Katharine Tippins, Oyewale O. Shiyanbola, W. N. Rose
Abstract Evidence regarding the efficacy of plasmapheresis for pruritus due to hepatobiliary disease is sparse. The mechanism of pruritus in this context is poorly understood. Some candidates for the offending agents are bile salts and histamine. Primary sclerosing cholangitis is one such disease and appears to have an autoimmune component. The rationale for plasmapheresis for patients who are refractory to medical therapy has some plausibility because the nonspecific nature of plasmapheresis may significantly decrease one or more of the offending substances in the patient's plasma. We share our experience of a patient with pruritus due to primary sclerosing cholangitis who benefited from plasmapheresis.
{"title":"Primary Sclerosing Cholangitis Pruritus Treated with Plasmapheresis","authors":"Katharine Tippins, Oyewale O. Shiyanbola, W. N. Rose","doi":"10.1055/s-0043-1761510","DOIUrl":"https://doi.org/10.1055/s-0043-1761510","url":null,"abstract":"Abstract Evidence regarding the efficacy of plasmapheresis for pruritus due to hepatobiliary disease is sparse. The mechanism of pruritus in this context is poorly understood. Some candidates for the offending agents are bile salts and histamine. Primary sclerosing cholangitis is one such disease and appears to have an autoimmune component. The rationale for plasmapheresis for patients who are refractory to medical therapy has some plausibility because the nonspecific nature of plasmapheresis may significantly decrease one or more of the offending substances in the patient's plasma. We share our experience of a patient with pruritus due to primary sclerosing cholangitis who benefited from plasmapheresis.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77929157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Foreign body in the airway is the most life-threatening situation. Most foreign bodies present as acute emergency and can be removed by endoscopy/bronchoscopy, while a few causes complication of a retained foreign body which requires emergency tracheostomy to secure airway followed by foreign body removal. Case Presentation We report our experience in the management of three children who required tracheostomy through which bronchoscope was introduced and foreign body removed. All patients with unrecognized retained foreign body presented with respiratory distress with desaturation. Imaging was suggestive of atelectasis. After foreign body removal patients recovered well and decannulated by day 5. Subglottis is the narrowest part of pediatric airway. As these foreign bodies were vegetative they are hygroscopic in nature and hence would not be able to remove the foreign body by bronchoscopic guidance. Hence, tracheostomy was done to provide access followed by bronchoscopic removal. Conclusion Aspirated foreign body present challenges to the ear, nose, and throat surgeon. Newer techniques enable removal of foreign body easier. Tracheostomy combined with bronchoscopy can be a life-saving and easy to perform procedure which involves removal of foreign body at the same time.
{"title":"Difficult Bronchoscopy and Foreign Body Removal: Our Experience","authors":"P. S., N. Rb, G. K., Karthika Sr, R. S","doi":"10.1055/s-0043-1764365","DOIUrl":"https://doi.org/10.1055/s-0043-1764365","url":null,"abstract":"Abstract Background Foreign body in the airway is the most life-threatening situation. Most foreign bodies present as acute emergency and can be removed by endoscopy/bronchoscopy, while a few causes complication of a retained foreign body which requires emergency tracheostomy to secure airway followed by foreign body removal. Case Presentation We report our experience in the management of three children who required tracheostomy through which bronchoscope was introduced and foreign body removed. All patients with unrecognized retained foreign body presented with respiratory distress with desaturation. Imaging was suggestive of atelectasis. After foreign body removal patients recovered well and decannulated by day 5. Subglottis is the narrowest part of pediatric airway. As these foreign bodies were vegetative they are hygroscopic in nature and hence would not be able to remove the foreign body by bronchoscopic guidance. Hence, tracheostomy was done to provide access followed by bronchoscopic removal. Conclusion Aspirated foreign body present challenges to the ear, nose, and throat surgeon. Newer techniques enable removal of foreign body easier. Tracheostomy combined with bronchoscopy can be a life-saving and easy to perform procedure which involves removal of foreign body at the same time.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73819829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract A young male who was a diabetic presented with gradually progressive hearing loss, recurrent episodic behavioral abnormality, easy fatigability, proximal weakness, and seizures. The patient was evaluated in detail to find out the etiology of encephalitis. The serum autoimmune encephalitis panel was negative. On magnetic resonance imaging of the Brain, there was temporoparietal T2 and fluid-attenuated inversion recovery hyperintensity. In the magnetic resonance spectroscopy study, a lactate peak was found. So, the patient was evaluated for mitochondrial illness mitochondrial encephalopathy lactic acidosis with stroke-like symptoms) and it was confirmed by a genetic study. This case illustrates that though it is a rare disease, always a strong clinical index of suspicion is required for the diagnosis of mitochondrial disorders in case of multisystem involvement so that diagnosis would not be missed.
{"title":"Mitochondrial Disease Masquerading as Recurrent Encephalopathy","authors":"Rajalaxmi Satapathy, Pragateshnu Das","doi":"10.1055/s-0043-1761616","DOIUrl":"https://doi.org/10.1055/s-0043-1761616","url":null,"abstract":"Abstract A young male who was a diabetic presented with gradually progressive hearing loss, recurrent episodic behavioral abnormality, easy fatigability, proximal weakness, and seizures. The patient was evaluated in detail to find out the etiology of encephalitis. The serum autoimmune encephalitis panel was negative. On magnetic resonance imaging of the Brain, there was temporoparietal T2 and fluid-attenuated inversion recovery hyperintensity. In the magnetic resonance spectroscopy study, a lactate peak was found. So, the patient was evaluated for mitochondrial illness mitochondrial encephalopathy lactic acidosis with stroke-like symptoms) and it was confirmed by a genetic study. This case illustrates that though it is a rare disease, always a strong clinical index of suspicion is required for the diagnosis of mitochondrial disorders in case of multisystem involvement so that diagnosis would not be missed.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86876482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Small bowel obstruction accounts for about 3% of the emergency laparotomies, hence there is a need for early recognition of the risk associated with strangulated small bowel obstruction. However, there is no single reliable tool for evaluating the bowel strangulation risk precisely and quickly, hence we sought to assess the specificity and sensitivity of a scoring system named “Clinicoradiological score” as a tool to assess the risk of strangulated small bowel obstruction in tertiary care center for early intervention. Methods The study was an observational study conducted on 50 patients with clinical symptoms of small intestinal obstruction, diagnosed by CT and admitted in-patient basis at the general surgery department in the hospitals attached to Bangalore Medical College and Research Institute, Bengaluru from November 2017 to May 2019. In this scoring system, one point was given to each factor which includes pain duration (4 or more days), guarding, leucocyte count at least 10 ×10 9 /L, C-reactive protein 75 mg/L or more, free fluid at least 500 mL (CT criteria), reduced wall contrast enhancement (CT criteria) leading to a maximum score of 6. Statistics Based on standard treatment outcome, patients were grouped into three categories (conservative management, laparotomy without resection and anastomosis, and laparotomy with resection and anastomosis). Data was analyzed by descriptive statistics. The risk factors were compared between three patient groups and Chi-square test used for hypothesis testing. Sensitivity and specificity were evaluated for accuracy of score. Results Out of the six factors of Clinicoradiological score, five factors were found to be predictors ( p -value <0.01), while history of pain more than 3 days did not have a significant p -value. In our study all 18 patients with score more than 3 had gangrenous changes and underwent resection. The p -value of the score was found to be significant. Conclusion Clinicoradiological score has been proved to be a valuable tool in predicting the risk of strangulated small bowel obstruction and ascertained the need for subsequent intestinal resection.
背景小肠梗阻约占急诊剖腹手术的3%，因此需要早期认识绞窄性小肠梗阻的相关风险。然而，目前还没有一种可靠的工具可以准确、快速地评估肠绞窄风险，因此，我们试图评估一种名为“临床放射学评分”的评分系统的特异性和敏感性，作为评估三级保健中心绞窄性小肠梗阻风险的工具，以进行早期干预。方法对2017年11月至2019年5月在班加罗尔医学院附属医院普通外科住院的50例经CT诊断有小肠梗阻临床症状的患者进行观察性研究。在这个评分系统中，每个因素都给1分，包括疼痛持续时间(4天或更长)、保护、白细胞计数至少10 ×10 9 /L、c反应蛋白75 mg/L或更多、游离液至少500 mL (CT标准)、壁增强减弱(CT标准)，最高得分为6分。根据标准治疗结果，将患者分为保守治疗、开腹不切除吻合、开腹切除吻合3组。数据采用描述性统计进行分析。比较三组患者的危险因素，采用卡方检验进行假设检验。对评分的准确性进行敏感性和特异性评估。结果在临床放射学评分的6个因素中，有5个因素是预测因子(p值<0.01)，而疼痛史大于3 d无显著p值。在我们的研究中，所有18例评分超过3分的患者都发生了坏疽性改变并进行了切除。发现得分的p值具有显著性。结论临床放射学评分是预测绞窄性小肠梗阻风险和确定后续肠切除术必要性的重要工具。
{"title":"“Clinicoradiological Score – Valuable Tool to Assess the Risk of Strangulated Small Bowel Obstruction in Tertiary Care Center”","authors":"Gunasekaran Monisha, M. S, H. Ranganath","doi":"10.1055/s-0043-1761416","DOIUrl":"https://doi.org/10.1055/s-0043-1761416","url":null,"abstract":"Abstract Background Small bowel obstruction accounts for about 3% of the emergency laparotomies, hence there is a need for early recognition of the risk associated with strangulated small bowel obstruction. However, there is no single reliable tool for evaluating the bowel strangulation risk precisely and quickly, hence we sought to assess the specificity and sensitivity of a scoring system named “Clinicoradiological score” as a tool to assess the risk of strangulated small bowel obstruction in tertiary care center for early intervention. Methods The study was an observational study conducted on 50 patients with clinical symptoms of small intestinal obstruction, diagnosed by CT and admitted in-patient basis at the general surgery department in the hospitals attached to Bangalore Medical College and Research Institute, Bengaluru from November 2017 to May 2019. In this scoring system, one point was given to each factor which includes pain duration (4 or more days), guarding, leucocyte count at least 10 ×10 9 /L, C-reactive protein 75 mg/L or more, free fluid at least 500 mL (CT criteria), reduced wall contrast enhancement (CT criteria) leading to a maximum score of 6. Statistics Based on standard treatment outcome, patients were grouped into three categories (conservative management, laparotomy without resection and anastomosis, and laparotomy with resection and anastomosis). Data was analyzed by descriptive statistics. The risk factors were compared between three patient groups and Chi-square test used for hypothesis testing. Sensitivity and specificity were evaluated for accuracy of score. Results Out of the six factors of Clinicoradiological score, five factors were found to be predictors ( p -value <0.01), while history of pain more than 3 days did not have a significant p -value. In our study all 18 patients with score more than 3 had gangrenous changes and underwent resection. The p -value of the score was found to be significant. Conclusion Clinicoradiological score has been proved to be a valuable tool in predicting the risk of strangulated small bowel obstruction and ascertained the need for subsequent intestinal resection.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86989678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Ureteral double-J stents have become a part and parcel in contemporary urologic practice. As the use of stents is increasing, the complications are also increasing. Knot formation in the double-J stent is rare phenomenon. Twenty-seven cases have been reported till now. This case would be the 28th case to be reported, in a young male with solitary left kidney and who was on regular periodic stent substitution.
{"title":"Knotted Stent—Emphasizing the Need of Radiology Assistance in Urology","authors":"S. P. Dhangar","doi":"10.1055/s-0043-1764364","DOIUrl":"https://doi.org/10.1055/s-0043-1764364","url":null,"abstract":"Abstract Ureteral double-J stents have become a part and parcel in contemporary urologic practice. As the use of stents is increasing, the complications are also increasing. Knot formation in the double-J stent is rare phenomenon. Twenty-seven cases have been reported till now. This case would be the 28th case to be reported, in a young male with solitary left kidney and who was on regular periodic stent substitution.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73797671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Intertrochanteric fractures are fractures of elderly population and are known for morbidity and mortality. Early stabilization with minimal surgical trauma is important for early mobilization to prevent recumbence-related complications. Methods This prospective study was conducted on 50 stable intertrochanteric fractures that were managed by fixation with a small two-hole dynamic hip screw –(DHS) side plate using a minimally invasive technique. The surgical time, intraoperative blood loss, length of the skin incision, duration of hospital stay, time to full weight bearing and fracture union, and complications were recorded. Results The mean age of the patients was 60.2 years with 64% belonging to male sex. The mean operative time, average blood loss, and mean incision length were 35.6 minutes, 68.4 mL, and 3.7 cm, respectively. Time to bone healing ranged from 10 to 16 weeks (mean 13 weeks). Two patients had hip screw backout but that did not interfere with failure of fixation. Conclusion Stabilization of stable intertrochanteric fractures with two-hole DHS using minimally invasive approach is a viable option with negligible complication rate related to failure of small DHS side plate.
{"title":"Clinical and Radiological Results of Minimally Invasive Two-Hole Dynamic Hip Screw Fixation of Stable Intertrochanteric Fractures: A Prospective Study of 50 Patients","authors":"F. A. Dar, Zaffar Iqbal, A. H. Lone, N. Ali","doi":"10.1055/s-0043-1761618","DOIUrl":"https://doi.org/10.1055/s-0043-1761618","url":null,"abstract":"Abstract Background Intertrochanteric fractures are fractures of elderly population and are known for morbidity and mortality. Early stabilization with minimal surgical trauma is important for early mobilization to prevent recumbence-related complications. Methods This prospective study was conducted on 50 stable intertrochanteric fractures that were managed by fixation with a small two-hole dynamic hip screw –(DHS) side plate using a minimally invasive technique. The surgical time, intraoperative blood loss, length of the skin incision, duration of hospital stay, time to full weight bearing and fracture union, and complications were recorded. Results The mean age of the patients was 60.2 years with 64% belonging to male sex. The mean operative time, average blood loss, and mean incision length were 35.6 minutes, 68.4 mL, and 3.7 cm, respectively. Time to bone healing ranged from 10 to 16 weeks (mean 13 weeks). Two patients had hip screw backout but that did not interfere with failure of fixation. Conclusion Stabilization of stable intertrochanteric fractures with two-hole DHS using minimally invasive approach is a viable option with negligible complication rate related to failure of small DHS side plate.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83775477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Shrivastava, Rishita Kalra, Somyagupta Somyagupta, V. Pathak, P. Nayak, Stuti Shukla
Abstract Introduction A cholesteatoma is a three-dimensional sac lined by keratinized squamous epithelium containing desquamated keratinized epithelial cell which secretes enzymes that have the tendency to expand and erode the bony structure underlying it and cause intracranial and extracranial complications. This cystic mass is in an abnormal location such as the middle ear, the petrous apex, or the external auditory canal (EAC). It is mostly found in the middle ear and rarely in the EAC. Here we have reported a rare case of unilateral primary EAC cholesteatoma with mild hearing loss in a middle-aged male. Case Report We have reported a case of a 34-year-old male with complaints of right-sided ear discharge and right-sided decreased hearing for the last 5 to 6 years. On examination, right ear EAC was found to be dry, and a sac was observed in posterior wall extending to mastoid present with clear attic, and intact retracted tympanic membrane that was then followed by radiological evaluation to establish the diagnosis of EAC cholesteatoma. This was surgically treated and ear was cleared of all disease. Patient's symptoms improved postoperatively. Conclusion Primary EAC cholesteatoma with disease-free middle ear is a rare finding and there is very less definitive literature available on the pathogenesis of the same.
{"title":"A Case of Primary EAC Cholesteatoma Extending into Antrum with Normal Middle Ear","authors":"S. Shrivastava, Rishita Kalra, Somyagupta Somyagupta, V. Pathak, P. Nayak, Stuti Shukla","doi":"10.1055/s-0043-1761458","DOIUrl":"https://doi.org/10.1055/s-0043-1761458","url":null,"abstract":"Abstract Introduction A cholesteatoma is a three-dimensional sac lined by keratinized squamous epithelium containing desquamated keratinized epithelial cell which secretes enzymes that have the tendency to expand and erode the bony structure underlying it and cause intracranial and extracranial complications. This cystic mass is in an abnormal location such as the middle ear, the petrous apex, or the external auditory canal (EAC). It is mostly found in the middle ear and rarely in the EAC. Here we have reported a rare case of unilateral primary EAC cholesteatoma with mild hearing loss in a middle-aged male. Case Report We have reported a case of a 34-year-old male with complaints of right-sided ear discharge and right-sided decreased hearing for the last 5 to 6 years. On examination, right ear EAC was found to be dry, and a sac was observed in posterior wall extending to mastoid present with clear attic, and intact retracted tympanic membrane that was then followed by radiological evaluation to establish the diagnosis of EAC cholesteatoma. This was surgically treated and ear was cleared of all disease. Patient's symptoms improved postoperatively. Conclusion Primary EAC cholesteatoma with disease-free middle ear is a rare finding and there is very less definitive literature available on the pathogenesis of the same.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82976986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suryakanth Kalluraya, AA Hosangadi, Prabhu P. Munavalli, Akash Kumar
Abstract Fragility fractures, a form of stress fracture brought on by physiological stress on weak bones, are not common. It might be challenging to diagnose a fragility fracture since a standard radiograph shows signs of fracture repair rather than the actual fracture. We present a case of a 32-year-old woman who has been complaining of both leg pain for the last 4 months and has been unable to stand for the last 1 week. Further analysis revealed that her vitamin D levels were insufficient.
{"title":"Atraumatic Isolated Bilateral Fibular Shaft Fragility Fracture: A Rare Case","authors":"Suryakanth Kalluraya, AA Hosangadi, Prabhu P. Munavalli, Akash Kumar","doi":"10.1055/s-0043-1764363","DOIUrl":"https://doi.org/10.1055/s-0043-1764363","url":null,"abstract":"Abstract Fragility fractures, a form of stress fracture brought on by physiological stress on weak bones, are not common. It might be challenging to diagnose a fragility fracture since a standard radiograph shows signs of fracture repair rather than the actual fracture. We present a case of a 32-year-old woman who has been complaining of both leg pain for the last 4 months and has been unable to stand for the last 1 week. Further analysis revealed that her vitamin D levels were insufficient.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76773623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Junaid Khurshid, S. A. Bashir, A. Rasool, Onkar Kulkarni
Abstract Background: Blast injuries to hand can have disastrous consequences on account of loss of critical hand functions. This study was conducted to study the epidemiology and outcome of hand blast injuries reporting to emergency department of a tertiary care hospital. Materials and Methods: All the blast injuries to hand admitted at our center between 2016 and 2020 were assessed at the time of injury and at 6 weeks after completion of primary management. The severity of injury and functional outcome was assessed using modified hand injury severity score (HISS) and quick disabilities of the arm, shoulder and hand (QuickDASH) scale, respectively. Descriptive statistics was calculated and correlation between HISS and DASH was assessed using Pearson's correlation coefficient. Results: A total of 26 cases with a mean age of 23.12 ± 9.1 years were included. The subjects included 25 males and 22 subjects had injury to their dominant hand. The grade of injury was severe in 12 (46.15%) cases followed by moderate in 5 (19.2%) cases and major in 5 (19.2%) cases. The mean HISS score at injury was 67.46 ± 37.6. The mean QuickDASH score at follow-up was 37.24 ± 29.7. QuickDASH score at follow-up had a significant correlation with HISS score at baseline with a Pearson's correlation coefficient of ( r = 0.67, p = 0.0012) Conclusions: Blast injuries to hands are primarily seen in young males with low-grade explosives being the primary source of injury. Dominant hand is most commonly involved with many cases needing revascularization procedures. Higher severity of blast injuries to hand is associated with poor outcome at follow-up.
背景:由于手部关键功能的丧失，手部爆炸伤害会造成灾难性的后果。本研究旨在探讨某三级医院急诊科手部爆炸伤的流行病学及转归。材料与方法:2016年至2020年期间在我中心收治的所有手部爆炸伤患者在受伤时及初步处理完成后6周进行评估。分别采用改进的手部损伤严重程度评分(HISS)和手臂、肩部和手部快速残疾(QuickDASH)量表评估损伤严重程度和功能结局。进行描述性统计，并采用Pearson相关系数评价HISS与DASH的相关性。结果:共纳入26例，平均年龄23.12±9.1岁。研究对象包括25名男性，其中22名有惯用手损伤。损伤程度为重度12例(46.15%)，其次为中度5例(19.2%)，重度5例(19.2%)。损伤时HISS平均评分67.46±37.6。随访时QuickDASH平均得分为37.24±29.7。随访时的QuickDASH评分与基线时的HISS评分具有显著的相关性，Pearson相关系数为(r = 0.67, p = 0.0012)。结论:手爆炸伤主要见于年轻男性，低品位爆炸物是主要的伤害来源。在许多需要进行血运重建手术的病例中，优势手是最常见的。手部爆炸伤的严重程度越高，随访结果越差。
{"title":"Epidemiology and Treatment Outcome of Blast Injuries to the Hand at a Tertiary Hospital of Kashmir Valley, India","authors":"Junaid Khurshid, S. A. Bashir, A. Rasool, Onkar Kulkarni","doi":"10.1055/s-0043-1762569","DOIUrl":"https://doi.org/10.1055/s-0043-1762569","url":null,"abstract":"Abstract Background: Blast injuries to hand can have disastrous consequences on account of loss of critical hand functions. This study was conducted to study the epidemiology and outcome of hand blast injuries reporting to emergency department of a tertiary care hospital. Materials and Methods: All the blast injuries to hand admitted at our center between 2016 and 2020 were assessed at the time of injury and at 6 weeks after completion of primary management. The severity of injury and functional outcome was assessed using modified hand injury severity score (HISS) and quick disabilities of the arm, shoulder and hand (QuickDASH) scale, respectively. Descriptive statistics was calculated and correlation between HISS and DASH was assessed using Pearson's correlation coefficient. Results: A total of 26 cases with a mean age of 23.12 ± 9.1 years were included. The subjects included 25 males and 22 subjects had injury to their dominant hand. The grade of injury was severe in 12 (46.15%) cases followed by moderate in 5 (19.2%) cases and major in 5 (19.2%) cases. The mean HISS score at injury was 67.46 ± 37.6. The mean QuickDASH score at follow-up was 37.24 ± 29.7. QuickDASH score at follow-up had a significant correlation with HISS score at baseline with a Pearson's correlation coefficient of ( r = 0.67, p = 0.0012) Conclusions: Blast injuries to hands are primarily seen in young males with low-grade explosives being the primary source of injury. Dominant hand is most commonly involved with many cases needing revascularization procedures. Higher severity of blast injuries to hand is associated with poor outcome at follow-up.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90853823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naveen Aalasyam, Shilpa Potnuru, Chandra Mouli Sileveru, Uma Pokala, N. P.
Abstract Introduction Otorhinolaryngological infections are very common in adults and in children also. These infections are caused by various microorganisms and to treat these infections, antimicrobial agents are used frequently. As irrational use of antimicrobials leads to the development of antibiotic resistance and it is a big threat to the society, the present study was planned to get awareness among the practitioners regarding the antimicrobial prescription pattern. Aim To study the prescription pattern of antimicrobial agents in outpatient department of otorhinolaryngology in a tertiary care teaching hospital. Materials and Methods An observational study was planned over a period of 8 months from July 2019 to February 2020 in ENT outpatient department (OPD) at Mamata General Hospital, Khammam in Telangana. In total, 562 prescriptions were collected. Patient's details, probable diagnosis, prescribed medication details such as generic name, dose, and dosage forms were taken. The collected data was analyzed and the conclusions were drawn using descriptive analysis. Results Total number of prescriptions were 562. The majority of the prescriptions belonged to the 21 to 40 years of age group. Males were included more than females (males 320 and females 242). Chronic suppurative otitis media (CSOM) (16.2%) was the commonest infection. Most commonly prescribed antimicrobial was amoxicillin and clavulanic acid combination (26.17%), followed by cefpodoxime with clavulanic acid (21.9%) and ciprofloxacin (19.06%). In 371 (66.01%) prescriptions, only one antimicrobial was prescribed, whereas in 36 (6.40%) prescriptions no antibiotic was given. The average number of drugs per prescription was 3.18 and the average number of antimicrobials per prescription was 1.25. Tablet form (52.9%) was the commonest dosage form and most of the drugs were prescribed by generic name (74.06%). Conclusion The present study though prescription pattern of antibiotics and adherence to the hospital formulary by the physicians in the hospital is encouraging, still there is a chance in reducing the number of drugs prescribed per patient. The findings of this study will be useful to prescribe antimicrobials rationally so that the patient and health care system on the whole will be benefited.
{"title":"Antimicrobial Prescription Pattern in ENT Outpatient Department in a Tertiary Care Teaching Hospital, Telangana, India","authors":"Naveen Aalasyam, Shilpa Potnuru, Chandra Mouli Sileveru, Uma Pokala, N. P.","doi":"10.1055/s-0043-1761502","DOIUrl":"https://doi.org/10.1055/s-0043-1761502","url":null,"abstract":"Abstract Introduction Otorhinolaryngological infections are very common in adults and in children also. These infections are caused by various microorganisms and to treat these infections, antimicrobial agents are used frequently. As irrational use of antimicrobials leads to the development of antibiotic resistance and it is a big threat to the society, the present study was planned to get awareness among the practitioners regarding the antimicrobial prescription pattern. Aim To study the prescription pattern of antimicrobial agents in outpatient department of otorhinolaryngology in a tertiary care teaching hospital. Materials and Methods An observational study was planned over a period of 8 months from July 2019 to February 2020 in ENT outpatient department (OPD) at Mamata General Hospital, Khammam in Telangana. In total, 562 prescriptions were collected. Patient's details, probable diagnosis, prescribed medication details such as generic name, dose, and dosage forms were taken. The collected data was analyzed and the conclusions were drawn using descriptive analysis. Results Total number of prescriptions were 562. The majority of the prescriptions belonged to the 21 to 40 years of age group. Males were included more than females (males 320 and females 242). Chronic suppurative otitis media (CSOM) (16.2%) was the commonest infection. Most commonly prescribed antimicrobial was amoxicillin and clavulanic acid combination (26.17%), followed by cefpodoxime with clavulanic acid (21.9%) and ciprofloxacin (19.06%). In 371 (66.01%) prescriptions, only one antimicrobial was prescribed, whereas in 36 (6.40%) prescriptions no antibiotic was given. The average number of drugs per prescription was 3.18 and the average number of antimicrobials per prescription was 1.25. Tablet form (52.9%) was the commonest dosage form and most of the drugs were prescribed by generic name (74.06%). Conclusion The present study though prescription pattern of antibiotics and adherence to the hospital formulary by the physicians in the hospital is encouraging, still there is a chance in reducing the number of drugs prescribed per patient. The findings of this study will be useful to prescribe antimicrobials rationally so that the patient and health care system on the whole will be benefited.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85245556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：