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  • ISSN: 2379-948X
    Volume 4, Issue 9
    Case Report
    Amit Kumar, Abhijeet Singh*, Anand Subash, and Anamika Rathi
    The rarity of primary hydatidosis in sub mandibular neck region may create a diagnostic dilemma with brachial cyst, dermoid cyst, sebaceous cyst and even lipoma. Even in endemic population with frequently reported hydatid disease, the diagnosis ofsubmandibular region hydatidosis needs a high index of radiological suspicion like double capsule pattern on ultrasonography and multiloculated hypoechoic cystic disease with scolices seen on computed tomography scans.An experienced radiologist may reportthese rare diagnoses and avoid aspiration cytology thus decreasing chances of theoretical anaphylactic reactions. Different clinical presentation of primary hydatidosis depends on the cyst load, topographic location of cysts and the host's immune response. We report a case of an 18-year-old boy with soft, painless left submandibular region swelling since eight years, who was diagnosed radiologically to be a case of hydatid disease of submandibular gland region and successfully underwent surgical excision without pre operative fine needle aspiration cytology. The review of literature suggest no definite consensus regarding routineuse of aspiration cytology for diagnosis but we here by propose that proper preoperative radiology may avoid need of any cytology whatsoever.
    Carlos Alberto Cavalcante de Barros Junior, Genival Barbosa de Carvalho*, Renan Bezerra Lira, Mauro Kasuo Ikeda, Felipe D' Almeida Costa, Daniele Sismeiro Carnevalli, Marcelo Luiz Balacin, Gislaine Cristina Lopes Machado Porto, Joel Rodrigo Beal Lusa, Clovis Antonio Lopes Pinto, and Luiz Paulo Kowalski
    The Malignant myoepithelioma (MME) is an extremely rare type of tumor of the salivary glands. There are few case reports. In this report we present a case of laryngeal MME with aggressive behavior and a review of the literature regarding the diagnosis, treatment options and standard prognosis of this tumor.
    Research Article
    Yasemin Eren*, Ebru Karaca Umay, Guleser Kılıc, Atılay Yaylacı, Sibel Alicura, and Selim S.Comoglu
    Background: Early identification of dysphagia reduces morbidity and mortality in acute stroke patients. During the acute phase of stroke, the Barnes-Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) is commonly recommended for such cases. In this study, our aim was to perform validity and reliability of the Turkish version of BJH-SDS with a different method.
    Methods: The scale was administered to 140 acute stroke patients within the first 24 hours of the event. The procedures were scored by two blind independent expert observers. Cronbach's alpha and item-to-total correlations were used to assess internal consistency. Inter-rater reliability studies were also conducted. Endoscopic evaluations were performed within the first 24 hours following the application of the screening tests. The flexible fiberoptic endoscopic evaluation of swallow (FEES) method was used to describe the validity of measures.
    Results: The mean age of 140 patients [58 (41.4 %) female, 82 (58.6 %) male] included in the study was 67.20 (SD 12.82) years. The internal consistency of the test was good with Chronbach's α values between 0.831 and 0.894, and there was a very good inter-rater agreement based on an intra-class correlation coefficient between 0.850 and 1.000. The item-to-total correlation for test items was between 0.493 and 0.712, exceeding the commonly accepted level of > 0.3. A significant positive association between total test scores of the raters and FEES levels (r: 0.733 p=0.001 and r=0.744, p=0.001).
    Based on the total scores, the sensitivity and specificity for detecting the presence of dysphagia were 78.6% and 80 to 82.8%, respectively.
    Conclusion: Our results suggest that the Turkish version of BJH-SDS that performed by using FEES method is a valid and reliable instrument when determining dysphagia in acute stroke patients.
    Review Article
    Jorge Filipe Rodrigues*, Francisco Moreira da Silva, Joao Mangussi-Gomes, Felipe Marconato, Camila Soares Dassi, Leonardo Balsalobre, and Aldo Stamm
    Background and objectives: Solitary lesions of the clivus are uncommon and represent a diagnostic and therapeutic challenge. There is a wide range of entities, with several behaviours, that can affect the central region of skull base. Imaging studies constitute an important tool in differentiating between malign, benign and non-tumoral lesions. The aim of this study is to provide an overview of the clinical and radiological characteristics of clival lesions.
    Subjects and methods: A literature review was conducted, with special attention to clinical and imaging features of the different diseases that can affect the clivus. Clinical examples of some cases are also given.
    Results: Chordoma is the most frequent lesion in this location, although they are difficult to distinguish from chondrosarcomas or metastases on CT scans and MR images. Benign neoplasms can also be life-threatening and clinically undistinguishable from malignancies. Non-tumoral lesions can mimic neoplasms and lead to unnecessary aggressive treatments.
    Conclusion: Clival disorders comprise a large range of entities with different characteristics and behaviors. Imaging study allows an evaluation of the tumor extent, a reliable distinction between benign and malignant processes and helps in the suspicious diagnosis. Despite imaging is an important supporting element, a final diagnosis often cannot be found without histologic biopsy.
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