Chronic trans-scaphoid perilunate dislocation: Current management protocol

Abstract Introduction Open injuries have a potential for serious bacterial wound infections and may lead to long term disabilities, chronic wound or bone infection, and even death. This QI study was undertaken to ring in changes to the current management protocol and align them as per WHO guidelines. Method Implementing changes through a Plan-Do-Study-Act (PDSA) cycle post an initial clinical audit among 38 patients of the organization. Re-audits were done to measure the outcome against the standard and establish a new protocol. Results Initial audit showed only a dismal 37% (n = 14) of patients being managed as per WHO protocol. Patient satisfaction percentage (as measured by a questionnaire) was also low with only 54% of patients satisfied with the treatment. Significant variations were noted post implementation of changes after the first PDSA cycle where >90% (n = 35) of patients reported that they noticed better wound healing, transition to optimal performance and were satisfied with treatment outcomes. Conclusions Timely wound dressings, appropriate antibiotic prophylaxis and increased patient’s awareness on wound hygiene through means of regular educational sessions and updated management protocols have led to healthier patients, lesser long term disabilities and happy patients.

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Post-destructive eye surgery, associated depression at Sekuru Kaguvi Hospital Eye Unit, Zimbabwe: Pilot Study

African Vision and Eye Health ◽

10.4102/aveh.v72i2.48 ◽

2013 ◽

Vol 72 (2) ◽

Author(s):

M. M. Kawome ◽

R. Masanganise

Keyword(s):

Cross Sectional Study ◽

Current Management ◽

Cross Sectional ◽

Systematic Random Sampling ◽

Eye Surgery ◽

Management Protocol ◽

Before And After ◽

Patient Health ◽

Study Population ◽

Structured Questionnaire

Destructive eye surgery is associated with more complications than just loss of visual functions of the eye and aesthetics. Currently there is very little published literature on post-destructive eye surgery associated depression. Zimbabwe has been experiencing a surge in the rate of destructive eye surgery done at the National Tertiary Eye Unit. This situation could be churning out lots of unrecognized depressed clients into the community who require assistance in one form or another.Objectives: To determine the prevalence of post-destructive eye surgery associated depression among patients attending Sekuru Kaguvi Hospital Eye Unit and assess if the current management protocol of patients undergoing destructive eye surgery at the Eye Unit addresses the problem adequately.Methods: A cross-sectional study of 28 randomly selected patients who had destructive eye surgeries at Sekuru Kaguvi Hospital was conducted over five months from 1st March 2012 to end of July 2012. A structured questionnaire containing 15 questions on the following items: gender, age, diagnosis, surgical procedure done, expectations before and after surgery, adequacy of counseling given and involvement of family was used to collect data. Nine questions to assess depression were adapted from the Patient Health Questionnaire (PHQ-9).Setting: The study was conducted at SekuruKaguvi Hospital Eye Unit, Parirenyatwa Group of Hospitals in Harare.Results: Twenty-eight patients who underwent destructive eye surgery during the study period were selected using systematic random sampling. The gender ratio was 1:1 and the mean age was 38.7 years with a range from 24 to 65 years. Fifty percent of the patients in the study had orbital exenteration while the rest had enucleation (14%) and evisceration (36%). Twenty-eight percent of the study population had depression.Conclusion: Destructive eye surgery is frequently associated with depression and our current management protocol of patients undergoing destructive eye surgery does not address this problem.

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Combined Fractures of the Distal Radius and Scaphoid

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408090099 ◽

2008 ◽

Vol 33 (4) ◽

pp. 478-483 ◽

Cited By ~ 17

Author(s):

M. RUTGERS ◽

C. S. MUDGAL ◽

R. SHIN

Keyword(s):

Internal Fixation ◽

Distal Radius ◽

High Energy ◽

Optimal Management ◽

Current Management ◽

Wrist Motion ◽

Intraarticular Fractures ◽

Management Protocol ◽

The Mean

Combined fractures of the distal radius and scaphoid are uncommon, are usually the result of a high-energy trauma and there is no consensus regarding their optimal management. We present a retrospective study of ten patients, out of whom nine underwent internal fixation of their fractures. Open reduction and internal fixation were performed in six of the eight intraarticular fractures of the distal radius. After a mean follow-up of 40 months, eight patients reported no pain and the mean range of wrist motion was 55° flexion and 71° extension. Our current management protocol is outlined. Emphasis on treatment of this combined fracture should be placed on the management of the distal radius fracture. Internal fixation of both fractures, followed by early rehabilitation, optimises outcomes. Cast treatment is indicated only in patients with completely undisplaced fractures of both the radius and the scaphoid.

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A New Technique for Penile Revascularization: Current Management Protocol for Dorsal Vein Arterialization

The Journal of Urology ◽

10.1016/s0022-5347(17)75550-4 ◽

1987 ◽

Vol 137 (6) ◽

Cited By ~ 2

Author(s):

William L. Furlow

Keyword(s):

New Technique ◽

Current Management ◽

Dorsal Vein ◽

Penile Revascularization ◽

Management Protocol ◽

A New Technique

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Choriocarcinoma - Varied Presentations

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v30i3.12464 ◽

2012 ◽

Vol 30 (3) ◽

pp. 145-150

Author(s):

Shamsun Nahar Begum

Keyword(s):

Early Diagnosis ◽

Rare Disease ◽

Malignant Tumour ◽

Treatment Modalities ◽

Current Management ◽

Fatal Disease ◽

Mode Of Presentation ◽

Appropriate Treatment ◽

Management Protocol

Choriocarcinoma is a highly malignant tumour that originates in developing trophoblast of pregnancy. It is a potentially fatal disease but current management protocol has turned the prognosis highly favourable.Gestational choriocarcinoma is not a rare disease in our country. Various mode of presentation sometimes makes it difficult to diagnose.Eleven cases of choriocarcinoma were presented here along with treatment modalities and prognosis. Two patients expired during treatment while other respond well with chemotherapy. Early diagnosis and appropriate treatment have better prognosis. DOI: http://dx.doi.org/10.3329/jbcps.v30i3.12464 J Bangladesh Coll Phys Surg 2012; 30: 145-150

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Validity of no-zone approach for management of isolated penetrating neck injuries in hemodynamically stable patients

International Surgery Journal ◽

10.18203/2349-2902.isj20213686 ◽

2021 ◽

Author(s):

Kamal A. M. Hassanein ◽

Osama A. Ismail ◽

Islam A. Amer ◽

Ahmed Abdel Kahaar Aldardeer ◽

Tarek Elsayed Ftohy ◽

...

Keyword(s):

Neck Exploration ◽

Neck Injuries ◽

Current Management ◽

Missed Injuries ◽

Safe Management ◽

Management Protocol ◽

Tomographic Angiography ◽

Complications And Mortality ◽

No Zone Approach ◽

Rule Out

Background: Routine neck exploration for isolated penetrating neck injuries (PNIs) in hemodynamically stable patients increases the frequency of unnecessary interventions and complications. Current management protocol involves the no zone approach which uses physical examination and computerized tomographic angiography (CTA) to guide treatment. The aim was to assess the validity of the no-zone approach in the management of isolated PNIs in hemodynamically stable patients.Methods: This retrospective study included patients with isolated PNIs with soft signs who were hemodynamically stable. They were classified into patients with negative CTA findings and were managed conservatively and patients with positive CTA findings suspecting aerodigestive tract injuries (ADTIs) who were submitted to further selective investigations to confirm or rule out these injuries. Detected injuries were managed accordingly.Results: This study included 106 PNIs patients who had soft signs and were hemodynamic stable. 37 cases (34.9%) had negative CTA findings and were managed conservatively. Sixty nine patients (65.1%) had positive CTA findings and were subjected to subsequent selective investigations and revealed 3 patients with negative endoscopic findings who passed without need for any surgical intervention. Therefore, 40 (37.7%) patients were saved from surgery with no missed injuries. Patients with definitive injuries (66 patients) underwent neck exploration and managed accordingly. No missed injuries were recorded in this study. Complications were detected in 6 cases (5.7%) while death was recorded in 2 cases (1.9%).Conclusions: No-zone approach offers a safe management protocol for isolated PNIs in hemodynamically stable patients. It provides no missed injuries, negligible rates of negative exploration and minimal complications and mortality.

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A case report: remdesivir effective in the treatment of severe category COVID-19

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204265 ◽

2020 ◽

Vol 8 (10) ◽

pp. 3742

Author(s):

Hetal Pandya ◽

Archit Jain ◽

Pradeep Reddy ◽

Aarsh Shah

Keyword(s):

Treated Patient ◽

Health Care Systems ◽

Antiviral Drug ◽

Respiratory Illness ◽

Current Management ◽

Standard Management ◽

Management Protocol ◽

Experimental Therapies ◽

Care Systems ◽

Severe Acute Respiratory Illness

Since the first cases were reported in December 2019, infection with the severe acute respiratory corona virus 2 (SARS-CoV-2) has become a worldwide pandemic. COVID-19 the illness caused by SARS-CoV-2 is overwhelming health care systems globally. In the absence of a proven effective therapy, current management consists of supportive care, including invasive and noninvasive oxygen support and off-label or compassionate-use therapies, including anti-retrovirals, anti-parasitic agents, anti-inflammatory compounds, and convalescent plasma. Amongst these experimental therapies, remdesivir a broad-spectrum antiviral drug has shown some promising results. We present a successfully treated patient of severe acute respiratory illness by SARS-CoV-2 with remdesivir along with standard management protocol. Reporting a case with aim to add favoring evidence for remdesivir in the treatment of SARS-CoV-2.

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