scholarly journals Leptospirosis Case Report with Renal Insufficiency

2021 ◽  
pp. 169-172
Author(s):  
Savita Pohekar ◽  
Seema Singh
Keyword(s):  
Chloride Solution ◽  
Mortality Rates ◽  
Intravenous Fluids ◽  
Nursing Management ◽  
High Grade Fever ◽  
Stiff Neck ◽  
History Of ◽  
Inpatient Management ◽  
Asymptomatic Diseases

Introduction: Leptospirosis is an international zoonotic condition relay and rising prevalencethe causes of the infection Leptospira spirochete with popular exhibition of polluted clean water.Most asymptomatic diseases, but the symptoms are moderate, autonomous, specific febrile and respiratory non-specific disorder high mortality rates of renal failure. Case: A 33-years-old woman from rural area came to the hospital in casualty with a history of high grade fever (40 degree Celsius), with chilling, headache, stiff neck. Urinary retention along with productive cough for three days. Intervention: The patient underwent inpatient management, which included tablet Ceftriaxone 1gm twice a day, Tablet Doxycycline 100 mg bd given and intravenous fluids 5% dextrose and dextrose/sodium chloride solution, Injection Furosemide20 mg intravenously twice a day were given to the patients. Nursing management: monitoring the vital sign, maintain the O2 levels as well as the consumption and output. All basic nursing care has been provided. Her symptoms cured after two weeks of treatment, she was discharged. Results: Fever has been minimized. The therapy is reacted to and restored. Conclusion: Management was mainly aimed at protecting patient wellbeing, preventing complications and improving the quality of life. The patient received all medical therapy and the results show that the therapy and care was effective.

scholarly journals Dengue and scrub typhus co-infection causing septic shock

2021 ◽  
Vol 2021 (11) ◽  
Author(s):  
Prakriti Subedi ◽  
Manoj Ghimire ◽  
Karun Shrestha ◽  
Kalpana Ghimire ◽  
Sudeep Adhikari ◽  
...  
Keyword(s):  
Septic Shock ◽  
Clinical Improvement ◽  
Scrub Typhus ◽  
Intravenous Fluids ◽  
High Grade Fever ◽  
X Ray ◽  
Chest Auscultation ◽  
History Of ◽  
Chest X Ray ◽  
Laboratory Investigations

ABSTRACT A 33-year-old female presented with a history of high-grade fever, cough, dyspnea, joint pain and myalgia. On examination, the patient was febrile with tachycardia, hypotension and decreased oxygen saturation. Chest auscultation revealed bilateral decreased air entry with crepitation supported by bilateral pulmonary infiltrates on chest X-ray. The laboratory investigations showed leukocytosis, thrombocytopenia, transaminitis and renal impairment. The patient was treated with intravenous fluids, ceftriaxone and levofloxacin; however, there was no clinical improvement till 48 h. She was then diagnosed with scrub typhus and dengue co-infection via serologies. Doxycycline was started following which the patient improved in 24 h. Scrub typhus can present with septic shock but does not respond to the usual antibiotics and the addition of doxycycline will result in rapid clinical improvement. Co-infection with other tropical diseases such as dengue is also common, hence it is important to test based on local endemicity.

scholarly journals Relocation of an infected tracheostoma: anterior mediastinal tracheostomy as Mission:Impossible

2021 ◽  
Author(s):  
Marc Hartert ◽  
Wolf Jürgen Mann ◽  
Ömer Senbaklavaci
Keyword(s):  
Quality Of Life ◽  
Treatment Option ◽  
Male Patient ◽  
Mortality Rates ◽  
High Morbidity ◽  
Oncological Surgery ◽  
Adjuvant Radiochemotherapy ◽  
History Of ◽  
Mediastinal Tracheostomy

Abstract Infected tracheostomas are frequently associated with high morbidity and mortality rates—especially in patients after neck-oncological surgery with subsequent radiochemotherapy. A 59-year-old male patient with a history of hypopharynx carcinoma, successive laryngectomy and adjuvant radiochemotherapy developed an oesophagotracheal fistula with massive inflammation and periodical bleedings, uncontrollable by regular stent alternations. In a multidisciplinary setting, the decision was made to treat the patient with an anterior mediastinal tracheostomy. Extending usual anterior mediastinal tracheostomy indications, we present an ultimate treatment option for infected tracheostomas and highly advocate this interdisciplinary venture, as it significantly improves quality of life.

Probiotics in gastroenterology – from a different angle

2013 ◽  
Vol 154 (8) ◽  
pp. 294-304 ◽  
Author(s):  
György Miklós Buzás
Keyword(s):  
Side Effects ◽  
Beneficial Effect ◽  
Analytical Data ◽  
Well Being ◽  
Gastrointestinal Diseases ◽  
Convincing Evidence ◽  
Probiotic Treatment ◽  
History Of ◽  
Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

EXPLORING HEALTHCARE ARCHITECTURE THROUGH THE MEDIUM OF FILM: Motives and Techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 29
Author(s):  
Stephen Verderber
Keyword(s):  
Real World ◽  
The Real ◽  
Healthcare Settings ◽  
Interdisciplinary Field ◽  
Body Of Knowledge ◽  
Behavior Setting ◽  
Physical Environments ◽  
Scant Attention ◽  
History Of

The interdisciplinary field of person-environment relations has, from its origins, addressed the transactional relationship between human behavior and the built environment. This body of knowledge has been based upon qualitative and quantitative assessment of phenomena in the “real world.” This knowledge base has been instrumental in advancing the quality of real, physical environments globally at various scales of inquiry and with myriad user/client constituencies. By contrast, scant attention has been devoted to using simulation as a means to examine and represent person-environment transactions and how what is learned can be applied. The present discussion posits that press-competency theory, with related aspects drawn from functionalist-evolutionary theory, can together function to help us learn of how the medium of film can yield further insights to person-environment (P-E) transactions in the real world. Sampling, combined with extemporary behavior setting analysis, provide the basis for this analysis of healthcare settings as expressed throughout the history of cinema. This method can be of significant aid in examining P-E transactions across diverse historical periods, building types and places, healthcare and otherwise, otherwise logistically, geographically, or temporally unattainable in real time and space.

РАССКАЗЫ В.ШУКШИНА И ПРОБЛЕМЫ ПЕРЕВОДА ИХ НА КЫРГЫЗСКИЙ ЯЗЫК

2020 ◽  
pp. 77-81
Author(s):  
Джээнбүбү Бегеева
Keyword(s):  
Key Words ◽  
Russian Literature ◽  
Main Task ◽  
Stylistic Variation ◽  
Psychological Feature ◽  
Translation Analysis ◽  
History Of ◽  
The Creation ◽  
Problems Of Translation

Аннотация. В статье анализируется качество переводов рассказов В.Шукшина, осуществленных в середине 70-х годов С. Наматбаевым. Переводоведческий анализ вывил многочисленные стилевые расхождения между оригиналом и переводом. При переводе одного из лучших рассказов Шукшина «Чудик» искажения стиля не передали психологические тонкости рассказа. При переводе рассказа «Дядя Ермолай» философский аспект рассказа выпал, так как переводчик исказил жанровую специфику. Перевод рассказа «Два письма» оказался более качественным по сравнению с предыдущими. Переводчик рассказа «Два письма» сумел приблизиться к оригиналу, расшифровать его основную тональность, воспроизвести атмосферу напряженных поисков истины героем рассказа Николаем Иванычем. Этот перевод оказался более качественно выполненным по сравнению с предыдущим рассказом «Дядя Ермолай». Причину переводческого успеха можно объяснить, прежде всего, доступностью содержания рассказа, да и сам герой не столь сложная и глубокая личность, как повествователь в рассказе о дяде Ермолае. В целом, переводы С.Наматбаева являются своеобраз- ным этапом в переводческом деле. В настоящее время необходимо более полное и глубокое восприятие творчества В.Шукшина и создания новых адекватных переводов. Ключевые слова: качество переводов, стилевые расхождения, психологические тонкости, философский аспект, этапом. Аннотация. Макалада В.Шукшиндин аңгемелеринин кыргыз тилине которуудагы сапаты каралат, котормолор 1970-жылдары котормочу С.Наматбаев аркылуу жаралган. Котормонун сапатына талдоо жүргүзгөндө көпчүлүк каталар табылган, алардын эң олуттуусу стилдердин айырмасы, негизги чыгарма менен котормонун ортосунда. Мисалы, “Чудик” деген аңгеменин психологиялык мүнөздөмөсү жоголуп кеткен. “Ермолай байке” деген аңгемеде жанрдын туура эмес берилишинен жазуучунун негизги ою жоголуп кеткен. “Эки кат” деген аңгеме беркилерге караганда сапаттуу которулган. Котормочу " Эки кат" деген аңгемени оригиналга жакындатып которгон. Башкы каарман Николай Иванычтын изденүүлөрүн, ойлорун, чындыкты табууга аракеттерин Шукшинден кем эмес окуучуларга жеткирген. Котормочунун жетишкендиги аңгеменин түшүнүктүү мазмуну менен түшүндүрсө болот, жана Николай Ивановичтин жөнөкөйлүгү менен. С.Наматбаевдын котормолору каталарына карабастан котормочулук иште алдыга жылуу болгон. Бирок, азыркы заманда сапаттуу котормо жаратууда мезгил келди. Түйүндүү сөздөр: которуудагы сапаты, стилдердин айырмасы, психологиялык мүнөздөмөсү, негизги ою жоголуп. Annotation. The quality of translation of the Shukshins stories is analyzed in the Middle 70- years. By S.Namatbaev. The translation analysis had idenh hed numerous style discrepancies between the original and the translation. The psychological feature of the compasihion were not be hansfered by the translation one the bestand famous story by. V.Shukshin due to distorhion of the style. By the translation of the story “The uncle Ermolai” had full a phisichal aspect of the story, because the translator had distorted the genre specifics. The translation of the stories “Two letters” was wade more qualitative comparated with another stories. Generally, the Namatbaevs translation are a sui generis stage in the translatiobs. We need currently more total and profound perception of the creation by V.Shukshin. The create of the new adeavate translation is the main task. The head of the theory and history of Russian literature department. V. Shukshin’s stories and problems of translation them into Kyrgyz language. This article is analysed the quality of translation of V. Shukshin’s stories, which were written in 70 th with S. Namatbaev. Translation analyse deduced many stylistic variations between translated version and original. There is a misrepresentation, was not transmitted psychological subtleties of the story in translation of one of the best V. Shuk- shin’s story “Wierdo”. Metaphysical dimension is disappeared in translation of the story “Uncle Ermolai”, since translator destort the genre specificity. The translation of the story “Two letters” has been more qualitative in comparison with previous translations. In common, S. Namatbaev’s translation is a genius stage in translation. It needs more full and deep comprehension of S. Shukshin’s work and to establish new suitable translation. Key words: Quality of translation, stylistic variation, psychological subtleties, metaphysical dimension, stage.

Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez
Keyword(s):  
Antimicrobial Stewardship ◽  
Historical Review ◽  
Original Data ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Continuous Quality ◽  
Stewardship Program ◽  
History Of ◽  
Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

Neglected woman with hyperemesis gravidarum leading to Wernicke encephalopathy

2020 ◽  
Vol 13 (12) ◽  
pp. e238545
Author(s):  
Papa Dasari ◽  
Smitha Priyadarshini
Keyword(s):  
Grey Matter ◽  
Hyperemesis Gravidarum ◽  
Intravenous Fluids ◽  
State Of Health ◽  
Wernicke Encephalopathy ◽  
Periaqueductal Grey ◽  
Mri Brain ◽  
Good State ◽  
Periaqueductal Grey Matter ◽  
History Of

A teenage primigravida at 13 weeks of gestation presented with hyperemesis gravidarum of 45 days and a history of giddiness and inability to walk due to involuntary movements of limbs and eyes since 2 days. She was treated with intravenous fluids, thiamine and antiemetics. MRI brain showed hyperintensities in bilateral dorsomedial thalami, periaqueductal grey matter in T2-weighted and FLAIR images. A diagnosis of Wernicke encephalopathy was made and she was managed in intensive care unit and received injection thiamine as per the guidelines and her weakness and ataxia improved over 3 weeks and she was discharged at 17 weeks of pregnancy in good state of health.

Pseudo-Parkinson Disease Secondary to Ritonavir–Buspirone Interaction

2003 ◽  
Vol 37 (2) ◽  
pp. 202-205 ◽  
Author(s):  
Patrick G Clay ◽  
Molly M Adams
Keyword(s):  
Drug Interaction ◽  
Inhibitory Effect ◽  
Hiv Positive ◽  
High Dose ◽  
Resting Tremor ◽  
Case Summary ◽  
History Of ◽  
Drug Drug Interaction ◽  
To Receive

OBJECTIVE: To report a case of Parkinson-like symptoms appearing in a patient after introduction of ritonavir to buspirone therapy. CASE SUMMARY: A 54-year-old HIV-positive white man presented to the clinic with a 2-week history of ataxia, shuffling gait, cogwheel rigidity, resting tremor, and sad affect with masked features. This patient had been receiving high-dose buspirone (40 mg every morning and 30 mg every evening) for 2 years prior to the introduction of ritonavir/indinavir combination therapy (400 mg/400 mg twice daily) 6 weeks prior to initiation of the above symptoms. Buspirone was decreased to 15 mg 3 times daily, ritonavir/indinavir was discontinued, and amprenavir 1200 mg twice daily was added. The patient's symptoms began to subside after 1 week, with complete resolution after about 2 weeks. The patient continued to receive buspirone for an additional 12 months without recurrence of symptoms. DISCUSSION: This is the first reported interaction of buspirone and antiretrovirals. Buspirone, extensively metabolized by CYP3A4, was likely at supratherapeutic levels due to the inhibitory effect of ritonavir and, secondarily, indinavir. The Parkinson-like symptoms developed rapidly and severely, impacted this patient's quality of life, and necessitated significant clinic expenditures to identify this drug–drug interaction. CONCLUSIONS: This case demonstrates a severe drug–drug interaction between buspirone and ritonavir and further demonstrates the need for awareness of the metabolic profile for all agents an HIV-infected patient is receiving.

scholarly journals Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2506
Author(s):  
Mark van Barele ◽  
Bernadette A. M. Heemskerk-Gerritsen ◽  
Yvonne V. Louwers ◽  
Mijntje B. Vastbinder ◽  
John W. M. Martens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Hormone Replacement ◽  
Breast Cancers ◽  
Younger Women ◽  
Alternative Pathways ◽  
Increased Risk ◽  
History Of ◽  
Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

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