scholarly journals Epidemiological Pattern of Foot Injuries in India: Preliminary Assessment of Data from a Tertiary Hospital

2012 ◽  
Vol 46 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Manuj Jain ◽  
Sarvdeep Dhatt
Keyword(s):  
Tertiary Hospital ◽  
Road Accident ◽  
Preliminary Assessment ◽  
Foot Injuries ◽  
Surgical Delay ◽  
Foot Injury ◽  
High Incidence ◽  
Epidemiological Pattern ◽  
High Index Of Suspicion ◽  
Open Injuries

ABSTRACT Foot injuries are an often disabling, especially when the diagnosis is delayed and treatment is inappropriate; this becomes significant in polytrauma where diagnosis maybe missed, and in young adults who are injured in the prime of life. No data on foot injury is available from India or any other developing country; we undertook a prospective 1 year study to evaluate incidence and epidemiology of foot injuries seen at our center. One hundred and thirty-four feet were injured in 1,765 patients, with 82% being males, and the average age being 30.8 years. Road accident was predominant cause (73.8%) in contrast to the published literature, with two-third being open injuries; 47% were polytrauma victims. The surgical delay averaged 3.14 days, reasons for which were multifactorial. This high incidence of foot injury (7.59%) in men in their most productive years assumes significance when residual disability occurs due to mismanagement. A high index of suspicion needs to be maintained in road accident victims and polytrauma cases, so that foot injury is not missed and treatment is not inordinately delayed. How to cite this article Dhillon MS, Aggarwal S, Dhatt S, Jain M. Epidemiological Pattern of Foot Injuries in India: Preliminary Assessment of Data from a Tertiary Hospital. J Postgrad Med Edu Res 2012;46(3):144-147.

scholarly journals Outcome Assessment of Open Foot Injuries in A Teaching Hospital in Ghana

2019 ◽  
Vol 2 (4) ◽  
pp. 14-22
Author(s):  
Dominic Konadu-Yeboah ◽  
Peter Konadu ◽  
Ampem Darkwa ◽  
Virtue Fiawokome De-gaulle ◽  
Holdbrook Smith ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Weight Bearing ◽  
Open Fractures ◽  
Time Interval ◽  
Foot Injuries ◽  
Concomitant Injuries ◽  
Adequate Treatment ◽  
Foot Injury ◽  
Chi Square Analysis ◽  
Open Injuries

Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.

scholarly journals SARS-CoV-2 infection in an infant with non-respiratory manifestations: a case report

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Muhammad Adel ◽  
Ahmed Magdy
Keyword(s):  
Computed Tomography ◽  
Aplastic Anemia ◽  
Rt Pcr ◽  
Positive Real ◽  
Case Presentation ◽  
Chest Computed Tomography ◽  
High Incidence ◽  
Laboratory Investigations ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Abstract Background Coronavirus disease (COVID-19) presents in children usually with less severe manifestations than in adults. Although fever and cough were reported as the most common symptoms, children can have non-specific symptoms. We describe an infant with aplastic anemia as the main manifestation. Case presentation We describe a case of SARS-CoV-2 infection in an infant without any respiratory symptoms or signs while manifesting principally with pallor and purpura. Pancytopenia with reticulocytopenia was the predominant feature in the initial laboratory investigations, pointing to aplastic anemia. Chest computed tomography surprisingly showed typical findings suggestive of SARS-CoV-2 infection. Infection was later confirmed by positive real-time reverse transcription polymerase chain reaction assay (RT-PCR) for SARS-CoV-2. Conclusions Infants with COVID-19 can have non-specific manifestations and a high index of suspicion should be kept in mind especially in regions with a high incidence of the disease. Chest computed tomography (CT) and testing for SARS-CoV-2 infection by RT-PCR may be considered even in the absence of respiratory manifestations.

HIV-TUBERCULOSIS: A STUDY OF CHEST X-RAY PATTERNS IN RELATION TO CD4 COUNT

2021 ◽  
pp. 10-12
Author(s):  
Abdhesh Kumar ◽  
Naveen Kumar ◽  
Kumar Sourav
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Hospital ◽  
Hiv Positive ◽  
Who Guidelines ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray ◽  
Radiological Patterns ◽  
High Index Of Suspicion ◽  
Ray Patterns

Background: Fight against human immunodeciency virus (HIV) is incomplete without addressing problems associated with difcult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods: Prospective cohort study was conducted in a tertiary hospital in J.L.N.M.C.H Bhagalpur from april 2019 to january 2021 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results: 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Inltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Inltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen. Conclusion: In patients with CD4 lower than 200 noncavitory inltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement was higher than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIVpositive patients.

scholarly journals Epidemiology of Operative Foot injuries in College Level Athletes

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0013
Author(s):  
Jimmy J. Chan ◽  
Kevin K. Chen ◽  
Javier Z. Guzman ◽  
Ettore Vulcano
Keyword(s):  
Female Athletes ◽  
Injury Rate ◽  
College Level ◽  
Time Loss ◽  
Foot Injuries ◽  
Injury Rates ◽  
Foot Injury ◽  
Ncaa Athletes ◽  
Multiple Variables ◽  
Lisfranc Injuries

Category: Hindfoot, Lesser Toes, Midfoot/Forefoot, Sports, Trauma Introduction/Purpose: Foot injuries represent a broad category of injuries that may have profound implications in National Collegiate Athletic Association (NCAA) athletes. Accordingly, a more thorough characterization of these injuries and what predisposes NCAA athletes to them is crucial to their prevention. This study examines the incidence and effect of foot injuries on NCAA athletes and their athletic season. Methods: Foot injuries across 16 sports among men and women during the 2004-05 to 2013-14 academic years were analyzed from the NCAA Injury Surveillance Program (NCAA-ISP). Three common orthopaedic foot injuries were sub-analyzed, including fifth metatarsal injuries (5MT), Lisfranc injuries, and turf toes. Multiple variables were reported including injury rates per 100,000 athlete-exposures (IR), operative rate, annual injury rate trends, re-injury rates, in-season status (pre/in/post-season) at time of injury, and time loss distributions were compiled and calculated. Results: A total of 3718 foot injuries were identified over 10-year period. 4.4% of all injuries were operative. Overall foot injury rate was comparable between male (IR=31.1) and female athletes (IR=32.4); however, the operative injury rate was greater in male compared to female (IR=2.0 vs. 0.6) athletes. The top three operative injuries were 5MT (45.1%), stress fractures (12.2%), and Lisfranc injuries (7.9%). 10.8% of turf toes are re-injury, and average time loss was 7.0 days. 43% of 5MT injuries were operative, and 19.2% were re-injuries. 40.6% of 5MT injuries were season-ending with an average time loss of 36.5 days. 33% of Lisfranc injuries were operative, and 7.5% were re-injuries. 45.9% of Lisfranc injuries were season-ending with an average time loss of 25.9 days. Conclusion: Foot injuries are among the most common form of injuries that occur in NCAA athletics. In addition, these injuries can sometimes lead to significant loss of playing time and may even result in the end of the athlete’s season or career. Certain NCAA sports such as men’s football and basketball may more likely predispose patients to season ending injuries and require operative fixation. Close examination of the kinds of foot injuries and their respective mechanisms may help elucidate trends useful in the development of various prevention strategies.

scholarly journals Gallstone ileus: a rare type of intestinal obstruction in Ghana

2021 ◽  
Vol 55 (1) ◽  
pp. 84-87
Author(s):  
Offei K. Asare ◽  
Henry E. Obaka ◽  
Nelson K. Affram
Keyword(s):  
Intestinal Obstruction ◽  
Gallstone Ileus ◽  
Clinical Information ◽  
Healthcare Facility ◽  
Tertiary Hospital ◽  
Adhesive Small Bowel Obstruction ◽  
Rare Type ◽  
Delay In Diagnosis ◽  
Low Incidence ◽  
High Index Of Suspicion

Gallstone ileus is an uncommon cause of intestinal obstruction in Ghana. A patient with gallstone ileus that was diagnosed intra-operatively after being treated conservatively as adhesive small bowel obstruction for ten days is reported to highlight the importance of the clinical information in this condition. A 60-year-old Chinese male with recurrent intestinal obstruction who was initially being managed at a primary healthcare facility was subsequently referred to a tertiary hospital on account of computer tomography diagnosis of an intraluminal object obstructing the bowel. He had hypokalaemia that was corrected before surgery. Intra-operatively, a 4.5cm in diameter gallstone was removed from the terminal ileum. Gallstone ileus is rare in Ghana. A high index of suspicion is required to avoid a delay in diagnosis due to the low incidence of cholelithiasis in Ghana.

scholarly journals Intravascular Lymphoma of the Inferior Turbinate: An Unusual Rhinologic Presentation of a Rare Neoplasm

2007 ◽  
Vol 22 (1-2) ◽  
pp. 24-26 ◽  
Author(s):  
Milabelle B. Lingan ◽  
Francis V. Roasa
Keyword(s):  
Fever Of Unknown Origin ◽  
Medical Condition ◽  
Unknown Origin ◽  
Inferior Turbinate ◽  
Tertiary Hospital ◽  
Sinus Surgery ◽  
Intravascular Lymphoma ◽  
High Grade Fever ◽  
The Right ◽  
High Index Of Suspicion

Objective: To present a unique case of intravascular lymphoma of the inferior turbinate because of its rarity, unusual clinical presentation and difficulty in establishing a diagnosis. Design:      Case Report Setting:      A tertiary hospital Patient:      A 66-year-old male admitted to the hospital due to intermittent high grade fever of six months duration. Result:  The patient presented with fever of unknown origin, and exhaustive laboratory, ancillary procedures and biopsies to rule in/out infectious, autoimmune and oncologic causes were performed to arrive at a diagnosis. Nasal endoscopy revealed an enlarged, hypertrophied and violaceous right inferior turbinate with watery to mucoid discharge and septal deviation to the right confirmed by CT scans of the paranasal sinuses. Functional Endoscopic Sinus Surgery (FESS), septoplasty and turbinoplasty with biopsy revealed Intravascular Lymphoma. Chemotherapy was deferred due to the deteriorating medical condition and the patient expired 7 months after the initial onset of symptoms. Conclusion:  Patients who present with fever of unknown origin should undergo a thorough otorhinolaryngologic examination to exclude primary ENT conditions and ensure proper management. Given its rarity and multiplicity of presentation, it is extremely difficult to make a diagnosis of intravascular lymphoma. A high index of suspicion of Intravascular Lymphoma is necessary so that timely acquisition of tissue biopsy of any lesion involved will make a definite diagnosis. Keywords: Intravascular lymphoma, Fever, Fever of Unknown Origin

scholarly journals High index of suspicion for Brucellosis in a highly cosmopolitan city of southern China

2019 ◽  
Author(s):  
Hai-Yan Ye ◽  
Fan-Fan Xing ◽  
Jin Yang ◽  
Simon K.F Lo ◽  
Ricky W.T. Lau ◽  
...  
Keyword(s):  
Southern China ◽  
Rare Complication ◽  
Unknown Origin ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Human Brucellosis ◽  
Presenting Symptoms ◽  
Route Of Transmission ◽  
Soft Tissue Abscess ◽  
High Index Of Suspicion

Abstract Background:Brucellosis is one of the most widespread zoonosis worldwide, it is caused by Gram-negative coccobacilli, Brucella spp. In China, 90% of brucellosis occurred in six northern agricultural provinces. However, there is an increasing trend of human brucellosis in southern provinces but only limited cases were reported. Our study aims to describe the clinical features and epidemiology of brucellosis in a tertiary hospital of southern china. Methods:A retrospective study was conducted in the past 4 years. Clinical details of brucellosis including occupation, suspected transmission route and complications were retrieved. Serum for tube agglutination test to check Brucella antibody. Blood and aspirate were collected for culture, Vitek 2 and MALDL-TOF MS were used for identification.Results:Thirteen cases of laboratory confirmed brucellosis were encountered in a highly cosmopolitan city Shenzhen of South China between January 2014 and October 2018. Seven of the thirteen patients were male, with age ranging from 29 to 73 years old. Five patients (38.5%) came from Guangdong province, and eight patients (61.5%) came from other provinces. The commonest route of transmission was handling and consumption of infected placenta from goats. Common presenting symptoms include fever, osteoarticular pain and urinary symptoms. Common physical signs were fever, splenomegaly and lymphadenopathy. The commonest complication was spondylodiscitis/ peripheral joint arthritis (n=4), while exotic complications including abdominal aortitis with pseudoaneurysm, hepatic and spleen abscess, soft tissue abscess, and epididymo-orchitis were also observed in 4 other patients. The most life-threating but rare complication of abdominal aortitis in the elderly could be easily missed due to the nonspecific presenting symptom. Conclusions:In summary, brucellosis is increasingly seen in highly cosmopolitan part of southern China. In addition to tuberculosis, typhoid fever and typhus, brucellosis should be considered in the differential diagnosis of fever of unknown origin in this locality. Presence of extensive atherosclerosis in elderly patient may predispose them to endovascular infection by Brucella species.

scholarly journals Malaria in a 2-Month-Old HIV-Exposed Nigerian Infant: Challenges of Care

2019 ◽  
Vol 18 ◽  
pp. 232595821984905
Author(s):  
Olusola Adetunji Oyedeji
Keyword(s):  
Clinical Presentation ◽  
Tertiary Hospital ◽  
Early Infancy ◽  
Good Knowledge ◽  
Intermittent Fever ◽  
Tropical Countries ◽  
Hiv Exposed Infants ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
High Index Of Suspicion

Background: Reports on malaria and HIV coinfections in exposed infants from tropical countries are scarce. Results: The case of a 2-month-old HIV-exposed Nigerian infant who presented with intermittent fever at a Nigerian tertiary hospital is reported. The rarity of the case and the challenges associated with making the diagnosis informed our decision to report the case. Conclusion: Diagnosing malaria in HIV-exposed infants in early infancy requires a high index of suspicion, good knowledge of the clinical presentation, and appropriate microbiological investigations for sepsis and malaria. Further studies need to be conducted on the association between malaria and HIV exposure.

Kawasaki disease; rare; or misdiagnosed: A case report in a tertiary hospital in Nigeria

2021 ◽  
Vol 5 ◽  
pp. 35-39
Author(s):  
Callistus Achuri Okwuchukwu Enyuma ◽  
Anthony Chimereze Amajor ◽  
Enobong Ufot Akpah ◽  
Ekaete Samuel Brown-Abang
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Delayed Diagnosis ◽  
Male Infant ◽  
Tertiary Hospital ◽  
Moderate Dose ◽  
Diagnostic Dilemma ◽  
Dose Aspirin ◽  
High Index Of Suspicion ◽  
Children Under 5

Kawasaki disease (KD) is a self-limiting, acute febrile vasculitis with predilection for children under-5 years. Most reports have emanated from Japan with only a few cases reported in Africa. KD presents a diagnostic dilemma and a high index of suspicion is critical as early treatment reduces the incidence of complications. We describe a 5-month-old male infant who presented with classical clinical features though with delayed diagnosis. Received moderate dose aspirin with limitation of access to intravenous immunoglobulin and who did not develop coronary artery complication. The case report highlights the diagnostic challenges faced by practitioners, made worse by the low index of suspicion inherent in our setting. The fatal complications that may be associated with KD can, therefore, be avoided. It is hoped that pediatricians in particular would become conversant with the diagnostic criteria to facilitate early diagnosis and intervention in children.

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