Spectrum of ovarian tumors: Histopathological study of 218 cases

Ovarian tumors are a group of neoplasms that have diverse spectrum of features according to the particular tumor entity. Ovarian cancer is the leading cause of death in females. The aim of this study is to determine the frequency of ovarian tumors and its distribution according to cell of origin and age group. This is a retrospective study of all cases of ovarian tumors collected during a period of 9 years from the Histopathology Department of AI-Gamhuria Teaching Hospital from 1993-1996 and Ibn Sina laboratory in Aden Governorate from 2009- 2013. The tumors are grouped according to the nature of tumor whether benign, borderline or malignant, and according to cell of origin and age group. Benign tumors are the most frequent [86.7%], and malignant are less [13.3%]. The total surface epithelial tumors are 63.7%, benign serous tumors are the most common [44%], followed by mucinous tumors [9.6%], serous cystadenocarcinoma [2.8%], mucinous cystadenocarcinoma [1.8%], serous cystadenoma borderline [1.4%], and endometrioid adenocarcinoma [1.4%]. The least frequent tumors are mucinous cystadenoma borderline and poorly differentiated carcinoma at 0.9% each. Tumors derived from sex cord stromal tissue as benign fibroma and thecoma comprise 5%, while malignant tumors are granulosa cell tumor [1.4%] and androblastoma moderately differentiated [0.5%]. Tumors derived from germ cell as benign cystic teratoma are 26.6% while malignant tumors were dysgerminoma [0.9%] and malignant teratoma [0.5%]. Benign tumors outnumber the malignant tumors. Surface epithelial tumors are the most common class of tumors. Bilateral tumors are not frequent. Thehigli death rates are due to advanced malignancy during the time of diagnosis from the majority of cases

Native valve candida endocarditis complicating pregnancy after abdominal surgery

Candida endocarditis is an emerging infectious disease, usually involving patients with intravascular prosthetic devices, and associated with substantial morbidity and mortality. A 28?year?old primigravida at 32 weeks of gestation was admitted with low?grade fever and lower abdominal pain for 2 weeks. She had undergone open appendicectomy 2 months before admission. Echocardiogram showed a pedunculated 24 mm × 21 mm mass attached to the undersurface of anterior mitral leaflet near the tip and moderate mitral regurgitation. Repeated blood cultures showed growth of nonalbicans candida. She was immediately started on liposomal amphotericin and was taken up for surgery, but despite all efforts she succumbed to her illness

Management of empyema thoracis-Peshawar experience of 450 patients

To observe the various clinical presentations of empyema thoracis and evaluate its management and outcome. An observational descriptive study. Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from June 2001 to June 2004. Clinical record of 450 patients who underwent various surgical procedures during 3 years were retrospectively analyzed. Detailed scrutiny of record was carried out to analyze the clinical presentation; various surgical procedures and outcome. There were 270 [60%] male and 180 [40%] female patients. Majority of the patients 310 [68.8%] were in the age range of 20 - 40 years. Common presentation was fever [62%]; cough [26%] and chest pain [11%]. The duration of symptoms was less than 8 weeks in 57% and more than 8 weeks in 42% cases. Common etiologies were pneumonia [31%], post tuberculous [37.7%], traumatic [24%] and iatrogenic [6.6%]. Tube thoracostomy was the initial l ine of management in 200 patients. Decortication was required in 200 patients while 50 patients needed thoracoplasty to obliterate persistent residual pleural space. The mortality was 4% [18/450]. Thirty one [7%] had wound infection, air leak in 18 [4%], wound dehiscence in 9 [2%] and septicemia in 14 [3%] cases. Depending upon the stage, various surgical options exist for the treatment of thoracic empyema. Selection of the most appropriate procedure must be individualized but the basic principle is evacuation of pus from the pleural space, appropriate antibiotic therapy and obliteration of empyema cavity

Management of difficult intubation in a patient with ankylosing spondylitis - A case report

We describe a case of difficult intubation in a patient suffering from ankylosing spondylitis undergoing total hip replacement surgery. The anesthetic management of 42 years old patient with difficult airway is discussed. Failure of epidural anesthesia procedure necessitated general anesthesia. The problems of performing awake fibreoptic intubation and other alternative techniques to secure the airway are described. Cervical spine involvement in ankylosing spondylitis is of great concern for the anesthetist. Longstanding progressive course of this disease leads to fibrosis, ossification and ankylosis of entire spine and sacroiliac joints. Cervical spine mobility is decreased and in severe cases total fixity occurs in a flexed position. Patient may also have atlanto-occipital and temporo-mandibular joint involvement as well. Cricoarytenoid cartilages involvement may result in upper airway compromise. Furthermore cervical spine vertebrae are prone to fractures, especially on hyperextension and may lead to spinal cord transection and quadriplegia. In this case report we describe the airway management of such patient with fixed rigidity of cervical spine and thoracolumbar kyphosis