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Abstract Introduction The efficacy of sentinel node biopsy in early stage oral cancer is well established. Its evolving role can be reinforced by further studies. Objective Analyzing the predictability of the levels of echelon nodes for various oral cavity tumor subsites on sentinel node biopsy. Methods A prospective study of 20 patients with stage I/II oral squamous cell carcinoma who underwent sentinel node biopsy-guided neck dissection between January 2017 and 2018 at our institute. The procedure included radiotracer injection, imaging (lymphoscintigraphy, single photon emission computed tomography-computed tomography), and gamma probe application. Sentinel node detection on imaging and gamma probe were compared. Results Out of 20 patients, 13 (65%) had carcinoma of the tongue, 6 (30%) had buccal mucosa carcinoma, and 1 (5%) had retromolar trigone carcinoma. Themean age of the patients was 52.3 years. A total of 13 (65%) patients were male, and 7 (35%) were female. The sentinel node identification rates with imaging and gamma probe were of 70% and 100% respectively. In tongue and retromolar trigone primaries, the most common first-echelon nodes in both modalities were levels IIA and IB respectively. For buccal mucosa primaries, first-echelon nodes were detected only with the gamma probe, which was level IB. On imaging, second-echelon nodes were detected only for tongue primaries, and had equivalent incidence of levels II, III, and IV. On the gamma probe, level IIA, followed by III, and IV for the tongue, and level IIA were the most common second-echelon nodes for the buccal mucosa. Third-echelon nodes were detected only with the gamma probe for tongue carcinoma at level IV. Conclusion The combined use of imaging and gamma probe provides the best results, with high identification rate and predictability of echelon levels.
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Background: Majority of poorly functioning kidney (PFK) due to primary ureteropelvic junction obstructions (UPJO) in young adult have potential to recover after an attempted percutaneous nephrostomy (PCN). The split renal function measured by nuclear renal scan may not be sufficient enough to predict recovery of such kidney. Therefore, this study was undertaken to determine the functional recovery and potential salvageability of PFK due UPJO. Objective of the study was to evaluate safety and efficacy of PCN in adult patients with severe hydronephrosis due to PUJO.Methods: A total of 25 (10 male and 15 female) young adult patients of severe hydronephrosis due to PUJO and SRF<20% underwent PCN procedures. Only, those who had significant improvement in their SRF ≥10% and developed PCN output ≥400 ml/day underwent Anderson-Hyenas pyeloplasty and rest underwent nephrectomy.Results: Both male and female young patients had significantly improvement after 6 weeks of PCN, their mean pre-PCN SRF changed from 16.30% and 12.27% to became 28.10±08.41% and 18.53±09.89%, respectively. Those with age <30 years improved most with ≥10% increase in the mean SRF and in 72% patients average PCN output increased from 279.80±93.90 ml/day to 445.20±160.341 ml/day at 6 weeks period. Overall, the patients with average PCN output ≥400 ml/day had a mean improvement of 10.33±05.48% in SRF. However, 5(20%) developed haematuria, 8% fever, 16% displaced PCN tip with no major puncture site bleed.Conclusions: The trial of PCN before definite surgery in young adult patients with poorly functioning kidney due to UPJO not only predicts renal renal function recovery but also prevent unwarranted renal loss.
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This record review of 82 children with Down Syndrome (DS) between April 2004 and March 2014 who had thyroid dysfunction, showed that majority (76, 92.6%) had subclinical hypothyroidism. Of the 60 patients who underwent radionuclide scan, 63.3% had a normal gland; the rest exhibited only impaired tracer uptake. Ultrasonograms done in 20 patients showed reduction of thyroid gland size in 3 (15%) patients only.
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Background & objectives: Information on gastrointestinal manifestations and then response after curative parathyroid surgery is scarce in symptomatic primary hyperparathyroidism (PHPT). This study was carried out to analyse gastrointestinal manifestations in patients with PHPT and their associations with biochemical parameters. Methods: This retrospective study included 153 patients with symptomatic primary hyperparathyroidism (PHPT). The signs and symptoms pertaining to gastrointestinal system were analyzed. The difference of symptoms between men and women and difference in biochemical parameters in presence of different symptoms were evaluated. The relationship between serum calcium, phosphate and parathyroid hormone (PTH) levels with presence of gallstone and pancreatitis was also studied. Result: Of the 153 patients, 46 (30%) were men. The mean age was 39.2 ± 13.9 yr. Nearly 80 per cent of PHPT patients had at least one symptom/ sign related to gastrointestinal system. The most common gastrointestinal manifestations were abdominal pain 66 (43%), constipation 55 (36%), and nausea/or vomiting 46 (30%). Nearly one-fourth 34 (22%) of patients had a history of either gallstone disease or cholecystectomy or both. The prevalence of gallstone disease was higher in women (P<0.05). Imaging and biochemical evidence of pancreatitis was found in 27 (18%) patients. Pancreatitis was more common in men compared to women (P<0.05) despite the higher prevalence of gallstones in women. Serum calcium, phosphate or PTH levels were not associated with high risk for gallstone disease, however, serum calcium (P<0.05) was associated with 1.3 times higher risk of developing pancreatitis. In majority of patients, gastrointestinal manifestations resolved within three months of curative parathyroidectomy. Except two patients, none had recurrence of pancreatitis. Interpretation & conclusions: The study revealed that the gastrointestinal symptoms were common in patients with symptomatic PHPT. There was not much gender difference in gastrointestinal symptoms except higher occurrence of gallstones in women and pancreatitis in men. There was no difference in biochemical profile between those who had and did not have gastrointestinal symptoms.
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We report a 24-year-old woman with corrosive poisoning who was subjected to pertechnetate scintigraphy to evaluate gastric injury. Fusion imaging (SPECT-CT) provided valuable information regarding viability of gastric mucosa, and it helped guide appropriate management.
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Infantile cortical hyperostosis (Caffey disease) is characterized by radiological evidence of cortical hyperostosis, soft tissue swellings, fever and irritability. We report a case of Caffey disease highlighting its presentation as pyrexia of unknown origin, appearance on radionuclide bone scintigraphy and our unsatisfactory experience of treating it with Ibuprofen, a prostaglandin inhibitor.