scholarly journals Childhood accidental poisoning among hospitalised children in a tertiary health care in North Central Nigeria - A two year prospective report

2020 ◽  
Vol 47 (3) ◽  
Author(s):  
P.A. Ahmed ◽  
V.E. Nwatah ◽  
C.C. Ulonnam
Keyword(s):  
Hospital Stay ◽  
Clinical Features ◽  
Acute Poisoning ◽  
Accidental Poisoning ◽  
Time Interval ◽  
Fisher Exact Test ◽  
Severity Scores ◽  
Childhood Poisoning ◽  
Home Intervention ◽  
The Mean

Background: The young child can be at risk of accidental poisoning because of its being very inquisitive to mouth objects. The prevalence and typesof poisoning vary within Nigeria and different parts of the world. Aim: To describe the sociodemographics, clinical features and outcome in childhood poisoning seen at the National hospital Abuja (NHA) Nigeria. Subjects and Methods: A descriptive prospective study on children admitted for acute poisoning from September 2014 -August 2016. Consecutive children with a history of poisoning were recruited during the study period. The children were examined, and poison severity scores were recorded into a proforma, and followed up till discharge or demise. Results: Twenty-two children were admitted for acute poisoning, out of the 2336 children seen during the study period, with a prevalence rate of 0.94%. Fourteen (63.6%) were of upper social class, with 12 (54. 5%) mothers having tertiary level education. The mean time (±SD) of presentation was 11.9 ± 23.9 hours, while the mean (SD) duration of hospital stay was 4.8 ± 6.2 days; hospital stay was significant with types of poisoning (Fisher exact test 22.062, p<0.0001). The common poisoning agents were kerosene and organophosphate, 8(36.4%) each, while main clinical features were  cough in 8 (36.4%), tachypnoea in 7(31.8%), fever in 6 (27.3%) and 8(36.4%) had home intervention. Two (9.1%) and 4(18.2%) had poison severity  scores (PSS) of 3 and 4 respectively, which was significant for time interval of presentation and use of harmful home intervention (Fisher exact test3.697, p=0.024) and (Fisher exact test10.04, p=0.018) respectively. Fatality was 18.2%. Conclusion: kerosene and organophosphate were most common poison agents, while PSS was related to time of presentation, home intervention and types of poisoning agents. Key words: childhood, poisoning, hospitalized, outcome.

scholarly journals TEVAR versus open repair of blunt traumatic descending aortic injury in polytraumatic patients involved in motor vehicle accidents

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Imthiaz Manoly ◽  
Mohamed El Tahan ◽  
Maymoona Al Shuaibi ◽  
Fatimah Adel ◽  
Mohammed Al Harbi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Open Repair ◽  
Motor Vehicle ◽  
Aortic Injury ◽  
Motor Vehicle Accidents ◽  
Time Interval ◽  
Vehicle Accidents ◽  
Severity Scores ◽  
The Mean

Abstract Background Thoracic endovascular aortic repair (TEVAR) is the standard-of-care for treating traumatic aortic injury (TAI). Few retrospective studies compared TEVAR to open repair in blunt traumatic aortic injury (BTAI). Our objectives were to compare the early outcomes of TEVAR for blunt traumatic descending aortic injury to open repair (OR) in polytraumatic patients involved in motor vehicle accidents (MVA). Results Between February 2005 and April 2017, 71 patients with TAI due to MVA presented to our institution. All patients with descending aortic injuries were considered for open repair (n = 41) or TEVAR (n = 30) if there was no contraindication. The primary outcome was mortality, and secondary outcomes were stroke, paraplegia, intensive care unit (ICU), and hospital stay. The mean age was 28.4 ± 10.1 years in the OR group and 33.3 ± 16.6 years in TEVAR-group (P = 0.13). The injury severity scores were 41 ± 10 in the OR group and 33 ± 17 in the TEVAR group (P = 0.03). Patients in the OR group underwent emergency repair with a mean time of 0.56 ± 0.18 days from arrival. The TEVAR group had a longer time interval between arrival and procedure (2.1 ± 1.7 days, P = 0.001). The OR group had more blood transfusion (24 (58.5%) vs. 8 (27.5%), P = 0.002), renal impairment (6 (14.6%) vs. 1 (5.50%), P = 0.23), and wound infection (21 (51.2%) vs. 3 (10%), P < 0.001). Three TEVAR patients had a perioperative stroke compared to two patients in the OR group (P = 0.64). There was no difference in the mean ICU (6 ± 8.9 vs. 5.3 ± 2.9 days; P = 0.1) or hospital stay (20.1 ± 12.3 vs. 20.1 ± 18.3, P = 0.62) between the two groups. There were four deaths in the OR group and none in the TEVAR group (P = 0.13). Conclusion The results of TEVAR were comparable with the open repair for traumatic aortic injury with good early postoperative outcomes. TEVAR repair could be associated with lower mortality, blood transfusion, and infective complications. However, the complexity of the injury and technical challenges were higher in the open group.

scholarly journals Accidental childhood poisoning in Paediatrics department of a tertiary care facility: A retrospective review

2020 ◽  
Vol 47 (3) ◽  
Author(s):  
D.C. Obu ◽  
M.C. Orji ◽  
U.V. Muoneke ◽  
U.V. Asiegbu ◽  
G.O. Ezegbe
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Accidental Poisoning ◽  
Female Ratio ◽  
The Public ◽  
Tertiary Care Facility ◽  
Childhood Poisoning ◽  
The Mean ◽  
The Relationship ◽  
Male To Female

Background: Accidental childhood poisoning is a recognized preventable cause of morbidity and mortality among children worldwide. This studywas aimed at determining the prevalence, pattern, and outcome of childhood poisoning among children in Abakaliki, Ebonyi State. Material and Methods: Medical records of all cases of accidental childhood poisoning admitted into Children’s emergency room (CHER) of the health facility of study between January 2014 and December 2018 were retrospectively identified and relevant data extracted and analyzed usingSPSS version 22. Results: Out of the 7,700 children that presented to CHER over a 5- year period, 42 were cases of poisoning, giving prevalence rate of 0.5%. Of the 42 cases, only 20 case notes were retrieved. The male to female ratio was 2.3:1 while the ages ranged between 6months and 14 years with the mean age of 3.06±2.88. Kerosene poisoning had the highest proportion of 50.0% (10/20) with the overall mortality rate of 5.0% (1/20).The relationship between age, place of residence and outcome in poisoned children was statistically significant (p = 0.038, 0.045 respectively). Conclusion: Accidental childhood poisoning is common in Abakaliki. Kerosene still remained the major agent while male toddlers were most  vulnerable. There is need to intensify enlightenment campaigns and education of the public about the hazard of improper storage of kerosene and other implicated substances at home. Keywords: Accidental poisoning, Childhood, Kerosene

Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey

2005 ◽  
Vol 24 (2) ◽  
pp. 49-54 ◽  
Author(s):  
Cahfer Güloglu ◽  
Ismail Hamdi Kara
Keyword(s):  
Emergency Department ◽  
Suicide Attempts ◽  
Biological Effects ◽  
Acute Poisoning ◽  
University Hospital ◽  
Accidental Poisoning ◽  
Pesticide Poisoning ◽  
Monthly Basis ◽  
Ed Visits ◽  
The Mean

Aim: This study was conducted to determine the biological effects of acute poisoning, the nature of agents involved and the pattern of poisoning in Diyarbakir City, in the Southeast Anatolian region of Turkey, during 2000. Method: Hospital records of all admissions to the Emergency Department (ED) of Dicle University Hospital following acute poisoning were revised and all data from January to December 2000 were analysed. The present study included 44 (25.9%) male (M) and 126 (74.1%) female (F), a total of 170 patients. The M/F ratio was 1.0/3.5. Results: The mean age of patients was 23.39±6.3 years; 63 (37.1%) of them were under 20 years of age and 147 (86.5%) were under 30 years of age. Most intoxication cases occurred during the summer season (93 of 170 patients). On a monthly basis, admissions during April, May and July were most common (24, 26 and 30 patients, respectively). Sixty-two (36.5%) cases involved accidental poisoning while 108 (63.5%) involved deliberate poisoning. In suicide attempts, intoxications were more common in females (77 cases, 71.3%, P < 0.05), and in unmarried persons (74 cases, 68.5%, P < 0.05). There were only two deaths (1.2%) among the 170 admissions of acute poisonings. One of the deaths was due to pesticide poisoning and the other was due to medical drug abuse. Tachycardia (59, 34.7%), vomiting (55, 32.4%) and loss of consciousness (42, 24.7%) were frequently observed, whereas hypersecretion (15, 8.8%), bradycardia (5, 2.9%), convulsion (8, 4.7%) and hypertension (2, 1.2%) were less frequent. Among pesticide poisoning cases the incidence of convulsion (6, 10.2%), miosis (6, 10.2%), and hypersecretion (12, 20.3%) were significantly higher when compared to other cases (P–0.018, P B < 0.0001 and P B < 0.0001, respectively). Conclusion: In the Southeast Anatolian region of Turkey, pesticide intoxication is common especially among young, unmarried females and most of these intoxications are intentional self-poisonings. The annual rate of poisoning-related ED visits and mortality were found to be within expected ranges; psychoactive agents being the most common cause.

scholarly journals Clinical Features of Imported Chinese COVID-19 Patients Following Chinese Inactivated Vaccines Injection Abroad

2021 ◽  
Author(s):  
Jianwu Li ◽  
Na Jiang ◽  
Qing-Lei Zeng ◽  
Yue Zhang ◽  
Yao Chu ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Clinical Features ◽  
Medical Records ◽  
Severe Case ◽  
Shaanxi Province ◽  
Time Interval ◽  
Common Symptom ◽  
Limited Data ◽  
Inactivated Vaccines ◽  
The Mean

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has been demonstrated as an effective way to reduce the risk of coronavirus disease 2019 (COVID-19), and only a few vaccinees suffered from SARS-CoV-2 infection. However, limited data concerning the clinical features of these vaccinees infected with SARS-CoV-2 can be identified. Methods We retrospectively collected and analyzed epidemiological and clinical characteristics data of the imported COVID-19 cases who received Chinese inactivated vaccines abroad. Data were extracted from electronic medical records from a designated hospital in the Shaanxi Province of China between March 22 and May 17, 2021. Results Totally, 46 confirmed SARS-CoV-2 infection patients were enrolled. The mean age was 40.5 years (range 20-61), 41 (89.1%) are male. Eighteen (39.1%) patients were from Pakistan. Fourteen (30.4%) patients had at least one comorbidity. Forty (87.0%) and 6 cases were fully vaccinated and partly vaccinated. The time interval between vaccination and infection was 88 days (IQR, 33-123), 31 (67.4%) and 15 (32.6%) were asymptomatic and symptomatic cases, respectively. Fever (3/46, 6.5%) was the most common symptom; however, none had a body temperature higher than 38.0℃, and no severe case was observed. Notably, the rate of SARS-CoV-2 shedding discontinuation at 7 days after hospitalization in asymptomatic cases was higher than symptomatic one (93.5% vs 40%, P < 0.0001). Conclusions Individuals who received Chinese inactivated vaccines abroad remain have the probability to be infected with SARS-CoV-2, but all the vaccinees infected with SARS-CoV-2 were asymptomatic or had mild symptoms with favorable clinical outcomes.

scholarly journals Clinical profile and outcomes of childhood poisoning

2017 ◽  
Vol 10 (4) ◽  
pp. 264
Author(s):  
Farzana Ahmed ◽  
Md. Masudur Rahman ◽  
Muhammad Tawfiq
Keyword(s):  
Acute Poisoning ◽  
Accidental Poisoning ◽  
Age Group ◽  
Urban Background ◽  
Female Ratio ◽  
Childhood Poisoning ◽  
Poisoning In Children ◽  
Age Range ◽  
Male To Female ◽  
Accidental Introduction

<p class="Abstract">The patterns of accidental poisoning in children usually differ from country to country and from one region to another within the same country. This retrospective study was performed from January 2012 to December 2014 to determine the trends of childhood poisoning in urban area of Bangladesh. A total of 32 cases were analyzed completely; intention of poisoning was classified as accidental, suicidal and homicidal. The commonest age range for accidental poisoning was 1-5 years (64.7%). Suicidal poisoning was prevalent among mid adolescence group. The overall male to female ratio was 1:1; in case of accidental poisoning male to female ratio among preschooler was 2.66:1. All the patients were from urban background and drug overdose was the commonest cause of poisoning. Accidental poisoning was found in 53% of patients, suicidal 41% and homicidal 6% cases. The mortality was 3%. This study showed that boys at pre-school age group were at greater risk for accidental poisoning. Drug over dosage was the most common poisoning in this study. Alarmingly, accidental introduction of per rectal analgesic was the most common cause of acute poisoning during infancy in this study.</p>

scholarly journals Risk Factors and Outcome of Acute Poisoning in Childrens

2021 ◽  
pp. 36-44
Author(s):  
Abdul Sami Qureshi ◽  
Farhana Zafar ◽  
Madiha Waseem ◽  
Muhammad Taimor ◽  
. Sobia
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family Support ◽  
Working Mothers ◽  
Toxic Substance ◽  
Acute Poisoning ◽  
Home Garden ◽  
Accidental Poisoning ◽  
Time Interval ◽  
Care Hospital

Objective: To determine the risk factors and outcome of acute poisoning in children at a tertiary care hospital of Karachi. Study design: Cross sectional study Place and duration of study: Department of Emergency Medicine, Dr Ziauddin Hospital, Karachi, Pakistan.  From January 2019 to January 2021 Methodology: The patients (n=136) were selected of either gender with the precise age group of twelve years. All the patients selected were meeting the inclusion criteria and enrolled with a history of poisoning exposure within 24 hours of arriving at the hospital's emergency department. The name of the toxin, the time since ingestion of the toxic substance, factors prompting coincidental harming like age, ill-advised capacity of hurtful specialists, for example, lamp oil and blanch in soda bottles, simple access of kids to meds utilized by different individuals from the family, mother's schooling, working moms, financial status were completely assembled from the guardians or orderlies as referenced in the Performa. In general, people were poisoned primarily from within their own homes. Non-accidental poisoning cases were omitted. SPSS version 22 was used to analyze the data. Results: Out of 136 patient enrolled in this study mean age was 5.2+2.9 years, 77(56.6%) were male and 59(43.4%) were female and mean time of presentation was 2.3+1.7 hours. Most common risk factor was unsafe storage of chemicals (n=98) (72.1%), followed by education level of mother (n=)65 (47.8%), inadequate supervision of child (n=60) (44.1%), non authorative parenting (n=51) (37.5%), working mothers (n=41) (30.1%), lack of family support (n=30) (22.1%), developmental delay (n=11) (8.1%) and poisonous plant in home garden (n=6) (4.4%). Outcome mainly depends upon type of poisoning and time interval between poisoning and presentation to the hospital, 26 (19.11%) were discharged safely from ER, while 45 (33.08%) admit in wards and 48 (35.29%)  were admitted in Intensive Care and 17 (12.5%) were expired in ER. Conclusion: In this study we have concluded that number of accidental poisoning are often occur in toddler and school going children. The major risk factor of acute poisoning found was unsafe storage or easy accessibility of house hold chemicals, second one was low level of education of parents, than non-authorative parenting,  and working mothers and lack of family support. The outcome mainly depend upon time interval from ingestion of poison to presentation at hospital and type poisonous agent taken, that can lead to the need of specialized care, prolong hospital stay and sometimes results in death of a child.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

EVALUATION OF LONGO’S HEMORRHOIDECTOMY AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 79-85
Author(s):  
Van Lieu Nguyen ◽  
Doan Van Phu Nguyen ◽  
Thanh Phuc Nguyen
Keyword(s):  
Hospital Stay ◽  
Perioperative Complications ◽  
University Hospital ◽  
Anal Pain ◽  
Stapled Hemorrhoidectomy ◽  
Fourth Degree ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Good For

Introduction: Since Longo First described it in 1998, Stapled Hemorrhoidectomy has been emerging as the procedure of choice for symtomatic hemorrhoid. Several studies have shown it to be a safe, effective and relative complication free procedure. The aim of this study was to determine the suitability of (SH) as a day cas procedure at Hue University Hospital. Methods: From Decembre 2009 to April 2012, 384 patients with third- degree and fourth-degree hemorrhoids who underwent Stapled Hemorrhoidectomy were included in this study. Parameters recorded included postoperative complications, analegic requirements, duration of hospital stay and patient satisfaction. Follow-up was performed at 1 month and 3 months post-operative. Results: Of the 384 patients that underwent a Stapled Hemorrhoidectomy 252 (65,7%) were male and 132 (34,3%) were female. The mean age was 47,5 years (range 17-76 years. Duration of hospital stay: The mean day was 2,82 ± 1,15 days (range 1-6 days). There were no perioperative complications. There was one case postoperative complication: hemorrhage; Follow-up after surgery: 286 (74,4%) patients had less anal pain, 78 (20,3%) patients had moderate anal pain, 3 (0,8%) patients had urinary retention; Follow-up after one month: good for 325 (84,6%) patients, average for 59 (15,4%) patients; Follow-up after three months: good for 362 (94,3%) patients, average for 22 (5,7%) patients. Conclusion: Our present study shows that Stapled Hemorrhoidectomy is a safe, reduced postoperative pain, shorter hospital stay and a faster return to unrestricted daily activity

Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures

2020 ◽  
pp. neurintsurg-2020-016728
Author(s):  
Joshua S Catapano ◽  
Andrew F Ducruet ◽  
Stefan W Koester ◽  
Tyler S Cole ◽  
Jacob F Baranoski ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hospital Costs ◽  
Length Of Hospital Stay ◽  
Diagnostic Procedures ◽  
Femoral Access ◽  
Catheter Size ◽  
The Mean ◽  
The Difference ◽  
Procedure Type ◽  
Angiographic Findings

BackgroundTransradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions.MethodsElective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access.ResultsOf the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI −$4931 to −$97; p=0.04).ConclusionNeuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.

scholarly journals Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098278
Author(s):  
Xing Du ◽  
Yunsheng Ou ◽  
Guanyin Jiang ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Bone Graft ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Operative Time ◽  
Bone Grafts ◽  
Surgical Indications ◽  
Operative Blood Loss ◽  
The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

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