scholarly journals A Five-year Report on Body Packing and Body Stuffing in Isfahan

2021 ◽  
Vol 15 (4) ◽  
pp. 215-222
Author(s):  
Farzad Ghesglaghi ◽  
◽  
Mojgan Gomari ◽  
Shaun L. Greene ◽  
Joe Anthony Rotella ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Outcomes ◽  
Illicit Drugs ◽  
University Hospital ◽  
Crystal Methamphetamine ◽  
Body Packing ◽  
X Ray ◽  
Therapeutic Modalities ◽  
Significant Difference ◽  
Close Observation

Background: Body packing and body stuffing of illicit drugs have increased in recent decades. The drug contents of the packages vary from region to region, and there are controversies surrounding the diagnostic and therapeutic methods. The aim of this study was to explore the clinical presentations, diagnostic and therapeutic measures, and the subsequent clinical outcomes of drug concealment by people. Methods: A retrospective analysis was performed on data for all cases of body packing and body stuffing that were referred to a university hospital, in Isfahan, Iran, from Mar. 2013 to Feb. 2018. Results: Sixty-eight body stuffers and 18 body packers (n=86) were included in this study. Seventy-eight patients (90.7%) were male, mostly aged between 20 to 40 years. There was no significant difference between the two groups with respect to the signs and symptom, hospital stay, treatment and clinical outcomes. Heroin and crystal methamphetamine, n=52 (60%) and n=22 (25%), respectively, were the most substances detected, irrespective of the concealment method. Abdominal X-ray and CT scan tests were positive for the detection of at least one packet in each of the 94.4% of the patients. Conclusion: Heroin and crystal methamphetamine were the most common substances concealed in the bodies of the patients. Based on our findings, CT scan was more sensitive than abdominal X-ray test in the detection of illicit drug packets concealed in the patients. Close observation and whole bowel irrigation were effective therapeutic modalities in most cases. All cases were fully recovered and discharged from the hospital.

scholarly journals Association of Plasma Levels of Nitric Oxide Oxidative Metabolites with Acute Stroke in Patients Presenting to the Emergency Department of a Low-Middle Income Country

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Shahan Waheed ◽  
Ayaz Ghouse Kalsekar ◽  
Ayeesha Kamran Kamal ◽  
Nathan S. Bryan ◽  
Asad I. Mian
Keyword(s):  
Nitric Oxide ◽  
Emergency Department ◽  
Acute Stroke ◽  
Clinical Outcomes ◽  
Hemorrhagic Stroke ◽  
Nonparametric Tests ◽  
University Hospital ◽  
Stroke Severity ◽  
Oxidative Metabolites ◽  
Significant Difference

Introduction. Acute stroke incites an inflammatory reaction in the brain’s microvasculature, activating formation of nitric oxide oxidative metabolites, nitrate and nitrite (NOx, collectively), measurable in plasma. Our objectives were to investigate plasma NOx in patients with acute stroke presenting to the Emergency Department (ED) and to determine if it could (i) differentiate between ischemic and hemorrhagic stroke; (ii) predict clinical outcomes. Methods. A cross-sectional study was conducted in the ED of Aga Khan University Hospital, from January 1 to December 31, 2016. Participants were enrolled if they had clinical acute stroke with confirmatory brain imaging to differentiate between ischemia and hemorrhage. Clinical demographic information, ancillary blood, and diagnostic specimens were collected as per standard of care since the center follows stroke algorithmic guidelines. Plasma NOx analysis was performed using high performance liquid chromatography. Clinical outcomes were assessed using Barthel Index and Modified Rankin Score. Data was analyzed using SPSS 19 and expressed in medians with interquartile ranges. Nonparametric tests were applied for comparing among groups. Pearson’s correlation was used to determine associations with aforementioned stroke severity and disability scales. Results. Seventy-five patients were enrolled, with median age of 57 years (IQR 47-66 years), 53 (71%) were males, and 46 (61%) had ischemic stroke. Overall, median NOx was 20.8 μM (IQR 13.4-35.3); there was no statistically significant difference between NOx in ischemic versus hemorrhagic stroke (21.2 μM vs. 17.9 μM; p=0.2). However, there was a significant positive correlation between NOx levels and aforementioned acute stroke scales [r(73)=0.417, p=0.0001], for both. Conclusion. Although plasma NOx could not differentiate between ischemia and hemorrhage, higher levels of the biomarker did show associations with poststroke disability scales. Further study with more patients in a multicenter trial is warranted to establish the real biomarker potential of plasma NOx in acute stroke.

scholarly journals Hybrid emergency room reduces blood transfusion for patients with severe trauma

2021 ◽  
Author(s):  
Hiroaki Watanabe ◽  
Ryo Matsumoto ◽  
Shunsuke Kuramoto ◽  
Tomohiro Muronoi ◽  
Kazuyuki Oka ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Emergency Room ◽  
Ct Scan ◽  
Injury Severity ◽  
Ct Scanning ◽  
Severe Trauma ◽  
Fresh Frozen Plasma ◽  
University Hospital ◽  
Clinical Effects ◽  
Significant Difference

Abstract Background: A hybrid emergency room (hybrid ER) is defined as an emergency unit with four functions: resuscitation, computed tomography (CT) scanning, performing operations, and angiography. The safety and efficacy of performing CT scans in a hybrid ER is not well known in the primary survey. The purpose of this study was to evaluate the safety and clinical effects of hybrid ERs. Methods: This was a retrospective observational study using the Shimane University Hospital Trauma Databank from January 2016 to February 2019. Hospitalized patients with severe trauma and an injury severity score ≥ 16 were divided into two groups: the non-hybrid ER group (n=134) and the hybrid ER group (n=145). The time from arrival to CT scan and interventions, and number of in-hospital survivors, preventable trauma deaths (PTD), and unexpected survivors (US) were assessed between both groups. The amount of blood transfused was also compared between the groups. Results: The time from arrival to CT scan and interventions was significantly reduced in the hybrid ER group compared with than in the non-hybrid ER group (25 vs. 6 minutes; p <0.0001, 101 vs. 41 minutes; p =0.0007). There was no significant difference in the rate of in-hospital survivors (96.9 vs. 96.3%; p=0.770), PTD (0 vs. 0%), and US (9.0 vs. 6.2%; p=0.497) between the groups. The amount of blood transfused was significantly reduced in the hybrid ER group compared to the non-hybrid ER group (red blood cell: 6 vs. 2, p =0.012, fresh frozen plasma: 9 vs. 6, p =0.021). Conclusions: The results of our study suggest that trauma treatment in a hybrid ER is as safe as previous conventional treatment in a non-hybrid ER, and that hybrid ERs, which can reduce the time for trauma surveys and treatment and do not require patient transfer, can reduce the amount of blood transfusion required for resuscitation.

CT with Coronal Reconstruction Identifies Previously Missed Smaller Diaphragmatic Injuries after Blunt Trauma

2011 ◽  
Vol 77 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Indermeet S. Bhullar ◽  
Ernest F. J. Block
Keyword(s):  
Ct Scan ◽  
Blunt Trauma ◽  
Exploratory Laparotomy ◽  
Fisher Exact Test ◽  
Exact Test ◽  
X Ray ◽  
Significant Difference ◽  
Chest X Ray ◽  
The Mean ◽  
Level I

Diaphragmatic injuries (DIs) are difficult to diagnose and often go unrecognized after blunt trauma. We proposed that CT scan with coronal reconstruction (CTCR) improves the detection of small DIs missed by chest x-ray (CXR) and CT scan with axial views (CTAX). We performed a retrospective review at a Level I trauma center from 2001 to 2006 and identified 35 patients who underwent operative repair of DI after blunt trauma. The size of the DI and the radiographic test (CXR, CTAX, and CTCR) that identified the defect was compared. Results were analyzed using mean, Mann-Whitney U test, and Fisher exact test. Of the 35 DI repairs, nine were performed after CXR alone and 12 after identification by both a CXR and CTAX. There was no significant difference between the mean DI size identified by CXR with and without CTAX (10.6 vs 9.7, P = 0.88). The remaining 14 DIs were undetected by CXR and CTAX. Seven of these (before CTCR) were found during exploratory laparotomy and seven were identified by CTCR (4.6 cm vs 3.5 cm, P = 0.33). The mean DI size identified by CTCR was significantly smaller than that identified by CXR alone (4.6 cm vs 9.7 cm, P < 0.05) and by CXR and CTAX (4.6 cm vs 10.6 cm, P < 0.0005). CTCR improves the ability to detect smaller DI defects (4 to 8 cm) that were previously missed by CXR and CTAX. CTAX adds little to CXR alone for the diagnosis of large defects (greater than 8 cm).

Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

2020 ◽  
Vol 3 ◽  
pp. 36-39
Author(s):  
Samson O. Paulinus ◽  
Benjamin E. Udoh ◽  
Bassey E. Archibong ◽  
Akpama E. Egong ◽  
Akwa E. Erim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Work Experience ◽  
Radiation Risk ◽  
Radiological Protection ◽  
X Ray ◽  
Tertiary Hospitals ◽  
Medical Exposure

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

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

The Y-shaped trabecular bone structure in the odontoid process of the axis: a CT scan study in 54 healthy subjects and biomechanical considerations

2019 ◽  
Vol 30 (5) ◽  
pp. 585-592 ◽  
Author(s):  
Nicola Montemurro ◽  
Paolo Perrini ◽  
Vittoriano Mangini ◽  
Massimo Galli ◽  
Andrea Papini
Keyword(s):  
Ct Scan ◽  
Healthy Subjects ◽  
Bone Structure ◽  
Cone Beam Ct ◽  
Odontoid Process ◽  
Trabecular Structure ◽  
Anatomical Entity ◽  
Significant Difference ◽  
Axial Ct ◽  
The Mean

OBJECTIVEOdontoid process fractures are very common in both young and geriatric patients. The axial trabecular architecture of the dens appears to be crucial for physiological and biomechanical function of the C1–2 joint. The aim of this study is to demonstrate the presence of a Y-shaped trabecular structure of the dens on axial CT and to describe its anatomical and biomechanical implications.METHODSFifty-four C2 odontoid processes in healthy subjects were prospectively examined for the presence of a Y-shaped trabecular structure at the odontocentral synchondrosis level with a dental cone beam CT scan. Length, width, and axial area of the odontoid process were measured in all subjects. In addition, measurements of the one-third right anterior area of the Y-shaped structure were taken.RESULTSThe Y-shaped trabecular structure was found in 79.6% of cases. Length and width of the odontoid process were 13.5 ± 0.6 mm and 11.2 ± 0.9 mm, respectively. The mean area of the odontoid process at the odontocentral synchondrosis was 93.5 ± 4.3 mm2, whereas the mean one-third right anterior area of the odontoid process at the same level was 29.3 ± 2.5 mm2. The mean area of the odontoid process and its length and width were similar in men and women (p > 0.05). No significant difference was found in the mean area of the odontoid process in people older than 65 years (94 ± 4.2 mm2) compared to people younger than 65 years (93.3 ± 4.4 mm2; p > 0.05).CONCLUSIONSThe authors identified a new anatomical entity, named the Y-shaped trabecular structure of the odontoid process, on axial CT scans. This structure appears to be the result of bone transformation induced by the elevated dynamic loading at the C1–2 level. The presence of the Y-shaped structure provides new insights into biomechanical responses of C2 under physiological loading and traumatic conditions.

A STUDY ON THE CORRELATION BETWEEN MORPHOLOGIC ANORMALIES AND LEFT VENTRICULAR DIASTOLIC FUNCTION IN DILATED CARDIO-MYOPATHY

2011 ◽  
pp. 137-144
Author(s):  
Thi Ngoc Ha Hoang ◽  
Anh Vu Nguyen ◽  
Minh Loi Hoang ◽  
Cuu Long Nguyen ◽  
Thi Thuy Hang Nguyen
Keyword(s):  
Pulmonary Artery ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Pulmonary Arteries ◽  
Left Ventricular ◽  
University Hospital ◽  
Cross Sectional ◽  
X Ray ◽  
Key Words Dilated Cardiomyopathy

Purposes: Describe the morphological and diastolic function of left ventricular changes in the patients with dilated cardiomyopathy (DCM) on US, X-ray findings, and Evaluate the correlation between morphology and diastolic function of left ventricular. Materials and method: Cross sectional study from Dec 2009 to Aug 2010, on 39 patients with dilated cardiomyopathy were evaluated at the University Hospital of Hue College of Medical and Pharmaceutical. Results: 1. X-ray and US findings characteristics of DCM is significantly increased in diameter of L, H and mG; LVM, LVMI, LVDd and LAD. 2. The pression of pulmonary artery has been significantly increased with redistribution pulmonary arteries in 61.5% cases and 23.1% have reversed pulmonary artery distribution. 3. DCM have diastolic dysfunction in 100% patients, including severe disorders to 61.5%; the restrictive dysfunction has ratio E/A>2 and E/Em average was 23.89± 17.23. 4.The correlation between the morphology and function in DCM: the diameter of H and L on the X-ray, LAD and ratio LA/AO on US correlated with the level of diastolic dysfunction (p< 0.05). All three radiographic parameters on the radio standard (H, L, the index Cardio/Thoracic) and LVDd on US have negative correlated with EF and FS with p <0.05. Key words: dilated cardiomyopathy, diastolic dysfunction, cardiac tissue Doppler, reversed pulmonary artery distribution

HIP FRACTURES IN 5 YEARS AT HUE UNIVERSITY HOSPITAL

2014 ◽  
pp. 47-50
Author(s):  
Duy Binh Ho ◽  
Nghi Thanh Nhan Le ◽  
Maasalu Katre ◽  
Koks Sulev ◽  
Märtson Aare
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Age Groups ◽  
Femoral Fractures ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
High Risk Population ◽  
Intertrochanteric Fractures ◽  
Significant Difference

Aim: This study aimed to review the clinical findings and surgical intervention of the hip fracture at the Hue University Hospital in Vietnam. Methods:The data of proximal femoral fractures was collected retrospectively. All patients, in a period of 5 years, from Jan 2008 to December 2012, suffered either from intertrochanteric or femoral neck fractures. The numbers of patients were gathered separately for each year, by age groups (under 40, 40-49, 50-59, 60-69, 70-79, older) and by sex. We analyzed what kind of treatment options were used for the hip fracture. Results:Of 224 patients (93 men and 131 women) studied, 71% patients are over 70 years old, 103 women and 56 men (p<0.05). For patients under 40 years, there were 1 woman and 11 men (p<0.05). There were 88 intertrochanteric and 136 femoral neck fractures. There was no significant difference in the two fractures between men and women. The numbers of hip fracture increased by each year, 29/224 cases in 2010, 63/224 cases in 2011, 76/224 cases in 2012. Treatment of 88 intertrochanteric fractures: 49 cases (55.7%) of dynamic hip screw (DHS), 14 cases of hemiarthroplasty (15.9%), 2 cases of total hip replacement (2.3%). Treatment of 136 femoral neck fractures: 48 cases of total replacement (35.3%), 43 cases of hemiarthroplasty (31.6%), 15 cases of screwing (11%). In cases of 40 patients (17.9%) hip fracture was managed conservatively, 23 were femoral neck fractures and 17 were intertrochanteric fractures. Conclusions: Hip fracture is growing challenge in Hue medical university hospital. The conservative approach is still high in people who could not be operable due to severe medical conditions as well as for patients with economic difficulties. Over 70% of the hip fractures in people 70+ are caused by osteoporosis. The number of hip fracture is increasing in the following years, most likely due to the increase in the prevalence of osteoporosis. Early detection and prevention of osteoporosis should be addressed, particularly in high risk population. More aggressive surgical approach should be implemented in order to improve the quality of life in patients with hip fractures. Key words:Hip fracture.

scholarly journals Procedural times in early non-intubated VATS program - a propensity score analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabella Metelmann ◽  
Johannes Broschewitz ◽  
Uta-Carolin Pietsch ◽  
Gerald Huschak ◽  
Uwe Eichfeld ◽  
...  
Keyword(s):  
Propensity Score ◽  
Surgical Procedure ◽  
Recovery Time ◽  
Propensity Score Analysis ◽  
Wedge Resection ◽  
University Hospital ◽  
Implementation Phase ◽  
Score Analysis ◽  
Significant Difference ◽  
Procedural Time

Abstract Background Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. Methods This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Results Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Conclusions Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

scholarly journals Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

2021 ◽  
Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash
Keyword(s):  
Outcome Measures ◽  
Functional Outcomes ◽  
Rating Scale ◽  
Tertiary Care ◽  
Depression Scale ◽  
Inpatient Rehabilitation ◽  
University Hospital ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

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