Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Esthesioneuroblastoma (ENB) is a slow growing malignant tumour of olfactory neuro-epithelium that is locally aggressive with a tendency to recur years later.Infrequently, it can be associated with paraneoplastic syndrome. Here, we a report a pediatric case of ENB in whom syndrome of inappropriate ADH secretion (SIADH) was detected during ongoing primary treatment which reflected disease progression after initial response to chemotherapy, that was substantiated radiologically. SIADH has been reported in only a few cases of ENB.

Background: One of the symptoms annoying patients after total knee replacement (TKR) is numbness around the operative scar. Some studies have shown that altering the incision in terms of placement or length may decrease the incidence of numbness. It still remains unknown whether numbness affects patient-reported outcomes. Methods: We conducted a randomized study to compare a short-length incision (n = 50) and a lateral exit incision (n = 50) with a standard midline TKR incision (n = 50) in terms of the incidence of numbness and its progress over 1 year of follow-up. Our secondary objective was to look at the involved zone, area of numbness, and secondary symptoms. We also looked at patient-reported outcome in terms of satisfaction in all groups using a visual analog scale and Forgotten Joint Score. Results: At 3 months postoperatively, the incidence of numbness was least in the lateral exit group: 46.2% as compared to midline (62%) and short (58.3%), but the difference was not significant (p = 0.07). At 6 months, the short incision group had a significantly lower incidence (8%) of residual numbness as compared to 30% in the other two groups (p = 0.003). At 1 year, most patients recovered sensation loss and had similar function. Conclusions Placement or length of an incision did not significantly affect the incidence of numbness; however, the short incision led to early recovery of numbness. At 1 year of follow-up, most patients did not complain of loss of sensation and had similar functional outcome.

No abstract available.
Fires ; Open Access Publishing

No abstract available.
Histoplasmosis ; India

BACKGROUND: Hip fractures are a significant cause of morbidity and mortality in the elderly. Fast-track multidisciplinary co-management of these patients, rapid preoperative optimization, early surgery, and expeditious rehabilitation may minimize morbidity and mortality. In this study, we evaluated outcomes of fixation of hip fractures in the elderly patients managed by Geriatric Hip Fracture Program at a military hospital in India. METHODS: A total of 114 patients above 60 years of age with hip fractures were enrolled. They were comanaged by a team of specialists and fast-tracked to surgery. Independent ambulation with support of a walker was achieved before discharge to home. Patients were followed up for 1 year. RESULTS: The average age of the 114 patients was 77 years; 24 patients were octogenarian. Eighty-four percent of injuries were due to a domestic fall. Hypertension (41%) and diabetes (22%) were the most common comorbidities. All patients were optimized before surgery. The average delay from injury to admission was 1.7 days (range, 0 to 14 days) and that from admission to surgery was 1.8 days (range, 0 to 19 days). Hence, the average time from injury to surgery was 3.5 days. The length of stay in hospital was, as per rehabilitative milestones achieved, 2 to 5 days in 40% of the patients and 6 to 15 days in 60% of the patients. At 1 year after surgery, 95 patients were independently ambulant (56 patients with support and 39 patients without support). Twenty-three percent of the patients had postoperative complications and eight patients died (7.7%) at 1-year follow-up; 11 patients were lost to follow-up. CONCLUSIONS: Elderly hip fracture has a high risk of mortality (14%–58%). Thus, expeditious surgery within 24 hours of admission has been advocated in the Western literature to minimize mortality. Mortality rate at 1 year after surgery remains at 10% to 24%. In our study, even with aggressive co-management, the average delay to hip fracture fixation was more than 3 days; however, the 1-year mortality was relatively low (7.7%). This indicates the importance of preoperative optimization and postoperative rehabilitation for independent ambulation and mortality reduction in the elderly population.
Aged ; Aged, 80 and over ; Comorbidity ; Follow-Up Studies ; Fracture Fixation ; Hip Fractures ; Hip ; Hospitals, Military ; Humans ; Hypertension ; India ; Length of Stay ; Lost to Follow-Up ; Mortality ; Postoperative Complications ; Rehabilitation ; Specialization ; Veterans ; Walkers ; Walking

OBJECTIVES: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. MATERIALS AND METHODS: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. RESULTS: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). CONCLUSION: PRF is a better alternative than ZOE for the effective management of alveolar osteitis.
Dry Socket ; Eugenol ; Fibrin ; Humans ; Inflammation ; Periodontal Index ; Wound Healing ; Wounds and Injuries ; Zinc Oxide ; Zinc