Surgical Medicine Open Access Journal最新文献

{"title":"I Feel Something in My Eye; A Retrospective Study on the Outcome of Patients with Corneal Foreign Bodies Presenting to Emergency Department","authors":"P. Pouryahya, A. Meyer, Z. Ling, A. Ooi","doi":"10.31031/SMOAJ.2020.03.000573","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000573","url":null,"abstract":"Introduction: Extraocular foreign bodies (EOFBs) are a common presentation to the emergency department (ED). Given that inadequate management can result in severe complications including visual impairment, ED clinicians may be overly cautious and often schedule patient reviews in the ED even where it is unnecessary, placing a burden on hospital resources. Objective: This study aims to identify potential risk factors in predicting re-presentation of patients with EOFBs following ED management. This will not only help in providing better patient outcomes but also reduce the burden on hospital resources. Method: A retrospective data analysis of patients who presented to three Monash Health EDs between June and December 2016 with EOFBs was performed. Characteristics of cases where patients presented with corneal EOFBs including the size and material of EOFB, visual acuity at initial presentation and outcome of follow-ups were reviewed and analysed. Result: 123 patients presented with corneal foreign bodies, of which 3 were referred directly to the ophthalmology clinic after initial ED assessment for removal and post-removal management by ophthalmologist. 77 patients were managed in the ED and discharged with no planned reviews, of which 2 represented with complications. 31 patients were scheduled for review in ED 24 to 72 hours post-discharge, and 10 patients were referred directly to the ophthalmology clinic for follow up post ED discharge. Conclusion: The study demonstrated that the rate of re-presentation for patients with corneal foreign bodies is higher if the EOFB is metallic, the size is smaller or visual acuity is abnormal on initial presentation.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"280 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116561801","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}

{"title":"A Rare Case of Mural Thrombus in Normal Descending Thoracic Aorta with Literature Review","authors":"J. Sagar","doi":"10.31031/SMOAJ.2020.03.000572","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000572","url":null,"abstract":"The Virchow’s triad, published by German physician Rudolf Virchow in 1856, described three broad categories of factors1. Hypercoagulability, 2. Haemodynamic changesstasis/ turbulence in blood flow, 3. Endothelial injury/dysfunction); contributing to thrombosis [1,2]. Definite risk factors such as hyper viscosity, coagulation factor mutation (Factor V, Factor II G2021A) or deficiency (antithrombin III, protein C or S), familial dysfibrinogenemia, chronic smoking, nephrotic syndrome, drug abuse, severe trauma/burns, cancer, late pregnancy, steroid/contraceptive use; lead to hypercoagulability and thrombus formation [2]. Delayed diagnosis of this can lead to end organ damage and acute limb ischaemia (ALI) secondary to embolization [3]; resulting in amputation in 13-14% patients while mortality rate stands at 9-12% [4]. Approximately 80-85% of all arterial thrombi and emboli originate due to disturbances in cardiac functions such as atrial fibrillation, valvular abnormalities, prosthetic heart valves, endocarditis, and myocardial infarction. Around 5% of thrombi arise in diseased aorta, related to either atherosclerosis, dissection or aneurysm. The aortic isthmus is more prone to trauma as compared to the rest of the aorta and hence, is the commonest site of thrombus formation [3,5,6]. Incidences of mural thrombus in a NADTA with no associated significant medical history have been rare.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122627458","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}

{"title":"High-risk Neuroblastoma Predisposing to Osteomyelitis: A CaseStudy","authors":"V. Reddy","doi":"10.31031/SMOAJ.2020.03.000570","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000570","url":null,"abstract":"Neuroblastomas are rare extracranial tumors of the pediatric population arising from cells of the embryological sympathetic nervous system. These malignancies most commonly occur in the abdomen, but other sites include the chest, neck, and pelvis with a predisposition for lymphatic and hematogenous spread. Metastasis to the bone is a poor prognostic indicator, requiring surgical excision and other extensive medical management. Staging, location, and histopathology of neuroblastomas are therefore important criteria that help stratify risk and direct treatment. We present a case report of a pediatric male with a history of metastatic neuroblastoma in remission for 3 years who was found to have a relapse of his malignancy in the bone. Further investigation yielded concomitant osteomyelitis at the recurrence site. This case illustrates the importance to evaluate for coexisting infectious processes in the setting of malignancy.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125925411","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}

{"title":"Pilonidal Sinus: Karydakis Technique is as yet an Undemanding Compelling Alternative in Current Practice","authors":"Elmutaz A. M. Kanani","doi":"10.31031/SMOAJ.2020.03.000569","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000569","url":null,"abstract":"Background: Pilonidal sinus disease is a soft tissue infection. It presents either acutely with abscess or the chronic form of sinus formation. The disease affects multiple body regions but the commonest is the sacrococcygeal region. There are different treatment strategies ranging from simple incision and drainage of an abscess to complex constructive procedures. Objectives: The aim of this study is to share our experience and spotlight that the Karydakis procedure is as yet a legitimate and relatively simple effective treatment alternative for the non-specialized surgeon. Materials and Methods: In this retrospective study the management of patients presenting with sacrococcygeal pilonidal sinus disease to Khoula hospital (Oman) over a period of 10 years is analyzed. Data, being retrieved from the electronic patient’s records, covered the presentation, management, complications, and follow up. Results: A total of 333 patients were included. The commonest presentation was of chronic sinus and the main procedure was the Karydakis operation (93.1%). Postoperative complications developed in 24.6% of all treated patients, and the recurrence rate was 4.5%. Conclusion: The Karydakis operation is a relatively simple procedure to achieve cure in a reasonable time frame with acceptable risks of postoperative complications and recurrence.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124611312","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}

{"title":"Heart Risk Assessment for Mining Workers in Papua New Guinea. Summary Paper for Heart Assessment and Stratification","authors":"Arnold Waine","doi":"10.31031/SMOAJ.2020.03.000568","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000568","url":null,"abstract":"Papua New Guinea has about seven active mining and exploration activities for minerals like gold, copper, and other minor minerals. Each is managed by different company and together employs about ten thousand workers. A fifth of this would be foreign workers. Most of the Mine workers that are screened at the Employees Health and Wellness clinics tend to have similar compounding health risks. As a result, the common diseases that are prevalent are Hypertension, Diabetic Mellitus, High Cholesterol, general Obesity (BMI>25m2/Kg) with minimal to zero level of physical exercise. Despite advice to religiously take the medications, there is noticeable lack of medication compliance, and a handful are usually under dosages.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"1517 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125948742","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}

{"title":"Intestinal Intussusception in an Adult Affected by Vanek Tumor: A Case Report","authors":"Morazán Ad","doi":"10.31031/SMOAJ.2020.03.000567","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000567","url":null,"abstract":"Inflammatory fibroid polyp (IFP) is a rare benign lesion, originating from the submucosa in the gastrointestinal tract. It generally appears as an isolated benign lesion, rarely located at the level of the ileum. Its origin is controversial. Clinical presentation varies depending on its location; invagination and obstruction are the most common indicative symptoms when the polyp is located at the level of the small intestine. We report the case of a 60-year old patient with abdominal pain, nausea and vomiting and a personal history of intermittent constipation. Radiological imaging objectified ileo-ileal invagination completely obstructing the ileum light. Segmental resection of the obstructed ileal segment and terminal-terminal anastomosis were performed. The final diagnosis of IFP was established using histological examination.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"289 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122534332","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}

{"title":"Candida Tropicalis Infection of the Knee Joint in an Immunocompromised Pediatric Patient: A Case Report","authors":"Benjamin D. Sookhoo","doi":"10.31031/SMOAJ.2020.03.000566","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000566","url":null,"abstract":"Background: Candida septic arthritis is a debilitating condition affecting joint function. Candida tropicalis , an organism found in normal human flora is noted to be the third most common pathogenic yeast in the elderly and immunosuppressed population. Infections are rare in the US, typically limited to the neonate and elderly populations. Most infections occur in the south America and southeast Asian regions. In the last 2 decades, Tropialis infection rates have risen impart due to antifungal resistance. We present a case of Candida tropicalis infection in the knee of a 13-year-old female with a past history of relapsed Acute Myeloid Leukemia following bone marrow transplant, pancytopenia and graft vs . host disease. Methods: Patient case is thoroughly discussed, and a review of the current literature performed. Result: Patient underwent multiple open irrigation and sharp debridement as well as arthroscopic complete synovectomy in addition to medical management. Patient remained pancytopenic throughout her course and eventually underwent granulocyte transfusion. During her course, she developed a relapse of her AML and subsequently expired. Limited case reports exist in the literature, with no recent reports of Candida arthritis in an adolescent in the United States. Discussion: Candida septic arthritis remains a rare but potentially devastating condition, particularly in the immunocompromised patient population. Candida arthritis","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124217802","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}

{"title":"New Discoveries in Medicine and Physiology Originated in Urology","authors":"A. Ghanem","doi":"10.31031/smoaj.2020.03.000564","DOIUrl":"https://doi.org/10.31031/smoaj.2020.03.000564","url":null,"abstract":"on the following For the discovery of VOS and relation to the path-etiology of the TURP syndrome, dilution Hyponatraemia (HN) and the Acute Respiratory Distress Syndrome (ARDS) as well as phenomenon of G tube as replacement for the wrong Starling’s law the following studies were done. Physics study on the hydrodynamic of the porous orifice tube comparing it to Poiseuille’s tube- based on which Starling’s law attributes capillary filtration to hydrostatic pressure. 2578-0379 Abstract Objective: To report new discoveries made by a single investigator working solo. Methods: The discoveries were reported. All the investigations were self-financed done over a career life. The discoveries originated in Urology but cover specialties that include Physics, Physiology, Medicine, Nephrology, Cardiovascular, respiratory medicine and Surgery. Result: The discoveries include 2 new vascular shocks, namely Volumetric Overload Shocks (VOS) that complicate fluid therapy in hospitals. Proving a physiological law of Starling wrong and providing the correct replacement which is the hydrodynamic of the porous orifice (G) tube. Revealing many errors and misconceptions on fluid therapy and reporting its corrections. It all started with an investigation aimed at understanding a rare obscure syndrome that kills patients in Urology; the Transurethral Resection of The Prostate (TURP) syndrome. The patho-etiology of the Loin Pain Haematuria Syndrome (LPHS) was discovered revealing its link with Symptomatic Nephroptosis (SN) and reporting a new curative surgery for its treatment- the Renal Sympathetic Denervation and Nephropexy Surgery (RSD&N). A new point of technique on the surgery for cancer bladder, namely capsule sparing cystoprostadenectomy that make the surgery easier and shorter while avoiding incontinence, impotence and urethral anastomosis was reported. Conclusion: The discoveries started in urology but extended to Physics, Physiology, Medicine, Nephrology, Cardiovascular, respiratory medicine and Surgery. It includes 2 new shocks of VOS, proving a physiological law of Starling wrong and providing the correct replacement: the hydrodynamic of the G tube. It resolves the puzzles of TURP syndrome, hyponatraemia, the acute respiratory distress syndrome and LPHS.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132051241","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}

{"title":"Symptomatic Nephroptosis (SN) Causes the Loin Pain and Haematuria Syndrome (LPHS)","authors":"A. Ghanem","doi":"10.31031/SMOAJ.2020.03.000562","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000562","url":null,"abstract":"The objective of this letter is to report recent advances on the diagnosis and therapy of the loin pain hematuria syndrome (LPHS). The patho-aetiological link of LPHS with symptomatic nephroptosis (SN) is a novel discovery of the 21st century that was first preliminary reported in 2002 [1]. The link was confirmed in 2016 in an article that précised the exact pathoaetiology of LPHS; ischemic nephritis and sympathetic neuropathy of SN. It also advanced a 100% curative therapy for LPHS namely; the renal sympathetic denervation and nephropexy (RSD&N) surgery [2]. Symptomatic nephroptosis has been known for centuries [3] but was disparaged [4] >70 years ago and omitted from all textbooks. Hence it is a forgotten disease. The loin pain hematuria syndrome was first reported in 1967 [5] and has remained without any effective therapy till now [6-8].","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"298 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116387241","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}

{"title":"Unusual Intra-Operative Variable Plateau Capnogram Waveform in a Patient with Critical Unilateral Pulmonary Artery Stenosis: Case Report","authors":"R. Saab, Surendrasingh Chhabada","doi":"10.31031/SMOAJ.2020.03.000563","DOIUrl":"https://doi.org/10.31031/SMOAJ.2020.03.000563","url":null,"abstract":"Introduction End tidal carbon dioxide (EtCO2) monitoring using capnography is a standard of care in anesthesia and essential for patient safety [1]. Intraoperative capnography provides information about CO2 production, pulmonary perfusion, alveolar ventilation and respiratory patterns. The different capnogram waveform shapes can reflect abnormalities that can be simple and common or can be a sign of imminent life-threatening complications [2,3]. Here we present a case of an unusual capnogram waveform that was detected during a diagnostic and therapeutic cardiac catheterization in a pediatric patient with history of Tetralogy of Fallot (TOF) repair with transannular patch and left pulmonary artery (LPA) patch.","PeriodicalId":283483,"journal":{"name":"Surgical Medicine Open Access Journal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133987672","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}