Barefootharper4697

INTRODUCTION Cervicothoracic spinal tuberculosis (CTSTB) is a rare and disabling disease involving the mobile, transitional zone between the lordotic cervical and the kyphotic thoracic spine. Approximately half of those cases involves one or two segments of cervicothoracic vertebrae. We reported a 28-year-old female with tuberculous involvement of fourteen contiguous vertebral segments. PRESENTATION OF CASE A 28-year-old female presented with tuberculous involvement of fourteen contiguous vertebral segments is presented. A series of radiographic and CT scan depicted multiple vertebral body destruction anteriorly, along with facet joint dislocation and mild retrolisthesis of C4-C5 segments. MR images of the cervical region was demonstrated pathologic contrast enhancement on C4 to T7 vertebrae, a total of fourteen contiguous segments. DISCUSSION Of all spinal tuberculosis, CTSTB accounts for only 5%. In addition to its rarity as a site for tuberculosis, the cervicothoracic junction has anatomical and clinical peculiarities, as a reversal of the mobile-lordotic cervical vertebrae to rigid-kyphotic thoracic vertebrae occurs at this location. Most CTSTB involves only two segments; however, in this case, we found a very extensive case wherein there were fourteen damaged segments. CONCLUSIONS Our report demonstrates one of the longest involvement of extensive contiguous CTSTB who was treated with one-stage posterior-only approach. However, as this is only a report of one case, further studies are required to investigate the safety and efficacy of such approach for treating extensive CTSTB. PURPOSE Testicular torsion is an urological emergency and an important cause of male infertility. Recent studies have shown that not only ischemia, but also the restoration of blood flow creates a deleterious situation for the testis. The goal of this work was to evaluate the role of systemic epithelial growth factor application and its association with decompressive fasciotomy in tissue recovery of the testes undergoing the torsion of the spermatic cord. METHOD Torsion of the spermatic cord was induced in 40 Wistar pubescent testes for a period of 4 h. At the time of detorsion systemic epithelial growth factor and decompressive fasciotomy were applied as treatment alternatives. After 21 days, the testicles were examined macro and microscopically. RESULTS The variables evaluated were weight, testicular volume and the degree of histological alterations by optical microscopy. The rate of healing of testicular torsion showed significant difference between the groups. It was noted that in terms of testicular weight and volume the animals treated with systemic epithelial growth factor resembled the control group and had a better histological classification than the other groups. The mean Johnsen score was significantly higher in the group treated with systemic growth factor and decompressive testicular fasciotomy than in the group without fasciotomy. No significant changes were noted in the contralateral testes. CONCLUSION Although decompressive testicular fasciotomy improved spermatogenesis, recovery was limited. Systemic epithelial growth factor administered in combination with decompressive testicular fasciotomy was more effective for spermatogenesis than fasciotomy alone. Administering epithelial growth factor after reperfusion might have the potential to decrease long-term histologic damage after testicular torsion. The combination of decompressive testicular fasciotomy and epithelial growth factor had a synergistic effect on the healing of these testes. OBJECTIVE An early start of toilet training, which is related to a younger age of acquiring full bladder control, can generate important health advantages. Children display different 'elimination signals' related to voiding or defaecation. The aim of this systematic review is to map these 'elimination signals' in young, healthy children aged 0-4 years. METHOD The systematic literature search was performed in two databases and was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement). RESULTS Two main distinctions in elimination signals were made. The first could be classified as visual, auditory and tactile, most frequently involving a change in facial expression, often combined with body movements and verbal expressions such as a short cry or grunting. Secondly significant changes in heart rate, respiratory frequency or EEG frequency could be defined as 'clinically assessed elimination signals'. CONCLUSION Different 'elimination signals' could be detected in healthy children while voiding or defaecating and should be observed when initiating toilet training. Detection of noticeable visual, auditory and tactile signals will facilitate and shorten this process. INTRODUCTION Delayed cortical transit time (CTT) has been recently studied and proposed as a parameter that can predict the need for surgery in children with pelviureteric junction obstruction (PUJO). AIM The aim of this study was to study the change in CTT, after surgery, in children with PUJO and to correlate CTT with intrapelvic pressure of the kidney. MATERIAL AND METHODS A prospective study was performed, and all children who underwent pyeloplasty from January 2016 to December 2017 were included. Pre-operative and postoperative renal ultrasonography and Technetium-99m mercaptoacetyltriglycerine Tc-MAG3 renal scintigraphy were performed. Cortical transit time was measured by a visual method by two different observers. The renal intrapelvic pressure of the kidney was also measured during surgery after giving a diuretic to replicate the diuresis induced during the renal scan. The correlation was studied between the pre-operative CTT and intrapelvic pressures and between the pre-operative CTT and the renal fand CTT. The significant negative correlation between CTT and renal function also emphasizes the need to take the renal function into consideration before interpreting and using the absolute value of CTT for guiding treatment. CONCLUSION Cortical transit time assessment by the visual method is a useful parameter in the management of children with PUJO. There is a significant improvement in CTT after surgery. Multiple hereditary exostoses (MHE) and enchondromatosis are rare multifocal benign disorders usually causing skeletal deformities appearing already in childhood. MHE is a dominant autosomal inherited disorder characterized by multiple osteochondromas (exostoses) growing outward from the metaphyses of long bones as well as from flat bones. They may cause reduced joint motion and pain due to tendon, muscle, and nerve compression. Enchondromatosis (or Ollier's disease) is a noninherited disorder characterized by the presence of multiple intraosseous enchondromas located asymmetrically in the skeleton and with a wide variation regarding location, size, and number ranging from the involvement of a single hand to the involvement of the entire skeleton. It can occur together with soft-tissue hemangiomas in Maffucci's syndrome. Clinical problems caused by the enchondromas are mainly related to skeletal deformities causing malalignment and restricted motion of joint. In both disorders, there is a risk of malignant transformation as well as secondary degenerative joint changes. Congenital myasthenic syndrome (CMS) caused by mutations in MUSK is very rare and the genotype-phenotype relationship in MUSK related CMS is still unclear. Here we identified two patients carrying a homozygous hotspot mutation, c.308A > G in MUSK from a Chinese family. Both of them presented predominant bulbar weakness and atrophy of bilateral temporalis and masticatory muscles. To address the phenotype-genotype relationship, a total of 27 MUSK related CMS patients were reviewed. Patients with nonsense, frameshift or splicing mutations showed earlier onset (10/13 vs 2/14 neonatal onset, p = 0.0018) and more occurrence of vocal cord paralysis or stridor (8/13 vs 0/14, p = 0.0006), indicating a more severe phenotype. Comparing with patients carrying other missense mutations, the four patients carrying a homozygous c.308A > G mutation showed the female predominance (4/10 vs 4/4) and dramatic exacerbation after emotional or physiological stresses (2/10 vs 4/4) like pregnancy, menstrual periods and infection. All these indicated a genotype-phenotype relationship in MUSK-related CMS. The present prospective cohort study evaluates the effect of three-dimensional (3-D) endoscopy on outcome in transphenoidal endoscopic surgery of pituitary adenomas compared to conventional two-dimensional (2-D) endoscopy. Prospective data was collected from patients undergoing endoscopic surgery for pituitary adenomas before and after the introduction of 3-D endoscopy. Patients, grouped by having 2-D or 3-D endoscopic surgery, were compared in regard to procedure time, intraoperative blood loss, complications, hospital stay, grade of resection and quality of life (QoL). Twenty-six patients having surgery with 2-D endoscopy were compared with 29 patients having surgery with 3-D endoscope. Only primary procedures were included. There were no significant differences in baseline characteristics between the two groups. No statistically significant differences in outcome were noted with 3-D endoscopy. Procedure time, complication rate, hospital stay, rate of gross total resection and post-operative QoL were unaffected by surgical technique though there were non-significant increases in new pituitary insufficiency with 3-D endoscopy and diabetes insipidus with 2-D endoscopy. This prospective cohort study fails to show obvious outcome advantages with 3-D endoscopy in pituitary surgery using basic parameters including post-operative QoL. To our knowledge this is the first prospective study published on the matter, thus corroborating results from previous retrospective studies with similar results on 3-D neuroendoscopy and 3-D endoscopy in general. The main advantage of increased depth perception is more likely found in more complex extended transphenoidal skull base procedure. INDIA- As for reported in 360 COVID-19 cases (till March 22, 2020), seven people were died, and 23 people were treated successfully.1 This virus can easily affect who having respiratory problem and especially who all have been aged older than sixty. Most of the affected peoples had reached India from different part of the world, as like of carrier. Owing to this, India made several precautionary measures to mitigate/neglect the disease in beginning stage, however, the denser population of country will not be simple to control the same for long time (community spread), if government will not incorporate the visionary strategies. Since attacked several nations have been worried mostly for their people life (health), despite that developing country like India with huge population should consider about the livelihood (for Below Poverty Line (BPL) people), equally with the life. This article will give insights to make effective strategy to culminate the world threat COVID-19 in India. V.The first imported case of XDR typhoid fever in Taiwan contracted with a bacterial strain, which was most closely related to the blaCTX-M-15-carrying strains linked to Pakistan. Meropenem, in combination with an antimicrobial with intracellular activity against Salmonella, should be used for the treatment of XDR typhoid fever. V.