ABSTRACT Soft-tissue sarcomas (STS) are a rare, and comprise a relatively heterogeneous group of malignant tumors arising from mesenchymal tissue. STS can affect any age group. In order to provide patients suffering from STS, with a functional extremity without local tumor relapse, treatment decisions must involve a multidisciplinary team decision-making approach. We conducted a retrospective, descriptive study, of 43 cases of soft tissue sarcoma, collected between January 2013 and December 2018, in the department of Radiation-Oncology of the Oncology and hematology hospital of Mohammed VI University Teaching Hospital. With this study we aimed to report the epidemiological, clinical, histological, therapeutic and evolutionary characteristics of soft tissue sarcomas in the Radiation-Oncology department, and to define the factors influencing patient survival in order to improve the quality of care. The items collected were: epidemiological, clinical, histological, radiological, and therapeutic. Univariate and then multivariate analyzes were performed looking for factors influencing 2-year survival. During the study period, we collected 43 cases, 22 Men and 21 Women, the average age was 45.23 years (Extreme = 11-78 years). The tumor was deep in 73% percent of the cases, and the lower limbs were the most affected (65%) especially in the thigh. The predominant histological type was Liposarcoma in 16 cases (37.20%). The tumor stage was localized in 35 cases (81.39%), metastatic in 8 cases (18.60%). Thirty-five tumors were treated with surgery, including 31 cases (88.57%) of conservative surgery and 4 cases (11.42%) of radical surgery. Radiotherapy was performed in 33 patients, and chemotherapy in 24 patients. Follow-up monitoring has detected 5 cases (28%) of local recurrence, and 13 other cases (72%) of distant metastases. In univariate analysis the prognostic factors were age (p = 0.03) and tumor stage (p = 0.09). In our study, radiation therapy is an integral part of the ......
ABSTRACT Scaphoid dislocation is an uncommon entity of the carpal injuries that has been rarely reported in the literature. We report a case of a 41-year-old right-handed male who presented with a partial palmar scaphoid dislocation following a motor vehicle accident. Closed reduction was successfully performed and an immobilization by a short arm thumb cast has been maintained for 6 weeks. The last follow-up X-rays showed no evidence of redislocation, malunion or avascular necrosis. Our patient returned to his daily activities without any limitations. This case report emphasizes the importance of early diagnosis and orthopedic treatment for improved prognosis.
ABSTRACT The incidence of fractures of the upper extremity of the femur continues to increase as the population ages. Dynamic hip screw (DHS) is the treatment of choice for stable fractures. We report the case of an 80-year-old man with no notable pathological history presenting with a pertrochanteric fracture. Intraoperatively, the cephalic screw migrated unexpectedly into the pelvis. Several attempts were made to remove it, but the screw had penetrated deep into the pelvis, making removal impossible through the femoral neck. An emergency abdominal CT scan was performed showing that the screw had penetrated into the bladder. The urological surgeon was called in to remove the screw via a medial abdominal approach, which was fnally removed without any further complications. Intravesical migration of a DHS screw is a rare complication. Compliance with the DHS surgical technique, especially in very old osteoporotic patients, can avoid this complication.
ABSTRACT Tibial plateau fractures are articular fractures that must benefit from anatomical reduction to avoid the occurrence of complications, a source of serious functional sequelae. Their management has become largely surgical. We report a retrospective study of 100 tibial plateau fractures treated surgically between 2012 and 2018. The objectives were to study the epidemiological characteristics of tibial plateau fractures, to evaluate and compare the clinical and radiological results, in the short and long term, of different techniques for the surgical treatment of tibial plateau fractures. The average age of our patients was 45 years old. The male sex was affected in 66% with a sex ratio of 1.94. The etiologies were dominated by domestic accidents in 52% of cases, followed by public voting accidents (47%). The fracture was open in 3 cases. We adopted the classifications of DUPARC and FICAT and of SCHATZKER, thus the patients were classified: 30 cases of unituberosity fractures, 41 cases of spinotuberosity fractures and 29 cases of bituberosity fractures. Stabilization was provided by a screwed plate in 62 cases and by screwing in 32 cases, 26 of which were percutaneous. Only 1 patient had stabilization with a HOFFMAN-type external fixator for an open CAUCHOIX II fracture. 5 patients had an ILIZAROV type external fixator. Autologous corticocancellous bone grafting was performed in 12 cases. According to the criteria of HOLH AND LUCK, the anatomical results were satisfactory in 77% of cases. According to the criteria of MERLE AUBIGNE and MAZAS, the functional results were satisfactory in 82% of cases. In the light of our results and a review of the literature, it appears that the prognosis of these fractures depends on the type of fracture, the degree of comminution, the quality of the reduction, the patient's age, the time to treatment, meniscal and ligament lesions, type of surgical treatment and quality of rehabilitation.
ABSTRACT Epiphyseal detachment of the greater trochanter is a rare entity. Femoral head necrosis is the most dreaded complication. We report the case of a displaced Salter I epiphyseal detachment in a young high-level athlete who resumed his sports activities after synthesis by bracing.
ABSTRACT The problem of extravasations has become crucial in radiology and has important medico-legal implications. Treatment of contrast product extravasations should be immediate. Ionic products with high osmolar contrast should also be definitively abolished from medical practice given the risk associated with their major hyperosmolality. The severity of the lesions is therefore a function of two essential factors: the osmolarity of the contrast product and therefore in particular its concentration and the extravasated volume and therefore the injection rate.
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Mst. Tanzina Islam
Nursing Instructor, Naogaon Nursing Institute, Naogaon, Rajshahi, Bangladesh
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