Askin's Tumor: A Dual Case Study

Askin's tumor is a rare tumor arising from the chest wall. It is a subset of Ewing sarcoma characterized histologically by the presence of small round blue cells. It is a highly malignant tumor with guarded prognosis, which is dependent upon the extension of tumor at the time of diagnosis. A dual paper of Askin's tumors in young boys is being presented here

The risk associated with iron deficiency anemia for simple febrile seizures in children: A case–control study

Background: Studies have postulated iron deficiency state to be a risk factor for febrile convulsions as it changes the threshold of neurons excitation which may lower the threshold for seizures in children. However, many other studies have reported a protective role for febrile convulsions by increasing the neuronal threshold. Objective: The objective of the study was to evaluate the association of iron deficiency anemia (IDA) as a risk factor for the occurrence of simple febrile seizures (FS) in children. Material and Methods: A case-control study was conducted in a tertiary teaching hospital from September 2015 to February 2017. A total of 240 cases with fever and simple FS were enrolled according to the inclusion and exclusion criteria. Another 100 cases of children without seizure but with short duration of fever were enrolled as controls. Blood samples were then taken for assessing the hematological indices of these patients. The results were statistically analyzed. Results: Incidence of IDA was found to be more in children with simple FS than controls but was not statistically significant (p=0.35). Furthermore, no association was found with other hematological indices with FS occurrence. Conclusion: We could not find any association of IDA as a risk factor for a simple FS

Benefit of linking hospital resource information and patient-level stroke registry data

Variation in the delivery of evidence-based care affects outcomes for patients with stroke. A range of hospital (organizational), patient, and clinical factors can affect care delivery. Clinical registries are widely used to monitor stroke care and guide quality improvement efforts within hospitals. However, hospital features are rarely collected. We aimed to explore the influence of hospital resources for stroke, in metropolitan and regional/rural hospitals, on the provision of evidence-based patient care and outcomes. The 2017 National Audit organizational survey (Australia) was linked to patient-level data from the Australian Stroke Clinical Registry (2016–2017 admissions). Regression models were used to assess the associations between hospital resources (based on the 2015 Australian National Acute Stroke Services Framework) and patient care (reflective of national guideline recommendations), as well as 90–180-day readmissions and health-related quality of life. Models were adjusted for patient factors, including the severity of stroke. Fifty-two out of 127 hospitals with organizational survey data were merged with 22 832 Australian Stroke Clinical Registry patients with an admission for a first-ever stroke or transient ischaemic attack (median age 75 years, 55% male, and 66% ischaemic). In metropolitan hospitals (n = 42, 20 977 patients, 1701 thrombolyzed, and 2395 readmitted between 90 and 180 days post stroke), a faster median door-to-needle time for thrombolysis was associated with ≥500 annual stroke admissions [−15.9 minutes, 95% confidence interval (CI) −27.2, −4.7], annual thrombolysis >20 patients (−20.2 minutes, 95% CI −32.0, −8.3), and having specialist stroke staff (dedicated medical lead and stroke coordinator; −12.7 minutes, 95% CI −25.0, −0.4). A reduced likelihood of all-cause readmissions between 90 and 180 days was evident in metropolitan hospitals using care pathways for stroke management (odds ratio 0.82, 95% CI 0.67–0.99). In regional/rural hospitals (n = 10, 1855 patients), being discharged with a care plan was also associated with the use of stroke clinical pathways (odds ratio 3.58, 95% CI 1.45–8.82). No specific hospital resources influenced 90–180-day health-related quality of life. Relevant to all international registries, integrating information about hospital resources with clinical registry data provides greater insights into factors that influence evidence-based care

A Case of Two Abdominal Gossypibomas in a Patient: A Rare Case Report

Gossypiboma is a rare condition caused by retention of a foreign body, most commonly surgical sponge following any surgical procedure. The patient may be asymptomatic, can present with vague symptoms, or rarely with acute symptoms depending on the location of the foreign body and the complications associated with it; thus it may be difficult to diagnose this condition. A 30-year-old woman presented to our hospital with complaints of lump and mild pain on both sides of the lower abdomen for 3 months following caesarean section which was performed in a rural hospital. Ultrasound and computed tomography findings along with the classical history helped in arriving at the diagnosis of two gossypibomas in lower abdomen, one in each flank which was further confirmed on laparotomy

Test of a Homeopathic Algorithm for COVID-19: the Importance of a Broad Perspective

Abstract Background/Objective Most of the symptoms of coronavirus disease 2019 (COVID-19) are covered by large repertory rubrics and hence many remedies have been proposed as “genus epidemicus”. The aim of this study was to combine the information from various data collections to prepare a COVID-19 Bayesian mini-repertory/an algorithm-based application (app) and test it. Methods In July 2021, 1,161 COVID-19 cases from 100 practitioners globally were combined. These data were used to calculate “condition-confined” likelihood ratios (LRs) for 59 symptoms of COVID-19. Out of these, 35 symptoms of the 11 medicines that had at least 20 cases each were considered. The information was entered in a spreadsheet (algorithm) to calculate combined LRs of specific combinations of symptoms. The algorithm contained the medicines Arsenicum album, Belladonna, Bryonia alba, Camphora, Gelsemium sempervirens, Hepar sulphuris, Mercurius solubilis, Nux vomica, Phosphorus, Pulsatilla and Rhus toxicodendron. To test concordance, the doctors were then invited to re-enter the symptoms of their cases into this algorithm. Results The algorithm was re-tested on 358 cases, and concordance was seen in 288 cases. On analysis of the data, bias was noticed in the Merc group, which was therefore excluded from the algorithm. The remaining 10 medicines, representing 81.8% of all cases, were included in the preparation of the next version of the homeopathic mini-repertory and app. Conclusion The Bayesian mini-repertory and app is based on qualitative clinical experiences of various doctors in COVID-19 and gives indications for specific medicines for common COVID-19 symptoms