Isolated orbital myocysticercosis in a Muslim boy

Orbital cysticercosis is secondary to an infestation by Cysticercus cellulosae, the larval form of Taenia solium. We report a case of isolated orbital myocysticersosis in a four year old non pork eater boy who presented with sign and symptoms suggestive of mass lesion in superior orbit. He was managed with medical line of treatment and showed complete resolution of his symptoms. It becomes important to report this case because of unusual site of the cyst, young age of the patient and to highlight the importance of proper sanitary measures in preventing this disease

Assessing the Burden of Unnecessary Central Venous Catheters in Patients on Medical-Surgical Floors

Project goals: Our project goals are to: a) assess the burden of unnecessary PICCs and other non-tunneled central lines on med-surg units at TJUH and b) understand the underlying reasons behind the problem. In the first phase of our project we conducted an audit of med-surg unit PICCs and other non-tunneled central lines with the goal of obtaining a rough estimate of the number of line days that are unnecessary. SMART AIM By December 31, 2017, the TJUH medical-surgical floors will reduce the number of unnecessary PICC lines by 30%.https://jdc.jefferson.edu/patientsafetyposters/1024/thumbnail.jp

The role of 18F fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in children with rheumatic carditis and chronic rheumatic heart disease

BACKGROUND: We report the use of positron emission tomography (PET) using 18F-FDG for the diagnosis of carditis in children with rheumatic heart disease (RHD). MATERIAL AND METHODS: Thirty-six children aged 6–17 years (seventeen males and nineteen females) with isolated rheumatic significant mitral regurgitation (MR) underwent FDG-PET scanning of the heart after fasting for 6 h within a period of 2 years. They were divided into two groups based on Jones criteria — acute rheumatic carditis and chronic RHD. Age- and gender-matched twelve children who underwent whole body 18F-FDG-PET scan for routine PET scan for oncological evaluation was taken as controls. Nineteen patients had active carditis and 17 were chronic RHD cases. RESULTS: All 12 controls and all 17 cases with chronic RHD with MR showed diffuse uptake pattern. Of the 19 active cases, 14 showed 18F-FDG uptake in the myocardium, 5 did not show any uptake. Thus the finding of no uptake pattern on 18F-FDG-PET scan had a sensitivity of 26% but positive predictive value of 100% for acute carditis cases. This study describes the 18F-FDG-PET uptake pattern in children with RHD and in 12 age-matched control subjects in the fasting state. Those with chronic RHD with MR showed diffuse myocardial uptake pattern similar to that of the control group. Patients with active carditis showed mixed results; the majority showed diffuse uptake pattern. CONCLUSION: In view of its poor sensitivity, 18F-FDG-PET is not recommended as a routine imaging modality for the diagnosis of rheumatic carditis

Late noninvasive evaluation of cardiac performance in mildly symptomatic older patients with Ebstein's anomaly of tricuspid valve: Role of radionuclide imaging

AbstractTen patients 8 to 54 years of age with isolated Ebstein's anomaly of the tricuspid valve were evaluated by electrocardiography, maximal exercise treadmill testing, 24 h electrocardiographs (ECG) monitoring, echocardiography and rest radionuclide imaging of the left ventricle. The patients presented after the 1st year of life and had not undergone surgical intervention. All except one were in functional class II. No patient had preexcitation on the surface ECG, but abnormal tachyarrhythmias or bradyarrhythmias were seen in five patients on 24 h ECG monitoring. Subnormal exercise performance was observed in five patients.Echocardiography demonstrated typical variable tricuspid valve displacement and paradoxic interventricular septal motion. Left ventricular end-diastolic dimensions were normal in all patients, but posterior wall motion was reduced in two. Moderate to severe tricuspid regurgitation with a Doppler jet velocity <2.5 m/s was demonstrated in eight patients. Left ventricular radionuclide scintigraphy revealed a subnormal ejection fraction (<50%) in 5 of 10 patients; these 5 had previously shown suboptimal exercise performance.The two youngest patients (<15 years) had no arrhythmia, normal exercise performance and normal left ventricular ejection fraction. There was no correlation between the degree of tricuspid valve displacement or régurgitation and the presence of rhythm disturbance, exercise performance or radionuclide left ventricular function.Late evaluation of patients with Ebstein's anomaly may demonstrate significant unsuspected abnormalities in cardiac rhythm, exercise performance and left ventricular function. Radionuclide scintigraphy is a useful noninvasive technique for assessing left ventricular dysfunction in these patients

Ocular involvement in diabetic patients attending tertiary care centres of eastern U.P., India: a prospective study

Background: Diabetes mellitus is increasing day by day in developing countries especially in India. It is a main treatable cause of morbidity in eye. Diabetic cataract, neovascular glaucoma and retinopathy are important ocular complications due to diabetes mellitus. The objective was to study the variations in ocular complications in patients of diabetes mellitus.Methods: A prospective study from July 2012 to June 2013 was conducted in RMCH and RC, Kanpur & GSVM Medical College, Kanpur. One hundred one selected diabetic patients who are having abnormal slit lamp and fundus examination were included in this study.Results: In our study it was found that more the duration of diabetes, greater the severity of diabetes. Well controlled diabetics have lesser complications in eyes due to diabetes.Conclusion: Patient’s age, sex, duration and control of diabetes play important role in development and severity of complications in eye due to diabetes mellitus

Prevalence and determinants of hypertension in apparently healthy schoolchildren in India: a multi-center study

Background: Hypertension in children is often under recognized, especially in developing countries. Data from rural areas of developing countries is particularly lacking. Objectives: To study prevalence of hypertension and its determinants in apparently health school children from predominantly rural populations of India. Methods: Apparently healthy schoolchildren (n = 14,957) aged 5–15 years (mean (standard deviation) age 10.8 (2.8) years; 55.5% boys) at four predominantly rural sites in separate states of India were studied. Systolic and diastolic blood pressures were recorded by trained staff in addition to age, gender, height, weight, type of school and season. Waist circumference was also recorded in 12,068 children. Geographic location and type of school (government, government-aided or private) were used to determine socio-economic status. Results: Systolic and/or diastolic hypertension was present in 3443 (23%) children. Systolic hypertension was present in 13.6%, diastolic hypertension in 15.3% and both in 5.9%. Isolated systolic hypertension was present in 7.7% while isolated diastolic hypertension was present in 9.4%. On univariate analysis, age, gender, geographical location, socio-economic status, season and anthropometric parameters (z-scores of height, weight and waist circumference, waist/height ratio and body mass index) were all significantly related to risk of hypertension (p &lt; 0.0001 for each). Similar association was observed with weight group (normal, overweight and obese). Multiple regression analysis showed lower age, female gender, richer socio-economic status, certain geographical locations, higher weight and larger waist circumference to be independently associated with a greater risk of hypertension. Conclusion: There is a high prevalence of hypertension in apparently healthy schoolchildren even in predominantly rural areas of India. Screening and management programs targeted to high risk groups identified may prove cost-effective

Cardiac catheterization in children with pulmonary hypertensive vascular disease:Consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces

Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD.</p

Cardiac catheterization in children with pulmonary hypertensive vascular disease:Consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces

Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD.</p

Cardiac catheterization in children with pulmonary hypertensive vascular disease:Consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces

Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD.</p

Cardiac catheterization in children with pulmonary hypertensive vascular disease:Consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces

Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD.</p