scholarly journals A farmer with successful recovery from pulmonary melioidosis

2021 ◽  
Vol 8 (2) ◽  
pp. 149
Author(s):  
Niranjan Chandramal ◽  
Ranjith Kalupahana ◽  
Chathurya Pothmulla
Keyword(s):  
Successful Recovery

THERAPEUTIC MANAGEMENT OF ASCITES IN SPITZ DOG IN BANGLADESH WITH A BRIEF REVIEW ON CANINE ASCITES

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
M. A. Samad
Keyword(s):  
Ascitic Fluid ◽  
Clinical Examination ◽  
Clinical Case ◽  
Abdominal Distension ◽  
Multiple Organ ◽  
Therapeutic Management ◽  
Vitamin Supplement ◽  
Case Record ◽  
Successful Recovery ◽  
History Of

Background: Ascites is one of the most important clinical syndromes, caused by multiple organ disorders, characterized by abdominal distension with accumulation of fluid of various colors and consistencies depending on the etiology that are encountered commonly in canine practice worldwide. Although it has been reported from different countries including India but it has not yet been documented from Bangladesh. Objectives: To evaluate the successful therapeutic management of a clinical case of ascites in dog supported with its brief review for its appropriate application Materials and Methods: A female Spitz dog two and half years old brought for treatment with the history of abdominal distension on 1st November 2009. Clinical examination, abdominocentesis and laboratory examination of ascitic fluid were used for the diagnosis of ascites in dog. Results: Clinical examination revealed dyspnea, discomfort, lethargy, weakness, pale mucous membrane, normal rectal temperature 103.2 0F and distended abdomen with fluid thrill on palpation. Examination of ascitic fluid revealed clear white fluid (pure transudate) which is mainly hepatic origin resulting portal hypertension and hypoproteinaemia. Treatment with restricted sodium diet, antibiotic (amoxicillin), diuretic (furosemide; Lasix, Sanofi Aventis) and vitamin B-complex and C- vitamin supplement with regular monitoring assisted in successful recovery. The recovered dog survived for next five years up to 2014 and then died due to other reasons. Conclusions: This clinical case record on canine ascites with successful treatment along with review especially on the methods of diagnosis and cause-wise treatment would certainly help the clinician for proper management of the clinical cases of canine ascites. Keywords: Ascites, Spitz dog, Diagnosis, SAAG, Therapeutic management, Brief review

scholarly journals Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932098629 ◽  
Author(s):  
Yulia Bugaevsky ◽  
Yochai Levy ◽  
Avital Hershkovitz ◽  
Irena Ocheretny ◽  
Adaya Nissenholtz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Functional Improvement ◽  
Orthopedic Department ◽  
Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

scholarly journals The Use of Supra-Hemodiafiltration in Traumatic Rhabdomyolysis and Acute Kidney Injury: A Case Report

2021 ◽  
pp. 26-35
Author(s):  
Gabriele Donati ◽  
Maria Cappuccilli ◽  
Federica Di Filippo ◽  
Simone Nicoletti ◽  
Marco Ruggeri ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Septic Patient ◽  
Medical Therapy ◽  
Kidney Injury ◽  
First Case ◽  
Successful Recovery

Oliguric acute kidney injury due to traumatic rhabdomyolysis can be potentially lethal if the proper medical therapy combined with extracorporeal detoxification is not performed. Different extracorporeal techniques are available to overcome this syndrome. Here, we report the first case of removal of myoglobin and successful recovery from acute kidney injury in an elderly septic patient using supra-hemodiafiltration with endogenous reinfusion technique (HFR-Supra) combined with the medical therapy.

Assessing Physical Activity After ACL Injury: Moving Beyond Return to Sport

2021 ◽  
pp. 194173812110253
Author(s):  
Christopher Kuenze ◽  
Katherine Collins ◽  
Karin Allor Pfeiffer ◽  
Caroline Lisee
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Young Patients ◽  
Return To Sport ◽  
Acl Injury ◽  
Noncommunicable Diseases ◽  
Successful Recovery ◽  
Patient Reported ◽  
Anterior Cruciate

Context: Return to sport is widely utilized by sports medicine researchers and clinicians as a primary outcome of interest for successful recovery when working with young patients who have undergone anterior cruciate ligament (ACL) reconstruction (ACLR). While return-to-sport outcomes are effective at tracking progress post-ACLR, they are limited because they do not necessarily capture physical activity (PA) engagement, which is important to maintain knee joint health and reduce the risk of noncommunicable diseases. Therefore, there is a critical need (1) to describe current PA participation and measurement recommendations; (2) to appraise common PA measurement approaches, including patient-reported outcomes and device-based methodologies; and (3) to provide clinical recommendations for future evaluation. Evidence Acquisition: Reports of patient-reported or device-based PA in patients with ACL injury were acquired and summarized based on a PubMed search (2000 through July 2020). Search terms included physical activity OR activity AND anterior cruciate ligament OR ACL. Study Design: Clinical review. Level of Evidence: Level 5. Results: We highlight that (1) individuals with ACLR are 2.36 times less likely to meet the US Department of Health and Human Services PA recommendations even when reporting successful return to sport, (2) common patient-reported PA assessments have significant limitations in the data that can be derived, and (3) alternative patient-reported and device-based assessments may provide improved assessment of PA in this patient population. Conclusion: Clinicians and researchers have relied on return to sport status or self-reported PA participation via surveys. These approaches are not consistent with current recommendations for PA assessment and do not allow for comparison with contemporary PA recommendations or guidelines. Return to sport, patient-reported outcome measures, and device-based assessment approaches should be used in complementary manners to comprehensively assess PA participation after ACLR. However, appropriate techniques should be used when assessing PA in adult and adolescent populations.

scholarly journals A Patient of Using Presepsin to Diagnose Streptococcal Toxic Shock Syndrome during Anticancer Drug Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Gaku Takahashi
Keyword(s):  
Blood Culture ◽  
Toxic Shock Syndrome ◽  
Lower Leg ◽  
Rapid Progression ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Anticancer Chemotherapy ◽  
Successful Recovery ◽  
Short Period ◽  
Infection Focus

Background. Streptococcal toxic shock syndrome (STSS) is a rapidly progressive infection, with potentially rapid patient deterioration in a very short period. We experienced a rare case of STSS during anticancer chemotherapy, and we continuously measured presepsin (P-SEP) and evaluated its usefulness. Case Presentation. A 60-year-old woman with pulmonary metastasis from cervical cancer began anticancer chemotherapy. A fever of >40°C and right lower leg swelling developed on day 3. Symptoms worsened despite cefmetazole treatment (1.0 g/day). Blood culture was performed without suspecting STSS. On day 5, symptoms worsened and acute disseminated intravascular coagulation (DIC) and sequential organ failure assessment (SOFA) scores increased. C-reactive protein (CRP) increased from 28.8 mg/dl to 35.5 mg/dl and P-SEP also increased from 1,635 to 2,350 pg/mL. STSS was suspected due to the rapid progression of brown discoloration of the entire right lower leg. Ceftriaxone 2 g/day and clindamycin 1,200 mg/day were begun. On the evening of day 5, blood culture revealed rapidly progressive group A streptococci. After that, symptoms improved rapidly with treatment, and SOFA and DIC scores also decreased. While CRP remained at about 0.5 mg/dl, P-SEP remained slightly elevated at about 400 pg/mL. A residual infection focus was suspected. Contrast-enhanced computed tomography (CT) revealed a capsule-enclosed abscess in the right lower leg soleus muscle on day 32. Debridement was performed and antibiotics were continued until P-SEP was 88 pg/mL. CT confirmed the disappearance of the abscess. Conclusion. Prompt diagnosis by blood culture and a sufficiently early, appropriate change in antibiotic therapy led to successful recovery from STSS during anticancer chemotherapy without lower limb amputation. P-SEP was useful in assessment of the residual infection focus and suspending treatments.

scholarly journals Baseline clinical features in a large-scale registration survey of patient with hypertrophic cardiomyopathy throughout Japan: J-HCM registry study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kubo ◽  
H Takano ◽  
M Takayama ◽  
Y.L Doi ◽  
Y Minami ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Large Scale ◽  
Risk Group ◽  
Nyha Class ◽  
Left Ventricular ◽  
Registry Study ◽  
Icd Implantation ◽  
Successful Recovery

Abstract Background Hypertrophic cardiomyopathy (HCM) is a most prevalent primary myocardial disorder with heterogeneous clinical features. However, there have been few studies on clinical features of HCM as a prospective cohort. In 2015, we established a large-scale registration survey of patients with HCM throughout Japan, named J-HCM registry study. Purpose The aim of this study was to clarify the clinical features of Japanese patients with HCM. Methods J-HCM registry study is a prospective, multicenter investigation, consisting of 24 hospitals. This time, we present the baseline clinical characteristics in this survey. Results Total 1484 patients were registered. The ages at registration and at diagnosis were 65±15 and 56±17 years, respectively, and 806 patients (54%) were men. Majority of the patients (95%) was NYHA class I or II. With regard to subtypes of HCM, there were 526 patients (36%) in the HCM with left ventricular (LV) outflow tract obstruction, 126 patients (8%) in the mid-ventricular obstruction, 57 patients (4%) in the end-stage phase characterized by LV ejection fraction &lt;50%, and 197 patients (14%) in apical HCM. At registration, 80 patients (6%) had prior successful recovery from sustained ventricular tachycardia or ventricular fibrillation, 162 patients (11%) suffered from heart failure hospitalization, and 64 patients (4%) had history of embolic event. Regarding invasive treatment, 160 patients (10%) had prior septal reduction therapy and 162 patients (11%) had ICD implantation. According to the 2014 European Society of Cardiology Guidelines on sudden cardiac death (SCD) prevention, the study patients were divided into 3 categories by the HCM Risk-SCD calculator: patients distribution, 4% in the high risk group (≥6% calculated HCM Risk-SCD at 5 years), 7% in the intermediate risk group (4% to &lt;6%), 69% in the low risk group (&lt;4%), and 16% in the patients with extreme characteristics (Figure 1). Conclusions In this multicenter registration survey of patients with HCM, the baseline clinical characteristics were almost similar to several retrospective large-scale cohorts in Western countries except older age and less symptomatic state. This study will provide important knowledge regarding management of HCM. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Vocationalization of education in Kenya: the Classroom Practice and the Learners’ Responsibilities for Change in the 21st Century

2011 ◽  
Vol 1 (1) ◽  
pp. 142
Author(s):  
Samson Ondigi ◽  
Henry Ayot ◽  
Kiio Mueni ◽  
Mary Nasibi
Keyword(s):  
Political Development ◽  
Classroom Practice ◽  
History Of Education ◽  
Status Quo ◽  
Knowledge And Skills ◽  
Successful Recovery ◽  
Common Practices ◽  
The Status ◽  
History Of ◽  
The Individual

Abstract The essence of education is to prepare an individual for lifelong experiences after schooling. Education as offered in schools today is expected to give the teacher a chance to impart knowledge and skills in the learner, and for the learner to be informed and be able to put into practice what has been gained in the course of time. The Kenyan curriculum and goals of education are clearly stipulated if followed to the latter. Basically, the classroom practice by both the teachers and the learners exhibit an academic rather than a dual system that is expected to meet the needs of both the individual and those of the communities which form subsets of the society at large. It is upon this premise that education of a given country must prepare its individuals in schools so as to meet the goals of education at any one given time of a country’s history. This paper looks at the perspective of vocationalization of education in Kenyan at this century. The history of education ever since independence in 1963 by focusing on the Ominde commission through the Koech report of 1999 have been emphatic that education must meet the national goals of education as stipulated in the curriculum. But what is edging the practice that has not revolutionalized the socio-economic, cultural and political development of Kenya? Differentiated Instruction is a teaching theory based on the premise that instructional approaches should vary and be adapted in relation to individual and diverse students in classroom aimed at achieving diversified learning and common practices in the career. The challenges herein are: where have we gone wrong as a nation, what is the practice in the classroom, when can the nation be out of this dilemma, who is to blame for the status quo and finally what is the way forward? By addressing these questions, the education system will be responsive to the changes in time and Kenya will be on the path to successful recovery.

scholarly journals The Management of Multi-Site, Bleeding, Visceral Artery Pseudoaneurysms, Secondary to Necrotising Pancreatitis

2009 ◽  
Vol 91 (3) ◽  
pp. 255-258 ◽  
Author(s):  
J Skipworth ◽  
D Raptis ◽  
D Brennand ◽  
C Imber ◽  
A Shankar
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Enterocutaneous Fistula ◽  
Fistula Formation ◽  
Visceral Artery ◽  
Haemodynamic Instability ◽  
Successful Recovery ◽  
Necrotising Pancreatitis ◽  
Tomographic Angiography

We present the case of a 45-year-old man, who presented to his local casualty department with severe epigastric pain following an alcohol binge, and was subsequently diagnosed with acute pancreatitis. Pancreatic necrosis with multiple collections ensued, necessitating transfer to an intensive care unit (ITU) in a tertiary hepatopancreaticobiliary centre. Initially, the patient appeared to slowly improve and was discharged to the ward, albeit following a prolonged ITU admission. However, during his subsequent recovery, he suffered multiple episodes of haematemesis and melaena associated with haemodynamic instability and requiring repeat admission to the ITU. Computerised tomographic angiography, followed by visceral angiography, was used to confirm the diagnosis of multisite visceral artery pseudoaneurysms, secondary to severe, necrotising pancreatitis. Pseudoaneurysms of the splenic, left colic and gastroduodenal arteries were sequentially, and successfully, radiologically embolised over a period of 9 days. Subsequent sequelae of radiological embolisation included a clinically insignificant splenic infarct, and a left colonic infarction associated with subsequent enterocutaneous fistula formation. The patient made a prolonged, but successful, recovery and was discharged from hospital after 260 days as an in-patient. This case illustrates the rare complication of three separate pseudoaneurysms, secondary to acute pancreatitis, successfully managed radiologically in the same patient. This case also highlights the necessity for multidisciplinary involvement in the management of pseudoaneurysms, an approach that is often most successfully achieved in a tertiary setting.

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