Application and Experience of Various Reconstructive Procedures in Scalp Defects

Aim: To evaluate the outcome of various reconstructive procedures in scalp defects. Study Design: Cross sectional descriptive study. Place and Duration of Study: Department of Plastic/Reconstructive Surgery & Burns, LUMHS Jamshoro from 1st January 2018 to 31st December 2020. Methodology: Thirty patients of scalp wounds were admitted through outpatient and casualty departments. The patients were diagnosed by pre-operative workup and on clinical parameters were included. The patients unfit for general anaesthesia, patients having associated skin pathology, patients with history of allergic reactions and patients having any poorly controlled systemic co-morbidity like diabetes and hypertension were excluded. Results: Twenty two (73.33%) were males and 8 (26.66%) were females with mean age of 38.98±8.25 years. Scalp defect was due to trauma in46.66%, electric injury 23.33%, benign lesions 16.66%, malignant tumour 3.33%, Infection 3.33%, haemangioma and pigmented nevus 3.33%. Follow up duration was 42.34±7.83 weeks. Conclusion: Primary closure remained the mainstay of our treatments hence proved that simplest reconstruction should be used whenever possible to provide the most functional and aesthetic scalp reconstruction, with the least amount of complexity. Key Words: Scalp, Reconstructive surgical procedure, Graft, Flap

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Risk factors for functional deterioration in a cohort with late effects of poliomyelitis: A ten-year follow-up study

Neurorehabilitation ◽

10.3233/nre-210216 ◽

2021 ◽

pp. 1-9

Author(s):

Zeev Meiner ◽

Anat Marmor ◽

Murad Jalagel ◽

Hagai Levine ◽

Shimon Shiri ◽

...

Keyword(s):

Risk Factors ◽

Functional Status ◽

Accelerated Aging ◽

Late Effect ◽

Paralytic Poliomyelitis ◽

Cross Sectional ◽

History Of ◽

Initial Severity ◽

Functional Deterioration

BACKGROUND: More than 7000 patients developed poliomyelitis during the main epidemic in the fifties in Israel. In recent years, there is a further deterioration in their condition due to accelerated aging process and post-polio syndrome. OBJECTIVE: To evaluate the risk factors for the progression of functional status in a cohort of patients with late effect of poliomyelitis over a period of ten years. METHODS: A cross-sectional cohort study including 82 individuals with late effect of poliomyelitis evaluated over ten years. Mean age was 67±8.5 years, 52.4%were men and 79.3%were Jewish. Functional status was evaluated by activities of daily living (ADL) questionnaire. Risk factors, including general comorbidities, history of poliomyelitis infection, use of assistive devices, employment, and physical activity statuses were evaluated using specific questionnaires. RESULTS: Independence in ADL functions deteriorated significantly over ten years. Older age, ethnicity, use of a wheelchair, and use of orthotic devices in childhood were risk factors for deterioration in ADL function. No correlation was found between the presence of other comorbidities or poliomyelitis parameters and worsening of ADL functions. CONCLUSIONS: Late effect of poliomyelitis was associated with deterioration in ADL functions probably due to the combined effect of the initial severity of the paralytic poliomyelitis symptoms and accelerated aging.

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Primary orbital extraskeletal osteosarcoma and review of literature

BMC Ophthalmology ◽

10.1186/s12886-020-01690-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jingwen Hui ◽

Yun Zhao ◽

Lei Zhang ◽

Jinyong Lin ◽

Hong Zhao

Keyword(s):

Soft Tissues ◽

Malignant Tumour ◽

Extraskeletal Osteosarcoma ◽

Complete Excision ◽

Case Presentation ◽

Left Orbit ◽

Orbital Wall ◽

Previous Trauma ◽

History Of

Abstract Background Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. Case presentation The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. Conclusions ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.

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Minimizing Variability in Interpretation Modality Among Spanish-Speaking Patients With Limited English Proficiency

Hispanic Health Care International ◽

10.1177/1540415319856329 ◽

2019 ◽

Vol 18 (1) ◽

pp. 32-39

Author(s):

Seiichi Villalona ◽

Christian Jeannot ◽

Mery Yanez Yuncosa ◽

W. Alex Webb ◽

Carol Boxtha ◽

...

Keyword(s):

Limited English Proficiency ◽

English Proficiency ◽

Cross Sectional ◽

Time Points ◽

Spanish Speaking ◽

History Of ◽

Vas Scores ◽

Communication Modalities ◽

The Impact

Introduction: Provider–patient language discrepancies can lead to misunderstandings about follow-up care instructions and decreased adherence to treatment that may contribute to disparities in health outcomes among patients with limited English proficiency (LEP). This observational study aimed to understand how emergency department (ED) staff went about treating patients with LEP and examine the impact of consistent interpretation modality on overall patient satisfaction and comprehension. Method: A cross-sectional study was conducted among Spanish-speaking patients with LEP presenting to the ED. A survey was administered at two different time points: after patients provided their history of present illness and after the patient received information regarding follow-up treatment. Results: Analysis of average visual analog scale (VAS) scores by consistency of interpretation suggested higher overall scores among participants that received care via the same communication modalities during both the history of present illness and at disposition, when compared with patients that did not. At both time points, video-based interpretation was associated with higher VAS scores in comparison to other modalities, whereas phone-based interpretation was associated with lower VAS scores. Conclusion: Providing consistent modes of interpretation to patient’s with LEP throughout their ED visits improved their overall satisfaction of care provided and understandings of discharge instructions.

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The Influence of Clinical and Socio-Demographical Characteristics on Medical Co-Morbidity Occurrence in Unipolar Depressive Individuals

European Psychiatry ◽

10.1016/s0924-9338(09)70871-5 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

V.R. Enatescu

Keyword(s):

Diagnostic Criteria ◽

Total Duration ◽

Unipolar Depression ◽

Cross Sectional Study ◽

Cross Sectional ◽

Co Morbidity ◽

Icd 10 ◽

History Of ◽

Severity Of Depression ◽

Demographical Data

Aims/Objectives:Our main purpose was to examine the clinical and socio-demographical influencing factors that play a significant role to medical co-morbidity occurrences in unipolar depressives.Methods:We performed two types of clinical studies, one longitudinal retrospective study on 248 unipolar depressives admitted in our Clinic during 2001 - 2005 and second represented by a cross-sectional study on 45 inpatients and outpatients that had meet diagnostic criteria of unipolar depression according to ICD-10 and DSM-IV.Results:Socio-demographical factors that concurring to medical co-morbidity in unipolar depressives were represented by advanced current age and low educational level. Interestingly, the total duration of unipolar depression was not significant correlated with medical co-morbidity. A positive familial history of depression was correlated with a significant higher risk for coronary hearth diseases (depressives - average=0.443, S.D. =0.652; bipolars+delusionals - average=0.252, S.D.=0.499; t=2,665, p=0.008). Cluster C personality traits have had higher risk of cardiovasculare diseases (p=0.024). Inversely, in cross-sectional research those who met diagnostic criteria for cluster A and/or B personality disorders have had significant higher risk to develop medical co-morbidity. The higher level of co-existing anxiety, both as a trait as well as a state, was correlated with medical co-morbidity of unipolar depression. Surprisingly, in both type of studies, the severity of depression was not significant correlated with the extension of medical co-morbidity. Unipolar depressives were more prone to use dysfunctional copings as psychoactive substance use.Conclusions:Both clinical and socio-demographical data profiles could give us some valuable informations in predicting medical co-morbidity in unipolar depressives.

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Psychiatric Co-Morbidities of Suicide Attempters: A Cross Sectional Observation in a Tertiary Care Hospital of North India

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20210408 ◽

2021 ◽

Vol 6 (2) ◽

pp. 40-46

Author(s):

Shaveta Bhagat ◽

Mohammad Maqbool Dar ◽

Ibrar Ahmed

Keyword(s):

Family History ◽

General Hospital ◽

Psychiatric Illness ◽

Care Hospital ◽

Cross Sectional ◽

Suicide Attempters ◽

Increased Risk ◽

Co Morbidity ◽

History Of ◽

Suicide Attempted

Background: Psychiatric disorders are at increased risk for suicide. Attempted suicide is a common clinical problem in a general hospital. It has a serious clinical and socio-economical impact too. Aims: This study was carried out to assess the prevalence of psychiatric co-morbidities of suicide attempters attending the emergency. Material and methods: This study was a cross sectional, observational study which was conducted at the Community General Hospital Unit, Institute of Mental Health and Neurosciences-Kashmir an associated hospital of Government Medical College Srinagar among the suicide patients attending the outpatient service and inpatient services of the hospital fulfilling inclusion and exclusion criteria over a period of one and a half year, from November 2017 to May 2019. Written informed consent was obtained in a simple and easily understandable unambiguous language. For the diagnosis of psychiatric comorbidity, we used MINI International Neuropsychiatric Interview Schedule Plus (MINI PLUS). A p-value of <0.05 was taken as statistically significant. Results: A total of 221 cases who had been admitted following unsuccessful suicide attempts to the emergency and psychiatry department were taken up for the study. They were evaluated in detail with regards to past attempt of suicide, family history of psychiatric illness or suicide and the presence of psychiatric co-morbidity and the results have been presented below in tabulated and graphical forms. 77.4% of the attempters had no history of psychiatric illness in their family while 22.6% of patients did have family history of a psychiatric illness. 98.2% of attempters had no family history of suicide while 1.8% of the patients gave a family history of suicide. 21.26% males and 54.75% females had associated psychiatric co-morbidities and 23.9% had no associated psychiatric co-morbidities. Conclusion: The most common psychiatric morbidity associated with suicide was found to be major depressive disorder. Most importantly, the suicide attempters should be looked with sympathy rather than with a grimace on face. Such people should not be stigmatized and we should not let their shoulders drop. Keywords: Depression, Bipolar Disorder, Morbidity, Suicide.

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Prevalence and Associated Factors of Self-Medication among Pregnant Women on Antenatal Care Follow-Up at University of Gondar Comprehensive Specialized Hospital in Gondar, Northwest Ethiopia: A Cross-Sectional Study

International Journal of Reproductive Medicine ◽

10.1155/2020/2936862 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Faisel Dula Sema ◽

Deres Gezahegn Addis ◽

Eshetie Azezew Melese ◽

Demeke Dana Nassa ◽

Zemene Demelash Kifle

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Previous History ◽

Cross Sectional Study ◽

Monthly Income ◽

Self Medication ◽

Cross Sectional ◽

Specialized Hospital ◽

History Of

Background. Self-medication is being prevalent throughout the globe. Although pregnant women are among the most vulnerable group of the population for drug-induced adverse effects on their fetus and themselves, many pregnant women use self-medication without adequate safety precautions. Objective. This study was aimed at assessing the prevalence and associated factors of self-medication among pregnant women on antenatal care follow-up at University of Gondar Comprehensive Specialized Hospital. Methods. A cross-sectional study was employed among 400 pregnant women attending antenatal care clinic at the University of Gondar Comprehensive Specialized Hospital between February 01 and May 30, 2019. A structured interviewer-administered questionnaire was used for data collection. Data were analyzed using SPSS® (IBM Corporation) version 22. Descriptive statistics were presented using frequency and proportion. Binary logistic regression was used to identify factors associated with self-medication with a 95% confidence level and p value of 0.05. Results. Among 400 respondents, the prevalence of self-medication during the current pregnancy was 44.8% (95% CI=40.5-50). Among all respondents (400), 38.0% (95% CI=33.3-42.8) and 12.5% (95% CI=9.5-15) used herbal and conventional medicine, respectively. Self-medication showed a significant association with a previous history of self-medication and monthly income. Conclusions. The prevalence of self-medication among pregnant women is considerably high. The previous history of self-medication and monthly income showed a significant association with self-medication. Awareness creation should be done for reproductive-age women on the potential risks of self-medication.

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The Role of Surveillance in the Management of Small Renal Masses

The Scientific World JOURNAL ◽

10.1100/tsw.2007.157 ◽

2007 ◽

Vol 7 ◽

pp. 860-868 ◽

Cited By ~ 11

Author(s):

Alessandro Volpe

Keyword(s):

Natural History ◽

Active Treatment ◽

Initial Period ◽

Renal Tumors ◽

Small Renal Masses ◽

Renal Masses ◽

Cross Sectional ◽

Slow Growth Rate ◽

History Of

Incidentally detected, small renal masses (SRMs) have been increasing significantly in recent years due to the widespread use of improved cross-sectional imaging. A significant number of incidental SRMs are diagnosed in elderly patients who are more likely to undergo imaging for other medical issues. The natural history of SRMs has not been historically well understood because most masses are surgically removed soon after diagnosis.Several reports of surveillance of SRMs have been published in the last few years. When followed conservatively with serial imaging, SRMs have variable growth rates with an average of 0.28 cm/year, according to a recent meta-analysis. Larger series with longer follow-up are needed, but a significant number of small tumors seem to have an indolent behavior with a slow growth rate and a limited tendency to progress. The standard of care for enhancing SRMs is surgery. Up to one-third of surgically removed, <4-cm tumors are histologically benign. The outcomes of current surgical treatment of histologically confirmed, <4-cm, renal cell carcinomas are excellent, but this has not led to a decrease in mortality. Based on these considerations and on the available data on the natural history of SRMs, it seems reasonable to consider that we may be overtreating these lesions. This is especially true for elderly or unfit patients who have a decreased life expectancy. In these selected patients and in patients who refuse active treatment, it seems reasonable to propose an initial period of active surveillance for incidental SRMs, with delayed intervention for those tumors that will exhibit fast growth during follow-up. Percutaneous needle biopsies of renal tumors can be safely performed with the use of modern techniques and have the potential to characterize SRMs at histologically diagnosis, thereby allowing a better selection of the conservative or active treatment that is best suited for each individual patient.

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Serotonin transporter polymorphism (5HTTLPR), severe childhood abuse and depressive symptom trajectories in adulthood

BJPsych Open ◽

10.1192/bjpo.bp.115.000380 ◽

2015 ◽

Vol 1 (1) ◽

pp. 104-109 ◽

Cited By ~ 2

Author(s):

Timothy B. Nguyen ◽

Jane M. Gunn ◽

Maria Potiriadis ◽

Ian P. Everall ◽

Chad A. Bousman

Keyword(s):

Depressive Symptom ◽

Childhood Abuse ◽

Serotonin Transporter ◽

Symptom Severity ◽

Cross Sectional ◽

Symptom Trajectories ◽

History Of ◽

Depressive Symptom Severity ◽

Serotonin Transporter Polymorphism

BackgroundCross-sectional studies suggest that the serotonin transporter promoter region polymorphism (5-HTT gene-linked polymorphic region,5HTTLPR) moderates the relationship between childhood abuse and major depressive disorder.AimsTo examine whether the5HTTLPRpolymorphism moderates the effect childhood abuse has on 5-year depressive symptom severity trajectories in adulthood.MethodAt 5-year follow-up, DNA from 333 adult primary care attendees was obtained and genotyped for the5HTTLPRpolymorphism. Linear mixed models were used to test for a genotype × childhood abuse interaction effect on 5-year depressive symptom severity trajectories.ResultsAfter covariate adjustment, homozygoussallele carriers with a history of severe childhood abuse had significantly greater depressive symptom severity at baseline compared with those without a history of severe childhood abuse and this effect persisted throughout the 5-year period of observation.ConclusionsThe5HTTLPR s/sgenotype robustly moderates the effects of severe childhood abuse on depressive symptom severity trajectories in adulthood.

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Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients on Follow-Up Clinic at Jimma Medical Center, Southwest Ethiopia, 2019: An Institutional-Based Cross-Sectional Study

Journal of Diabetes Research ◽

10.1155/2020/4106383 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Daba Abdissa ◽

Tesfaye Adugna ◽

Urge Gerema ◽

Diriba Dereje

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Foot ◽

Medical Center ◽

Previous History ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Cross Sectional ◽

History Of

Background. Diabetic foot ulceration is a devastating complication of diabetes mellitus and is a major source of morbidity and mortality. So far, there are few published data on diabetic foot ulcers and its determinants among diabetic patients on follow-up at Jimma Medical Center. Hence, the aim of this study was to assess the prevalence of diabetic foot ulcer and its determinants among patients with diabetes mellitus at Jimma Medical Center. Methods. A hospital-based cross-sectional study was conducted from June 1 to August 30, 2019, and systematic random sampling technique was applied. The total number of study subjects who participated in the study was 277. Data were collected using an interview-administered structured questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 20 software for analysis. Analysis was done using descriptive statistics and logistic regression. A variable having a p value of <0.25 in the bivariate model was subjected to multivariate analysis to avoid confounding the variable’s effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval and considered significant with a p value of ≤0.05. Result. The mean of age of participants was 50.1±14.19 years. More than three-fourths of participants (82.7%) were type 2 DM. The mean duration of diabetic patients was 6.00±5.07 years. The prevalence of diabetic foot ulcer was 11.6% among study participants. According to multivariate logistic regression analysis, previous history of ulceration (AOR=5.77; 95% CI: 2.37, 14.0) and peripheral neuropathy (AOR=11.2; 95% CI: 2.8, 44.4) were independent predictors of diabetic foot ulcer. Conclusion. The prevalence of diabetic foot ulcer was 11.6%. Previous history of ulceration and peripheral neuropathy were associated with diabetic foot ulcer. The health care providers are recommended to thoroughly give emphasis during follow-up of patients who had previous history of ulceration and peripheral neuropathy in order to decrease the occurrence of diabetic foot ulcer.

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A Cross-Sectional Evaluation of Illness Perception About Asthma Among Asthma Patients at a Referral Tertiary Care Public Chest Hospital in Delhi, India

International Journal of User-Driven Healthcare ◽

10.4018/ijudh.2012070104 ◽

2012 ◽

Vol 2 (3) ◽

pp. 32-43

Author(s):

Sushil Shendge ◽

Barnali Deka ◽

Anita Kotwani

Keyword(s):

Inhaled Corticosteroids ◽

Tertiary Care ◽

Illness Perception ◽

Clinical History ◽

Self Management ◽

Cross Sectional ◽

The Public ◽

Co Morbidity ◽

Asthma Patients ◽

History Of

Adult patients visiting emergency room (March 2009-December 2009) of the public chest hospital for asthma exacerbation completed interviewer-administered questionnaires on sociodemographics, clinical history, disease beliefs, use of inhaled corticosteroids (ICS), and self-management of asthma after stabilization of their condition. Overall 87% patients believed that they had asthma when they are having symptoms, which is called as no symptoms, no asthma belief. No association was found between no symptoms, no asthma belief with gender, income, family history of asthma, and co-morbidity. Younger patients in the age group 18-29 years had four to five-fold greater odds and patients with education above 10th grade had three to four-fold greater odds of having the no symptoms, no asthma belief or the acute episodic belief. Acute episodic belief was negatively associated with beliefs about always having asthma, asthma being a serious condition, having lung inflammation, or the importance of using ICS, and was positively associated with expecting to be cured. All patients irrespective of their belief of acute or chronic nature of asthma had poor adherence to the treatment and other self-management behaviors.

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