scholarly journals Profile of Intentional and Iatrogenic skin afflictions: An observational study

2021 ◽  
Vol 7 (2) ◽  
pp. 153-157
Author(s):  
Rohit D Chordiya ◽  
Som Jitendra Lakhani ◽  
Vinaykumar Biyani ◽  
Rashmi Mahajan ◽  
Jitendra D Lakhani
Keyword(s):  
Abdominal Pain ◽  
Observational Study ◽  
Umbilical Hernia ◽  
Chronic Abdominal Pain ◽  
Hypertrophic Scars ◽  
Body Piercing ◽  
Medical Disorders ◽  
Medical Issues ◽  
Psychosocial Consequences ◽  
Image Problems

Intentional skin afflictions are often done as a means of relief from medical disorders as in the case of skin branding or as a means of cosmesis and beautification as in body piercing and tattooing. Such practices often have medical and psychosocial consequences.An observational study was carried out at a teaching hospital where a total of 36 (20 male and 16 female) consecutive patients with skin affliction which were either intentional and/ or iatrogenic, were included in the study after informed consent. Medical consultation was done for variety of skin afflictions and their consequences including skin branding (8), tattooing (12), body piercing(4), keloids(9) and hypertrophic scars(3). Abdominal causes of branding like ascites, umbilical hernia, chronic abdominal pain, huge splenomegaly were present in subjects who had undergone skin branding from faith healers. Psychosocial consequences of subjects who came for intervention and advice regarding unwanted tattoo marks and body piercing were Tattoo regrets, Army tattoo Policy, Requirement for job procurement, Relationship Conflicts, Disapproval from Peers, Self disapproval, Body image problems, Parental disapproval and others. Subjects having hypertrophic scars and keloids sought treatment for medical issues like pruritus and fear of carcinogenesis as well as for cosmetic reasons.Studyingprofileandpsychosocial problems related to intentional/iatrogenic skin problems may give insight for prevention of such consequences in dermatology and medical practice.

Assessment of clinical outcomes among CT scan in the diagnosis of chronic abdominal pain

2019 ◽  
Vol 10 (3) ◽  
pp. 15-18
Author(s):  
Anant Madhukarrao Bhuibhar ◽  
◽  
Challa Anil Kumar ◽  
Lalwani Shyam Tekchand ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Clinical Outcomes ◽  
Chronic Abdominal Pain

scholarly journals Causes of discharge delays from the acute medical unit (AMU) in a tertiary level teaching hospital, Brunei Darussalam

2021 ◽  
pp. 201010582110061
Author(s):  
Dayang Nur Hilmiyah binti Awang Husaini ◽  
Justin Fook Siong Keasberry ◽  
Khadizah Haji Abdul Mumin ◽  
Hanif Abdul Rahman
Keyword(s):  
Observational Study ◽  
Discharge Planning ◽  
Patient Factors ◽  
Medical Unit ◽  
Prolonged Length ◽  
Acute Medical Unit ◽  
Brunei Darussalam ◽  
Medical Issues ◽  
Hospital Factors ◽  
Prolonged Hospital

Background: Many patients admitted to the acute medical unit experience a prolonged length of stay in hospital due to discharge delays. Consequently, this may impact the patients, healthcare institution and national economy in terms of patient safety, decreased hospital capacity, lost patient workdays and financial performance. Objectives: The main aim of this observational study was to identify the causes of discharge delays among acute medical unit patients admitted in the Raja Isteri Pengiran Anak Saleha Hospital, Brunei. Methods: A retrospective observational study, with data of patients admitted to the acute medical unit collected from Brunei Health Information Systems between September and December 2018. Statistical analyses were performed to obtain relevant results and any statistically significant associations. Results: A total of 357 patients were admitted to the acute medical unit over the 4-month period; 218 patients (61.1%) experienced discharge delays. Of these 218 patients, 158 patients (72.5%) encountered discharge delays mainly due to intrinsic patient factors, while the discharge delays in 88 patients (40.4%) were attributed to hospital factors. The main reason for discharge delays for patient factors was slow recovery among 67 patients (30.7%), whereas for hospital factors it was the weekend limitation of services available in 23 patients (10.6%). Conclusions: There were various causes of discharge delays identified among the 218 acute medical unit patients who experienced discharge delays. Older patients with frailty, polypharmacy and complex medical issues were more likely to have a prolonged hospital stay in the acute medical unit. Stringent inclusion criteria, increasing discharge planning as well as an effective multidisciplinary approach will aid in reducing discharge delays from the acute medical unit.

scholarly journals A227 UMBILICAL HERNIA INCARCERATION IN LIVER CIRRHOSIS: A RARE COMPLICATION OF PARACENTESIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 263-265
Author(s):  
A LAGROTTERIA ◽  
A Aruljothy ◽  
K Tsoi
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Large Volume ◽  
Umbilical Hernia ◽  
Rare Complication ◽  
Abdominal Wall Hernia ◽  
Refractory Ascites ◽  
Large Volume Paracentesis

Abstract Background Patients with decompensated liver cirrhosis with ascites frequently have umbilical hernias with a prevalence of 20% and are managed with large volume paracentesis (LVP). Common complications of LVP include hemorrhage, infection, and bowel perforation that occur infrequently with a frequency of less than 1%. However, incarceration of umbilical hernias has been reported as a rare complication of LVP and is speculated to be from ascitic fluid decompression that reduces the umbilical hernia ring diameter resulting in entrapment of the hernia sac. It is unclear whether the quantity or the fluid removal rate increases the herniation risk. Based on case series, this rare complication occurs within 48 hours of the LVP and requires emergent surgical repair and involves a high risk of morbidity and mortality due to potential infection, bleeding, and poor wound healing. Aims We describe a case report of an incarcerated umbilical hernia following a bedside large-volume paracentesis. Methods Case report Results A 59-year-old Caucasian male presented to the emergency department with a 24-hour history of acute abdominal pain following his outpatient LVP. His medical history included Child-Pugh class C alcoholic liver cirrhosis with refractory ascites managed with biweekly outpatient LVP and a reducible umbilical hernia. He reported the onset of his abdominal pain 2-hours after his LVP with an inability to reduce his umbilical hernia. Seven liters of clear, straw-coloured asitic fluid was drained. Laboratory values at presentation revealed a hemoglobin of 139 g/L, leukocyte count of 4.9 x109 /L, platelet count of 110 xo 109 /L, and a lactate of 2.7 mmol/L His physical exam demonstrated an irreducible 4 cm umbilical hernia and bulging flanks with a positive fluid wave test. Abdominal computed tomography showed a small bowel obstruction due to herniation of a proximal ileal loop into the anterior abdominal wall hernia, with afferent loop dilation measuring up to 3.4 cm. He was evaluated by the General Surgery consultation service and underwent an emergent laparoscopic hernia repair. There was 5 cm of small bowel noted to be ecchymotic but viable, with no devitalized tissue. He tolerated the surgical intervention with no post-operative complications and was discharged home. Conclusions Ultrasound-guided bedside paracentesis is a common procedure used in the management of refractory ascites and abdominal wall hernia incarceration should be recognized as a potential rare complication. To prevent hernia incarceration, patients with liver cirrhosis should be examined closely for hernias and an attempt should be made for external reduction prior to LVP. A high index of suspicion for this potential life-threatening condition should be had in patients who present with symptoms of bowel obstruction following a LVP. Funding Agencies None

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