Thirty-day postoperative outcome of patients with non-traumatic gastroduodenal perforations in southwestern Uganda

2019 ◽  
Vol 50 (1) ◽  
pp. 15-19
Author(s):  
Ronald Okidi ◽  
Vanusa D Sambo ◽  
Martin D Ogwang ◽  
David Mutiibwa ◽  
Noralis P Benitez ◽  
...  
Keyword(s):  
Postoperative Outcome ◽  
Exploratory Laparotomy ◽  
Unique Challenge ◽  
Female Ratio ◽  
Regional Referral Hospital ◽  
Gastroduodenal Perforation ◽  
H Pylori ◽  
One Year ◽  
Southwestern Uganda ◽  
Male To Female

We studied our 30-day postoperative outcomes in patients with non-traumatic gastroduodenal perforation (NTGDP) in Mbarara Regional Referral Hospital, southwestern Uganda. We conducted a one-year prospective study of patients who underwent exploratory laparotomy for suspected NTGDP between June 2016 and July 2017. Twenty-nine patients had NTGDP, the male-to-female ratio was 3:1 and median age was 60 years (range = 13–80 years). Most (83%) patients were negative for Helicobacter pylori on histology. One patient had a gastric adenocarcinoma. A total of 26 (90%) patients had Graham's omentopexy performed. The 30-day mortality rate was 34%. Pyrexia at hospital admission, pre-surgical delay (> 72 h), preoperative shock and peritoneal contamination, were associated with higher mortality rates with preoperative shock being an independent predictor of mortality. H. pylori-negative NTGDP presents a unique challenge in our setting, affecting mainly middle-aged and elderly patients. One-third of our patients did not survive one month.

scholarly journals The non traumatic acute abdomen and its clinical spectrum

2019 ◽  
Vol 6 (5) ◽  
pp. 1710
Author(s):  
M. Srujan Kumar ◽  
Bharath B. ◽  
K. S. Balasubramanya ◽  
K. Thinagaran
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Clinical Examination ◽  
Open Appendectomy ◽  
Postoperative Outcome ◽  
Exploratory Laparotomy ◽  
Medical Sciences ◽  
Female Ratio ◽  
Perforative Peritonitis ◽  
General Surgeons

Background: Acute abdomen poses a big challenge to the general surgeons in terms of both diagnosis and management. The aim of this study was to know in detail the clinical and postoperative outcome in non traumatic acute abdomen.Methods: Prospectively collected data of 326 patients with non traumatic acute abdomen admitted in PES institute of medical sciences and research, Kuppam from November 2016 to June 2018. All patients were subjected to clinical examination, relevant blood and imaging investigations, Intra and postoperative findings events were recorded.Results: Non traumatic acute abdominal pain was more common in 2nd to 5th decade of life. Males are more affected than females with a male to female ratio of 3.4:1. Acute appendicitis forms the commonest cause of acute abdomen (n=160=49%) followed by perforative peritonitis (n=85=26%). Most common surgical procedures done were laparoscopic/open appendectomy for acute appendicitis, exploratory laparotomy with Graham’s omentoplasty for perforative peritonitis.Conclusions: Systematic approach in history taking and a proper clinical examination with supportive imaging findings are most important in making an accurate diagnosis and need of appropriate surgical intervention in patients with non traumatic acute abdomen.

scholarly journals Chronic Myeloid Leukemia in Adolescents and Young Adults Treated with Generic Form of Imatinib in Resource Limited Setting: A Single Center Experience from Myanmar

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5451-5451
Author(s):  
Yin Nwe Han ◽  
Aye Aye Gyi ◽  
Khin Thida Htut
Keyword(s):  
Young Adults ◽  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Chronic Phase ◽  
Female Ratio ◽  
Resource Limited ◽  
One Year ◽  
Male To Female ◽  
Limited Setting

Abstract Chronic myeloid leukemia (CML) is an acquired myelo-proliferative disorder characterized by the presence of BCR-ABL1 fusion transcript with deregulated tyrosine kinase activity. Leukemias are one of the leading causes of cancer related deaths in adolescents and young adults (AYA) particularly in resource limited countries. Recent democratic government in Myanmar holds supportive policies for treatment of cancers in younger population and subsidizes some therapies including imatinib mesylate, a selective BCR-ABL 1 tyrosine kinase inhibitor, although there is still limitation for cytogenetic and molecular monitoring of therapy. This study on response to imatinib in newly diagnosed chronic phase CML was carried out during January 2016 to February 2018 at the North Okkalapa General and Teaching Hospital of Yangon, Myanmar where molecularly confirmed new CML in chronic phase were treated with generic form of imatinib bought by hospital tender system, Unitinib (United Biotech (P) ltd. India) followed by cytogenetic analysis of bone marrow and molecular detection of BCR-ABL1 transcript from peripheral blood by in house real time PCR machine at one year. They are divided into AYA (aged 15-39 years) and adult age groups (40 years and older) and clinical parameters and response to treatment with imatinib 400mg per day were compared. Among 56 cases (median age of 39.5 years, male to female ratio of 1.5:1), half were AYA (28 of 56) with median age of 28.5 years compared to 50 years in adult group with higher male to female ratio of 3.6:1 in AYA group. Patients in AYA had larger spleen size (11 vs 5.5 cm) and higher median white cell count compared to adults (366 x 109/l vs 224 x 109/l) although initial platelet count, peripheral blood eosinophil, basophil and blast percent and Sokal score were comparable. Additional chromosomal abnormalities were detected in 2 AYA and 3 adults with CML. There was no difference in complete haematologic response at 3 and 12 months between AYA and adults (96.4% vs 96.4% and 92.9% vs 89.3% respectively). At 12 months, complete cytogenetic response of AYA at 67.9% was less than 75.0% of adults, it was statistically not significant. Using in house molecular method although not standardized, 14.3% of AYA and 32.1% of adults were molecularly undetectable at one year. The response of AYA to imatinib in this study was comparable to adults despite having adverse prognostic features and receiving only generic forms of treatment in resource limited setting and it would further help support from authorities for leukemia in younger population. Disclosures No relevant conflicts of interest to declare.

scholarly journals A clinical and epidemiological study of non-venereal genital dermatoses: A cross-sectional, hospital-based study from Nepal

2022 ◽  
Vol 13 (1) ◽  
pp. 16-21
Author(s):  
Vikash Paudel ◽  
Deepa Chudal ◽  
Upama Paudel ◽  
Dwarika Prasad Shrestha
Keyword(s):  
Fungal Infections ◽  
Venereal Diseases ◽  
Cross Sectional ◽  
Female Ratio ◽  
Inflammatory Dermatoses ◽  
Number Of Patients ◽  
Tertiary Center ◽  
Ethical Approval ◽  
One Year ◽  
Male To Female

Background: Non-venereal genital dermatoses are the conditions of the genitalia that are not transmitted sexually. They may be confused with venereal diseases and be responsible for concerns among patients as well as diagnostic dilemmas for physicians. This study was conducted to determine the prevalence and describe the patterns of non-venereal genital conditions. Methods: This was a hospital-based, cross-sectional, prospective study conducted in a tertiary center in Kathmandu, Nepal, over a period of one year. Non-probability purposive sampling was employed to select the samples. Two hundred patients were enrolled in the study. Ethical approval was taken prior to the study. Detailed history taking along with a complete cutaneous examination were conducted for all patients and recorded in a preformed proforma. Results: Among 21366 patients, two hundred patients had non-venereal genital dermatoses. The prevalence of non-venereal dermatoses was 0.93 %. The mean age of the patient was 29.5 ± 15 years, ranging from 2 months to 81 years. The male-to-female ratio was 2.7:1. Itching was the most common presentation (46%). Fifty-four different types of non-venereal diseases were encountered and classified into inflammatory lesions (n = 84; 42%), infections and infestations (n = 43; 21.5%), normal variants and benign abnormalities (n = 41; 20.5%), and miscellaneous (n = 21; 10.5%). The most common were, among inflammatory dermatoses, drug reactions (11.5%) and eczema (6.5%) and, among infections and infestations, scabies (9.5%) and fungal infections (7.5%). Conclusion: Non-venereal genital dermatoses are important yet less common dermatological conditions. A number of patients have misconceptions about them as venereal. A comprehensive study of non-venereal dermatological genital conditions is required for careful management to minimize morbidity.

scholarly journals Assessment of Kenyan Optometrists Knowledge, Skills and Practice on Cataract, Kisumu County, Western Kenya

2019 ◽  
Author(s):  
Shadrack Muma ◽  
Stephen Obonyo
Keyword(s):  
Health Care Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Female Ratio ◽  
Primary Health Care Providers ◽  
Level Of Knowledge ◽  
Cross Sectional Design ◽  
One Year ◽  
Male To Female ◽  
Cataract Patients

Abstract BackgroundCataract is a major contributor to avoidable blindness in the world. It is the clouding of the normally clear lens of the eye characterized by reduced vision, increasing difficulty with vision at night and sensitivity to light and glare. The risk factors of cataract include increased age, smoking and excess exposure to sunlight. Though studies have focused on the causes and treatment of cataract, there is no data on optometrist knowledge, skill and practice on cataract in Kenya. The optometrists are the primary health care providers for cataract patients, they are well placed to assess, provide advice and refer cataract patients to the ophthalmologists.Methods: a cross sectional design was used. Stratified random sampling was used to select sample. Fisher’s formula was used.ResultsA total of 49 optometrists were interviewed over a period of four months, the male to female ratio was 2:1, mean age of 45.8(72%) years, age ranged from 25-39 years with mean duration of practice of one year and maximum of 10 years. One hundred percent optometrists had good knowledge and understanding of importance of slit lamp assessment in making cataract diagnosis. However, our results found that (83.6%) of optometrists used pen torch for assessment of lens changes in patients. On skills, optometrists were classified as having poor skills with thirty nine (79.6%) being unable to diagnose. 61.2% of optometrists did not screen patients aged 40 years and above who attended eye clinics for cataract. The most common challenges reported for not screening was long queues. The study further established that the optometrists had various reasons to refer patients to another hospital including 52.6% for availability of ophthalmologists and 39.5% of optometrists for availability of equipment.ConclusionThe study established that despite the good level of knowledge among the optometrist on cataract, there exist gaps in skills in categorizing the type of cataract. Most optometrists do not screen patients aged 40 years and above for cataract. Hence there is need to sensitize optometrists on the significance of screening for cataract to prevent blindness due to cataract.

scholarly journals URINARY BLADDER STONE

2018 ◽  
Vol 25 (11) ◽  
pp. 1655-1659
Author(s):  
Mubeena Laghari ◽  
Shazia Murtaza ◽  
Rafique Ahmed JalbanI
Keyword(s):  
Urinary Bladder ◽  
Calcium Oxalate ◽  
Pediatric Surgery ◽  
Calcium Oxalate Monohydrate ◽  
Urinary Stones ◽  
Female Ratio ◽  
Bladder Stones ◽  
Ammonium Hydrogen ◽  
One Year ◽  
Male To Female

Objective: To analyze the biochemical composition and biochemical types ofurinary bladder stones in children. Study design and setting: Observational study, Departmentof Pediatric Surgery, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad.Place and Duration: One year duration from January to December 2006. Materials &Methods: A sample of 30 children was selected according to criteria of inclusion of age <10years of urinary bladder stones without any anomaly. Urinary bladder stones were washed indistilled H2O deionized to remove contaminations. Urinary bladder stones were dried at 1000C for overnight in an oven. The urinary bladder stones cut into pieces were used for the FTIRspectroscopy analysis, carried out on “Nicolet Avatar 330 FTIR spectrophotometer”. Data wasanalyzed on SPSS 22.0 at 95% confidence interval. Results: Of 30, 6 (20%) were female and24 (80%) were male. The male dominancy was noted with male to female ratio of 4:1. Mean±SD age was noted as 4.839 + 2.819 years. Urinary stones of pure and mixed biochemistrywere noted in 5 (16.6%) and 25 (83.3%) respectively (P=0.0001). Most frequent urinary bladderstone found was the calcium oxalate monohydrate - ammonium hydrogen urate. Conclusions:Most frequent type of urinary bladder stones was the calcium oxalate monohydrate–ammoniumhydrogen urate type in the children.

scholarly journals Low post-arthroplasty Infection rate is possible in developing countries Long-term Experience of local Vancomycin use from a high-volume tertiary Knee center in Iran

2020 ◽  
Author(s):  
Mohammad Naghi Tahmasebi ◽  
Arash Sharafat Vaziri ◽  
Fardis Vosoughi ◽  
Mohamad Tahami ◽  
Majid Khalilizad ◽  
...  
Keyword(s):  
Infection Rate ◽  
High Volume ◽  
Control Group ◽  
Routine Practice ◽  
Female Ratio ◽  
Vancomycin Powder ◽  
Total Knee ◽  
One Year ◽  
Vancomycin Group ◽  
Male To Female

Abstract Background: Utilizing intrawound vancomycin powder in TKA surgery has yielded rather contrasting results in the current literature. Furthermore, CDC criteria, although effective in general, are not specifically designed for post-TKA infections. Here, we present a 7-year experience of vancomycin use in primary TKA in a high-volume tertiary knee center in Iran. Also, new criteria are proposed to detect suspected superficial post-TKA infections. Methods: This is a retrospective analysis of primary total knee arthroplasties performed in a tertiary knee center, from March 2007 to December 2018, by a single senior knee surgeon. All patients with follow-up periods of less than one year were excluded from the study. Since March 2011, all patient received vancomycin (powder, 1gr) before water-tight closure of the joint capsule. Comparison was made between this group and historical control subjects (operated from March 2007 to March 2011). Results: Altogether, 2024 patients were included in the study. The vancomycin and the control group included 1710 and 314 cases respectively. Patients were mostly women (male to female ratio: 1 to 4), with a mean age of 65.20 (SD=10.83) years. In the vancomycin group, the rate of suspected SII (1.87%) and PJI (0.41%) was significantly lower than the control group (P= 0.002). Conclusions: Our experience shows that by utilizing intrawound vancomycin as a routine practice along with other measures, we were able to reach relatively low rates of deep post-TKA infections. Howbeit, randomized controlled trials are required to clarify the effect of intrawound vancomycin on post-TKA infection rate.

scholarly journals Outcome of treatment of high fistula in ANO, with fistulectomy plus seton placement.

2021 ◽  
Vol 28 (11) ◽  
pp. 1600-1603
Author(s):  
Kaleem Ullah ◽  
Shamsuddin ◽  
Muhammad Danish Yasin ◽  
Hafiz Bilal Ahmed
Keyword(s):  
Single Case ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Stool Incontinence ◽  
Patient Reported ◽  
Flatus Incontinence ◽  
One Year ◽  
Male To Female ◽  
Seton Placement

Objective: To determine post procedure recurrence and incontinence rate for high fistula-in-ano cases, who underwent procedure of fistulectomy and Seton placement. Study Design: Descriptive study. Setting: Department of General Surgery, Khyber Teaching Hospital Peshawar. Period: January to December, 2018. Material & Methods: This study was conducted over 50 patients with diagnosis of high fistula-in-ano, treated with combined procedure of fistulectomy and Seton placement. Patients follow up was done for one year for recurrence and incontinence. Results: Out of 50 patients, 28(56%) were male and 22(44%) were female. Overall male to female ratio was 1.27:1. Average age of patient was 36.88 years+6.63 SD. Flatus Incontinence was observed in single case (2%), no patient reported stool Incontinence. Recurrence of disease was found in 2 patients (4%). All patients were followed for one year. Conclusion: This technique for treating high Fistula-in-ano showed overall low recurrence and incontinence rates during follow up, thus reducing morbidity and costs associated with recurrent surgery for Fistula-in-ano.

Lower risk of gastric atrophy and intestinal metaplasia in MALT lymphoma patients despite of H. pylori infection.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 33-33
Author(s):  
San Min Lee ◽  
Dae Young Cheung ◽  
Jin Il Kim ◽  
Soo-Heon Park
Keyword(s):  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Gastric Adenocarcinoma ◽  
Malt Lymphoma ◽  
Gastrin Level ◽  
Gastric Malt Lymphoma ◽  
Female Ratio ◽  
Pepsinogen I ◽  
H Pylori ◽  
Male To Female

33 Background: Atrophic gastritis and intestinal metaplasia are sequential consequences of chronic H. pylori infection. H. pylori infection is a well-known risk factor for gastric adenocarcinoma and MALT lymphoma of stomach. Atrophic gastritis and intestinal metaplasia increase the risk of gastric adenocarcinoma development. The relationship between gastric MALT lymphoma and atrophic gastritis-intestinal metaplasia has not been on the spot of interest. We investigated the clinical characteristics of gastric MALT lymphoma and co-presence of atrophic gastritis and intestinal metaplasia. Methods: Study was conducted by review of electronic medical record of patients who were diagnosed with gastric MALT lymphoma at an academic institute, the Yeouido St. Mary's Hospital, Seoul, Korea, from January 2001 to March 2018. Results: A total of 51 subjects were enrolled consecutively during the study period and analyzed retrospectively. The mean age was 57.5-year-old. The male to female ratio was 1.04 (26/25). On histologic examination, background atrophic gastritis was accompanied in 64.7% (33/51). Serum pepsinogen I, II and gastrin level, as serological marker for atrophy, were evaluated in 21 subjects. Thirteen out of 21 (61.9%) were compatible with serological atrophic gastritis (pepsinogen I / II ratio of less than three or pepsinogen I < 70 ng/mL). Conclusions: Prevalence of background mucosal atrophy or intestinal metaplasia was around 60% in patients with gastric MALT lymphoma. This is comparable to that of general population and lower than that of patients with gastric adenocarcinoma. Even though age can be a confounding factor, this result suggests different carcinogenic pathway of gastric MALT lymphoma from adenocarcinoma.

scholarly journals A study of association of H. pylori infection and cholelithiasis

2018 ◽  
Vol 5 (2) ◽  
pp. 701
Author(s):  
Virendra S. Athavale ◽  
Shivmurti N. Khandalkar ◽  
Prachi C. Bhide ◽  
Iresh Shetty ◽  
Aditya Lad
Keyword(s):  
Positive Association ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Predominance ◽  
Medical College ◽  
The Mean ◽  
H Pylori ◽  
Male To Female

Background: Aims and objective of the study was to study the association of H. Pylori infection and cholelithiasis.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years and is a descriptive cross-sectional type of study using 100 patients.Results: In this study 26 % of total patients were seen in the age group of 21-30 years. The mean age of the patients was 26 years. 78 patients in present study were male (78%) and only 22 were females (22%) male predominance was seen. male to female ratio is 3.5:1. 18 % patients show association with cholelithiasis and 84 patients were detected positive by RUT method.Conclusions: H. pylori infection has a positive association with cholelithiasis and if eradicated, may lead to prevention of gallstones.

scholarly journals Coronary Angiographic Findings of Symptomatic Patients with Essential Hypertension

2017 ◽  
Vol 29 (1) ◽  
pp. 32-34
Author(s):  
Abu Tarek Ikbal ◽  
Md Ayub ◽  
Md Salehuddin
Keyword(s):  
Risk Factor ◽  
Essential Hypertension ◽  
Tertiary Care ◽  
Care Hospital ◽  
Common Risk Factor ◽  
Female Ratio ◽  
Triple Vessel Disease ◽  
One Year ◽  
Male To Female ◽  
Angiographic Findings

Essential hypertension is a common risk factor for ischemic heart disease. So the Objective of the present study was to find the different angiographic pattern among the symptomatic patients having essential hypertension. A total of 100 symptomatic patients with essential hypertension were evaluated in a one year period by coronary angiography (CAG) in a tertiary care hospital of Chittagong, Bangladesh. Standard protocol and procedure were followed during doing CAG. All data were compiled and were analyzed by SPSS-20. Among 95 patients evaluated male were more 76 (80%) and male to female ratio was 4:1. Most of the patients were involved in service 55(57%). Among all 77(81%) patients were at age group <60 years. Regarding risk factor analysis 39 (41%) patients had DM, 18 (19%) patients had different kinds of dyslipidemia, 66 (69%) patients had hypertension and 25(26.5%) were smoker. Angiographic study revealed 9(9.2%) had involvement of LMCA, 56(58%) had LAD, 29(30%) had LCX, 31(32%) RCA and 18(19%) patients had triple vessel disease. ETT is be a valuable screening tool before doing invasive CAG in our setting.Medicine Today 2017 Vol.29(1): 32-34

Sign in / Sign up

Export Citation Format

Share Document