scholarly journals An Audit of Surgical Management of Pressure Sores in a Resource Constrained Hospital in Kenya

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
W. F. Nangole ◽  
S. O. Khainga ◽  
Soren Otieno ◽  
Audi Tanga

Objective. To determine the surgical management of pressure sores at the National Spinal Injury Hospital and the outcome. Design. This was a four-year prospective study from June 2008 to June 2012. Setting. The study was carried out at the National Spinal Injury Hospital, Nairobi, Kenya. Subjects. Patients with pressure sores operated on during the defined period of study. Results. A total of 46 patients with 58 pressure sores were operated on during the defined period of study. The male : female ratio was 10.5 : 1. The mean age was 36.5 years. Trochanteric sores accounted for 60 percent of the pressure sores operated on with the V-Y tensor fascia lata, the commonest surgical procedure, accounting for 37 percent of the procedures performed. At one year of followup 90 percent of the surgeries done were successful with no ulcer recurrence noted. Conclusion. Surgical management of pressure sores even in resource constrained environment would result in faster rehabilitation and early patient discharge. The recurrence of the pressure sores could be greatly reduced by involving patients relatives in the rehabilitation and home-based care.

Author(s):  
Kulwinder Singh Mehta ◽  
Aamir Yousuf ◽  
Iftikhar Ali Wazir ◽  
Kouser Sideeq

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Concha bullosa is a common anatomical variation in nasal cavity, responsible for headache, Rhinogenic origin is an important cause for headache wrongly managed now a day, which may be treated by medical or surgical intervention, proper diagnosis and patient’s selection is very important to achieve good results with surgery of CB. The aim of this study is to evaluate the efficacy and assess the clinical benefits outcome results of our endoscopic turbinoplasty technique for CB. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was done in SMHS GMC Srinagar for a period of one year and about 30 patients with mild/moderate DNS and associated CB with symptoms of facial pain, head ache, nasal obstruction, anosmia, recurrent rhinitis were selected for surgical management and symptoms assessment was done using VAS.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The 30 patient group with 1: 1 male: female ratio predominatly in 3<sup>rd</sup> decade of life presented with nasal obstruction more on concha bullosa side, 26 with facial pain and 27 patients with head ache and nasal obstruction, anosmia/hyposmia in 20 and recurrent rhinitis in 26. There was statistical significant benefit on symptoms score in patients managed with endoscopic chonchoplasty. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The endoscopic turbinoplasty is safe and efficacious procedure for concha bullosa and is causuative factor for rhinogenic origin of headache and facial pain.</span></p>


2019 ◽  
Vol 9 (2) ◽  
pp. 24-31
Author(s):  
Elina Shrestha ◽  
Narayan Bikram Thapa ◽  
Shankar Bahadur Singh Rajbhandari

Introduction: Proptosis is defined as bulging of eye anteriorly out of the orbit. Our main objective was to analyze the pattern of computerised tomographic findings in evaluation of proptosis. Computerised tomography (CT) is noninvasive, easily accessible, affordable and reliable imaging which helps in early diagnosis and prompt treatment. Methods: A descriptive cross sectional study of total 58 patients presenting with proptosis referred to our department of radiology for computerised tomography evaluation during one year period were undertaken into study. The clinical information provided by ophthalmologist also helped our study to derive into conclusion. SPSS version 20 software was used for statistical data analysis. Results: Out of 58 patients, the most common cause of proptosis was neoplasm constituting of 25 cases (43.1%). Retinoblastoma was the commonest orbital tumor. Out of remaining cases, 15 (25.8%) were infective, 14 (24.1%) were inflammatory, two (3.44%) were traumatic and remaining two cases (3.44%) had no definitive cause for proptosis. Bilateral proptosis was commonly associated with thyroid ophthalmopathy. Among the subjects 32 were male, 26 were female. Male: Female ratio was 1:1.23. Age group was ranging from 1 month to 73 years.Mean age was 26.4 ± 22 years. Conclusions: Computerised tomography has an important role in distinguishing the different types of lesions based on their characteristics, location and extension prior to undertaking definitive surgical and medical treatment. Overall accuracy of CT in our study was 81%, sensitivity of 82.6%, specificity of 80.6%, positive predictive value of 76% and negative predictive value of 86.2%.


2015 ◽  
Vol 85 (3) ◽  
pp. 374-380 ◽  
Author(s):  
Amely Eckstein ◽  
Hans-Joachim Helms ◽  
Michael Knösel

ABSTRACT Objective:  To assess camouflage effects by concealment of postorthodontic white-spot lesions (WSLs) to sound adjacent enamel (SAE) achieved over 12 months with resin infiltration (Icon, DMG, Hamburg, Germany). Methods:   Twenty subjects (trial teeth nteeth = 111) who had received resin infiltration treatment of noncavitated postorthodontic WSLs were contacted for a 1-year follow-up assessment of CIE-L*a*b* colors (T12). Color and lightness (CIE-L*a*b*) data for WSLs and SAE were compared to baseline data assessed before infiltration (T0) and those assessed after 6 months (T6), using a spectrophotometer. The target parameter was the difference between the summarized color and lightness values (ΔEWSL/SAE). Intergroup (WSL, SAE) and intertime comparisons (T0 vs T6, T12) were performed using paired t-tests at a significance level of α = 5%. Results:  Nine subjects (trial teeth nteeth = 49; male/female ratio 5/4; age range 13–19 years) were available at T12. After the highly significant reduction of ΔEWSL/SAE discrepancies between T0 and T6, analysis of 12-month records revealed color and lightness discrepancy of WSL vs SAE that was significantly decreased compared with baseline, indicating an assimilation of WSL color to SAE appearance after infiltration, while an additional reduction of discrepancies between T6 and T12 was not significant. Conclusion:  As color and lightness characteristics of the Icon infiltrant as well as the esthetic camouflage effects achieved by WSL infiltration were not altered significantly or clinically relevant after 12 months, the method of resin infiltration can be recommended for an enduring esthetic improvement of postorthodontic WSL. (Angle Orthod. 2015;85:374–380.)


Author(s):  
Niraj Kumar ◽  
Shallini Gupta ◽  
Sanjeev Sharma ◽  
Vikram Gupta

Background: Acute poisoning is one of the commonest Pediatric emergencies and an important cause of morbidity and mortality. This study is aimed at understanding the incidence, aetiology and manner of poisoning, outcome among children less than 18 years reporting to Pediatric department at sub district Hospital level in Jammu region.Methods: All the children between one month and eighteen years of age reporting to the Pediatric Emergency of SDH Akhnoor, Jammu over a period of one year as a case of acute poisoning were included in the study. The information obtained from subjects/parents/guardians and examinations of subjects was recorded on a pretested proforma and analyzed.Results: A total of 150 patients were admitted as a case of poisoning over a study period of one year. Male: Female ratio was 1.41:1. Total incidence rate was 2.94/100 0 population over a period of one year. Majority of the cases were accidental (94.67%) while suicidal attempt cases were 5.33%. Most the cases (49.33%) were due to accidental ingestion of household products followed by drug ingestion (21.33%), food poisoning (14%) and then agricultural/industrial products (8%). Maximum patients (86.6%) recovered while 2% referred to higher centre and rest 11.3% either absconded or lost to follow up.Conclusions: Acute poisoning in children is usually accidental with favourable outcome. Death can happen depending upon nature of poison and the stage at which the patient is brought to the hospital. Poisoning can be prevented by increasing public awareness, counselling and right guidance to the parents. 


2016 ◽  
Vol 9 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Syed Hassan Abdullah ◽  
Meerjady Sabrina Flora

Drowning has been identified as a major cause of death in children in both developed and developing countries. Non-fatal drowning is several times higher than the fatal drowning. To describe the socio-demographic and environmental attributes of non-fatal drowning in rural children this community based descriptive study was conducted on 122 children having non-fatal drowning events within one year of study period. This study was undertaken in Raigonj sub-district of Sirajgonj district in Bangladesh. Mothers of those children were interviewed using a structured questionnaire. Out of all participants 56.6% children were 2-4 years of age and male-female ratio was almost equal. Of the total respondent mothers 55% were illiterate and 41.8% were below the age of 25 years. Seasonal variation was observed in non-fatal drowning. Rainy season (50.8%) appeared as the most risky period followed by summer (29.5%). Higher incidence occurred (53.3%) between 10 am to 2 pm of the day. Although most of the drowning occurred outside the home, 9% drowning occurred in water container (like drum, tub) within the home. Pond (50.5%) was found as the most common place among open water source. During the occurrence, 23% child was not accompanied by parents or any caregivers. At the time of drowning, 47.5% mothers were engaged with usual household work and were not present at the place of occurrence whereas 13% mothers were present around the place of occurance. Before drowning, 45.1% victim was either playing, bathing or swimming in the water. Only 10.7% needed resuscitation, 25% were taken to health centre and reached the health centre within an hour, about a fifth (22.6%) of them were admitted. Restriction in dangerous water activities, strengthening supervision of children might decrease the incidence of drowning while quick and effective medical response might prevent its fatal consequences.Ibrahim Med. Coll. J. 2015; 9(2): 37-41


Author(s):  
Mohammad Adil ◽  
Syed Suhail Amin ◽  
Mohd Mohtashim ◽  
Sabha Mushtaq ◽  
Mehtab Alam ◽  
...  

<p class="abstract"><strong>Background:</strong> Leprosy was eliminated as a public health problem in India in 2005. Yet, more than 60% of all new cases of leprosy are reported from India.</p><p class="abstract"><strong>Methods:</strong> A retrospective analysis of the records of patients attending the leprosy clinic of the Dermatology Out Patient Department was done for a period of one year from May 2017 to April 2018. The data was analysed for clinical and epidemiological characteristics of the patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 225 patients visited the leprosy clinic during the study period. Almost half of all patients (47.1%) were aged between 21-40 years. Among the patients were 32 children (14.2%) below 16 years. There were 60 patients (26.6%) suffering from paucibacillary disease and 158 patients (70.2%) had multibacillary disease. Seven patients (3.2%) presented with other forms of leprosy like historic leprosy and pure neuritic leprosy. Borderline lepromatous leprosy was found to be the commonest subtype seen in 86 patients (38.2%). There were 152 males (67.6%) and 73 females (32.4%). The male female ratio was 2.08:1. A total of 118 patients (52.4%) were from rural background and 107 (47.6%) hailed from urban areas. Multibacillary disease was seen in 83.6% of the total females compared to 63.8% of males.</p><p class="abstract"><strong>Conclusions:</strong> Leprosy may be down but is not yet out. The high proportion of children diagnosed with leprosy is a warning regarding the active transmission of the disease in the community. Continued efforts are required to prevent the disease from making a resurgence.</p>


Author(s):  
Roshny Jacob ◽  
Deepthi M. L. Raj

Background: Pancytopenia is a clinical condition which poses diagnostic challenge to the haematologist. The aetiology of pancytopenia is varied and depends on many factors. A bone marrow study is highly indicated in cases of pancytopenia and it provides information regarding the underlying disease process. This study was done to learn the causes of pancytopenia and to document how each case was evaluated and followed up.Methods: The present study is a descriptive retrospective one year study on bone marrow samples received in the laboratory. Bone marrow samples included aspirate smears, imprint and trephine and their findings were correlated to arrive at a final diagnosis.Results: Out of the total 28 patients with pancytopenia, 35.71% were from the age group between 61 and 80 years. A male female ratio of 1.5:1 was observed. Most common presenting complaint documented was easy fatiguability. Anisocytosis with macrocytes and ovalocytes were the most common peripheral smear finding. In current study, a cellular marrow was described in 24 (85.71%) cases and hypocellularity in two (7.14%) cases. Final diagnosis was evident in 16 cases, in which the most common cause was acute leukaemia (14.28% each) followed by lymphoma infiltration and myelodysplastic syndromes in 3 cases (10.71%).Conclusions: Bone marrow study helps to arrive at a diagnosis of pancytopenia. But proper technique for sampling, good clinical workup and history taking and clinico haematological correlation is mandatory for the proper diagnosis of a pancytopenia case.


2019 ◽  
pp. 1-3
Author(s):  
Pietro Gareri

We describe a case report regarding an elderly woman affected with Alzheimer’s disease (AD), presenting to the ER for chest pain, and showing ST-segment elevation on electrocardiography, and elevated cardiac enzyme levels. She was hospitalized and after a number of laboratory and instrumental exams she was diagnosed Tako-tsubo syndrome. One year after the event she is feeling fine, electrocardiogram is normal, and no symptoms of cardiac heart failure are present. Tako-tsubo syndrome is a stress-induced cardiomyopathy that involves left ventricular apical akinesis and mimics acute coronary syndrome. It was first described in Japan in 1991, it is rare (1:36.000) with 1:3 male/female ratio and survival is usually 96%. The novelty of this case-report is due to its rarity and to the onset of the disease in an elderly patient affected with AD.


2018 ◽  
Vol 5 (1) ◽  
pp. 68
Author(s):  
Rakesh B. Bilagi ◽  
Hafiz Deshmukh

Background: Tuberculosis is one of the most important cause of most of the respiratory diseases. It is estimated that about one-third of the world's population is infected with mycobacterium tuberculosis. It is important to know about the clinical profile of these patients. There are many studies which are done among OPD patients but fewer among indoor patients hence, the current study was planned.Methods: Retrospective study of the patients admitted in the inpatient department of the study area were taken as the sample size from May 2016 to April 2017, who were diagnosed as TB patients.Results: a retrospective study was conducted among admitted patients, which included data of one year. There was male predominance with male: female ratio of 2.89. major cause of admission was extrapulmonary causes. The HIV patients were more predisposed to extrapulmonary and diabetes than pulmonary tuberculosis.Conclusions: There is male predominance for admission cases. There is also increased cases of extrapulmonary TB admitted than pulmonary cases.


Author(s):  
Rohit Sane ◽  
Rahul Mandole ◽  
Gurudatta Anand Amin ◽  
Pravin Ghadigaokar ◽  
Sneha Paranjape ◽  
...  

Background: The occurrence of Diabetes Mellitus (DM) has been creating a havoc since past few decades on a global platform. As per available literature, prevalence of DM in Mumbai is around 10%. Comprehensive Diabetes Care (CDC) is a form of Ayurvedic therapy which combines panchkarma and diet management. The present study was planned to evaluate the effectiveness of CDC in patients of DM by analysing changes in body mass index (BMI), body weight, OGTT, HbA1c, etc.Methods: The present study was of retrospective design, conducted at Madhavbaug clinics in western Mumbai. The duration of study was of one year, conducted from October 2018 to September 2019. It included patients diagnosed with type 2 DM i.e. HbA1c>6.5%, who were given CDC therapy.Results: In the present study, out of 183 type 2 diabetic patients, 99 were males (52%), while 84 were females (48%), thus male: female ratio was 1.17:1. On analysing the results of HbA1c in patients who had completed 12 weeks of CDC therapy, it was found that controlled DM status was seen in 109 patients (59%), while uncontrolled DM status was noted in 33 patients (19%) as compared to 102 patients (58%) at baseline.Conclusions: From the findings of the present study, it is clear that CDC is effective in the form of increasing number of euglycemic patients at the end of study period, as well as reduction in all glycaemic and anthropometric parameters, and reducing dependency on conventional medicines.


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