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Anthropological Approach of the Proximal Tooth Area: A Systematic Review
No full textAn analysis of dental anthropological literature dealing with the dental wear of prehistoric men, reveals that little information about interproximal dental attrition and its evolution with the modern man is available. This observation marked anthropologists and dentists for a long. The objective of this review is to determine the origin of the interproximal contact region of the tooth. In other words, which interproximal contact was first to appear in human dentitions? Is it the interproximal contact point or the contact surface?An electronic search was performed in four databases: PUBMED, SCOPUS, Cochrane Database, and EBSCO. Our search was limited to articles in English. We included in our research dental and anthropological studies concerning Homo sapiens and excluded all the other species such as Homo Habilis, Homo Erectus, Homo Rhudolfensis, and Homo Neandertalensis. Attritional occlusion and flattened proximal facets are considered some of the main characteristics of the masticatory system of nonindustrialized men. Theories and dental researches tried to explain the proliferation of malocclusion and severe tooth crowding in modern society.The study of dental wear is a path of research that highlights the evolution of the manducatory system and thus, it influences the choice of treatment in our practices
A Rare Tumor of the Mediastinum: Inflammatory Myofibroblastic Tumor
No full textIntroduction: Inflammatory myofibroblastic tumors (IMTs) arising in the mediastinum is rare. Their etiology remains unknown and their diagnosis is often overlooked before the use of surgery which allows the proper diagnosis and adequate treatment.Case report: We report a case of the 56-year-old woman that had a mediastinal mass discovered after a long complaint of chest discomfort. Chest contrast-enhanced computed tomography (CT) showed a heterogeneously enhanced mass in the middle mediastinum The diagnosis was confirmed by histopathology and immunohistochemical study after surgical resection through a thoracotomy The patient was well and had no recurrence 6 months after surgery.Conclusion: The diagnosis of IMT should be kept in mind and included in the differential diagnosis of mediastinal masses
Histiocytic Sarcoma: A Case Series of Extranodal and Nodal Presentations
No full textIntroduction: Histiocytic sarcoma is an aggressive malignancy of mature histocytes which often carries a poor prognosis. Histiocytic sarcoma is defined in the World Health Organisation (WHO) classification of histiocytic and dendritic cell neoplasms. Case Presentation: Case 1 depicts a 42 year old Malay gentleman with no premorbids presented to the haematology unit with a three month history of fever, night sweats, unintentional weight loss, left axillary and bilateral inguinal swellings which were progressively enlarging. Physical examination revealed a medium built gentleman with left axilla, bilateral inguinal lymphadenopathies and hepatosplenomegaly. Excision biopsies of the left axillary and inguinal lymph nodes were compatible with histiocytic sarcoma. He did not have any bone marrow infiltration. He was treated with 6 cycles of CHOP (Cyclophosphamide, doxorubicin, vincristine, prednisolone) polychemotherapy but he subsequently succumbed to severe hemophagocytic syndrome shortly after his 6th CHOP chemotherapy. Case 2 describes a 55-year-old previously healthy Malay gentleman who presented with perianal swelling and weight loss for two months. Physical examination revealed a large perianal swelling measuring 10 cm with bilateral inguinal lymphadenopathies. Anorectal tissue histology was compatible with the diagnosis of histiocytic sarcoma. He underwent a transverse colostomy which was subsequently reversed post-chemotherapy. He completed 6 cycles of CHOP chemotherapy followed by upfront consolidation autologous stem cell transplant. He is currently 9 months in complete remission. Conclusion: Histiocytic sarcoma remains a disease with poor treatment outcomes and high mortality. Understanding the pathogenesis and pathobiology of the disease will provide a future to the development of novel therapies
Epidemiological, Clinical, Therapeutic and Evolutionary Aspects of Primary Operated Bronchial Cancer
No full textIntroduction: Bronchial cancer is the leading cause of cancer death in the world. We conducted this work in order to describe the epidemiological, clinical, therapeutic, and evolutionary characteristics of primary operated bronchopulmonary cancers. Methods: Retrospective study including all operated patients from January 2016 to October 2018. The data was entered on an Excel file and then transferred to SPSS software for analysis. Results: The rate of primary operated bronchopulmonary cancers was 6,3 %. The sex ratio was 3,11. The average age was 58,5 years old. The average consultation time exceeded three months in 80% of cases. Adenocarcinoma was the most common histological type. Conclusion: The very low rate of stages I and II at the time of diagnosis requires awareness of the value of screening and early diagnosis so that patients can benefit from surgical treatment.
Chemotherapy of Prostatic Adenocarcinoma : State of the Art 2019
No full textProstate cancer is a heterogeneous disease, with different clinical-biological and evolutionary aspects. Most often it is a disease with indolent evolution. Chemotherapy has long been a therapy of last resort in the treatment of prostate cancer. Deploying chemotherapy in this context certainly implied the failure of all possibilities of hormonal manipulation. Thus, antineoplastic chemotherapy was first proposed in metastatic situations, with resistance to castration. Many molecules have confirmed the effectiveness of chemotherapy in this indication. Several phase III trials have placed chemotherapy as a serious option in less advanced situations, with very encouraging results in terms of survival and quality of life. Chemotherapy is currently considered as a therapeutic weapon that should be included in the management strategy, after discussion in a multidisciplinary consultation meeting. Through this review, we will try to establish the state of the art of the use of antineoplastic chemotherapy in prostatic adenocarcinoma in 2018, in metastatic (de novo or in a phase of resistance to castration), localized, or locally advanced situations
Contralateral Fracture-Dislocation of the Shoulder Due to Electric Shock
No full textElectrical injuries are relatively common and can produce various types of adverse effects on organs, but injuries to the musculoskeletal system are less frequent. Bone injuries can involve both long and flat bones and they encompass several types: osteonecrosis, dislocation, and fracture. Cases of shoulder dislocation with fracture have been reported in the literature; the mechanism is linked to the tetanizing effect from the alternating current flow through the shoulder without a fall or a violent trauma. Posterior dislocation is the most common shoulder injury. We report the case of an anterior fracture-dislocation of the shoulder contralateral to the entry point and we emphasize that any pain or functional impotence in the context of electric shock, even when it’s distant from the entry point, should trigger suspicion of bone injury
Cardiac Manifestations in Human Immunodeficiency Virus-Infected Patients: An Electro- and Echocardiographic Study
No full textBackground : Advanced novel therapies and antiretroviral medications for the treatment of human immunodeficiency virus (HIV) infection have led to the improved management and survival of the infected patients. However, I [i]t manifestations in late-stage diseases such as cardiac deformities, which are the major cause of fatality in HIV-infected patients. Hence the current study was undertaken to derive the association of cardiac dysfunctions in HIV-infected patients using electrocardiograph (ECG)and echocardiography (ECHO).Methodology : The study included a total of 100 consecutive patients with HIV infection and was performed during January–December 2016 in the Department of General Medicine. Prior to the commencement of the study, ethical clearance was obtained from the Institutional Ethical Committee. Patients underwent complete blood count, ECG, and ECHO. Data were analyzed using Microsoft Excel spreadsheet and R-3.4.1 software.Results : Majority of the patients were males (79) and 40–49 years was the most common age group. The duration of HIV infection in most of the patients (73) was 1–10 years. Among the study population, 79 patients received antiretroviral drugs. Chi-square test was used to find the association of clinical symptoms and cardiac abnormalities with CD4 count. Cardiac manifestations were observed in 62% patients; sinus tachycardia (29%) was found to be the most common cardiac manifestation on ECG. Diastolic and systolic dysfunctions were observed in 35 patients and 49 patients, respectively.Conclusion : Patients with HIV infection are at a higher risk of developing cardiac dysfunctions. Early identification through ECG and ECHO-revealed abnormalities might assist in cardiac-targeted interventions, which can significantly reduce the fatal outcomes in HIV-infected patients
Penile Fracture : Experience from a Tertiary Care Hospital
No full textIntroduction: Penile fracture is a misnomer, penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed, or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination. the standard model of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital Srinagar,(Jammu and Kashmir), extending over a period of about three and a half years from June 2013 to January 2017. All patients with diagnosed penile fracture were included in this study. All except one patient were operated on the same day of admission.Results: out of a total of 50 patients studied, the mean age of presentation was 26.7 years. The majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as a cause of trauma, followed by vaginal intercourse in38% and rolling on the erect penis in 20%. About 80% of patients gave a history of audible click/crackling sound. All patients had swelling and discoloration on examination,90% of patients had a penile deformity, only 36 % had a palpable defect. Doppler USG was correct in 93% of patients. The majority (44%) of patients had defects less than 1cm. the defect was mostly seen on the right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of a penile fracture
Unusual Presentation of a Rare Tumor of the Chest Wall : Giant Cell Tumor of Bone
No full textIntroduction: Giant cell tumors account for 5% of all bone tumors. However, the anterior chest wall is rarely involved.Clinical case: This is a 68-year-old housewife who has been thyroidectomized, for 11 years and is under hormone replacement therapy, and hysterectomies for 6 years after a uterine tumor. She is present for the onset of a 5-month-old hard submammary mass on the left associated with left anterior chest pain under mammals. The clinical examination had found an irregular hard mass under the left mammary which is fixed to the anterior arch of the 4th left rib. A thoracic x-ray showed a limited left Hilo-axillary with a homogeneously dense opacity. The thoracic CT scan showed the presence of a thoracic parietal mass of osteolytic tissue density centered on the anterior arch of the 4th left rib; without a contrast agent, the surgical exploration through thoracotomy revealed a thoracic parietal tumoral process at the expense of the anterior arch of the 4th limb pushing the corresponding lung inwards. Surgical excision allowed ablation of the whole tumor in monobloc towards a healthy zone. The anatomopathological study of the operative specimen showed a morphological and histopathological aspect compatible with a costal tumor with giant cells. The postoperative recovery was marked by a good clinical and radiological improvement. The last check-up after the surgery revealed that the patient was still asymptomatic. Good clinical, biological and radiological improvement was noted with a decline of 8 months.Conclusion: Giant cell tumors are aggressive bone tumors, yet histologically benign. The chosen examination is a thoracic CT scan with surgical treatment. Clinical and radiological monitoring is necessary. The recurrence is rare, but it usually necessitates a second surgery. The objective of this clinical observation is to highlight the possibility, although rare, of a giant cell tumor in case of the swelling of the soft parts, and a lytic lesion of the anterior part of a rib. Therefore, this tumor must be added to the list of diagnoses to be mentioned in this situation
Anesthetic and Surgical Difficulties of Substernal Goiters: A Series of 16 Cases
No full textIntroduction: Haller first described substernal goiter in 1749. Authors report different definitions, but the most commonly used defines substernal goiter as a goiter that does not sit in the neck in the operating position and has a lower extension to more than two fingers breadth under the manubrium. The aim of our work is to highlight the perioperative anesthetic and surgical difficulties within substernal goiters' care.Materials and methods: This is a retrospective study conducted in both anesthesiology and thoracic surgery departments in Moulay Ismail hospital in Meknes over a period of three years from January 2013 to December 2015. This study has been based on the medical records of all patients operated for substernal goiter. The data investigated were: demographic characteristics, medical and surgical history, Mallampati and intubation difficulties, surgical approach, and finally intraoperative and postoperative complications.Results: The average age of our patients was 61.5 years with extremes ranging from 34 to 83 years old. The most affected age group was between 50 and 70 years old, 9 out of 56 cases. The sex ratio was 1.5, 10 women and 6 men. The approach was anterior cervicotomy, with total thyroidectomy, in almost all patients. A thoracotomy was decided from the outset for a single patient with goiter missed in endothoracic after thyroid surgery. The evolution was favorable in 16 patients of our series. Redon drains were removed 48 to 72 hours after surgery and the average hospital stay was five days.Conclusion: The substernal goiter care is easier if a full preoperative examination is made, allowing the anticipation of eventual anesthetic and surgical difficulties