Introduction: Pilocytic astrocytoma is the most common cerebral glioma in pediatric age, preferentially located in the posterior cerebral fossa. Atypical presentations have rarely been described in the literature. Clinical Case: We report a case of pilocytic astrocytoma whose appearance on CT scan is unusual. It concerns a young boy of 9 years old, who presented convulsive seizures since the age of 6 years old, followed by general practitioners with irregular treatment based on gardenal. 2 months ago the seizures became more frequent and this prompted a specialist consultation with the neurologist, after a brain scan he referred the patient to us. The neurological examination was unremarkable today. Brain CT with contrast showed a right parietal lesion. It was a lesion with a double cystic and fleshy component associated with calcifications with heterogeneous enhancement which amputated the posterior horn of the lateral ventricle. The radiological appearance was in favor of a low-grade oligodendroglioma. The patient underwent surgery with complete macroscopic excision of the lesion. Histological examination revealed a pilocytic astrocytoma (grade I). Conclusion: The usual radiological appearance of pilocytic astrocytoma combines a cystic part and a highly contrasting mural nodule. It rarely presents in the form of a supratentorial lesion with calcifications. This form of presentation is rare and can lead to confusion with other gliomas. We can achieve healing for the patient with total excision.

Renal pathologies following viral infections have become an emerging public health problem in both developed and developing countries. Diagnostic criteria are complex. In most cases, they involve correlation between clinical, biological and histological data, with occasional recourse to molecular biology techniques. Several mechanisms are involved in the pathogenesis of virus-related nephropathy, including virus tropism in the kidney, formation of immune complexes in situ or in the bloodstream, direct cytopathogenic effects, and multiple organ failure. The hepatitis C virus is responsible for three main types of kidney disease: membranoproliferative glomerulnephritis, cryoglobulinemia and membranous nephropathy. Hepatitis B virus is associated with membranous nephropathy, membranoproliferative glomerulnethritis, and IgA nephropathy. HIV (human immunodeficiency virus) infection is associated with several glomerular and tubular kidney damage. HIVAN (HIV-associated nephropathy), a specific entity mainly affecting Africans and African-Americans, presents as a rapidly progressive glomerulonephritis rapidly progressing to the terminal stage. Infections secondary to adenovirus, cytomegalovirus, epstein-barr virus, poliomavirus and coronavirus are often responsible for acute or chronic tubulointerstitial nephritis. Treatment is mainly symptomatic, based on nephroprotection measures, rarely combined with antiviral therapy. Prophylaxis with vacci-nation, when available, remains the best means of preventing viral nephropathy.

Pituitary apoplexy (PA) is a rare clinical situation caused by pituitary infarction with or without haemorrhage. Although it is usually spontaneous, dopaminergic agonists (DA) are known to be predisposing factors, particularly Bromocriptine, more rarely Cabergoline. We report the case of a 31-years-old patient with a microprolactinoma who developed acute visual acuity loss due to pituitary apoplexy 5 months after taking Cabergoline. The evolution was marked by a considerable improvement of the visual state. Pituitary apoplexy is a rare situation. Often reported with Bromocriptine, PA can also occur with Cabergoline. Due to the high mortality and morbidity of apoplexy, it should be borne in mind that close monitoring is necessary when treatment with DA is prescribed and the patient should be informed of this risk. Although DA precipitate risk, treatment can be continued for hormonal and anti-tumour remission.

Introduction: Open appendectomy (OA) and laparoscopic appendectomy (LA) are the choices of treatment for acute appendicitis. However, laparoscopic approach is emerging for the benefits it provides, but it also sometimes may has some drawbacks like OA including fistula. Objective: This retrospective study aims to investigate the management of fistula in 50 post appendicectomy fistula patients. Methods: A retrospective study was done at MH Samorita Medical College & Hospital, Hi-Tech Surgicare Hospital & Piles Centre, Savar Specialized Hospital and Lab Zone Hospital Savar, Bangladesh during January 2019 to December 2023 from January 2019 to December 2023, among the patients who had underwent laparoscopic appendicectomy and open appendicectomy. The total study population was 50, among which 33 (66%) patients were in open appendectomy and 17 (34%) were in laparoscopic appendectomy. The patients’ age group included 10 years to 50 years of both male and female patients. P< 0.005 was considered significant in this study. Results: Out of total study population, 33 were from OA (66%) and 17 were from LA (34%) group. Most of the study patients were male, aged 21-30 years age group. Fistulogram found to be the commonly use method to diagnose fistula. Tuberculosis was found to be the frequent cause of post appendicectomy fistula. Conclusion: Post appendicectomy seems to have different outcomes with some adverse impact, fistula is one of them. The present study finds that the chances of post appendicectomy fistula is less in LA group compared to OA. Proper study and better investigation may bring this to null with time.

Background: Over the last 10-15 years, dengue fever (DF) and dengue hemorrhagic fever (DHF) have become the leading causes of hospitalization and death among both children and adult. Carica papaya leaves juice is said to increase platelet count, reduce complication and duration of Hospital stay. Objective: This study aimed to determine the effect of Carica papaya leaf juice on duration of Hospital stay in child patients with DF and DHF. Methods: This randomized controlled trial was conducted among 77 children with DF and DHF. Patients were purposively selected from the inpatient department of Dhaka Shishu hospital from July 2018 to December 2019. Patients were randomly allocated in group A and group B. Group A patients received standard treatment along with a bottle containing C. papaya leaves juice 10 ml single morning dose 15 minutes after breakfast for three consecutive days and group B patients received only standard management as per the National Guideline for Clinical Management of Dengue Syndrome, 2018. Three patients in group A and two patients in group B dropped out from the study. Results: There was no significant difference between the groups regarding age, sex, mean duration, type and severity of fever between the groups (p>.05). In group A, the mean platelet count increased from 105000.00/ mL to 152428.57/mL after 48 hours and it reached to 212228.57/mL at 72hrs. In group B, the mean platelet count initially decreased from 129485.71/ mL to 91114.28/mL after 48 hours and then it increased to 96142.85/mL at 72 hours. There was highly significant statistical difference between group A and group B at 48 hours and at 72 hours regarding mean platelet count as p <0.001. Haematocrit values become significantly normal in group A than group B by 72 hours and p value ˂0.05. There was highly significant statistical difference between group A and group B regarding mean hospital stay as p <0.001. Conclusion: Administration of Carica papaya leaf juice shorten hospitalization in patients with Dengue fever and Dengue haemorrhagic fever.

Objectives: The objective of present study was to develop chitosan-based sustained release Levofloxacin microspheres to reduce the dosing frequency. Materials and Methods: The Levofloxacin -loaded microspheres were prepared by emulsification cross-linking method using glutaraldehyde as cross-linking agent. Accurately weighed quantity of Chitosan was dissolved in 1% (v/v) aqueous acetic acid. Results: The percentage yield of the emulsification cross-linking method was determined to be between 74 and 81.5 percent, and the spherical microspheres had particle sizes ranging from 2 m to 200 m. According to the in vitro dissolution analysis of the improved formulation (F2) (table 7.8), when the medication was enclosed in Chitosan microspheres, 95 percent of the formulation was released after 12 hours, demonstrating that the drug is released from the formulation in a controlled way. Conclusions: The percentage of entrapment effectiveness, particle size, and percentage of drug release were significantly impacted by the drug: polymer ratio and GA volume. According to research using scanning electron microscopy (SEM), microspheres were round and had a smooth surface. Nicorandil-loaded chitosan microsphere formulations released their drugs via fickian diffusion.

Hepatic abscess is a suppurative collection developed in a neoformed hepatic cavity as a result of the invasion and multiplication of micro-organisms. The prognosis depends on early diagnosis and rapid treatment. The aim of the study was to determine the clinical, biological, ultrasound and therapeutic characteristics of liver abscesses in children aged between 1 month and 15 years hospitalised in the Paediatrics Ward of the District Hospital in Commune V, Bamako. This was a retrospective descriptive study which took place from January 2017 to December 2020, i.e. a period of 4 years, and a prospective study from January 2019 to December 2020, including all children aged between 1 and 15 years in whom the diagnosis of liver abscess had been confirmed by liver ultrasound. Out of 2756 children hospitalised during the study period from January 2017 to December 2020, i.e. a période of 4 years, 12 patients were diagnosed with liver abscess, i.e. a frequency of 0.43% or 4 cases/1000 admissions, with a female predominance of 58.3%, i.e. a sex ratio of 0.7. The mean age was 57 ± 34 months, with extremes of 16 and 120 months. The main reason for consultation was abdominal pain associated with fever, accounting for 75% of patients. Pus culture was positive for Staphylococcus Aureus in one patient (8%). Amebic serology was positive in 33% of patients. Ultrasound revealed a predominance of single abscesses located in the right lobe of the liver in 42% of patients. However, 92% of patients were cured, with an average hospital stay of 12 days, ranging from 2 to 19 days. Liver abscesses uncommon in our context, an early diagnosis and management can improve the prognosis.

Background: The ability of the first responder to identify and effectively treat hypovolemic shock will determine whether or not a child with severe volume depletion survives in the emergency room. Although the fundamentals of fluid and electrolyte therapy have been studied for decades, the issue is still difficult to resolve because there is no universally accepted therapeutic care approach. Objectives: This systematic review aims to study the updated management of dehydration and electrolyte disturbance in children and infants. Methods: PubMed, Science Direct, and Google Scholar were systematically searched for relevant literature. Rayyan QRCI was employed throughout this comprehensive process. Results & interpretation: This review included a total of ten studies with 2285 patients, and 883 (38.6%) were males. According to this comprehensive study, home-based therapy and ORS were successful in straightforward instances. Other methods, such as ORS plus Xyloglucan and ORS with honeybee added, were secure and efficient in reducing the frequency of vomiting and diarrhea. The electrolyte balance and rehydration of the patients were improved by diluted apple juice, rehydration treatments, and preferred fluids. However, gelatin tannate proved ineffective for rehydrating the child, although it advised against ever stopping breastfeeding. Drugs like intravenous Metoclopramide and Domperidone demonstrated efficacy for treating pediatric dehydration in the event that ORS failed.

Ovarian cancer, the fifth most common neoplasia in women, presents challenges in diagnosis and treatment, often resulting in poor prognosis due to advanced stage at diagnosis and limited treatment options. Platinum-based chemotherapy and surgery have been the mainstay treatments, but efforts to improve outcomes with additional cytotoxic drugs have yielded mixed results. Angiogenesis plays a crucial role in tumor growth and metastasis, leading to the investigation of bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor (VEGF). Clinical trials have demonstrated its efficacy in delaying disease progression in ovarian cancer. This case report illustrates the successful use of neoadjuvant chemotherapy followed by surgery and maintenance therapy with bevacizumab and olaparib in a patient with advanced ovarian cancer, highlighting the potential benefits of this treatment approach in improving survival outcomes.

Iron-deficiency anemia is very common among patients in gastroenterology. The digestive system plays a key role in the pathophysiology of iron-deficiency. Indeed, digestive causes are one the most fequent etiology. This is why endoscopic evaluation is part of the etiological assessment of iron-deficiency anemia. The aim of this study is to investigate the usefulness of esophagogastroduodenoscopy (EGD) and histopathology in the etiological diagnosis of iron-deficiency anemias. Materials and Methods: This is a monocentric study conducted from January 2019 to December 2023. All patients with iron-deficiency anemia who underwent EGD were included. Various data were recorded, including patients' epidemiological information, laboratory findings, and results from endoscopic examinations. Results: Out of 2960 EGD, 576 (19,5%) were included in the study. The mean age of the patients was 49.81 years, ranging from 18 to 83 years. The male-to-female sex ratio was 0.67. It is notable that 47.5% of the patients had various medical histories: inflammatory bowel disease (IBD) in 19.13% of cases, history of non-steroidal anti-inflammatory drug (NSAID) use in 12.17%, coeliac disease in 6.13%, cirrhosis with portal hypertension in 8.70%. All patients underwent EGD. An abnormality was found in 63.4% of cases, including: Esophageal lesions: gastroesophageal varices in 13.3% of cases, erosive esophagitis in 7.5%, esophageal tumor in 0.6% of cases. Gastric lesions: erosive gastritis in 35% of cases, ulcerative gastritis in 22%, erythematous gastritis in 17%, gastric tumor in 15% of cases, supra-centimetric hyperplastic polyps in 5% of cases. Bulboduodenal lesions: erosive bulboduodenitis in 25% of cases, ulcerative bulboduodenitis in 18%, duodenal fold rarefaction in 16%, angiodysplasia in 3.5%. Gastric and duodenal biopsies were systematically performed. Duodenal biopsies showed a celiac disease aspect in 7.6% of cases, and nonspecific duodenitis in 4.6% of cases. Gastric biopsies revealed gastritis with Helicobacter pylori (Hp) in 57.6% of cases. Thus, the diagnostic yield of EGD was 47.33%. Conclusion: Iron deficiency anemia are common medical conditions in daily clinical practice. The multiple etiologies of iron deficiency anemia and the nonspecificity of symptoms make diagnosis difficult. Gastrointestinal lesions are frequently observed in patients with iron deficiency anemia. Digestive endoscopy has a great value in the etiological investigation of this pathology. Gastroscopy allows for the etiological diagnosis for many patients that’s why it is systematically recommended do it.

With the rising trend in obesity, the incidence of gestational diabetes mellitus (GDM) and perinatal complications associated with the condition are also on the rise. Since the early 1900s, much knowledge has been gained about the diagnosis, implications, and management of gestational diabetes with improved outcomes for the mother and fetus. Worldwide, there is variation in the definition of GDM, methods to screen for the condition, and management options. The International Association of Diabetes in Pregnancy Study Groups has published recommendations for a one-step approach to screen pregnant women for GDM, in order to develop outcome-based criteria that can be used internationally. However, management of GDM continues to be varied, and currently several options are available for treatment of hyperglycemia during pregnancy. A review of various aspects of GDM is discussed with a focus on the medical management during pregnancy, as practiced in the United States.

Background: Bronchial asthma, a prevalent chronic respiratory condition, poses a significant health concern among secondary school students in Bangladesh, particularly in the bustling urban centers with associated environmental challenges. Objective: This study aimed to determine the prevalence of bronchial asthma and its associated factors among secondary school students. Method: This cross-sectional study, conducted from January to June 2023, aimed to assess the prevalence of bronchial asthma among 250 secondary school students (aged 10-15 yrs) in Bangladesh. The study employed a structured questionnaire, including the International Study of Asthma and Allergies in Childhood (ISAAC) asthma questionnaire, to collect socio-demographic details and assess asthma prevalence. Results: The findings revealed a mean age of 12.9 years, with an equal distribution of males and females. Notably, 11.6% had been diagnosed with asthma by a doctor. Factors such as sex, age, monthly family income, history of childhood pneumonia, and passive smoking exposure showed significant associations with bronchial asthma. Logistic regression analysis identified being male (OR=2.32, p=0.042), a history of childhood pneumonia (OR=3.10, p=0.007), and maternal asthma (OR=2.739, p=0.032) as predictors of bronchial asthma. The prevalence was higher in males and those with a history of childhood pneumonia or maternal asthma. Conclusion: This study emphasizes the need for comprehensive health initiatives targeting the identified risk factors to mitigate the impact of bronchial asthma on the health and academic performance of secondary school students in Bangladesh. Addressing childhood pneumonia and reducing passive smoking exposure are crucial strategies for preventing the development of bronchial asthma in this vulnerable population.

This is the case of a 63-year-old female patient admitted for management of a liver mass discovered incidentally on imaging. The patient presented with weight loss and prutitus, and on clinical examination had collateral venous circulation and scraping lesions. Abdominal ultrasound coupled with Doppler showed a hepatic tissue mass with left-sided portal thrombosis. Hepatic MRI confirmed the diagnosis and also revealed SBC with infiltration of the left and median hepatic veins. Liver biopsy confirmed diagnosis of hepatocellular carcinoma (HCC)in cirrhotic liver. Etiological work-up for prothrombotic factors and cirrhosis was negative. The patient was a candidate for palliative treatment. But our dilemma: is this a case of primary or secondary BCS?