal or near normal return of facial function
Serum Amyloid A Level in Patients with Juvenile Idiopathic Arthritis
No full textBackground and Aim of the Work: JIA is the commonest rheumatic disease in childhood characterized by inflammatory arthritis lasting more than 6 weeks before the 16th birthday. In addition to routine ESR and CRP, there are other inflammatory biomarkers as SAA. It is one of the major acute phase reactants which was found to be elevated in inflammatory arthritis and a good indicator of disease activity.This study assessed the value of SAA level in a cohort of patients with JIA.Subjects and Methods: 45 JIA patients and 40 healthy controls were recruited from the outpatient clinic of Rheumatology and Rehabilitation Department at MUCH. All patients underwent a thorough clinical evaluation. Assessment of JIA patients involved assessment of disease activity, tenderness and functional status. Laboratory tests were done including: CBC, ESR, CRP and SAA.Results: A significant rise in SAA levels was found in JIA patients compared to control group and it was significantly higher in SJIA subtype. SAA level was positively correlated with JADAS-27, VAS, physician global assessment, C-HAQ, Ritchie articular index score, platelet count and ESR in 1st hour and 2nd hour. The levels of SAA were significantly lower in JIA patients taking methotrexate while it was significantly higher in cyclosporine treated patients.Conclusion: SAA can be used as additional indicator of JIA disease activity. Moreover, it can help in differentiation between subtypes when combined with clinical features of the disease and it may be considered in assessment of patient, s response to therapy
Correlates of Preconception Care among Mothers Prone to Hypertensive Disorders in Nairobi City County
No full textImproved uptake of preconception care has been associated with reduced rates of maternal mortality yet the awareness and uptake of preconception care services among pregnant women, and healthcare teams remain low. This study assessed the awareness of preconception care among pregnant mothers with hypertensive disorders, to examine the influence of male partners in seeking of preconception care and to determine the perceived effects of lack of pre-conception care among pregnant mothers with hypertensive disorders. This was a cross-sectional study in which a sample of 325 mothers seeking ante-natal care was selected from Mbagathi District Hospital, Pumwani Maternity Hospital and Langata Health Centre respectively. A stratified proportionate sampling was used to select the 325 mothers from the three health facilities. Structured questionnaires were used in data collection. Descriptive statistics (mean, median, frequency) were used in analyzing characteristics of the sample. Inferential statistics (Chi-square) was used to test for the relationship between the study variables and seeking of pre-conception care. A p-value of 0.05 was considered significant at a 95% confidence level. A majority of respondents n=232 indicated that preconception care consists of advice prior to conception, medical care during pregnancy and receiving ante-natal care. Health workers at 63% (n=174) were the main source of information on pre-conception care. 72.5% of the respondents had discussed a joint pre-conception care with their male partner. About 27.5% of the respondents had not discussed a pre-conception care plan with their male partners with the leading reason being that partners did not see the reason to accompany their wives for pre-conception care. Marital status at p=0.000 (c2 = 25.365, df=4), education at p=0.048(c2 = 18.465, df=10), discussing and making joint plans with partner on pre-conception care at p=0.008 (c2 = 9.782, df=2) significantly influenced decision to attend pre-conception care. 44.67 % (n=130) of respondents indicated that lack of pre-conception care increases the risk of hypertension disorder causing miscarriage. Twenty-eight percent (n=80) of the respondents indicated that lack of pre-conception care exposes a mother to birth complications that develop due pre-eclampsia. This study identified views of mothers on the uptake of pre-conception care. Perceived lack of time and lack of interest among men were the main barriers that hindered male partners from accompanying their female partners for pre-conception care. Factors that promoted uptake of pre-conception care included, being married, discussing a joint plan with a male partner and having a higher level of education. This study highlights the need for health promotion activities to encourage the need of preparing for pregnancy in the general population. In this regard, health care workers should incorporate health messages on preconception care during ante-natal, immunization and post-natal care sessions to increase awareness on the importance of preconception care
VIQ-PIQ Discrepancies are Unrelated to Mental Health Indicators in a Child Psychiatric Sample
No full textIn a sample of children aged 8-16 years (N = 151) in a child psychiatric setting, the relationship between VIQ-PIQ discrepancies and both Quality of Life (QoL) and psychosocial problems was explored. It was hypothesized that compared to children without a VIQ-PIQ discrepancy children with a discrepancy would have lower QoL and show more psychosocial problems. Using the WISC-III to measure IQ discrepancies, QoL and the severity of psychosocial problems (measured with the Child Behavior Checklist) were found not to differ between the two groups of children. Neither were there any significant correlations between VIQ-PIQ discrepancies and these mental health indicators. Moreover, the proportion of children showing a VIQ-PIQ discrepancy was found not to deviate from the value in the normal population. The conclusion is that in children with psychiatric problems, VIQ-PIQ differences and core mental health indicators are unrelated and that therefore in diagnostic practice psychologists should be hesitant in assuming such a relationship
Bilateral Spermatocyte Seminoma: A Case Report
No full textSpermatocyte seminoma is rare pathologic presentation of testicular cancer. We report a case of bilateral testicular seminoma in an 18-year-old man with thoracolumbar metastases. He presented with large, bilateral painless scrotal masses with a normal appearance of the scrotal skin. He also had thoracolumbar gibbus, and flaccid paraplegia that has been evolving for a month. Bilateral orchiectomy was performed but the patient died before adjuvant treatment
Now you see the drum, now you don’t: a rare case of conductive hearing loss in a child
No full textIntroduction: Fibrous dysplasia is a benign disease of the bones, which affects the differentiation and maturation of osteoblasts. Fibrous dysplasia can affect the craniofacial bones, which can be asymptomatic or present with symptoms commonly found in an ENT outpatient clinic.Method: We present an unusual case of temporal bone fibrous dysplasia. This is used as a platform to discuss craniofacial fibrous dysplasia further and the investigations and management.Results: Other cases have been reported on temporal bone fibrous dysplasia, but our case is unique in the presentation. Gold-standard diagnosis for craniofacial fibrous dysplasia is by histopathological sampling, although computerised-tomography imaging can be used to diagnose fibrous dysplasia if a biopsy cannot be sought.Conclusion: Fibrous dysplasia of the temporal bones is uncommon. Many cases from other series are found incidentally from radiology reports
Uric Acid Association with the Metabolic Syndrome and Type 2 Diabetes
No full textIntroduction and Objectives: The metabolic syndrome (MetS) consists of a group of cardiovascular risk factors, highly prevalent worldwide, afflicting an estimated 20 to 25% of the world’s population. There is a probable relationship between serum uric acid (SUA), Type 2 diabetes (T2D) and the MetS but the literature presents conflicting data. Our primary objective was to assess any association between SUA, T2D, MetS, the lipid profile and pre-diabetes (PD).Materials and Methods: We conducted a prospective study on 116 patients with T2D, PD or MetS. Patients aged between 18 and 89 years were chosen randomly from private clinics. Data covering personal, socio-economic, health and dietary habits, lab tests, anthropometric measures and medications were collected.Results: The prevalence of T2D and MetS in our group was 74% and 85.9% respectively. The mean SUA level was 4.95 mg/dL±1.45 with males having a higher mean (5.28 mg/dL ±1.26) compared to females (4.56 mg/dL ±1.57). The highest association was found between SUA levels, obesity and insulin levels. No association was found between the levels of SUA and Triglycerides (TG), High Density Lipoproteins (HDL), the Systolic or Diastolic Blood Pressures (BP). The fasting glucose levels were found to be inversely associated with SUA among subjects with the MetS. Fish and shellfish and soft drinks were the food items most associated with SUA levels.Conclusion: In conclusion, we found no direct association between SUA and T2D, the MetS, BP, TG, and HDL. SUA levels were associated with obesity, insulin levels, male gender, and the consumption of fish and shellfish and soft drinks
