scholarly journals Visual loss from mismanaged ocular injury with foreign body impaction: A Case Report

2018 ◽  
Vol 4 (2) ◽  
pp. 198-204
Author(s):  
Ifedayo O. Akintoye ◽  
Caroline O. Adeoti
Keyword(s):  
Foreign Body ◽  
Health Workers ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Health Concern ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Health Extension Workers ◽  
Foreign Body Impaction ◽  
Upper Lid

Ocular injury occurs commonly and it may lead to visual impairment if it is not properly managed. We report the case of a 35-year old man with a retained infected ocular foreign body in his right eye following an injury. The foreign body was not discovered despite consulting non-ophthalmologists at a Maternity Centre and an Optical Shop over a period of ten days.  At presentation at the Specialist Hospital, he was unable to see with swelling of the eyelid, red eye and discharge. On examination, the visual acuity in the affected eye was NLP and an infected stick that penetrated the eyeball was discovered in the superonasal aspect of sclera covered by the swollen upper lid. This resulted in endophthalmitis, cataract and blindness of that eye. Ocular injuries must be promptly referred to the ophthalmologist for appropriate care and to prevent complications. The case clearly showed a diagnostic and therapeutic challenge for paramedics who encounter eye injuries outside the tertiary hospital setting. Therefore, this report raises public health concern intended to increase awareness on the management of eye injuries. The incorporation of Primary Eye Health into Primary Health Care along with training and re-training of Community Health Extension Workers, General Practitioners and other rural health workers cannot be overemphasized.

Vitrectorhexis in penetrating eye injuries in adults

2018 ◽  
Vol 29 (6) ◽  
pp. 689-693
Author(s):  
Miklós D Resch ◽  
Anikó Balogh ◽  
Gábor L Sándor ◽  
Zsuzsanna Géhl ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Posterior Chamber ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Anterior Capsule ◽  
Safe Alternative ◽  
Anterior Lens Capsule ◽  
Pars Plana

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.

Spread of NDM-producing Klebsiella pneumoniae in a tertiary Greek hospital

2021 ◽  
Author(s):  
Κonstantina Kontopoulou ◽  
Georgios Meletis ◽  
Styliani Pappa ◽  
Sofia Zotou ◽  
Katerina Tsioka ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Rapd Analysis ◽  
Random Amplified Polymorphic Dna ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Whole Genome Sequence ◽  
Health Concern ◽  
Resistant Bacteria ◽  
New Delhi ◽  
Whole Genome

AbstractBacterial carbapenem resistance, especially when mediated by transferable carbapenemases, is of important public health concern. An increased number of metallo-β-lactamase (MBL)-producing Klebsiella pneumoniae strains isolated in a tertiary hospital in Thessaloniki, Greece, called for further genetic investigation.The study included 29 non-repetitive carbapenem resistant K. pneumoniae isolates phenotypically characterized as MBL-producers collected in a tertiary hospital in Greece. The isolates were screened for the detection of carbapenemase genes (K. pneumoniae carbapenemase (blaKPC), Verona-integron-encoded MBL-1 (blaVIM-1), imipenemase (blaIMP), oxacillinase-48 (blaOXA-48) and New Delhi MBL (blaNDM)). The genetic relationship of the isolates was determined by Random Amplified Polymorphic DNA (RAPD) analysis. The whole genome sequences (WGS) from two NDM-positive K. pneumoniae isolates were further characterized.The presence of New Delhi MBL (blaNDM) gene was confirmed in all K. pneumoniae isolates, while blaKPC and blaVIM-1 genes were co-detected in one and two isolates, respectively. The RAPD analysis showed that the isolates were clustered into two groups. The whole genome sequence analysis of two K. pneumoniae isolates revealed that they belonged to the sequence type 11, they carried the blaNDM-1 gene, and exhibited differences in the number and type of the plasmids and the resistant genes.All MBL-producing K. pneumoniae isolates of the study harbored a blaNDM gene, while WGS analysis revealed genetic diversity in resistance genes. Continuous surveillance is needed to detect the emergence of new clones in a hospital setting, while application of antimicrobial stewardship is the only way to reduce the spread of multi-resistant bacteria.

scholarly journals Management of Otological Foreign Bodies Impaction in Tertiary Health Care Center

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Waheed Atilade Adegbiji ◽  
Shuaib Kayode Aremu ◽  
AbdulAkeem A. Aluko ◽  
Olawale Olubi
Keyword(s):  
Health Care ◽  
Foreign Body ◽  
Health Workers ◽  
Care Center ◽  
Predisposing Factors ◽  
Female Ratio ◽  
Health Care Center ◽  
External Canal ◽  
Foreign Body Impaction ◽  
Male To Female

Background: Otologic foreign body impaction are common ear disorder with an associated challenge due to high levels with of pre-hospital unskilled attempted removal. Aim: This study aimed at determining the prevalence, socio-demographic features, etiology, clinical presentation, management and outcome in a tertiary health care center in Nigeria. Materials and Methods: This is a prospective hospital-based study of all patients with an impacted otologic foreign body. Consented patients were studied between October 2015 and September 2017. The interviewer-assisted questionnaire was used to collect data. Analysis of obtained data was done SPSS version 16.0. Results: Prevalence of otologic foreign body impaction was 4.5%. There were 58.5% males with a male to female ratio of 1.5:1. The main type of ear foreign body impaction was 85.2% organic (living or dead) and 14.8% inorganic. Commonest otologic foreign body were a cotton bud, insects and seeds in 38.5%, 17.0% and 11.9% respectively. The foreign body was unilateral in 97.0% and bilateral in 3.0%. Left ear in 42.2% and right ear in 54.8%. The foreign body was in the external canal in 97.8% and middle ear cleft in 2.2%. Main sources of referral were self-reporting in 30.4% and general practitioners in 22.2%. Commonest predisposing factors were 31.1% allergy, 23.7% otitis externa, 15.6% earwax and 3.0% mental disorders. Conclusion: There are the different type of otology foreign body in all age group and associated predisposing factors. Pre-hospital attempt removal by unskilled sympathizers and untrained health workers leads to avoidable complications.

Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

2019 ◽  
Author(s):  
Waheed Atilade Adegbiji ◽  
Shuaib Kayode Aremu ◽  
AbdulAkeem Adebayo Aluko
Keyword(s):  
Foreign Body ◽  
Head And Neck ◽  
Clinical Features ◽  
University Teaching ◽  
Age Group ◽  
Geriatric Population ◽  
Female Ratio ◽  
Common Diagnosis ◽  
Foreign Body Impaction ◽  
Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

scholarly journals Description of the epidemiological characteristics of work-related eye injuries in Spain: a retrospective study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035696
Author(s):  
Sergio Martin-Prieto ◽  
Cristina Álvarez-Peregrina ◽  
Israel Thuissard-Vasallo ◽  
Carlos Catalina-Romero ◽  
Eva Calvo-Bonacho ◽  
...  
Keyword(s):  
Injured Workers ◽  
Insurance Companies ◽  
Secondary Outcome ◽  
Ocular Injury ◽  
Insurance Company ◽  
Age Group ◽  
Eye Injuries ◽  
Manual Task ◽  
Work Related ◽  
Epidemiological Characteristics

ObjectiveTo describe the epidemiological characteristics and trends of work-related eye injuries (WREIs) in Spain over a 10-year period by sex, age and occupational sector.Design and settingsA descriptive, retrospective and longitudinal study based on data from workers insured by a labour insurance company in Spain from 2008 to 2018 was presented. The study considered the ratio of the number of WREI per 100 000 population and the relative risk of suffering an ocular injury. WREIs were characterised by sex, age and occupational sector of injured workers.Primary and secondary outcome measuresRatio of the number of WREI.ParticipantsIn Spain, all workers are insured by a labour insurance company that provides cover in the event of work-related accidents. In this study, we have included all workers insured by one of these insurance companies, IBERMUTUA, with workers in all areas of Spain.ResultsThe study included 50 265 WREI in the company over the 10-year period. Most of the injuries occurred in males (44 445; 88.4%), in 35–44 age group (15 992; 31.8%) and in industry workers (18 899; 42.6%). The average incidence was 429.75 per 100 000 workers insured and 4273.36 per 100 000 IBERMUTUA accidents (related and not related to eyes). Males, 16–24 age group and industry occupational sector group, have the highest incidence for WREI. The incidence of WREI decrease over the study period in all variables. Males have 6.56 (95% CI 6.38 to 6.75) times more risk of suffering WREI than females. 16–24 age group have 1.77 (95% CI 1.71 to 1.83) times more risk than in the group of workers older than 55. Finally, industry workers have 7.73 (95% CI 7.55 to 7.92) times more risk than services workers.ConclusionsThe risks of suffering WREI is higher for males, younger and less experienced workers, and for those who works in a manual task.

scholarly journals Predictors of Malaria Rapid Diagnostic Tests’ Utilisation Among Healthcare Workers in Zamfara State

2018 ◽  
Author(s):  
Usman Rabi ◽  
Ahmad A. Umar ◽  
Saheed Gidado ◽  
A.A Gobir ◽  
Izuchukwu F. Obi ◽  
...  
Keyword(s):  
Community Health ◽  
Healthcare Workers ◽  
Health Workers ◽  
Diagnostic Testing ◽  
Study Data ◽  
Good Knowledge ◽  
Health Extension Workers ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Influencing

AbstractIntroductionEarly diagnosis and prompt and effective treatment is one of the pillars of malaria control Malaria case management guidelines recommend diagnostic testing before treatment using malaria Rapid Diagnostic Test (mRDT) or microscopy and this was adopted in Nigeria in 2010. However, despite the deployment of mRDT, the use of mRDTs by health workers varies by settings. This study set out to assess factors influencing utilisation of mRDT among healthcare workers in Zamfara State, Nigeria.MethodsA cross-sectional study was carried out among 306 healthcare workers selected using multistage sampling from six Local Government Areas between January and February 2017. Mixed method was used for data collection. A pre-tested self-administered questionnaire was used to collect information on knowledge, use of mRDT and factors influencing utilization. An observational checklist was used to assess the availability of mRDT in the six months prior to this study. Data were analyzed using descriptive statistics such as means and proportions. Association between mRDT use and independent variables was tested using Chi square while multiple regression was used to determine predictors of use at 5% level of significance.ResultsMean age of respondents was 36.0 ± 9.4years. Overall, 198 (64.7%) of health workers had good knowledge of mRDT; malaria RDT was available in 33 (61.1%) facilities. Routine use of mRDT was reported by 253 (82.7%) healthcare workers. This comprised 89 (35.2%) laboratory scientists/technicians, 89 (35.2%) community health extension workers/community health officers; 59 (23.3%) nurses and 16 (6.3%) doctors. Predictors of mRDT utilisation were good knowledge of mRDT (adjusted OR (aOR):3.3, CI: 1.6-6.7), trust in mRDT results (aOR: 4.0, CI: 1.9 - 8.2), having being trained on mRDT (aOR: 2.7, CI: 1.2 - 6.6), and provision of free mRDT (aOR: 2.3, CI: 1.0 - 5.0).ConclusionThis study demonstrated that healthcare worker utilisation of mRDT was associated with health worker and health system-related factors that are potentially modifiable. There is need to sustain training of healthcare workers on benefits of using mRDT and provision of free mRDT in health facilities.

scholarly journals Building a patient blood management program in a large-volume tertiary hospital setting: Problems and solutions

2020 ◽  
Vol 28 (3) ◽  
pp. 560-569
Author(s):  
Serdar Serdar Günaydın
Keyword(s):  
Large Volume ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Management Program ◽  
Successful Implementation ◽  
Patient Blood Management ◽  
Blood Management ◽  
Specific Patient ◽  
Management Protocol ◽  
Problems And Solutions

Successful implementation of a patient blood management program necessitates the collaboration of a strong organization and a multidisciplinary approach. We organized a meeting with broad participation in our center to establish a consensus for implementation of a specific patient blood management program. International and domestic experiences were shared, the importance of coordination and execution of different pillars in patient blood management were discussed, and the problems about the blood transfusion system were also investigated with the proposal for solutions. The data obtained from this meeting are presented to be a guide for similar large-volume tertiary hospitals for integration of a patient blood management protocol.

scholarly journals Oesophagal foreign Bodies Ingestion: Experience of 109 Cases

2020 ◽  
Vol 11 (4) ◽  
pp. 7410-7416
Author(s):  
Firas Shaker Mahmoud Al-Faham ◽  
Samer Makki Mohamed Al-Hakkak ◽  
Laith Fathi F. Sharba
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Middle Part ◽  
Food Refusal ◽  
Surgical Department ◽  
Magill Forceps ◽  
Pediatric Age Group ◽  
Body Sensation ◽  
Medical City ◽  
Foreign Body Impaction

Esophageal foreign bodies ingestion is a worldwide surgical issue in pediatric age group while less likely in adults. We estimate endoscopic, clinical and therapeutic sides of this situation in the surgical department in Al-Hussein Teaching Hospital, Karbala city, Iraq and in Al-Sader Medical City, Najaf city, Iraq. The study made to revise our experience for all patients admitted to our hospitals with a diagnosis of oesophagal foreign bodies and their treatments and outcome. The medical registrations resolved concerning demographic information, symptoms presented, investigation and treatments. We revised 109 (61 males and 48 females) patients ranged from 4 months to 65 years with (median age of 2 years). Coins most repeatedly ingested objects (27.5%), miscellaneous metal objects (17.4%), batteries (13.8%) and food (9.2%). The clinical features we encountered vomiting (27.5%), dysphagia (22.9%), asymptomatic (15.6%), drooling and food refusal (12.8 %) and foreign body sensation (8.3%). Usually X-ray screen finding the foreign body in 89(81%) patients. Magill forceps and rigid oesophagoscope performed within six hours from admission under general anaesthesia and from 12-48 from time of ingestion. Foreign body Impaction in the hypopharynx and the upper part of the oesophagus (68.8%) middle part (23%) and the lower part (8.2 %).100(91.7%) patients recovered completely without any complications,9 (18.3%) patient get bleeding, mucosal ulceration and infection which treated successfully.

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