Cervicofacial Necrotizing Fasciitis and Its Relationship with Aeromona Hydrophila

2020 ◽  
Author(s):  
Juárez-Rebollar AG
Keyword(s):  
Necrotizing Fasciitis ◽  
Surgical Management ◽  
Medical Center ◽  
Maxillofacial Surgery ◽  
Blood Cultures ◽  
Contaminated Water ◽  
Rapid Progression ◽  
Tissue Destruction ◽  
Cross Sectional ◽  
One Year

Introduction: Necrotizing fasciitis is a severe polymicrobial infection with rapid progression and significant tissue destruction, which requires immediate antimicrobial and surgical management; the frequent location is in the extremities (pelvic and thoracic), genitals and thorax, its appearance being rare in the cervicofacial region, it is very rarely associated with causal agents such as Aeromonahydrophila, however, the presence of said bacillus in contaminated water can manifest as Fasciitis Cervicofacial necrotizing agent (CNF). Material and Method: A retrospective, descriptive, cross-sectional, observational study was carried out in Maxillofacial Surgery at the “La Raza” Medical Center, for one year. All patients with a diagnosis of Necrotizing Cervicofacial Fasciitis (CNF). For one year who had cultures and blood cultures, with Aeromonahydrophila, who had been cared for in the Maxillofacial Surgery service from October 1, 2013, to October 1, 2014, were included. Discussion: Giant oral floor cysts located under the mylohyoid muscle are usually removed extra orally. We report the case of a large dermoid cyst of the floor of the mouth, with extension at the base of the tongue, removed intraorally. Results: A sample of 7 patients with a diagnosis of Necrotizing Cervicofacial Fasciitis was obtained; dental origin, of which 3 were women and 4 men; the mean age was 66.7 years; A correlation was made with respect to comorbidities, the management was given by the Maxillofacial Surgery service of the “La Raza” Medical Center was surgical and clinical, with support from the central laboratory of the “Dr. Antonio Fraga Mouret ”and the central epidemiology laboratory of the same hospital, blood cultures and bacterial tissue culture (biopsy) were performed, respectively. The taking of cultures was proportional to the number of surgical events, only 3 patients of which their blood cultures reported the development, two of them presented Gram (+) and Gram (-) and the third Gram (+) and Facultative aerobes. From the tissue cultures, the biota reported was: Candida Albicans; Candida Krusei, Morganella morganii, Coryneform bacilli, Enterobacter aerogenes, Trichosporonasahii, Pseudomona aeruginosa and only one developed AeromonaHydrophila. Antibiotic was administered based on the antibiogram obtained individually with specificity for each case as reported in the cultures. Discussion and Conclusion: CNF is an entity rarely associated with Aeromonahydrophila, it is common to find another type of microbiota in this entity, however, it should be known that this A.hydrophila bacillus is frequently isolated in contaminated water and the patient can acquire it by performing any daily activity, more if you have any injury or previous immunocompromise. The importance of medical-surgical management will determine the prognosis of the patient, the correct extension of debridement and resection will allow delimiting the CNF and the multidisciplinary management together will reduce complications (septic shock, multiple organ failure, death) if it is carried out in a timely manner.

scholarly journals Frequency of Cervicofacial Necrotizing Fasciitis Secondary to Odontogenic Abscess

2020 ◽  
pp. 46-51
Author(s):  
Juárez-Rebollar Alejandra Giselle ◽  
López-Saucedo Francisco ◽  
Juárez-Rebollar Daniel ◽  
Juárez-Paredes Celso Marcelo
Keyword(s):  
Necrotizing Fasciitis ◽  
Surgical Management ◽  
Medical Center ◽  
Maxillofacial Surgery ◽  
Cross Sectional ◽  
National Medical ◽  
Odontogenic Abscess ◽  
Immunosuppressed Patients ◽  
The Mean ◽  
The Right

Introduction: One of the complications of odontogenic abscess is cervicofacial necrotizing fasciitis; which is infrequent in the cervicofacial region. This disease usually occurs in immunosuppressed patients. Treatment is broad spectrum antibiotics and surgery. Material and Method: A research study was conducted with the following characteristics: retrospective, descriptive, cross-sectional and observational, for a year, in the maxillofacial surgery service, of specialty hospital: “Dr. Antonio Fraga Mouret”, national medical center“ La Raza ” (IMSS), Mexico city; all patients (six) diagnosed with necrotizing cervicofacial fasciitis secondary to Odontogenic abscess, older than 18 years were included. The protocol consisted of taking a biopsy, antibiotic, culture with an antibiogram and surgical management. Data were collected to estimate the frequency of this pathology in the maxillofacial surgery service. Results: In one year, 6 patients with a diagnosis of necrotizing cervicofacial fasciitis secondary to odontogenic abscess were treated. No significant differences were found with respect to gender, the mean age was 69.16 years, (86; minimum 40). The mean number of affected aponeurotic spaces was 6.5 (maximum: 14; minimum: 2); the most affected side was the right. The most frequent aponeurotic spaces were: the facial (in turn, more were reported in the submandibular followed by submental and genian aponeurotic space) and one third the cervical. Surgical management was: cannulation and drainage of persistent abscess or purulent collection in four patients, surgical lavage was performed in all, 3 patients required more than 4 surgical washes. Debridement was performed in all patients. Discussion: The importance of this study is to show and report the frequency with which necrotizing cervicofacial fasciitis appears secondary to odontogenic abscess, to continue with the control and report in maxillofacial surgery, as well as improvements and proposals for a better management of patients who are diagnosed with this disease.

scholarly journals Cervicofacial Necrotizing Fasciitis and Candida spp

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Juárez-Rebollar Alejandra Giselle
Keyword(s):  
Necrotizing Fasciitis ◽  
Candida Species ◽  
Bacterial Infections ◽  
Medical Center ◽  
Bacterial Species ◽  
Maxillofacial Surgery ◽  
Candida Spp ◽  
National Medical ◽  
Dental Origin ◽  
One Year

Cervicofacial necrotizing fasciitis is a rapidly evolving bacterial infection, which can be associated with multiple complications and poor health. However, there are few reported cases that are associated with Candida species, and the studies that report this indicate that it is found mainly in areas such as the pelvis, thorax and to a lesser degree in the arms and legs. The presence of Necrotizing Fasciitis in the cervicofacial region is very rare, which makes the present study relevant. Material and Method: Descriptive, observational and retrospective study of Odontogenic Cervicofacial Necrotizing Fasciitis and the presence of Candida spp., Carried out during one year, in the Maxillofacial Surgery service of the Specialty Hospital, of the National Medical Center "La Raza" (IMSS). Patients older than 18 years, who were diagnosed with Necrotizing Cervicofacial Fasciitis of dental origin, were included in the study, reporting the presence of Candida. Treatment consisted of debridement of necrotic tissue, culture, dressings, intravenous antibiotics, and secondary surgical scrubs. Results: In one year, 7 cases of Cervicofacial Necrotizing Fasciitis of dental origin were obtained, of which 3 patients had associated Candida species, the rest of the cultures were reported polymicrobial. The most associated comorbidities were uncontrolled diabetes mellitus and arterial hypertension, there was a predilection for the male sex, the median age was 63 years, the ranges (min: 24 and max: 83). In addition, it was found that the 3 patients who presented candida species in their cultures were overweight and their evolution was torpid. Conclusion: It is important to perform cultures and biopsies to report the microbial species found in pathologies such as Necrotizing Fasciitis and to be able to provide better treatment specifically to the patient. Candida species do not usually appear associated with Necrotizing Fasciitis, which is why when other non-bacterial species are present, patients must undergo specific and individualized treatment to treat bacterial infections (necrotizing fasciitis) and in this case also the fungal (candida), remembering that the two act synergistically.

Detection of Novel mutation in VANGL1 gene indicating genetic association of Myelomeningocele

2021 ◽  
Vol 15 (8) ◽  
pp. 1938-1941
Author(s):  
Urooj Fatima ◽  
Syed Meesam Iftikhar ◽  
Sabahat Gul ◽  
Farrukh Mustafa Memon
Keyword(s):  
Folic Acid ◽  
Genetic Association ◽  
Novel Mutation ◽  
Medical Center ◽  
Folic Acid Deficiency ◽  
Lumbar Region ◽  
Cross Sectional ◽  
Rare Mutation ◽  
Congenital Birth Defect ◽  
One Year

Aim: To detect the novel mutation in VANGL1 gene indicating genetic association of Myelomeningocele. Methodology: The study design was cross sectional. It comprises of sixty individuals, of them fifty were diagnosed cases of myelomeningocele and ten were healthy individuals taken as controls. The cases were collected from Jinnah Postgraduate Medical Center. The study was carried out in Dow Diagnostic and Research Laboratory (D.D.R.L.). Most of the patients were less than one year of age. The cases were evaluated for various other parameters like site and size of cyst and associated features like presence of hydrocephalus in the individuals. Since folic acid deficiency is the key component in the causation of the disease so mothers were also asked about the consumption of folic acid. Blood was drawn from patients after a written permission from the parents of the concerned patient. It was followed by the conduction of PCR to seek for any mutation in VANGL1 gene. Results: We found a rare mutation in VANGL1 gene revealing substitution of valine to serine at position 239 i.e. V239S. Hydrocephalus being the associated anomaly was present in 32% of the patients. Most of the affected individuals were males. 98% mothers of the sufferers did not take folic acid during pregnancy. In most of the patients, lump was present on the lumbar region. Conclusion: Myelomeningocele is a congenital birth defect with lifelong complications. Its prevalence can be decreased by taking certain measures. Periconceptional intake of folic acid has been established to lessen the risk of the disease. We identified a rare mutation in VANGL1 gene that may result in the causation of myelomeningocele. Keywords: Neural tube defects, mutation, myelomeningocele.

scholarly journals Patterns of Cone-Beam Computed Tomoography (CBCT) Utilization by Various Dental Specialties: A 4-Year Retrospective Analysis from a Dental and Maxillofacial Specialty Center

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1042
Author(s):  
Silvina Friedlander-Barenboim ◽  
Wafi Hamed ◽  
Avraham Zini ◽  
Noam Yarom ◽  
Itzhak Abramovitz ◽  
...  
Keyword(s):  
Medical Center ◽  
Maxillofacial Surgery ◽  
Cross Sectional Study ◽  
Temporomandibular Joint Disorders ◽  
Cone Beam ◽  
Oral And Maxillofacial Surgery ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Root Canals ◽  
Baseline Information

The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9–86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.

scholarly journals Prevalence Of Syphilis, Neurosyphilis And Associated Factors In a Cross-Sectional Analysis Of HIV Infected Patients Attending Bugando Medical Centre Mwanza Tanzania

2019 ◽  
Author(s):  
Adeodatus Richard Haule ◽  
Evarista Mgaya ◽  
Peter Masikini ◽  
Betrand Msemwa ◽  
Samuel Kalluvya
Keyword(s):  
Lumbar Puncture ◽  
Associated Factors ◽  
Medical Center ◽  
Treponema Pallidum ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Rapid Progression ◽  
Cross Sectional ◽  
Bugando Medical ◽  
High Prevalence

Abstract Background: HIV-syphilis co-infection is a combination that enhances rapid progression of early syphilis or late latent syphilis to neurosyphilis and can cause catastrophic neurological complications. In studies in Mwanza, syphilis affects ~8% of healthy outpatients, and older studies have suggested that up to 23.5% of HIV-syphilis co-infected patients also have neurosyphilis. The study aimed at determining the prevalence of syphilis, neurosyphilis and associated factors among HIV infected patients attending Bugando Medical Center.Methods: This was a cross sectional study in which HIV infected patients who were hospitalized or attending the outpatient Care and Treatment Clinic (CTC) were interviewed using structured questionnaire and screened for syphilis using serum Treponema Pallidum hemagglutination assay (TPHA). We included all HIV-infected persons aged 18 years and above who consented. Blood was also taken for CD4+ T cells and viral load. Those who were found to have syphilis underwent neurological examination for any neurologic deficit and offered lumbar puncture.Results: The prevalence of syphilis in HIV infected patients was found to be 9.6%. The majority of these were female (72.5%) and median age was 42 years [interquartile range, 32-50]. Most patients were on ART (99.4%).The majority of participants with syphilis (89.2%) reported not knowing that they had syphilis, and had not previously been treated. One hundred forty one participants with syphilis had neurological examinations performed, 4 of whom had abnormal findings that necessitated that they undergo lumbar puncture. One of these had confirmed neurosyphilis.Conclusion: The high prevalence of syphilis in HIV infected patients indicates that there is a need to increase efforts in targeting this population to reduce sexually transmitted infections. Screening for syphilis should be done for all HIV patients given the high prevalence of the infection and the risk that aggressive forms of neurosyphilis can occur despite recovery of CD4+Tcell counts in untreated syphilis.

scholarly journals Demographic Characteristics and Prevalence of Mandibular Condylar Fractures at a Tertiary Care Dental Hospital in Dhaka City

2017 ◽  
Vol 1 (2) ◽  
pp. 50-52
Author(s):  
Mohammad Wahidul Islam ◽  
Mohiuddin Ahmed ◽  
AFM Shahidur Rahman
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Maxillofacial Surgery ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Oral And Maxillofacial Surgery ◽  
Condylar Fracture ◽  
Cross Sectional ◽  
One Year ◽  
Condylar Fractures

Background: Mandibular condylar fracture is a critical condition. Objectives: The purpose of the study was to see the demographic characteristics and prevalence of mandibular condylar fractures. Methodology: This cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery of Dhaka Dental College and Hospital from January 2009 to September 2010 for a period of one year and nine months. All the patients presented with mandibular condylar fractures at any age with both sexes were included as study population. Details demographic characteristics and the rate of occurrence were recorded. Result: A total number of 26 patients were included in this study. Majority of the patients were male (88.5%) and age belongs to 21 to 30 years (38.5%). Road traffic accident (46.2%) was the main cause and unilateral fractures were more frequent. The prevalence of mandibular condylar fracture was 14.9%. Conclusion: Mandibular condylar fracture is most commonly occurred in male with a low prevalence.Journal of National Institute of Neurosciences Bangladesh, 2015;1(2): 50-52

scholarly journals Longitudinal Imaging-Based Clusters in Former Smokers of the COPD Cohort Associate with Clinical Characteristics: the SubPopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS)

2020 ◽  
Author(s):  
Chunrui Zou ◽  
Frank Li ◽  
Jiwoong Choi ◽  
Babak Haghighi ◽  
Sanghun Choi ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Rapid Expansion ◽  
Rapid Progression ◽  
Cluster Number ◽  
Quantitative Ct ◽  
Cross Sectional ◽  
Former Smokers ◽  
Longitudinal Imaging ◽  
One Year ◽  
Progression Patterns

Abstract Background: Quantitative CT (qCT) imaging-based cluster analysis identified clinically meaningful COPD former-smoker subgroups (clusters) based on cross-sectional data. We aimed to identify progression clusters for former smokers using longitudinal data.Patients and Methods: We selected 472 former smokers from SPIROMICS with a baseline visit and a one-year follow-up visit. A total of 150 qCT imaging-based variables, comprising 75 variables at baseline and their corresponding progression rates, were derived from the respective inspiration and expiration scans of the two visits. The COPD progression clusters identified were then associated with subject demography, clinical variables and biomarkers.Results: COPD severities at baseline increased with increasing cluster number. Cluster 1 patients were an obese subgroup with rapid progression of functional small airway disease percentage (fSAD%) and emphysema percentage (Emph%), and preserved FEV1%predicted but impairment of FEV1/FVC ratio over one year. Cluster 2 exhibited a decrease of fSAD% and Emph%, an increase of tissue fraction at total lung capacity, airway narrowing, and a reduced post-bronchodilator FEV1%predicted but preserved FEV1/FVC ratio over one year. Cluster 3 showed rapid expansion of Emph% and an attenuation of fSAD%. Cluster 4 demonstrated severe emphysema and fSAD and significant structural alterations at baseline with rapid progression of fSAD% over one year. Subjects with different progression patterns in the same cross-sectional cluster were identified by longitudinal clustering.Conclusions: qCT imaging-based metrics at two visits for former smokers allow for the derivation of four statistically stable clusters associated with unique progression patterns and clinical characteristics. Use of baseline variables and their progression rates enables identification of longitudinal clusters, resulting in a refinement of cross-sectional clusters.

scholarly journals New dental graduates Satisfaction regarding acquired competencies during BDS course

2014 ◽  
Vol 2 (2) ◽  
pp. 26-31
Author(s):  
Golam Rabbi ◽  
Mohammad Faruque ◽  
Jumayun Kabir Talukder ◽  
Abdal Mia ◽  
Tawhidur Rahman ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Medical Officer ◽  
Oral And Maxillofacial Surgery ◽  
Cross Sectional ◽  
Clinical Exposure ◽  
New Graduates ◽  
Study Results ◽  
Clinical Ward ◽  
Good Relation ◽  
One Year

Objectives To assess the level of job satisfaction during BDS course among the new dental graduates according to their views including existing barriers and ways of further improvement. Materials and methods This was a cross sectional type of descriptive study and was carried out for one year. In depth interview were performed using interview schedule among twenty new dental graduates those were very interested and willing to participate in this study. Results Among them 96 new graduates were passed from non-government and 55in government dental colleges. Of them 53.3% were female and 46.7% were male. Satisfaction level on acquired competencies was not in desired level in Oral and maxillofacial surgery, orthodontics and some competencies in prosthodontics. Corresponding teacher, senior doctor and medical officer also by available patient and instrument and materials, good academic environment and good relation with teacher, causes much satisfaction. Main causes of dissatisfaction includes Less availability of the patients and instruments, lack of supervision and feedback in the clinical ward, insufficient practical classes and lack of competent instructors in all level. Conclusion New qualified dentists were more or less satisfied on their acquired competencies in most of the clinical areas. This may be due to having sufficient clinical exposure, experience and teaching time during their undergraduate course. There are several causes of satisfaction and so many causes of dissatisfaction. Co-operative and helpful teachers and senior doctors were very important issue for causing satisfaction. More teacher supervision and more patients for practice is recommended by them. DOI: http://dx.doi.org/10.3329/bjme.v2i2.18138 Bangladesh Journal of Medical Education Vol.2(2) 2011: 26-31

scholarly journals EFFECTIVENESS OF CONVENTIONAL ANTIBIOTICS IN SALMONELLA TYPHI POSITIVE BLOOD CULTURES

2020 ◽  
Vol 28 (4) ◽  
pp. 318-322
Author(s):  
Aftab Ahmad Khan ◽  
Rizwan Uppal ◽  
Gul E Rehan ◽  
Farhat Khurshid ◽  
Khurshid Ahmed ◽  
...  
Keyword(s):  
Positive Culture ◽  
Paediatric Population ◽  
Generation Cephalosporin ◽  
Salmonella Typhi ◽  
Cross Sectional Study ◽  
Blood Cultures ◽  
Cross Sectional ◽  
Diagnostic Center ◽  
One Year ◽  
Conventional Antibiotics

Abstract: Objective: 1.To determine the pattern of resistance of salmonella Typhi strains to multiple antibiotics in Islamabad and adjoining areas. 2.Suggestions regarding the regular upgradation of antibiogram according to the most susceptible strains. Method: Cross sectional study conducted for duration of one year ,recruited those patients whose blood cultures were found positive for Salmonella Typhi at Islamabad Diagnostic Center. We analyzed 100 samples and Positive culture were then assessed for sensitivity by using various antibiotics and pattern of resistance was analyzed.   Results: Majority of positive patients were male and children. Sensitivity to the conventional antibiotics was found to be more in children. In all the positive isolates, 89% were sensitive to the first line treatment options.Among them, 96.6%were showing sensitivity to third generation cephalosporin. However, a few cases were having extensively drug resistant patterns (XDR). Conclusion: Despite the fact that extensively drug resistantstrains are emerging and indicating an alarming situation,its found out that more than 80% of patients are responding to the conventional therapy,making it a dire need for upgradation of antibiograms, so that the side effects of second line and advanced antibiotic can be avoided, mostly in paediatric population.  

Nurse’s knowledge and Awareness Regarding Cervical Cancer and its Prevention in Different Hospitals of Quetta, Pakistan

2017 ◽  
Vol 4 (1) ◽  
pp. 436-441
Author(s):  
Saba Haider ◽  
Noman Ul Haq ◽  
Sohail Riaz ◽  
Aqeel Nasim ◽  
Muhammad Saood ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Family History ◽  
Sampling Technique ◽  
Knowledge Score ◽  
Validity And Reliability ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Current Area ◽  
One Year

Objective: This study aimed to assess the knowledge and awareness regarding cervical cancer and its prevention among nurses working in different hospitals of Quetta, Pakistan. Methodology: The cross sectional, descriptive study was conducted by using structured questionnaire in different hospitals of Quetta from January to September 2016. Convenient sampling technique was applied by targeting all the nurses working in different hospitals of Quetta city. Study questionnaire was developed and tested for validity and reliability. Descriptive and inferential statistics (Mann Whitney U test and Kruskal Wallis tests, p<0.05) were used to assess the significance among study variables and were performed by using IBM SPSS v.20. Results: Out of 415 distributed questionnaires 324 were returned (response rate of 78%). The mean Age of respondents was 28.18 ±9.5 years. Majority (n=127, 43.3%) of participants were interns and had no or less than one year of experience (n=128, 43.7%) with negative family history of any cancer (n=275, 93.9%). Mean knowledge score was 18.52±4.84with majority (n=258, 88.1%) had adequate knowledge regarding cervical cancer. Respondent sage, current area of practice, qualification, Institute of degree and past family history were contributing factors (p > 0.05) in adequate knowledge in this study. The results also reviled that not only 68.3% (n=200) and 65.5% (n=192) respondents knew that cervical cancer is vaccine preventable and availability of the vaccine for it. Conclusions: Nurses working in different hospitals of Quetta city had better understanding of the disease cervical cancer and its prevention. Yet many of the respondent are not aware of it vaccine and its availability.

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