Outcomes of Children Presenting with Button Battery in Esophagus: A Retrospective Review

2020 ◽  
Vol 42 (1) ◽  
pp. 44-48
Author(s):  
Bigyan R Gyawali ◽  
Rajendra P Sharma Guragain ◽  
Yogesh Neupane ◽  
Heempali Dutta ◽  
Lava Shrestha ◽  
...  
Keyword(s):  
Mucosal Injury ◽  
Paediatric Population ◽  
University Teaching ◽  
Time Interval ◽  
Button Battery ◽  
Patient Demographics ◽  
Final Sample ◽  
Superficial Ulcer ◽  
Mucosal Erosion ◽  
Abductor Palsy

Introduction Foreign body in esophagus is a common ENT emergency. Button batteries tend to have more grievous outcomes due to caustic mucosal injury to the esophagus. The objective of our study was to review the clinical profile and outcomes of the paediatric population in our center who presented with button battery in esophagus following accidental ingestion. MethodsThis was a retrospective study conducted in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Hospital records of all the patients who presented with button battery esophagus and underwent rigid oesophagoscopic removal from January 2013 to January 2019 were reviewed and analyzed for patient demographics, time interval between ingestion and presentation, site of impaction, status of oesophageal mucosa at the time of rigid oesophagoscopic removal of the battery, early post-operative complications, outcomes at the time of discharge and on follow-up. ResultsOur final sample size was 11 and all cases were <15 years. The average duration from time of ingestion to presentation to our hospital ranged from 1 day to 2 months. Variable oesophageal mucosal findings such as superficial mucosal erosion, superficial ulcer with slough and granulations with deep discrete ulcer were seen at the site of impaction of the button battery. One case was diagnosed with bilateral abductor palsy on 10th post-operative day following rigid oesophagoscopic removal of the battery. All other cases didn’t develop any significant complications. ConclusionButton battery in esophagus results in oesophageal ulceration and thus warrants an early endoscopic removal. Delayed removal can also cause bilateral abductor palsy from the caustic damage to recurrent laryngeal nerve.

Study of Pakistan manufacturing workers shows entrepreneurial leadership is the key to developing creativity

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Keyword(s):  
Psychological Empowerment ◽  
Manufacturing Sector ◽  
Psychological Safety ◽  
Time Interval ◽  
Entrepreneurial Leadership ◽  
Employee Creativity ◽  
Content Type ◽  
Entrepreneurial Skills ◽  
Final Sample ◽  
Training Programmes

Purpose The main was to investigate the effect of entrepreneurial leadership on employee creativity and the mediating influence of psychological empowerment and psychological safety. Design/methodology/approach Data were collected from the manufacturing sector in Pakistan, including textile, chemical and automobile industries. Questionnaires had three parts, one for managers and two for employees. The researchers collected data in three phases with a one-month time interval. First, employees rated statements about entrepreneurial leadership behaviours. Then, employees rated statements about psychological empowerment and psychological safety. Finally, managers rated statements related to employees’ creativity. The final sample comprised of 54 leaders and 280 employees. Findings Results showed that entrepreneurial leadership inspired employee creativity. In addition, psychological empowerment and psychological safety mediated the relationship between entrepreneurial leadership and employee creativity. Originality/value The study has practical implications. Organizations should hire managers with the entrepreneurial skills to inspire creativity. Leaders should also stress the value of the employee’s work by sharing organisational goals, as well as directing employees when tasks are complex. Meanwhile, organizations need to develop training programmes to help managers to improve their leadership skills. Entrepreneurial leaders can inspire employees by modelling behaviours, which will be psychologically empowering and ensure employees feel secure enough to be creative.

scholarly journals Multiple Gastric Erosion Early after a 3 V Lithium Battery (CR2025) Ingestion in an 18-Month-Old Male Patient: Consideration about the Proper Time of Intervention

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Ioannis Patoulias ◽  
Christos Kaselas ◽  
Dimitrios Patoulias ◽  
Konstantinos Farmakis ◽  
Eleni Papacrivou ◽  
...  
Keyword(s):  
Male Patient ◽  
Proper Time ◽  
Emergency Situation ◽  
Gastric Erosion ◽  
Button Battery ◽  
Negative Pole ◽  
Asymptomatic Patients ◽  
Lethal Complications ◽  
Mucosal Erosion ◽  
Time Of Intervention

Introduction. Button battery ingestion is considered an emergency situation in pediatric patients that needs to be managed promptly; otherwise, it may lead to serious and potentially lethal complications, especially when it is impacted in the esophagus. Less attention has been given in cases where the battery passes into the stomach, with guidelines for emergency intervention being based on the presence of symptoms. Case Report. We present a case of an 18-month-old male patient who presented to our emergency department after button battery ingestion. He did not have any symptoms and no pathological findings were encountered during clinical examination. X-ray investigation revealed the presence of the battery in the stomach. The patient was admitted for observation and two hours later he had two episodes of vomiting. He underwent urgent endoscopic removal of the battery where multiple acute gastric mucosal erosion in place of direct contact of the battery’s negative pole with the mucosa of the gastric antrum was found. Conclusion. In specific cases the urgent endoscopic intervention for removal of an ingested button battery that is located in the stomach even in asymptomatic patients should be suggested.

scholarly journals Immunoglobulin A (IgA) Nephropathy in Protocol Graft Kidney Biopsy done at six months Post Transplantation in a Tertiary Care Center Hospital of Nepal

2017 ◽  
Vol 6 (1) ◽  
pp. 6-11
Author(s):  
Midhan Shrestha ◽  
Dibya Singh Shah
Keyword(s):  
Iga Nephropathy ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
University Teaching ◽  
Time Interval ◽  
Post Transplantation ◽  
Protocol Biopsy ◽  
Post Transplant

Background: Renal transplantation is the treatment of choice for end stage renal disease. The focus of interest has been to increase the life of the transplanted graft. Recurrence of native kidney disease or occurrence of denovo glomerulonephritis has adverse effects in graft survival. Protocol graft biopsy done at fixed time interval after transplantation aids in early identification of post-transplant glomerulonephritis before development of clinical signs and symptoms. This study describes the incidence of post-transplant IgA Nephropathy in protocol renal graft biopsies done at six months post- transplantation.Materials and Methods: This is a hospital based observational descriptive study, done in Tribhuvan University Teaching Hospital, Kathmandu, Nepal, a tertiary medical referral center in the capital. Protocol biopsy of the graft kidney was performed at six months post-transplantation in all recipients who underwent kidney transplantation in this hospital between 2071 Kartik and 2072 Ashwin.Results: Protocol biopsy was performed in total 47 recipients. Mean age of the recipients was 33.7 years ±10.83 years. The study population consisted of 33 (70.2%) male and 14 (29.8%) female recipients. IgA Nephropathy was present in 6 (12.8%) recipients.Conclusion: Our study demonstrates that IgA Nephropathy does occur in patients with stable GFR and without any clinical or laboratory abnormalities. Protocol biopsy is valuable in detection of early histologic abnormalities before onset of clinical manifestations, thus helping in prompt management with aim to prolong the graft survival.Journal of Nobel Medical CollegeVolume 6, Number 1, Issue 10 (January-June, 2017)

Gastric Secretory and Mucosal Injury Response to Severe Head Trauma

Neurosurgery ◽  
1983 ◽  
Vol 12 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Steven K. Gudeman ◽  
C. B. Wheeler ◽  
Douglas J. Miller ◽  
Gregg L. Halloran ◽  
Donald P. Becker
Keyword(s):  
Acid Output ◽  
Titratable Acidity ◽  
Mucosal Injury ◽  
Mean Value ◽  
Injury Response ◽  
Gastrointestinal Complications ◽  
Mucosal Erosion ◽  
The Mean ◽  
Level Of Significance ◽  
Injured Patients

Abstract The problem of gastric secretory and mucosal injury response was evaluated in 19 patients who had suffered a severe head injury. Fifteen of 19 patients had some evidence of gastrointestinal hemorrhage. In 7 cases, this was marked. The mean volume of gastric secretions ranged from 36.4 ml/hour on Day 1 to 47.6 ml/hour on Day 6. The mean value of titratable acidity ranged from 3.4 meq/hour on Day 1 to 3.9 meq/hour on Day 6. Possible risk factors were analyzed as a means of predicting specific subgroups of severely injured patients who would be more prone to have gastrointestinal complications. During the first 6 days after injury, there was no significant association (correlation coefficient not significant at the 0.05 level of significance) of the presence of an intracranial mass lesion, elevated intracranial pressure, brain stem dysfunction or prior episodes of hypotension or hypoxia, sepsis, shock, or the requirement for pressor agents with elevated gastric acid output, mucosal erosion, or hemorrhage. Because no specific risk factor or factors could be identified, all severely braininjured patients should be on some form of therapy for the prevention of gastrointestinal complications.

Prevalence of Inhaled Corticosteroid Use among Patients with Chronic Obstructive Pulmonary Disease: A Survey

1997 ◽  
Vol 31 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Cynthia A Jackevicius ◽  
Kenneth R Chapman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Medical Records ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
University Teaching ◽  
Chronic Obstructive ◽  
Inhaled Corticosteroid ◽  
Obstructive Pulmonary Disease ◽  
Patient Demographics

Objective To determine the extent of inhaled corticosteroid use among patients with chronic obstructive pulmonary disease (COPD). Design Review of medical records. Setting Tertiary-care university teaching hospital. Patients Seventy-two consecutive patients prescribed an inhaled corticosteroid during hospitalization. Intervention None. Measurements Patient demographics, inhaled corticosteroid regimen, respiratory diagnosis, and inhaled corticosteroid use before and during hospitalization. Results The majority of patients (85%) were receiving their prescribed corticosteroid inhaler prior to admission. Beclomethasone dipropionate 250 μg/puff was the most commonly prescribed inhaled corticosteroid formulation accounting for 43% of the total corticosteroid inhaler orders. COPD was the most common respiratory diagnosis (43%) associated with inhaled corticosteroid use, followed by asthma (37%), COPD/asthma (13%), and no diagnosis (7%). During the study period, the proportion of all hospitalized patients with COPD who also received inhaled corticosteroid prescriptions (35%) was not significantly different from all hospitalized patients with asthma who received inhaled corticosteroid prescriptions (33%). Conclusions The rate of inhaled corticosteroid use far exceeds the rate expected among the general population of patients with COPD. Educational intervention is needed to encourage compliance with published guidelines for the management of COPD.

scholarly journals Out-of-Hospital Cardiac Arrest in a Teaching Hospital in Hong Kong: Descriptive Study Using the Utstein Style

2005 ◽  
Vol 12 (3) ◽  
pp. 148-155 ◽  
Author(s):  
AKC Wai ◽  
P Cameron ◽  
CK Cheung ◽  
P Mak ◽  
TH Rainer
Keyword(s):  
Cardiac Arrest ◽  
Hong Kong ◽  
Hospital Discharge ◽  
Teaching Hospital ◽  
Discharge Rate ◽  
Demographic Data ◽  
University Teaching ◽  
Time Interval ◽  
Utstein Style ◽  
Hospital Cardiac Arrest

Objective To describe, using the Utstein template, the characteristics of patients presenting with out-of-hospital cardiac arrest to a university teaching hospital in the New Territories of Hong Kong, and to evaluate survival. Design Prospective study. Setting The emergency department of a teaching hospital in the New Territories, Hong Kong. Participants Patients older than 12 years with non-traumatic out-of-hospital cardiac arrest who were transported to the hospital between 1 July 2002 and 31 December 2002. Main outcome measures Demographic data, characteristics of cardiac arrest and response time intervals of the emergency medical service presented according to the Utstein style, and also survival to hospital discharge rate. Results A total of 124 patients were included (49.2% male; mean age 71.9 years). The majority of cardiac arrests occurred in patients' home. The overall bystander cardiopulmonary resuscitation (CPR) rate was 15.3% (19/124). The most common electrocardiographic rhythm at scene was asystole, whilst pulseless ventricular tachycardia (VT)/ventricular fibrillation (VF) was found in 18.0%. The overall survival was 0.8% (1/124), and survival to hospital discharge was significantly higher for patients with VF or pulseless VT than those patients with other rhythms of cardiac arrest (11.1% versus 0%). The median witnessed/recognised collapse to defibrillation time was 14 minutes. The median prehospital time interval from collapse/recognition to arrival at hospital was 33 minutes. Conclusion The prognosis of out-of-hospital cardiac arrest in Hong Kong was poor. Major improvements in every component of the chain of survival are necessary.

Avascular Necrosis of the Talus After Subchondroplasty

2021 ◽  
pp. 107110072110054
Author(s):  
Andrew E. Hanselman ◽  
Elizabeth A. Cody ◽  
Mark E. Easley ◽  
Samuel B. Adams ◽  
Selene G. Parekh
Keyword(s):  
Avascular Necrosis ◽  
Case Reports ◽  
Case Series ◽  
Time Interval ◽  
Foot And Ankle ◽  
Specific Procedure ◽  
Radiographic Evidence ◽  
Level Of Evidence ◽  
Index Procedure ◽  
Patient Demographics

Background: Subchondroplasty (SCP) is a relatively new procedure, developed in 2007 for the treatment of bone marrow lesions (BMLs), that has shown promising results in the knee through several different case series. The foot and ankle literature, however, is sparse, with only a few documented case reports or case series. At our institution, we have identified several patients with complications after this specific procedure. As a result, we report our case series of patients who developed talar avascular necrosis (AVN) after undergoing SCP. Methods: A retrospective review was performed of patients who underwent SCP for a talar BML at our facility or who were referred to our facility after undergoing SCP at an outside institution. Patients were included if they developed radiographic evidence of talar AVN after the procedure. Patient demographics, comorbidities, concomitant intraoperative procedures, complications, and subsequent interventions were reviewed. Results: Seven patients were identified as having radiographic evidence of talar AVN after SCP. Average time interval was 23 months postoperative from index procedure to radiographic confirmation of AVN. Two of the index procedures were performed at our institution, whereas 5 of the index procedures were performed at outside institutions and referred for further management. Three patients had documented risk factors for AVN before the SCP procedure. All 7 patients were symptomatic from the AVN. Conclusion: We identified 7 patients who went on to develop talar AVN after having undergone SCP. Level of Evidence: Level IV, case series.

scholarly journals Clandestine Abortions in Cameroon: Risk Factors for Severe Complications

2016 ◽  
Vol 29 (1) ◽  
pp. 21-25
Author(s):  
Elie Nkwabong ◽  
Efuetnkeng Bechem ◽  
Joseph Nelson Fomulu
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
University Teaching ◽  
Time Interval ◽  
Fisher Exact Test ◽  
Primary Health Center ◽  
Significance Level ◽  
Exact Test ◽  
Dilatation And Curettage ◽  
The University

Objective (s): The aim of this study was to identify risk factors for severe complications (SC) of clandestine abortions.Methods: This retrospective descriptive study was conducted between March 1st and August 31st, 2012 in the maternities of the University Teaching Hospital and the Central Hospital, Yaoundé (Cameroon). Files of women with clandestine abortions were recruited. Main variables studied were maternal age, parity, gestational age, the method used, the time interval between abortion and consultation, the complications presented. Data of women with SC were compared to those of women who had with non severe or no complications (NC). Fisher exact test and student t test were used for comparison. The significance level was p=0.05.Results: Amongst 94 women, 76 (80.9%) had SC against 18 (19.1%) with NC.Risk factors for SC were gestational age e”12 weeks (OR 2.7, 95%CI 0.8-8.9), abortion carried out with dilatation and curettage/evacuation (OR 2.4, 95%CI 0.6-9.2) or with intramuscular injection of a non specified medication (four cases against zero respectively), by a nurse (OR 1.4, 95%CI 0.5- 4.1), by a friend (nine cases against zero respectively) or a traditional healer (three cases against zero respectively). Other risk factors were abortion carried out in a primary health center (OR 1.5, 95%CI 0.4-4.7) and late consultation after abortion (P=0.0404).Conclusions: For prevention of severe post abortal complications, women and abortionists should be informed on these risk factors.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 21-25

scholarly journals Button battery ingestion in children: An emerging hazard

2013 ◽  
Vol 04 (03) ◽  
pp. 071-074 ◽  
Author(s):  
Mayank Jain ◽  
Chandrashekhar Waghmare ◽  
Sagar Adkar ◽  
Shohini Sircar ◽  
Ajay K. Jain
Keyword(s):  
Retrospective Study ◽  
Mucosal Injury ◽  
Age Group ◽  
Pediatric Age ◽  
Button Battery ◽  
Pediatric Age Group ◽  
Rigid Esophagoscopy ◽  
Local Injury ◽  
Button Batteries

AbstractButton battery ingestion is an emerging hazard. In this retrospective study, we report six cases of lithium button battery ingestion in pediatric age group (mean age 2.8 years). Three button batteries were removed from stomach and three from esophagus. Esophageal site was associated with significant local injury, and one button battery was impacted in the esophagus, requiring rigid esophagoscopy for removal. Small battery size, used batteries, and early removal (<12 h after ingestion) were associated with lesser mucosal injury. No long-term complications were noted. Our study emphasizes that early diagnosis and urgent removal of ingested button battery are the only measures which prevent complications.

scholarly journals The impact of day of surgery on the length of stay for major urological procedures

2016 ◽  
Vol 10 (11-12) ◽  
pp. 367 ◽  
Author(s):  
Gregory J. Nason ◽  
Eabhann M. O'Connor ◽  
Cathleen O'Neill ◽  
Omer Izzeldin ◽  
Shane W. Considine ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
University Teaching ◽  
Open Partial Nephrectomy ◽  
Patient Demographics ◽  
Open Radical Prostatectomy ◽  
Significant Difference ◽  
Hospital Resources ◽  
Urological Procedures ◽  
The Impact

Introduction: Surgery performed later in the week has been associated with longer length of stay (LOS). The aim of this study was to assess if the day of the surgery impacted the LOS for two major urological procedures in a tertiary referral university teaching hospital.Methods: A retrospective review was performed of two major urological procedures consecutively performed by a single surgeon in our unit from March 2012 to December 2015. Patient demographics, histopathological characteristics, operative details, and LOS were obtained from the patients’ medical records. Procedures performed on Monday or Tuesday were defined as early in the week and procedures performed on Wednesday, Thursday, or Friday were defined as late in the week.Results: During the study period, 140 open radical prostatectomy (ORP) and 42 open partial nephrectomy (OPN) procedures were performed. There was a significant difference in median LOS for major urological procedures performed early in the week compared to late in the week (3 [3‒4] days vs. 4 [4‒5] days; p= 0.0001). There was a significant difference in median LOS for ORP performed early in the week compared to late in the week (3 [3‒4] days vs. 4 [4‒5] days; p= 0.0004). There was a similar significant difference in OPN performed early in the week compared to late in the week (4 [3‒5.5] days vs. 5 [4‒5] days; p= 0.029).Conclusions: The day of surgery impacts LOS for major urological procedures. Major procedures should be performed early in the week, when it is feasible to facilitate prompt safe discharge and better use of hospital resources.

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