Hydatid cyst of the quadrigeminal cistern: A case report for unusual location with literature review

Intracranial hydatid cyst involves supratentorial area and mainly affecting the middle cerebral artery territory with the predilection of the partial lobe. It can be single - which is the most common - or multiple up to 35 cysts. They tend to be huge at the time of symptomatic presentation especially when they are presented as a solitary lesion with a slow growth rate around 1.5 cm/year, however, it is variable and it can be up to 10 cm/year. Surgical treatment is mandatory for all patients once the correct diagnosis is made, except for patients with multiple organ involvement in poor general conditions and deep-located cysts. The existence of hydatidosis in the cisternal spaces must not be neglected given the capacity of E. granulosus larvae to disseminate via the CSF. In this case report; two and half years’ male child presented with a history of 2 attacks of generalized seizure for the last 72 hours with the head circumference at the upper normal limit for his age. This paper presents the first case report demonstrating a primary single hydatid cyst located in the quadrigeminal cistern in a child. We concluded that in spite of the feasibility of the imaging and the high suspension of cerebral hydatid cyst, still, the reports show more locations which can be described as unusual although for a head to toe suspected distribution of hydatid disease is already understood. An eminent medical and surgical (if indicated) treatment of the primary cerebral hydatid cyst are always effective and recommended

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially