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   Table of Contents - Current issue
January-June 2021
Volume 20 | Issue 1
Page Nos. 1-25

Online since Tuesday, April 13, 2021

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Brainstem vertigo: A brainstorming clinical entity for a clinician p. 1
Santosh Kumar Swain, Ranita Sahana
Stroke at the brain stem and cerebellum may cause sudden vestibular syndromem and isolated audiovestibular loss can herald impeding for infarction at the anterior inferior cerebellar artery territory. Patients complaining sudden isolated dizziness or vertigo are higher chance for the stroke than the general population. Proper bedside assessment of the patient is superior to the imaging such as magnetic resonance imaging for detecting the central cause. Misdiagnosis of the stroke in patient of brain stem vertigo leads to significant morbidity and mortality. The overdiagnosis of this clinical entity will cause unnecessary costly workups and medical treatment. It is important for a clinician to differentiate brain stem vertigo with isolated dizziness or vertigo from the benign disorders of the labyrinth as the treatment strategy and prognosis are different in these two situations. Bedside clinical indicators are often helpful to identify the central pathology, and so neuroimaging should be advised accordingly. This review article focuses on the epidemiology, pathophysiology, clinical presentations, and current management of the brain stem vertigo. This article will surely increase awareness among the clinicians for accurate diagnosis and treatment of the brain stem vertigo.
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Comparison between stool antigen test and urea breath test for diagnosing of Helicobacter pylori infection among Children in Sulaymaniyah City p. 6
Adnan Mohammed Hassan, Hamza Hama Ali Faraj, Hayder Fakhir Mohammad
Objectives: Due to increasing incidence of Helicobacter pylori infections among children, it is important to understand which diagnostic test among the noninvasive tests is more accurate, specific, and sensitive. Methodology: Forty-five children who underwent osophagogastroduodenoscopy by the same pediatric gastroenterologist, with Urea Breath Test (UBT) and Stool Antigen Test (SAT); their data were analyzed by retrospective study (2013–2019) to make a comparison between UBT and SAT (Specificity, Sensitivity, and Accuracy) using biopsy finding (histopathological finding) as confirmatory tool for diagnosis. Patients were selected according to their clinical presentations and inclusion criteria in this study are: (pediatric age group, have clinical presentation of H. pylori infection, full information in history, clinical examination, and tests). Patients with incomplete information were excluded. Results: Male (75.56%) more common than female (24.44%), abdominal pain (53.3%) is the major presentation followed by hematemesis (20%), UBT is more influenced by demographic characteristics than other tests, UBT has a statistical significant correlation with result of biopsy, also it is more accurate and more sensitive than SAT, but they share same positive predictive value and same specificity. Conclusions: UBT more preferable than SAT specially in children above 6-year-old.
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Clinical and pathological examination of jaw masses: Retrospective analysis of 69 cases p. 12
Sedat Aydin, Mehmet Gökhan Demir, Hacer Baran
Introductıon: The aim of this study was to retrospectively evaluate the clinicopathological features of the patients who presented with a mass in the jaw. Materıals and Methods: Clinical files and histopathological records of 69 patients who presented to our clinic with complaints of swelling or mass in the upper or lower jaw between 2010 and 2018 were analyzed retrospectively. Results: Of the cysts and tumoral lesions in patients, 50.7% (35/69) were located in the maxilla and 49.3% (34/69) were located in the mandible. 23 (32.8%) odontogenic cysts, 11 (15,7%) non-odontogenic cysts, 15 (21.4%) odontogenic tumors, 12 (17,4%) local metastases from adjacent tissues to maxilla and mandible, 5 (7.1%) other distant metastases. Among the odontogenic cysts, the most common radicular cysts were 39.13% (10/23), the second had dentigerous cyst 34.78% (8/23). In our 11 patients with non-odontogenic cysts, only nasoalveolar cysts were observed. The distribution of odontogenic tumors are; 40% (6/15) odontoma, 26.6% (4/15) giant cell reparative granuloma, 20% (3/15) ameloblastoma, 6.6% (1/15) rates of cementoma and odontogenic fibroma. Conclusıon: When the etiologic causes of the patients who have complaints of mass in the jaw are examined, we can encounter many different pathologies. Although odontogenic and non-odontogenic cysts are the most common benign masses, we should consider the masses that metastasize to this region and the primary tumors originating from this region.
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Differentiation of typical and atypical meningiomas using magnetic resonance imaging p. 17
Imran Nazir, Suhail Rafiq, Mohammad Naseed, Musaib Ahmad Dar, Feroze Shaheen
Background: Meningiomas are the most common intracranial neoplasms. They are usually homogeneously enhancing extraaxial masses. However, 10% of meningiomas are atypical with different imaging appearance. Distinguishing typical from atypical meningiomas on imaging is highly important in surgical and treatment planning. Materials and Methods: Our study was a retrospective one comprising twenty cases each of pathologically proven typical and atypical meningiomas excluding enplaque lesions. Magnetic resonance images were reviewed with each of the lesions showed as dural-based enhancing mass. Individual features analyzed were age, gender, maximum size, location, signal characteristics on T1, T2 weighted, susceptibility weighted imaging , diffusion-weighted, apparent diffusion coefficient, contrast-enhanced T1, interface with adjacent brain tissue, signal changes in adjacent brain tissue, and changes in overlying bone. Aim: The aim of the study is to retrospectively assess the magnetic resonance imaging (MRI) features of pathologically proven typical and atypical meningiomas. Results: Magnetic resonance features such as diffusion restriction, bony changes in form of destruction, indistinct interface with brain parenchyma, heterogeneous postcontrast enhancement, and edematous changes >6 mm thick in adjacent brain parenchyma were in favor of atypical meningioma. Conclusion: MRI has the ability to differentiate typical and atypical meningiomas based on imaging appearance which is important in surgical and treatment planning.
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World's hunger and obesity both on the rise: Time to intervene p. 21
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
In general, the public health concerns of obesity and hunger appears different, but in reality, the root cause of these problems is overlapping to a great extent. The findings of studies have indicated that childhood obesity and food insecurity can coexist, while in some children and youths, food insecurity has been linked with more risk of development of obesity. Considering the fact that a large section of human population is vulnerable to the threat of food insecurity, it is the need of the hour to take specific interventions to bridge the existing challenges. As the problem has deep roots within the existing system, the first and foremost thing will be to rope in all the concerned stakeholders and plan for a holistic approach. As maintenance of nutrition and ensuring adequate supply of food commodities is an integral aspect of elements of primary health care, the national government should design policies to warrant equitable distribution of food commodities. To conclude, the twin problem of hunger and obesity has demonstrated a significant rise in the different parts of the world. It is of utmost importance to acknowledge the problem as a public health priority and respond to the same in a concerted and organized manner.
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A dental professional's personal experience as an author: Innovational and educational approach p. 23
Thorakkal Shamim
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Foliate papillitis masquerading as squamous cell carcinoma in clinical presentation p. 25
Thorakkal Shamim, Koyakkunjakath Padinhare Ottayil Shabeer
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