scholarly journals Case Report on Intertrochanteric Fracture Femur Left Side

2021 ◽  
pp. 612-615
Author(s):  
Saloni Inwati ◽  
Darshana Kumari
Keyword(s):  
Intertrochanteric Fracture ◽  
Treatment Options ◽  
The Elderly ◽  
Clinical Findings ◽  
Mortality And Morbidity ◽  
Fracture Femur ◽  
Femur Fractures ◽  
Appropriate Treatment ◽  
Risk Of Mortality ◽  
Wbc Count

Fractures of the femur are a common injury among the elderly. Understanding the pathogenesis as well as the appropriate treatment options can help to reduce the risk of mortality and morbidity associated with this condition injury. This activity focuses on the diagnosis and treatment of intertrochanteric femur fractures, emphasizing the importance of the In evaluating and treating people with this condition, an interprofessional team is used [1]. Clinical Findings: Pain in leg, swelling over the leg. Diagnosis Evaluation: Hb-11.3gm%, total WBC count- 1011/ cu.mm, total RBC count- 5.44 million/cu. mm, RDW- 14%,HCT-35.4%, Granulocytes-60%, Monocytes- 0.2%, Lymphocytes-36%, Basophils- 00%, Eosinophils- 0.2%, total platelet count - 3.16 lacs/cu.mm. Therapeutic Intervention: Inj.voveron- two time in a day. Tab. paracetomol- two time in a day. Tab. pantaprazole- two times in a day. Inj. tramdole- two times in a day. Outcome- After treatment, the patient show improvement. His pain is reduced. Conclusion: My patient age is 40 year old male. They are suffering from intertrochanteric fracture femur left side with same complaint. He is admitted in 8 -11-21.

Anaesthesia for major abdominal surgery in the elderly

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin
Keyword(s):  
Abdominal Surgery ◽  
The Elderly ◽  
Major Abdominal Surgery ◽  
Bowel Distension ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
Surgery In The Elderly ◽  
Fluid Losses ◽  
Effective Analgesia ◽  
Emergency Abdominal Surgery

Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should be avoided. Elderly patients should receive postoperative care in an environment that is appropriate to the degree of comorbidity and the type of surgery. Effective analgesia is known to improve outcome. Only experienced anaesthetists should manage major and emergency abdominal surgery.

scholarly journals The Relationship Between BMI and Stability of Intertrochanteric Fracture Following Low-Energy Falls. A Retrospective Cohort Study

2019 ◽  
Vol 10 ◽  
pp. 215145931985755 ◽  
Author(s):  
Devan Irving ◽  
Jacob Hinkley ◽  
Matthew Marquart
Keyword(s):  
Intertrochanteric Fracture ◽  
Statistical Significance ◽  
The Elderly ◽  
Relative Difference ◽  
Fracture Pattern ◽  
Low Energy ◽  
Case Review ◽  
Retrospective Case ◽  
Femur Fractures ◽  
Increased Risk

Introduction: Intertrochanteric proximal femur fractures are common injuries in the elderly. Certain patterns are considered unstable and confer increased risks. Risk factors for these patterns are not well defined. We sought to determine whether increased body mass index (BMI) was associated with increased risk of sustaining an unstable pattern intertrochanteric (IT) fracture following low-energy trauma. Materials and methods: Retrospective case review of all patients presenting to a level-2 trauma center between October 2010 and August 2014 with Intertrochanteric fracture. Fracture pattern (stable or unstable) and BMI were analyzed using odds ratios and age was controlled for. Results: Four hundred fifty-two patients were identified. No difference was found between fracture stability when BMI of 25 was used as a cutoff. However, when a BMI of 30 was used as a cutoff, there was a trend of difference (relative difference 30%) in rates of fracture type favoring unstable patterns in the obese group. This difference approached but did not reach statistical significance ( P = .08). When adjusted for age, the difference remained but still did not reach statistical significance ( P = .11). Discussion: Unstable type IT fractures were found more frequently in the obese cohort (BMI >30) than those who were not obese.

Distal femur fractures of the elderly—Different treatment options in a biomechanical comparison

Injury ◽  
2011 ◽  
Vol 42 (7) ◽  
pp. 655-659 ◽  
Author(s):  
Dirk Wähnert ◽  
Konrad Hoffmeier ◽  
Rosemarie Fröber ◽  
Gunther O. Hofmann ◽  
Thomas Mückley
Keyword(s):  
Distal Femur ◽  
Treatment Options ◽  
The Elderly ◽  
Femur Fractures ◽  
Biomechanical Comparison

scholarly journals Case Report on Sickle Cell Anemia

2021 ◽  
pp. 121-124
Author(s):  
Saloni Moon ◽  
Kavita Gomase
Keyword(s):  
Blood Transfusion ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Clinical Findings ◽  
The Body ◽  
Therapeutic Interventions ◽  
Cold Pain ◽  
Appropriate Treatment ◽  
Wbc Count ◽  
Body Ache

Introduction: Sickle cell anemia is a kind of anemia caused by a virus a homozygous HbS mutation (HbSS). Sickle cell disease (SCD) is a congenital blood illness that has an impact children. It is inherited from a parent’s DNA. SCD patients produce an abnormal kind of hemoglobin. This is the oxygen-transporting protein found in red blood cells. SCD causes a lack of oxygen in organs and tissues of the body. Clinical Findings: Fever, Cough and cold, pain in lower extremities, Bodyache , Fatigue and Anemia (6.3 gm/). Diagnostic Evaluation:   Blood test: Hb -6.3gm%, Total RBC count -2.2millions/cu mm, RDW- 18.2%, HCT-20.2%, Total WBC count 3000/cu mm, Monocytes 02%, Granulocytes 20%, Lymphocytes 77%, AST(SGOT) – 110 UL. Peripheral Smear: RBC mild hypochromic with mild cytosis which show few microcytic and mildly Hypochromic. Platelets – Reduced on smear, APC -60,000 cells. Ultrasonography: Splenomegaly. Therapeutic Interventions:  Blood transfusion, Inj. Cefotaxime 750 mg IV x BD, Syr. Azee 4ml x OD, Tab. Folic Acid 5 mg x OD, Tab. Udiliv 150mg x BD, Cap. Hydra 500 mg x OD. Outcome: After treatment, the child show improvement. His fever and body ache, cough and cold fatigue and pain in hands and leg were relieved and his Hb% increased from 6.4 gm% to 11 gm% after blood transfusion. Conclusion:  My patient was admitted to Pediatric Ward No- 22 in AVBRH with a known case of SCA   kind of anemia a body in which he had complaint fever and body ache, cough and cold fatigue and pain in hands and leg. After getting appropriate treatment his condition was improved.

scholarly journals Are New Biomarkers Useful in the Diagnosis of Meningitis in Adults?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S303-S303
Author(s):  
Firdevs Aksoy ◽  
Gürdal Yilmaz ◽  
Nurten Nur Aydin ◽  
Selcuk Kaya ◽  
Süleyman Caner Karahan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Blood Cell ◽  
The Elderly ◽  
Clinical Findings ◽  
Acute Bacterial Meningitis ◽  
Diagnostic Significance ◽  
Distribution Width ◽  
Mortality And Morbidity ◽  
Diagnostic Characteristics ◽  
New Biomarkers

Abstract Background Meningitis is infection of the central nervous system with high mortality and morbidity in adults. Markers for diagnostic purposes can therefore be useful guides in differential diagnosis. Procalcitonin (PCT), platelet distribution width (PDW) and red blood cell distribution width (RDW) can be easily calculated with automated blood systems, and have been regarded as biomarkers showing inflammation in infection-related diseases. The purpose of this study was to determine the diagnostic significance of these biomarkers in adult meningitis. Methods This study was a retrospective investigation. Diagnosis of meningitis was based on clinical findings and microbiological and biochemical investigations of CSF specimens. Patients’ white blood cell count (WBC), C-reactive protein (CRP), PDW, RDW and PCT levels at time of presentation were compared. P < 0.05 was regarded as statistically significant. Results 137 patients were assessed. Ninety-five patients had acute bacterial meningitis (ABM), 17 had aseptic meningitis (AM) and 25 had chronic meningitis (CM). When patients were evaluated by age, AMB was more common in the elderly and AM in the young (P < 0.05). CRP and PCT levels at presentation were significantly higher in AM than in AM and CM (P < 0.05). WBC levels differed statistically significantly between ABM and CM (P < 0.05). PDW levels were significantly higher in AM then in CM (P < 0.05). RDW was statistically significantly higher in CM than in ABM and AM (P < 0.05). When ROC analysis was performed to differentiate ABM from the other forms (table). Correlation analysis between CSF biochemistry and biomarkers revealed that PCT was positively correlated with CRP, PDW and CSF protein and negatively correlated with CSF glucose. Conclusion Our results suggest that PCT and CRP have diagnostic characteristics in favor of ABM at differential diagnosis in cases in which LP is contraindicated and/or CSF examination cannot be performed immediately or the agent cannot be identified. WBC and RDW can be useful guides in differentiating ABM from CM, and PDW and RDW in differentiating CM from ABM and AM. Disclosures All authors: No reported disclosures.

Clinical, Diagnosis, and Treatment in Retinal Vasculitis

2021 ◽  
pp. 43-50
Keyword(s):  
Clinical Diagnosis ◽  
Treatment Approach ◽  
Inflammatory Diseases ◽  
Treatment Options ◽  
Retinal Vasculitis ◽  
Clinical Findings ◽  
Diagnosis And Treatment ◽  
Ocular Involvement ◽  
Appropriate Treatment

Retinal vasculitis can be in the form of isolated ocular involvement or can be associated with infections, neoplastic, degenerative, and systemic inflammatory diseases. The differentiation of infectious and non-infectious causes is very important for the appropriate treatment approach. The aim of this review is to provide an overview of the clinical findings, diagnostic evaluations, and treatment options of non-infectious retinal vasculitis.

scholarly journals Management of proximal femur fractures in the elderly: current concepts and treatment options

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
H. Fischer ◽  
T. Maleitzke ◽  
C. Eder ◽  
S. Ahmad ◽  
U. Stöckle ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Treatment Options ◽  
Fluid Management ◽  
Young Patients ◽  
The Elderly ◽  
Operative Management ◽  
Old Patients ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Frail Patients

AbstractAs one of the leading causes of elderly patients’ hospitalisation, proximal femur fractures (PFFs) will present an increasing socioeconomic problem in the near future. This is a result of the demographic change that is expressed by the increasing proportion of elderly people in society. Peri-operative management must be handled attentively to avoid complications and decrease mortality rates. To deal with the exceptional needs of the elderly, the development of orthogeriatric centres to support orthogeriatric co-management is mandatory. Adequate pain medication, balanced fluid management, delirium prevention and the operative treatment choice based on comorbidities, individual demands and biological rather than chronological age, all deserve particular attention to improve patients’ outcomes. The operative management of intertrochanteric and subtrochanteric fractures favours intramedullary nailing. For femoral neck fractures, the Garden classification is used to differentiate between non-displaced and displaced fractures. Osteosynthesis is suitable for biologically young patients with non-dislocated fractures, whereas total hip arthroplasty and hemiarthroplasty are the main options for biologically old patients and displaced fractures. In bedridden patients, osteosynthesis might be an option to establish transferability from bed to chair and the restroom. Postoperatively, the patients benefit from early mobilisation and early geriatric care. During the COVID-19 pandemic, prolonged time until surgery and thus an increased rate of complications took a toll on frail patients with PFFs. This review aims to offer surgical guidelines for the treatment of PFFs in the elderly with a focus on pitfalls and challenges particularly relevant to frail patients.

Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

1996 ◽  
Vol 35 (04) ◽  
pp. 116-121 ◽  
Author(s):  
G. E Fueger ◽  
M. Vejda ◽  
R. M. Aigner
Keyword(s):  
Bone Scintigraphy ◽  
Antibiotic Treatment ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Serum Parameters ◽  
Wbc Count ◽  
Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

Candida albicans endocarditis involving a normal native aortic valve in an immunocompetent patient

2020 ◽  
Vol 13 (11) ◽  
pp. e236902
Author(s):  
Taha Sheikh ◽  
Jeremy C Tomcho ◽  
Mohammed T Awad ◽  
Syeda Ramsha Zaidi
Keyword(s):  
Candida Albicans ◽  
Mortality Rate ◽  
Aortic Valve ◽  
High Mortality ◽  
Treatment Options ◽  
Immunocompetent Patient ◽  
Fungal Endocarditis ◽  
Appropriate Treatment ◽  
Mechanical Valves ◽  
Serious Infection

Fungal endocarditis, specifically from Candida species, is a rare but serious infection with a high mortality rate. Most cases occur in bioprosthetic or mechanical valves and are uncommon in native, structurally normal valves. When Candida endocarditis is detected and appropriate treatment is initiated earlier, there is an improvement in mortality. While the recommendation is usually to treat with a combination of surgery and antifungal medications, patient comorbidities may limit treatment options.

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