HighlightsGastric Schwannoma is a rare neoplasm of stomach.It mimic clinically and radiologically with Gastric GIST.Immunohistochemical study can differentiate these two tumors.
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review
Background: Acute Pancreatitis (AP) is one among the major diseases in the surgery wards with high rate of mortality. In spite of many scoring systems introduced to grade the severity of AP for optimal and timely management, mortality rate is still in a high pace. The aim of this study is to compare BISAP scoring system and APACHE II scoring system for accuracy and easiness in predicting the severity and mortality of AP and to deliver appropriate and timely intervention.Methods: The first 100 patients with AP in the year 2016 (January to August) were studied prospectively by calculating APACHE II score and BISAP score. According to Revised Atlanta classification severe AP was ascertained and the sensitivity and specificity of both scoring systems were assessed from chi square table. By using ROC curve accuracy and diagnostic value of two scoring systems were compared.Results: 100 patients with an age ranging from 20 to 80 years with a mean of 41.18 and male female ratio of 10.1:1 were studied. 95% of the patients presented with a symptom of abdominal pain and 49 out of 100 were having alcoholism as etiology. The average hospital stay of the patients was 12.03 days. Four patients died out of 11 severe AP and rest 89 were grouped into mild AP. BISAP score more than or equal to three have 64.2% chance of severe AP and was statistically significant in predicting the severity of AP. Areas under curve of the ROC curve after depicting the sensitivity and specificity of BISAP scores for severity and mortality were 0.90 and 0.96 respectively. APACHE II scores more than or equal to nine have 23.8% chance of severe AP and was statistically significant in predicting severity of AP. When sensitivity and specificity of APACHE II score were charted in ROC curve, areas under curve were 0.853 and 0.75 for severity and mortality in AP respectively.Conclusions: Compared to APACE II, BISAP is better scoring system in predicting both severity and mortality of AP on considering accuracy and easiness.
Background: The pressure of the chronic SDH (subdural haemotoma), the age of the patient, preoperative GCS score and midline shift were considered prognostic dependent factors. The study aimed at the significance of the pressure of chronic SDH in the outcome of patients.Methods: A correlation between subdural hematoma pressure and preoperative and postoperative clinical variables such as hematoma volume, midline shift, age, GCS score and postoperative modified ranking scale score as well as complications were assessed and analyzed.Results: According to the pressure of chronic SDH, 56 patients were grouped into 4 groups. In the pressure group <15 cm/h20 group the mean age was 85 and postoperative ranking score was 3 and the recurrence was 21 % while in high pressure group (>25 cm/h20) the mortality was 14% and no recurrence.Conclusions: The pressure of the chronic SDH has significant prognostic value in chronic SDH surgeries.
Background: Cervical spondylotic myelopathy (CSM) is one of the most common dysfunctions of spinal cord occurs due to degenerative changes in cervical spine disc and facet joints. It is a form of progressive spine disease including herniated disc and spinal cord stenosis which manifests as changes in gait, skilled hand movements, muscle strength, bladder dysfunction etc. Recent studies and trials have established that surgical decompression of cervical spinal is a cost-effective treatment modality which provide satisfactory functional recovery. This study aimed at the functional outcome of surgical decompression of CSM.Methods: The prospective study of 100 cases of cervical myelopathy for which decompressive surgery was done from August 2020 to August 2021. Results were analysed according to Nuricks and modified Japanese orthopedic association scoring system (MJOA).Results: Seventy one males and 29 females were included in this study with average age was 53 and average hospital stay was 3.55 days. Average pre-op Nurick score was 1.93, while score after 6 months and 1year were 1.44 and 1.15respectively. Average pre-op MJOA score was 13.63, while score after 6 months and 1 year were 14.58 and 15.74 respectively.Conclusions: The functional results of decompressive surgeries for cervical myelopathy are satisfactory. Both anterior and posterior approaches are recommended for multiple cervical myelopathy with comparable outcomes. DM and age was observed as the independent predictor for functional outcome, while, gender and level of disease got less significant predictive value.
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