Pub Date : 2024-07-01Epub Date: 2024-02-29DOI: 10.1177/00494755241236230
Dipankar Pal
{"title":"Scope of antibiotic stewardship in enteric fever: An evidence-based summary.","authors":"Dipankar Pal","doi":"10.1177/00494755241236230","DOIUrl":"10.1177/00494755241236230","url":null,"abstract":"","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"298-299"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-03-18DOI: 10.1177/00494755241239087
Mohammed H Anwar, Rishabh Dwivedi, Bhupendra Singh, Vrinda Agarwal, Pawan Agarwal, Dhananjaya Sharma
Postoperative monitoring of skin flaps is subjective and cannot detect early circulatory problems in the flap. Early detection and rapid remedial re-exploration are important for flap salvage. We evaluated flap glucose measurement to monitor the flaps for early detection of circulatory problems. In total, 30 patients underwent cutaneous flap reconstruction. This is an easy, economic, objective, and reliable method for flap monitoring and can detect early venous congestion requiring remedial measures.
{"title":"Flap blood glucose measurement for flap monitoring and early detection of circulatory problems.","authors":"Mohammed H Anwar, Rishabh Dwivedi, Bhupendra Singh, Vrinda Agarwal, Pawan Agarwal, Dhananjaya Sharma","doi":"10.1177/00494755241239087","DOIUrl":"10.1177/00494755241239087","url":null,"abstract":"<p><p>Postoperative monitoring of skin flaps is subjective and cannot detect early circulatory problems in the flap. Early detection and rapid remedial re-exploration are important for flap salvage. We evaluated flap glucose measurement to monitor the flaps for early detection of circulatory problems. In total, 30 patients underwent cutaneous flap reconstruction. This is an easy, economic, objective, and reliable method for flap monitoring and can detect early venous congestion requiring remedial measures.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"248-250"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-29DOI: 10.1177/00494755241234081
Harpreet Singh, Arvind Subramanian, Deba P Dibhar, Vikas Suri, Ashish Bhalla
Vitamin B12 and folate deficiency are reversible causes of megaloblastic anemia. Strict vegetarians are at risk of megaloblastic anemia due to low cobalamin in their diet. Knuckle hyperpigmentation in patients with megaloblastic anemia is due to excess melanin synthesis in skin. Here we present a case of a young vegetarian male with megaloblastic anemia with knuckle hyperpigmentation managed successfully with intravenous followed by oral vitamin b12 and folate supplementation.
{"title":"Knuckle hyperpigmentation in a young male: A clinical sign of B12 deficiency not to be missed.","authors":"Harpreet Singh, Arvind Subramanian, Deba P Dibhar, Vikas Suri, Ashish Bhalla","doi":"10.1177/00494755241234081","DOIUrl":"10.1177/00494755241234081","url":null,"abstract":"<p><p>Vitamin B12 and folate deficiency are reversible causes of megaloblastic anemia<b>.</b> Strict vegetarians are at risk of megaloblastic anemia due to low cobalamin in their diet<b>.</b> Knuckle hyperpigmentation in patients with megaloblastic anemia is due to excess melanin synthesis in skin. Here we present a case of a young vegetarian male with megaloblastic anemia with knuckle hyperpigmentation managed successfully with intravenous followed by oral vitamin b12 and folate supplementation.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"282-283"},"PeriodicalIF":0.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-03-11DOI: 10.1177/00494755241234400
Shubhajeet Roy, Jay Tewari, Jyoti Bajpai, Kartikeya Mani Tripathi
{"title":"e-Cigarettes: Assessing the differences and the harms.","authors":"Shubhajeet Roy, Jay Tewari, Jyoti Bajpai, Kartikeya Mani Tripathi","doi":"10.1177/00494755241234400","DOIUrl":"10.1177/00494755241234400","url":null,"abstract":"","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"227-228"},"PeriodicalIF":0.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Typhoid ileal perforation (TIP) is a common surgical emergency in low-middle income countries (LMICs). Its high surgical morbidity and mortality is due to its often late presentation or diagnosis, the patient's malnutrition, severe peritoneal contamination and unavailability of intensive care in most peripheral hospitals. This prompted the philosophy of minimizing the crisis by avoiding any repair or anastomosis, limiting the surgery in these physiologically compromised patients and performing only a temporary defunctioning ileostomy (DI) which could then be closed 10-12 weeks later.
{"title":"Defunctioning ileostomy for typhoid ileal perforations: Out of the frying pan into the fire?","authors":"Amrendra Verma, Reena Kothari, Arpan Mishra, Pawan Agrawal, Dhananjaya Sharma","doi":"10.1177/00494755241241830","DOIUrl":"10.1177/00494755241241830","url":null,"abstract":"<p><p>Typhoid ileal perforation (TIP) is a common surgical emergency in low-middle income countries (LMICs). Its high surgical morbidity and mortality is due to its often late presentation or diagnosis, the patient's malnutrition, severe peritoneal contamination and unavailability of intensive care in most peripheral hospitals. This prompted the philosophy of minimizing the crisis by avoiding any repair or anastomosis, limiting the surgery in these physiologically compromised patients and performing only a temporary defunctioning ileostomy (DI) which could then be closed 10-12 weeks later.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"245-247"},"PeriodicalIF":0.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-27DOI: 10.1177/00494755241232171
Djenna Chebli, Fatema Dhaif, Ali Ridha, Alexander Schade, Chetan Khatri
Open tibia fractures are devastating, life changing injuries, with infection associated with substantial morbidity to the patient. Reducing infection is a research priority, but before interventional studies can be designed, the incidence of infection following this injury needs to be better defined. Our aim was to estimate the global incidence of infection following an open tibia fracture. A systematic review was performed of MEDLINE, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science and Global Index Medicus. We included randomised controlled trials with more than ten participants which reported infections after open diaphyseal or distal fractures (AO 42 or 43). Primary outcome was deep infection according to the Centres for Disease Control and Prevention criteria. Secondary outcome included causative micro-organisms. A meta-analysis using a random effects model to assess incidence and between-treatment effects was performed. Thirteen studies including 1463 adults from seven middle-income countries, seven high-income countries and one low-income country were included. The incidence of infection was 12.12 person-years (95% CI 7.95-18.47). A subgroup analysis compared external fixation and intramedullary nailing showed no difference between infection rates. There were limited data on organisms, but Staphylococcus aureus was the most commonly identified. There are limited to no data on antimicrobial resistance.
开放性胫骨骨折是一种破坏性的、改变生命的损伤，感染会给患者带来很大的发病率。减少感染是研究的当务之急，但在设计干预性研究之前，需要更好地界定这种损伤后的感染发生率。我们的目的是估算开放性胫骨骨折后的全球感染发生率。我们对MEDLINE、EMBASE、对照试验中央注册中心（CENTRAL）、Web of Science和Global Index Medicus进行了系统性回顾。我们纳入了有十名以上参与者的随机对照试验，这些试验报告了开放性胫骨骺端或远端骨折（AO 42 或 43）后的感染情况。根据美国疾病控制和预防中心的标准，主要结果为深度感染。次要结果包括致病微生物。采用随机效应模型进行了一项荟萃分析，以评估发病率和治疗间效应。共纳入了 13 项研究，包括来自 7 个中等收入国家、7 个高收入国家和 1 个低收入国家的 1463 名成人。感染发生率为 12.12 人年（95% CI 7.95-18.47）。一项分组分析比较了外固定和髓内钉，结果显示两者的感染率没有差异。关于病原体的数据有限，但金黄色葡萄球菌是最常见的病原体。关于抗菌药耐药性的数据有限，甚至没有。
{"title":"A meta-analysis of the incidence of infections following open tibia fractures and the microorganisms that cause them in high-, middle- and low-income countries.","authors":"Djenna Chebli, Fatema Dhaif, Ali Ridha, Alexander Schade, Chetan Khatri","doi":"10.1177/00494755241232171","DOIUrl":"10.1177/00494755241232171","url":null,"abstract":"<p><p>Open tibia fractures are devastating, life changing injuries, with infection associated with substantial morbidity to the patient. Reducing infection is a research priority, but before interventional studies can be designed, the incidence of infection following this injury needs to be better defined. Our aim was to estimate the global incidence of infection following an open tibia fracture. A systematic review was performed of MEDLINE, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science and Global Index Medicus. We included randomised controlled trials with more than ten participants which reported infections after open diaphyseal or distal fractures (AO 42 or 43). Primary outcome was deep infection according to the Centres for Disease Control and Prevention criteria. Secondary outcome included causative micro-organisms. A meta-analysis using a random effects model to assess incidence and between-treatment effects was performed. Thirteen studies including 1463 adults from seven middle-income countries, seven high-income countries and one low-income country were included. The incidence of infection was 12.12 person-years (95% CI 7.95-18.47). A subgroup analysis compared external fixation and intramedullary nailing showed no difference between infection rates. There were limited data on organisms, but <i>Staphylococcus aureus</i> was the most commonly identified. There are limited to no data on antimicrobial resistance.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"272-281"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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